Hacking the Holidays – Dr. J Live Podcast #160

Dr. Justin Marchegiani discusses different options, substitutions and modifications that can be made during the holiday season. Learn about what ingredients to use in some of the traditional Thanksgiving dishes including the turkey, stuffing and gravy that can help to still improve your health. 

Gain insight on the different modifications and options that you can use for some of your desserts so you can still indulge without having to feel guilty afterwards. Also, learn about some other cool options including meal timing, fasting, exercise and alcohol intake for a healthier you during this holiday season.Healthy Holiday Recipes

In this episode, we cover:

01:49   Grain-free holiday meal

03:01   Enzyme Support

05:55   Desserts Options

10:36   Timing Recommendations and Alcohol

15:00   Exercise

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Dr. Justin Marchegiani:  Hey, everyone! It’s Dr. J here.  Evan, Happy Holidays, man! We got a short Thanksgiving Day week. I love turkey day, man. Some time with the family, really good eating. Are you excited too?

Evan Brand: I am and I’ve got blue skies here which is very unusual for this time of year. We’ve got sunny every single day this week. So I’m super grateful for that.

Dr. Justin Marchegiani: Love it. Yeah, it’s a great time of the year. It’s uh— important year, time of the year to be really grateful and to be extra uh— particular in all the things that we have to be thankful for. Coz there’s a lot of things but it’s easy to be so focused on everything it’s not there. So we got to really focus on all the things that are there. So couple that is just how about, just some really good Intel that we can use to hack our holidays. Meaning we can still indulge in feel good and connect with our family members but not go into a food coma and feel like absolute crap. What do you think about that?

Evan Brand: Agreed. Yeah. A lot of our clients recommend we do this subject because they feel deprived if they’re doing AIP or some type of dietary approach. They feel like that we’re the bad guys and we’re making their holidays not as fun. But that doesn’t have to be the case.

Dr. Justin Marchegiani: Absolutely. So, couple of things if you look at Thanksgiving, it can totally be Paleo, right? We have like basically the centerpiece in the Thanksgiving Day meal is the turkey, right? Awesome. Especially if we can go after the darker meat. That’s gonna be excellent. Good fats, right? Try to buy an organic or at least a Pasteur-fed turkey. It costs a little bit more but the nutrients are to be much higher, right? So you get good fats and proteins there. That’s the kind of a starting point. And then after that, you control your sides. So most people want mashed potatoes and maybe squash which you know, I’m okay doing a little bit more starch in the holidays. I’m okay with that.  It’s better than doing, let’s say a grain-based stuffing, that’s number one. Number two, we try to substitute for the things that we typically have grains. What’s gonna have grains? Well, typically, your gravy is gonna be thickened with flour so we do a gravy that’s gonna be a carrot and celery based and we thicken it with coconut flour if we do it. And we use the actual uhm— turkey stock from the actual turkeys. That’s a huge way to get to the stuffing, I mean the gravy going. And then the stuffing there’s typically some good stuffing recipes out there where we do a celery and carrot-based stuffing and it’s totally grain-free and it taste phenomenal. So, off the bat, you can have your starches. I’m okay with that. Number two, you have the gravy. Because the gravy kinda goes on everything. So if your gravy isn’t too good, you can really mess everything up coz you just basically coating everything with thickened uh—turkey giblets and flour. And then uhm—then after that, you have I mentioned your starches and then after that you can do cranberry sauce, really, you know, super Paleo. You can do like, I’ll do green beans and I’ll cut up some bacon, I’ll layer that on there, too. Uhm—those are kinda my big things off the bat and of course, a really good turkey. We’re gonna smoke our turkey this year. We typically use our smoker this time of the year. Any other thoughts, Evan, off the bat for your? Just with the Thanksgiving Day meal?

Evan Brand: Well, my thoughts are you got me hungry but besides that—<laughs>

Dr. Justin Marchegiani: <laughs>

Evan Brand: But besides that, the enzyme piece.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: You and want to talk about enzyme.

Dr. Justin Marchegiani: Yes.

Evan Brand: So let’s go into that. So one’s that you and I were talking about off-air was one from designs for health. It’s called allerGzyme. And this is more specific to people that if they’re just going to go off the rails, they are going to do or get it possibly get exposed maybe a cross-reactive issue with dairy or egg or soy or gluten or casein peanuts, things like that. You can take the specific enzymes. They’ve got like a patented version they call it what, Glutalytic in there.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: It is supposed to be pretty helpful. And they’ve got bromelain. Way but it’s a very, very super high dose bromelain which is a pineapple enzyme. It’s a really good enzyme. So there’s that. And then you and I both have our own custom digestive enzyme formulas that I say those are the best nutritional insurance policies that you can bring with you like a little glass jar or something.

Dr. Justin Marchegiani: Especially the fact that people forget that I uhm— having a meal like that is gonna be stressful not necessarily because it’s bad because obviously we’re gonna try to make the substitutes. We’re not gonna focus on eliminating. We’re gonna focus on substituting.  So we have the most healthiest options possible but because we’re probably gonna eat such a ton of food, it’s going to be a lot for our digestive system to handle. So we’re gonna really utilize more enzymes and more HCl and maybe even some bile salts to really optimize our ability to actually break it down.

Evan Brand: Yeah. I love it. I’ve got a small little old honey jar that my wife just keeps in her personnel and so if we go out to restaurant or if we got to family member, I’m just gonna pull out those enzymes and popp them down. So that’s can be my strategy and I think everybody who is dealing with bloating, gas, indigestion, a lot of these common symptoms heartburn, you’ve got that excessive heaviness feeling.

Dr. Justin Marchegiani: If you already got those symptoms and it’s not even Thanksgiving yet, then you’re a person who needs extra care when it comes to using enzymes.

Dr. Justin Marchegiani: Absolutely. So we talked about the meal. We talked about maybe the potatoes and/or the sweet potatoes or the squash. I’ll typically put some extra cinnamon on my squash, too, which is great for blood sugar. And the blood sugar and the insulin kina receptor sites that which is good. I talked about the green beans. I talked about how to maximize the gravy because the gravy is one of those things that’s gonna be layered on everything. So if you can fix the gravy component— and we’ll have in the show notes some Paleo uhm— gravy recipes so we’ll make sure we get some Paleo recipes in the notes.  Uh—we’ll make sure we get some stuffing recipes. Coz those are gonna be the the big— the big things—the gravy and the stuffing. Almost everything else, you can dial it in. The turkey’s pretty good. You can do really good cranberry sauce, you can do uhm— squash, you can do sweet potatoes, you can do regular potatoes or any other sides that we’re missing.

Evan Brand: Yeah. You hit the green beans.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Sometimes peas, sometimes carrots you.

Dr. Justin Marchegiani: Yup.

Evan Brand: I think honestly, if you’re eating real food and you just always think, “Am I eating real food?” you’re gonna be just fine.

Dr. Justin Marchegiani: Yeah. Then a couple of things—let’s go to desserts pretty fast. So we’re just kinda laying out the meal options or the meal substitutes, I should say, and then we’ll talk about little hacks that you can incorporate, too. So, off the, my Paleo Apple Crisp is something that I utilize a lot. I actually have it made once a week and it’s basically just a combination of the crust, which is gonna be coconut shreds, pecans and walnuts, kinda crushed up. And it’s gonna be kinda layered over some Granny Smith apples that are cut up. And the Granny Smith apples are basically mixed with butter. And they’re also gonna have a little bit of cinnamon on them and then we also have a little bit—

Evan Brand: I need this.

Dr. Justin Marchegiani: .. a little bit of organic palm cane sugar. And we like the organic palm cane coconut sugar because it’s got a glycemic index of 15. So it goes into your bloodstream a little bit slower and we try to use the least amount possible. So what I recommend is put the smallest amount whether it’s like uhm an eight of a cup or something in there. And just kinda glaze it and then mix it up. And then try a couple before you know, layer all the nuts and cook it. And then just see if it’s at the sweetness you want. So I don’t need a lot. I just put a very, very small amount. Once I have it, you know, typically, an eighth of the cup or sixteenth of a cup, a very—typically, I just glaze it. I don’t even h measure it. I just gently glaze it over so very small amount. And then once I have it to taste, then I pretty much put uhm—then it’s mixed with butter, of course, right? And then I put that topping right on top and there and then 350 for 30 to 45 minutes till the apples are nice and soft. And then you’re pretty much good to go.

Evan Brand: That sounds delicious. Did you invent that recipe or is that something you found?

Dr. Justin Marchegiani: No, I invented that one. That’s a good one. And then if you want mix it up, too, you want to make it more like a cake, you can do uhm—a tapioca and arrowroot flower and then typically you just add the arrowroot flour in with the apples, typically, half a cup to cup each. And then that kind of gives that more of a thickened flavor. And then you can just bake it not use the nuts. And then it comes more like a cake. And that’s a really good option. We have that Apple cake option on there, too. So, apple cake and/or uhm— the Paleo Apple Crisp. Apple crisp I think is a little bit more healthy coz you don’t’ have any flours in there. They’re all just a good healthy nuts and fats.

Evan Brand: Right. Yeah. I have a female client last week. She said she’s going to make a like a pumpkin pie but she’s going to do coconut flour and I think she said coconut flour and Coke and cashews maybe. So I know that there’s options out there. I just don’t eat too much dessert anyway, you know, besides a good piece of chocolate. But if you’re somebody who you’re going to go to one of these events and you think, “You know what I don’t want to miss out” Well then you just make it. You know, let  everybody else bring the meat and veggies. You just bring a healthy dessert. That way, you know that you’re gonna be safe and you’re not gonna cause yourself a flare-up or new problems.

Dr. Justin Marchegiani: Totally. For the most part, your turkey’s gonna be good, right? If you’re gonna do your mashed potatoes, fine. If you do cranberry sauce, if you’re gonna do squash, if you’re gonna do green beans or will do like uhm— Brussels sprouts with bacon, that’s typically gonna be good. You’re gonna mess it up with the excess uhm—gravy. So do the gravy right way and you do a healthy stuffing options. So I recommend is if you’re going somewhere, maybe you bring some gravy, or if you don’t bring the gravy, maybe you just uhm— bring the stuffing. And people won’t even know. We bring some of these healthy Paleo options we go places to get invited. People wouldn’t even know the difference a lot of times.

Evan Brand: Exactly.

Dr. Justin Marchegiani: The big thing is for me it’s about, it’s not about, “Oh, Dr. J, you’re being, you know, such uh—so tight about this. You know, why can’t you roll?” Well, the reason why  is I wanna feel freaking good afterwards.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. I wanna eat a lot and I want to feel good. And there are great options and I don’t notice a difference in flavor. I can make my option and it will taste just as good. So those are some good options. Anything else you want—Oh, also dessert. Just, you know, if you’re doing a pumpkin pie, you can just leave out the crust are there some really good gluten-free, crust options or you can do coconut uhm— crust option. That’s fine. And you can just do your pumpkin pie without you know, just the lower amount of sugar. That’s totally good right there. Uhm— is or anything else you want to mention for desserts outside of the Apple Crisp?

Evan Brand: I think you covered it. I mean you could bring along a piece of dark chocolate if you’re just super scared and you don’t want to go for any of the more processed things. Bring a cup— bring a bar of dark chocolate with there on the fridge when you get to your family’s house.

Dr. Justin Marchegiani: Yeah. And again, you could do Pecan Pie a little bit higher in sugar. You just have to make sure the crust is gluten-free. That’s totally fine, too. And obviously, just some really good maybe some coconut ice cream, coconut vanilla ice cream’s totally cool. And then what about supplement options? So we talked about, number one, the enzymes, HCL and digestive support. Number two, you could always add in some activated charcoal.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Activated charcoal. Number three, you could always throw in some probiotics later just to kinda help soothe and relax the tummy. Number four, well how about the approach like when do we eat the meals? So, number one, I recommend intermittent fasting and adding in some exercise in the morning. Even if it’s just a quick Tabata, or just a quick little weightlifting circuit where you kinda do upper-lower, upper-lower and just kind of a simple circuit for 15-20 minutes. Just something in the morning to really get the metabolism revved up. You may fast a little bit more. You may hold that fast a little bit longer than normal because you know that your gonna feast at the end of the day and all those calories will be coming in there to make up for that deficiency. Most aren’t gonna be working out on Thanksgiving. They’re gonna be relaxing and so it’s not as big of a deal.

Evan Brand: How about alcohol? You mentioned that off-air. You said we need to make sure we talk about that. So you’re recommending after meals instead of before meals saving?

Dr. Justin Marchegiani: Well, yeah, I recommend just have a little bit. Well, number one, there’s a couple of strategy. So I may do one glass just to kinda get that buzz in my system fast. It’s like, “Ooh, I could feel it.”  And then I’ll throw maybe a couple of things, a charcoal in, and then maybe there will be like a shrimp cocktail out and have a couple of little shrimps just to kinda get the protein, fat in there which kinda stabilizes my blood sugar level a little bit more so I’m not gonna go wonky. And then I typically just go with like a dry champagne or a dry Prosseco. So it’s very dry kind of a demi-sack, not a lot of sugar white and I like the sparkling. The sparkling has been shown to increase alcohol absorption. There was a—one study out of a bunch of college students. Can you imagine that? I would love to have been in the study in college where they gave them shots of vodka and then the other group got shots of vodka with carbonated water or like soda water. And they measured their blood-alcohol content and they found that the group that had the bubbles with their vodka had a much higher blood alcohol content for the same amount of alcohol. So, go figure. So what’s the moral of the story? You get— your alcohol goes for little bit longer of array when there’s little bit of carbonation or, bubbles in there. And James is saying, “What about Cheetos?” Yeah. So I would do Cheetos with my ginger Kombucha and a little bit of lime. The lime provides extra vitamin C, which is great for glutathione. The Kombucha has extra B vitamins and antioxidants and EGCG in there and uhm—probiotics. So it actually helps detoxify and help your gut microbes while you get a little tipsy.

Evan Brand: See that almost makes me wanna drink alcohol but every time I drink alcohol, I feel like I can’t comprehend simple things, like I like to I like to always have my brain going going going.

Dr. Justin Marchegiani: Totally.

Evan Brand:  And for me to shut off with the alcohol, it’s almost stressful. It’s almost like, “Nope, my brain is slowing down.” I don’t like this.

Dr. Justin Marchegiani: Well, we should make sure the demand on our brain is less.

Evan Brand: Right.

Dr. Justin Marchegiani: When the time—we’re not gonna be like opening up the champagne bottles when we’re seeing patients, right?

Evan Brand: Right.

Dr. Justin Marchegiani: We wanna make sure our patients get a 100% of our brain capacity. But when it’s the holidays and we’re just watching some football, and our brain is like 80% off, maybe it’s not that big of a deal.

Evan Brand: <laughs> For sure.

Dr. Justin Marchegiani: Yeah. But, yeah, we have the activated charcoal. We just have really good quality alcohol. Uhm— again, why does it matter? Coz I don’t want a headache. I don’t wanna feel crappy. I don’t want a ton of breakouts the next day. So we’ll choose uh—and typically, I’ll just get $15 bottle of really good dry Prosseco from Whole Foods. And I try to, you know, if I can go organic or you know, typically, the dryer ones are not gonna have as much sugar. It’s the sugar that’s gonna really throw you off. Uhm—you can also do the dry Creek wines. They have some decent stuff. Again, they don’t have a lot of bubbles like a lot of spike, Prosecco, I do that because number one, it helps with alcohol absorption. Number two, I just like the bubbles.  They don’t have a lot of options with that. So I will check out some of the whole foods or local stores, they have a very low sugar like as for a brewed or a Demi-Sec uhm—Prosecco option.

Evan Brand: The holidays are fun.

Dr. Justin Marchegiani: They are. Absolutely!

Evan Brand: I think our next month of episodes is probably be silly. It’s coz that’s the that the holiday vibe. It’s relaxing. It’s like, you know what, the summer time things have cooled off. It’s time to relax, time to rekindle, time to cuddle up, snuggle under your wool blanket next to a fireplace. This is a good time of the year.

Dr. Justin Marchegiani: I got a fireplace in my office so it’s actually nice coz I actually get to use it this time  of the year, so—

Evan Brand: That’s awesome.

Dr. Justin Marchegiani: So my dog just like—it’s basically a magnet for my dog. She just kinda—next to it all day. But, yeah, totally. And then uhm—you mentioned a couple things there. We talked about the alco—so yeah, really getting the exercise component going. Coz that really is gonna wring out a lot of the glycogen in your muscles. So think of glycogen as stored carbohydrate in your muscles and imagine you wringing that muscle out. You’re wringing that sponge out so all of that water in the sponge, all that glucose stored in the muscle now gets used up doing the exercise. Now what does that do? It’s like, well, it’s the equivalent of going and having a nice dry sponge to sop up a whole bunch of liquid drink that your kid knocked over, right? So you can just— that sponge is gonna work a lot better and be more absorbent. Think of your muscles as being more absorbent. So when you get extra carbohydrates into your uhm— body from your meal in your celebration that you’ll have a bigger sponge to soak it up.

Evan Brand: That’s a good idea. I don’t know if many people act on it but if they do, they’re gonna see a really good result. Here’s a question for Mike. He says, “It’s crazy. My Oura ring consistently shows my sleeping heart rate 5 to 15 bpm higher even after having just two drinks like red wine. I feel it the next morning. Any suggestions?” Justin, I know what you’re gonna say. Go ahead.

Dr. Justin Marchegiani: Well, alcohol can drop blood pressure. So it could be your blood pressure is lower than your heart has to be a little bit faster the compensate for that drop in blood pressure. That’s probably what it is.

Evan Brand: So you’re thinking maybe you don’t need suggestions. So I thought you might say, “Oh, just are you doing charcoal? Make sure you do charcoal.”

Dr. Justin Marchegiani: Of course, right? Like of course, extra charcoal. We can always throw some vitamin C in there, add in L cysteine. And we could even throw in, yeah like in our lines, we can throw in some detox aminos which is kind like your sulfur base, kinda NAC with a whole bunch of other sulfur amino acid in there. That— that’d be fine. I mean, I would do that. You can also throw a little bit of magnesium in there to uhm— to help with the with that component. But uhm—yeah, I would just look at potentially that just being the alcohol and just do all the things that help detoxify.

Evan Brand: Okay. Cool. Awesome. I think that’s everything we’ve hit. I don’t know if there’s any other piece to the holidays you wanted to go over.

Dr. Justin Marchegiani:  Yeah. I would try to time off like for me, I notice if I have felt any alcohol in my system when I go to sleep, I do not sleep nearly as good so I tried to give myself like a good three-hour washout period before bed. So I don’t have you know a lot of alcohol in my system. I just don’t sleep as good. I literally have more nightmares, I’m more active, I move around the bed a lot more. I had a glass of champagne before bed like a week or two ago and I like literally woke up at a right angle. So I was like laying across the whole head. I’m just way more active. Normally, I don’t move much at all. So again, if I I had that like at seven and I went to bed at like 10, it wouldn’t be a problem. But if I’m having it right up against bedtime, sometimes it could be the__ plus you know, I’m— I don’t know what the alcohol is when I go out if I order it. I try to order, you know, a nice low sugar kind but you have the bottle in front you look at it, so you just try to go off the waiter’s suggestions.

Evan Brand: Exactly. Yeah. I think it’s all good advice the liver-gallbladder support. I mean, that’s always helpful, too. So if it’s milk thistle or if it’s your Cordyceps mushroom. I mean there’s a lot of different products we use for for liver gallbladder support. One of the thing I was gonna mention, too, make sure that you check in with your practitioner if it’s Justin or myself. If you’re taking anti-parasitic herbs, some of these herbs can get intensified with alcohol. So one glass of wine may feel like four. You may not be able to make it home. See—take a  look and see what you’re actually using. I know some of these can create that sensitivity up.

Dr. Justin Marchegiani: Totally. Any other suggestions just like meal wise or anything that you guys are doing with your family for the holidays?

Evan Brand: I’m gonna bring some snacks just in case. I mean we don’t know the full spread coz we’re gonna go to like three or four different events.

Dr. Justin Marchegiani: That’s tough.

Evan Brand: ..this week and we don’t know exactly what people are cooking, what people are bringing. So just in case, I’m just gonna go ahead and bring uh—I’ve got a couple of some jerky like some jerky strips like some grass-fed steak strips that I’ve got and then I’ve also got a handful of macadamia’s of customer cons would also have coconut chips so I’m just gonna bring some snacks just have that in my wife’s purse just in case just in case we get somewhere and it’s just— I have been to a couple events where it was literally like a casserole, it was covered in cheese and that was the only—that was like the main entrée. There’s no way I could do this.

Dr. Justin Marchegiani: Totally.

Evan Brand:  Like you know, with enzymes, I’d be destroyed so uh—that’s— that’s about it. Just be prepared boy scout. Act like I was going to place that had no food.

Dr. Justin Marchegiani: Exactly. And again, there are some people out there where they may be really happy with her health right now. They’re just like, “Hey, this is a once a year thing and I’m just gonna cheat and really enjoy it. And that’s fine, too. But you know, still you can utilize some of the supplements and strategies we recommended so you at least doesn’t hit you as hard. And if you want to wreck if you want to apply some of the substitutes that Evan and I apply, and I’ve done it for years that in my opinion allow me to continue to feel good. I just— for me, it’s not just feeling good that day. I got four days off  work. I don’t take a lot of time off. I wanna feel good for those four days and I also don’t want to get sick either.

Evan Brand: Yup. Exactly.

Dr. Justin Marchegiani: Well, any other thoughts, Evan?

Evan Brand: I think that’s it.

Dr. Justin Marchegiani: So any other plans for you this week? Are you taking some time off from patients or—?

Evan Brand: Yeah. So Thursday, Thursday- Friday I’ll be taking some time off. My wife she’s can go out and participate in the consumer holiday on Friday. And I think that’s about it. I’m gonna try to spend some time out in the woods. I may— I may go out and and go for a deer hunt again. I want to get my own dear this year. 99% of it is just sitting out in nature listening to the birds but may be .01% of the time an animal walks by.

Dr. Justin Marchegiani: Totally.

Evan Brand: Really, it’s just my excuse to go do some forest bathing. I may try to do that.

Dr. Justin Marchegiani: What’s the Japanese term for that?

Evan Brand: Shinrin Yoku.

Dr. Justin Marchegiani: Shinrin Yoku. I love that, man. That is crazy. Cool. And we also add another herb to our parasite killing line, too. The mimosa Pudica. So I know will be adding that to our stores in the next week or two. It’s one of those things that we are kind of experimenting with. We’re helping to kill bugs and some of the wormies. So it’s something out there that if your patient and you want to inquire about that, we can chat about that very soon.

Evan Brand: Yeah. Stay tuned. I’ve gotten many, many pictures in my inbox of worms that people are pooping out from using this Mimosa Pudica. I was just a guest on the parasite summit, which is how I learned about this formula. And tons of people are taking it now and everybody’s saying, “Oh my God! My stool test showed up negative but I took this stuff anyway. And here’s what I pooped out. Surprise!” And it’s pretty nasty stuff. So Justin and I are talking off like, “Are you going to try some of the stuff?”  I’m guessing we’re gonna have to because we’ve been guinea pigs for everything else. So, who knows if we’ve got some hidden—

Dr. Justin Marchegiani: Absolutely. Well, what a great call today here, Evan. Happy holidays and Happy Thanksgiving for you and your family. And we’ll talk next week.

Evan Brand: Take care.

Dr. Justin Marchegiani: You, too.

Evan Brand: Likewise. Bye.

 


REFERENCES:

Justin Health Paleo Apple Crisp

https://justinhealth.com/products/detox-aminos/

http://catalog.designsforhealth.com/AllerGzyme-60_3

http://www.drycreekvineyard.com/

Natural solutions to combat stress – Podcast #122

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

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

In this episode, topics include:

1:46   Forest Bathing and its benefits

4:48   Cortisol levels and its effects on our body

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

21:13   How the amygdala and hippocampi reacts to stress

26:09   Different approaches on how to beat stress

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

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

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

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

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

Evan Brand: Exactly.

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

Evan Brand: Yes, absolutely.

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

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

Dr. Justin Marchegiani: Yeah.

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

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

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: Totally.

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

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

Evan Brand: Pre frontal cortex-

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

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Yup.

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

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

Dr. Justin Marchegiani: 100%.

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

Dr. Justin Marchegiani: Yes.

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

Dr. Justin Marchegiani: Yes.

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

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

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

Dr. Justin Marchegiani: Right.

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

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

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ha ha

Evan Brand: Thanks.

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

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m gonna tap this out.

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

Evan Brand: Sheesh.

Dr. Justin Marchegiani: Isn’t that amazing?

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

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

Evan Brand: Cool.

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

Evan Brand: Yeah.

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

Evan Brand: I’m sure.

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

Evan Brand: That is excellent.

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

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

Dr. Justin Marchegiani: Huge.

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani: Yup.

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

Dr. Justin Marchegiani: Yeah, absolutely.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: I agree.

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

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

Evan Brand: Yup.

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

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

Dr. Justin Marchegiani: Yes.

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

Evan Brand: So you have this –

Dr. Justin Marchegiani: Yes.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: Yup.

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

Dr. Justin Marchegiani: That’s it.

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

Dr. Justin Marchegiani: Yup.

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

Dr. Justin Marchegiani: Yes.

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

Dr. Justin Marchegiani: There you go.

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

Dr. Justin Marchegiani: Yup.

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

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

Evan Brand: We didn’t even-

Dr. Justin Marchegiani: Yes.

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Yup.

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

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

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

Dr. Justin Marchegiani: Huge.

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani: Totally.

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: We gotta live.

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

Evan Brand: It’s not good.

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

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

Dr. Justin Marchegiani: I feel fortunate.

Evan Brand: Yeah, haha.

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

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

Dr. Justin Marchegiani: Oh, man.

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

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

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

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

Evan Brand: Ooh, I’m proud of you.

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: Oh my God.

Evan Brand: And so-

Dr. Justin Marchegiani: Really?

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

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

Evan Brand: I had that-

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani Oh, yeah. Yeah.

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

Dr. Justin Marchegiani: Gigahertz.

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

Dr. Justin Marchegiani: Yup.

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

Dr. Justin Marchegiani: Right.

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

Dr. Justin Marchegiani: Yeah.

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

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

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

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

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

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

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

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

Evan Brand: Oh, yeah. Don’t say that.

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

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.

Reasons Why Diets Don’t Work – Yoyo Dieting

Reasons Why Diets Don't Work

By Dr. Justin Marchegiani

Watch this video and learn more about Yoyo dieting, its immediate and long-term effects on our body.


Yoyo dieting is essentially is going on a low-calorie, some kind of extreme diet usually it involves cutting out certain macronutrients. Whether you’d be cutting way down on proteins or fats and essentially restricting calories.

 

Why Yoyo Dieting Doesn’t Work

Why Yoyo Dieting Doesn't Work

The first thing that happens is that any time you restrict calories from the body, the first thing your body says is, “Whoa, what’s going on?” – it’s thinking genetics are hardwired for famine. Something is happening in the environment we got to be really careful, we got to conserve our energy. So the first thing when we send that scarcity signal to our genetics, the first thing our body thinks is famine. And it’s going to turn down our thyroid hormone. So our thyroid again, this is essentially the thermostat of our body. So we turn it down a little bit, it’s going to basically run a little less energy, run a little colder, maybe a little less brainpower. It’s trying to conserve energy. And then we start to hard wire the metabolism, instead of it to burn fat and fuel efficiently and easy, we start to tell our body, “Know what, store that energy in the fat cell for a rainy day. We’re okay for a little fatigue. You rather have that reservoir or fuel so that if we need it, we got it.”

CLICK HERE to learn more about  Yoyo dieting

So again, the first thing we really always want to do when we’re trying to trying to lose weight is never do Yoyo dieting. 

How to stop Yoyo Dieting

How to Stop Yoyo Dieting

So the call is we do not want to alter our thyroid hormone for the negative. We actually want to make a lasting change. So its taking into an anti-inflammatory diet, avoiding the most inflammatory foods, essentially grains, dairy and legumes. And eating every 3 to 5 hours. It really is a good way to stabilize blood sugar and send signals to your metabolism, “Hey, burn fat for fuel, have lots of energy, use it all up, feel good, perform well.” It gives us the signals to be vital and not to go into a scarcity mode.

 Need help to stop Yoyo Dieting? CLICK HERE


I hope this talk benefited you. For any questions, feel free and visit https://justinhealth.com and/or email the office.

 

Putting together the optimal functional medicine program – Podcast #116

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

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

In this episode, topics include:

01:26   Get help as early as possible

07:00   Body System One

10:19   Diet and lifestyle

17:16   Body System Two

38:22   Tests

itune

 

 

youtuve

 

 

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

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

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

Evan Brand:  Nice. Excellent.

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

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

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

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

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

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

Dr. Justin Marchegiani:  Absolutely.

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

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

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

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  A ton.

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

Dr. Justin Marchegiani:  Yup.

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

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

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

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

Evan Brand:  Right.

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

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

Dr. Justin Marchegiani:  Oh, yeah.

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

Dr. Justin Marchegiani:  Yeah.

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

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

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

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

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

Dr. Justin Marchegiani:  Oh, yes.

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

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

Evan Brand:  Environmental.

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

Evan Brand:  Yup.

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

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  I know.

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

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

Dr. Justin Marchegiani:  Wow.

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

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

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

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

Evan Brand:  Right.

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

Evan Brand:  Right.

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

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

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

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

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

Evan Brand:  Yup.

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

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

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

Evan Brand:  Yup.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Cool.

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

Dr. Justin Marchegiani:  Yup.

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup.

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

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

Dr. Justin Marchegiani:  Yup.

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

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

Evan Brand:  Yeah.

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

Evan Brand:  Yup, amen.

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

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

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

Evan Brand:  Yes, sir.

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

Evan Brand:  You, too. Take care.

Dr. Justin Marchegiani:  Have an awesome day!

Evan Brand:  You, too. Bye.

Dr. Justin Marchegiani:  Bye.

Rachel Adams – Lifestyle strategies to get your health back on track – Podcast #113

Dr. Justin Marchegiani’s guest for this podcast episode is Rachel Adams. Listen as she shares her life journey that will inspire people who are experiencing the same similar issues as she did to really fight and become who they are meant to be. 

Rachel AdamsDiscover how changing your diet, adjusting sleeping habits, paying close attention to nutrition, and taking time to exercise, even in subtle ways can surely impact your overall health and wellness. Learn practical tips and tricks that you can apply in your life right now to get you moving in the right direction health-wise.

In this episode, topics include:

01:05   Rachel’s story

09:03   The 90-day journey

14:35   Diet changes

28:25   Sleep habits

36:26   Supplements for pain and inflammation

itune

 

 

youtuve

 

 


Dr. Justin Marchegiani:  Hey there, it’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio. Today we have a really great interview with Rachel Adams. Rachel has a real interesting story. She is an executive, owns four different businesses, is really big in the real estate industry, and she had a health crisis about three years ago. And she’s taken a lot of the health principles that we talk about on the show, sleep, diet, nutrition, exercise, and she’s really turned her health around. I think it’s great for people that are in or were in Rachel’s situation to really have the hope to see someone that’s been where they are now and get out of it. So I’m happy to introduce Rachel to the show. Rachel, how you doin’?

Rachel Adams:  I’m awesome. Thank you so much for having me, happy whatever day today is to you.

Dr. Justin Marchegiani:  Happy Monday, right?

Rachel Adams:  Happy Monday!

Dr. Justin Marchegiani:  Cool. Well, why don’t you share with the listeners your story? I think you have a compelling story—people that are trying to make it, whether it’s they’re executives or entrepreneurs, or just a busy, you know, housewife that’s trying to make it by and has—is struggling with health symptoms. Why don’t you just talk about yourself and your story?

Rachel Adams:  Definitely. Well, you know, I—I really wanted—I’ve always kind of been a person who has struggled a little bit with like weight and body issues and, yeah, I’m 5 feet tall. So I’ve only going to—I’m never gonna grow vertically. I’ll only grow horizontally.

Dr. Justin Marchegiani: Right.

Rachel Adams:  And so for me, weight’s been something I really struggled with, but what happened is that I—I hit top without an agent for the country, for the Wall Street Journal for real estate in three years. And so from the outside looking in, my world looked perfect. Like if you wanna talk about like the Facebook life, right? Because everything you see on Facebook is real.

Dr. Justin Marchegiani:  Yeah, exactly.

Rachel Adams:  And so, you know, I had the perfect car, the perfect life, the perfect job, but what people didn’t know if that is that, you know, a lot of times in—in the struggle it takes to—to have such massive success in three years, you give up some stuff. And some of the things that I wasn’t necessarily admitting to people was that in the three years, I had gotten a divorce that I never dealt with.

Dr. Justin Marchegiani:  Uh-hmm.

Rachel Adams:  I had gained 32 pounds.

Dr. Justin Marchegiani:  Uh-hmm.

Rachel Adams:  And I was putting everybody else’s needs in front of my own, like family, friends, clients, you name it. And my corporate company, Keller Williams Realty–

Dr. Justin Marchegiani: Yup.

Rachel Adams:  They’ve heard there is this young girl, she’s doing big things, like let’s bring her down to Texas, to headquarters, and interview her on how she’s leading this amazing lifestyle and she’s so successful. Because at the time, I’m literally travelling all around the US, like coaching people on how to build a business and work on their mindset. So I go to Texas to shoot this commercial and I’m sitting down with Nina Rowan Heller, and she is an international health and wellness coach. She has coached Matthew McConaughey.

Dr. Justin Marchegiani:  Uh-hmm.

Rachel Adams:  Founders of Microsoft, like leaders at Keller Williams, and I go there and I, you know, get hair and make-up done, and I’m wearing like the most serious squarest things you could buy.

Dr. Justin Marchegiani:  Right.

Rachel Adams:  Kinda like suck it all in, and I go to interview with her and—and I’m used to people asking me questions about real estate, so I’ve got like my normal canned answers. But we’re going through the questions and Nina stops and kinda gives me a funny look and she’s like, “And how does that make you feel?” And I’m like, “Feel?” I mean, you know, bumps and bruises but you do it, too.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And then we keep talking and she stops again, and she’s like, “And how did that make you feel?” I’m like, “Ah, you know, I mean it was tough, but that’s what happens.” And so we keep talking and she kinda like gets this funny smirk on her face and she’s—she looks at the camera crew and she is like, “Hey guys, can I get you to step outside for a second?” And they step outside and I’m like, “What is going on?” You know? And she takes my hand then she says something to me that I’ll never forget. She said, “Rachel, have you ever heard that your video isn’t matching your audio?” Like what you said or doing–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  It’s clear you’re not doing.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  I’m like, “Well, I’ve heard it but not in relation to me.” And she’s like, “Sweetie, what’s really going on?” And I’ll tell you, Justin. It was like in this workout bench, in Texas, in this fancy outfit, I just like burst into tears.

Dr. Justin Marchegiani: Right.

Rachel Adams:  And I just said, “You know what, Nina? I got a divorce and I’ve never dealt with it, and I thought that if I shoved it down far enough, it’d go away.”

Dr. Justin Marchegiani: Right. Uh-hmm.

Rachel Adams:  But unfortunately, it’s showing up in different ways. You know, it’s showing up in unhealthy, like you know, unhealthy food habits. It’s showing up in like, I’m like, “Nina, I literally have a headache, but I also didn’t sleep well last night. So I’m taking an Advil with a cup of coffee.”

Dr. Justin Marchegiani: Oh, man.

Rachel Adams:  You know, my–

Dr. Justin Marchegiani: Your poor gut.

Rachel Adams:  I know. I know. I know. And I’m just like, you know what, I was—I was just—I was happy on the outside because I choose to be happy.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  But when I went home at night like I wasn’t happy, and we end up having—instead of doing this interview, we have this amazing 2-hour conversation about what my life could look like if I was truly leading it with authenticity–

Dr. Justin Marchegiani: Right.

Rachel Adams:  And intention. And instead of feeling like my divorce was something that I needed to be ashamed of–

Dr. Justin Marchegiani: Right.

Rachel Adams:  Know that it’s just part of my journey, and she actually sent me home. I never got to shoot the commercial. I cried for like two days, but I had this moment.

Dr. Justin Marchegiani: Right.

Rachel Adams:  And I had this moment two days later, sitting on my—floor of my living room, and I remember looking up to—to the sky or the roof, to God, whatever you want to call it, and I just said, “I know I’m meant for more.” Like, I can’t have gone through all that I’ve gone through, and have this amazing platform of people that I get to connect with to not be meant for more. So I took a step back and I realize that I had some people in my life, and potentially some things in my life that were actually serving me.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And so I went on this 90-day journey of self-discovery, and pretty much everything changed.

Dr. Justin Marchegiani: Wow!

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: So you kind of hit rock bottom with this interview, right?

Rachel Adams:  Yup.

Dr. Justin Marchegiani: The lady, it seemed like was asking a lot of questions that were just drawing a lot of introspection, kind of looking at your health, looking at your life. Does that sound right?

Rachel Adams:  A hundred percent.

Dr. Justin Marchegiani: And what was the first change you made? Okay, so now you’re at rock bottom. What’s the first–

Rachel Adams:  Yup.

Dr. Justin Marchegiani: Change you made with your health or your mindset that kind of got this journey going for you?

Rachel Adams:  So I—I look at my life and I said, “Okay, I know that I am not leading my life at the level that I want to, so if I could pick two things to remove from a life, like two distractions if you will–“

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

Rachel Adams:  What are those distractions? Like what—what they—what could they be? And if I remove them what could my life look like? And at the time—a little embarrassing to say—I was actually on three online dating sites–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And that’s a distracting thing to have. You know, the little pings always coming at you.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And then drinking. So I checked out dating–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And all alcohol for 90 days, just to kind of see what would change for me.

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

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: And what was the result of that?

Rachel Adams:  And you know, the thing—well, the thing about it like with taking out alcohol for me was a really big deal because it wasn’t like I was drinking every night of the week but I would have you know, happy hours with girlfriends or a cocktail with clients, and you can have the greatest intentions about food for the day, but once you have a couple cocktails in you, you’re like, “Yeah, let’s—with the French fries, sure we can have cheesecake.” You know?

Dr. Justin Marchegiani: Yeah, of course.

Rachel Adams:  So when I checked out alcohol, like I found that I was coming home earlier–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And instead of having a glass of wine at night, I had a cup of tea. And I was having all this time to sit at my house and I was like, “What do I want with my life?” So I started journaling and then I started reading about meditation, and then when you’re not like hungover every morning or any morning rather, you go, “Okay, well, maybe I’ve—I’m gonna go to bed a little earlier.” So if I wake up earlier, what if I start to exercise? So I started doing a morning routine–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  With just like getting out of bed and I made these little rules for myself, and one of my rules was—I feel like so many times people—the very first thing in their body it’s—they put in their body in the morning is coffee.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  When I was—I was one of those people.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  So before I went to bed every night, I put a glass of water by my bed, and my rule was that before my 2 feet hit the floor, I would drink that glass of water because your body naturally dehydrates as you sleep. And so I drink water and then when I got out of bed, I just set this simple exercise routine up where I would drop to the ground then I would do like 22 push-ups, and the simple ab routine, and some squats. And just like something to get my blood moving, and then I would take my journal and I would write three things I was grateful for every morning, and in the beginning it’s like kinda surface-y stuff–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  Like I’m grateful for, you know, the air. And then you start to get really deep, and you’re like, “I’m grateful for my struggles.” I’m—I mean I ended up being grateful for my divorce like who knew? You know?

Dr. Justin Marchegiani: Right. Right.

Rachel Adams:  But–

Dr. Justin Marchegiani: And then what was the best thing for you emotionally? Because as a functional medicine doctor, we—

Rachel Adams:  Yeah.

Dr. Justin Marchegiani:  You know, we deal with a lot of the metabolic things, right? Diet–

Rachel Adams:  Yes.

Dr. Justin Marchegiani:  Lifestyle.

Rachel Adams:  Yes.

Dr. Justin Marchegiani:  You know, we do fancy lab tests and create protocols. But a lot of what creates dysfunction or dis-ease, right? In someone’s body is a lot of the emotional things that are on process.

Rachel Adams:  Uh-hmm.

Dr. Justin Marchegiani: And you mentioned the—the divorce and those kind of things. How did you process that? What were the steps that you went through afterwards to help eradicate that?

Rachel Adams:  Well, you know, I didn’t even necessarily know that they were like—they—they didn’t turn into steps for me. I was just—what starts to happen is when you decide you’re gonna commit to, you know, eating clean or—or you’re gonna do an exercise routine, like when you start to feel good—like what happens is you’ll make one good decision, like “Okay, I’m gonna take out drinking for 90 days.” And after you do one good decision then you make another good decision, and you’re like, “Well, maybe I should start to look at what I’m feeling my body with,” because you know, I—I didn’t fit like I—when I was going through the divorce, I was like, “I’m really sad. I should eat comfort food.” I was like, “I’m happy. It’s a great day! I’m goota eat a celebratory meal.” And what I realized for the—like the healing part with divorce is I found some really good books. I found a book called From Me To We—I’m sorry—From We To Me. And I thought that was a really good book. I actually—I started going to a group called Divorce Care and it was through my church. And it was a Divorce Recovery Group and I mean, I was raised Jewish and I was like, “I can’t walk into a Christian church.” I bet they’ll have this worse. But the cool thing was that it was—they were just really nice and accepting, and you know, I realized like I’m not the first person to get divorced, and it was so crazy because I did this 90-day journey, and I’m you know, focusing on like my purpose, like what I really want to do in this world and planning my day better, like respecting my boundaries, and I’m—I’m just, I’m making all of these good decisions, and I remember this like moment where it was like towards the end of the 90 days and I was actually driving up to go visit my parents and they live up in the country, and it’s like a 2½-hour drive and I stopped at a fruit stand. Like I pulled over to stop at a fruit stand to bring fresh fruit home. I remember picking up a peach and—and smelling this peach, and I, for some reason, I just felt so light like I felt so happy. And it was like what the heck is going on, like why do I feel so good? And I realized in that moment that I had forgiven myself for the divorce. And it was like the most powerful thing because I wasn’t—I wa—I didn’t know how much guilt I had around it, but I did. You know? And it wasn’t—it wasn’t that I didn’t try. I tried everything I could have, it was just I saw it as—as failure instead of it just being part of my journey.

Dr. Justin Marchegiani: Got it. So if someone’s dealing with emotional stress in your relationship, if you can kinda boil down the biggest, maybe 1 to 3 things, that someone can do to help either, you know, save it and/or recover from it, you know. What would those things the?

Rachel Adams:  You know, one thing I would encourage people to do is to find out really what a good—what a healthy relationship means to them?

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  So not—not in relation to anyone else, but take—take a piece of paper, or you do—take a computer and—and write out all the words that matter to you in a relationship.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  Like communication, intimacy, a sense of community, like whatever matters to you.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And next to each word, write a paragraph about what that word means you.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And I think that it will help you really—it—it’s creating clarity around what you want for yourself but it’s also setting a standard for what you will and you won’t allow in your life. And you know, if you’re in a relationship right now and it—it’s not the one that necessarily fulfils you, then look at this list you’re making and see if this person, if it’s conversations you can have with this person, and say, “Listen, I really have been taking some time to—to really reflect and—and this is what matters.” And see if this person aligns with you because I will tell you that the right people are going to come into your life and the right people are also going to leave your life.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  In something else I would say is, you know, if you’re—if you’re not in a relationship yet, and you wanna get in a relationship, a lot of times people will start a new hobby or they’re like, “I’m gonna lose weight, so I’ll meet the right person.” And they do all these things because they think that that’s gonna be the reason a guy—or you know, someone’s gonna be attracted to them. But the reality is is that when you’re actually, you know, living in your powerful space, when you’re being who you are supposed to be, the person is going to appear. Like I was in—I basically took a three-year break. I mean I dated a lot but from being divorced ‘til being in my next serious relationship, it was three years and the funny thing is it was three months to the day after I met Ryan–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And he is—he literally is my list. He is everything I’ve ever wanted in a per—like he’s just my best friend and then it’s a bonus that were silly in love and like 38 days ago, not that I’m counting, we got engaged.

Dr. Justin Marchegiani: Oh, wow! Congratulations!

Rachel Adams:  And—yeah, thank you. But it’s like it is so cool to get to go through such an amazing transformative process and then meet the person that you’re like, “Oh, my gosh, like it really could be this good?” Like how fun can life be now?

Dr. Justin Marchegiani: Yeah, that’s great.

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: So that’s awesome. So you got your relationship dialed in. You related some soul-searching, figuring out what you wanted so you can kinda–

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: Create that that magnetic energy to attract it in.

Rachel Adams:  Absolutely.

Dr. Justin Marchegiani: That’s great. So then what are the next things because we have lots of people listening to this podcast that are—they’re either healthy and they’re—they’re really rocking it in all areas in their life and they are trying to get in the edge, or you have people that are kind of at a baseline of not so happy with their health and they’re trying to make those changes kind of moving forward. So we talked about the morning routine. I’m a big fan of you know, good clean filtered water.

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: Throw some extra sea salts in there. Get some minerals going in your body.

Rachel Adams:  Love it.

Dr. Justin Marchegiani: Do a little bit of movement. I think that’s great. What’s that next change for you on the diet side? What was that big one feel?

Rachel Adams:  Oh, my gosh. So I am that person who have—I really honestly, I went diet to diet to diet and diet in a bad way because there is such a negative rep on the word diet but in reality diet is just what you eat.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  It’s not what you’re on.

Dr. Justin Marchegiani: Right.

Rachel Adams:  And I mean, I’m not kidding you. I was high carb, low carb, no carb, yo carb, like I—I did any diet that I could think of because I wanted the quick fix. I wanted to find what works for me.

Dr. Justin Marchegiani: Right.

Rachel Adams:  And what happened was when I took out drinking, I also set some other rules out for myself, and I decided that I was gonna take out white flour–

Dr. Justin Marchegiani: Yup.

Rachel Adams: White sugar and anything processed.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  No, just simple stuff. Right?

Dr. Justin Marchegiani: Simple stuff, right, just kind of foundational stuff, right?

Rachel Adams:  Nothing too crazy, right.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And so what happens when you take out these, I call them distractions and noise—sugar to me is a noise and—and alcohol is a noise. It’s something—it almost numbs your body so you can’t—your taste buds aren’t even alive. They’re like kind of numb. They don’t know what’s going on and so what happened is I took this out and all of a sudden, food started tasting different to me. And so when I would need something, instead of—instead of just eating because I ate, because it was just what I did. I started to eat something and go, “Okay, how does my body feel when I eat this?”

Dr. Justin Marchegiani: Right.

Rachel Adams:  How does my body feel? Do I get energy? Do I feel a little tired? Do I have a—you know, a slump a couple hours later? And what I realized is that my body feels good when I eat a lot of vegetables, when I eat lean proteins, and the other thing that I—that I told myself is like no more restricting because I would go on a diet, the bad kind of diet, and I would say, “Okay,  I can’t eat this. I can eat this. I can eat this.” So I don’t eat and I restrict myself for a long time, and then I get towards the end and I’m like, “I did so great, now I’m gonna eat seven donuts.” Like it is such a weird cycle.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And so what happened is I go, “Okay, how does my body feel?” And you know, I—I really—I honestly, I took a piece of paper and I drew a circle, and the circle to me it could represent a plate for some, for me it represented my daily intake of what I was eating, and down the middle of the plate in a straight line, so slitting the plate or the circle in half, I put a line. And on the left side for me that—half of what I eat in a full day is vegetables, literally vegetables.

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

Rachel Adams:  And then I took the other half and I—I cut that in half. So I now have, and so with those two halves on the right side, one of them I put protein.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And for me that’s beans, that’s, you know, chicken, fish, tofu, whatever. That’s my lean protein. And then the all—the other one, I—I literally put it in the tiny little slivers, and I had dark chocolate. I had red wine. I—I put cheese on there like all—but it was—it was all the other things that I love in life that I realized like I don’t need huge portions of these. And I implemented another rule that was really big for me. And it’s kind of an opposite of what I think a lot of people think when they eat, but I do breakfast like a queen, lunch like a princess, and then dinner like a pauper.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams: So I’m eating bigger meals earlier in the day.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  Still all good fuel. And it—and then when I go to bed at night, it gives my body time to kind of rest and recuperate, and it’s not working on this huge meal. Could I even eat a really big meal at night? Then it would affect my sleep, you know?

Dr. Justin Marchegiani: So you feel better having a bigger meal at breakfast and kind of your—your number two at—at lunch from a mealtime perspective.

Rachel Adams:  I do.

Dr. Justin Marchegiani:  How long would you go between meals?

Rachel Adams:  I do and I eat two snacks, too.

Dr. Justin Marchegiani:  Okay.

Rachel Adams:  Like two or three hours. I do little snacks.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  I’ll do like a Trader Joe, like I’m big because I—I own four companies so I’m always jamming, like I’m on the road a lot or–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  I’m at meetings and I have to prep in order to be successful because if I don’t—I prep meals on Sunday and Wednesday.

Dr. Justin Marchegiani:  Ahh, huh!

Rachel Adams:  And, yeah, so like I always have raw vegetables with me, like I have almonds, like different things. I do—a Trader Joe makes a turkey jerky with low sugar.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And so I do—I have to have fuel with me in order to keep me going and so I just—I just made little rules that every two or three hours I would eat, and I wouldn’t eat if I wasn’t hungry but your body will speak to you. If you take out the distractions, your body is speaking to you. And it’s so just up to you to choose to listen.

Dr. Justin Marchegiani: Absolutely. So looking at kind of the meal timing thing, it sounds like you really were doing a good job stabilizing your blood sugar, eating really good, you know, proteins, healthy fats, and you were trying to consume more of your carbohydrates from kind of like non-starchy veggies. Does that sound about right?

Rachel Adams: Yes, definitely. And—but the cool thing is I will tell you, I was like terrified. My whole life was like bread or potatoes. Like I can’t eat them, bad news, can’t do it. But reality is, you can. Just choose a really good whole-grain that doesn’t have a bunch of processed junk in it. And if you’re gonna have a potato, eat a sweet potato, you know? And—and telling myself that I can have stuff and taking out the you can’t have that, it was the most freeing feeling and go figure. I’m not kidding you. I—from the start of my journey to the end, I lost—I started at 162 and when I ended the journey, I was like at 130. And I have a before and after picture on social media, but like my morning routine and my little abs, and these little things that was doing these little small implemental changes, they added up. And I ended the journey feeling so strong and so healthy, and it was—and everybody is like, “What are you doing? Oh, my God. What’s your new diet?” And I’m like, “Oh, my God! We need to talk.”

Dr. Justin Marchegiani: That’s funny. That’s great. That’s a nice little tip there. So give me a quick rundown. I’ll put you on the spot here. What’s–

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: A day in the life like? Well, let’s go. Today what did you have for breakfast?

Rachel Adams:  So this morning I woke up, before again, before my 2 feet hit the floor I have a glass of water, and then dropped to the ground, did my quick little exercise, I—my journal is by my bed. So I write three things that I’m grateful for. I just came off this two-day conference where I spoke a bunch about actually health and my journey, so I was just grateful for the connections I made there. So this morning for breakfast, I had a cup of egg whites.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams: I had half a banana with about a teaspoon of peanut butter and then I had, well, let’s see. I had quite—so I sautéed vegetables.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  So this was sautéed from last night.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  So I’ll do half the plate sautéed vegetables and all different kinds. Like I—I don’t really—I’m—I really like vegetables so I don’t limit a ton except for maybe onions in the morning to spare everybody health. And then I’ll do a little bit—I added a little bit of smoked salmon and then I do have a cup of coffee.

Dr. Justin Marchegiani: Okay, so you got some good omega 3’s, some good proteins, some good fats.

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: Awesome. What’s typical lunch look like?

Rachel Adams:  Lunch for me is usually either a salad with some kind of a lean protein or like sautéed veggies or some kind of a lean protein. Sometimes I throw in a little quinoa on there. Sometimes I’ll have a little sweet potato and sometimes I don’t.

Dr. Justin Marchegiani: So you’re really sure to keep the inflammation down.

Rachel Adams:  Absolutely, yes. And I—

Dr. Justin Marchegiani: And, uh-hmm.

Rachel Adams:  I believe in that.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  Like, see I do a ton of stuff with like—I know you talk about it on your show—but like spices. Like natural–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  Curries.

Dr. Justin Marchegiani:  Yeah.

Rachel Adams:  And you know, like I get a lot of my flavor now from spices instead of from like sodium and different salts and stuff like that.

Dr. Justin Marchegiani:  Yeah.

Rachel Adams:  Like I think it’s different to put salt in your water versus salt all your food.

Dr. Justin Marchegiani: Yeah, and I think also sea salt is totally different than your typical table salt–

Rachel Adams:  The only time.

Dr. Justin Marchegiani: That’s just Sodium Chloride.

Rachel Adams:  I keep one in my purse.

Dr. Justin Marchegiani: Oh, that’s great. Yeah, if you can–

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: When I was in California at the Whole Foods, they had the—the real salt packs.

Rachel Adams:  Yup.

Dr. Justin Marchegiani: Those were awesome because you get like 60-70 minerals versus just the refined sodium chloride.

Rachel Adams: That’s literally what’s in my purse right now.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  I take them from Whole Foods.

Dr. Justin Marchegiani: Yeah, that’s great. Yeah, it’s a really good electrolyte support. Awesome! So what other little tips and tricks that you did on—on the diet and lifestyle side that you would say are like in that top 5 that listeners that are making that transition now, what can they do outside of what you already mentioned?

Rachel Adams:  You know, I—so I kind of implement the 85-15, or–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  All I know everybody have their different process–

Dr. Justin Marchegiani: 80-20, 90-10, yeah, I get it.

Rachel Adams:  Yeah, so for me it’s 85-15. So 85 for the—the 85% of the time I eat clean, and then 15% of the time I’ll eat whatever I want. But it—but what—what you find is like so say you love desert. You have a super sweet tooth. You know, like I—I love getting desert at dinner.

Dr. teen Justin Marchegiani: Yeah.

Rachel Adams:  So perfect. Get desert but share it with a friend and have a couple bites because the first bite tastes amazing. You’re like, “Oh, my gosh! This is so good.” And the second bites tastes pretty freaking good. But then the third or the fourth bite, it doesn’t even—it stops tasting as good, and then you’re kinda eating to eat empty calories.

Dr. Justin Marchegiani: Yeah, totally.

Rachel Adams:  So I—I would encourage you to just really try—like listen to your body, really listen. And then my fiancé, he eats—like he is 6’3” and I’m 5 feet tall. And he can literally eat whatever he wants, but the coolest thing about talking to him about food and his relationship with food–

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

Rachel Adams:  Because he has no emotional relationship with food at all, is he eats really slowly and he chews all his food. He like—I swear he chews like 50 bites, every time, it’s 50 times. But the cool thing is like, so I wanted to pace myself with him because I was like, “Gosh, I wonder, that’s so crazy. He eats so slow.” But I love it because it—it gives you—like you can respect your food. You can respect your meal time, and so many people rush through their food, scarf it as fast as they can to keep moving throughout the day. And what you realize and for me because I was such a driver in my business world, I ate like a driver. I slept like a driver. I mean, and what I mean by that is I was like, “Go, go, go. Sleep—like it’s little sleep. Wake up. Get moving. Go! Quick breakfast.” And there is such a beautiful power in slowing down. So my rule when I eat is they just, it’s simple but I set my fork down in between bites, instead of having my fork always in my hand, I set my fork down in between bites. And that slows me down and really, really was helpful. And then I’d say the last piece to nutrition that’s really helpful for me is if you’re starting at clean eating and you don’t really know what it is, think about when you go to the grocery store, just hanging out on the outside perimeter, like where the vegetables are and the fresh, you know, fresh fruits and the—the lean proteins, because when you get into the center aisle, that’s where all your processed saturated fat, crackers, like that’s where all this stuff is that’s gonna be doing harm to your body and you know, like I said when you start making one good decision, your body is gonna crave it. Like you’re gonna be like, “Are you serious?” Like sometimes I wake up in the morning and I’m craving vegetables. Craving it.

Dr. Justin Marchegiani:  Right.

Rachel Adams: And it’s a beautiful thing like I just went on this all-inclusive vacation, and I was joking around yesterday, but 85-15 rule was pretty much reversed. Like at 85% of the time I ate whatever I wanted and 15% of the time I was like, “I should probably have a salad.” But the cool thing is when you treat your body really, really well, when you come home you don’t have to go on this crazy diet to restrict to get you back to where you were, you just go back on how you like to eat, what feels good for your body, and all of a sudden you’re like, “Oh, that was just some extra like saltwater, water weight.” And then you’re near back to where you were and it’s—it’s really empowering.

Dr. Justin Marchegiani: Oh, absolutely. I think that makes a ton of sense. I mean, these are just real practical things that everyone could be doing. I think the timing of food is really important also–

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: That adage of like, you know, one chew per tooth, right? You have about 32 teeth on average, right? So that’s about 30 chews or so. That gets your food up to that liquid kind of consistency. There’s that old Buddhist proverb saying, “Drink your food and eat your water,” or chewing your food up to a consistency so it’s almost liquid so when you swallow it, it’s a lot of surface area for your enzymes and your hydrochloric acid to work and break it down. And then also when you drink your water, letting it imprint on your saliva so your body can—can process it better. So I think those are some really good things, and also just giving your appetite that appestat, that center of your brain that controls your appetite, time to let the nutrients kinda get into the body so it can sense it and allow you to feel full faster, where if you just scarf that food down its really east to overeat when your appestatic mechanisms that control satiety aren’t working optimally.

Rachel Adams:  Yeah, absolutely. Do you—what is your feeling on drinking like a glass of water before you eat? I’ve heard a lot of people talk about that.

Dr. Justin Marchegiani: Yeah, I think with hydration with water, hydrating about 10 minutes before is ideal. I mean if you’re gonna drink like an ounce or two, just to help food kind of process down or maybe you’re sipping a little bit of wine or something with your meal, fine. But hydration ideally about 10 minutes or so before meal because their stomach’s really acidic. It needs to be acidic. It’s about a pH of about 2. So hydrochloric acid and can activate a lot of the protein-digesting enzymes and water’s got a pH of 7. So if you’re raising up that pH, that’s gonna lessen your hydrochloric acid levels and lessen your enzymes and create more bloating and burping and belching. So I find 10 minutes or so before meal and/or about an hour or two after a meal is ideal for hydration.

Rachel Adams:  Awesome! Okay.

Dr. Justin Marchegiani: Yeah, and I find a lot of people, too—this is a big thing—is the mechanism for like craving food and craving water can be easily mistaken in some individuals. So–

Rachel Adams:  Yes.

Dr. Justin Marchegiani: Like before you eat, having like a big glass or two of water, you’d be surprised what happens to your appetite when that meal comes. It’s like you eat less even though you’re not trying to because you’re just giving your brain a chance to catch up with what it really needs.

Rachel Adams:  Absolutely.

Dr. Justin Marchegiani: Yeah. So okay we got the alcohol stuff down. We got meal timing. You’re—you’re really doing I think a lot of mindfulness with the chewing and giving your body time to—to process that food. I think that makes a ton of sense. What else? What else is on that big 5 list that you use to help improve your health?

Rachel Adams:  Well, you know, one, a big thing for me was sleep.

Dr. Justin Marchegiani: Yeah, huge.

Rachel Adams:  I—I fought sleep almost my whole life because I always was—even when I was in college, I was like 20 units and 2 jobs. Like I’m just—it’s just how I operate. And I, from 2007 to 2013, I literally took Ambien, the sleep—over-the-counter sleeping pill–

Dr. Justin Marchegiani:  Oh, wow.

Rachel Adams:  Four nights a week. Yeah, 4 nights, and it only was not 7, because I don’t wanna feel like I was addicted.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And when I decided to really take a look at how I—how I slept, I realized that I was doing a disservice to myself and like I said, when I—I found myself home earlier, I was like I wonder if I, you know, I fought sleep always, so I’m—I hadn’t taken a sleeping pill in quite a long time and I’m drinking tea and I almost started to create this like—so you know we talked about a powerful morning routine–

Dr. Justin Marchegiani: Yeah, yeah.

Rachel Adams:  So I decided to create a powerful nighttime routine and it’s been such a huge shift for me, so what happened for me is like when I walk into my bedroom, I look at it and I say, “Okay, I—like so think about going into a spa, that when you go into a spa like you just feel good.” You feel relaxed, right?

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

Rachel Adams:  You feel like you want to unwind. So I—I looked at my bedroom and I said, “Why—why doesn’t my bedroom represent that?” Like if your bedroom is your—so I literally consider my bedroom now my sacred space.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And I changed the paint colors to—to be more like calming colors because I—I had liked red. And that’s not so the most calming color.

Dr. Justin Marchegiani:  Yup.

Rachel Adams:  So I do a lot of like cream—now is like creams and ivories, and I have a little bit of gold tones, some blue–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  And I don’t have full lights on. So I change my light bulbs in my room, too, so they are dimmer. I had a system that every night before bed I had this folder, and I would watch—it is on my comp—on my phone and I would look at e-news and Facebook and Instagram and Pinterest, and I’m like, “What? He’s dating her?” And you know, my mind is racing. So I implemented a rule and it’s a no tech hour. So before bed, any email, anything I wanna look at in the Internet, any text messaging, anything I wanna do before bed is done one hour before bed. So I unwind from technology a full hour before bed. I do not plug my phone in by my bed.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  A lot of people have their phone plugged in by the nightstand. It’s too easy for me to grab it. So I actually plug my phone in by—in my bathroom. And that does one of two things. One it makes it easy so I can’t go grab it to go chat on it, right?

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

Rachel Adams:  And the other thing it does is when my alarm goes off to wake me up, I actually have to get my butt out of bed to go turn it off, because I was like a four-time snoozer. I was like, I just keep it in you know?

Dr. Justin Marchegiani: Right.

Rachel Adams:  And I—I aim for eight hours. I really do. I’m intentional about my—my sleep but the last thing to sleep for me was that sometimes life shows up and sometimes I don’t get eight hours. And I realized there was a mindset shift in here and I can, you know, it—I could either say, “Okay, I’ve got five hours. I’m going to be so freaking tired tomorrow. Tomorrow is gonna suck. I’m gonna need a cup of coffee at 4 PM and I’m gonna drag all day.” Or I can say, “Okay, I’ve got five hours. I’m going to shut down now and when I wake up, I’m gonna feel refreshed and amazing. I’m gonna have the most beautiful restful night’s sleep.” And then I wake up and I do my morning routine, and like mental shift for me was sleep. It was super, super huge. I think the last piece for sleep that really has been helpful is my mind races. Like I, a lot of times, couldn’t fall asleep because I’m thinking about a client I didn’t write back or a blog I need to write or whatever. So I keep a–

Dr. Justin Marchegiani: Totally.

Rachel Adams:  Journal by my bed, the same gratitude journal and I call it a mind dump. So something’s happening in my head and I’m not getting sleep, I literally look to my journal and just get it out of my head and once it’s out of my head and on paper, I usually can get back into the place of getting—getting into sleep mode.

Dr. Justin Marchegiani: Yeah, I totally agree. I think one of the biggest things—my biggest issue is just getting off technology earlier. The biggest thing I do is—I’m trying to do and working on it is one, throwing your phone or iPad into airplane mode, and then also clicking the night time button.

Rachel Adams:  Oh, good for you.

Dr. Justin Marchegiani: You know? Throw it in airplane mode.

Rachel Adams:  That is dangerous.

Dr. Justin Marchegiani: I know it’s hard. Throw it into airplane mode and then also hit the little moon button, half moon button that kills all your notifications, so then you don’t you don’t have like calendar things popping up or you know, your to-do list going off saying, “You gotta do this, you gotta do this.” And then it’s just dead, then your phone’s off. There’s no EMF. I throw my phone all the way across the room, kinda like you mentioned, at least 6 feet–

Rachel Adams:  Yeah.

Dr. Justin Marchegiani: But I keep it you know, 25 feet away.

Rachel Adams: You check it?

Dr. Justin Marchegiani:  Yeah, I just have an end table that’s literally at the polar opposite corner of my bedroom, and then number one when the alarm goes off, it forces me to actually get up.

Rachel Adams:  Yup.

Dr. Justin Marchegiani: And then number two, it keeps that EMF away. And then also with the Apples, they have the application, their Night Shift, and I make sure Night Shift is on so it kills all of the blue light, so which—that’s the light that really disrupts melatonin. So kill, putting the Night Shift application on or if you’re Android, there are other applications out there that will kill the blue light which shuts down melatonin.

Rachel Adams:  Yeah, I have that.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  You know how you said the moon? It—do you have to hit that? Do you hit that again in the morning to take it off?

Dr. Justin Marchegiani: Yeah, you gotta take it off–

Rachel Adams:  Okay.

Dr. Justin Marchegiani: Or like–

Rachel Adams:  Got it.

Dr. Justin Marchegiani: Your calendar notifications or people call you, it just will go. You won’t even hear it. So it’s great at night because it just, you know, sometimes at night I’d have like calendar stuff popping up. I’m like, “What the heck?” So I just—I use that now and then it’s like, it’s perfect. There’s no more issues, but it takes discipline. It really does.

Rachel Adams:  Yeah, absolutely. It does.

Dr. Justin Marchegiani: Well, awesome here. We’ve had a really great talk and I wanted just highlight a little bit more where people can get more Intel and more info on you over at lost2found90.com, like a 90 days to kinda get your health and your life back on track. So I think that’s gonna be some great Intel for people that wanna get more information about how they can get their life back. Also any way else people can get a hold of you or find out more about you, Rachel?

Rachel Adams:  Absolutely, yeah. I’m really active on Facebook so if you do the /racheladamsrealtor, you can find out about me and then my main website that kinda houses everything I do is www.RachelAdamsInspire.com and you can talk to me about speaking. You can see my book and program, real estate coaching, and all fun stuff I’m up to.

Dr. Justin Marchegiani: RachelAdamsInspire. Awesome! And the last question that I ask everyone–

Rachel Adams:  Please.

Dr. Justin Marchegiani: Let’s say you are stuck on a desert island and you only can bring one thing, one supplement with you, what do you bring?

Rachel Adams:  Oh, that’s so good. One supplement. Hmm. So it’s health related? One thing?

Dr. Justin Marchegiani: Yeah, health-related, but you know, if you want to go outside of health related, I’ll—I’ll let you do that, too, as long as we can—as long as you really have a good answer why.

Rachel Adams:  I just—I think I’d bring like a flint to make a fire so that I can cook food and boil water and you know what I mean?

Dr. Justin Marchegiani: Yeah, from a practical standpoint. That—that makes a lot of sense.

Rachel Adams:  Yeah, that would be my go-to, and this horrible—I’m not a fan of it, but my fiancé really likes watching Naked and Afraid–

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  So I keep seeing people like going on the shows and doing all these horrible things, but that—that would be my take away.

Dr. Justin Marchegiani: Very cool. And is there one supplement that you’re—you’re doing now or you’ve done in the past that you really like or you’ve gotten some success with?

Rachel Adams:  Well, I’d love it—I’d love to actually hear your feedback on this. So I am training for my first full marathon right now.

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  And I—I did a half marathon and we were told by some runners to—look, I’m not a big believer—I think that the—the supplement industry from like a GNC standpoint–

Dr. Justin Marchegiani: Yeah.

Rachel Adams:  Is poison.

Dr. Justin Marchegiani: Oh, yeah, 95%.

Rachel Adams:  So I steer super clear from those.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  I really—I only do natural supplements in my body.

Dr. Justin Marchegiani: Uh-hmm.

Rachel Adams:  But I will tell you turmeric, they told us use turmeric after running to like help restore muscles are something.

Dr. Justin Marchegiani: Inflammation, yeah.

Rachel Adams:  It freaking made such a difference, I think, but I’m wondering if I—it’s in my head because we honestly like we had a fairly okay healing process for tearing down our muscles as much as we did and I’d love to hear your feedback on that.

Dr. Justin Marchegiani: Well, turmeric I think, yeah, that’s great.

Rachel Adams:  That’s—that’s one of my favorite.

Dr. Justin Marchegiani: I think turmeric’s great for inflammation and you know, marathon running can be very inflammatory in the body. Sell for some people if you’re not already healthy it can be—it can be a stressor but for my marathoners, the biggest thing I like is branched-chain amino acids because the body will allow those amino acids to pinch-hit instead of breaking down your muscle and getting more catabolic, i.e. breaking down faster. And then also mitochondrial nutrients like extra CoQ10, carnitine, creatine, ribose, you know those type of nutrients that pinch-hit because the parts of your—little cells of your body, these powerhouse cells, the mitochondria, really use them to generate energy and that’s a big part of you know, that kind of energy systems you’re using when you’re running as well. To those would be my two—branched-chain aminos and mitochondrial nutrients.

Rachel Adams:  Awesome!

Dr. Justin Marchegiani: Well, great. Any other parting words you want to leave with the listeners here, Rachel?

Rachel Adams:  No, I think just, you know, the—the one thing I would talk—that I think about a lot is people make such big goals for their lives, and they have these beautiful ambitions, but they forget that they only have one body. They only have one vessel that’s gonna get them there. So I would really encourage you to just remember that if you’re not taking care of you and you’re not making yourself a priority, you’re never going to achieve these big goals that you wanna achieve because you’re not gonna feel good. And in reality it is all about how you feel. So just remember that, you know, you can’t be the best wife, you can’t be mom, you can be husband, dad, all of that if you’re not taking care of number one.

Dr. Justin Marchegiani: Got it. Yeah, I think even in the—the Bible, right? It says you gotta love your neighbor as you love yourself.

Rachel Adams:  A hundred percent.

Dr. Justin Marchegiani: That’s pre—that’s pre-assuming that you already love yourself, so I think that’s really important. Spiritual text from all religions echoes that as well so I think that’s a really, really great point to—to leave on.

Rachel Adams:  Awesome!

Dr. Justin Marchegiani: Well, thanks so much, Rachel. Appreciate your time.

Rachel Adams:  Thank you. I appreciate you have me on.

Dr. Justin Marchegiani: Thank you. Bye!

Rachel Adams:  Bye!

Bloating and gas solutions from extra protein and fat intake

bloating and gas solutionsBy Dr. Justin Marchegiani

Today’s talk is going to be on gas and bloating from increasing proteins and fats in your diet. I see this quite frequently with patients in my clinic where patients have come to me. They’re on the standard American diet, a lot of processed carbs, a lot of grains. That kind of 60, 15, 20—60-70% carbohydrates, lower amounts of fats and moderate amount of proteins.

And now, we are changing their diet around by reducing a lot of the inflammatory foods, the grains, the refined sugar, the inflammatory omega 6 fats. We are pulling them out and shifting it. We are increasing good fats and maybe some more good protein to stabilize blood sugar. And guess what happens? They start getting bloaty and gassy. Now what does that mean? So let’s break down some of the digestive physiology. Let’s go through what it could potentially mean and some interventions and treatment options.

 

Get expert advice on how to get rid of bloating and gas from a functional medicine doctor by clicking HERE!

Bloating and gas from fats and proteins

Let’s give you some contextual value of what the physiology is doing so it makes sense. So we have our stomach and kind of laid it out, left or right. Typically the intestines are all kind of mushed up in this spaghetti goose. Protein digestion primarily happens in the stomach. What does that mean? So if we start giving someone more protein, more high-quality protein, whether it’s grass-fed meat, maybe omega 3 rich, you know, wild Alaskan sockeye salmon, maybe a clean collagen powder, that protein—well, maybe not the powder per se; but the real animal whole food proteins, they get digested in the stomach.

 

The Digestive Process

digestive process

Stomach

Step one is when hydrochloric acid is produced. Hydrochloric acid activates certain enzymes from the stomach that kicks off the cascade for protein digestion. Step two is this acidic chime. This nice low pH of about 2-2.5, gets released into the small intestine and from here, what happens is we have our organs involved—imagine this being our gallbladder (GB) and then this is our pancreas. Based on the acidity, they actually shoot over some bile salts and some enzymes, multiple enzymes—lipase, trypsin, chymotrypsin.

In the gallbladder, we have various bile salts and that’s going to kick off fat digestion. But again there’s still going to be some protein digestion happening in the small intestine as well. This is because we do have other proteolytic enzymes coming out from the pancreas such as trypsin and chymotrypsin. So you can see protein digestion here. Fat and protein digestion is here.

Small Intestine

Now again, this is the first part of the small intestine. So this is the small intestine down here and these are the different parts: the duodenum, the jejunum, and the ileum. And again, we need nice acidity coming in here. So here are the three parts. A lot of the nutrients gets reabsorbed in the small intestine and if we don’t break it down at step one or step 2, then we’re going to have problems here.

Colon

Here’s our colon here as well. And again, what typically happens here is nutrients are all extracted here and then what happens here we have electrolytes get re-uptaken along with different fluids as well. So we have electrolytes met various minerals and then fluids. We have proteins, fats and proteins, and electrolytes and fluids. And we have different processes that can go wrong that can create dysfunction.

Digestion Issues

Now let’s talk about what can happen. So over here with the stomach, we can easily have acid reflux and heartburn if we’re not breaking down our protein correctly. Again, the nice acidity tightens up this esophageal sphincter up there. So nice acidity closes that up tight and prevents acids from rising up. We have to make sure we break it down. And so we reflux to that esophageal sphincter to close it up so that acid won’t come back up.

Same thing down here in the small intestine. If we don’t create a whole bunch of these enzymes to break down these foods, we’re going to have more fermentation, putrefaction and rancidification. Rancidification are fats going bad. Fermentation is going to be carbohydrates getting a whole bunch of gases being fed on by the bacteria being created, and then putrefaction is the proteins rotting.

If we don’t have this happen correctly here, a whole bunch of gas, a whole bunch of bloating will happen. We have our  ileocecal valve acting as a two-way street, so we have either bad bacteria from here going this way, or bacteria going the other way. So if we have bad bacteria, it can go back and forth and create more gas, more bloating, more flatulence, and more intestinal disruption. The bloating, the gas, the discomfort, the indigestion, feeling is like there’s a brick in your tummy.

 

Acid reflux, burping, bloat

With stomach issues, one of the first things we notice is burping, belching. Excessive gas is here because food is not being broken down properly. Now more fats and proteins do a couple of things. They put more stress on your digestive system. So let’s say you have this much hydrochloric acid and enzymes in your stomach to digest much protein and fat; if we start increasing protein and fat because your digestive physiology is not going to be enough to start creating an indigestion of protein down here, then it will give rise to acid reflux, maybe the burping, the belching and the bloat.

Maldigestion

And then same thing happens down here; if we don’t knock over this domino correctly, let’s say it falls and misses, the second domino is not going to fall correctly either. So we’re going to have maldigestion of more fats and more proteins, and this can create more gas in the intestines, more bloating, more gas.

Fermentation, Putrefaction, Rancidifcation

We may start even to see with the fermentation, putrefaction and rancidification lower in the intestines. We may even start seeing more flatulence, too. And a good gauge is if your flatulence is kind of foul-smelling, that’s more methane. Methane gases tend to drive more constipation. Hydrogen gases tend to be more air like you don’t have the foul odor as much. But again, those are just general rules of the game there.

Constipation or Diarrhea

And then again, you can see here with the colon, we could have either constipation or diarrhea from the colon. Again if we have excess hydrogen gas, we can have more diarrhea, excess methane gas more constipation, or we can have a combination of the two, an alternate back and forth. So you can see here, each step is really important – Protein, protein and fat, reabsorbing electrolytes and fluid.

Lab Testing

lab testing

Now we can do different lab testing to look at the function each step along the way. So in the stomach, we may look at glucose testing or we may look at various H. pylori test or dysbiotic bacteria test to look for things that could be causing protein to maldigest in the stomach.

With fats and proteins in the small intestine, we may look at SIBO testing, like a lactulose breath test which can be effective at looking at the hydrogen and methane gases. Of course, different highly functioning stool—highly specialized stool tests that maybe look at DNA or stool antigens of various infections like parasites, bacteria, Klebsiella, Citrobacter, fungal overgrowth. Also, the different types of critters and worms can be effectively looked at with this type of testing.

And again, infections can affect any step along the way and if you have an infection up higher, guess what? It’s going to cause the domino of top to fall off track and then all the other dominoes below will be off kilter. So again, issues up top can cause issues to spill down to the next and so on.

 

Treatment Options

treatment options

Diet

Well, obviously diet is going to be important. So if we draw our 3 macronutrient dials—these are our dials here. So we have carbs, proteins and fats. Imagine we can control our little dials or we have levers. Either one to help get your mind wrapped around it, we would just dial down the proteins and fats just for the time being. We also work on supporting digestive secretions, HCL enzymes, bile salts to help break down these foods in the stomach. So that’s a really good start.

We may even look at certain diet options, too. Even FODMAP approaches or specific carbohydrate approaches where we cut down these Fermentable, Oligo-, Di-, Mono-saccharides and Polyols—the specific fermentable sugars in the diet. We may even look at cutting out phenols and salicylates, and even peeling and/or really mashing and cooking our vegetables well, and even avoiding raw veggies, too.

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Nutrients

We treat the various infections that come up and we also may have, depending on how long the problems have been happening, malabsorption. And the longer it’s been happening, the more nutrients get malabsorbed. Part of what’s important in the stomach and hydrochloric acid is it helps to ionize minerals. That allows minerals to get into the bloodstream and to go where they need to go, so they can be absorbed and utilized.

So we can easily have mineral issues and minerals are so important because zinc helps make hydrofluoric acid. If we are low in zinc, that can affect our body’s ability to make more hydrochloric acid. It also affects sex hormone levels. If we have low sex hormones and the more inflamed we are, that will cause inability to repair.

Also if we can’t break down proteins, it will affect other factors, too, since proteins become our neurotransmitters. It helps how we feel, control the reward centers like dopamine and serotonin. It also becomes the precursor to sleep hormones like melatonin. And you can see, if your sleep starts going and your mood starts going, and then we lose the ability to break down high-quality cholesterol in our diet that’s the building block to a lot of our hormones, we now start having poor sleep, poor sex hormones, poor mood. We also have PMS, we have brain fog, and we don’t have the building blocks to help our body repair.

So you can see digestive issues can really start to make this whole thing spiral out of control.


Try some of the things I already mentioned earlier in the video. If that’s not working, click on screen so you can schedule a consult with myself. We can dig in a little bit deeper and help you get to the next step of what could be going on under the hood, so to speak. And then also click on the subscribe button. We have more videos coming your way, lots of great solutions to your everyday health challenges.

Other strategies to lose weight and reduce stress – Podcast #92

Dr. Justin Marchegiani and Evan Brand talk about weight loss secrets and weight loss mindset in this podcast episode. They discuss about weight loss being the effect of good health. Get educated about your body so you can effectively lose weight.

weight loss strategyDiscover why weight loss is more challenging for women and how hormones affect it. Learn about how excessive exercise and/or cutting calories can send stress signals to the body. Find out why you need to get nutrients 100% dialed in and eating organic and grass-fed or pasture-fed as much as possible, avoiding hormones and pesticides and GMOs. Learn about forest bathing, the Nature Pyramid, breathing exercises, body fat percentage and body water content, as well as the waist and hip circumference when you listen to this interview.

In this episode, topics include:

02:00   Female hormones

03:50   Stress in women vs stress in men

07:52   Nutrients

10:23   Diet and quality of the macronutrients

13:47   Forest bathing and Nature Pyramid

21:42   Breathing exercises

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Dr. Justin Marchegiani:  Evan, what’s going on? It’s a fabulous Monday. How you doin’?

Evan Brand:  Hey!

Dr. Justin Marchegiani:  How’s your weekend?

Evan Brand:  Oh, I’m doing great. Our weather was just incredible. I was outside probably 23 out of 24 hours throughout the weekend and it was just a blast. What about you?

Dr. Justin Marchegiani:  Same here. I was—went for a little hike on Saturday, went on the boat yesterday, did some water skiing, and then went to Whole Foods and get some shopping done. So I’m ready for my week, man.

Evan Brand:  Sweet.

Dr. Justin Marchegiani:  Very cool. Well, we talked pre-show that were gonna touch upon some weight loss secrets and weight loss mindset issues because we have so many patients that come in to us initially really wanting to focus on weight loss and weight loss really is the effect of good health and all the things we’re doing and it may not be the cause. Essentially, we don’t lose weight and then we get healthy. We get healthy and then we lose weight. The problem is a) which is getting healthy and then b) the effect of losing weight, it can be different for some people. Especially women, there can be a lot of lag time between a) getting healthy and b) losing weight. And we have to make sure we have the right mindset so we can stay the course.

Evan Brand:  Definitely, then that’s something that it’s on our Top 5 list for most of the people that we work with, weight loss is a goal, and a lot of times it’s just really an education process for you and I to really tell them, “Look, with this type of adrenal health or with this type of thyroid health, or with this gut infection, etc., it’s gonna be hard for you to lose weight, if not impossible.” And so a lot of times it’s just patience, honestly, and sometimes if people try to bail out too early and they don’t stick through their program to fully get better, the weight loss may never come. So sometimes it does take 3 to 6 months, and that’s pretty good if it took you 40 years to become overweight, if it only takes you six months to start turning, to dial the other way, then that’s pretty good.

Dr. Justin Marchegiani:  Absolutely and I would say with a lot of my female patients, because females tend to have a harder time losing weight if they’ve gained weight just because of the fact that hormonally there’s fluctuations that happen throughout the month, especially if they’re still cycling, meaning they’re progesterone and estrogen’s falling, they’re having a period every month or ovulating, it’s gonna be a little more difficult because excessive exercise and/or cutting calories can send stress signals to the body. And when those stress signals happen to the body, that can throw off the hormones, that can cause increase in PMS, lower thyroid function, and just more metabolic stress on the body. With guys, guys can kind of up exercise a bit, maybe even tweak calories down a little bit, maybe even lessen fat a little bit and then really drive weight loss in a more non-sustainable way per se, meaning it’s nothing that you do forever, and they will have less ramifications because of the fertility and the hormonal fluctuations. Men’s hormones are kind of like a foghorn. It just kinda goes, “Eeeee” throughout the month; where women you kinda get this orchestra going on and anything who listens to an orchestra, you know, you have the strings, and you have the—the percussion instruments and the horns and if one of these things is off, that orchestra can really go and sound like noise pretty fast.

Evan Brand:  Yeah, so that’s a good point that you already hit on is there are a lot of sources of stress that women honestly may not be aware of in terms—in terms of the obesogens for example, the hormone-disrupting chemicals that are out there that can cause you to gain weight. Some of the skincare products, that’s something that I always try to get to, maybe it’s not top of the food chain issue, but if you’re somebody listening, maybe you’re working with one of us with a program already, take a look at your skincare products and make sure that all the parabens and all of the thalates and all these other chemicals are gone because that can be roadblock. Maybe not a huge one, but definitely one that I’ve seen.

Dr. Justin Marchegiani:  Absolutely and in stress affects women and men differently, right? You know we also talk about women and men they’re equal but not the same, and by—when you mean not the same, there’s different biology and biochemistry happening. So Dr. John Gray talked about this at a lecture I attended recently. He talked about men under stress—and again obviously prolonged stress is gonna affect person. It’s gonna lower their hormones. It’s gonna create a more catabolic environment, meaning more stress hormones and that will eventually drop down their anabolic, they’re rebuilding hormones. So they’re more catabolic, they’re breaking down faster, with less anabolic hormones where they—they don’t heal and repair as fast. So men under stress, they actually can get a bump in testosterone from a little bit of stress. So you get actually a little bit of a boost of their repairing hormones and in the same lecture, Dr. John Gray talked about women under a little bit of stress like that, that can actually drop down their testosterone and may make them a little bit harder to recover and can also decrease their libido and such as well. So we just gotta be careful. There’s a fine balance in which women will be under so much stress where it may start dropping down their anabolic hormones, and again some—with different women, it’s gonna be, you know, different for each. Like I have—my wife for instance is an executive. She runs a massive company and she—when she’s under stress, it affects her just a little bit. It affects her a little bit. Now in the beginning after a vacation, after more meditations and more lifestyle strategies, she can deal with it better but that anabolic hormone definitely declines, her ability to exercise and repair is less. Now I have some women that are attorneys and they work hundred-hour weeks and they can do it up to a period of time. So because of the fluctuations in hormones with women, not everyone is gonna handle that stress the same. So we gotta be careful of how much stress that we’re under at work, and we also have to make sure that the harder we’re working, the harder we’re resting. So there’s that old analogy like “work hard, play hard”. I don’t like that. It’s—it’s “work hard, rest hard, play a little”. So if you’re working hard, especially as a female, because of the hormonal fluctuations you’re under, we just have to be very careful of that. Men don’t have quite the same issues. They do—I mean I see a lot of men who are stressed out but because their hormones aren’t fluctuating as much and because fertility is a little bit easier for a man, because the main goal of fertility is just having good sperm that—that have good shape and a good amount and good movement. Outside of that, we don’t have this beautiful flow of hormones that need to be present to have that—that sperm fertilize that egg and to have it stick. So we gotta be very careful of women and gotta make sure stress is dialed in and the constitution, meaning how much stress we can handle, is different for each person. I see women who are attorneys who work hundred hours a week and their adrenals actually look pretty good, and some women working 40 hours a week and their adrenals look like crap. So it’s different for each person.

Evan Brand:  Yeah, or stay-at-home moms. I’ve seen it both ways–

Dr. Justin Marchegiani:  Oh!

Evan Brand:  Being completely wrecked or being pretty good.

Dr. Justin Marchegiani:  Being a stay-at-home mom is—is a full-time job especially in the beginning when their sleep is declined. That is like—you might as well be, you know, an executive working a hundred hours a week, because when you’re getting up like that—you might as well be a doctor on call, right? You know, getting called in, because your sleep’s getting interrupted which is gonna throw off your blood sugar and you may not have the time to exercise and move because the baby needs to be fed all the time. So we kinda have a couple of different aspects there. That’s why I said, the harder you’re working, and being a stay-at-home mom especially in that first year, it’s super stressful. We gotta make sure the diet is 100% dialed in and we can’t use the excuse of eating for two is a reason to eat junk food. We gotta make sure you’re like a prized fighter, getting all of the nutrients in that you can.

Evan Brand:  Yup. So that was the first good piece there is—is the stress component, how that could a stall in weight loss, the different sources of stress, the chemicals, etc. Maybe we should talk about some of the nutrients that are helpful, too. You know, some of the zincs and the seleniums and the other, you know, trace minerals that are imp for the thyroid because every time you hear some woman that thinks that they’re overweight, they think, “Oh, there’s something wrong with my thyroid. Do I need to put—be put on thyroid meds?” And a lot of times, that’s not—that’s not the answer, right?

Dr. Justin Marchegiani:  We wanna make sure the nutrients, they’re 100%. So when it comes to that fat-soluble nutrients, especially vitamin A are gonna be really important for the thyroid, especially with the thyroid receptor sites. Zinc’s gonna be vitally important so if we have issues with losing our taste, I find a lot of people that are really craving a whole bunch of sugar. What’s happened is their taste buds have downregulated because of deficiencies in zinc and poor digestion and poor HCl and the higher amounts of sugar foods, they don’t even notice the overpowering sugar. Like if I engage in some kind of refined sugar ingestion, I’m just like, “Whoa! What the heck is this? This is so overstimulating, just from a taste perspective, forget a hormone perspective.” And some people I find their taste buds have really downregulated. We get them off of a lot of that sugar and we get them on a good high quality multivitamin with 20-30 mg of zinc in there per day and we get their diet full of really good zinc rich foods, high quality meats, etc. that their taste buds get more sensitive and they need less sugar to have the same type of mouth-feel response.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So we talked about zinc. Selenium is gonna be a big one especially for the thyroid and thyroid conversion, and a lot of women have autoimmune thyroid antibodies, so getting this—the selenium out there where it’s 1-2 Brazil nuts a day is a pretty good backbone. Good quality organ meats, oyster, seafoods are gonna be very helpful to get the selenium and get some of the nutrients in there. Iodine’s helpful but we don’t wanna go too high and if you are autoimmune currently active, we wanna be careful at boosting it up, you know, outside of 500mcg because we don’t wanna stimulate more autoimmune reaction. So the thyroid’s really important for fat loss and energy and the nutrients that connect and help with thyroid function, to name a few are gonna be zinc, to name a few are gonna be magnesium, selenium, vitamin A. We can even throw in copper as long as we’re not getting an excess. Typically, if we’re getting enough selenium, that will help balance the copper out as well.

Evan Brand:  Yup, so what comes next? I mean, is it the nutrition piece? Is it watching out for too many carbs? Is it the exercise, not too intense? Not too long duration, like what’s the next keystone for you?

Dr. Justin Marchegiani:  Well, I always look at the diet piece first. And we’re always starting with a Paleo template and most people in their head, I say the word Paleo, they go to meat—meat diet. And that’s basically brainwashing from conventional media, so we have to like hit Ctrl-Alt-Delete and put that in the trash right there. So a Paleo template really is just talking about the quality of the macronutrients.  Macronutrients being PFC—proteins, fats, and carbohydrates. So it’s talking about eating organic and grass-fed and pasture-fed as much as possible, avoiding hormones and pesticides and GMOs and then dialing in the macronutrients meaning proteins.  How high are we gonna be? Are we gonna have maybe just a palm serving of meat twice a day? Or are we gonna have 5 full hand servings throughout the day, you know? A full hand, maybe 4 or 5 times throughout the day, like where are we at with that? Also, how much starch can we handle? Can we handle a sweet potato once or twice a day? Or are we gonna primarily be more on a keto or gonna crank the fats super high, 70-80%, keep the vegetables as the majority of our carbohydrates and primarily eat, you know, moderate to lower protein and food? So we have that dialed, the PFC dials there, and we’re gonna dial that up accordingly and just kinda hit that delete button about pro—Paleo meaning high amounts of meat. It can but it also doesn’t have to be.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that’s important because that aspect right there allows us to have the nutrients coming in. It allows us to not drive inflammation because people forget, right? We’re either driving inflammation or we’re not. So it’s kind of binary. If we’re driving—if we have an inflammatory diet, that’s great. But we’re also not doing something that’s just as important. We’re not driving inflammation which a lot of people are gonna be driving with their typical diet and if we’re stabilizing the blood sugar, we’re also gonna be taking less stress off the adrenal glands, which the more stressed we are, the more we trigger our epigenome, our epigenetics, right? These are the things that turn on our genes to be in a stressed out state. The more stressed out we are, the more we wanna hold on to calories especially as fat so we have them in times of famine if you will.

Evan Brand:  Yup. To me, I mean stress has popped up time and time again in every conversation I think we’ve had. I think honestly, this is probably the biggest root of it, because I feel like a lot of people listening, they already have the diet pretty dialed in, but they’re not resting as much, you know, they’re not resting hard like you say, and maybe not playing enough at all. You could have a perfect diet and a good supplement program, but if you just come home from work and you’re just completely tanked and then you go straight to more emails at home or straight to TV or some other distraction and you’re not really actively resting, your brain is still stuck in that Fight or Flight sympathetic, I feel like that’s gonna be the biggest roadblock that’s gonna make you or break you, it’s the nervous system. I feel like that if your endocrine system is stressed, it’s stressed, no matter how much you tweak your sweet potato or whatever. If you’re stuck in that mode, I feel like you’re gonna continue to struggle.

Dr. Justin Marchegiani:  Yeah, that’s why things like stepping out and getting a 5 or 10 medit—5 or 10-minute meditation during the day is helpful. Also you talked a lot about forest bathing, kinda getting out in–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Nature for a few minutes. You wanna touch upon that?

Evan Brand:  Yeah, I mean, the—the science has proven if in case people want it, but the fact is you’re built to be outside. There used to not be such a thing as indoors, maybe the cave was indoors, but now we have ability to hide ourselves from the outdoor environment which is good if there’s a bad storm, but otherwise we wanna be out there where we’re getting tons of negative ions out there when you’re talking about being around water or sources of trees, you’re gonna get exposed to these phytoncides, these aromatic compounds in nature. Now if you’re—if you only have the beach available, then that’s awesome. If you don’t even have that and you just have the dessert, well, you have to just work with—with what you have. I had people email in, “Well, I don’t have a forest. What am I supposed to do?” Just use the nature that you have around you. But the forest specifically is something that they’re doing a lot of research on. It’s called Shinrin-yoku in Japan, and they’re seeing reductions in cortisol. They’re seeing reductions in blood pressure. They’re seeing all sorts of other biomarkers that are indicative that we’re shifting people into the parasympathetic state, and to me that’s like the biggest top of the food chain issue is whether you’re in the parasympathetic or whether in the sympathetic, and for me modern life it is very tough to stay having a balance between those two. So anything that you take away from it, anytime you’re out, you know, even in the grocery store—let’s say you’re at Costco and there’s tons of people everywhere and it’s madness. You have the ability to respond to that situation with that Fight or Flight mode or you have the ability to say, “Man, we’re spoiled. This is a first world problem that I have to wait in line to buy my organic food.” And then you just shift yourself out of that Fight or Flight, and if you can control your nervous system a little bit better with your mind, that’s gonna help you because everybody’s gonna get exposed to similar forms of stress issue, but if you have built up yourself, whether that’s with the supplements that we talked about, or whether that’s with a mindfulness practice and you have the ability to disengage the trigger so to speak at this loaded gun—that you’re gonna disengage—you know, not gonna pull the trigger of that Fight or Flight, you’re gonna be a lot more powerful that someone else who’s gonna break under a stressful time.

Dr. Justin Marchegiani:  I agree. So getting out, like what’s the dose? Are we talking like, something like 5 or 10 minutes even out there, getting out there enough? Is that okay? Or are we talking like we need 20 minutes? How much you think?

Evan Brand:  Yeah, it’s a good question. There’s a cool thing that people should look up and maybe you can put this on the show notes. It’s called a Nature Pyramid, and I’m not sure if this was a national park service or who came up with the Nature Pyramid but it’s kinda like the old food pyramid converted for nature and it shows sort of the dosage of nature that you want. So daily, you know, you wanna be getting exposed to your city parks and your urban environments, and then it goes up to I believe it’s like monthly. You wanna get exposed to like State Parks or National Forest, you know bigger places. And then whether it’s a couple of times a year, you wanna get exposed to even bigger sources of nature, and then at the very tip top of the pyramid, it’s like, you know, National Parks and massive places where you’re just completely in undomesticated wilderness and that’s sort of the top of the food chain. So it’s sort of like you do the best that you can during your normal work life, but you do want to make some time to actually just completely get disconnected from the grid and just go into pure wilderness, you know, as much as possible really but they have kind of a recommendation there that I—I can’t remember right now.

Dr. Justin Marchegiani:  Got it, because my wife went for a walk this morning pretty early. I think walking can be great. I look at it more as restoration and stress-reducing than exercise to put on muscle per se, you know, I wouldn’t consider that like exercise like going in doing some sprints or doing some kettlebell swings, but I see it more as a restorative type of exercise versus a—a stimulus to build muscle from that sense. Does that make sense?

Evan Brand:  Oh, yeah! You could walk your way to weight loss if you wanted to. You don’t have to beat yourself up and wear silly ankle weights–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And carry little dumbbells with yourself either. If you just walk, I mean, that’s what you’re designed to do and if you’re not walking, you have a deficiency of walking—let’s say if you like numbers, you’re not getting 6,000 steps a day, you’re getting less, then if you’re hitting that number, you’re gonna guarantee your success rate, you know? It’s gonna go up a lot more than if you’re just being sedentary, I mean, let’s face it, that’s not—that’s not good.

Dr. Justin Marchegiani:  Yeah, I think it depends, too, where you’re at. Like if you’re getting close—the closer you are getting to the weight you wanna be, those—those last pounds are gonna be harder to come off, so walking may not get you there because of the fact that the muscle that you need to stimulate fat loss and put on muscle, you have to have a higher level of stimulus and especially like the glutes for instance, these are phasic base muscles, meaning you need a lot of hip extension and deep angle at the hip joint to stimulate them. So like a box jump or a sprint where you’re really moving that hip joint through a larger range of motion. Where if you look at a walk, you know, you’re kinda only moving your hip joint through like maybe a 50-degree range of motion, but you look at a sprinter who’s leaning in at a 45-degree angle and that knee coming all the way and then kicking all the way back, it’s just—I mean, you’re almost moving that hip joint at 160 degrees.

Evan Brand:  Yeah, sprints are amazing.

Dr. Justin Marchegiani:  Yeah, you’re getting a lot more stimulation so I think walking is great, then once you plateau on it, doing a walk, sprint, walk, sprint, even if it’s a few minute walking followed by a 10-second sprint, that is a phenomenal way to go. And if you’re starting out, it could even just be a power walk, like you just going all out for 10 to 20 seconds is helpful, just to get those muscles stimulated because certain muscles are tonic muscles, meaning they’re more endurance, low threshold, low stimulus muscles. Others are gonna be phasic, meaning we need a higher level of stimulation, that’s where box drop—box jumps, plyometrics, sprints, and resistance training with heavier weights is gonna be what’s needed to get those muscle recruited.

Evan Brand:  Yup, and that’s what I do. I mean, I—I do, I’m not currently in a sprint, I mean, I’m pretty lean right now so I’m mainly just lifting weights, but a lot of people, you know, this is also gonna depend on where you’re at in your journey with your adrenals, because you know Justin and I would never recommend going straight into sprints if you’re stage 3 adrenal fatigue. You’re just gonna tear yourself up and make yourself feel awful. So this is sort of like, I don’t know, what would you call it, Justin? Like phase 2 of your program if you’re already kind of working towards health, then you may be ready for the sprints, but right out of the gate it might destroy you.

Dr. Justin Marchegiani:  Correct. If you have symptoms right now of fatigue and sleep issues or mood issues, or inability to perform at work or in—in your house and living, then we wanna always follow my three rules. Number one, choose exercise that allows you to feel good after it. So–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Again, if you’re going to CrossFit and doing your AMREP, right? As many reps as possible and feeling like really depleted afterwards and not energized, well, that’s already strike one. Number two is you wanna feel light emotionally after you do it, like you wanna be able to step back and say, “Yeah, I could do that again.” Like, “That’s doable. I can do that.” And then number three, if it’s a morning workout, you know, later on that night, how do you feel? Or if it’s an afternoon or night workout, how do you feel that next morning? Do you feel like run over by a bus, or do you feel like, “Yeah, I feel okay.” You know, barring all stressors being stable and sleeping stable, how do you feel? So three positive answers have to be there. Do you feel energized? Can you emotionally repeat the movements? And then number three, how do you feel later on that day or that next morning?

Evan Brand:  Yup, that’s perfect. That—you—you ought to make like a little poster or some type of little visual for that. I think that’d be cool for us to share to people.

Dr. Justin Marchegiani:  I think it’d be good idea. I’ll put that on my queue.

Evan Brand:  Alright.

Dr. Justin Marchegiani:  And then also one last thing to add to that, start out with a restorative. If you’re in doubt, the restorative movements are gonna be walking, and I’m a big fan of like breath walking so it’s kind of a walking meditation where you take 4 breaths into the nose. And then 4 breaths out. Yeah, I like that because nose breathing is very powerful for the parasympathetic stimulation. The olfactory nerve is I think olfactory is either 1 or 2—I think it’s number 1. I think the optic nerve is number 2. But that olfactory nerve, that’s like inside your nose, inside your nasal cavity, and those nerve fibers are actually parasympathetic. You know, they’re helping that rest and digest side of the nervous system, which is great because a lot of people are in the sympathetics and they’re chest breathing, meaning they’re breathing through their neck muscles and their check—their chest, and it’s really simple. You can just put your hand on your—your stomach and your chest and breathe, and see which hand moves first. And a lot of people, their top hand, their chest hand moves first. So that cranial nerve number 1 really is a parasympathetic fiber. So we talk about activating the parasympathetics to rest and digest is really focused on good nose breathing, deep nasal breaths throughout the day.

Evan Brand:  Yeah, you want that diaphragm or the belly, when you’re putting your hand down there to pop out first. I just read a book this weekend called Medical Meditation and it was great, all about like Kundalini yoga and tons of different breathing exercises and different poses that you can do for different things. So balancing out the nervous system was one of them. So if you just, if you’re sitting in a chair, you can do that, too. And you would just put your thumb on your index finger and you would have this pose here, they call it like a—a mudra where you have—put your thumb on the index finger there and you literally can just sit and you have your hands on your knees and you don’t have to be in what they call the easy pose. You can’t just be sitting in a chair, sitting upright with your spine straight. And the breath work for that was just inhaling through the nose, holding for 10, and then exhaling. And that was it and it suggested that you do that for 11 minutes. And so if you just do that, and you turn off that Fight or Flight, in a way maybe we can’t directly prove that you’re gonna start losing weight because of it, but if you can just do these little minor shifts in your nervous system state throughout the day, that can be enough to prevent you from getting into that fat storage mode like you talked about because your body thinks it’s getting chased by a bear and it needs to put you into a storage mode, because you never know when you’re going to eat next. So better store that body fat because you might need it for protection on all sorts of other things. So it is a protective mechanism. Your body’s not stupid and a lot of self-hatred and you know, self-abuse, negative self-talk comes up from this for women when they have excess body fat but the body’s doing what it would have needed to do to keep you alive pre-historically. Now it’s just not cool to store fat, so you know, it’s not sexy to do that in a lot of women have pressure on them. Your body is doing what it’s told to do. So if it’s being told to run from the bear and be in Fight or Flight and store fat, that’s what it’s gonna do. So don’t, you know, beat yourself up, don’t talk down about yourself. You just have to look at what’s going on hormonally and biochemically, and then try to tweak that as best you can.

Dr. Justin Marchegiani:  I like that and that breathing pattern was what again.

Evan Brand:  That breathing pattern is inhaling through the nose, you hold it for a count of 10, which is a little bit long if you’re not used to breathing exercises and then exhaling, and then repeat. And you do that for a total of 11 minutes with the thumb on your index finger and those hands resting on your knees, sitting straight up or sitting in what they call the easy pose where you’re in like Indian style, and you just sit there and that’s it. And I did this morning and it was a trip like I was sitting outside on the chair outside by the patio, just—and by the time I opened my eyes, which is super bright green, the trees were green, the birds sounded louder, like I was tuned in, so I know that I made a significant shift.

Dr. Justin Marchegiani:  That’s great. And there’s something called box breathing as well which is pretty similar, where you’re doing that 4-second breath in through the nose, 4 in and then it’s a 7-second hold and then an 8-second out. Now the hold is important because you actually ho—by holding, you actually build up CO2 and CO2 is actually a vasodilator to the brain so it actually increases blood flow to the frontal cortex. So that’s why like people that hyperventilate, they actually get too alkaline and that’s why they take the bag and they put the bag over their mouth, and they breathe into the bag because the whole goal is to increase CO2, right? So if you kinda take that concept, people get stressed over breathing, over exhaling, then they get this kind of panic attack going and they use the bag. So, you say, “Okay, now what can we do from a breathing strategy when we’re stressed to help that?” Well, the good deep breath in through the nose that activates the parasympathetic nervous system, the PNS, and then that hold for a bit of time followed by a slow, breathe out so we don’t go too alkaline with getting that CO2 out. Now I find though just focusing on the breathing timing is actually a little bit stressful–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I kinda do it, get like a rhythm of what it feels like and then once you understand the feeling of what it feels like, go more of the feeling versus the counting. Because I find if you’re trying to relax, it’s actually stressful trying to count this stuff out. So I kind of just breathe in as deeply and as comfortably as I can through my nose. I try to just have a nice comfortable hold and a nice slow breath out, but count for a bit so you know what it feels like and then go back, reach for the feeling versus the counting number.

Evan Brand:  Yeah, I—I’m glad that you called that out. That’s something I did but I wasn’t aware that—I should have made the distinction there, yeah, definitely for me, once I get in the flow, I don’t ever—number don’t even exist.

Dr. Justin Marchegiani:  Exactly.

Evan Brand:  It’s just a matter of feeling your body and you’ll know when you need to exhale.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You’ll know when you’ll need to take the next breath.

Dr. Justin Marchegiani:  Exactly. And then also I think it’s important that we get a baseline. A lot of women especially, they’re fixated on the scale. I think it’s good to have an idea of where your weight’s at from a starting point, but remember weights on scale, cannot look at the quality of the weight. It does not break up fat from water from muscle. So we gotta keep that in mind. Now if you’re gonna use a scale, a better scale to use is a Tanita scale. That will actually look at fat percentage. It will even look at water percentage. So that’s helpful because if you see you know, someone eating a whole bunch of gluten one day, that will drive inflammation and their water percentage will go up. Women before menstruation, their water percentage will go up. Even potentially around ovulation, things can happen, too. So because of the hormones fluctuating, that can cause fluctuations of water going up which can increase weight 3 or 4 lbs, like that. And then number two, stress will cause water retention. Eating inflammation foods will cause water retention, and we don’t know if we’re putting on muscle because if we started some of these strategies when we’re getting inflamed, our body is in a less stressed out state. The less stressed out we are, the more our body favors putting on muscle, because muscle is very metabolically active. Our body only wants to put muscle on when it’s safe, meaning when there’s an abundance around us because why put calories and nutrients into tissue that’s very metabolically expensive and muscle is very metabolically expensive. So think about it. When you go into debt, the first thing you cut out are gonna be vacations and maybe going out to dinner and extra fun little excursions. Well, think of your muscle as the fun excursions or the nice restaurant, or the vacation. It’s the first thing that gets crossed off the list when you go into debt, or when you go into adrenal debt, or stress debt if you will.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Comments on that?

Evan Brand:  No, that was great.

Dr. Justin Marchegiani:  Yeah, more analogies. So get the analogy—get the anal—get the analogy down and forget—forget the—the route facts of what’s happening in your body. Get the analogy and you don’t have to worry about memorizing this stuff. That—that’s me and your job, Evan.

Evan Brand:  Yeah, I’m getting better at it.

Dr. Justin Marchegiani:  Yeah, you’re doing good. So the scale, body fat percentage, also weights—I’m sorry waist and hip circumference. Take the widest part of your waste and the widest part of your hips. A good place to do it around your waist is the belly button because it’s stationary. It’s always there and just make sure the tape that you use is flat and parallel with the ground. I like a tape called MyoTape because it has a set bit of tension to it and that tension allows it to be consistent each time, so parallel MyoTape around the belly button, and then choose the widest part of the hips. Use the MyoTape as well, pull the slack out and let it come to a homeostasis of where it’s naturally at resting tension. Write down that where it’s at. Do it first thing in the morning before water and after your first, you know, morning pee, and then you’re set. So that you have a good baseline.

Evan Brand:  Now did you say something about dividing those numbers like a ratio there?

Dr. Justin Marchegiani:  Yeah, you could do that but that’s fine—I’m fine with that. And maybe we know if the numbers go down. Here’s the problem, if your numbers go down equally, well, the ratio stays the same, right?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I think it’s still good to look at it, but where the ratio really is helpful is if women typically have that—I think that—the Marilyn Monroe ratio is like 0.78 to 0.8. So meaning your waist is 20% less than your hips. I think that’s kind of the—the overall metric. For men it’s closer to a 1:1. But when your tummy is so big that it’s closer to your hips, that’s where you get closer to a 1:1, right? Like let’s say a 35-inch—let’s do like a 38-inch hips for women with a 38-inch waist, where that’s like a 1:1, right? That’s not good. So you wanna drop the waist in a bit, ideally you know, around 30 or so or even maybe below to get that ratio at, I’d say an upper 0.7 to lower 0.8. Now that’s like optimal, right? Like they’ve gone back and they’ve actually measured a—a lot of the Greek, Roman sculptures of women that were, you know, thousands of years old. They even looked at Marilyn Monroe, right? And she was I think today’s equivalent of like a size 8 or size 10 or 12, like not like your typical 0 or 2, right? But like an 8 or 10 or 12 in that area. And they found that this ratio like 0.78 to 0.8 is like the ideal ratio and they measured all these different sculptures. In ancient Rome, they found this ratio is kinda consistent. So keep that in mind. It’s nice to look at it. Now I like ratios because guess what? As—if you get bigger, if your hips get a little bigger but your waist stays in that ratio, that’s actually a good kind of thing. So it’s not 100% based off of how small you are, but how proportionate you are.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  So I like that, so it—it kinda adds a level of—of individualization to it.

Evan Brand:  Yeah, and you’re not just looking at a poster or a magazine to think you need to look like that and most of the time, they are sickly skinny.

Dr. Justin Marchegiani:  Right. Exactly. I think for me, too, there’s like a ratio of like hips to—hips to—to shoulder ratio like 0.9 or something. There’s another—a famous ratio with men but that kind gives you the idea of the ratio. So get your ratios down with measurements, get a good Tanita scale if you’re gonna use it, look more at the body water content as well as body fat content, and just try to exercises that are gonna focus on putting on muscle once you get out of that restorative phase, right? Restorative phase, muscle building second, and then just ask those three questions first.

Evan Brand:  Say the questions again.

Dr. Justin Marchegiani:  Number one, do you feel energized with the exercise? Two, can you emotionally repeat it after a workout? And then number three, how do you feel later on that day or that next day?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  That’s the word.

Evan Brand:  I just got a—I just an email this morning from a female patient who ran a 10—was it a 10K or a 10-miler, might have been like a 15K, closer to 10-mile—anyway, retested her adrenals significantly backtracked—surprise, surprise—from this race and all the training that she was doing. She was running like 6 or 7 miles a day or something for weeks, I mean, just awful. And I, you know, basically told her, “Look, this is gonna destroy you. But if you wanna do it, then that’s fine, I’ll support you and I’ll let you live out your dream of, you know, completing this race,” and then she emailed me this morning and she says that she threw in the bib. She was gonna run another 10-miler or a 10K or something in a couple of weeks, and she has been convinced and she—she threw in the—the bib and she’s not doing it anymore. So not to say don’t chase your dreams, but I mean, that’s something that is just really unnecessary and is really not gonna help your weight loss. I can’t count the number of massively overweight men and women that I’ve seen and they’re running these long endurance races thinking that it’s gonna help you. It is not gonna help you. It’s gonna destroy you.

Dr. Justin Marchegiani:  I agree and you gotta fine tune, you know, goals and achievement versus what’s sustainable in the long term.

Evan Brand:  Yeah. So–

Dr. Justin Marchegiani:  Because that’s—you gotta have to, you know, you gotta balance that out and figure out what’s more important for you. But getting back on to the calorie standpoint, I know a lot of women that have—may have done the standard American diet or like a WeightWatchers or a low-calorie diet, may have done a lot of the conventional exercises like running marathon-type of training, you know 5, 8, 10 miles a day. And they’re like, “Yeah, I lost a lot of weight,” and that can happen initially. Like I’m not gonna sit here and tell you that type of exercise doesn’t help you lose weight in the short run. I mean, in the first few months you will definitely lose a lot of weight. The question is, is it sustainable? Number two, is it healthy for your hormones? And then number three, does it—is it gonna be something that creates realistic expectations? Meaning, women do it for 3 or 4 months, and then they lose this amount of weight and then what happens is let’s say they’re at 160, and now they’re down to 140 or 130. Now that 130 becomes like the dragon they’re always chasing. That’s like the baseline in their head of where they should be at.

Evan Brand:  Right.

Dr. Justin Marchegiani:  And that’s tough because that may not be where your body wants to be when everything else is dialed in. That may be kind of like, you know, a body builder or a fitness trainer, they—they dip down to that weight they wanna be at for competition and then they come out of it. And I think people need to—to realize that you could probably dip down 20 lbs below where you’re at but it wouldn’t be something you’d wanna be at all year-round. So we wanna make sure you have a sustainable weight that you can be at and it’s tough because we have ectomorphs in society that can stay very lean all the time, especially we see it like the runway model-type figure that Hollywood has chosen to be like, you know, what’s hot and sexy, but again it’s a very small amount of people that are this ectomorph body type that they can be less selective of what they eat, less selective on exercise, and they keep this, you know, very tall, lean frame year-round. Now I see a lot of these people, once they hit menopause especially as females, things go downhill fast, and I’ve—I have that perspective of seeing women literally gain 100 lbs over a few years without really doing much different.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  So this can look nice, you know, when you’re below age 50 and you can have a lot of latitude and flexibility, but as you go up in age, that can change. And I see a lot of women do that are at this runway model physique and they have so much gas and bloating and digestive issues that you would think, “Oh wow! They—they must look—they must be healthy because they look, you know, stereotypically healthy but they have a lot of internal health issues and they may even have brain fog and fatigue, so they’re health challenges may be manifesting more internally especially as they’re younger, and then will sometimes express more externally especially once they hit menopause where their hormones significantly shift.

Evan Brand:  That’s a killer point. I’m so glad you brought that up. Just because you look beautiful or you look ripped as guy or something, generally those people are not that healthy. I’ve seen plenty of ripped guys, you know, eating Lucky Charms and you know, Reese Puffs. They look ripped and guys are idolizing them, “Wow!” But I guarantee, their brain probably doesn’t work good. I guarantee their sex drive’s probably not healthy. They probably have some mood issues, depression, anxiety, etc. I’d rather look a little bit like a normal person, still have some muscle, but my brain and my gut work good. Because I’ve been there and done that with IBS for years, and it sucks and I looked better or more ripped and had more muscle when I had the worse of my health issues compared to now, maybe a little less ripped just because I’ve been so busy I’m not working out as much, but my gut’s better and my brain’s working better. So I’m happy to take that sacrifice.

Dr. Justin Marchegiani:  Totally, and I think everyone especially the females because of the—the pressure of society on them, go watch my video on body typing, because you wanna know what kinda body type you are first because that kinda really sets the expectation, to be the ectomorphs which are the—the leaner, you know, it’s so hard to gain weight. These are the runway models, these are the super lean skinny guys. It’s just harder for them to put on weight.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Number two, we have the mesomorph which are kinda like the in-between, they’re kinda like the hybrid. They can kinda go either way so to speak. And then we have the endomorph, these are the people that are definitely more rounder, you know, rotund, you know, people that we would just, you know, typically say I’m big-boned, right? You know, the South Park expression. They’re just easier to keep fat on and when we—when you know what kinda body type you are, you just know that you have a more upward or an uphill battle if you’re an endomorph and you’re trying to get leaner, you’re just gonna have more of an uphill battle and you may have a lot less latitude to cheat. So then when you hang around your ectomorph friends and they’re able to do different things and have not the same result as you, not the same ramifications, you gotta just be realistic at the cards you’re dealt with.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it doesn’t mean you can’t be healthy though. It doesn’t mean you still can’t perform well. It doesn’t mean you can’t be at your optimal leanness and have good muscle mass. It doesn’t mean that. We just have to know the card you’re dealt with, play them to your best. So if you’re like a—let’s say an endomorph and you oscillate between 160 and 200. Let’s say you’re like a 5’5” frame, well, you know, there’s a lot of things we can do to be at that lower side, but we just gotta make sure you know, if you’re at 160 and then you’re comparing yourself to your ectomorph friend who oscillates between 100 and 130, and you’re comparing their 100 to your 160, right? You know, or let’s say their 130, their bad side of the—of the fence to your good side of the fence, you’re always gonna feel like a failure. So you have to get your mindset, where’s your body type at, and then you gotta get your diet dialed in. So the Paleo template will always be the template and then within that template, we adjust the macronutrients and then we adjust the exercise according to where you’re at and then the next level on top of that is where you see a functional medicine doctor or practitioner to get the hormones and the thyroid and the gut and the detox and the nutrients looked at if we’re still having health challenges beyond that.

Evan Brand:  Absolutely. Great way to summarize there.

Dr. Justin Marchegiani:  Any last comment you wanna make? I have one more I wanna make before–

Evan Brand:  Yeah, last one. Drink more water. Dehydration could be an issue and it’s surprising how many people are not drinking enough water because they’re drinking say Bulletproof coffee or herbal teas all the time, so hydration is—is another important factor that you can kinda tweak a little bit and see if anything changes for you.

Dr. Justin Marchegiani:  Absolutely and I always say a death rattle for a lot of women is too much fasting.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  If you’re doing a lot of intermittent fasting or fasting that can create a stress response because of the hormonal fluctuation and fertility, that can create some problems with women. So we gotta be very careful. Men can have it, too, but because of the delicate orchestra of female hormones, we gotta be careful with that. The next I will say is counting your calories isn’t important per se. I try to make sure people are getting enough calories, but for the most part, if we’re eating the nutrient dense, low toxin, anti-inflammatory Paleo type of template, we’re—and if we’re using our appetite as a gauge, we’re always gonna get enough calories for the most part. There are exceptions to every rule. Where I get concerned is if people really ramp up the fats too much and they’re having an issue with gaining a little bit of weight, I like to look at the calories, see where the calories are at, total-wise, look and see where your macros are at. So let’s say you’re at like a 20% carb, 15% protein, 50 or 60% fat and your calories are at 2,100 and you’re a female and we found out that based on your height and weight and activity you could probably be at 1,900 to 2,000, we may drop the calories a hundred at a time and just make sure you’re not feeling hungry throughout the day. Make sure you’re not missing meals and sometimes just dropping the calories just a bit like that as long as we’re not getting hungry can make a big difference. So drop the calories a touch, be in touch with yourself. Look at the extra fats like the nut butters, it’s really to overdo those. Maybe putting too much fat in your coffee. Take a look at those but do it with a doctor’s or nutritionist’s support. Because you wanna make sure you’re not starving yourself. You wanna make sure you’ve calculated how many calories you need based on your activity level and then you wanna do an assessment of what your macronutrient percentages are, whether it’s a 20, 15, 60 and then you wanna where your total calories are at and then just try to tweak it down just a little bit per week and see if that makes a difference as well as you know, the exercise should already be dialed in, too.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Any comments on that?

Evan Brand:  No, I think that’s good.

Dr. Justin Marchegiani:  Well, Evan, anything else you wanna say here?

Evan Brand:  Not today. I mean, that was a lot. That was a lot of information to take in. I think we’ve—I think we’ve—we gave double the amount of info that I thought we may have given. So you may have to go back and listen to this one again.

Dr. Justin Marchegiani:  And we got the transcriptions up here, so go to Evan’s site, NotJustPaleo.com. Go to BeyondWellnessRadio.com. We got the transcriptions. Leave us a review on iTunes. Again there may be one thing in here that resonates with you so try to just pick one thing that works for you. Again, men have these issues, too. And all the strategies that we talked about and we kinda of dialed in and we spoke to maybe more of the female crowd, all men listening, these—these things still apply for you as well. So still, you know, we’re not ignoring you, we’re just really reaching out to the women because I feel like they have a little bit of a harder time in this area but all of these things still apply to all the—the males listening, too.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Alright, Evan. Great show. Anyone that really liked it. Go on iTunes, go to the click below your video or your mp3 listening to on iTunes and just click the review button. That’ll bring you right to the iTunes page and you can leave us a great review. And just you know, sharing is caring. We appreciate it.

Evan Brand:  Definitely. Take care.

Dr. Justin Marchegiani:  Evan, Sound good. Take care, man.

Evan Brand:  Bye.

Dr. Justin Marchegiani:  Bye.

Dr. Peter Osborne – No grain, no pain! – Podcast #88

Dr. Justin Marchegiani interviews Dr. Peter Osborne in today podcast episode where they talk about being true gluten-free and what the gluten-free diet is all about. If you aren’t having the results you are looking for after trying the gluten-free diet, here’s everything you need to know. 

Dr. Peter Osborne Dr. Osborne has a book out right now called No Grain, No Pain. Listen to this podcast and learn how diet becomes a potential cause for autoimmune disease. Discover two common nightshades that most people tend to forget or don’t know about and the need to stay away from these if they are having chronic pain. Find out what highly specialized testings are available that you can take to check if your body tolerates gluten or not.

In this episode, topics include:

01:45   The history of gluten

9:47   Gluten-free diet vs true gluten-free

13:54   Pain and nightshades

16:20   Mechanism of gluten causing pain

25:00   Prescription pain trap

31:44   Summary

itune

 

 

youtuve

 

 

 

References:
Gluten Free Society: https://justinhealth.com/gluten-free-society
http://drpeterosborne.com/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526354/
No Pain No Grain Book: https://justinhealth.com/no-grain-no-pain
Gluten Free DNA Testing: https://justinhealth.com/gluten-testing

no_grain_no_pain

 

Dr. Justin Marchegiani:  Hey, there! It’s Dr. Justin Marchegiani. Welcome back to the show. Today I have an awesome guest, a friend and mentor, Dr. Peter Osborne. Peter’s got a book out right now called No Grain, No Pain, all about reducing chronic pain by making simple dietary changes. And I first heard of Peter about 5 or 6 years ago because I was one of these conventional gluten-free diets and I wasn’t quite having the results I was looking for. I still had some skin issues, some rosacea, some inflammation and he was the first person that put the concept out there that really resonated with me called being true gluten-free and the phenomenon of gluten-free whiplash. So it stuck with me 5 or 6 years ago and Peter’s out there helping thousands of people. He’s reaching out to hundreds of thousands of people via his weekly emails and this new great book that we wanna talk about and get some more information out to all the listeners today. So Peter, welcome to the podcast.

Dr. Peter Osborne:  Hey, Justin! Thanks for having me, it’s great to be here.

Dr. Justin Marchegiani:  It’s great for you to be here. Before we start, what did you have for breakfast this morning?

Dr. Peter Osborne:  Right out of the gate, well, I had a couple of scrambled eggs and coconut oil with a cabbage salad. I had some purple and green cabbage with some shredded carrots on top, some pecans and some sliced red bell peppers. That was—that was breakfast for—for me this morning.

Dr. Justin Marchegiani:  That’s great. I was hoping you weren’t say a gluten-free bagel.

Dr. Peter Osborne:  No, I stay away from anything gluten-free. At least labeled gluten-free, right?

Dr. Justin Marchegiani:  Yeah, absolutely.  Now one of the podcasts I first heard of you on a few years back, you kinda talked about the history of gluten. I think it was Dr. Willem Dicke, he was physician over in Holland and how he came about connecting the dots, I think with World War II rationings that grains, especially wheat, barley and rye, and as you put out there in your research, it’s much deeper than that. But can you just go over, just a brief overview of the history of gluten, and how we know it to be, you know, what it is today from a clinic perspective, cutting it out actually helps with a lot of these issues?

Dr. Peter Osborne:  Yeah, this is a really unique story. So, you know the physician was—was treating kids in—in a pediatric ward during World War II and what happened was grain was rationed and so no grain was available as food source for the hospitals, so the kids all went into spontaneous remission.  Now this was at a time in our history where we—we knew of celiac dis—disease, we just didn’t know what caused it.  So here—here all of a sudden, grain’s no longer available, all these kids are healing because celiac disease is—basically it’s a disease, you know, pediatric disease where you vomit and—and diarrhea and until you dehydrate and die. So—so he wrote a paper. It was published in 1952 and the same year, a group of researchers at the University of Alabama Burming—Burmingham did a study on 10 patients with celiac disease. Now here’s the sad part. This study was done on 10 patients. This is the study that isolated the protein that we—we commonly refer to as gluten. This protein is named alpha gliadin.

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Peter Osborne:  And they said, “Look, no further, we’ve discovered the cause of celiac disease. It’s alpha gliadin, therefore, all these other things are fine. All we really need to worry about is anything that contains alpha gliadin, and this is where wheat, barley and rye comes from.” Because when we’re referring to gluten in the FDA and the—and the definition in the grocery stores referring only to alpha gliadin, it’s not referring to this family of proteins which gluten is technically, it’s—it’s a family of proteins found within all grains—all grains, meaning corn, meaning rice, and sorghum, and millets. So not just wheat, barley and rye. But again, this study isolated alpha gliadin and it was again, only on 10 patients, but this was kind of a platform moving forward.  And another group of—of physicians did a study and wrote a book on it. It’s called If You’ve—If You’ve Heard Or Read, it’s one of these books—I’m actually pulling it off my library shelf right now, by Sidney Valentine Haas.

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  It’s called the Management of Celiac Disease and they did this—this study on 600 patients. So again, a comparative, 10 patients versus 600 patients. And what they found is they found that really grain-free was—was actually what led to a remission, and they had a remission in 600 patients.  So 100%—100% remission rate versus today, if you look at the standard gluten-free diet, what is the remission rate if we measure—if we measure the components of celiac disease, which are antibodies, persistent inflammation as well as villous atrophy on biopsy. If we look at how many of the patients with celiac disease actually are cured with a wheat, barley, rye-free diet? It’s in essence, it’s less than 9%.  So it’s about 8%–

Dr. Justin Marchegiani:  Yeah.

Dr. Peter Osborne:  Could actually experience a curative rate.  So—so this was my first kind of techy endeavor into or scientific endeavor into this because for me it was—I was eating all these gluten products just like you—gluten-free products. I was drinking the gluten-free beers. I was eating the gluten-free breads and for me, what—what was happening was I felt worse. I—I could go eat a loaf of wheat bread and feel better than if I ate this gluten—this—this gluten-free rice bread or corn bread, etc. So it—it really started to get me asking different questions and so I started reading about the history of—of grain in and of itself, and TJ Osborne who discovered prolamins. He’s actually the—the—who we call the father of plant biochemistry. He discovered prolamins and classified prolamins, which—prolamins are a form of gluten, and—and so we have gluten being this family of proteins found within grains. Grains are the seeds of grass. Within the seeds of these grass, we have proteins that are storage proteins that are designed to feed the—the embryo of the grains so that it can grow and sprout and to form a new grass, right? So, but also designed to protect the embryo so that predators don’t eat all the seeds, and basically eradicate the species of grass. So these glutens are not only storage proteins but they’re defense mechanism proteins found within grains and the—and—and interesting that the guy who discovered this and classified it shares the same last name with me.

Dr. Justin Marchegiani:  Small world, right?

Dr. Peter Osborne:  Right, right.  I was blown away by it, I mean it certainly I don’t take credit for it, but I—I love that he did that work and—and has that available for us to read and—and to think and ponder on, but so we’ve got these—we’ve got these gluten proteins and there are over—in 2010, there was a study done in Australia by Bob Anderson and his group. They discovered 400 new forms of gluten, and they found that 10% of these forms of gluten were worse than alpha gliadin in terms of celiac patient cells. So they found that 10% of these new discovered gluten proteins actually interacted and caused an inflammatory response in celiac cell lines greater than—than alpha gliadin.  So we know there’s more to this story and I think—I think it’s important to say, Justin, that, you know, I wrote No Grain, No Pain to shed light on this information so that people could think clearly and people could get real scientific information and—and make good smart decisions, and—and right now, with, you know, if people go to the celiac sites and to the—the general GI doctors, what they’re gonna get is they’re gonna get, “Hey, if you have celiac disease, go wheat, barley, rye-free. Don’t worry about oats. Don’t worry about corn. Don’t worry about rice.” And the vast majority of them are not gonna heal, the vast majority of them are gonna go on to develop multiple autoimmune disease as in have a life span that’s 26 years shorter. So I felt like getting that information out there to the world was an extremely important part of my mission.

Dr. Justin Marchegiani:  Love that. And I had a patient just maybe a month or two ago came in with severe RA, had multiple surgeries on her spine and hands because of the actual disfigurement and she had been on gluten-free diets, but then we kind of upped it one notch with a true gluten-free diet or an autoimmune diet following a lot of the same tenets in your book and her pain, 30-year pain, literally vanished in little less than a month. I couldn’t believe it, so this stuff is real. So a lot of the things that you’re talking about should be a first line defense with anyone with chronic pain or joint issues and it’s too bad the rheumatologists out there aren’t holding this book up and giving it to all their patients.

Dr. Peter Osborne:  Yeah, I would love to see it become a primer in—in rheumatology internships and rotations in hospitals across the country, and—and maybe one day we’ll get that to happen. I—I actually, you know, what’s ironic is? I—I started this whole thing started for me in Rheumatology. I—I was fortunate enough to do a rotation in the VA Hospital here in Houston, Texas in the Rheumatology Department.  So what I got to see first-hand was patient after patient on methotrexate, on steroids, on immune-suppressing drugs.  None of them really ever got better.

Dr. Justin Marchegiani:  It’s terrible.

Dr. Peter Osborne:  It—it was a horrible environment for these people, and then the surgeons would come in on—on one day a week and they would do these surgical consults and it was kind of like a mill. So, you know, the patients would get drugged with immune-suppressants. They really didn’t get better. Their joints continued to deteriorate and then they got surgical consults and got surgical joint replacements and then they were back 10 years later with a—with—with a need for a secondary joint replacement because there other one wore out. And so I got to see kind of all these kinds of patients going through that rotation through the VA Hospital. It was very eye-opening and enlightening for me and it’s actually what led me down the path or even investigating diet as a potential cause for autoimmune disease.

Dr. Justin Marchegiani:  Yeah and a lot of people talk about gluten-free being kind of like a fad, and I think people need to kind of realize if you study the Paleo diet, gluten-free from a true gluten-free perspective that you echo really cutting out the grains in general is not a fad, it’s actually has history of 10-plus thousand years, it being in our, you know, in part of our diet and lifestyle, but really what it is the fad is the gluten-free substitutes that are being added in. I mean, you don’t ever have to put a label on broccoli being gluten-free, but you have to put a label on maybe rice flour or potato flour being gluten-free. So can you just talk briefly about the—the misnomer of gluten-free being a fad and then compare it to the true gluten-free aspects?

Dr. Peter Osborne:  Yeah, so I mean, in—in any diet trend and we’ve seen this with Atkins and—and South Beach and we’ve seen this with—even with Paleo and ketogenic diets and probably the—the most famous of all is the gluten-free diet, right? Because what happens is big business, big companies take advantage of ignorance and—and that’s—they take advantage of ignorance through marketing. So gluten-free is a perfect example of this. We’ve got, you know, tons of companies that are out there. I think—I think some of them really started with good intention, Justin. I think, you know—you know, not really understanding what gluten truly was, they were just trying to create options for people with celiac disease, you know, rice breads, corn breads, and pastas, etc. But I mean, the reality is we have the science and we have the knowledge and—and now that they’re continuing to do that, to me now there’s an ethical and moral obligation for them to reevaluate their business models and to come back and say hey, we need to look at this in a different way. But if you look at what they’re doing, you know, first of all, we’re taking people who are very sick—autoimmune disease, right? Years, decades of damage, and we’re saying, “Hey, cut out gluten but eat crap.” I mean, that’s literally what these marketers are saying is cut out gluten, but here it’s still okay. Coke is gluten-free. Snickers candy bars are gluten-free, and hey, by the way, there’s genetically modified corn that we just shaped into the form of pasta spirals so that you can still eat macaroni and cheese. We want you to go ahead and buy a ton of that for 10 times what you pay for regular macaroni and cheese, it’s not healthy for you but we’re gonna—we’re gonna label it gluten-free and we’re gonna—we’re gonna kind of put the trend out there that gluten-free is healthier, and that’s what marketers have done.  That’s what companies have done, is they’ve created this kind of trend in the market that says, “Hey, gluten-free is better for you.” But the—the problem is that the vast majority of—of people out there are ignorant to the fact of what gluten actually is. So they’re just going out buying gluten-free products, right? They’re eating them and they’re still feeling like crap, and then they’re saying, “Hey, why do I still feel like crap on this gluten-free diet?” It’s because they’re—one, they’re not really on a gluten-free diet. Two, they’re eating food that isn’t good for them, right? And the cardinal rule in nutrition, you can’t get healthy or stay healthy eating food that isn’t healthy regardless of gluten-free status. There are, you know, sugars gluten-free but it isn’t good for you, and so if you’re diet is 60% sugar, you’re still gonna feel bad and you’re still not gonna heal and recover from years of chronic autoimmune damage. So it’s important to understand perspective and perspective for the person who needs this diet is that, “Look, you’ve been sick and you’ve been accumulating damage, inflammatory damage in an—in an overactive immune system for decades.” That requires a degree of stoicism in the diet. That requires a degree of—of discipline. It requires a degree of willpower and change and desire to change if your desire to get healthy is greater than your pain, then you will make these right decisions. If your desire to get healthy is not your priority, then you’ll continue to buy these processed foods, and you’ll continue to—to buy into these marketing hype and you’ll be one of those statistics where—or you’ll be one of those people out there that say, “Yeah, I tried that gluten-free diet thing, it didn’t work for me.”  And it’s not that it doesn’t work, it’s that it didn’t work for you because you didn’t apply it correctly.

Dr. Justin Marchegiani:  Exactly. That makes so much sense. And I have so many patients that we even go grain-free but there’s one element because you talk about the pain in your—in your book, all about pain. I find some patients have to really cut out some of the nightshades, the tomatoes, the potatoes, the eggplants, peppers, and we know there’s a high amount of alpha-solanine and glycoalkaloids that can be very irritating to the joints and cause pain. Can you touch more upon the nightshade piece and pain?

Dr. Peter Osborne:  Yeah, so—I mean, nightshades, in and of themselves, especially for rheumatic-arthritic conditions, we see these more. So like a person with a thyroid condition, we might not see nightshades be as much of a problem, but if somebody is really suffering with joint pain, these compounds in nightshades really have a great tendency. If there’s an intestinal leakage or a leaky gut or a permeability, they have a tendency to travel to the joints and really create a lot of the irritation and breakdown. So this is one food group that really needs to be looked at with aggression at removing and—and I see it in—very chronically and a lot of patients have to remove it indefinitely meaning that it’s not like a, you know, remove it for the next six months and then bring it back in. It’s a remove it because for you, as a unique person, as a unique genetic biochemical individual, this group and this compound of foods it—it irritates your joints. It’s actually we could—we could actually look at nightshades with rheumatic pain and say they’re probably just as much of a problem as grains are and that we really wanna get them out of the diet. Potatoes, peppers, one of the nightshades that people tend to forget about is a goji berry.

Dr. Justin Marchegiani:  Ahh.

Dr. Peter Osborne:  I mean, we—you buy the goji berries in these, you know, you can buy, you go to Whole Foods or like Trader Joe’s and buy the bags and berries frozen to make smoothies and stuff like that, and a lot of times, goji berries are in these mixes. You gotta remember goji berry is a nightshade. Now one of the other nightshades that—that people tend to forget about because you don’t eat it is tobacco because you smoke it.

Dr. Justin Marchegiani:  Oh.

Dr. Peter Osborne:  And so let’s say that you live—and I just had a patient. She’s living in a home, her father smokes, she’s getting exposure to second-hand smoke, she’s got chronic rheumatic pain and what ends up having to happen is we gotta get this girl out of this place and into her own place, so that—and she was an adult, so we—we were able to make that recommendation.  She was able to get out of there and basically was able to recover a little bit better. Now you will see a higher tendency of people who are smokers developing rheumatic-arthritic and that’s one of the reasons why. It’s that tobacco is a nightshade.

Dr. Justin Marchegiani:  Well, I just learned two new things. Goji berries and tobacco. That’s great. Good clinical call on that one. And what’s the mechanism of gluten actually driving the joint pain. We know we have the underlying leaky gut which can cause all these proteins, undigested proteins to kind of get into the bloodstream. We know the immune system and then maybe the potential molecular mimicry that’s happening where the immune response is calling out an APB for this type of protein and then other tissues kinda get in the way because they look similar. What else is happening just beyond that molecular mimicry mechanism?

Dr. Peter Osborne:  So, okay, you’ve got—you’ve got leaky gut, which like you just said, it allows all these things into the bloodstream that, you know, can travel to the joint, can travel to the muscles and that’s where the inflammation process is occurring. The immune response is occurring and so we’re getting secondary or collateral damage, right? Collateral damage to the tissue as a result of the immune system mounting a response. But one of the other things is just the direct inflammation, so gluten has been shown to cause a number of different pathways in the immune system. It’s been shown to activate a number of different ones. We generally tend when we’re measuring, clinically when we’re measuring to analyze to see where the person’s making antibodies, we measure antibodies to something called an antiendomysial antibodies. We will measure antigliadin antibodies. We’ll measure anti-tissue transglutaminase antibodies. But when we’re doing these measurements, we’re typically only measuring IgG which is one type of antibody or IgA. Now we make also IgM, okay? Which is an antibody that very rarely gets measured. So you’ve got also IgE which is an acute allergic response, and then you’ve T-cell responses and immune complex responses that are also potential pathways where people are reacting to gluten but then you have this whole other pathway that isn’t measurable at this point in time. We don’t have a commercial lab that measures this and this is the innate immune response. So antibody responses are called humoral immunity, it’s—it’s ada—what we call adaptive immunity where people get exposure and they create antibodies to what they’re getting exposure to to protect themselves, so that, you know, the example would be like a virus. You get—get exposed to a virus, your body responds by making these antibodies to protect you. But in the case of a virus, the virus comes, your body attacks it, and the virus goes away. It’s not like gluten where you—gluten comes, your body creates antibodies against it and gluten goes away, because if you keep eating the gluten, you continue to make the antibodies, you continue to battle it. You continue to create inflammation and collateral damage. But, so that’s humoral immunity. Then we have innate immunity. And innate immunity is the immune system you’re born with. Humoral immunity is the immune system you adapt with. So your body gets smart and basically takes the feedback from the environment and makes decisions. Whereas innate immunity is what you’re born with. And so there are specialized immune cells that look—they look at things and they just don’t like them and they’re gonna attack them. And so there’s not a way that we can clinically measure innate immune response specific to gluten or specific to grain. It doesn’t exist. There’s no technology out there at this point in time. Maybe they’ll happen in the next 10 years but as of right now, it doesn’t exist. And so that’s one of the other mechanisms of inflammation damage is an innate immune response. And so what we’ll see is we’ll see people with high levels of interferon gamma or tumor necrosis factor alpha, you know, these are other markers in the blood. You can measure that they’re high. They’re markers of inflammation but again, you—you can’t measure that they’re high because of gluten but—but you can—you can measure them and you can see that their high and then you can take gluten out of the diet and then you can measure them again and see that they come down. So—so does that make sense? So you have these generalized markers of inflammation that you can measure. You can get a baseline and then you can do a follow-up and you can say, “Okay, yeah, we changed your diet and these markers have come down.”  But there’s not a test that says your—your markers are high because of gluten. Because those markers can be high for other reasons, too, Justin. They can be high because you have a bacterial infection or a viral infection. They can be high over trauma, over an ankle sprain, or over liver damage. So there are other reasons why these—these inflammatory markers can be high. So it’s up to the clinician to kind of piece that together when he’s working with a patient. So–

Dr. Justin Marchegiani:  Yeah, totally agree with that.

Dr. Peter Osborne:  The other mechanism of damage that we see in—in rheumatic athritity, so in autoimmune arthritis is infection. So when that gut is leaky, we get bacteria that now get access and so some of the bacteria that are notorious for contributing to arthritic pains, Klebsiella and pseudomonas are two different species of bacteria. Another one is Lyme. Lyme is a very, very common cause and mimicker or rheumatoid arthritic symptoms. So you’ve got multiple forms of bacteria, so the other thing that’s important to rule out is infection. So you’ve got food that can cause leaky gut, then the bacteria leaks in, and it can get in—it can get in to the joints and start creating damage, so now you’ve got, you know, food started the problem but bacteria is finishing the problem, so if you just treat the bacteria but you don’t treat the leaky gut, then you still don’t win the war. So all of these things have to be looked at, because it—it’s the old scenario, which came first, the chicken or the egg?

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Peter Osborne:  It doesn’t matter. We can’t answer the question but we have to address the chicken and the egg if we’re gonna get the patient better.

Dr. Justin Marchegiani:  Also I think mycoplasma pneumonia is a—a big infection, too, for some of the joint stuff, do you see that, too?

Dr. Peter Osborne:  Yup, yup. It’s another one, Absolutely.

Dr. Justin Marchegiani:  And I also notice where there’s smoke, there’s fire. Could we have this systemic inflammation thing happening and pain may be the first indicator for people that have that genetic predisposition, but we also see autoimmune issues, maybe even type I diabetes or MS, so how many other—they call it PGAS or polyglandular autoimmune syndrome and they say, I think 78% of people that have one autoimmune condition, maybe it’s RA or some type of fibromyalgia pain, probably have another one, how much of the people—patients that you’re seeing individually in your office are having more than just the pain? There’s something else right next to it or beside it that’s happening.

Dr. Peter Osborne:  Well, pretty much all of them.

Dr. Justin Marchegiani:  Yeah.

Dr. Peter Osborne:  It’s very rare to see a—a singular autoimmune disease that just presents in solo fashion if you look. Now you know a lot of times, the patient’s symptoms, whatever predominating symptoms they have, those are the ones they bring to the doctor and then the doctor gives them a singular diagnosis. But I find if you’re thorough and ask enough questions, you find that these patients don’t have singular autoimmune conditions, and these can actually be measured, too. You can—there are a number of autoimmune tests that can be run if a person has—if a person doesn’t have a severe immune compromi—compromization, you can run tests that measure different autoimmune responses to different tissues, and you can actually find in many of these patients, 4, 5, 6 different autoimmune reactions going on in multiple tissues. It explains a lot of their other mysterious symptoms. It’s just a lot of times, doctors don’t dive in any deeper than just kind of, patient’s got joint pain, they go to the rheumatologist. They run rheumatoid factor and any nuclear antibodies as tests, and if those come back positive, they give them a diagnosis of lupus or RA or reactive arthritis, and that’s where it ends. You know? And then patient, you know, then they stay putting them on drugs and then you know, maybe that patient’s tired, too. Maybe that patient has other symptoms like chronic brain fog and fatigue, but they never get that piece put together, they never get—they never get tested for brain antibodies or neurological antibodies, so they never even know that that piece is part of their—is part of their underlying autoimmune complex problem. It just ends with the rheumatologist.

Dr. Justin Marchegiani:  Exactly. And then you just kinda talked about the—the dangerous medications that they’re putting a lot of the patients on. What really bothers me a ton is that the first line of therapy that they’re using actually perpetuates the problem even more because you have the NSAIDs which then are gonna create more of a leaky gut. It’s gonna lower glutathione levels, make it harder to detoxify the inflammation to begin with. Typically there’s gonna be gastrointestinal symptoms so they’re gonna be put on a proton pump inhibitor which will then decrease stomach acid which will make it harder to ionize minerals like selenium, calcium, magnesium, iron. They’ll get anemic. They’ll have low B12. That’s gonna create more fatigue, more leaky gut, more brain and mood issues because of the LPS that you mentioned, that lipopolysaccharide. So then now a couple years in, they’re on an antidepressant. They probably have low libido. They’re on a—a proton pump inhibitor. And then they’re on all these dangerous pain medications creating more, more issues decreasing detox. So it’s like conventional medicine is setting these people up for a world of hurt. Can you talk about the conventional approach that I outlined briefly and then your approach to get into the root?

Dr. Peter Osborne:  Yeah, so I actually I call this the protru—the prescription pain trap, because what ultimately happens with chronic pain is you get patients that are put on—they’re—they’re put initially some form of pain reduction medication, typically a nonsteroidal anti-inflammatory like an ibuprofen or a—or a Celebrex or a Mobic. You know, one of these—one of these classes of—of nonsteroidal anti-inflammatories that will—will erode the mucosal lining of the GI tract and induce a permeability within the gut itself and also induce ulceration within the GI tract. So it starts to affect their nutrition. Now once you start affecting nutrition and you start reducing their ability to absorb and digest, now it’s—it’s even harder for them to heal. So you’ve—you’ve kinda established this—this is why it’s called a trap, because you start with the medication and the medication does reduce the pain. It is effective at that, but it’s effective at keeping the person trapped in a state of always needing the medication and never being able to truly fully heal because of the damage to the GI tract. You’ll also induce vitamin and mineral deficiencies in this way—vitamin C and folate, and as you mentioned, glutathione. These are nutrients that get depleted and that’s just nonsteroidal anti-inflammatory drugs. But then we look at some of the other drugs that are used in these patients. The—the steroids, so the steroids themselves which inhibit calcium and magnesium and vitamin D. Vitamin D deficiency all by itself can cause an autoimmune condition. So for being put on a drug that causes a deficiency of vitamin D long-term and we’re being treated with an autoimmune condition. We’re just allowing again—we’re allowing vitamin D deficiency to never kind of recoup, and so one of vitamin D’s function is—is it regulates immune response. It regulates how strong immune cells respond to a threat. That’s why vitamin D deficiency can cause a hyperreactive immune system, and so again these steroid medications cause these nutrient deficiencies. They also cause bone loss and water retention and bloating and weight gain. So now you take this person who’s got pain and you’ve just given them a drug that causes them to gain weight and increase their chance of diabetes, and now they’ve got joint pain already, so you’ve increased the physical pressure on their joints because now they weigh more. So now that joint gets eroded and damaged, just having to carry more weight and so that extra weight now causes more erosion.  You see where it’s kind of a bleak scenario, isn’t it?

Dr. Justin Marchegiani:  Yeah.

Dr. Peter Osborne:  And the now we look at other drugs that sometimes get brought in and these drugs are basically severe immune-suppressants like Humira or Enbrel, and these things shut down immune system so now you—you start these medications and you’re on them 5-10 years, now you’re looking at a huge risk, increased risk for cancer and other kinds of infection. Well, we said earlier that infections play a big role, and the by-products of infection is lipopolysaccharides, play a big role in perpetual joint pain.  So it’s—it’s a futile effort in modern rheumatology. It is a futile effort to go that route and expect to get resolution. All you will do is—is fall into that trap. Now how do you get out of that trap? Because a lot of people will say “Well, I can’t get off my methotrexate, or I can’t get off my–”

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  “My steroid because it hurts so much.” Yes, you can. But it has to be done. It has to be done with scrutiny. It has to be done with intelligence and purpose. The first step is you gotta change your diet. Diet change, first and foremost, has to be implemented because a lot of the inflammation is stemming from the poor diet in the first place. The second step is part of changing the diet is increasing your Omega 3:Omega 6 ratio. You want—for somebody with chronic pain, you want a 2:1 at least Omega 3:Omega 6 ratio of fat–

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  In your diet. Now that’s really hard to achieve in modern diets today. Most people don’t live on the coast where they have access to fresh coldwater fish–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Peter Osborne:  Where they can get that quantity of Omega 3. So we’re gonna use concentrated EPA and DHA, you know, fish oils, so that we can drive that factor up. And I see working really, really well anywhere from 4 to 8 grams. So a lot of people stop shy of about 2 grams and they never really achieve a therapeutic dose of Omega 3 to switch that—that balance. So we’re looking at 4-6 grams potentially there. Other things that can be done naturally is the use of turmeric. It’s very, very–

Dr. Justin Marchegiani:  Uh-hmm.

Dr. Peter Osborne:  Effective at pain control and—and it can be—you can use turmeric to cook with, and so if you—if, you know, a lot of Indian recipes, this is where turmeric hails, a lot of our knowledge from turmeric actually comes from that culture but it’s being—been studied more and more and more. We know it has extremely powerful and potent anti-inflammatory and pain reductive properties so the use of turmeric and I recommend 3-4 grams of turmeric, concentrated turmeric, meaning it should be at least 90% or more concentrated curcurminoid. So it needs to be standardized to contain that, otherwise, you gotta use so much turmeric in your cooking, it’s really, really hard to achieve that level for pain reduction. So if we’re trying to get pharmacological pain reduction, we really gotta go high doses, we can’t go small doses.

Dr. Justin Marchegiani:  And only 15% of that’s absorb, too. I’ve—I’ve seen.

Dr. Peter Osborne:  Right, so you can use things like pepper, black pepper, or BioPerine to enhance absorption then there are also lipophilic forms of curcuminoids, meaning they’re—they’re fat-soluble forms, it get absorbed better than your traditional powder. So those are all things that if you’ve got a good functional medicine doctor to guide you, that—that ultimately is a—is a really smart thing to have. You know one other thing that works extremely well for kind of pain reduction in—in these people, who there’s a couple—I’ll talk about a couple more. One is a proteolytic enzyme. Proteolytic enzymes work extremely well at modulating pain and there are a number of good clinical brands that are out there. I actually have my own formulation called Matrizyme, but they—they work really, really well at pain reduction and inflammation control. You’ve got to get the dose high enough and then the other thing that I find that is very, very helpful is something called an SPM. It’s—SPM stands for specialized pro-resolving mediators and these are by-products of fish oil. So what these are is ultra-concentrated resolvents that are derived from EPA and DHA that have a tendency to shut off the inflammatory cascade when it’s overreactive and so this is—again this is one of those things it can be used, it’s—it’s clinical so you can use it clinically in high doses for several months as you’re trying to get a patient to wean off some of their pain medications and get them moving back in the right direction. So again, if we summarize: the diet’s gotta change, inflammatory foods have to go away, grains gotta come out, nightshades gotta come out, I recommend that dairy comes out, I recommend high levels of—of Omega 3 fatty foods as well as high levels 4-8 grams a day of Omega 3 fatty acids concentrated EPA and DHA, I recommend high levels of turmeric anywhere form 4—3 to 4 grams a day, concentrated curcuminoids at least 90%, I recommend proteolytic enzymes, and I recommend SPMs, specialized pro-resolving mediators, to help with all of these different things to wean that person out of that prescription pain trap.

Dr. Justin Marchegiani:  And you also use Gluten Shield as well, I think, you formulated that. It’s very high in dipeptidyl peptidase-4 to help with any cross-reactive gluten and you also use a lot of anti-inflammatory herbal blends. I think you use like your GI Soothe or your GI Restore, is that true, too?

Dr. Peter Osborne:  I do, yeah. We try to seal the gut, and—and so the difference is, Justin, as you know, when we’re doing a podcast together, we’re trying to give a general—general quantity of information to people. Ultimately what I recommend if somebody has an autoimmune arthritis or an autoimmune condition, really to work with a doctor like yourself or myself or another functional medicine expert who has these things at their disposal and discretion but also the ability to run highly specialized types of tests, because the testing and you know the—we’re do—we’re giving general advice and it’s good advice but highly specialized testing allows us to take the guesswork out, because for some patients—for some patients, it’s not a bacteria at all. It’s a yeast overgrowth and for some it’s not bacteria or yeast. For some patients, it’s that their reac—I had one young child terminal allergic to blueberries, right? And every morning, blueberry smoothie was breakfast, so—so this is the kind of specialization, you can do all these right general things and still be struggling to find an answer, and that’s why taking the guesswork out, you know, sometimes it’s the best thing that you could possibly do.

Dr. Justin Marchegiani:  That’s great. So in summary, get the food dialed in. Go get a good functional medicine doctor in your corner to get the—the right supplements, whether it’s getting rid of the infections, adding in digestive support whether it’s specific enzymes and hydrochloric acid, anti-inflammatory herbs to help reduce inflammation, anti-inflammatory fats and then healing-repairing nutrients. Is that a good summary to start?

Dr. Peter Osborne:  Yeah, it’s great. Perfect summary.

Dr. Justin Marchegiani:  Good, and then you touched upon the lab testing. You already talked about we have some of the immune testing, IgA, IgG, which is indirect—it’s not looking at things directly, and we know based on whether your weakened immune system, that may even come back a false-negative. You also talked about the conventional testing, looking at endomysial antibodies, transglutaminase, and then also your typical villous atrophy where we need like an 80% reduction in those microvilli in the small intestine to be even be able to pick up celiac which is one out of hundreds of manifestation of gluten-sensitivity, but your big thing is you’ve really gotten into the genetic testing and you’ve laid out the—the conventional HLA-DQ2 and HLA-DQ8 as being the—the celiac. But then you go deeper into the different subtypes, A1, B1, and then all the different subtypes there. Can you just kinda give us an overview with the HLA-DQ genetic typing? I know you do it on your site over at GlutenFreeSociety. We’ll put some links below the video so if anyone’s on the fence and doesn’t know if they have a sensitivity to gluten, they can get the—the tell-tale sign which is the genetic test. Can you go into that, Peter?

Dr. Peter Osborne:  Yeah, so as you—as you mentioned, a lot of these tests they detect late-stage disease. So you’ve gotta have 80% of your villi destroyed before biopsy comes back.

Dr. Justin Marchegiani:  Yup.

Dr. Peter Osborne:  I actually had a patient, you know, it—it was a 19-year trek for her. She literally had 19 biopsies. The 20th biopsy was positive. The first 19 were negative. And—and so I say it because a lot of people go to the GI doctor, they’re dependent upon this test to give them a definitive answer. And it’s not that you shouldn’t get a biopsy per se, it’s that, look if you get a biopsy and it’s negative and you suspect gluten, you shouldn’t rule gluten out just because the biopsy is negative. You get false-negatives with biopsies very frequently. One of the reason why is the damage has to be severe enough to identify, too.  The intestinal tract is 22-foot long and has a surface area of a tennis court. So when you do a biopsy, you take one little tiny cross-section, one little microscopic—it’s like taking a little tiny pebble off the tennis court and saying this pebble represents the entire tennis court and it doesn’t. And so you can’t rely on that information as definitive. You can rely on it if it’s positive. You can’t rely on it if it’s negative.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  What genetic testing does, HLA-DQ2—there are two genes, there’s HLA-DQ2, alpha 1 and HLA-DQ beta 1—these are immune genes and they’re job is—and they’re on Chromosome 6, their job is to produce an antenna that sits on the surface of the white blood cell, and the—the job of this antenna is to identify what is good versus what is bad. So if the body says, “Hey, we don’t like this.” That antenna says bad guy and then it—it captures it, presents it to the immune system and create some kind of inflammatory reaction. Okay? They’re a variety of different types of inflammatory reactions that can occur as a result of that. So there are certain pattern s on the HLA-DQ2 alpha 1 and beta 1 gene that are gluten-sensitive patterns, meaning if a person has these patterns, their body, their genetic receptor is gonna look at gluten as an enemy not as a friend. And so it doesn’t—so gene—what genetic testing tells us is that they’re going to look at gluten as a friend or an enemy. It doesn’t tell us whether they’re currently reacting to gluten, it tells us whether or not they would react to gluten and to me that is far more variable because you can take somebody who’s chronically, chronically sick, and run a genetic test and not worry about a false-negative, because a lot of these chronically sick people have immune suppression over time.  Their—their IgA levels plummet and—and they’re malnourished, so they don’t have enough protein to generate enough IgG to generate an IgG-positive response. So if we’re using these traditional labs, we have this high tendency towards false-neg—excuse me—false-negative.  Genetic testing doesn’t ever change. You either have the gene pattern for gluten-sensitivity or you don’t. And so again, what it tells us—it doesn’t tell us that it tells that you are reacting to gluten. It tells us that you will or you will not react to gluten. And these genes are activated by gluten exposure, so you know, a lot of people say, “Well, how do you turn these genes on?” Well, you eat gluten and these genes get mad and they activate the immune system and create an inflammatory response. So it allows us to actu—it actually and accurately identify people who should be taking gluten out of their diet and it’s a genetic issue. So gluten—we’ve defined gluten sensitivity as it’s not disease. It’s a state of genetics. If you have the gluten-sensitive gene pattern and you eat gluten, your body’s normal and natural response is gonna be to create inflammation. The more gluten exposure you get over time, the more inflammation you make. The more inflammation you make, the more you perpetuate disease processes and the more sick you become with time. So it’s—it allows us to say, “Look, you could be a little kid who doesn’t have any symptoms, but have gluten-sensitive genes, we can now say, ‘Look, get it out of your diet now, so that in 20 years, you’re not back at my clinic for me to treat your 3 or 4 different autoimmune and disease and 20 or 30 years’ worth of damage.’” We can—we can actually isolate and identify the people who need to get it out of their diet right now regardless of their illness and—and that to me is a much valuable, clinical tool than any other form of blood test because genetics don’t change. Blood tests can vary dramatically.

Dr. Justin Marchegiani:  And I know that the conventional celiac genes are 2 and 8, HLA-DQ2 and HLA-DQ8, which supposedly about 35-40% of the population has those, but when you look at the other HLA-DQ1, 2, and 3, and then 1 breaks down into 5 and 6, and the alpha 1 and beta 1, and 3 breaks down to the 7, 8, 9. According to, I think, Kenneth Fine, he says 90-95% of celiacs have a copy—have at least 1 copy of those genes. So we know it went from 35-40 to 90-95 and then we originally thought well, it was at 1 in 133 people were celiacs, so now we’re starting to see it’s getting the infinites is getting greater and greater and greater.

Dr. Peter Osborne:  Well, and part of that it has to do with—you know, I—I honestly believe that most people are gonna benefit from a gluten-free diet because most people have a degree of genetic gluten intolerance or gluten sensitivity. Nobody has done enough of broad scale genetic study to confirm that one way or the other, but you know, we’ve got data in our clinic that tends to—tends to go to that direction. But the other factor that you—you have to consider, it’s a—it’s a dose response issue, so the more gluten you eat, the more damage you create. So with some people who don’t eat as much, maybe don’t create as much damage and don’t get quite as sick, but so you’ve got that as an issue, but then you also have certain medications that enhance–

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  The way we would react to gluten, and so these are what would—and Dr. Fasano refers to these as—as the trick. He says what happens is there’s a trick. There’s basically an event that occurs and then your body starts reacting to the gluten more aggressively to the point where you could identify it almost immediately. Those tricks per se are things like chronic non-steroidal anti-inflammatory use, chronic Nexium or Prilosec or Zantac or you know, antacid–

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  Medication use. Chronic antibiotic use, right? Chronic intake of chlorine because you’re drinking chlorinated water which disrupts gut bacteria.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  You know, these are the tricks per se that we now we have an environment—a modern environment that has—we have all these elements that damage our gut and make it more susceptible. So we may already have genetic susceptibility but now you add all these other factors and it accelerates the damage that’s being done to the GI tract so that we’re getting more leaky gut. We’re getting more of these chemicals and bacteria and other things that are leaking through. So we have a modern environment that accelerates the damage that gluten can cause, because that’s one of the big questions I get, what—you know, go—go back in time 50 years ago, why weren’t people quite as reactive? Well, 50 years ago, you didn’t have antibiotics in the major cities’ drinking water on accident, right? Fifty years ago, doctors weren’t just hammering everybody with the antibiotic. You know, you didn’t have ear infections in kids and every other week, the kid’s getting put on a new antibiotics. You didn’t have mother delivering vaginal—or cesarean babies where kids don’t get normal bacterial flora from the vaginal canal when they’re being born. They get nosocomial disease-causing bacteria as the first bacteria that colonize our GI tract. So we have all these other factors that are going on today that enhance gluten sensitivity and make it happen earlier in life, and I think that’s the trend that we’re seeing. But then you also add, Justin, you add to the compo—all that component, you add to the fact that grain is processed with heavy quantities of glyphosate.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  Atrazine is another pesticide that’s used. So these grains are soaked in pesticide. These grains are stored in large bins where they have this tendency to grow heavy quantities of mold which produce mycotoxins.

Dr. Justin Marchegiani:  Exactly.

Dr. Peter Osborne:  Okay, and then you also have the fact that grain in and of itself, some of the—some of the grains have been hybridized so that genetically they’re more complex and harder to digest. Some of them have been genetically manipulated and so they actually produce their own chemical toxins and so when we eat them, we’re eating a lot of that. So you’ve got all these different factors that play a role in why we’re seeing people respond so well to going grain-free. That’s why that—that’s why the gluten-free diet trend is there. And if you look at historically at how this is all played out, it really started with Dr. Atkins. You know, he—he challenged the original conventional wisdom and said, “Look, quit eating carbohydrate and he—what he was onto is he was on—I think he was on to two very important things. One, he was onto the burden of—of too much excessive sugar in the diet creates a problem, causes sticky blood and—and damaged blood and it—it causes brain damage and brain fog, and it disrupts mitochondrial function and a number of other things, but I think the other piece that he really stumbled on and—and maybe he was aware of it, maybe not—I never—I never had the chance to talk to him, so I can’t say one way or the other. But I couldn’t detect that he—that he was onto this by reading any of his—his books, is that gluten in and of itself was in all these carbohydrates that people were eating as staple foods, and so just eliminating those two factors, eliminating excessive carbohydrates but also eliminating grain and—and glutens, people were dramatically improving their health and so today we have evolutions of that. We’ve got the gluten-free diet. We’ve got ketogenic diets. We’ve got Paleo diets. All kind of evolutionary diets that have moved in—into a—and they all have the same thing in common, right? And that’s grain-free for the most part.  Let’s get the grain out of the diet and I think that’s why we see that as all those different reasons that we just talked about again. That’s why I wrote No Grain, No Pain. It’s not another gluten-free diet book. So those of you who are out there listening, it’s like you’re tired of hearing about gluten. It’s not another gluten-free diet book. If you really wanna understand this topic and you really wanna be able to apply it to your life intelligently so that you can restore your health, you gotta understand that this book is so much deeper than just a gluten-free diet.

Dr. Justin Marchegiani:  That’s great. So if anyone’s on the fence about whether or not getting grains or out, you know, are a good thing for you? Definitely get it out, but if you need more, the genetic testing’s gonna be great especially the one that Peter’s talking about because it looks at that alpha 1, beta 1 subtype and we’ll put a link in the podcast and the video description below so people can access it. Now in your testing, you also talk about HLA-DQ4 being the only genotype that technically isn’t a gluten sensitivity genotype but even if you have that, you may still have problems with gluten. Can you talk about that for a second?

Dr. Peter Osborne:  Well, it would—it wouldn’t necessarily be that you had problems with gluten per se as much as it might—is it might be that you have problems with—with grain because of all the unhealthy other factors.

Dr. Justin Marchegiani:  All the things you mentioned.

Dr. Peter Osborne:  Right. Well, here’s the—here’s another thing. This has been around for a number of years, but it’s really starting to come to head. There are several new classes of proteins found in grain.

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  That are non-glutens, and one of them is—is called ATI, amylase trypsin inhibitors. These are proteins that shut off your pancreas. So here we’re—we’re saying, we’re shutting off your pancreas, then—then we’re shutting off the digestive function of your pancreas so that when you eat these grains, they’re not being digested because the grain’s goal—it’s a seed, right? It wasn’t to come out. It—it doesn’t wanna be your food. It wants to come out of your butt with poop around it because that’s fertilizer so it can grow.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  So it has developed mechanisms to protect itself from predators and one is to prevent digestion. So this—this family of proteins called ATIs have been shown to shut down pancreatic function. But they’ve also been shown to acti—activate something in the GI tract called the toll-like receptor.  And one of the things that happen when you activate this toll-like receptors is you get an anti-inflammatory pathway or an inflammatory cascade going, and so this ATI has not only created a gastrointestinal inflammation but they also created pancreatic shutdown and these have nothing to do with gluten. So if we’re talking just specifically HLA-DQ testing is—is gonna identify gluten sensitivity where-as grain may be unhealthy for other reasons and I just want—I want the—I want the audience to understand that, and ATI is one of those reasons. I actually—I wrote there’s 5 different—part of the book is I wrote, there’s 5 different classes of new proteins that have been discovered in grains. They’re inherent to protect the grain, and—and so part of their job in protecting the grain is to defend it from us and our ability to digest it and our ability to process it. So you wanna understand that those are part of the problem of grains beyond gluten. Pesticides are part of the problem. Molds and mycotoxins are part of the problem. None of these things have anything to do with gluten.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  And that heavy metals like cadmium and arsenic are part of this problem because especially rice, rice contains high quantities of these. And then you have what Atkins and so many others have discovered is that grains are super high sugar producers.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  You know? So we’re gonna get, you know, the amylopectin which is one of the—one of the elements to grain that causes elevations in blood sugar worse than sugar does. So you’re gonna get carbohydrate load that’s going to induce a diabetic state. So you’ve got all these different reasons. We could—we could say, “Look, regardless of your gluten status, maybe you are HLA-DQ4, but do you really want to eat this grain as a primary staple food in your diet because all of these other things are gonna wreck your health, too.”

Dr. Justin Marchegiani:  Totally agree. I got a study here form the Journal of Experimental Medicine that says more over ATIs, that’s the trypsin inhibitors you just mentioned, may fuel inflammation and immune reactions in—in other intestinal and non-intestinal immune disorders. So this is right out there in the literature, everyone. So what we’re talking about really is—is deep and hardcore science.  It’s just most conventional doctors haven’t really got into it yet.

Dr. Peter Osborne:  And that’s the sad part, Justin, is like—look, you know, one of biggest criticisms I take on, you know, and I’m—I’m definitely a leader, a thought leader in this field, I—I know that to be the—the truth, and I don’t say that, I’m not tooting my own horn, but I take on this criticism because I’m a chiropractor, you know, and I’ve got other degrees and diplomas, but my heart is in chiropractic as well, and that because I’m not a medical doctor, so many people say, “Oh, he’s a quack. He doesn’t know what he’s talking about.” But the reality is, I didn’t create any of this information like out of a whim or even out of clinical experience. This information comes directly from the medical literature. The problem is most doctors don’t read their own literature.

Dr. Justin Marchegiani:  Nope.

Dr. Peter Osborne:  I happen to read an extra 15 to 20 hours a week in my spare time so that I can keep up with this type of information because I feel like it’s my job. If I’m gonna help patients get better, I gotta understand the latest and the greatest and the newest and even the oldest and—and if more doctors took time to take that on and take their jobs more seriously, I think a lot of doctors just get into this, you know, this regular routine of just cranking patients through a mill and not really seeing patients, not really hearing patients, just kinda of—just kind of going through the motions with patients. I think that’s a travesty. That’s—that’s one of the hugest problems we face in the United States is that we’ve got doctors who have lost bedside manner, who’ve lost compassion, who are in it for the wrong reasons and I’m—and I’m not categorizing all doctors here. I know there’s a lot of great doctors, too. But look, I wouldn’t have a clinic with 5-month waiting list if those doctors they were out there, for most of the GI doctors that were out there, most of the specialists that were out there, if they actually look the moments and the time to read the literature and to—to apply the literature with their existing patients, I would be out of job. But the fact of the matter is, I’m not out of a job. I’m busier than I’ve ever been in my life because the experts who are supposed to be being the experts, who are supposed to be being the leaders and leading the field, are dropping the ball. So the chiropractor has to pick up the literature and he’s gotta read it and he’s gotta be able to apply it with his patients and he’s gotta be able to apply functional medicine, you know, and I—and I just say that because that—that is one of the things that makes me the maddest, it—it, you know, it’s frustrating to deal with every patient coming through the door who’s so frustrated because they’ve been to 8 to 9 or 10 different doctors who are supposed to be the leading experts. It’s so—so it’s an uphill battle, Justin, as you know, not only do we have to educate our patients, but we’ve got to overcome all the misinformation. And look, a lot of these doctors—I had a patient come in to see me last week, her child had hives—had had hives for years. They didn’t know why. So they were seeing a pediatrician. They were seeing an allergist. The kid had been taking allergy shots for 2 years and the doctor said, “Well, it’s gonna take about 5 years of allergy shots to really get it to clear up.” Now that’s ridiculous, to take 5 years of allergy shots–

Dr. Justin Marchegiani:  Oh, man.

Dr. Peter Osborne:  To clear up hives. We cleared them up in less than months. Now when this woman took her son back to the allergist, she took all the paper work and all lab testing that we did to this allergist and she said—she said, “Here, I just want you to know what we’re doing because he’s better and, you know, we—it’s not like I—I didn’t give you to get him better. We’ve been doing this for 2 years but I wanted to share this with you because I think that if you understand this, you might be able to help other patients.” And this doctor rolled his eyes at her.

Dr. Justin Marchegiani:  Unreal.

Dr. Peter Osborne:  It basically laughed at her and said, “Well, you know, if it’s working, keep doing it, but it isn’t really important,” and it’s like, “Shame on that doctor!” I could tell you something right now from patient who brought in information to me. If I had been treating a patient for 2 years and not been able to get them better, and they—and they came back and said, “Look, I visited another doctor and this is what we did.” And it got me better, you can bet your bottom dollar, I’m gonna be on a the phone with that doctor, as soon as that appointment is over, trying to figure out where he’s doing something that I’m not doing, how could I better improve my own skill set so that I could help more people, you know? But—but the attitude with a lot of these doctors is, look, if it’s not mainstream, it’s quackery, which is—which is BS. And—and if—if he’s a chiropractor, he doesn’t know very much and he’s not qualified which is also, as you know, BS. We have our background and education is—is so advanced compared to what people think that it is and anyway that’s—that’s a horse site, we don’t have time to get on but–

Dr. Justin Marchegiani:  Yeah.

Dr. Peter Osborne:  I just—I just had to say that because, you know, a lot of people that’s—that’s, you know, I would say, “Look, if you—if you doubt the information in this book just because I’m a chiropractor, shame on you.” It’s documented.

Dr. Justin Marchegiani:  Right.

Dr. Peter Osborne:  There are 33 pages of medical references. I didn’t create this science. I just interpreted, put it out there for the rest of the world in a manner that’s consistently easy to read so they can be applied. So get out there. If you’re struggling with autoimmunity and you’ve gone through convention and it hasn’t worked for you, you know, get your—get off your high horse and read the book and apply it, and watch miracles happen.

Dr. Justin Marchegiani:  That’s great. That’s great. And I think a lot of doctors—it—it’s not like this great grand conspiracy but I think a lot of people, a lot of doctors for instance, they are under the impression and most people are, too, that if I didn’t learn it in medical school, it’s not important, and everything in medical school is gonna be all I need to help my patients get better. And that’s I think the grand assumption that most doctors and most people that go the conventional route are under. And you’re really dispelling a lot of that in your book. And—and my last question before we give you a send off, as I heard someone on the podcast just recently talking about, well, you know, get—go gluten-free, cut it out, and then add a little bit back in, and if you don’t have a reaction or a symptom when you add a little bit back in, then you may be able to handle a little bit. So what’s your perspective on just relying off of symptoms and adding a little bit of gluten back in? Is that the best way to do it or should we look deeper?

Dr. Peter Osborne:  Symptomatic response, it’s like saying, don’t exercise tomorrow and if you don’t feel diabetic symptoms tomorrow–

Dr. Justin Marchegiani:  Beautiful.

Dr. Peter Osborne:  That—that, you know what I’m saying? It’s—it’s–

Dr. Justin Marchegiani:  Yeah.

Dr. Peter Osborne:  It’s a ridiculous statement.

Dr. Justin Marchegiani:  It is.

Dr. Justin Marchegiani:  I don’t know who said that, but shame on them.  Shame on that person. Gluten sensitivity is a very, very serious issue, and if you’re truly gluten-sensitive, you shouldn’t be introducing it back in. So I—I would say, you know, there’s no safe amount of gluten. There’s, you know, not if you’re gluten-sensitive, in fact and as a matter fact, research shows it’s 20 parts per million, which is equivalent to a drop of water to a gallon of water, that—that amount of gluten exposure can create an inflammatory response for up to 2 months.

Dr. Justin Marchegiani:  Wow.

Dr. Peter Osborne:  So you know, absolutely don’t reintroduce it and try and see if you tolerate it, because what’ll happen is you go gluten-free for 6-8 months, you’re gonna feel dramatically better. Most people do, and when you feel better and your body is now healing, it’s gonna be more adaptive, it’s gonna be more resilient, it’s going to have a greater reserve to combat, you know–

Dr. Justin Marchegiani:  Perfect.

Dr. Peter Osborne:  Environmental problems. It’s part of what we’re after with wellness, is to have good adaptability to the environment without becoming sick, you know? So—so to say, okay, take the gluten out and then start reintroducing it, it’s like saying, okay, take the sugar out and when the diabetes clears up and the blood sugar normalizes, start eating sugar in again, what’ll happen is eventually you’ll start developing diabetes again, so it’s—it’s a ludicrous statement.

Dr. Justin Marchegiani:  Totally agree. And I wanna push everyone to head over to GlutenFreeSociety.org. This is where I got my foundational information about gluten and even being a physician, there’s tons of great info and if even if you’re a layperson just getting into a it, there’s still a ton of great info to kinda get your feet wet and even go beyond that with some of the clinical stuff. So I wanna push everyone to go to GlutenFreeSociety.org. We’ll have some links for the specific lab testing as well. Also head over to DrPeterOsborne.com. Peter’s got his awesome 7 Highly Effective Habits for a Gluten-Free Warrior. Lots of great information there. Anything else Peter that you wanted to kind of leave the listeners with? And then also I’m gonna go purchase my—my copy of your book here, No Grain, No Pain right now and I wanna urge everyone to get their copy as well. Let’s push it on to the New York Times’ List. I know you’re almost right at the 10,000 mark for sales and we’re gonna push it way above it and get you on there so we can get more exposure to people that need access to this information.

Dr. Peter Osborne:  I—I would say I’d leave with your audience, you know, if—if you’re suffering and—and you don’t know why and you’ve gone through convention and it hasn’t worked for you, you don’t’ have anything to lose. Try phase 1 and phase 2, it’s a 30-day plan.  Try it out. Take it for a test spin. You have nothing to lose. You have everything to gain. I would say to any of your listening audience, if you’re a healthcare practitioners or clinicians, and you really wanna get this dialed in and get this information, because part of my goal is to help people get better and part of that is helping physicians, I’ve created a 10-hour post-Graduate course for physicians. If you go to GlutenFreeSociety, there’s a tab that says GF Doctors, click on that and you can learn more about that. Take the course because the information you’ll learn from it, that knowledge you’ll get from it will allow you to help more people get better.

Dr. Justin Marchegiani:  Love it, awesome! Great information and last simple question I ask it to everyone—I almost missed it with you—if you were stuck on a desert island, what supplement or herb would you bring with you or one supplement?

Dr. Peter Osborne:  I—you know, what? I think if I were stuck on a desert island, I would probably take my high-quality multivitamin.

Dr. Justin Marchegiani:  Mmm.

Dr. Peter Osborne:  Simply because I want a diverse amount of vitamins and minerals in me and if I’m gonna be foodless or missing certain foods that are gonna be devoid or certain nutrients, I want as much of a variety to prevent major malnourishment diseases like beriberi, pellagra, or scurvy.

Dr. Justin Marchegiani:  Very common sense answer. I appreciate it, Peter. We’re gonna do a video basically summarizing all of the key points with all of the links on the video. Thank you so much, Peter. We really appreciate your time.

Dr. Peter Osborne:  Hey, Justin. Thanks for having me and have a great afternoon.

Dr. Justin Marchegiani:  You, too. Bye.

 

 

Fine tuning your diet for your body type – Podcast #87

Dr. Justin Marchegiani and Evan Brand dig in deeper into calories today where they talk about calorie consumption and some diet stuff. They discuss about the different diets like the Keto and whether to go low carb or high carb. Find out what cutting carbohydrates really does and how your body type should be considered when going on a diet. 

body_types_menLearn about the mechanism of insulin resistance and inflammation and how that affects your body. Discover the various approaches when it comes to choosing a particular diet. Listen to this podcast to know when exactly counting calories does matter and also how you can do an intermittent fast easily. Get the actions steps and a very concise summary on fine tuning your diet in this interview.

In this episode, topics include:

02:44   Calories and the diet piece

7:07   Carbohydrates

13:21   Body types

20:00   Adrenal issues and diet

31:03   Counting calories

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Dr. Justin Marchegiani:  Evan Brand, what is up? It is Friday.

Evan Brand:  Yes, sir! Ready to dig into a topic that I’ve had this discussion all week, and now I’m gonna have this discussion again about counting things and how it’s a waste of time, so I’m excited about it.

Dr. Justin Marchegiani:  Me, too. Me, too. And a couple of things I wanted to chat about—we were gonna talk about calories today, calorie consumption and some diet stuff. Also man, this new Apple thing came out—the iOS update, I think it’s called Shift or Shift Work. It’s a new app that knocks out the blue light.

Evan Brand:  I saw—yeah, I saw–

Dr. Justin Marchegiani:  Night Shift.

Evan Brand:  An article. Yeah.

Dr. Justin Marchegiani:  Night Shift. It’s phenomenal.

Evan Brand:  So I saw an—I saw an article about it that says that it’s garbage though and that someone tested—I don’t know how they used it, if it was an imaging device or what they did to find it or figure it out, but that it’s not actually reducing the spectrums of blue that you need to reduce.  It looks like it does but they say it’s actually not, and they’re still saying, you know, and F.lux and the blue blocker glasses are still superior to it. I don’t have an iPhone. I have Android, so I’m not sure.

Dr. Justin Marchegiani:  Right. Yeah, I mean if you look at it, there’s some customization on it so you can—you can kind of like tweak and have it do more blue light but I mean it looks, like if you, you know, compare it like your laptop screen when you have F.lux on to this, it—it looks pretty similar so.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  The nice thing about Apple is they’ll probably just keep on tweaking it to make it better over time.

Evan Brand:  Well, I think the–

Dr. Justin Marchegiani:   But I like it.

Evan Brand:   The—well, that is a cool thing to hit on the bigger picture is that this stuff has actually entered the mainstream. I mean Apple is a huge company and so for them to have the thought of “Hey, we need to help people block blue light at nighttime,” that’s pretty amazing.

Dr. Justin Marchegiani:  Exactly. I think it’s great and I notice the difference on my eyes.  Could it be better? Maybe, but it’s something that we can at least be using and it’s gonna be better than not.

Evan Brand:  Yup, I use Twilight on my Android.  So anybody has Android, Twilight’s the app I use from the Playstore and you’re able to tweak the intensity where you can basically turn your screen almost full red and remove all the blue and white and colors and then you can also change the brightness of the screen, too.  So definitely–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  If you’re breaking the rules and using your phone at nighttime, then that’s what you wanna do.

Dr. Justin Marchegiani:   Yeah, same with mine, too. You can do like more warm or less warm for color temperature and you can almost make it kinda just showing you on the screen now like pretty red—I think it looks really red.  So there’s less blue light there.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:   So it’s kinda cool.  So I like that we’re working on our circadian rhythms here today a bit and I know you’ve written a book on sleep so everyone should go to your site,  NotJustPaleo.com, and check out your book on sleep.

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:   Cool. Well, we talked earlier about—chatting about calories today. Many people are hyped up and—and focused on calories. We’ve done previous podcasts or I did.  I think my first podcast ever like 2 years ago was on calories. So let’s kinda revisit this topic and give it a Dr. J-Evan spin to it. What do you think?

Evan Brand:  Definitely, yeah. So I mean, calories—that’s definitely one thing that people are counting. Carbs, I think are another that people are counting that they really don’t have to especially people doing maybe a Keto style diet or a cyclical carb diet. I don’t have to call out these people. They know who they are, creating diets where they’re keeping people at 30g of carbs or less, assuming that they’re just gonna be able to adapt to it if they have adrenal stress. I personally don’t think that it’s a good idea, so I’m curious to hear what your experience is, too, with patients that if they’re wrecked adrenally, I mean, we can’t just throw them into a keto plan successfully, can we?

Dr. Justin Marchegiani:  So regarding with diet piece—so ketosis, there’s like nutritional ketosis where you’re cutting your carbs down significantly where you’re starting to rely on ketones, these fatty acid esters for fuel. Now for a lot of people who are insulin-resistant, this is actually a great thing, because when you’re insulin-resistant, your cells are numb to insulin, that means it’s very difficult to utilize fats for fuel. So imagine the see-saw, right? As insulin levels go up, your body wants to be a sugar burner, okay? So it’s actually gonna rely more on sugar for burning for fuel while at the same thing though, when you burn sugar for fuel, high levels of insulin also make your tired. So it’s this conundrum, right? As insulin goes up, you get more tired, and you rely more on sugar for fuel.  And if that sugar is not being burned because of that high level of insulin, it’s escorting things into your cell to be stored as fat. High levels of insulin make you tired, so when people eat certain foods that dry up insulin, you have less energy a lot of times. When you have less energy, you’re more likely to not use that energy for activity, so then it goes into fat and it can be stored as fat and actually make you fatter.  That’s why insulin and fat is a strong, strong connection with it. So kinda moving on with my story here, when there’s insulin resistance, going lower carbohydrate and even ketogenic for some people can be a game changer, because you’re sensitizing those receptor sites to insulin so now insulin works better meaning they’re no longer numb because you’re not pouring a whole bunch of insulin on to the receptor site. So it’s kinda like ringing your neighbor’s doorbell if you wanna go to see your neighbor and have a conversation with them, you ring the doorbell, they open up the door, and you guys chat. But if you and you ring in the doorbell every day, and like maybe you’re playing ding dong ditch like when you were a kid, they’re just gonna say, “I’m not opening up the door.” And the same thing happens—the same thing happens with sugar and all that sugar stays in the bloodstream instead of going in the cell and eventually gets stored as fat.

Evan Brand:  So let me ask you this then.  So let’s say we take someone that is pretty insulin-resistant. People say, “Well, how do you know if I’m insulin-resistant?” Just look in the mirror.  If you have some excess weight, we can assume that you have some level of insulin resistance. Now if we take them and we say, we throw them on a ketogenic or a super low carb diet for a while, is that someone that you would keep in place? Would you keep that person at that ultra-low carb or are you gonna do it the sort of jumpstart the spark plugs if you will to increase the sensitivity like you mentioned and then maybe you’ll add more back in? Because for me, I find that when people go super low and then let’s say we investigate their adrenals and their adrenals are real low as well, they start to feel like crap and they honestly kinda tank out and then they feel almost even more tired on that super low carb diet. So I usually tell people to add in, you know, the sweet potato or the rice or something to fuel them back up.

Dr. Justin Marchegiani:  Yeah, that’s a great point. So a lot of times when people go low carbohydrate, a couple of things happen to derail them, okay? And we’re talking about calories, right? Calories are attached to nutrients and your body really runs off of nutrients not off of calories. What I mean is you could just give plain white sugar that has no nutrients in it and you know, you’d probably develop lots of malnutrition and disease, scurvy, beriberi, because you have plenty of calories but you have no nutrients. So when we talk about calories, we’re really inferring nutrient-dense calories. So that’s kind of the assumption we’re moving forward on. So regarding the carbohydrate piece, when people start cutting the carbs, a couple of things happen. A lot times they’re already carboholic so when they are changing their diet, now 50-60% of their calories, if we’re talking the food pyramid, now magically go away.  Now the question is, do they replace those calories with other high nutrient-dense foods that aren’t of the super high carbohydrate variety?  And that’s the question. So a lot of people that start going low carb, they actually start cutting their calories by accident, and many will even start going lower fat by accident, too. So if we do go lower carb, meaning we cut out calories—our carb calories to about 10%, we have to make sure we have adequate amount of high quality fat to create satiation and to replace the calories that we’re missing from the carbs.

Evan Brand:  So basically, there’s never gonna be a cookie cutter program for people because depending on your activity level, like me, I mean, maybe I could. Right now I don’t go ketogenic because I don’t feel as well, even though I’ve stuck for it for several weeks, I don’t feel as well especially with my activity level, hiking and biking and long boarding and working out in the gym, I don’t feel as well. So maybe I’m—just didn’t want a long—long enough until I was adapted but for me, it just—it hasn’t worked 100% yet.

Dr. Justin Marchegiani:  And I think it also depends how you’re measuring it. How are you measuring your ketones back then?

Evan Brand:  I was using the breath, the Ketonix. I would always have, I think it was the yellow maybe on the Ketonix breath meter. It was like a light ketones. It wasn’t like a lot. It was just a tiny piece, so maybe that–

Dr. Justin Marchegiani:  There you go.  That—that could be enough for you. Now typically Jimmy Moore, he’s—I’m a big fan of Jimmy. I’m friends with him, too, personally. I spoke at his low carb cruise last year. He talks about being around 1, I think the—is the 1 millimoles and that’s on the Abbot meter. It’s on the Abbot one. I think it’s the—it’ll come to me. I have it on my desk here on the corner. I’ll dig it up–

Evan Brand:  Is that blood?

Dr. Justin Marchegiani:   That measures—yeah, it’s a blood—it’s a blood one. Yeah.

Evan Brand:  Oh.

Dr. Justin Marchegiani:  So he likes it around 1 millimoles, that’s a pretty good place to be. Now even if you’re a little bit less, that can be a big—that can still be helpful and people are increasing ketone esters just in their diet therapeutically whether they’re taking caprilic acid or MCT oil because of the benefits that it has cognitively on increasing brain function and also on reducing cancer because ketones don’t really fuel cancer. So anyone that has any cancer issues or history or past, or ones that prevent getting extra ketones in there is a great way to fuel the body and not have it fuel any cancer cells. So when we go back, looking at carbohydrate, my default always is a low carbohydrate diet, okay? I have a very non-dogmatic approach, very like macronutrient agnostic when it comes to diet, but I default to, where I’m a little dogmatic on—and I shouldn’t say dogmatic—it’s just what I—what we see out there is most people are insulin-resistant and overweight, right?  The research kinda says what, 60-80% of people are overweight. So we know if they’re overweight, part of what’s driving that metabolically is the mechanism of insulin resistance and inflammation. So if we know insulin resistance and inflammation’s part of that underlying mechanism, doesn’t it make sense to cut out the foods that are driving inflammation and cut out the foods that are driving insulin secretion, right? Does that make sense?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Okay, so we’re on the same page here. So if we can cut out the foods that are driving extra insulin secretion and cut out the foods that are driving inflammation, right? Omega 6 fatty acids like from refined vegetable oils, grains, processed grains, processed sugar.  We can even look at autoimmune foods that are higher in lectins and glycoalkaloids and things like that that could be more inflammatory. If we can do that, now we get people back to baseline and then from there, we can figure out where people feel better. So I tell patients, imagine you got three knobs in front of you.  You have the protein, the carbs, and the fat knob, right? These are your three major macronutrients, and again the assumption already is—I don’t want any—any comments on this afterwards—well, you gotta be organic, of course.  We’re—you’re assuming organic, pasture-fed, high quality, no antibiotics, you know, no hormones, we’re assuming the highest quality with all these macronutrients. You get these three levers now and we can move these levers up and down, back and forth according to how you feel. So my default position for these levers is gonna be lower carbohydrate, probably closer to 50g of carbohydrates. Now if you’re just doing your carbs and you’re just doing non-starchy vegetables, you’ll be somewhere around 20-30g of carbohydrates if your only carbs are non-starchy veggies like broccoli, spinach, kale, asparagus, as long as you’re getting enough protein and fat.  If you’re doing—getting enough fat, 50-60% fat, maybe 15-25% protein, you’ll be somewhere around 20-30g of carbohydrate if you’re just doing veggies for the most part, okay? Now from there we can dial up some starchy veggies, some safe starches to start. And then we can always dial up a little bit of low glycemic fruit, but we start there and then we can move these levers back and forth, and we can see how do you feel, how do you look, how do you perform and if you’re having this adrenal fatigue stuff like you’re mentioning then we definitely can adjust that according to how you feel.

Evan Brand:  Yup.  See?  So that’s—I knew that was the conclusion that we would eventually circle back to, is that it’s gonna be a spectrum. I can’t tell you how tough it is to convey that to people because we’re always having this lens of almost like biodiversity.  You know, everything, everyone’s different—individuality if you will.  And a lot of people, they want something super concrete, just write it out for me, show me the pie graph of exactly what I need, but that’s gonna—that’s gonna depend and so I know sometimes that’s not the answer that people want to hear, you know, which that was kind of a long answer you gave which basically says everyone’s different and we’re gonna have to look at your hormones, we’re gonna have to look at how you feel, how you’re performing in the gym and then we’re going to adjust accordingly but generally speaking, yeah, lower carb is getting. I probably eat 100g of carbs if not more, maybe even 150g and I feel good that way. So it’s just gonna depend. That’s—that’s the long answer made short.

Dr. Justin Marchegiani:  Yeah, and there’s a couple of things we can look at, too. What’s your body type? Are you an ectomorph, an endomorph or a mesomorph?

Evan Brand:  I’m a complete ecto.

Dr. Justin Marchegiani:  Yeah, ecto are gonna be the leaner, skinnier people, just super hard to even put on muscle, right? They are a hard gainer for muscle but it’s also hard for them to gain fat as well. So these are like the basketball players. People that are—are leaner, a little more lankier. Then you have the mesomorph that are kinda in between. It’s hard for them—they can kinda gain a little bit of gain, but they can also kind of gain a little bit of muscle. They’re kinda like a hybrid. These are like your NFL kinda linebacker people. I’m kind of closer to a meso. I can put on muscle pretty good. But it’s a little bit harder for me to gain weight, but I am still carb-sensitive. So meaning I can’t do too much carbs, so I keep my carbs in that 50-100g level, because I feel good there. Alright, and then you have the endomorph. These are the people that just—they gain weight very easily. Alright, they’re more carb-sensitive, even more than me where they just a little bit higher carbs and they’ll put on weight. These are people that are just thicker. These are like obviously the people that are gonna be your NFL linemen, like that’s the one extreme, right? But then you have people on—in everyday life, they’re kinda like that. So off the bat, if you are an ectomorph and you have metabolic issues, you’re gonna probably be one of these people that goes down to a lower carb diet, gets their stuff straight, get their body more keto adapted and then gradually shift out of it, and find out where their carbohydrates are best. So kinda looking at the Paleo world, this would be someone like a Chris Kresser or a like a Paul Jaminet. People that are like, “Oh, yeah, you know, going too low carb is bad, so we gotta up the carbs a bit,” and you get people that project their own bias because that’s how they feel.

Evan Brand:  Right.

Dr. Justin Marchegiani:  That’s how they perform. So you gotta look at people who are espousing these things. Say, okay what kind of body type do they have? Look at Chris Kresser. He’s a pretty lean, lanky guy, right? Paul Jaminet. These people are espousing 100-150g of carbohydrate a day. They’re talking about glucose being essential nutrient and safe starches and that’s the reason why. So you gotta know what they’re talking about. Number two, you got the endomorph. This would be like a Jimmy Moore. Jimmy Moore has gained a lot of weight in the pre—in the past and he lost 180-190 pounds going on an—an Atkins type of diet. Now the issue with Jimmy is he started gaining weight recently but people say, “Well, you’re gaining weight. This low carb thing doesn’t work,” and here’s the problem. When you’ve gotten to over 400 pounds, you created metabolic damage. Your metabolism is damaged so the ability for your body to be able to stay lean is gonna be harder. So the question is, if you weren’t on that lower carbohydrate diet, how much more would you weigh? So the questions isn’t is it causing it? Is it—the question is, if you weren’t doing that, how much more would be than what you are now?

Evan Brand:  Right.

Dr. Justin Marchegiani:  Makes sense?

Evan Brand:  Oh, yeah. That makes sense. And yeah, so to clarify in the beginning I was saying, “Yeah, don’t count. Don’t count.” And here we are throwing out numbers. But just to clarify, I do not anything. I don’t weight anything. I don’t measure anything. I don’t look at nutrition facts and see how much is a half cup of rice in terms of carbs? Until the point now I don’t think about it.  I don’t worry about it. I just eat and if I feel good and I’ve kinda tuned in and I close my eyes and kinda meditate for a minute. I feel good. Okay, good. And if I don’t, then okay, what do I need to do? Maybe I need to up my fat a little bit. I’m gonna add some extra butter to this. Oh, maybe I need to add a little bit more broccoli or maybe I need some rice, or oh, maybe I need a sweet potato tonight. I tune in. So I don’t count anything. So we’re throwing the numbers out there just to help you. If you are in that kinda number phase but eventually I want every single person listening to put minimal RAM, you know, just like your computer, minimal resources of your brain—I want minimal resources to be dedicated to worrying and focusing on this stuff, because I want it to be something that just goes on the backburner and you just do it almost subconsciously it makes people neurotic. And I think it makes people sick when they’re just freaking out and their counting and weighing and measuring. It just gets—I think it’s a whole another type of eating disorder almost.

Dr. Justin Marchegiani:  Yeah, there’s a couple of different schools of thought, right? There’s like that that bodybuilder’s school of thought where you’re weighing everything and measuring everything, but then there’s kind of my—my approach is a little bit more practical when it comes to this stuff, is just have a good idea of what you’re eating. One, appetite is gonna almost always give you enough, within reason. We can talk about some of the exceptions here in a bit. Appetite will almost always give you enough. The key things where I think it’s helpful to look is if you are sick or if you were unhealthy, I try to get my patients to that lower carbohydrate level which is somewhere around 50 and it’s pretty simple. You’re just eating non-starchy vegetables, that’ll get you around 30 baseline. Now you don’t even have to count. Really simple, just take a couple of days, plug in all the vegetables that you’re eating, minus out the net carbs. You’ll probably be somewhere around 20-30. It’s just the way it is. It’s just how nature works. You’re not gonna be able to do too much more because you can only eat so many servings of broccoli a day before just the fiber alone fills you up and then if you’re eating enough fats along with that, because remember if you’re not eating carbs, you’re—that means you’re eating more protein and fat which are very satiating and filling. So you’re gonna be more full. So from there, then you can dial that up and add how much? Well, you can do a palm size of sweet potato. How many carbs is that? Probably around 15-25. So you can easily just eye things by saying, “Well, how many palms is it or how many fists is it?” So it’s not a neurotic thing, it’s just like, “Oh, yeah, I’m gonna have 2 fists of, you know, broccoli. I’m gonna have maybe a fist worth of grass-fed meat and I’m gonna put a half of avocado on there.” Now I can tell you off the bat that you probably got about 10g of carbohydrate in that meal. It’s probably about 40-50% fat, maybe about 15-20% protein. Because when we’re eating real foods, these ratios can’t get distorted that much. They’re kinda locked in unless you’re adding a whole bunch of starch or fruit or sugar or bread in there. If we’re eating real whole Paleo kind of template foods, you’re gonna be locked in to that ratio unless you’re dumping in a whole bunch of safe starches on there. So we have this ratio and then we can kinda taper it up and down by either adding in lots of safe starches and more fruit, or we can pull that out and do more veggies. The protein will kinda be the same, right around 15-25, and the fats will be the same unless we’re doing a whole bunch of protein powders and we’re doing a whole bunch of lean cuts of meat. So if we’re doing—if we’re avoiding the lean cuts of meat and we’re doing coconut oil and avocado and full fat, 76% grass-fed meat then the fat will be closer to 40 to 50% and then if we do Bulletproof coffee or add in extra butter or coconut oil on our veggies, then we can bump it up a little bit more into that keto platform.

Evan Brand:  Did you wanna talk for a couple of minutes about how or why you may adjust things if someone does have some adrenal issues?

Dr. Justin Marchegiani:   Yeah, so as we get people—so off the bat, right? We talked about the ectomorphs, those are people that are gonna do better with higher carbohydrate. If they have health issues to begin with, let’s dip back down to that lower carbohydrate place around 50 or so for a few weeks, and see how we feel and then we can gently push them back up, so now when we’re dialing that in, the question is, how do you feel? How’s your temperature? Is your temperature dropping to low 97s, up or 96s? How does your hair look? Do you have drier eyes? Do you have more fatigue during the day? Case in point, a patient last night, we started getting her on a lower carbohydrate diet. She has Hashimoto’s. We dropped the carbs down. She was doing good for a while. She was losing weight and then we hit a plateau and we said, “Okay, let’s take that carb lever and let’s just add one serving of sweet potatoes at night.”  She did it.  She felt a little better. Great! Let’s add one serving to lunch. We increased it a little bit, move that lever up and she feels even better.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And she’s sleeping better as well. So better sleep, better hair, less dry eyes, better mood, and the key to it is if we do too much carbs after a meal, guess what happens? Well, that post prandial blood glucose dip, because the blood sugar goes up from the carbs and then we have this reactive hypoglycemic drop. It’s kinda like in a tug of war, I pull and then you pull back harder, and that’s what happens with our pancreas and insulin and cortisol when we’re too carb-sensitive. Meaning we can’t tolerate too much carbs. We take too much in and boom—we get tired afterwards. So this girl, this patient did much better adding in carbohydrates even once to twice a day. So she did well. So we can take that meter and we can kinda, you know, dial it up, dial it down. It’s simple. You know, I’m just doing palm-sized servings, so it’s really easy. You can eye it—there’s not this kind of analness of like pulling out your scale like when I used to do when I was, you know, more of my bodybuilding days where I do that stuff, and now it’s just—you’re eyeing it. It’s really simple.

Evan Brand:  Yup, that was a good example.

Dr. Justin Marchegiani:  Yeah, you wanna make any comments on that?

Evan Brand:  Does she have adrenals issues as well on top of the Hashimoto’s?

Dr. Justin Marchegiani:  Yes, so this person does have adrenal issues and Hashimoto’s. So when we have adrenal issues, I’m a big fan of for the most part doing relatively no carbohydrates in the morning because that’s where cortisol’s the highest throughout the day. So we’re already mobilizing blood sugar at a more optimal rate because cortisol is a glucocorticosteroid, so it’s already mobilizing sugar in the morning. So why add more to it? So I try to just do veggies, or none in the morning and just do protein and fat, and I’m much more a fan of carb backloading.  Do more of your carbs at night because that’s where cortisol’s the lowest and there’s lots of studies that find people that just eat their carbs at night versus spreading them out throughout the day actually lose weight and do better metabolically.

Evan Brand:  Definitely, yeah. That’s exactly what I found, too. The morning getting people whether it’s some leftovers, you know, like sometimes I’ll do some leftover steak, maybe a little bit of broccoli or something in the morning just depending. If not, maybe some sausage. Some—I don’t do eggs. You know, some bacon, something like that, but just the good meats, good fats, some proteins in the morning.  You’re gonna feel the best. Some people may say they feel better if they do more carbs in the morning, like let’s say you’re getting a like, I don’t know, a gluten-free toast or something, you may feel better but it’s gonna be kind of an artificial better. And I find that you’re gonna crash by lunch or 10 or 11AM and you’re gonna be setting up yourself for more cravings and then you’re gonna be more driven to eat a more poor choice that’s gonna make you feel even worse at lunch and then you just get in this vicious cycle. So that’s why you and I both stick to just more fat and protein and then as the day goes on, slowly working in more carbs. I sleep better, too. I feel so good. Like I had some rice for dinner last night. We did steak. We did some rice and then we did some mixed vegetables with a bunch of butter on them and I slept so good and all—earlier this week, we were doing mostly just vegetables, not many carbs and potatoes or anything like that, my sleep wasn’t as good those days. Last night, I slept like a rock with the additional of that rice. So this stuff does work.

Dr. Justin Marchegiani:  That’s great. And I’ll put this awesome article on ecto, mesomorph, and endomorph from precisionnutrition.com. I don’t agree with some of their carbs. They do a lot of beans and rice and some grain stuff. Not a big fan of that. I much rather default to safer starches, plantains, yucca, sweet potato, squash. I had a nice little dish the other night where it was just grass-fed, some cut-up onions, and it was a hollowed out squash and we just put it in the squash and a little bit of coconut milk mixed in there and it was phenomenal, and you can get a little bit of carbs that way. So I try to because I’m—I have an autoimmune thyroid condition, I try to stay away from grains at all cost. Sometimes a white rice, like a white mochi rice that has the lowest amylase or amylose amount and that’s a starch that people do people do better on that, but if we have autoimmune I try to keep it to the safe starches.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Now a couple of things, so talked about who’s gonna do better on these types of diets. So the ectomorphs will probably do better with a little bit more carbs, probably 100-150, maybe more if they’re doing exercise. So look at your body. If you’re that longer, lanky, harder to gain weight but harder to gain muscle, you’re gonna be the ecto category. If you’re a meso, right? Mesomorph is gonna be someone in the middle, right? They can gain weight but they can also gain muscle. They’re kinda in between, then you gotta figure it out, maybe 50-100, maybe 100-150 on your more stressful days. And if you’re an endomorph, bigger, harder to—to lose weight, very easy to gain weight, then we want—wanna be a little bit more lower carbs. So look at your body types. We’ll attach a link in the post here so you can take a look at that. And then also lab work. So if you have a fasting insulin greater than 7, we probably have some insulin resistance and you probably want to go lower carb. There was a great study called the A to Z Study, and it was done by Christopher Gardner over at Stanford. And what Gardner did was he took these different diets, the Atkins diet, the Zone diet, the Ornish diet and the standard American diet. He put people in different groups and he found the Atkins group did the best overall with all markers, right? They lost weight, blood pressure, cholesterol improvements, which wrap your head around that—they’re eating more fat and cholesterol but their cholesterol improves—that’s  a podcast for different time—and overall they’re better. Now what he did was, he took the same people in the Atkins group and put them in—and put—took the people in the Ornish group, the higher carb group and see which ones did better on it on each. Now we found the people in the Ornish group that lost weight, lost weight in the Atkins group as well. And the people that lost weight in the Atkins group—actually some of them actually gained weight in the Ornish group. So the deciding factor was if your insulin was greater than 7 or 8 in the Atkins group, that you actually would gain weight in the Ornish. And if you were in the Ornish group and you lost weight, but your insulin as less than 7 or 8, you could still lose weight in the Atkins group. So the whole idea was if your insulin levels were low, you lost weight in either group. If your insulin levels were higher, you lost weight only in the Atkins group. So what does this mean? You get people that have lower levels of insulin, they’re more insulin-sensitive. That’s means they’re not most apt to store sugar and carbs as fat, they’ll do better on all diets together. So these are the people that are out there that are eating crap, like the guy you mentioned last week with the Rice Crispy treats in his—in his smoothie or the Cocoa Puffs, right? These are the people that will do better on anything, right? And then they go and they—they taut whatever it is and this is the magic key, and it’s like, no. You just got a body type and a hormonal profile that allows you to get results doing anything. And then you get people that are more hormonally sensitive and they don’t have the ability to go up in the higher inflammatory and higher carb foods. So we have to dial that in and we have to know who is our audience and why is that person getting results over the other and if someone who is getting results on a higher carb diet, that’s not gonna be, you know, the gold standard for everyone. So we gotta know the differentiating factors in blood sugar and insulin levels are kind of big thing.

Evan Brand:  This may be a good new intake question. Please read this article. Are you an ecto, a meso, or an endo? And then we’ll have our patients tell us that way we can dial in a little bit more specifically faster.

Dr. Justin Marchegiani:  Yeah, I agree. And so I don’t think we have to be neurotic on calories, but one of the big things that I do find with patients is because most patients come to me with 50% of their diet being crap to begin with–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That do you replace the 50% of the calories that are now pulled out? Do you replace that with enough Paleo template calories? That’s the question. And so if patients start feeling tired, one of the first things we’ll do is we’ll throw their food diary into a MyFitnessPal just to one, get a look at their macros, but two, to make they’re getting enough calories in because no matter what you’re doing, with the mitochondrial, adrenal, or thyroid support, if you’re doing low calorie, you’re telling your epigenome that you are in a—a famine, starvation, let’s tone down the energy, let’s tone down the—the fuel going out because we gotta—we gotta conserve.

Evan Brand:  It’s a lot more common than people think to undereat on a whole foods diet.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  I mean, if you look at some of the stuff, I mean, you could be less than—some of the times like if you go to a restaurant and you see something, say they have like Healthy Menu and it’s like 600 calories, it would be an amazing meal. Like it could be something like a good steak and veggies, but it’s gonna be like 600 calories, and if you just eat that and let’s say you did a shake for breakfast because you were busy or you didn’t feel like eating in the morning, I mean, hell, you may only be at 1200 calories a day or something, which I don’t count, but that’s low so–

Dr. Justin Marchegiani:  That’s low. I call that Auschwitz diet.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I have patients coming into me that are like, “Yeah, I’m–” and we look at their diet and then I’m like, “Okay, so like how long have you been doing the Auschwitz diet for?” And they look at me, they’re like, “What?” Well, Auschwitz is a concentration camp, I think it was—I think it was in Poland or Austria. I think it was Austria during World War 2, they’re pretty famous. But the amount of calories they would serve their prisoners at the camp were 1200 calories. And everyone can remember back in our history books, right? The pictures of those con—those poor concentration camp victims, they were—they were skin and bones, right? Well, people are doing that daily. The only issue is these people didn’t have a fridge or a restaurant they could go to when they got their cravings or they were stuck eating that way for years on end. So they got emaciated, but we’ll do it, what’s called a yo-yo fashion. We’ll do it for a few days or a few weeks, come out of it, a whole bunch of carbs, and then go back to it, and then come out it. That’s the Yo-Yo Diet.

Evan Brand:  Yes.

Dr. Justin Marchegiani:  That’s why we gain 5% when you come off it, because these people—willpower was out of the equation because they didn’t have a choice, right? They were prisoners, but we aren’t.

Evan Brand:  Yes, that’s great.

Dr. Justin Marchegiani:  So now one more other topic I wanna touch upon is when does counting calories matter? Now this is really interesting. So we know if we’re eating good clean proteins and fats that stimulates a whole bunch of appestatic compounds that help tell us we’re full, right? Peptide YY, adiponectin, cholecystokinin—these are all good feedback loops that go tell the—the transverse nucleus of the hypothalamus, right? That part of the brain that controls the—the appetite is called the appestat center that we’re full. Now we don’t quite get that feedback loop with carbs, right? So that’s why we can eat a whole thing of Pringles, right? Remember the commercial in the 90s, once you pop—how does it go?

Evan Brand:  Yeah, you can’t stop. Yeah.

Dr. Justin Marchegiani:  There you go—ah, see! Look at that, you got it right in your head.

Evan Brand:  I know, it’s brainwash.

Dr. Justin Marchegiani:  And then you know, think about people in their college days have ordered a whole pizza and ate it to their—to themselves.

Evan Brand:  Well, yeah, Lay’s, too. I mean their slogan is “Bet you can’t just eat one” or something.

Dr. Justin Marchegiani:  There you go. So these food companies know this and they understand that there’s a delay kind of feedback loop with carbs and our appetite, right? They know that. So that’s why carbohydrates is super easy to overconsume, so if we choose real foods, we get this really good feedback loop of satiation and also ketones, right? When we make more ketones from keeping the carbs lower and the fat—the fat higher and the protein moderate, that’s actually an appetite suppressant as well. So a lot of people on these types of diets will actually keep their calories in check and maybe even go just a little bit lower because their appetite’s lower. So now here’s the exception. I see it more in women is that if they start gaining weight after a period of time on a Paleo type of template, and we look their carbs and fats and protein ratio, let’s say their carbs are maybe 50-100. They’ve tried tweaking the macros up or down, their proteins right around 15-25%,a and their fats is somewhere between 40-60, and we kinda—we tweak it up and down and we’re still not losing weight, and let’s say the exercise is dialed in, too. The exercise is appropriate. We’ll look at how many calories they’re eating, and then what we’ll  do is we’ll drop our calories by 100 calories, and the goal is do you still feel satiated and full throughout the day? Because there’s a lot of people I find that they can drop their calories just a touch, but they don’t get hungry. Now we can go maybe 100 more and they—they don’t feel hungry. So sometimes with people, I find that they may overeat just a touch, and if they were to cut off maybe 1 or 2 or 300 calories, they wouldn’t feel hungry. So the goal of our type of approach is can we cut the calories without creating that starvation feedback loop, because as soon as we start feeling hungry then we’re telling our epigenome, starvation, famine, decreased energy reserves, right? Get colder, have issues like that, conserve energy which will affect our hormones and thyroid, so can we cut the calories just a touch and still feel satiated and full and not like we’re depriving ourselves?

Evan Brand:  Yeah, I personally never tired that. I did see something interesting.

Dr. Justin Marchegiani:   Well, the thing is, you wouldn’t need to.  You’re an ectomorph.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  This wouldn’t apply to you.

Evan Brand:  Totally. I saw something yesterday in which it’s—it’s a mice study, so I don’t know how direct it’ll apply to humans, but that the cooler the mice were, like their blood temperature, the cooler they were, the longer they lived. So I don’t know though, it’s hard to say, like if you’re in that starvation mode and your body temperature is cooler, would you actually live longer? You know, maybe you’re not burning through things as much because you’re in reserve mode? I don’t know. It’s a good question. But then how is your energy level? I mean, if I can live 5 more years but my energy level is horrible, my whole life is not worth it, you know, so–

Dr. Justin Marchegiani:  Yeah, and a lot of that research on like the fasting or the super low calorie, some of that comes from the benefits that you get from maybe an intermittent fast with the cellular autophagy recycling, and I think you can get some of that by doing a little bit of intermittent fasting on non-stressful days to help get that anti-aging benefit. That’s one piece. Also some of it’s on the glycation piece, right? When we glycate, when we sugarcoat our proteins, we create basically a free radical magnet in our body where those proteins attract free radicals and create damage to our DNA and oxidative stress. So if we can keep the carbs under control we’ll have less glycation, right? Well, basically the glycation—what happens on our crème brulee when we go eat it, right? That’s that browning that happens in our arteries and then our cells, that’s inflammation, and if we can—if we can get that dialed in and maybe add in a little bit of intermittent fasting and increase ketones, we may be able to get that same kind of benefit without the, you know, all of the negative effects like you said, the—the fatigue and obviously you’re—you’re starving yourself and remember if you’re eating less calories, that means you’re eating less nutrients.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  We know the more stressed you are and the more you wanna do and achieve and become in life, you need the fuel to get there, right?

Evan Brand:  Yup. I feel like we have said a lot so do you wanna bring us home, give us a good nutshell?

Dr. Justin Marchegiani:  Yeah, what I’m—let’s do this. Let me kind of have you outline your nutshell first, because you have a different perspective on things. I wanna hear your nutshell first.

Evan Brand:  Yeah, so my nutshell is prioritizing eating in general, 3 meals a day at least, not skipping meals. If you do have some issues going on where you’re trying to fix your adrenal issues or we’re working together right now, and we’re fixing your adrenals, sometimes with some of those hypoglycemia issues, I may recommend even a snack or two which will total you basically eating 5 meals per day and some of those maybe full meals, some of those maybe small meals. Now those snacks are not bananas and cookies, gluten-free brownies, anything like that. The snacks are still real food—real food, so it could look like something like almond butter. It could look like something that is a shake like a coconut oil, you know, with some grass-fed protein or some type of shake. So we’re still supporting fat and protein but minimum 3 square meals per day because a lot of people including myself today, I haven’t eaten breakfast yet so I can feel my blood sugar getting a little bit low and I likely have some adrenal stuff that I’m still getting back into the perfect rhythm, you don’t wanna skip those meals. So—so that’s kinda my—my main nutshell.  If people just eat real food 3 times a day, most of the time they’re gonna have pretty good success overall, and then obviously there are some of the levers that I’ll tweak, too. Yeah, you need more carbs in the evening. This will help you with sleep. This will help with post-workout recovery, this is will help with weight loss, etc. But to me the skipping meals, that’s the biggest thing that I have to hit on and that’s probably my biggest thing in a nutshell is don’t do that just because a lot of these are broken and they assume that if they just don’t eat, that things will get better. But I think some signal to this whole system you’ve talked about is better than no signal, which is just eating nothing.

Dr. Justin Marchegiani:  Totally agree. Get healthy first before you play with intermittent fasting, get healthy first, especially my female patients.  Female’s hormonal fluctuations, they’re more like a symphony in the orchestra, right? And it doesn’t take more than just like the strings being off, or the flute’s being off, right? And that beautiful orchestra sounding like noise. So get healthy is a female first, especially the females because of all the things I mentioned, and then you can tweak around with a little bit of IF, intermittent fasting, on a non-stressful day. If you’re an executive or a teacher or even a stay-at-home and you have a stressful Monday, don’t intermittent fast on Monday.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Choose that Sunday or that Saturday, and you know, stop, have your dinner the night before at 6 and then don’t eat again ‘til 2, right?  That’s a really easy way to do it, and if you wanna have some fat in there, so it’s more of a protein fast, that’s still great, too, in the meantime. Make sure you look at your macronutrient levers.  Get down to a baseline if you’re unhealthy. Get to that lower carbohydrate-Paleo template to start and then we can move those levers in a non-dogmatic, non-analytical way like I mentioned weighing stuff, right? You can just use your fist or your palm or that decker cards mentality to up your carbs. And then also if you’re having a hard time we can also look at portion control, but there’s other things that we need to talk about on the functional medicine side and we’ll go in other podcast on this. I know Evan lost 20 or 30 pounds and you had a parasitic infection. I think you had Giardia and Crypto, right? Two infections. So if you’re having a hard time gaining weight or losing weight, there could be an inflammatory component, either with the microbiome, the gut, or an infection or a hormone issue that may need to be looked at. So we can only do so much with diet, it’s the foundation.  And Evan and I pride ourselves in—and rocking and dialing in the diet first, and then going up to the next level second. So if you’re having an issue, you’re tweaking the diet, you’re listening and you’re applying all the things we’re talking about, the next step would be the functional medicine component where we, you know, look underneath those rocks and see what’s there.

Evan Brand:  Yeah, that–

Dr. Justin Marchegiani:  Any—anything on the functional medicine component you wanna touch upon?

Evan Brand:  Well, that’s—that’s just a good—that’s a good intro to that idea because a lot of what we talked about, people make their entire life, their entire career, their entire business model just tweaking and adjusting the things that you and I talked about today, but that’s literally just the first rock that we’re looking under. There’s so much more to the picture. I mean, no matter what I did with my diet, I was unable to put on weight, and now I found out I had those two parasitic infections and now you and I talked about it and came up with a protocol and now we’re treating them, and I’ve already put on a few pounds. It could just be because I’m eating more, too, because I’m working out more, but I’ve already gained, you know, almost 5 pounds over the last 6 weeks, which makes me feel really good. My strength’s coming back. My hands and feet are a little less cold than they were. So these are the deeper pieces and man, I tell you how good it feels to actually find a reason of why something went crazy. Oh, it’s a good—it’s a relief!

Dr. Justin Marchegiani:  I knew you were looking better on Skype for some reason this morning.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  There’s something about Evan today. I don’t know what it is.

Evan Brand:  Good.

Dr. Justin Marchegiani:  And just so everyone knows at home, Evan’s giving me a big flex right now. He’s looking extra studly, I love it. And then also like one thing, right?  When we look at the diet component, if you’re just looking at the diet, that’s like just looking at the flat tire, okay? So let me give you this analogy. So the diet—the diet, right? If we have a poor diet, so many other things can happen metabolically to our gut and to our hormones and to our thyroid from long-term poor diet, right? Inflammation. Well, the same thing. Imagine you’re driving around on a flat tire, for a long period of time, okay? Well, the axle, the front end, the whole suspension system, right? All these things can get screwed up in the car. Now if we just go and we just change that tire, let’s say a year later, well, all of the collateral damage that happened over the last year doesn’t go away. That’s the key thing. So now let’s take that analogy, interject it back to nutrition. Great. You have this poor diet, your thyroid, your adrenals, your gut’s all screwed up. Great. You changed the diet, but just like changing the tire, you still had to have the mechanic go in and fix all the other parts of the carb that got damaged in the meantime. And it’s the same thing. Just because you changed the diet which is the foundational key underlying cause, you may have to go deeper and have other systems worked on and fixed because of that collateral damage was still on motion.

Evan Brand:  Yeah, and I had a guy that just started working with me last week, and he said—he said, “Evan, when you and Justin said, ‘Everybody needs a coach,’” he said that finally clicked with me because I’ve been doing this thing alone for so long and I know so many people out there listening are doing this thing alone and it’s like I don’t even do this thing alone, you don’t do this thing alone, we consult with each other, we help each other, it’s like if you are doing this thing alone, you’re sacrificing your results and you’re lengthening the time or even reducing the possibility of you getting the type of results that you want if you aren’t working with someone because you can only see what you can only see. So really this is just a pitch for, you know, working with either one of us, but if—if you don’t like us, then fine, but I don’t know why you’ve listened this long but if—if you don’t and you’re going with somebody else, then make sure they know what they’re talking about. Make sure that you’re asking the right questions. Make sure that you’re not just—I had a—Justin, I haven’t told you this.  A lady that just started work with me, she hired a naturopath and she paid him a huge amount of money. Let’s just say you could buy a car with this amount of money that she paid him upfront and she has Hashimoto’s–

Dr. Justin Marchegiani:  Mmm.

Evan Brand:  And he told her to go eat peppers because he ran a blood test that showed she had a deficiency in some minerals or vitamins or something and that she can get a lot of really good vitamins or minerals from peppers, but yeah, she’s got Hashimoto’s and–

Dr. Justin Marchegiani:  Ooohh.

Evan Brand:  And she’s like, “Are you sure?” And he goes, “Yeah, yeah, yeah, you’ll—you’ll be fine. Just eat some more peppers.” And so if there’s like crazy stuff that coming out of your practitioner’s mouth, don’t hesitate to get rid of them because hey, you—you and I—Justin and I, we’ll take you on and we’re gonna give you something that actually makes sense.  So that’s my pitch for—for this podcast.

Dr. Justin Marchegiani:  That’s great and I wanna make one more comment. I have some staff staying with me or they’re visiting in from California at my house over here in Austin and I was making dinner for them the other night and they saw what I was doing at home with my food, nutrition, and supplement plan, and they looked at me.  They’re like, “Wow, you—you really practice what you preach, what you tell your patients.” I’m like, “Yeah!”  I’m like, “This is it! You gotta own this stuff. If you don’t own it, people can smell it a mile away. People can smell it in—inauthenticity a mile away.” So it’s important that your practitioner lives it and practice it, and you should know because you’ll hear them talk about things and you’ll be able to tell if it’s a smokescreen or not, so you wanna make sure the person that you are working with and I know Evan, I’ve seen—we’ve eaten together, too. You practice what you preach, too, and that comes through in the communication because everyone knows when someone’s smoking it, right? Or you know, faking it. That—that BS detector, that Spidey sense kinda comes off.

Evan Brand:  Yeah, and I just watched a video about that the other day, since the Internet has taken off so much, people’s BS detectors are a lot more sensitive now. So you’ll know it and something in your gut’s gonna click. So if your gut feeling just feels weird with your practitioner and they’re telling you to eat peppers when you have an autoimmune disease or something similar—I don’t have any other examples for today—then speak up because that’s just crazy and ultimately, you’re in charge. We’re just here to guide you in the right direction.

Dr. Justin Marchegiani:  Love it, Evan. Great show today, man. High fives all around!

Evan Brand:  High five!

Dr. Justin Marchegiani:  Alright, man, you have a great weekend.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Take care.

Evan Brand:  Bye.

 

References: http://www.precisionnutrition.com/all-about-body-type-eating

Low DHEA Levels & Adrenal Fatigue – Podcast #85

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

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

In this episode, topics include:

00:58   About cortisol

2:33   What is DHEA?

5:03   Symptoms of adrenal imbalance

12:10   Strategies to help with stress hormones

15:00   Supplementing with DHEA

itune

 

 

youtuve

 

 

 

 

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

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

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

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:   Alright.

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

Dr. Justin Marchegiani:   Yup.

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

Dr. Justin Marchegiani:   Uh-hmm.

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

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

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

Dr. Justin Marchegiani:   Big time.

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

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

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

Dr. Justin Marchegiani:   Yes.

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

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

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

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

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

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

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

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

Evan Brand:  Right.

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

Evan Brand:  Uh-hmm.  That’s great.

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

Evan Brand:  Yes, sir.

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand:  Uh-hmm.

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

Evan Brand:   No.

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

Evan Brand:  No, that’s it.

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

Evan Brand:   Take care.

Dr. Justin Marchegiani:   Take care.

Evan Brand:  Bye.

Dr. Justin Marchegiani:   Bye.

 

 


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