Top 5 Reasons You Are Losing Muscle Mass | Podcast #369
Muscles are essential to everyday movements, and if you noticeably lose muscle mass — especially without knowing why — it can be alarming. Losing some muscle mass is normal as you age. However, losing muscle mass quickly or atrophy, especially in the context of other symptoms, can indicate an underlying illness.
In this video, Dr. J and Evan discuss the top reasons you lose muscle mass aside from aging. Preventing a loss of muscle mass can also be achieved by exercising regularly (such as functional strength training) in conjunction with a balanced food template of lean meats and proteins, fruits and vegetables, healthy fats, and whole grains.
However, if the loss is due to an underlying illness, it must also be addressed and mindfully managed with a trusted healthcare professional or your functional medicine doctor.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:33 – Functional movements
3:37 – Infections
7:21 – Vegan-vegetarian
9:35 – Autoimmune digestive disorders
12:21 – Hormones
15:06 – Types of muscle building
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be chatting about the top five reasons you are losing muscle mass. This is really important. All right. If you’re losing muscle mass, it’s gonna be essentially an all-cause predictor of mortality, increased mortality. So, we gotta make sure that we’re keeping our muscle mass and or improving our muscle, especially as we get older, we need good muscle to support and stabilize our body so we don’t get hurt, we don’t slip, we don’t fall, we don’t get injured. We don’t slip a disc so to speak. So, we have to make sure that we are keeping our muscles strong and functional. Evan, how are we doing today man?
Evan Brand: Doing really good. I talked with a guy actually this morning where his mother, due to age and related muscle loss, fell, broke her hip, got in the hospital, had to get surgery, got an infection, died. So, I’m not saying everyone is gonna end up like that. But my God, look at how quickly something just like a fall due to lack of muscle strength and mobility could turn into something scary where you’re hospitalized, you’re getting surgeries, you end up with a hospital acquired infection then you’re on antibiotics then you go septic, I mean, this is crazy and so I hope we can help people prevent. This is such a common story. I mean, how many times have you heard, like, old granny falls, breaks her hip and that’s the end of her. She never recovers. It’s like, that’s not good. And so, fortunately, in the past, up until the past couple years, both of my grandparents right around 80 years old, they were playing tennis and they were still active in mobile so I just encourage you guys, just because you’re getting grow older that doesn’t mean that you need to become a couch potato. Even some of her friends that she’d played tennis with are in their mid-80s, still playing tennis, still moving well on the court. So, I just encourage you to find something that you love first and foremost. Use exercise as a side effect of having fun, meaning, if it’s pickleball, if it’s tennis, if it’s ping pong for all I care, I mean, basketball, volleyball, I mean, whatever you can do it. It doesn’t have to necessarily be intense. That’s all fun stuff, maybe competitive, fine. But exercise is a side effect of it. But if you’re just trying to depend on willpower to go run a mile, I think that’s a terrible long-term strategy and I don’t think you’re gonna like to continue with it, like my row machine, you and I both, we have the same row machine, we love it. You can go on there, and you can do little games, you could do just row, you could pick like, oh, I’m gonna, I wanna burn 10 calories or I wanna grow 500 meters and you have this like goal that motivates you to do something, but at the end of the day, all this physical performance is gonna pay dividends.
Dr. Justin Marchegiani: No. Exactly. 100 percent. So, when I kind of, when I lift weights, I’m always trying to do functional movements, I think as you get older, especially as you know, you move into adulthood, you want muscles, right, you want to look fit or lean or trim right? You wanna feel solid but you wanna have functional muscles. One that allows you to do housework or click pick-up your kids easier and feel more confident or do well at your sport or just be able to enjoy life and feel good like if you think about, like, getting into a car, right? You get into a car, it’s like a one-legged kind of squat, right? So, I’m a bigger fan. As you get older, trying to do more unilateral body movements, meaning like a one-legged squat, a one-legged lunge or a lunge obviously with that, you know, you can look at discrepancies in your body. If you’re doing a squat, you know, you have other sides that you can compensate for but when you’re doing one-legged movements either a dead lift or a squat or a lunge or a step-up, it magnifies imbalances in the body. I like that because most of the time, when you’re moving, you’re actually on one foot in a sense and so it’s good to do movements like that so you start to develop a lot of the stabilizer muscles that support you when you’re moving so you don’t get hurt.
Evan Brand: Let’s get into the functional stuff, like the functional medicine stuff, not functional movement but like functional reasons, I’m gonna go ahead and say, number one as a category of infections and you and I can break this down as much as you want. Yeah. I’m gonna say infections because you know my story, you saw me, I lost like, 25 pounds without trying and some of it was related to H. pylori. I think the parasite also wrecked me so I would just say infections as a whole.
Dr. Justin Marchegiani: Yeah so when you have inflammation in the gut, right, it can be cause by infections like a parasite like Cryptosporidium, Giardia, Blasto, H. pylori, bacteria in that category, SIBO, general dysbiosis, bacteria imbalances, right? It creates inflammation in the intestinal tract, right? Whether it’s small intestine, large intestine, if you look at where these nerves sit on the spinal column, they sit in the lower thoracic to lower lumbar spine, and you know, let’s say t10 to L5 or so. Maybe even, maybe even S1 and when you have inflammation in the intestines, it’s on a two-lane nerve root highway from your intestines to your spine back to the muscles, right, so we have what’s called a visceral somatic reflex. So this Visceral means organ, somatic means muscles. So inflammation in the organ can actually take that signal of inflammation put on that two-lane highway to the muscle and it can actually create that muscle to shut down or not be fully facilitated or active and so with inflammation in the intestines can cause that. Now, women know this just think about the average women that has PMS and has PMS symptoms of back pain. It’s their ovaries having inflammation or hormonal imbalance that’s then refluxing to the muscle, right, visceral organ, somatic muscle. So, women know that if they have PMS or if you ever had a gallbladder issue, you feel it in your shoulder, if you have appendicitis, you feel it in that lower right hip quadrant, right? If you have a heart attack, you feel in the jaw down the left side down the left arm so we know there’s this organ muscle connection so a lot of people can have muscle issues because their core and their back gets very weak due to inflammation in their intestinal tract and the more inflammation there is the less likely you’re wanna, you’re gonna, wanna lift and want to do one of them, you know put resistance on your body because you’re just more inflamed and you’re more likely to get hurt and injured.
Evan Brand: Yeah. So, if you, now, not all people lose weight and I’ve seen many women who gain weight magically 20, 30, 40, 50 pounds, sorry ladies, sometimes it happens that way. It’s where you gain weight due to infection but for me and I’ve seen other men the same, you lose weight, so I don’t know, I would just say this, any fluctuation whether it’s weight gain, including muscle loss so you could gain weight and still lose muscle right. You could gain body fat and lose muscle so whether it’s a significant, let’s say 10, 20 pounds or more weight loss or weight gain with no explanation, I would definitely look into the gut, start looking for infections and as you mentioned, the strength is important and people don’t want to get strong if they feel like crap and so for me, luckily, my gut’s much better and now I feel good with resistance training whereas before I was just so depleted. So, let’s go into reason number two, I’m gonna say nutrient deficiencies, now, this ties directly into infections right because in the case of H. pylori, if it’s reducing stomach acid. Now, if you’re eating this good grass-fed steak, you’re not really getting as much nutrition from that and so these nutrient deficiencies compound over time because if you don’t have the amino acids being cleaved off the meats to produce muscle mass that also creates a big problem so nutrient deficiency and we could go any direction you want with this even vegetarian vegans, we could talked about the deficiencies there and how they’re gonna have trouvle with muscle mass.
Dr. Justin Marchegiani: Yep. 100%. So, of course, if we have vegan vegetarian, we’re not gonna get enough carbohydrate, we’re not gonna get enough protein, typically or if we get enough protein, right, let’s look at the combination of rice and bean which is a pretty common one. Well, you end up getting 70 grams of protein to 15 grams or so of carbohydrates so you get a lot of carbohydrates. Now, if you’re not that active or you’re more insulin resistant, you know some, most people are gonna need probably a minimum of half their body weight and in ounces of protein so if you’re like 200 pounds that’s 100 grams of protein. Well, do the math if you’re getting 15 to 20 grams of protein per 70, 75 grams of carbs that’s you know, 75 times five, you’re looking at like 340 to 400 grams of carbohydrates. Obviously, you can fix some of that by doing, like, a protein shake, like protein or hemp protein, you know, you can fix some of that. But again, you’re still relying on artificial sources, not whole food sources. Now, the benefit of the animal product is you’re gonna get all the protein, none of the carbs and you’re typically, if they’re grass-fed and pasture-fed, you’re gonna be getting excellent good fatty acids along with it and you won’t be getting a lot of the excess omega-6 fatty acids like you’re not gonna get on the vegetarian vegan side. So, you have this nutritional density that you get on the animal side which is wonderful and as long as we’re choosing you know, avoiding the factory farm, you know, we’re doing grass-fed pasture-fed, you’re gonna be in great shape and the next thing after vegan vegetarian is low stomach acid so if we have achlorhydria, low stomach acid, and that typically connects with low enzymes too, we may have a hard time breaking down a lot of that proteins. So, I know when you had some of your gut infections years ago, I think you had what Cryptosporidium, Gardia, H. pylori, that’s it Three Amigos, right? And so, when you had this gut infection, you also had lower stomach acid, lower enzyme levels. So, supplementing the enzyme and the acid so we can break down those amino acids and then also adding in or cutting out the bugs is helpful and then sometimes adding in some amino acids in a free form can be helpful because 40% of the Energy that you get from the protein actually goes into digesting the protein. It’s like having a credit card with a 40% transaction fee, right? Very expensive. So, there is some benefit by doing amino acids, if it’s already broken down but we still wanna make sure the whole food is dialed in and that we’re getting enough, uh, we’re getting access to the whole food nutrients via hydrochloric acid and enzymes too.
Evan Brand: All right. Moving on to another cause here, and this is inspired by a comment here from Teresa, she said that she has muscle wasting from my colitis. So, we could just say, any gut issues and that one include autoimmune gut issues, right? So, colitis or what’s called pancolitis would be the whole colon, even celiac, Crohn’s, I mean, any of these autoimmune gut issues oftentimes that’s gonna create a lot of muscle wasting that ties directly into what we just said though which is nutrient deficiencies and infections. A lot of these people with major gut issues, like this, there’s usually a trigger. Now, in the case of like, celiac, obviously, that may or may not have a parasite infection involved but this is still part of the equation and we can use gut healing nutrients to work on this, you can put some of this stuff into remission but you know what, I don’t want people to do, you know, what I don’t want people to do is like eat clean all week and then they go eat garbage on the weekend.
Dr. Justin Marchegiani: Correct. Yep. 100%. And so, of course, if you have colitis, right? Whether it’s microscopic or ulcerative colitis, you know, it’s an extreme irritable bowel disease, you gotta look at the foods and then sometimes the foods could even be in vegetables it could be in the oxalates, the phenols, the salicylates, the FODMAP, so sometimes even healthy foods on paper could be problematic and then of course, you know, the grains and the dairy and he refined carbohydrate and the omega-6 fats of course those right. So, getting the inflammation via food is super important, we talked about dysbiosis, we talked about SIBO, H. pylori, of course is super common because H. pylori is notorious for lowering stomach acid and so of course, if we’re just taking stomach acid and enzymes and we’re not fixing the H. pylori, you know, that may not get to the root cause. So, if we’re taking supplements like hydrochloric acid or enzymes or bile support, we also got to make sure we’re getting to the root cause of any additional bugs that could be present and if we’re chronically stressed like the adrenals if we’re in sympathetic fight or flight the sympathetic fight or flight nervous system tends to be more catabolic than anabolic. So, anabolic is building back up, healing, recovering, getting stronger. Catabolic is breaking down. So, from this fight-or-flight state, our bodies always tend to be it. You know, running versus, building and growing and so if you’re catabolic from the adrenals being over active with cortisol, that’s gonna make it hard to build muscle, you’re gonna be breaking down the muscle instead, making glucose out of it and it’s also gonna be harder to digest because your body’s hard wired to take blood and bring it to the extremity so you can fight, flight or kind of run versus to the organs so you absorb and break down. So, that fight or flight is really important in fir digestion, for where the blood goes and also and how it allocates nutrients. It’s more likely to break down muscle than build muscle back when that fight or flight is really active.
Evan Brand: That’s a good call. That’s exactly where I was gonna go next is hormones, I was gonna talk about maybe low testosterone. We’re seeing that in men in their 20s, 30s, 40s, I mean just low hormone levels and women need some level of testosterone too. So, if you do hormone issues whether that is adrenal related cortisol, thyroid hormone, maybe you can riff on that for a minute because I think people are focusing on gut gut gut, which is great but there’s also this other connection of the hormone piece and I will tell you my cortisol was completely depleted when I did a salivary panel years ago. My cortisol was flat all day and it was really tough no matter how much I tried in the gym, I was weak. Like, just my God, I could not make progress, fortunately better now, but man I’ve been through it.
Dr. Justin Marchegiani: Yeah. Some people, they may be high with their cortisol and we have to use adaptogens to calm it down of course, like good diet and lifestyle things, some may be low and typically you don’t just go low all of a sudden. You ten to be on the higher over stimulated side for a while and then you ten to crash and that’s where that low cortisol kind of comes together and with that chronic cortisol, a lot of times we see low DHEA, and DHEA is important because that’s gonna be a precursor to a lot of men and women’s sex hormones and so women will go more down the estrogen side. Men, it will trickle more down testosterone. These are both anabolic hormones and so if we have lower DHEA, that tells us the adrenal issues that are going on are more chronic and DHEA will go downstream to more of these anabolic building up type of hormones so very important to take a look at your DHEA because that could tell you if you’re more catabolic inflamed place. And also too, if you do exercise, I get it if it’s like your first couple of movements, It’s like a new exercise kind of thing, you may be a little bit torqued. It’s new but you shouldn’t be overly sore after your workouts. If it’s a new thing, fine, or it was really you know, an acute hard workout but in general you shouldn’t be overly sore, you know, more than two days or so later. You really shouldn’t, you should still be able to function like maybe you feel it like it feels like you did something but it’s not overly sore if you are um and it was a reasonable amount of exercise, it wasn’t like you did too much you’re probably in a more catabolic state, and it’s also you could be over exercising too. So, you gotta make sure you’re not over exercising.
Evan Brand: Yeah or I’m thinking like what about lactic acid build-up too due to gut bacteria or a mitochondrial issue due to some sort of toxin where they’re just depleted, they’re not recovering well, they’re not performing well. So, maybe not directly related to muscle mass but I think mitochondrial issues could be something to look into. You and I measure this and look at this on an organic acid test and we often find a lot of issues, I mean we’re in a toxic world with a lot of chemicals, metals, pesticides and so these things damage the mitochondria which to me would directly impair your ability to perform. Is it directly reducing muscle mass? If your mitochondria are damaged, I’m not sure on that. I’m sure we could look into it but it makes sense.
Dr. Justin Marchegiani: Yep. Absolutely. So, a couple different types of um ways you can build muscle, right, we talked about resistance training is obviously gonna be my favorite, right? So, we can do resistance training that kind of acts like cardio so if we do let’s say three or four movements back-to-back to back-to-back that kind of acts like cardio like or instance if I do like bicep curls, right, this is resistance training, you’re probably not gonna see a big bump in your heart rate which is bicep curls, right? So, there’s resistance training where you’re not getting a cardio effect and it’s resistant training where you’re actually getting a cardio effect. So, just like, people think cardio, like, oh, I’m gonna try them all that’s cardio. It’s well no, you can do exercise that’s resistance and still have a cardio effect. So, if I just did like bicep curls or tried extensions probably not a big cardio effect. Now, if I did like bicep curls and then I paired that with the next exercise, let’s say kettlebell swings, right and then the next exercise being some type of full body row or a lunge, you can see how you start getting more muscle groups involved. Your heart rate starts to go up significantly. So, that’s nice because there’s some benefit if you look at some of the zone two exercise theories that are out. With zone two exercises, essentially, when you’re working at about 60 to 70 percent of your max heart rate so if you’re at typically like you know, typically around if you’re like max heart rate for most people in their 40s or so will be like maybe around usually, it’s 225 minus your age and so if you’re like 40 that’s like what 225 minus 40 would be like what 185 and so you do 185 times 60 or so that should give you then you’re around like typically around 120 or so for your heart rate so they want you to stay around 120 for about 30 minutes. Now, you may find that you kind of have that zone 2 type of benefit while you’re actually doing lifting, if you kind of do it in a circuit fashion, then you choose movements that are more compound, you may find your heart rate stays that high. Now, the benefit of zone two is you get this really nice drop in your resting heart rate. There’s a lot of people that are reporting a lot of their data from like their fitbits or their or rings where they just have a significant drop in the resting heart rate that they wouldn’t necessarily see for like interval training or I’m sorry like a type of a tabata training where you’re like high intensity low, right? So, this kind of steady state thing for 30 minutes, you know, could have some cardiovascular muscle benefits and you may also be able to get some of that like if you do circuit movement so you can, you know, get one of these fitbits and measure your heart rate while you’re doing it and see if you can stay around 120 for that 30 minute phase that kind of put you in that zone two category around 120 or so.
Evan Brand: Very cool. There was a comment in here from Selena, what about muscle wasting with chronic Lyme? Yeah. 100%. Unfortunately, I’ve dealt with Lyme with co-infections from many tick bites over the years and that’s a big big factor because Lyme loves collagen. It really likes to eat up your collagen reserves and then the inflammation it creates, that invites other things like the Bartonella to move in and create more inflammation in your joints. I’m sure that is a big big factor for you. I think you can get better from it. I’ve certainly gained muscle mass even with the infections, I would still throw it in the infection category though. I think the gut infections are a big one too so don’t go all in online and forget the gut bugs because if you’ve got H. pylori, I think that’s a bigger smoking gun for your digestion. Lyme could still wreck you and cause you to lose muscle, I know one of the girls that I used to work with, I saw her recently at a park and she was so skinny, skeleton skinny and she’s had Lyme for like a decade so I know it really affected her in that way but I do think some of that is reversible if you work on the bugs and get your gut better.
Dr. Justin Marchegiani: Yeah. And also, people that have Lyme, it’s very rarely it’s just Lyme. It’s like Lyme but then they have, like a ton of dysbiosis, really poor digestion, so it’s usually people are already in this kind of not so great state and then Lyme comes in there and it’s the straw that breaks camel’s back and because it was the thing. They pushed them over the finish line. They just look at Lyme as being the culprit for all of it and therefore, I think it’s all then all they do is focus on that one thing because they think, oh well this is the root cause because this is what happened when everything went sideways and they get myopically focused on just that and then they’re on these crazy herbal antibiotic protocols for years and they don’t fix the other thing so still get back to the basics with your digestion with your, you know addressing the guts, um, really addressing all the stressors, the adrenals, make sure all of that’s kind of dialed in. Also, how did you do with collagen, I mean I found collagen it’s just great for building up that connective tissue because even like in today’s day and age, we’re getting a lot of muscle meat from our protein source, we’re very, we’re not getting enough of our connective tissue or skin or hide or those type of things like the soups and bone broths probably our ancestors used to do. We’re not getting a lot of those amino acids which are really important for connective tissue.
Evan Brand: I do good with it. I do it every day. I do collagen protein every day so it helps man. I don’t have any elbow problems anymore, my knees are better so like my joints are like so much better, my skin is probably better, hopefully that’s helping with the muscle too. She commented that she did have Bartonella and Babesia. So, yeah, that’s a triple whammy, I mean, you gotta keep working on it, I’m not a fan of the antibiotics, this is a topic for another podcast but you had mentioned that you were doing antibiotics and you know that typically causes the Lyme to go into like a cyst form where it hides from the immune system and a lot of people rebound and relapse on that so I prefer herbs.
Dr. Justin Marchegiani: Yeah. And also, if you go look at all the antibiotic side effects, they all match Lyme as well and so it’s like joint pain, fever, malaise, and so there’s like you see a lot of these conventional or should I say more natural minded medical doctors like oh that’s just
Herxheimer, that’s like but it’s like you literally are giving something that has the same side effects of the disease you’re trying to treat and so that’s why we tend to like herbal treatments that are more gentle and we’re trying not to hurt and we’re trying to kind of choose a low dose of herbs that are gonna allow us to support the immune system, still have an antimicrobial benefit, we’re still providing a lot of antioxidants and nutrients in the herbs which is the benefit of the herbs and they don’t cause as much mitochondrial damage while we work on everything else. So, we’re still not gonna ignore everything else and we’re gonna find a treatment that makes sense and doesn’t make you feel sicker and have this self-fulfilling prophecy that the side effects actually match the disease that you’re taking.
Evan Brand: No joke. I mean, we do a whole podcast. Let’s do one sometime on this but she said that she was tired of antibiotics, it’s been three years. Yeah. I mean, that’s affecting your gut which is affecting digestion. We know antibiotics damage the mitochondria so if someone had muscle mass and they had done antibiotics, obviously, you got to look at the gut so I would recommend that you do a stool panel. Do organic acids, try to uncover it, somebody said I look like Arnold Schwarzenegger with the beard, I hope that’s a compliment. Thank you.
Dr. Justin Marchegiani: Yeah. There you go. I like it. Very good. So, I hope this helps everyone out of the gate here. I mean, just kind of like start from the basics like all right, so to keep your muscles strong you have to have one not be stressed, right? So, do not put yourself in a catabolic state. Think of like, your adrenals being an overdrive, think of like good sleep, good hydration, good food, allowing yourself to be in a parasympathetic nervous system state. Deep nasal breathing, right, appreciation, gratitude, right, make sure we have good digestive support enzymes, HCl, we’re eating a really healthy anti-inflammatory, nutrient dense, low-toxin template, again, I have some patients that have autoimmune conditions where they have to be even more carnivore because they’re really sensitive to the plant nutrients then after that, looking at all the bottlenecks that could be absorbing things or causing absorption problems in the gut, right, like Evan mentioned, Evan had three Amigos, right, Giardia, Crypto, and H. pylori. And then looking at any of the other bugs there and then of course what types of movements are you gonna do, right? You can start out with just walking if that’s kind of a foundational level then you could start off with some type of a you know circuit training, picking three or four movements and going back-to-back-to-back. You could do some kind of a zone two cardio thing where you do about 30 minutes or so at 120 beats per minute and you can do something non-impact. I like rowing because rowing devices you’re using upper and lower body and you’re putting your body into extension or most of the times on like cardio, you’re kind of like hunched over and like doing your elliptical or you’re running like this or you’re kind of in this flexion state where a rower you’re kind of opening up so that’s kind of cool so those are a couple of tools you know to stimulate the muscles and to um make your heart work as well as make your muscles work.
Evan Brand: I love the rower. Hiking too. I mean, hiking is so easy.
Dr. Justin Marchegiani: Yep. Hiking is great.
Evan Brand: I really love it because there’s a lot more variability in your movement as compared to walking on a flat surface so I’m having to like bring my leg up more to go over that rock to go over that tree root like it’s a lot of more leg involved than a flat surface so I love it as long as I’m not getting a tick bite, I’m happy in the woods.
Dr. Justin Marchegiani: Yeah. And my favorite functional movements would be like a one-legged squat, uh, it’s excellent and you could just have a chair underneath you where you sit, touch and come back up and you could put up like a phone book on it or something so you don’t have to go all the way down to parallel, uh, a single leg deadlift is excellent and step up. I know, right. I know you can just grab whatever book right. I’m thinking up like the thickest book I could think of right. You know something like that. And then, you could do that and then you could do a step up which is great like on a plyo box and step up. That’s what this is.
Evan Brand: How about, I mean the jumps? Obviously, that’s more intense but man those jump boxes, my God, that’ll, you talk about workout, that’s intense.
Dr. Justin Marchegiani: Yeah. Yeah. I mean those plyo boxes are wonderful, I mean, I like is that
Evan Brand: What it’s called the plyo like p yeah how you spell that?
Dr. Justin Marchegiani: Yeah. Like P-L-Y-O like a plyometric box
Evan Brand: That’s where you’re jumping up and down up and down?
Dr. Justin Marchegiani: Yeah. I actually like going on top of those and then just jumping off and then get into a squat because then you’re teaching your body like I’m generating all this force and I’m trying to absorb it so you’re teaching your body to be a shock absorber like just soak up energy which is great.
Evan Brand: To think about that, that hurts my knee. Thinking about jumping off, I used to, I screwed up my knee years ago though you know, I was jumping off loading docks like behind warehouses when I was a kid with a skateboard and when you bail off the skateboard I would land flat on the concrete, my God. That hurt. That was done.
Dr. Justin Marchegiani: No. Totally. But yeah, if you’re putting your joints in that kind of intensity, make sure your form is good. Some people say don’t go knees over toes, there’s a whole knees over toe guy on I think Instagram that talks about knees over toes but if you do that just make sure your form is good and you’re not causing any inflammation. Make sure you have enough protein and collagen, amino acids on board as well so you’re dialed in.
Evan Brand: Yeah. And if you need help please reach out, we work with these issues all the time. We’ll help you investigate what’s going on. You may have this root cause, you may have that root cause, you may have multiple root causes but we’re happy to help find the puzzle pieces because you can’t fix what you can’t find so that’s where we come in, we’re happy to help you with this issue. If you want to reach out clinically, we work around the world with people we’d love to help. You can reach out to Dr. J directly at justinhealth.com and there’s consults available everywhere, lab testing, we can get it to your door. It’s no problem. If you’d like to work out with me, not physically but work out with the labs, let’s do it at evanbrand.com. So, justinhealth.com, evanbrand.com, we’re happy to help.
Dr. Justin Marchegiani: Yeah. We’re here to help and we’ll put some of the products that we talked about like collagen and some of the nutrient support, we’ll put them in the description below so if you wanna access some of the things that we recommend for our family and patients and take ourselves, feel free and access that. All right guys, hope you have a phenomenal day. Take care of you all. Peace.
Evan Brand: See you. Bye-bye.
Dr. Justin Marchegiani: Bye.
Evan Brand: Bye.
Collagen Diet: Collagen-Rich Foods for Healthy Joints, and Skin
We know collagen is going to help with the joints because we know half of your bones are protein. We need good building blocks for our cartilaginous tissue and ligamentous tissue. Frankly, most people get most of their protein from muscle meats. That’s a problem because they’re not getting the knuckles, the bones, and the cartilage, as we would from old-fashioned soups. So, if you’re doing a lot of soups and bone broth soups, that’s great. If not, we really want to add extra collagen.
I do 20 g of collagen in my coffee every morning. I think it’s amazing. I do my true collagen with some MCT oil and grass-fed butter. I love it. I think it’s excellent for skin, hair, nails, and just for overall prevention of bone loss and cartilage loss. We know the wear and tear that most people experience in their joints throughout the year, especially if they do a lot of long-distance cardio. You really need more building blocks to help prevent and mitigate the wear and tear, so you don’t have knee and joint replacements later in life. Collagen can really help decrease some of that wear and tear.
How do you take collagen?
I like adding collagen in my coffee in the morning because it has a nice little kind of creamer-like effect. It gives that little bit of frothiness which is wonderful. I also do it before bed. Sometimes I’ll do a little bit of collagen (glycine), magnesium, and vitamin C because vitamin C is a really important building block for making collagen. I find magnesium has some very good calming effects as well where there are plugs in the GABA or it’s just a natural beta-blocker as well. It can calm the heart and bring the heart rate down a little bit. I think magnesium does work on some of those GABA pathways as well and, of course, magnesium helps with blood sugar. You’ll get deeper sleep and better REM sleep when you have good magnesium. So, I love combining collagen and magnesium at night.
Where can you get collagen from?
You can get collagen from food via bone broth. Chicken skin is super rich in glycine, roughly 3.3 g for 3-1/2 oz. If you make chicken soup, throw the whole chicken in there. Get a rotisserie chicken from Whole Foods and or get the fattier cuts of the chicken at least with the bone and the skin, so that way you get the best of both worlds if you’re going to do it from a whole food source. Regarding seafood, wild salmon is going to be the best source of glycine.
The Top 5 Reasons Why Your Estrogen Levels are High – Men & Women!
Let’s talk about the top 5 reasons why your estrogen levels are high. We’re going to break them down today.
WHAT ARE ESTROGENS?
First, let’s look at the 3 major kinds of estrogens: E1 or estrone, E2 or estradiol, and E3 or estriol. In a woman’s regular cycle, it’s usually estradiol we’re talking about. When you start shifting to more menopausal and the ovary stops working, you start getting more estriol. The adrenals help in kick in a lot of DHEA and you make more estriol. Estradiol is more of the growth factor type of estrogen and estriol is a weaker estrogen.
WHERE CAN WE FIND ESTROGENS?
- PLASTICS. You’ll get it when the plastic is warm like in a microwave or out of a plastic water bottle especially if it’s in the car and the sun is hitting it or it’s outside. That’s why you want a good stainless steel or glass water bottle if you’re going to go outside or leaving it in the sun. The microwave heat and the radiation is going to cause a big release of plastic chemicals there, the xenoestrogens. One of the big ones are the phthalates but also BPA. There are other types of BPAs that are new which are supposedly safe but there are still estrogen-like compounds there as well. These plastics can affect women and men as well. Men are actually going to be more affected by them because men aren’t used to having estrogen in their environment and getting a whole bunch is going to be a problem.
- PESTICIDES. These tend to have an estrogenic quality to them and if you’re eating foods that are not organic, you’re definitely going to be getting organochlorines and various pesticides in your environment.
- PHYTOESTROGENS. These are found in soy. For example, I had a vegan-vegetarian patient. We ran a Dutch sex hormone panel on her and her estradiol was through the roof and really high. Phytoestrogens can be a big one, so soy may be a problem. With vegan-vegetarian, there’s a lot of phony protein consumption like fake meat kind of stuff such as the Beyond burger where there are a lot of soy and estrogen-like compounds in there. There are also hormones in meat. You have to make sure you get antibiotic-free, hormone-free, and ideally organic and pasture-fed or if you’re on the Whole Foods scale, step 4 or step 5 is ideal. Step 2 is at least pretty good. Organic means no pesticides, no hormones, and also the food they’re eating has no pesticides or hormones, too.
- HIGH LEVELS OF INSULIN. Too much carbs drive high levels of insulin because insulin responds to a high level of blood sugar. The blood sugars in your bloodstream go up and your pancreas comes in. The beta cells make a bunch of insulin to bring it down and bring it into the cellar and converted to fat. So, high levels of insulin upregulate an enzyme in men called aromatase that converts testosterone, the male hormones, to estrogen which becomes a problem. Now, in women, a similar thing happens but it’s the exact opposite or the big switch. Their estrogen is converted to testosterone. So, women can actually get more androgen-like issues which results in weight gain, acne, hair growth, and sometimes you can see some libido enhancements on that. So, that’s the difference between men and women.
- POOR GUT HEALTH. In the gut, we make healthy good bacteria in our gut that help us absorb a lot of nutrients. A good healthy gut function helps us break down protein for good HDL levels and good enzyme levels. We need these to break down protein into amino acids which are really important for helping us to detoxify. So, detoxification helps us to excrete estrogens that we’re getting exposed to in our environments such as the pesticides, plastic, or something that you don’t even know you’re getting exposed to. Good healthy detoxification will help your body eliminate that, so that’s a good backup plan.Also, if we have a lot of dysbiosis, SIBO and bacterial overgrowth, we can make a lot of what’s called beta-glucuronidase. This is an enzyme that’s made by bad bacteria and it makes it harder to detoxify estrogen. The beta-glucuronidase takes conjugated estrogens and binds it to a protein that helps us excrete it out the body. It takes that protein and it pulls it apart. It takes the handcuffs off that protein, so that allows that estrogen that’s been deconjugated to go back into the body in the general circulation. So, if we have gut issues, that could be a major concern.
HOW DO WE ADDRESS THE PROBLEM?
We need things like cysteine, glycine, glutamine, sulfur amino acids, and things that help us methylate like B12, B6, and folate. So, these nutrients we have to get them in our diet via a good diet. We need to be able to break down and absorb those nutrients, so we need good digestion to get those things in there.
So, in general, we’ve got to make sure we have a good gut bacteria balance. Even fungal overgrowth can cause problems and H. pylori that can lower stomach acid and make it harder to break down nutrition on one side and then it can create this bacterial overgrowth enzyme that makes it hard to detoxify estrogen. These are really important components. If you have any issues with estrogen, you’ve got to look there.
Now, we may want to do things to help detoxify like make lifestyle changes, food changes, pesticide changes, make the changes in regards to plastics, and make in in regards to your diet, your glycemic load, and your gut. That’s a good first step to get to the bottom. There are also different things we may do to help upregulate detoxification to help get that estrogen. It may be activated charcoal or various soluble fibers. It could be things like bentonite clay. We could use things like DIM or Calcium D-Glucarate or glutathione, sulfur amino acids, and vitamin C. They’re all helpful in different situations. We would recommend them based on what’s happening but at least make the diet and lifestyle changes out of the gates.
How To Enhance and Support Fertility with Functional Medicine | Podcast #332
There are two main methods for getting pregnant and if you’ve struggled with conceiving then you’ve likely looked into and/or pursued traditional medicine. This doesn’t necessarily make you healthier, but your doctors will try to change your hormones to encourage pregnancy. On the functional side, Dr. J would focus on enhancing health, enhancing physiology, regulating hormones, etc. Even then, sometimes measures like IVF are still necessary for the end. But before we get to that, we want to look at all the natural ways we can encourage your body to prepare for baby-making in both men and women.
Dr. Justin Marchegiani
In this episode, we cover:
0:24 Two Approaches in Fertility
7:29 Root Causes
17:20 Right Diet
30:40 Prenatal Supplements
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house. Evan, how are we doing today man?
Evan Brand: I’m doing better. I had COVID Believe it or not. And that was like a five day journey. I think I’m over the hump. So if I sound a little weird, that’s why, but family’s healthy. And I’m a survivor. Now I’m going to be in the, quote, recovered category.
Dr. Justin Marchegiani: Love it. That’s good. Excellent. Well, today we chatted kind of pregame that we wanted to talk about fertility, talk about natural ways to enhance fertility. We see lots of patients that as a side effect of getting healthier through natural medicine, functional medicine, good nutrition, diet and lifestyle. They get pregnant, even if fertility wasn’t a goal, and we have some patients that come in with a goal of fertility and the nice thing is, fertility is a byproduct of getting healthy. So I mean, there’s kind of two approaches to it. There’s the conventional medicine side where they’re not really making you healthier, they may just be changing some of the hormones in your body. So you can get pregnant, right? IE via IVF therapy, those kind of things, right. And then there’s kind of natural ways that we are utilizing the enhancing of healthy and enhancing physiology to get pregnant. And sometimes IVF may be necessary. If you’ve done everything you can do on the health side, and you’re still not getting pregnant, that may be an option, right? But we want to do everything we can do on the natural medicine side, because if you do that, you know, 80 to 90% of people I think are going to get the results they want, which is getting pregnant. So I’m excited to dive into this topic with you today.
Evan Brand: Yeah, I would say that it’s pretty rare to need IVF based on some of the people that you and I’ve seen clinically, I’ve had several men and women and it’s good as a couple right. So that’s the important thing to mention. It’s important for the couple to get healthy the a lot of the blame is placed on the woman but in many cases, you know, male sperm motility or sperm concentration is a big issue. So the men kind of, you know, I don’t know why, but in general, the men get ignored in this conversation, but it’s really important for them to get optimized as well. And we’ve had couples where they looked at the cost of IVF, you know, typically 10, upwards of $15,000, depending on where 20,000 Really? Yeah, okay, so 15 to 20. And people come to us first and say, Well, you know, we didn’t want to go to IVF yet, because of the cost cost was kind of their main motivator, and maybe they, you know, hopefully had some sort of a natural minded bias. And so they said, well, let’s see what we can do first. And then 100 out of 100 times, so far, we’ve been able to avoid IVF for those people. And we’ve had, you know, between you and I alone, we’ve had four healthy children on our own. And then, you know, countless women that have had healthy pregnancies with our support
Dr. Justin Marchegiani: 100% it’s all about getting to the root cause, right? And yeah, there is that whole idea of the pottenger cats experiment where pottenger was in a medical doctor, I think, in the 50s, and he had different cats and he would feed some raw food, some processed food and and then there was, I think, within three generations of eating processed food. The cat group that ate the processed food lost the ability to reproduce. So there is this idea that we’re on like the third generation or so of this pottenger cat experiment. And there is some people that are just at that and end level where they may have reduced fertility just because they’re living out the pottenger cat experiment in real life. It’s possible some of that is the case. So we want to do our best to really emphasize a whole food nutrient dense anti inflammatory diet. We know that pregnancy involves healthy hormones. And as a starting off point, we don’t want to eat foods or toxins or hormones in our animal products that could throw off our fertility. So the first step in any fertility program, nutrient dense anti inflammatory, low toxin, that’s going to mean an organic whole food diet. that’s going to mean cutting out hormones and antibiotics and pesticides, and GMOs. A lot of these pesticides are xeno estrogens, they mimic hormones as well because they affect the insects from reproducing. That’s how they kill them. Right. And so it can also have an effect a cumulative effect on women and men on the sperm count women on the fertility side. So diet is going to be one of the first things and the second thing is going to be blood sugar stability. I think this low fat low cholesterol era, skipping meals fad dieting has prompted lots of insulin resistance, lots of reactive hypoglycemia, meaning too much sugar, too much carbs, blood sugar goes up and then spikes down, which then creates this insulin surge and high levels of insulin is really what’s behind the leading cause of infertility in women which is pcls. That’s polycystic ovarian syndrome. And that the mechanism there is high levels of insulin, insulin resistance insulin surges, thus increase androgens, and then the androgens also can throw off prolactin and then that can dis regulate a woman’s cycle. So you can see There’s a lot of different hormonal rhythms that can that can go off together and create many issues. So the major mechanism is in the beetus, insulin resistance, followed by increased level of androgens, free testosterone, testosterone, and then also prolactin issues to boost. Those are kind of the big initial sequelae that we see. And of course, usually if they’re eating a lot of crap or hydrating junky foods, people that are missing that level of awareness, tend to also be consuming the pesticides, maybe going to low fat, low cholesterol, maybe not getting high quality animal products and getting all the hormones in there too. So that’s like kind of my first two things out of the gates.
Evan Brand: Yep, well said and just want to quickly go over the conventional treatments for infertility, especially resulting from pcls. That’s what we did on our gut health podcast, kind of the conventional versus functional gut health. People loved it. I got a lot of good feedback on that. So thanks for the feedback. But it’s not pretty you mentioned it’s not root cause and it’s not so you’ve got this clomiphene which is the American College of obstetrician gynecologist recommendation that’s their primary medical medication for pcls patients with infertility, it indirectly causes eggs to mature and be released. Then you’ve got Metformin, which we just talked about the insulin resistance problems. So Metformin would come in and help. They talk about it helping just in terms of population, but that would probably be just due to helping to lower insulin. That’s what it is.
Dr. Justin Marchegiani: Yeah, Metformin, it liquefies. That’s a big one.
Evan Brand: And then you’ve got the letrozole. This is a drug that slows estrogen production causes the body to make more follicle stimulating hormone FSH, which is what you need for ovulation. And what else here they’ve got just other hormones in shot form, which are going to cause ovulation and then the craziest one, let me just read this one here and then we’ll we’ll move on into the functional you’ve got ovarian drilling. And so the surgeon makes a small cut in your abdomen inserts a long thin tool. And they use a needle with an electric current to puncture and destroy a small part of the ovary. This surgery leads to lower androgen levels, which may improve ovulation. So Wow. And if you do all those and you don’t get pregnant, then you could go to the IVF, which is where the sperm in the egg are put in a dish outside the body fertilization, fertilization happens, and then they put the fertilized egg into the uterus, and then boom, there you go.
Dr. Justin Marchegiani: Exactly. Now, I kind of want to tie back to the root cause I want everyone thinking about fertility from a root cause perspective, because when you think about it from a root cause then you can say, hey, are we getting to the root cause doing this procedure or doing this thing? So first off, like I already mentioned, pcls is a big one. Now with infertility, there’s usually going to be some level of insulin resistance or blood sugar dysglycemia meaning your blood sugar is up and down. And your body has to make a lot of hormones to regulate that flow blood sugar So when your blood sugar goes really high, right, because of excess carbohydrates in balanced meals, not enough protein and fat, you’re going to surge a whole bunch of insulin to bring the blood sugar back down. Now, women that tend to be more on the heavier side, usually that blood sugar eventually start staying higher, because that’s that’s what diabetes is right chronically high levels of blood sugar, but usually before that, there’s some level of reactive hypoglycemia where blood sugar goes up and then crashes down because the body over secretes insulin. And when the cells are still sensitive to insulin, that blood sugar will drop down really, really fast. And then your body has to make a lot of adrenaline and cortisol to bring it back up. Okay. So if we tie in prolactin, prolactin is going to go high when there’s high levels of estrogen. So when we start having more estrogen dominance, Okay, first mechanism, how does estrogen dominance happen? Well, it’s going to happen one through exposure of estrogens and the environment to with gonna happen through metabolism of progesterone. So progesterone is a really important progestational Pro fertility hormone very important. When we get stressed we’ll actually convert progesterone downstream into cortisol. So when we get chronically stressed, we’re going to decrease progesterone. And then number three high levels of estrogen, estrogen dominance, that is going to start driving prolactin issues. And when we start burning up dopamine, right, dopamine is a very important neurotransmitter. Dopamine gets used to make adrenaline so when we start making a lot of adrenaline, a lot of stress neurotransmitter, dopamine gets used, and dope means a tonic inhibitor or prolactin. So imagine you have prolactin and you have dopamine level is like the foot on the brake, right. And as you start depleting your dopamine and you start getting more stress, you’re taking your foot off the brake and what happens to prolactin, it goes up and prolactin starts to go up one of the side effects Next is loss of ovulation. Right You can go, [inaudible]. So you have a couple of mechanisms, right? You have this prolactin mechanism from dopamine, you have estrogen dominance, which can affect prolactin as well. You have this infertility through pcls. And insulin resistance and elevation and androgens, right. And then also all of the food components, all of the hormones and the toxins and the pesticides also contribute to that.
Evan Brand: Yeah, those are, I would say the biggest and most important things affecting your average american. There’s a couple other small subgroups, I want to mention what I’ve seen with infertility, one being people that are overtraining with exercise, you mentioned also the period. So I had a woman who she was, she was in the small percentage, but we have to talk about the small percentage because you know, people who are healthy and want to be healthy, listen to our podcast, and so there’s people that may be overachievers will call them and so we had a lady that was doing CrossFit like four or five times a week 45 minute sessions, and just beating the pavement. Now, typically when someone’s doing that we don’t really need to run a hormone profile. But just because I knew that it would increase her compliance. If I told her to stop exercising, she may not listen to me. So we use the testing to prove on paper what we already knew intuitively, which is that she was causing her cycle to be disrupted due to the chronic stress of the overtraining. So when we ran the hormone profile, and we showed her what her cortisol look like, it was basically flatlined, except for the time of the day when she did the exercise, she had a mild spike, which is why she felt better. You know, she said, Oh, my day is not complete until I exercise that’s because her cortisol was so low, and when she whipped the tired horse, all of a sudden she got this temporary boost of cortisol and adrenaline. She felt normal and that was it. But the prescription for her to get pregnant was simply just go down in the exercise. I just told her do three days a week Max, but do yoga, restorative, do biking, do hiking, do gentle things that are fun for you, and fun. For your family, and that’s all she did. I mean, her diet was already dialed in. We did look at her gut. We didn’t see any infections there. You know, we knew that there was no insulin problem, the carbs were not an issue. And she got pregnant just by simply reducing the training. And then another small group of people are people, women, specifically that were just going to low carb. So I had several women that were on a ketogenic diet. And some would argue well, our ancestors they could have been ketogenic, right, they were out in the prairies eating the bison, and they may not have had access to potatoes and whatever else but I do believe that some carbs are beneficial and necessary for fertility and for healthy pregnancy. So I had some women that were on keto for a long time, all we did is just add in some starch, organic white rice, we did some potatoes every once in a while and boom, they got pregnant and we didn’t change anything else. This is of course after we do the whole functional medicine workup, which you and I will talk about in a minute. That was after we did all that then we tweak the diet and then boom, she got pregnant.
Dr. Justin Marchegiani: Yeah, and I would say because information ability is primarily driven through PC OS and PC OS, the major mechanism behind it is going to be insulin resistance. I think a default template should be a lower carb paleo ketogenic template. But just because that’s our default doesn’t mean we’re not clinicians and adjusting things for the patient. So of course, with this girl, she may have done really well with that. And then she may have tapped out her benefits with it. And she may have already been at a really good place with her insulin. Because if you get insulin too low, and you’re already are relatively healthy body comp, that could also be a problem too. So this is why we have to individualize it for patients. So we’re talking about pcls and insulin resistance. And for most people, that kind of a dietary strategy is going to be a really important starting point. But for some people, you may hit the wall, and you have to adjust like you haven’t talked about others, you may have to hang out there a lot longer. So it’s kind of keep that in the back of your mind because we’re kind of having two conflicting recommendations. And that’s because everyone’s at Individual, and we have a starting point for most and then we adjust according to the patient’s needs after.
Evan Brand: Yeah, and that’s just an extreme case, but I at least wanted to mention it right? Because you always have the people that say, well, I’ve already done paleo and I still you know, had issues of course, there could be other underlying causes, you know, infections or whatever else we’ll get into, but in her case, this lady who was literally just doing like meat, and maybe a salad, you know, she literally had almost like virtually no carbs at all. So, so that’s just an extreme manifestation. But if you’re doing your, like you said, just kind of standard paleo template, you’re probably going to do maybe it’s plantains or some berries or you’re probably eventually over the day would accumulate enough starch or carbs to to fuel the fertility, but in her case, no, she was too low.
Dr. Justin Marchegiani: And again, if you’re insulin resistant, the starch or carbs may be keeping you infertile, right? Yeah, we can always do testing. We can always run fasting insulin and we can see where your fasting insulins are at. If there’s pcus. We may also want to look at prolactin, we may also want to look at free and total to stop Throw a see where that’s fitting to make sure it’s not, you know, in the top half top top 25% of the reference range. That’s pretty good to look at. So what’s the underlying mechanism? So if this person’s over exercising, it’s probably one over exercising, it can create estrogen dominance, right? So it can decrease progesterone. It can also decrease your dopamine and adrenaline which can be that driver that increases prolactin, right. And it can also just deplete hormones in general, I see a lot of women that are low estrogen, low progesterone, and they still may be a little bit in estrogen dominance because the ratio is still skewed, but their hormones are just low across the board. I see that a lot as well. So you have to this is why it’s super important to to test right because if you’re not testing you’re guessing. So with fertility cases, we may run a month long test to see where you’re at from day one when you bleed, all the way to oscillation all the way to the end of the month looking through the luteal phase to see how high that progesterone gets. We may just come in there and run a snapshot on the luteal phase two If patients have some infertility issues, but it’s not a primary thing, then we may just come in there with the luteal thing. If they’re really struggling on the fertility side, then we may do that full month. So I’ll typically do one or the other. And of course, looking at the adrenals are so important. Why? Because the adrenals interplay with dopamine and adrenaline and cortisol and estrogen dominance, ie via progesterone going to cortisol, we have to look at the adrenals because they play a major role as a backup generator with the female hormones.
Evan Brand: Yeah, absolutely. I mean, adaptogenic herbs are part of my life. They’re part of your life, you know, on a daily basis for us clinically And personally, and it’s a game changer. I would say it’s one of the biggest, one of my most favorite and biggest tools that I will use with a woman who is struggling with infertility, especially because there’s so much emotional stress. And there’s trauma associated with this, especially if a woman’s had a miscarriage or if a woman you know, has worked on this for months and months and years and been to several doctors in practice. And she feels like she’s at the end of the rope and she’s aging and she’s kind of running out of her her fertile window anyway. I mean, there’s so much stress associated with the emotional component of this as well and maybe family pressure when you’re going to have kids and that whole thing so, to me, that’s where adaptogenic herbs come in and not only help with the hormonal side, but the mental emotional stress as well.
Dr. Justin Marchegiani: Exactly. So in general, like with women and men, similar things with the diet, right men, there’s less of a hormonal fluctuation that’s going to be throwing fertility off. So keeping the pesticides, the hormones, the artificial hormones, these you know, estrogens, the growth hormones, really emphasizing good proteins, good fats, high quality cholesterol from animal products, lots of good antioxidants from leafy greens, keeping insulin in check. That’s a good first step. Of course, we can add in resistance training, we can add in mitochondrial nutrients like carnitine and co q 10, and arginine and zinc and selenium. Again, it was certain male patients will come in. We’ll run a nutrient profile and see what nutrients Their low end as well and of course, we’re going to be fixing the gut fix to the adrenals. And using a lot of those first line things, it’s also herbs we can use as well. ashwagandha is a big one tyrosine and dopa means a big one right? You see macoun as well as a big one. Why? Because dopamine helps with fertility. You mentioned earlier tongkat Ali really helps with that upstream signaling from the banana tropic releasing hormone, which then helps with FSH and LH. Lh is really important for spermatogenesis and making healthy sperm. So these are really good first line steps for enhancing male fertility. Anything else you want to add about that?
Evan Brand: Yeah, we weren’t. We didn’t press the record button yet. When we when you were now we’re talking about that. So let me just give just a quick little story on Tongkat Ali. There’s a Latin name for it as well. It’s something that’s beneficial for for men. We give it a lot to athletes, it does help with testosterone levels. And there are a couple of really, really cool papers on it. Where it’s increasing supermoto Genesis by influencing that HP ga axis the hypothalamus pituitary go Natl access. And long story short, not only did it increase the sperm count, but it increased the sperm motility. So you’ve got better swimmers. So when we talk about men, you know, having an important role in this fertility, you know, piece, that’s also a game changer. And then tribulus is another, you know, tribulus is once again kind of used in the bodybuilding community quite a bit to help with muscle mass and androgen increasing effects and all that, but it does help with the testosterone in the DHT DHT levels, which are all sex hormones that are important. And then also, what about the What about the influence of the gut? Do you want to talk about that now because I’m just thinking out loud with you here. We should probably talk about the mechanism of beta glucuronicdase issues with men and women where they would be re circulating estrogen and having issues with estrogen due to the beta glucuronicdase. enzyme being hired. Due to like a bacterial overgrowth problem, for example.
Dr. Justin Marchegiani: Yeah, so in functional medicine, right, we may look at things a little bit closer when it comes to fertility, but we’re still going to be doing the same things with the gut because if we don’t go to the six R’s of healthy gut function, we don’t go to the six R’s, removing the bad foods, replacing enzymes and acids repairing the gut lining in the in the hormones, removing the infection, repopulating rynok elating, good bacteria retesting. The gut is where everything happens 80% of the immune systems there, that’s where all the nutrients are absorbed and digested and assimilated and utilized. So if we just were to skip that and go to a hormone protocol, or a typical augmentation program with progesterone, we may miss a lot of those nutrients getting assimilated, broken down and absorbed and utilized. So we have to always assume the gut could be a major interplay. And again, most people, they’re not connecting the gut with their hormones. They just never right. But like you mentioned beta glucuronidation plays a role in hormone detox and We could be increasing estrogen dominance to the bad bacteria causing us to reabsorb estrogens. Right. We could also just have bad liver and gallbladder function because we’re not digesting fat, partly because of low stomach acid partly because of an H. pylori infection or grd infection. And that can make us hard to break down and assimilate cholesterol and essential fatty acids, which are important building blocks for fertility, right. So these things always kind of connect whether they’re one two or three degrees away from the root.
Evan Brand: Now if you’re a little brain fog, and you’re listening to Justin talk, you’re like, Oh my God, he’s talking fast. What is he saying? Giardia? What the heck pet parents Oh my god. So yes, literally, gut infections can literally make you infertile. We had several women who were infertile, and we ran their stool panel, they showed up with parasites, whether it was Giardia or krypto. As you mentioned, H. pylori being a big influence on stomach acids. So now, if we think about we always talk about good diet for mom, which is going to be a good diet to feed and grow a baby. But what if she does have these infections, and she is doing a paleo template and she’s doing her Grass Fed Whey or whatever to get her amino acid profile complete. And now all of a sudden she’s got these gut infections. So literally, just by running a gut panel and walking someone through using herbs to eradicate these infections, boom, I’ve had I lost count many women who, during a parasite protocol, they’ll email the office, I’m pregnant. What do I do? I’m like, holy crap. Yeah, by the way, this protocol by eliminating parasites, it actually increases fertility. Boom, there you go. Congratulations. And so it’s, it’s pretty nuts.
Dr. Justin Marchegiani: In general, anything else you want to say about that? So we talked about gut being really important. So HCl, enzymes, those kind of things are really important. We talked about the six hour if you’ve done podcast on that topic, so just make sure if you’re thinking about fertility, make sure we don’t ignore that right. has to be on the women has to know On the men, usually male men are easier to deal with because they don’t have a very unique symphony of a cycle. They kind of have a foghorn of hormones. And usually that’s going to be depleted by stress and poor nutrition and gut stuff. So it’s a little bit easier on the hormone side. But with women, it’s a little bit more complicated because of the cycle. So we talked about IVF. We talked about medication like clomiphene citrate or Clomid, which is a stimulates gnrh, which then stimulates FSH and LH and follicle stimulating hormone luteinizing hormone from the pituitary, which then stimulates egg maturation and oscillation. So there’s that right. But that’s kind of like a stimulator. Like Think of it as you got a tired horse. Do you really want the horse to perform by whipping it harder? Right? Is that the mindset? So for some people, that’s like an easy, you know, quick, simple, okay, I’m pregnant now. And most people who are aren’t as natural minded, that’s usually the first line of therapy that they’re going to do on the fertility side right. Then usually after that, they may go I UI which is the inter uterus insemination and then they may go into IVF or they shut down the whole HPA access using Lupron, they come in there with certain like follistim and different hormones at certain times so they can grow the eggs, harvest them, put them back in, get the whole hormone cascade going with all the injections, and then while you’re pregnant and then maintain the pregnancy with progesterone, that’s kind of what happens on the IVF side. But that may not be necessary for a lot of women. We already talked about the major mechanisms. Now, what are some deal breakers that may hold you back from getting pregnant even with doing all this? So there are certain things you have to look out for fibroids are a big one. If you have some big fibroids that are just hanging out, they could be there could be enough there where it’s disrupting blood flow, because the fibroids are a blood flow hog, and that could be preventing the egg from implanting into the uterus lining. Also, the fibroid can create a little bit of inflammation now everything we’re talking about is designed to To help prevent those fibroids from growing, the question is How long have they been growing they’re they’ve been hanging out for like years and years and years and decades. Some of the natural things just make take may take too long. And so you have to be very, very aware of that. Or it may be so big where it has so much momentum, it may need to be removed surgically. So you have to be mindful of things like fibroids. Also, endometriosis is a big one. That’s endometrial tissue, can it which is basically the endometrial lining tissue starts growing in areas it shouldn’t be, it could grow on the ovaries, it could grow on the bladder. Sometimes endometriosis, endometriosis can cause inflammation in that area. And then a lot of times with a simple procedure where you come and take a laser and kind of laser it off can be very helpful. conventional medicine won’t fix the root cause of why the fibroids there or why the endometriosis is there, but sometimes it’s gotten so bad where that may be necessary. There’s also something called a chocolate cyst, which is basically an Dimitrios in the ovary and that can Definitely be a problem as well. So that may need to be drained. So that you have to look at some of these things, some of these tissues that have grown for a long period of time, they may need a conventional intervention. Now, as long as you’re relatively young, and you have some time, try the natural stuff first and see if your body can handle it. If not, that may be the next thing to look at. And then of course, we already talked about pcls, which is polycystic ovarian syndrome. And that’s where there’s system the ovaries from all the things I mentioned, elevations and insulin and androgens, and I seen those reabsorb time and time again. So I’ve seen the body be able to handle that. I don’t see most patients that will have to go in and get those things drain per se, I find the body can handle that. The other things may need to be addressed at some point over time, but I always say wait and see work with a good functional medicine Doc, have a good ob gyn or a reproductive ob gyn kind of in your back pocket. So you’re monitoring things as you move forward. And if you have to go a surgical route, don’t throw away the functional medicine doctor keep both of them working together.
Evan Brand: Yep. Yeah, good point. And you know, it’s possible that you could find like a holistic or more natural minded ob as well, that would be good to have on hand that way they would help support you with some of the dietary stuff. But yeah, with endometriosis, you know, there’s a hormone component to that as well. So we already talked about diet and things like that, but of course, in the beta glucuronidation, so like calcium D glucose rate, for example, you know, that’s something that we may use to help with getting out these excess xeno estrogens. And that could be a game changer too. And of course, in the diet, you’re getting some like, you know, calcium D glucose, right? You’ll get some of that naturally in the diet. So whether you’re doing like broccoli, or blueberries or whatever, I mean, different. You know, cruciferous veggies, you’re going to get some beneficial stuff like that. Anyway, that will help. Regarding the hormones. It sounds crazy that broccoli could help pregnancy but yeah, but it definitely could. And then also, I mean, there’s no there’s various exercises to that can be helpful. Exercise in general is helpful. So I mean, if you have a sedentary woman, and you get her moving, but not to the CrossFit, five, you know, five times a week level, you know, that could be a game changer.
Dr. Justin Marchegiani: Exactly. So you got to look at everything holistically, like, I’ll tell you my personal story. We have two Healthy Kids, two healthy boys. And my wife and I had a hard time getting pregnant in that first year. And we found she just had a really, really, really, really, really big fibroid, very big-
Evan Brand: Was that ultrasound or how gel, figure that out?
Dr. Justin Marchegiani: Transvaginal ultrasound, and my wife before she met me, she was on birth control pills for over a decade. So I think there was that she wasn’t he she was eating a lot of conventional foods in the beginning before she met me before we tweaked her diet. So I think there was a lot of hormonal growth that was going on for decades that caused some of that growth. And you can’t just pull it away and expect it to just reabsorb all of a sudden, right? You can’t take 10 years and just expect it to go away. And so we actually tried reducing it. Now there are things you can do, they can work there. You can do things like egcg epigallocatechin is in the green Green tea you can do things like resveratrol and lipids or curcumin, and you could do systemic enzymes like Sarah peptidase and lembrar kinase, which are helped to metabolize some of that tissue and can work. The question is, can it work fast enough? And so we went the surgical road that the fibroids removed and literally within two months of it being gone pregnant, no problems. And so sometimes that can be an issue. So you have to look at, okay, what’s the root? Cause? You know, do we have some limitations of matter, right? Were those tissues just been hanging out too long? Just the body needs a little bit of a head start getting that tissue removed. And if you got time, you know, do the natural things and just watch and wait, right watch and wait. So if you’re a female listening, and you’re not in a relationship, or you’re not looking to get pregnant anytime soon, but you want to at some point, I just recommend getting good, good workup with your ob gyn to make sure there are no endometriosis or fibroids, endometriosis. This is hard. Typically the only way to figure that out is laparoscopically, little incision for the scoping. So it’s kind of tough to know that one. But you know, usually a lot of the telltale symptoms like the painful periods, like those kind of things, if you’re having those symptoms work with a good functional medicine doc to help it, but keep an eye out on bigger issues, like fibroids and those things so you can act on it early.
Evan Brand: Yeah. Thanks for sharing the story. And now you got two little boys and they’re keeping you busy. So everything worked out.
Dr. Justin Marchegiani: You got it? Absolutely. So keep that in the back of your mind. Anything else you want to add? On the supplements? I know you were kind of riffing on a couple of adaptogens earlier. Anything else you want to add? You mentioned while you listen tongkat Ali?
Evan Brand: Yeah, so that could be for the men. I would just say during during the you and I’ve talked about this idea before we kind of call pregnancy more like a four trimester thing which women like cringe at like, Oh my God isn’t pregnancy long enough, but not just meaning that there’s a kind of a pre, a preNatal phase that happens before you even get there. Right now kind of a pre, you know, fertility supporting area. So we’ll bring in multis and omegas. And like you said, maybe systemic enzymes will bring in trace minerals, micronutrients, maybe Grass Fed Whey protein, maybe some Oregon supplements. I mean, there’s a lot of things that we can do right away to kind of prep the body before you even get pregnant. It’s not I disagree with this idea of you got, you’ve got a pot of positive pregnancy test start the prenatal, it’s like, No, you could be six weeks in already, like you should have been on the prenatal six months before you got pregnant in my opinion.
Dr. Justin Marchegiani: Yeah, and most prenatals I mean, prenatal is a more of a marketing thing, like in some of the prenatals that we recommend, what makes it a prenatal Well, there may just be a little bit more calcium, there may be some extra full weight in there. And of course, everything’s active, full light, no folic acid, everything’s mthfr. Of course, everything’s methylated. There may be some extra iron in there, right? So there may be a couple little nutrients that are a little bit extra. But if you look at a really good high quality multi versus a prenatal they’re going to be about 90 95% At the same Yeah, if you’re getting a high quality couple little tweaks here and there, of course, you may want to add in some extra essential fatty acids cod liver oil, those kind of things I think are are very, very helpful.
Evan Brand: I get so mad I get so mad when you go like if you go to like Whole Foods or I mean even even places like that where you’ll go and you’ll see these little cute gummies in like a clear container. And it’s like six gummies a day and the first ingredients like fructose or fructose tapioca syrup. And it’s like, okay, here you are taking the woman who, you know may not know exactly what’s going on may not understand the root causes, and he or she has eaten these little gummies every day as a prenatal it’s like no, it’s like candy.
Dr. Justin Marchegiani: Totally 100% agree. One other thing if you have to go a surgical intervention I recommend personally, if you’re a fertility age and you want to get pregnant that you see someone that has a specialty in reproduction as well as being a gynecologist. I find that certain gynecologist have a A perspective on what’s happening surgically with the goal of removing the tissue, while others have a perspective of that while maintaining fertility. So I find someone that’s a ob ob gyn as well as a reproductive specialist, they looking at the procedure with a lens of keeping fertility intact. So I always recommend if you have to go the surgical route, try to find an OB GYN that also has that reproductive specialty as well. Yep. Good advice. Yeah, I think that’s important. I’ve just seen, I’ve heard too many stories from ob gyns, who don’t have the repro specialty, and they’re just and again, some of these are older stories. They’re too easy. They’re too They jump the gun on just doing a complete hysterectomy or doing a partial hysterectomy just removing the uterus or just removing too much tissue and and that scaffolding of that uterus can collapse and other issues can happen. So I always like to make sure you have someone with an eye Keeping fertility intact.
Evan Brand: Yep. No, I mean that if that’s their job to just remove uterus and ovaries all day Yeah, they may not care about the fertility aspect at all.
Dr. Justin Marchegiani: Yeah, it’s really, really important. And then yeah, and that’s, that’s incredibly important and of course, the most non invasive to invasive is is the best way to go. Anything else having you want to add on the topic? I mean, Today’s been really great. I think we really hit a lot of things from the nutrition aspect to some of the herbs and nutrients just to dovetail that progesterone is a big one we may be adding in progesterone we may be adding in things like chase tree and damiana and different herbs that help modulate maka that modulate estrogen receptor sites and or modulate progesterone and even support progesterone and of course, we’re also supporting the adrenal so all of those key tenants there need to be fully looked at and supported that you want to add anything else that Evan?
Evan Brand: I don’t think so. There’s a Yeah, there’s a good handful of like female supporting herbs, things that we would typically use anyway. To help with like PMS, for example, things that are going to help regulate hormone levels, those things alone can contribute to fertility. So yeah, it’s sometimes where a woman comes to us with a different problem with hormones, they may say, Oh, I eventually want to get pregnant. But right now I need to focus on this major PMS. I’m out of work every week, you know, I’m laying in bed in pain, and we just help regulate hormones using some of those herbs you mentioned there and then fix the gut and then boom, hey, we got pregnant sooner than anticipated. Cool. Let’s go ahead and kind of transition now let’s, you know, let’s get you into this, you know, maternal support phase now and it’s really fun I tell you, there’s there’s nothing better than you know, whether it’s getting a picture in my inbox of a new baby or just a mom telling her birth story. It’s It’s fun, and it’s a very, very rewarding thing. And, and, and I always, I don’t know I like to pop my collar a little bit more after I hear a good story like that, especially when a woman was dealing with the conventional medical world and she was so frustrated. And so hopeless, and then she was able to actually do it naturally. It’s like, Yes, I told you so I told you you could do it because the conventional doctors are obese will be like, nope, you can’t do it. You’re not going to get fertile. You’re too old. Your hormones are too messed up. It’s not gonna happen. And then boom, a baby comes. It’s always just like I told you, so.
Dr. Justin Marchegiani: I like it. Well, after you talked about popping the collar, I’m gonna I’m gonna join you on that one. There we go. Excellent. Very good. So yeah, I love those stories. I think that’s excellent. We always want to focus on the root cause so just anyone listening we want to make sure our goal is that you’re looking at your fertility from a root cause perspective. If you have to bring a functional medicine doctor in great if you have to bring a conventional fertility MD and great just always make sure you’re looking at the root cause. If you have to go you know more invasive on the IVF or surgery side, that’s fine. Just make sure you exhaust all of the foundational options first, nutritionally and functional medicine wise. And then also make sure your husband’s a part of what’s going on. So Make sure he’s getting tested, his nutrients are assessed. He’s doing all the right things on the fertility side, we can also get a sperm count on him as well make sure sperm numbers are good, you know, at least 50 million, make sure shape and morphology and all that good stuff is dialed in as well to assess that being okay. And of course if, if it’s not, then we have to work on all the nutrients and work on removing a lot of the toxins that we already talked about.
Evan Brand: Yep. So get off the mountain dew. Oh God, we had a friend that was an old friend who was having issue with fellow body and her and her husband both just pounded the Mountain Dew. I’m like, who even drinks Mountain Dew anymore? I mean, it’s like, it’s like 80 grams of sugar per bottle. I was like, oh, get off the mountain dew. So of course, you know, typically people would think everybody around you and I like we’re just the circle of health, our family, our friends and everybody would just listen to us and reach out to us for help. But that’s typically not how it we’re not how it is. So of course they don’t ask me anything. What do they do? They go do IVF they spent, I think it was 15 or $20,000. They did like a fundraiser raise money. It’s like how about just like, let us give you the workup, it’s going to be a fraction of the cost. And you’re going to have, you know, minimal to no risk. I mean, like with other procedures, you know, you could have risk of twins and triplets. I mean, they’re not, you know, death necessarily risk, but there are risk associated with some of these other things. So, it’s just sad. It’s sad that people just don’t know. And, you know, you always say, oh, let’s talk about the root cause of this. It’s like, why is that so revolutionary? That should be the first way people think but it’s not.
Dr. Justin Marchegiani: 100% you’re never a prophet in your own town. And also, if women have to go the IVF road, the goal remember the end goal is not just to get pregnant, right? What’s the angle? Let’s huddle up and focus on what’s the end goal the end goal was to have a healthy baby, right that’s that’s the angle and pregnancies one step in that journey. So don’t confuse the first step as success number one, and then number two, If you’re going to engage in more conventional approaches that don’t address the root cause, I strongly urge you to make sure you’re addressing the root cause. So the angle should be having a healthy baby at the end. So just keep that in mind, make sure you are really focused on what the root cause and goals are.
Evan Brand: Let me say one last thing, and then I want to get your take on this real quick. And I love the way you said that, you know, the pregnancy is not just the end all Gold’s it’s the healthy baby and all that. So, you know, what about if a woman does get pregnant, and in an unnatural method, like IVF, for example, but she still has an insulin problem. I’ve seen cases where you could argue with something else, but I would argue that the elevated insulin and the sugar and the carbs and all the crap in the diet could potentially make the baby get too big. And then the doctors are saying, Hey, you know, now you’ve got a nine pounder, we’re gonna have to do a mandatory c section, for example. You know, there’s other complications there.
Dr. Justin Marchegiani: Yeah, I mean, just having that high amount of insulin, gestational diabetes. kind of thing going on, which a lot of times the Hopis don’t even acknowledge, really being a diet thing. I mean, I remember going in and my wife was getting testing on the blood sugar, and we were monitoring her blood sugar at home. And the nurse practitioner said, you know, hey, you know, the gestational diabetes is a genetic thing. And I’m like, I literally pulled up a study of like, literally says more grains, and trans fatty acids can actually increase it. And it was like a, it was just, it was like a paradigm thing. It’s like, even though like, if people are conventionally trained, and have to pass all these, you know, mainstream boards for their licensing, they’re not really up to date with the conventional literature in the conventional literature isn’t really injected in the first line therapies for what these doctors and nurses need to know. So it’s kind of sad. So we just want to bring that information everyone on the forefront now so they’re aware of it, and also test the blood sugar and if you’re at high risk for a miscarriage, then you’d want to keep an eye on your progesterone levels. As soon as you get pregnant. One of the easiest first things is using progesterone, an inter-vaginal progesterone probably 200 milligrams or so a day throughout that first trimester can be a godsend for a lot of women. So if you’re at high risk for miscarriage, make sure you keep an eye on testing those progesterone levels, you know, 15 to 20 or so in that first week, couple weeks of getting pregnant and to be important, so keep an eye on that with your ob. So you’re monitoring if you’re high risk.
Evan Brand: Yup. Well said. Well I’m sure I could break off a few of the things but let’s wrap it up and keep on reaching out clinically. We’d love to help you. Justin is available around the world at JustinHealth.com. Me, EvanBrand.com and we’ll be back soon to talk more.
Dr. Justin Marchegiani: Phenomenal chatting with you all. Have a good day.
Evan Brand: Take Care.
Dr. Justin Marchegiani: Bye.
Does Eating Healthy When Stressed Make You Feel Better? | Podcast #315
Eating a healthy diet can reduce the negative effects of stress on your body and a healthy diet builds a solid, more enduring foundation for your body by reducing oxidation and inflammation and by helping to reduce weight gain. So in this video, we have Dr. J and Evan talking about how we can handle stress while trying to stay fit and healthy.
Dr. Justin Marchegiani
In this episode, we cover:
0:30 Why is it hard to eat healthy?
7:01 Eating unhealthy junk
17:19 Avoid stressing out on eating healthy
25:51 We all have different journey
29:11 Get the momentum
Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here today’s podcast is going to be all about is your health making you stressed and anxious? Again, it takes a lot of effort and a lot of energy to be healthy. And we want to make sure that those goals are not making you sick and stress at the same time, Evan, how are we doing today man?
Evan Brand: Doing awesome. Let’s dive in. First of all, when you say that, why, why does it take so much effort to be healthy? Is it just the modern world, the circumstances, the toxins?
Dr. Justin Marchegiani: So my first step out of the gates, it’s all about habits, right? It takes no more effort to get what you want than what it does to get what you don’t want. It’s all about pattern of behavior. And so I always tell patients, the first month is typically the hardest because you’re creating new patterns of behavior. So there’s like, there’s four levels of competence, right? There’s the conscious or unconsciously unconfident, meaning you don’t know what you don’t know. You’re just totally clueless right? And then you’re unconsciously or then you’re, you’re, you’re basically unconsciously competent, where you kind of know that you don’t know something, right, you kind of know that you don’t know something. And then you’re consciously competent, where you know it. But you really have to be focused on the habits, choosing the right things, doing the right things. So usually, it’s the unconscious incompetence, these are people we’re not able to help, because they don’t even know there’s a problem. Once they go from unconsciously incompetent to consciously incompetent, they know that they don’t quite have the skills, that’s where we’re able to help them in stage two. And stage two to stage three is the hardest because this is where we go from, you’re consciously competent, you have to focus, you have to think about every little thing you’re doing right. What’s my analogy, anyone that’s driven a standard transmission car, it’s tough, like you’re driving a car, now you’re putting your left foot on the train on the on the clutch, you’re shifting gears, maybe you’re looking down and make sure you don’t go from first to third, right. But at the same time, you still got to fear and keep your eyes on the road. So it becomes this, you may be able to do what you’re grinding the gears, but it’s a lot of stress and you’re consciously competent, that’s kind of where most people are at with their health changes. And then there’s unconscious competence. That’s where we’re at, where we’re literally on cruise control, because we’ve done things thousands of times in regards to the clean filtered water that we’re drinking, eating good healthy proteins and fats, taking supplements, avoiding toxins, using health devices that help improve air quality and water quality and EMF and all the things that we’re doing. It’s unconscious, there’s literally no effort for us to continue to do or very little effort, right? Kind of like driving once you have a stick. It’s like no big deal. You’re like shifting gears, your eyes are on the road, you’re down shifting No problem, right? Is that a good analogy?
Evan Brand: Yeah, that makes sense. And a lot of people, they get overwhelmed, and then they just give up or they get pressured by their family members or their friends like you and I were talking about before we hit record, oh, just have some gluten. It’s not going to hurt you. You know, I’ve had family members joke like when we’re giving them the salt shaker at the dinner table. They’ll say, Oh, can you pass me some gluten? And they’ll try to like joke, like they’re pouring gluten on their meal. It’s like, Oh, come on. So you know, you get people like that that will try to influence you. And it may be a joke, but sometimes, I want to say weak people. But when I say weak, I mean people that are symptomatic people that are ill. They’ve been trapped in those habits for so long, they may actually fall off the wagon, from Aunt Betty saying, hey, try one of my famous cookies that are loaded with sugar and gluten, they may go for it Betty’s cookie when they know they shouldn’t. But I think number one, I think you have to suffer enough to be able to be more compliant. I don’t know if you agree with that or not. But like for me, I’ve suffered enough to where I don’t feel that I want to make those choices anymore. Like, I know that that case would be so friggin delicious. But I don’t want to pay the price with my skin. I don’t want to pay the price with my gut. So for me, I’ve suffered enough to be able to make the choices easier. But if you’re trying to just convince people just to convince them, I don’t think it’s as powerful.
Dr. Justin Marchegiani: So yeah, I have a couple of thoughts on those are all valid points Evan. So off the bat, it all depends where you’re starting, right? The healthier you are, the more adaptable you are, right? So the healthier you are, the more adaptation you are, more adaptable you are, the more you can deal with a stress like gluten like sugar, like being off on your diet, like being off on your sleep. So the healthier you are, you may have a little bit more resilience. And then the question comes down to how do you feel after you eat some crappy food? Right? How do you feel? How long does it take you to get back on track the next day? Is it just you’re okay? And that next day? Maybe you’re a little bit of a slow startup but then you’re good? Or does it take a couple of days or a whole week to kind of get back on track, right? So the healthier you are, the more adaptation your body has, the more you could cheat a little bit. Now there’s different levels of cheating is eating a lots of processed sugar and lots of gluten and lots of food allergens that you know you can handle. Now if you don’t have an autoimmune condition, and you aren’t as sensitive in regards to how you feel afterwards, you may be able They get away with that every now and then not that big of a deal. If you have a diagnosed autoimmune condition like myself, I have hashimotos that I’ve totally manage under control, I always try to choose the healthy alternative, you know, I’m always going to go grain free or gluten free, I’m always going to go gluten free over gluten full, if you will, right. So like for we had Thanksgiving last week, we got some squash pies from trophy, true food kitchen that were 100% grain free and like lower sugar, they were great, right? Good, better best. So I always try to make the best quality decision I possibly can. Because I know I have I have immune issues. And I want to prevent my immune system from attacking my body. Now if someone doesn’t have any diagnosed conditions, and they feel great, they may be able to do more of an 80 20 kind of 90 10. I do an 80 20 90 10. But I still keep it to ideally grain free processed foods or at least gluten free processed foods. And if someone isn’t at a stable place in their health or coming to see us during the middle of their functional medicine kind of onramp well, then we got to be a little bit more puritanical. Off, kind of off the the back. So it all depends where you’re at, in the plan that you’re on.
Evan Brand: Yeah. And even though I’m feeling better, and I could probably get away with more stuff, I just don’t go there. Because I know that I don’t want to say it’s a slippery slope. But I know that if I’m like, Okay, I got away with it once the next week, I may go for it again. And then boom. And then now I’ve got the skin issue again, or now I’ve got the gut issue again. So for me, it’s very easy to stay on track. I don’t feel like I’m missing out. I don’t feel deprived. I think one part of this conversation you you’re titling this, this talk is, you know, being healthy making you anxious or stressed. And I think where people get caught up in it is because they feel like they’re deprived. They look at these other people eating the pizza, and they’re like, well, I want pizza, I’m deprived. This is bullcrap. And then they get stressed that they have to eat their their grass fed steak and sweet potato. But for me, once you feel so good, it’s not a diet of deprivation. Would you agree? This is not a diet where you feel like you’re missing out? I don’t feel like I’m missing out on anything.
Dr. Justin Marchegiani: Well, anytime you’re dealing with, you know, eating a bunch of crappy food, you have to look at why. Okay? So in general, a lot of times neurotransmitters play a big role. So a lot of people use a big big whack of sugar to artificially boost serotonin and dopamine. And that we call that emotional eating, they’re using a lot of the sugar to get that under control. So with myself, um, if I cheat on anything, it’s going to be like the Unreal, coconut dark chocolate, it’s going to be my keto cups, like, Is it really a cheat? Probably not. There’s barely any sugar in it. But it still gives me that mouthfeel. And not that sense of cheating. Like, like, I’m really eating a whole bunch of bad foods, but it feels good. It feels like a cheat, it feels like a treat, so to speak. So we always try to choose the highest quality one, we try to choose the lowest quality or the highest quality nutrition like good fats, right, avoiding the trans fats good, lower sugar amounts, I try to do more of the organic coconut palm versus, you know, the high fructose corn syrup, maybe with some mercury in there. So we try to choose the better quality types. And how do you feel afterwards, a lot of people, they don’t really look at how they’re going to feel afterwards. So if you’re really bloating, you’re gassy and your skin breaks out and it lasts a week. Like if I have a skin breakout that lasts a week, I am like heck no not worth it. So I’m always gonna, you’re always playing damage control, you’re always making calculated assessments. So when you make a decision to engage in desserts and treats for the holidays, we’re going to be choosing the healthiest quality, the lowest sugar, but still have a great time like Well, my kids, we went trick or treating, what happened afterwards? Well, trick or treating bad with all the candy went away, we actually gave it to the fire station. And then we I got some of the Justin’s high quality dark chocolate peanut butter cups and some of the Unreal, dark chocolate with a little bit of coconut in there. And that was their substitute. And so they got one or one or two every now and then. And it was low sugar, good fats, the fats are important because it stabilizes blood sugar, prevents cravings and swings and actually makes them a little bit satiated afterwards. And we’ll give it to them after a dinner. So we’re not creating this blood sugar rollercoaster of eating sugar by itself. And so we’d always just make these really good calculated substitute because I want to give my kids and myself a chance to enjoy life or have a childhood or do things that are really, you know, they’re like special, but with that with kind of mitigating the the side effects, if you will.
Evan Brand: Yeah, that’s a great point. And I think it’s easier if the whole family can get on board, like you mentioned, you’re doing this with your kids. So if you got the husband or the wife that’s not on board, that’s going to be really tough. I don’t know if I have many other solutions besides wait until that person is symptomatic enough to get to get on board because they’re really not going to do it just out of choice unless they’re just a very, very supportive spouse and Wow, good job, you’ve got a keeper. But in most cases, like I said, it’s the husband or the wife making fun of the other one, like I’m going to drink the beer, eat the pizza and do the wine or whatever. And you’re going to just go eat your your AIP diet. So try to get family members on board. That’s the best advice I can do because Then it gets exhausting man, you’ve got the husband and the wife cooking double meals, right? They’re making the unhealthy meal, and then they’re making the healthy meal. And then you got double the cleanup. So just from a sustainability standpoint, it’s just really best if you can get everyone the kids on board too, because you don’t want Mom, I had one lady, this is gonna sound crazy, maybe not to you, but maybe to others. We had a lady with hashimotos, where we had determined that the reason that she was having flares is because she was touching the bread making her children sandwiches every day, and that she was basically holding it and there was some kind of like a gluten skin reaction, transdermal kind of thing. Yeah, yeah. And so we got her Ah, well, they hit well just quit making sandwiches, or at least go like a grain free bread, if you can find it. And luckily, the antibodies went down just by changing that, because she was already AIP with her diet. And we’re like, Well, why are the antibodies continuing to rise? The thyroid, we worked on the gut. And typically that would help but it didn’t help and then boom, we figured out it was lady making sandwiches. So in her case, it actually benefited her to help her kids as well.
Dr. Justin Marchegiani: Yeah, most of my patients is the women are tend to be on point, they tend to be 100% on point and to be a little bit more in tune with their health. Also, I think they tend to be a little bit more, let’s just say not supported by conventional medicine, right? Women have hormonal issues, what are they given me, if they’re cycling ages, birth control pills, right, the people are getting a little bit more cutting edge with hormones as they get into menopausal age, but they were doing horse hormones for the longest time and they weren’t fixing any of these underlying issues. And they were just throwing medications that are antidepressants at it. And they kind of most women intuitively knew that something was wrong. Now my other kinds of patients are like my, my, my my guys that are great. They’re like the biohackers. They’re like the guys that are like optimizing cell performance. They’re trying to really get their their level their RPM or performance to a higher level. Those are my two like great patient, my women patients that are really know something’s up and want to dive in deeper, and that my guys that are more on the biohacking side and kind of optimizing performance, they kind of know something is up. Now, when I make recommendations for patients, you got to really get focused on the performance aspect. Like you got to feel that people have this satisfaction, feeling of like their mouth and their taste and all that stuff. That’s a hard feeling to overcome, right? It’s always pain versus pleasure. So you really have to link up a lot of pleasure from the performance that you get from eating great food, whether that is clean skin, whether it’s all day energy, whether it’s good sleep, whether it’s good libido and mood, you really have to internalize the performance enhancements that you get. Now, the more adaptable you get, you can still keep those benefits while you cheat a little bit. Now we just choose the healthiest cheat possible, I already gave you a couple of options. What I do, you can do it going out to eat, you can do it going to steak houses, all kinds of good things you can do when you go to a nice restaurant with steak and vegetables, or if he goes to sushi will avoid the soy sauce. And we’ll do MCT oil and coconut aminos. Right. There’s a lot of substitutes we’re always doing. And it’s hard out of the gates because it’s stressful. But once you kind of make a habit out of it, you kind of have all of those go to substitutes there at your fingertips. Do you have any things that you do, Evan that, you know, maybe a treat for you, but it’s you know, a really good go to?
Evan Brand: Yeah, well in terms of drinks, you know, I think that’s a big one, right? Just getting people off of sugary drinks. So Suja I think’s done a great job with all of their green juices. They have one I want to say it’s called like skin beauty or something. I don’t have the label in front of me. But for me in terms of beverages, I mean, I’m typically doing herbal teas, chamomile, ginger, peppermint tea, and then good clean filtered water. That’s about it. I know you’re super into the total Chico’s and some of the other mineral waters, carbonated waters. Those are great. But for me, I think it’s called beauty scan or scan beauty something anyway. Suja makes it it’s a whole foods. It’s like maybe four grams of sugar, but it’s like lychee juice and blueberry juice. Man, if I just get something like that. It’s a treat for me. And it may have a little bit of stevia or monk fruit in there. Something like that is great for my wife. You know, she had previously used like, you know, we’re talking 10 years ago, she had previously use some of the coffee creamers. I know people really do a lot of sugar in those. They’ll say oh, I only you know this coffee creamer is only two grams of sugar but it’s a gap but you’re putting like frickin five tablespoons. You’re just pouring it in. So for her. She really loves the rebel like the mushroom. Coffee blend.
Dr. Justin Marchegiani: I like that one.
Evan Brand: Yeah, like the coffee with the mushrooms and I think it has coconut milk and stevia. So it’s basically a no sugar. So for us. Those are kind of our treats that make her feel like she’s still getting a good creamy sweet coffee without sugar. And then for me, you know, I used to love as a kid and a teenager man. I love soda. I mean Sunkist and Mountain Dew. I mean, I was into all the garbage for me now if I have that lychee juice, man, it tastes like candy. But it’s Yeah, my palates change. That’s the thing. The palate has evolved for us. So like you mentioned the treats your level of treat like you I think you and I’ve talked about blueberries you’ve done I think you said you’ve done frozen blueberries with like whipped cream and that’s a treat for you.
Dr. Justin Marchegiani: That’s like a dessert and a cream is great is awesome. Do it, it’s a coconut yogurt, it’s all about, okay, you know, try to do the right thing 80% of the time, right. And then a lot of the treats that we do is, it may still be part of the right thing, right? If we’re doing some almond butter, if you can tolerate knots and Granny Smith, apple and cinnamon, or if you can do some, some blueberries and some coconut cream, those still may be healthy things, right. So the cool thing is if we can choose healthy treats, that that feel like a treat tastes like a treat, but still healthy. That’s a win win, because then you can do that more frequently. And that’s kind of a it mixes up the monotony of your routine. And then of course, if we’re going to go and cheat a little bit, you know, when I go to a restaurant, what’s my go to? Well, I’ll get like a really nice, homemade, though a couple of restaurants, I go to their steak houses, they’ll make a nice ice cream that’s kind of a sorbet. Or it’s kind of coconut base, that those are really wonderful and tasty. Or I went to Truffaut kitchen and got a squash pie, which was wonderful. Or like a coconut, like is a restaurant down in Austin called Picnic. They have some wonderful autoimmune dessert recipes that are excellent. So you can try to always mitigate a little bit. And then if you something that’s really special, I don’t know your grandmother makes up especially around the holidays, and it’s worth the treat. Well, that’s fine. You’ve earned it, as long as you can deal with the side effects afterwards. And ideally, we don’t have an autoimmune condition with active antibodies that could be attacking your body. And it’s probably okay.
Evan Brand: Yeah, very, very good. And then of course, we’ve mentioned the enzymes before too. So you’re gonna go get your grandma’s secret recipe, you know, there’s probably wheat and other crap in there, you may just want to do your enzyme, right? So like you and I both manufacture professional enzymes. So if you’re working with us, you’re probably already taking those but that’d be a good, that’d be a good strategy. Oh, you know, another treat for us I just started making these recently, is to take the CFA, the soft tortillas, and make like a [inaudible] out of it. So you do like a little bit of coconut oil, or you could just do butter if you want. And then just kind of put it in a pan for 1015 seconds, heat up the tortilla, and then just a little bit of coconut sugar and cinnamon on it. Oh my god. It tastes like when I was a kid, I’d go to the county fair and go eat the what was it the funnel cake or the elephant ear? Like that wheat Yep, thing with a bunch of powdered sugar on it. Oh my god, I love that I know. But this little, you know, the grain free tortilla with the coconut sugar and sentiment, man things delicious. That’s a treat.
Dr. Justin Marchegiani: Yeah, and so you can mitigate. So number one, don’t feel stressed about being healthy. Just kind of know that first month, the two months is the hardest. If you’re coming in to, you know, this new healthy lifestyle and habits with a lot of symptoms. Don’t worry about cheating, worried put your focus on developing habits, right? Many people, they go into this place in their head of like, Oh my god, like, I’m not going to ever be able to eat this again. It’s like a divorce. It’s like a breakup, it’s like they’re literally grieving the loss of this food I’ll never eat again, don’t go into it like that go into it with the mindset of Hey, I’m going to focus on eating nutrient dense anti inflammatory, low toxin foods, so I can decrease inflammation in my body, accelerate healing and feel awesome. And then once you’re at a good level where you’ve kind of plateaued, and you work through some of the programs that we’re on with hormones and gut and your digestion is better, then we can start adding foods back in. And we’re always going to choose the healthiest treat options and the healthiest foods first. And then if your optimal health stays at that great level, then we can you know, if you want to go off the beaten path, here or there, you know, 80 20, 90 10, 95 5, and you’re able to maintain your benefits and it doesn’t take you too long to get back on track. That’s fine as the book out there called the Four Hour Body by Tim Ferriss. And Tim Ferriss talks about a cheat day eating, we’re at whatever you want for a whole day. That is I’m sorry for most people, it’s a terrible idea. Because they go have a cheat day on Sunday, and they’re so inflamed. It takes till Thursday, the next week to get back into homeostasis. That’s a problem. – go ahead and go ahead.
Evan Brand: Let me interject because I think that you may even be underplaying how bad of an idea that is because you and I’ve seen just by looking at thousands of people on test results, we’ve seen you know, gluten antibodies and other antibodies go up for potentially months after certain exposures like that. So you’re mentioning possibly a week to reset it could even be months.
Dr. Justin Marchegiani: If you have an active autoimmune thyroid issue or active autoimmune issue it could be now you can get your thyroid looked at, you could always do an Array Phi by Cyrax, to look at other silent antibodies that could be there. But if your health is great, and you feel great, and you know you can kind of get back on track the next day, all right, fine, but try to always choose a grain free option for most of your stuff, at least gluten free for most of it. But yeah, so my whole thing is how do you know something’s worth it? You should be able to get back on track that next day, if you’re not back on track the next day, that’s a problem. Now, Evan, you already alluded to what what if those antibodies popped up and we don’t know about it, so if you have an active thyroid autoimmune issue, you really Really want to be testing those antibodies or that ANA, or those autoimmune markers? If you have lupus or sjogren, or something kind of under the surface? I would say really choose the healthiest cheat possible. It’s just not worth it when tissues being destroyed.
Evan Brand: Yeah, yeah. Well said and, you know, for me, we’d like to leverage the lab testing and show like, look how good you’ve done. Look, we’ve got your dopamine back to normal. You mentioned neurotransmitters early on, look, we’ve got serotonin normalized. Now, doesn’t that feel good look at your calprotectin in your gut, we’ve got your inflammation down 1000 points, look at your Secretory IGA that’s starting to come back up because you’re removing the foods irritating the gut. Look at some of these infections, we’ve cleared out because you’re not using the sugar to feed the Candida and to feed the other pathogens. So when we use the functional medicine testing, plus just kind of our pep talks and motivation we give to people it’s a really good one two punch that keeps people on a sustainable path forever. And it really is a lifestyle. You know, we talked about, oh, this is a lifestyle. It’s easy to embrace once you feel good. So I agree with you, you got to focus on Hey, do you want to feel amazing? And then some people will ask the same thing with supplements, right? They’ll ask the same question about diet as they do supplements. How long do I have to do this? on their diet? And I’m like, well, and this might always punch back with as well. Do you want to survive? Or do you want to thrive? Well, obviously I want to thrive. Okay, well then do it forever. Okay, that was easy. So for me, that’s the that’s the default answer. Like when someone’s like, well, how long do I need to dial in my diet? I mean, as long as you want to feel amazing is the answer.
Dr. Justin Marchegiani: Yeah, tell patients out of the gates, you may have to be more puritanical. Because you’re trying to make up for lost time. It’s kind of like, if you’re in debt, from decades of poor spending habits, well, we’re gonna have to kind of get you on a really lean budget, and you’re gonna have to be investing and saving a large percent of what you make. Now as you get on top of that, and you’re debt free. And, and you’re feeling great. And now you’re making investments. And now you’re on your way to financial freedom, you can be a little bit more loosey goosey with your spending, right, it’s kind of the same thing with your health, just change the the the money equation to health. And it’s the exact same thing. And so we always try to look at getting momentum getting you on top of your health, reaching the level of conscious competence to unconscious competence, where it’s automatic, because the stress that people feel in that first month or two is just the fact they haven’t made a habit yet. And so if you want to live a healthy lifestyle, you have to make you have to let your brain and your physiology shift into unconscious competence. If you’re quitting before you get there, you’re you’re doing yourself a disservice. Because the amount of energy if you’re thinking, well, it takes me too much energy to do these things. It’s because you’re not in unconscious competence yet, and you will be there just give it a little more time people project their energy is going to be on this conscious competence wavelength the whole life, meaning the amount of energy they have to focus in and project has that will be at that level, but it won’t, it’ll get easier once you make that shift to unconscious competence. Totally, totally. It’s so easy, it’s so much, it’s easy, it’s easier for me to stay on the rails than it is to go off the rails like I would have to be, it would take me effort to go off the rails, I’d have to like seek out bad things like what could I do to try to test myself or destroy myself so it’s a good place to be 100% so out of the gates, we kind of talked about it you know where you’re at, if you’re not a mean person, and you have active issues or active things going on that are significant. Do the right thing, do the right thing be on point get momentum, get your symptoms on hundred percent under control, look deeper under the hood regarding hormones regarding everything else that’s happening in your body. Work with a good functional medicine practitioner and get your blood sugar, get dysglycemia under control, get inflammation, nutrient density, get toxins under control. That means going organic, clean, filtered water, all that good stuff, hormone free, antibiotic free, get your hormone stabilized and worked on whether it’s blood sugar, thyroid, female or male hormones, and then get your gut looked at because the healthiest food. We’ve kind of alluded to it. If you can’t digest it or break it down or absorb it properly, because of stress in the gut, you’re going to have a problem. So of course the next thing is we’re assuming that because you’re eating good foods, you’re breaking it down. The next step is going to be working on the gut. And so we don’t want foods that are full of inflammatory food allergens affecting your gut if it’s not stable yet.
Evan Brand: Yeah, my diet was great, but I had gut infection so my skin was crap. So for me, I put in all the work on the diet and I got frustrated because I thought well, I’ve got rid of gluten I’ve got rid of dairy What is wrong with me? And then luckily the functional medicine testing came in and kind of uncovered some stuff so if you’re more dialed in, you’re still struggling then you know look deeper. And so if you want to reach out to Justin you can do so clinically at his website, JustinHealth.com. That’s Dr. J at JustinHealth.com. Me Evan Brand at EvanBrand.com we work with people over the phone, Skype, Zoom FaceTime, however we need to connect we send the labs to your door. You send those back to the lab, we jump on a follow up call to discuss the results and make a protocol. It’s very, very awesome. And with everything that’s been going on, it’s funny that telemedicine has gotten, you know, 10 x more popular. So it’s really cool that we were actually ahead of this curve. We’ve been doing this this way the whole time. So feel free to reach out and we look forward to helping you.
Dr. Justin Marchegiani: Absolutely. So you guys know where to reach out. And just remember to start with one thing, like, if you’re coming into this journey, I find a lot of people who aren’t doing the right thing, if you’re around them, and you start, you know, being on point and making health changes, sometimes there’s this subconscious pull to pull you down, because you making the changes to improve your health sometimes magnifies their inability or lack thereof to make changes in their life. And sometimes they may sabotage you and pull you down. It’s a threat. Yeah.
Evan Brand: Yeah, you’re saying that you’re saying that by you trying to better yourself, you may piss off other people, and then they’re going to try to come bring you down with them and their misery just eat the cookie.
Dr. Justin Marchegiani: Yeah, and everyone’s on a different journey. So if you’re the autoimmune person, and you need to really be on point, because you’re starting this journey, and maybe they’re a little bit more stable, and healthy, you know, it may not even be something where they’re unhealthy and may just be there at a different place than you and they want to indulge this Saturday night, and you aren’t quite there. And that’s okay, you know, you just got to meet and support people where they’re at. And that’s, that’s a good thing to be at. So it’s good to have empathy. And it’s good to understand that we’re all in different places. And some people may not have even gotten out of the gate yet. They may be at that unconscious incompetence. They don’t know there’s even a problem yet. And so we just try to always meet people where they’re at, provide empathy, and understanding from where they’re at.
Evan Brand: Very true. Very true. One last story. So I had a woman. Actually, though, the husband and wife were both working with me and the woman just love baking. I hear the story a lot. The woman loves baking. And so like every Friday, she would make brownies or cookies or cake or something, right? She’s always baking some sweet thing. And then she only wants to eat a piece of it. And then she leaves it left for her husband. And if he tries to throw it away, then she’s like, no, you’re wasting it. You’re wasting our money. You’re wasting it right. So then he feels up, which I don’t know, maybe this is his excuse, maybe not. I’m just sharing the story. I’m just the messenger boy. So he comes in and he goes, Well, she’ll get mad at me if I don’t eat the whole cake. I’m like, Oh, that’s what it is. So you have to eat the whole cake. So she doesn’t get mad at you. Okay, interesting. So now we’re trying to switch her over to, you know, almond flowers and coconut flowers and whatever. So we’re just working better option.
Dr. Justin Marchegiani: Yeah.
Evan Brand: So we’re just working with them on where they’re at. But it’s funny. He blames her right? Oh, she’ll get mad if I don’t eat the whole cake. It’s like that’s a good excuse right there.
Dr. Justin Marchegiani: And we I mean, you got to take accountability. It’s not a valid excuse in the long run, right? You get two people in there and you got to get one to agree. All right, we got to stop this. That’s not good behavior. But yeah, I totally get it. And so outside of that there’s some really good autoimmune dessert recipes and treat recipes and my go to or some of the Unreal or Justin’s dark chocolate brands are pretty good. Or some of the endangered species dark chocolate or just some just some of the berries and coconut yogurt or maybe a hail mary tart, or I’ll just choose something that’s like a baked Apple, like my paleo apple crisp is a really good one. I just I have a couple of go twos. I tend to repeat that work pretty darn well. I know you did the waffles in the morning, which is kind of a nice treat. I’ll do that the keto birch benders waffles. Is there any other go twos that you do? They’re kind of a treat for you but still relatively healthy.
Yeah, yeah. You mentioned SWAPO Yeah, they’re swap foods is the brand of like a waffle but they’re Yuka those are delicious. And then you mentioned earlier the keto cups that’s evolved I think company and then I also like the keto bars there are keto bars that perfect keto makes. Yep. Anthony. He’s a Chiro who makes those are good. Those are like stevia, monk fruit, I believe. And those are like organic almonds or organic cashews. Those are good. I’ve done some of Dave’s bars, the bulletproof bars, with the MCT and organic cashews, those are pretty good depending on if you could do nuts or not. So those are some good treats that are easy and quick. And then also, bison. I like to do some of the epic bison meats like the bison bites, or Tonka makes really good bison meat. So I’ll do those or venison jerky or something like that.
Yeah, and one last thing is for patients or people listening, try to get momentum out of the gate. So really start your first two meals of the day solid, good protein, good fats get momentum. That makes a big difference. If you’re coming out of the gates with crappy food. In the morning, a Starbucks mocha frappuccino with a whole bunch of sugar, a crappy lunch, it’s hard to get on top of your day, from a physiological hormone, anti inflammatory support, it’s really hard. So get momentum out of the gate. It’s kind of like starting a race and you just kind of get out of the starting block at a walking speed that you got to sprint out of that walking out of that starting block. Right. Same thing with your health. So start your day with good habits, right whether it’s a cold shower, or whether it’s clean, filtered water or some minerals, some good protein, some good fat or if you’re healthy enough, maybe intermittent fasting again, people that aren’t healthy I think they need they need nutrition in the morning they don’t need nothing in the morning the healthier you are the more fasting I think provides a beneficial effect just like exercising really hard can be beneficial if you’re already fit right kind of like that. So that’s kind of where I’m at. I think you put some really good points out there EvanBrand.com for Evan reach out virtually worldwide for support JustinHealth.com for Dr. J myself. We are here for y’all. And you guys have a phenomenal day. Take care y’all.
Autoimmune Protocol – The Paleo Way | Podcast #312
The AIP diet is an elimination and reintroduction protocol which aims to reduce inflammation in the gut, heal the gastrointestinal tract and in turn, reduce overall systemic inflammation. It is a diet targeted specifically at autoimmune diseases. We have Dr. J and Evan chatting about the benefits of this diet and how it can bring our body to a healthier state.
One of the biggest benefits of the AIP diet is its ability to alleviate inflammation, which is key to reducing symptoms of autoimmune conditions and promoting better health. Eliminating a few specific foods from the diet and filling up on nutrient-dense whole foods instead can have a powerful effect when it comes to inflammation.
Check out the podcast below for more info!
Dr. Justin Marchegiani
In this episode, we cover:
0:42 What is Autoimmune Paleo
8:14 How is it Beneficial
21:18 How to’s in Food Sensitivity Issues
26:22 How Paleo Helps in AIP
31:03 Goal of Decreasing Immune Stress
Dr. Justin Marchegiani: We are live. It’s Dr. J in the house. Evan, how you doing today man?
Evan Brand: Doing well, let’s dive in. Let’s have some fun. We’re going to talk all about autoimmune paleo, which is the template that we push a lot of people towards, not because we’re some dogmatic attached to our cards kind of people, but because we like results. We like clinical success. We like people to get better. We like people to reverse their health issues. We like people to take back their health, we like people to get off their medications when their doctor allows them to. And autoimmune paleo is by far the best template you and I’ve ever implemented clinically, which has given us those various types of success. So where should we start?
Dr. Justin Marchegiani: Yeah, so off the bat, what is autoimmune paleo, so it’s a good starting point. It may not be good for everyone out of the gates, it just for me, it depends, right? I see a lot of patients that are sick and then have done a lot of things. And this is like the next logical step. If people were coming in to see me and they already have, let’s just say have a really kind of crappy kind of standard American diet. I may just start out with a Paleo Diet out of the gate. So we have paleo right that’s like no grains, legumes, dairy and then like kind of butter maybe like acceptable within that range that and then obviously no legumes, grains, so no grains, legumes or dairy, butter, acceptable meat, acceptable vegetables, non starchy veggies, and then of course, good healthy fats, right, not seeds, dairy based fats, animal fats are all acceptable. Okay, and then we have paleo I call it paleo 2.0, which is the equivalent to an autoimmune paleo template. And you notice how we use the word diets not. We use the word template, not diet. I don’t like the word diet, because diet is it’s very inflexible. This is what you eat, where a template gives you the ability to adjust things. So I like the flexibility within the description template. So an autoimmune template versus the Paleo template. paleo is no grains and legumes, no dairy. autoimmune is no nuts, seeds, nightshades nightshades, being tomatoes, potatoes, eggplants, peppers, and eggs. And so within that, that template, we’re still going to be having healthy proteins, healthy fats from animal products, fats that are not seated dairy free, but healthy animal products, other fats like olive avocado, and palm and coconut are all great. And then carbohydrates, from fruits from vegetables, minus the tomatoes, potatoes, eggplants, peppers, and we can adjust the macros accordingly, proteins, fats, and carbs. So that’s kind of a good first step out of the gate. So paleo, and then paleo 2.0, which is going to be on one and paleo and these are all paleo template, autoimmune template out of the gates.
Evan Brand: Yeah. And people don’t necessarily need to get stuck on the 2.0 the AIP forever. Okay, so this is not a podcast to say, look, everybody needs to do this. As Justin mentioned earlier, you know, we’re working with a lot of people clinically who’ve been to 510 20 practitioners before us, they’ve been on every diet under the sun, they’ve done every treatment under the sun, whether it’s natural pathi, homeopathy, functional medicine, doctors, conventional doctors, they’ve already been through the wringer. So in our patient population, it’s a bit more skewed towards the autoimmune because of the type of people we’re seeing. Now occasionally, we’ll get people in that are just Healthy People that want to feel better, or athletes and those people are not as compromised. And so for those, maybe we’re just standard paleo, and there’s a lot more flexibility. So just want to make that distinction because I don’t want your average person who doesn’t really have any major concerns thinking they need to go, you know, stick with AIP for life.
Dr. Justin Marchegiani: 100%. Now, what if you don’t have an autoimmune diet? What if you don’t have an autoimmune disease? Should you do an autoimmune template? Well, here’s the deal, autoimmune template, really, the goal is you’re cutting out any food that has a higher chance of being hyper allergenic, right, there’s a lot of data on these different studies with nuts or seeds, that they can they have one anti nutrients in them, right oxalates phytase, either they affect protein digestion, mineral absorption, and they can be irritating on the gut lining. So there’s a lot of hyper allergenicity increased immune activity. So the and then they also have maybe potentially more omega six fatty acids that can drive down more of the pro inflammatory pathway. So the goal is that we’re trying to reduce some of these anti nutrients that have a negative impact on the gut lining. And the number two, we’re trying to increase nutrient density. Alright, so we’re choosing foods that are higher and better fats, right? fats that are polyunsaturated fats that are more polyunsaturated, they can be damaged and they can be oxidized, right so animal fats, coconut oil, saturated fats, not so much. And and then just the just the gut permeability aspect. So we see nuts and seeds fit that criteria. Eggs potentially even though eggs are awesome and so nutrient dense with a good vitamin A and fat soluble vitamins and cholesterol in the yolk, especially, they’re amazing. So sometimes those compounds can be a little bit more allergenic. So can the nightshades with the alpha solonian compound and they’re in the saponins. They can be a little bit More irritating on the guts get into the joints create inflammation. So it depends. The goal is really that it’s just a nutrient dense, anti inflammatory and then low in toxins, but more importantly, plant toxins, anti nutrients.
Evan Brand: Yeah, well said and the reason you’re bringing up the lectins. And some of these other compounds of these foods are because they’re going to contribute to increased intestinal permeability. So when you’re talking with anyone, whether it’s rheumatoid arthritis or some other autoimmune disease, there’s always a domino that has to fall which is that the gut is leaky, this increased intestinal permeability has to take place. Now we’ve gone into the details of why that can happen from the infection perspective, low stomach acid, food fermenting in the gut, bacterial overgrowth, parasites, emotional stress, overtraining, we’ve tried to hit a lot of these different variables that can go into the leaky gut. But you can also have all the lifestyle infection piece dialed in, but if you’re eating, let’s just say, you’re doing salsa on your, you know, cassava flour, tortillas and your grass fed ground beef, but you’re just doing, I don’t know corn chips and salsa all the time with it, it’s possible that a lot of those lectins like you may get from your nightshades like your tomatoes and peppers. Those can irritate the gut lining contribute to that leaky gut and then that’s going to increase your autoimmune risk. Or if you’re already autoimmune, it may potentially flare you up depending on what’s going on.
Dr. Justin Marchegiani: Absolutely, there’s one study that came out looking at people that have potential autoimmune genetics, they have the likelihood to make 10 times more IGA antibodies against certain foods than healthier foods. And in this one study, it’s called food intolerance and patients with a manifest autoimmunity with manifest autoimmunity observational study, in the Journal of autoimmune review, they talk about that the IGG level for specific foods were higher in the patient control group and the control group. So if these people that had autoimmunity they had more antibodies, and what they found was they saw a significant increase level and IGG. That’s a type of antibody that’s produced. And most doctors only look at IGE, which is anaphylaxis type of allergy response, immune response. And that’s like you need the epi pen for that right and so this is kind of IGG there are other types of responses that aren’t even in that IGG IGA, IGM IGE category, and so IGG isn’t the be all end all by the way. But they found that casein cow’s milk weekly and wider the eggs, rice, even some nuts and what and walnuts and almonds tend to have more of a allergenic idg response. They found no antibody reaction with vegetables and fish and meat products. They seem to be very immunoglobulin neutral. Guess what we do with an autoimmune template or a paleo template, we’re cutting most of those foods out. Obviously, with autoimmune, we’re focusing cutting the eggs out and the nuts and the seeds out to that’s it’s about decreasing the immune response. People that have a lot of autoimmunity, their immune system is sucking up lots of energy and lots of resources, because it’s responding to all this food in a negative way. And so the goal is we’re just trying to calm down the immune system. And then those foods aren’t there. We don’t have the gut permeability. Therefore the the body can use those resources better versus having the immune system hyper responding.
Evan Brand: Yeah, well said. Now, one other point to why would this be beneficial to do or to go down this rabbit hole and as I mentioned, maybe not forever, right? Maybe temporarily, we pull out eggs for me, I pulled out eggs for a long time when I had gut bugs. I had an Louise on the podcast and we talked all about gallbladder and eggs and how there’s a big factor there where eggs can irritate the gut, you know, just based on the gallbladder issues. And so I pulled them out and now I can tolerate eggs, no problem duck eggs, I tried experimenting with those for a while some argue duck eggs are a little easier. quail eggs I played with those a little bit. You know, I can’t say that I’ve noticed a huge difference among the different types of eggs. But I think it’s a cool experiment when you try to get into the reintroduction phase where you’re going back to paleo 1.0 and adding eggs and things back in nuts. For me, same thing, I used to get really, really bad headaches from walnuts, so I cut those out for a while. If I do a little bit of those, I’m okay. So the good news is your body can calm down. And that’s one thing that this diet will help you do is it’ll help you to identify your trigger foods. Because if you’re just eating a bunch of different stuff, and your diet is too varied, and if you’re not tracking it, you don’t have a clue. If you go and you have a salad, where you’ve got walnuts and pecans and cranberries, and tomatoes and whatever on your salad, you’re not going to have a clue what’s irritating you but if you go AIP for a bit, now you’re going to know hey, you know what, as soon as I add it back in those tomatoes, boom, my joints hurt. And then you’ll have a much, much more clear path. So if anything else, it’s more helpful to use the journal plus reintroduce foods and it can be amazing. That’s how you really figure out what you tolerate what you don’t.
Dr. Justin Marchegiani: Yeah, I tell patients you don’t really know how dirty you get until you get really clean. Right, once you’re really clean, and then you get dirty, you’re like, Okay, I get it. I’m dirty right now, right? What does that mean? We want a clean baseline. So what’s the clean baseline? In my analogy, the clean showers the baseline. And in regards to the food, that’s the autoimmune diet, the autoimmune diet is the clean shower, it’s getting really clean. So then when we start to one, maximize the diet, usually people are going to see benefit within a within a couple of weeks, and or a month, and I always like patients to kind of plateau, some or plateau within three, four weeks, where they may see a lot of improvement and joint pain or energy or brain fog. And then it’s like, Okay, good. Now they’re kind of like running out of steam in regards to their initial jump and improvement. So I want patients to typically be on the diet for four weeks and the plateau for at least one week before they do any reintroduction, some autoimmune patients, they continue to see significant improvement week after week, and it may last a couple of months. So patients that are like that, I’m a little bit more strict on what they’re under reintroduction. Now, it’s usually not that big of a deal. Because if you get those kind of results, those results speak for themselves, and they really motivate you a ton. So it’s not like twisting an arm to get someone to follow that diet longer, because the results are guiding us that we’re on the right track. So I tell my patients, if you’re gambling and you’re on a streak playing poker, or blackjack, I’m not going to pull you off the table. Right? I’m going to let that streak roll a little bit. Same thing with the diet. So if you have a lot of success coming out of the gates, I’m gonna let it roll. I’m gonna let you plateau. And then we have a specific reintroduction protocol, and how we add foods back and I’ll go into that in a minute.
Evan Brand: Yeah, well said and, you know, there’s not a lot of money involved with this, meaning you can’t really make money just by getting people to eat meats and veggies. So the problem is, there’s not too many studies. Now I don’t know if you want to pull it up, but I just sent you one in the chat. For those watching on video, they may be able to see this. It’s a PubMed study here. It was in the inflammatory bowel disease journal 2017. As I mentioned, there’s not much money in this right. So it’s probably going to be few and far between clinical trials on autoimmune diets because there’s no drug involved and Big Pharma isn’t going to pay some random guy to do a diet trial. Right. But anyway, this was a study on patients with Irritable Bowel Disease. And they did it for six weeks, followed by five week maintenance. And it just goes into the results here it talks about significantly improving people with ulcerative colitis, and significantly improving Crohn’s disease. C reactive protein, they said didn’t change much. But the calprotectin, which is a marker we measure on the stool panel, it improved from 471, which is high was to 112 at week 11. And also Wow, those that did drop. I mean, that’s a lot. I mean, you’re talking hundreds of points, just put died alone. And then it says here among those with follow up endoscopy at week 11. improvements were also noted in a simple endoscopic score for Crohn’s disease and a Mayo endoscopy sub score. So we’re not obviously running that we’re not doing scopes on people, we’re running stool panels. But I’ve seen the same thing. I had a guy who had calprotectin above 1000, it was insane. He had pan colitis where it was the whole colon and you know, pretty much the whole intestinal tract was involved. It was pretty sad. But just with now, technically, in his case, we didn’t do just diet, we did a lot of really, really potent aloe extract. But I mean, we were able to get calprotectin down hundreds and hundreds of points within a few weeks. So there’s the proof.
Dr. Justin Marchegiani: 100% those are all excellent points. So a couple people in the chat here Andrew Hill wrote in that we got to be careful with tapioca because it’s a similar cassava similar to latex and yeah, if you’re a sensitive person, we may want to even cut that out for a few weeks before we add that in. Technically that may be allowed, right cassava yuca, tapioca. And that same kind of family. I think it’s the same thing. There’s different names, but that may be something we want to work on excluding others may just be some of the spices, you know, like pepper, some of the nuts or seeds or spices that are something that you don’t eat, but it’s more of a topical kind of thing on the food. Got to be careful over that if you’re really sensitive, usually foods going to have a dose dependency. So the more of that food you eat, the more the immune reaction will be exacerbated due to its we keep an eye on those things for sure. Riley wrote in that we know basically one of the no take on the food sensitivity test, when does a food sensitivity test become beneficial? So my issue with food sensitivity tests, is most of them come back with some level of autoimmune foods on there for people. Okay, that’s number one. So I always look at test, does it change the treatment? So most are going to have some of these foods on there, number one, number two, if it doesn’t have those foods on there, would a patient still benefit from cutting those foods out? That’s the important question, because your immune system may be responding in a way outside of a typical IGA G or IGA test. There are other tests out there that look at like the MRT or the Alliance akt look at other type of T cell intermediary responses, which could be it. But I still know people that run these tests and they have patients that test perfect for gluten. And then now you’re in this conundrum is do you allow your patient to eat gluten now because the test says gluten is fine, because we know there may be an immune response happening in the body outside of what’s being tested. So that’s why I don’t like it because you can give a lot of false sense of security that you can eat gluten or other grains. Number two, I’ve seen benefits cutting those foods out, even when it says it’s fine. So for me, it doesn’t change what I’m doing enough for the value for the cost. And I’d rather use that money on another lab or a stool test or supplementation that’s going to be more root cause supportive.
Evan Brand: Well said, I’m going to take that as my soundbite. So anytime somebody says, Evan, why won’t you run a food sensitivity test dummy? I’m going to say, Well, my good friend, Dr. Justin said it better than me, and then I’m going to play them your little soundbite you just did because it was it was so good. But I agree. And that’s exactly what what I do is I just tell them, Look, save your money. Let’s go AIP. And then let’s do reintroductions plus you journal. And we find that that’s going to be far better. I mean, when you look at gluten, for example, I have seen people where it does show up as that it’s going to be okay. However, they know when they eat it, they don’t feel as good. They feel a little brain fog, they feel bloated. And that didn’t show up on paper. So then they’re confused. And then the husband goes, See, I told you you’re crazy, eat a pizza, and then you just get yourself in trouble again.
Dr. Justin Marchegiani: So yes, now where food allergy tests may be helpful. It doesn’t quite fit into the patients that I see is if a parent is trying to help a child and or a family member who is totally on is totally uncompliant and resistant to doing anything. And if we can get some lab data saying to avoid these foods, that may help with leverage, but most people are coming to see us they’re they’re investing a lot to work with us. So they’re pretty darn compliant. If we say don’t do that, let’s save you some money. They just typically listen to us. Yeah, well, number two is if you’re already at a great, great super high level of health, and you want to see if there’s any maybe weird foods there, then that may be helpful to look and see if any other foods that are there. The problem is if it says don’t eat raspberries, and then you eat blueberries, what’s the chance that blueberries and now on the list next month? Right? That’s where it becomes this like whack a mole where you’re like, wow, like one and the other one pops up over here. And you’re like, crap.
Evan Brand: That’s a very good point. Yeah, the compliance and the leverage. I mean, that’s the reason that we do some of the testing in regards to the infections too, because somebody will say, Hey, I feel like I’ve got this, I want you to just give me a parasite protocol. I think I’ve got parasites with you know, you and I’ve covered this before people come in, and they have this idea of what they think’s wrong with them. And we, they just want us to pursue that rabbit hole with them. So we’ll come in and we’ll use the data first look on the paper. You know what, actually, no, we think this is a bigger priority over here. And then we circle back. So yeah, that’s that’s a great point.
Dr. Justin Marchegiani: Absolutely. So I think it’s, uh, you know, we want to always look at you know, the root cause why you’re sensitive to these foods, of course, you want to be fixing the gut that’s gonna be ideal. Whether it’s SIBO or H. pylori of bacterial issues, you want to work to the six hours because patients have a chance of having increased risk of food allergens when the food’s not broken down properly. So adequate levels of enzymes and acids chewing your food masticating your food Well, not overly hydrating when you eat adequate enzymes, adequate acids are all very helpful at being able to break down the food again, if you love it, rotate it. If you’re eating beef every single day over and over again, your chances of a beef allergy goes up right but you saw the study I just mentioned earlier, that study showed much less chance of animal products and vegetables causing an allergen right so that we cut out the big foods that are going to be the highest risk. Now. Outside of that there’s a reintroduction plan that I infuse with my patients when it’s time. So we add each food back in over a two to three day period. So we’ll start with egg yolks before eggs ghee before butter, one not one seed one Nightshade at a time. And typically a very small amount of food on day one, a little bit more on day two. And if we have no negative symptoms, then usually we’re good we can go to the next food if we’re on the fence, we can have a day three where we eat a larger amount of food because the response tends to be dose dependent small amount of bad food for you. Small amount of symptoms, larger amount of food, larger amount of symptoms and then if you stair step the dose up usually the symptoms go up as well. So if you’re on the fence, it gives you that ability to be confident that you’re sensitive or not. And we go right down the list.
Evan Brand: Yeah, so give me a little bit of concrete like view how would that look? So today’s Monday when we’re recording so let’s say you want to add back in almonds for me you’re gonna have me do what have you?
Dr. Justin Marchegiani: Yeah, so let’s just start in the right order. So egg yolks before eggs, so I may go and I may poach one egg, poach it, it comes up. I’m keeping the yolk a little bit soft. Why I don’t want to oxidize it. I trim away the egg white egg white tends to be more allergenic, feed it to my dog, have the yolk How do I feel? That’s a good if I do. Okay, let’s do two yolks tomorrow. Trimming away. Good. Excellent, great. Awesome. Very good. Next day we’re going to add in the full egg. Now we’re going to do a little omelet, right, but we’re not going to overly, we’re not going to overly cook up the egg yolk, the egg white, I’m sorry, we’ll keep it so it’s, you know, the whole eggs blended but it’s going to be a little bit more wet because we don’t want to overly oxidize the cholesterol on the proteins that are in there. Right? oxidized cholesterol and protein tend to be more hyper allergenic higher immune response. And then if we’re good there, then we go to gi waggy. Keys, clarified butter, less lactose, less casein, right? The casein and lactose have the biggest problem. If you can tolerate ghee Great, now we go to butter The next day, same kind of stairstep so my sensitive patients can handle ghee can’t handle butter. So we always want to start with the least allergenic to the most. So if we can handle one egg yolk but not the egg, guess what we at least have an egg yolk in our diet. If we handle the egg, the GI but not the butter we at least have some of that good butterfat clarified gi back in our diet. So we always go least to most, where if we did it the other way around. You wouldn’t have been able to add the food back in.
Evan Brand: Yeah, that’s great. Okay, and then when do you bring in some of the nuts, the seeds? How do you do those any particular order you found better or worse.
Dr. Justin Marchegiani: So I would just start with like, if you’re gonna do almonds, you could just do one or two almonds, right? And IDN sprouted is a little bit better, right where it’s soaked, and that can deactivate some of the anti nutrients, the lectins, the phytates, right, the oxalates. So you can do a couple of almonds, maybe one teaspoon or tablespoon almond butter. And the next day you can double or triple that dose. See how you feel if you’re okay, that’s a good sign. But of course, deactivating some of the anti nutrients can be helpful too. And then the next day, let’s say pecans are in your routine. Try pecans, try pistachios or walnuts. And again, if if you’re not eating those foods on the reg, it’s not that big of a deal, right? Just try to choose the nuts or seeds that are more on the regular things that you’re doing more on a daily routine.
Evan Brand: And of course we want to make sure these are organic. We want to make sure these are fresh. I advise keeping your nuts in the freezer like I keep my pecans in the freezer. And they taste so good frozen to like I’ll take pecans out of the freezer do a little bit of maple syrup. Oh my god, you talk about delicious.
Dr. Justin Marchegiani: Oh totally. Yep. 100%. Now here’s the other deal too. So then we have let’s say you’re able to get nuts or seeds or nightshades or eggs back in right you get everything back in. Do we ever allow grains now I always just tell patient it depends on how significant a patient is. If we know someone has diagnosed autoimmune condition I always try to stay more on the grain free side I hate the word gluten free because you can be gluten free and eat lots of process rights and oats and corn and that could be a problem right? Because the problem means are are the umbrella the problem? You know umbrella gluten is one prolamin under that umbrella, right? The most common one is the wheat, barley and rye that gliadin prolamin. Then you have horizen in which is rice, you have a vignette which is oh right you have seen what you have seen which is corn. So these are still like brothers and sisters of the Glee and protein. So just like someone you may see someone, a brother or sibling, and you may be like, Oh, you must be so and so you look just like him as a family resemblance. Well, your immune system has that same kind of resemblance with other proteins that are cousins and brothers and sisters of gliadin. And so your immune response can be triggered. Also, there’s a lot of data in the non celiac gluten sensitivity research that grains, even if you’re not allergenic to them can still increased gut permeability. And the more you increase gut permeability, the greater chance you have of creating more inflammation or triggering autoimmunity. Now, what does that mean? Does that mean never eat grains? It just means my general recommendation is always try to be grain free if you can have a substitute. If you’re relatively healthy, good health and you have no autoimmunity. Could you eat some grains that have gluten here, they’re probably you could probably get away with it, you know, and it probably wouldn’t be that big of a deal. I wouldn’t recommend it being a staple because those foods, they’re still inflammatory. They still have a lot of nutrient blockers in there. And they still aren’t nutrient dense. So I still much rather, I’d much rather see someone have some white potato over a bunch of wheat, right potato is actually pretty nutrient dense and has a lot of potassium in there and a lot of good minerals. I rather have someone do that over over gluten. Complete gluten full, if you will, grains, but it all depends where you’re at, the healthier you are, the more versatility and adaptation you have, the more unhealthy you have or the more diagnostic autoimmunity you have, you really want to be careful. A lot of times it’s just not worth it. Some people they eat some gluten, they’re inflamed for a week, it takes them days to get back on the wagon. So it depends upon how long it takes you to get back on the wagon. And if you have a known thyroid issue, there’s some data saying that autoimmune response can last for weeks and even months so it’s just not worth it depending on the damage that may occur. Dude after the fact.
Evan Brand: Yep. Well said and yeah, he’s talking about like the gluten cross reactivity issue. So like, for a while, you know, I had a lot of people doing corn because they thought, Okay, I’m gonna, I’m gonna be okay. But turns out they weren’t. Okay. So in a lot of cases, yeah, we do remove the corn if I do a much rather see
Dr. Justin Marchegiani: much rather see cassava or you could chips over anything with corn or anything else like that. So that’s much better like this yet they brands pretty darn good. Or just a really good white potato chip like the boulders make a good one with avocado or coconut oil that’s really good fat. On the potato side.
Evan Brand: I’ve noticed the same thing. Yeah, potato for some reason, even though it’s still potentially cross reactive. I’ve noticed it is better tolerated than corn for most people. So that’s good. Maybe it’s just a lower count or maybe a slightly different compound in there.
Dr. Justin Marchegiani: Exactly. And I use a lot of root vegetable chips. So I’ll do like a lot of turnips, rutabaga, or sweet potato, like a lot of root vegetable, like grain free type of stuff. And that tends to be pretty good. But the nice thing is, once you kind of work through that autoimmune template, you should get a lot of confidence in what you can or can’t handle. And then once you’re at a high level, if you’re if you’re going off the reservation too much, you’ll start to feel it. And that usually gives you a pretty good idea that you’re probably doing too much for you. So our goal is to get you feel really clean. And then once you’re really clean, it’s kind of easy to notice when you’re getting dirty.
Evan Brand: Yep, yep, well said. And the whole point of this is what well, it’s to give you relief is to get you to feel better is to get your brain to work better your joints to feel better your sleep to be better your food reactions, your gut, your, your everything. I mean, the skin, the brain, I mean, this literally can affect every body system here. So we really want to focus on what’s the end goal. It’s not just tweaking this just to tweak it make this like an obsessive OCD type thing because it can get a little crazy. No, it’s to get you to feel better. And then while we get you to feel better, we’re working behind the scenes on these other root causes. Because it’s very unlikely that someone became sensitive to all these foods just out of nowhere, right? There’s something that triggered it. And Okay, so we’re getting you simmering, okay, we got your diet, just you Okay, we got that pillar of the house in now, while that’s sitting there, simmering. Let’s work back here. We’re going to work on this, this this over here, and then boom, now we go back to this diet. Good job, you’ve been holding steady. Okay, now let’s bring normal quote normal things back in and then people tolerate him. So that’s kind of the whole rationale. That’s kind of our mindset behind this whole thing. When we’re working clinically. It’s not just the dietician, approach. Here’s the diet have a good life? It’s okay, well, why did you have to go to this level of specificity in the first place? And that’s the real question.
Dr. Justin Marchegiani: Exactly. And also, people want to start having more grains on the regular, I would say make sure your health is really great and stable. And I’d also say if you wanted to be more certain, run an HLA dq test for gluten sensitivity, if you have to or ate on there, you definitely want to avoid the gluten, one or three is going to be a little bit less. And then I think four is the only true genotype that is not gluten sensitive, you could still have other problems with the anti nutrients that are in there, or the higher amounts of fermentable carbohydrate, but that’d be my one test that would say just to really know that make sure there’s not a genetic issue. If you’re going to put it in there and more in the regular for me, my big cheats are going to happen. If I go out for sushi, I may have a couple of rolls. But usually I like the Alaskan roll that has like a lot of salmon, and a lot of avocado, and then there’ll be a little bit of white rice. So when I typically cheat, it’s going to be getting some white rice for sushi. And but I typically use coconut aminos and a soy free soy sauce and MCT oil and I’ll typically do extra enzymes and extra charcoal during those meals to mitigate the inflammatory response. So it’s a kind of couple of little tricks that I kind of do. If not for me, I just I just feel too good. I don’t want to have a setback. So there’s enough substitutes for me where I can engage in that substitute still feel really good and not have a problem?
Evan Brand: Yep, they are. Well said.
Dr. Justin Marchegiani: Anything else you want to add Evans? Oh, one more thing. I wanted to say. What if autoimmune paleo is not enough? What does that mean? So some patients they may have to do carnivore, they may have to do a variation of an autoimmune paleo, low fodmap SCD template where we’re cutting out fermentable, carbohydrates, even some of these really good fermented foods. Or we may have to be cutting out foods that are high in salicylates and females, that may have a little bit higher amount of anti nutrients that, you know, things that could be on the vegetable side, right, or fodmaps, like broccoli, and let’s say onions and garlic, things that are have good benefits, we may have to cut out other foods. And again, we see a lot of patients that come in that have done a lot and that are very sick or have a lot of gut inflammation, we may have to go to that extreme. We may even have to do an elemental diet or a carnivore diet. So everyone’s a little bit different and they come in from different places. But if an autoimmune diet does not work for you, there’s other things that we need to work on it. You’d really want to work with that practitioner at that point, because your health issues are a lot more nuanced.
Evan Brand: Yeah. And hopefully you’re not hopefully you’re not to that level. But just know that if you’ve done this and you’re still suffering The number one, there’s probably underlying triggers you haven’t identified yet things that are really aggravating your immune system or the gut. So we need to try to find those triggers. And then number two, you can tweak this thing even more to get you stable, the whole thing, the whole goal is to get you stable. So we can work on root causes here. So it’s not just diet and done, just remember that.
Dr. Justin Marchegiani: 100%. And also, what’s the goal of this diet, right, I always tell patients, what’s the goal is that we don’t have like a goal in mind. Most people, when they make a diet change, they kind of just go to this place in their hand, like it’s forever. And they kind of have like a little mini funeral, like how I miss my potatoes, my, or my seeds, they kind of have this really this kind of state of mourning, where it’s really sad and they’re depressed, I always tell my patients, the goal is to one first, increase your nutrient density in your diet, number two, to decrease inflammation overall, right, and then three, to decrease a lot of the toxins, whether those toxins or plant based toxins, whether those toxins are you’re not eating organic, and you’re getting pesticides, and chemical toxins, all those things are valid. And the goal of that is that now decreases the immune system stress, and that the immune system stress starts to go down. There’s less autoimmunity, there’s less inflammation in the body. And that kind of starts creating this snowball effect where your body can start to heal as we start addressing infections, supporting the adrenals addressing nutrient deficiencies, calming down the immune response by addressing infections and using probiotics and other nutrients on that side of the fence.
Evan Brand: Yeah, you made a great point, which is the emotional piece. So we could do a whole part two podcast on this if people want. We’re going into the whole rationale scientific part of that. But if you’ve got a woman who is addicted to her cookies, you’ve got to work through the emotional stuff, too, right? So we could come in with all these rational, very scientific studies and things you have gone into, right? It sounds really attractive and really scientific. But then you got the emotional bubbles popping up. And people are going Oh, no, but what about this? And what about Thanksgiving? And what about this and my family and I love to do go eat the popcorn at the movies, you know? And so then the emotional piece is hard. So you have to work through that with people. And we do we have those conversations. So on the face of it, it sounds all easy, right? It’s like, okay, just boom, boom, boom, boom, boom, you’re great. But then, once you actually sit down at the plate, and you’ve got that fork there, then the emotional stuff comes up. It’s the the husband or wife making fun of you for your choices. I mean, that’s a common one. It’s if there’s a divorced family, it’s the child going to the other part of the family, where the other family member doesn’t believe in this and say, This is all quackery. And then they come home after eating pizza all weekend, and then they’re in an autoimmune flare, or you go over to the parents house. And, you know, they think it’s a joke. So they still try to serve you bread and butter, you know. So there are some things you have to work through on the family emotional side, but you know, it’s definitely something that’s, that’s possible. Everybody can do it.
Dr. Justin Marchegiani: Yeah, where I see it a lot, you know, well, meaning grandparents that feed their kids cookies, their grandkids, cookies, you know, or like, they want to spoil them a little bit. That can be really tough, too. But yeah, you got to get everyone on the same page. And in general, you got to have a plan. And if you’re having a lot of cravings, most of those cravings, a lot of the protein orphans, which are like opiate like compounds in grains and dairy hit that same opiate receptors. So those foods can have a lot of addictive qualities to it. And a lot of people they’re used to operating on a blood sugar rollercoaster, so their blood sugar goes up and down, up and down. Because not enough good protein or fat in the meal or they’re not, they’re going too long between meals. So really working out the blood sugar. A lot of times if someone switches from a standard American diet to an autoimmune diet, the two big mistakes they make is one, they’re not getting enough calories from their autoimmune diet, therefore, they’re chronically hungry, which creates cravings. So you have to make sure you’re getting enough calories or nutrients. The second thing is they may go to low carb for them. So if someone’s needs a little bit more carbs, and they’re at a relatively more healthy way, they may come in go really to low carb, and that may cause more cravings too. So you may have to just add in some good, healthy, safe starches to fill that carb void if those carbs are a good place for you. My default set is always lower carb, higher fat, and then kind of work through that over time, because most people have more insulin resistance and going lower carb out of the gates helps resolve a lot of that.
Evan Brand: Good points. Good point. Yeah. And the gluteal morphin stew. I don’t know if you said I think it said the other thing that
Dr. Justin Marchegiani: Yeah, the protein orphans are gluteal morphemes. These are like the opiate like products like that are in gluten or the KCM orphans in the dairy.
Evan Brand: Yeah. So when people say oh my god, I’m addicted to my whatever, they’re not joking. You literally are and there can be some sort of a withdrawal from it. And then also from the neuro transmitter perspective, that’s something we’re going to look at on organic acids testing. So if we see for example, whether it’s low endorphins, low dopamine, low serotonin, we may come in with specific amino acids to try to repair and rebuild. And that can be a good let’s call it a nutritional support band aid for the brain chemistry, which is causing the underlying craving in the first place. So rather than say, hey, go from the gluten cookie to the grain free cookie, it’s okay. Yeah, maybe you do that. But we’re also going to give you a little bit of some DLP a or trip the fan or something to help the brain because the brain is involved with this too. This is not just the gut, the brains involved too. So we’re, we’re thinking about all these variables as we go. It’s kind of a moving, it’s like, I don’t know, maybe a good NASCAR analogy, you know, it’s like the, the guys are coming on and changing all the tires and we’re doing that in every category. So it’s the brain, it’s the gut, it’s the immunity it’s the adrenals we’re we’re simultaneously working on all of these pieces and then boom, you succeed you feel better. So I think we should wrap it up if you’re ready too.
Dr. Justin Marchegiani: I think we can’t man that we did a great job kind of outlining everything this will be a good reference for my patients as well that you know, just kind of want more intel on the autoimmune side. If you’re listening to this and you want to dive in deeper and you’re feeling a little bit overwhelmed with some of the diet changes out of the gates definitely reach out to myself for Evan, EvanBrand.comand there’s a little link there where you can click the schedule or myself Dr. J. At JustinHealth.com we’re happy to help you. We have experienced doing this for over a decade with thousands of patients. And if you’re ready to take that next step, we’re here to help you all if not just utilize all this free information and just kind of execute on it and make yourself healthier. We really appreciate it.
Evan Brand: Yeah, if you’re a do it yourselfer, that’s fine. But for me, and you and many others, it’s better to have a guide, it’s better to have the data test don’t guess get the information, know what you’re up against. So you can figure out and when we say test, don’t guess we’re talking the root cause stuff. We may not run a food panel out of the gate, but we’re gonna run a gut panel out of the gate figure out what infections could be causing these issues in the first place. So thanks for tuning in. We appreciate you guys and we’ll be in touch.
Dr. Justin Marchegiani: Put your comments down below. Let me know your success on an autoimmune diet. Really want to know and thanks for sharing. You guys. Have a good one. Take care of y’all.
Natural Hacks to Improve Sleep | Podcast #303
Everyone experiences occasional sleeping problems, so how can you tell whether your difficulty is just a minor, passing annoyance or a sign of a more serious sleep disorder or underlying medical condition?
As humans transition from the waking state to drowsiness and into sleep, parasympathetic vagal tone (responsible for downshifting) increases, and sympathetic tone (the go, go, go!) decreases. Many of us experience trouble sleeping at one time or another. Usually, it’s due to stress, travel, illness, or other temporary interruptions to your normal routine. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder. Here are Dr. J and Evan taking us to another perspective of ways to help better our sleeping patterns.
Since electronics and the bulbs that we have to use artificial lights, some suggestions are the use of blue lights and dimmer lights. It helps lessen or prevent too much cortisol (steroid hormones formed in the adrenal glands) and assist our melatonin is kicking in and put as to sleep. Intake of magnesium, holy basil, and ashwagandha are also useful for bringing the body to a lower gear as well as regular exercise to keep our body in good shape. Watch the full podcast to know more ways to manage your sleep!
Dr. Justin Marchegiani
In this episode, we cover:
2:31 Blue lights, Dimmer lights
09:15 Sleep Mechanism
18:04 Gut Inflammation
25:05 Sleeping Drugs
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand, Evan, how are we doing today man?
Evan Brand: I’m doing well. I’ve got an article here. We’re gonna start the show off. This is all about sleep today, issues that affect sleep. How do we mitigate the effect of stress on sleep and gut and all of it. But first, Pepsi, good old Pepsi Co. They’re launching its newest beverage, the de stressing and relaxation promoting drift. Well, this is just all about, what’s my point of this, that becoming healthier is becoming mainstream. So anyway, they’ve created a sugar free non carbonated water flavored with a hint of blackberry and lavender with 200 milligrams of L theanine, which you and I’ve talked about for years and years and years and years and years, DNA being an amino acid that helps to increase GABA comes from green tea. But you can also take it in supplement form. Here’s the thing I don’t like about this thing, though. Number one, it’s seven and a half ounces, I don’t really want to drink seven and a half ounces right before I go to sleep, if I’m going to take theming, I would much rather just take a capsule of 200 to 400 milligrams at the end and go to sleep. And then the second thing is there’s they’re wanting to sell this thing for $18 for a 10 pack that’s $1 at a dose basically, versus you and I if we’re gonna get a professional grade theanine, we’re probably getting what maybe 100 or 200 capsules for 20 bucks.
Dr. Justin Marchegiani: Yeah, it’s definitely a little bit more on the expensive side, kind of per dose, but you’re definitely paying confer convenience. So like I’m all about if a company can create a product like this without the artificial sweeteners, dyes and colors, and it’s using a clean water, you know, reverse osmosis kind of water source, and it has some of these nutrients in there. And it makes it convenient, because it really comes down to can people do it right? If you don’t do it, if you don’t apply it, you don’t get the benefit. So that’s a really good first step in the right direction. I mean, I’ll still take the supplements, you know, from a raw material standpoint, like you mentioned, but if we can get some non healthy minded people to jump on board that train, that’s great.
Evan Brand: Oh, yeah, I mean, imagine if we could get people to switch over from, I don’t know, doing a nightly beer. You know, let’s say they do beer at night. But instead, they could just do this, you know, themed drink, that’d be a hell of a lot better for their gut and their brain. And you know, theanine has benefits for the brain to it’s not just the sleep, they’re kind of promoting it as a relaxation drink. But I take theanine daily, and it definitely helps to buffer stress. It’s just something that it’s not like a sedative. I mean, it’s not a chill pill. It’s not like a passionflower would do for your sleep. But it, it definitely just kind of settles the mind a little bit.
Dr. Justin Marchegiani: Yeah, I agree. I mean, my nightly routine is typically some magnesium and some vitamin C. And then if I if I’m going to do any alcohol or any like cheating, kind of things, food wise, I’m going to be doing some load of iron ore and acetylcysteine and maybe some charcoal as well. And then if you have any issues ping before bed, just try to drink that an hour or two before bed. And that kind of sets in. And then you know, one of the nice thing people are doing today, a lot of the glasses have a blue light filter. So I have I upgraded my glasses that I typically use when I watch TV to a blue light filter. So nice blue light, really nice. And then, of course, one easy investment we all can make is just get dimmer switches on all your main lights that you’re going to have on at nighttime. Just kind of get those dimmers down 80% or so that’s going to help a ton. If you were reading glass or a glass for reading or TV, get a blue light filter in there, or just get like one of those nice blue light glasses that you can put over on anyway without a prescription on there. And that’s very helpful to kind of get your body in that parasympathetic state that we talked about so much.
Evan Brand: Yeah, I use Iris you can check it out, get Iris if you just search that you’ll find it. Iris tech is a company who their competitor to flux it’s better because it does have some supposedly has some anti flicker built in so it can help reduce the flicker rate of your screen. So smartphones, Windows computers, Macs, you can use Iris, I’ll leave it running 24 seven I have it on right now. So what I’m looking at Justin on the screen here, he’s a nice tan golden color to me, which looks good and it definitely reduces eye strain my eyes at the end of the day. You know, we’re looking at labs all day. So you know what we do is hard on the eyes and my eyes would just be exhausted. But once I run it at a more warm color, I definitely have less fatigue at the end of the day mentally.
Dr. Justin Marchegiani: Yeah, I’ll put the link to some of the things that I do. I use the viewsonic monitors that have a low flicker and low blue light naturally in there. And you can still run an iris in the background as well but I highly recommend I noticed my prescription. The last year two is actually gotten better. It’s actually improved my stigmatism which is the shape of the eyes also shifted as well. And I talked about it with my optometrist and he said you know it’s possible that just you doing the blue light at night and you shifting over the monitors last year or two could have helped with that so I mean outside of nutrition being stable lutein all of the vitamin A precursors, I think shifting over the monitors if you’re someone that’s on a computer all day, invest in really good blue light protecting technology and or good blue light monitor. Yeah, well blue light, low flicker very important.
Evan Brand: That’s good advice. Yeah. So nighttime we talked about that a little bit. You mentioned dimmer switches, blue light glasses, I’m using just salt lamps at night we have probably six or seven salt lamps. We have some that are just salt lamp night lights that are plugged into the bathrooms. That’s pretty convenient. Brush your teeth with just a salt lamp, it’s just a nice, pretty warm glow. I haven’t actually used a color, you know, like a color device to check if there’s blue light coming off of it, but it’s a pretty darn warm color. And it’s a little like couple watt incandescent bulb incandescence are going to have less blue in them naturally. So we like to use a lot of the Edison bulbs, a lot of the Edison bulbs now I’ve turned into LEDs though, they’ll look like Edison shape with the filament inside, but it’s led, which is so annoying. So make sure you’re actually getting the true Edison bulb, I use a company called Hudson, Hudson lighting, they make great Edison bulbs, and they’re going to be around 2700 Kelvin, which is a really nice amber color. When you get up to the 456 thousand Kelvin. Those are like your fancy car, ah ID headlights that are going to be really really blue kind of whitish, bluish color. That’s not what you want at nighttime. It’s amazing. You know, I’m rarely out at night. But if we’re out on the road, we’ll drive past someone’s home. And we’ll just see, like science lab lights on at nine o’clock at night. It’s like, No, those people aren’t sleeping good tonight. Some people will argue with me like even my grandparents, I tried to get them off of the TV in the evening or to wear blue blockers. And they’ll say, Oh, I sleep fine. And it’s like, Yeah, but what’s the quality of sleep? You’re saying you’re waking up three to four times a night to go pee. You’re not well rested in the morning when you wake up. So yeah, you may say, quote, you sleep fine. But what’s the quality? What’s your energy level? Like? What’s, you know, are you crashing out by 11am? Because that would tell me your sleep is not so good after all.
Dr. Justin Marchegiani: 100%. Yeah, I 100% agree. So I think it’s a good investment where if you wear glasses or contacts, look at getting a night per night glasses to have the blue light filter in there. And some brands don’t have a good blue light filter. So you know, you can get a blue light where it tests the actual wavelength going through. I’ve seen some of these glasses really only filter out the violet, which is interesting. So they’re kind of having a marketing ploy on it. So you’d want to go look at some of the reviews online, make sure you find a review where someone actually test those glasses, and sees if the blue light is blocked. But if you can get a significant amount of blue light blocked, you know, even if it’s 50% or so. And you get the dimmers on Well, that’s a good first step for sure.
Evan Brand: Yeah. And people listening may say, you know, any kind of skeptics listening, which most of those weed themselves out, so most people that listen to us love listening to us. But any skeptics may say, Well, why our ancestors, they didn’t have blue light blocking glasses. Yeah, but they didn’t have LED lights, they didn’t have electricity. In general, there was no artificial light at night. So when the sun goes down, and up, and the moon Yeah, when the sun goes down, and the sky is turning red and orange, the sun, the blue light can’t get through, when the sun’s at a low angle, the blue light doesn’t come through as much. And you naturally have a blue light filter, it’s the atmosphere. And so at nighttime, when you have a fire, which is the only source of light you would have had at night, look at a fire. I mean, you may have a tiny bit of blue if you’ve got a really, really hot fire, but it’s nothing. It’s it’s not going to impair melatonin production at all. And that’s the issue here is the artificial light at night is elevating cortisol, which is down regulating melatonin. And of course Melatonin is not just your sleep hormone. It’s very important as an antioxidant too, Melatonin is something that’s been shown in several studies to have some cancer protective benefits.
Dr. Justin Marchegiani: 100% and I’ll put up I’ll put a couple of links in here for people that are listening. Regarding my favorite monitors, I use the eye care monitors, and I think those have really been super helpful for me. So I’ll put a link down below people can access that. Okay, that’s good. We talked about some of the blue light glasses, there’s the the Swanwick glasses, there’s the true dark glasses. Those are some good ones off the bat, you can jump on Amazon and look for some ones that have good reviews on there. I think those are great. There’s some blue light glasses that that go over glasses. So if you wear glasses, you can look for a pair of blue lights that go over that that’s on top of that. But if you want extra protection, you’ll have that there. That’s a good kind of first step in the right direction. Why don’t we talk about mechanism? I think this is important. So we talked about like the parasympathetic and sympathetic nervous system. This is important. So the sympathetic nervous system is kind of controlled by the adrenal gland. So the sympathetic is the gas. It’s the Go, go, go go go Stress, Stress, Stress, Stress, Stress, and the adrenals kind of are the gateway between the nervous system and the sympathetic response because of the cortisol response and the adrenaline response. So typically, when there’s some kind of a stress, adrenaline is the first thing that comes to the table. And then cortisol comes a little bit later. So think of think of adrenaline as the primary it Prime’s the pump and then once the engine is going, now cortisol is flooding the zone afterwards. And so when you have a lot of these stress hormones going, you’re number one going to be shunting blood flow to the arms and the legs to fight and flee, you’re going to be making less enzymes and acids and digestive juices so your digestion won’t be as good. So if you’re eating healthy, you’re more likely to get bloated and gassy and have indigestion. And you’re less likely to absorb a lot of those nutrients. So if you’re eating lots of good amino acids and minerals, you won’t be able to ionize them and absorb them properly. And so we want to do natural strategies that decrease that sympathetic nervous system response which is going to help modulate adrenaline and modulate cortisol. And part of how we do that is we have to stimulate the parasympathetic side. So for instance, this new Pepsi product you mentioned, we don’t I’m not supporting Pepsi, but I’m supporting the mechanism. l theanine is a good precursor that Evan mentioned to Gabba, gamma amino butyric acid, and that’s a inhibitory neurotransmitter, think of it as the brake, it’s the stop the slow down. So think of the sympathetic nervous system response is it’s the shifting gear going from first, a second, third to fourth, fourth to fifth, it’s going faster, faster, faster, the parasympathetics. And the inhibitory response is down shifting, it’s going from 5 to 442-332-2221. And then park in that car. And so things like GABA can be helpful. passionflower, magnesium are excellent things. There’s different adaptogens that we use, like holy basil and ashwagandha that really helped decrease and help down shift that stressed out engine and bring it to a lower gear where you can slow down and relax.
Evan Brand: Oh, speaking of ashwagandha This is funny to man, a lot of the things we’ve been talking about for a very long time are becoming more mainstream. I never have the radio on because I’ve got streaming radio in the car, so we never have the real radio on. And so the this advertisement comes on, and it’s you know, the typical radio announcer voice, it’s this lady. And it’s this. It’s just talking about sleep and stress and all that and the lady’s like introducing ashwagandha gummies, an Ayurvedic herb that’s been used for thousands of years, it can really help you relax, and I thought, wow, a radio commercial for ashwagandha. This is hilarious times are changing. So it’s funny. This is something that you and I use all the time clinically And personally, and it really does help you can take ashwagandha during the day to help blunt stress but you can also use it in the evening, take a dose before bed, Stephen buehner, the herbalist I really love because of his books online, he talks about ashwagandha being very, very helpful in terms of calming down like brain inflammation, which can impair sleep associated with Lyme, so people that have that sleep, or if you’re waking up at two or 3am and you’re kind of bolting awake or having nightmares. You know, ashwagandha may be something to help. I’m a big fan of Magnolia Magnolia is a bark that can be very helpful. You and I’ve talked about relora. In the past relora is actually a blend of two different plants. I believe it’s two barks that are combined to create the patented relora. That’s something clinically shown to help modulate cortisol at night. You mentioned the passion flower, I like to mix passion flower with motherwort, especially if it’s a monkey brain situation. motherwort can really help calm the the racing thoughts, the racing mind motherwort, something that Rosemary gladstar and many other famous herbalist, they recommend keeping it in your first aid kit or in the car. So if you get in a car wreck, or if you have a traumatic experience, you could take a dose and mother would never really settle you down, you know, with all the shutdowns and a lot of our clients that are running small businesses and other things that I’ve had massive amount of reports of stress issues happening over the last six months. And so I really think the time that you and I are putting this out is important. It’s always important, but it’s more important now. Because once your sleep quality goes out the window, what happens then well, you have a shorter fuse, you are going to be more irritable, you could be more anxious, you could be more depressed, you may have cognitive issues. So you may not be making good decisions as a parent or as a boss or as a CEO. So I mean, this affects every aspect of your life, you really cannot ignore this and just go pound the coffee. First thing in the morning, you can do the coffee, but you’ve got to be making sure you’re doing all the nighttime strategies as well.
Dr. Justin Marchegiani: 100% I love it really, really good points off the bat. Also a couple other strategies I want to highlight is exercising too close to bed. So exercise, it’s a stress it does activate the sympathetic nervous system because that’s how you get blood flow to the arms and legs into the extremities. And then of course cortisol and immobilize glucose in the muscles and such. And so that is part of the stress response. So you got to make sure the more your parasympathetics are stressed right your rest digest part of the nervous system. The less strenuous the less sympathetic stimulating exercise you should be doing. And of course, you need to allow more buffer time to transition back into the parasympathetics at bedtime. So if you’re working out like at six or seven o’clock and then you’re trying to wind down At nine or 10, asleep by 11, that may not be enough time. So the more stressed you are you want to look at doing exercise first thing in the morning, and you always want to answer my three questions appropriately. Alright, you want to answer positively to these three things? Number one is do I feel better after the workout than when I started? Number two is, can I emotionally repeat the workout? Do you feel so depleted afterwards? Where you just you couldn’t emotionally do it, like, you may like have that high where you’re like, Oh, I feel good. And then like, you catch your breath, like 10 minutes, and you’re like, Oh, thank God, that’s done. You want to feel that sense of like, no, I could do that. Again, like I could do it again, you want to feel that kind of a sense of accomplishment. And then number three is you want to feel not excessively sore or beaten up afterwards. So that next morning, you wake up, you know, barring the fact that you slept good and all that’s okay, you didn’t drink alcohol, you want to feel not excessively sore with the exception. If you throw in maybe a new exercise you haven’t done in a while maybe some lunges or a deadlift, outside of something that’s a full body movement, you shouldn’t feel overly beaten up.
Evan Brand: Yep, good points, good points. And it’s possible, you could use some of those herbs to try to calm down that response. Right? If your work schedule just doesn’t allow it and you have to do a six 7pm workout. Like you said, maybe it’s not too intense. So you still could settle down, but maybe you, you do take a dose of some type of an adrenal cocktail, after the after the workout, I think that could be really smart. And then let’s go into a couple other mechanisms.
Dr. Justin Marchegiani: Just to highlight one thing before we move on topic. So if that’s the case, that’s the only window there’s three major levers with exercise frequency, intensity, duration. So frequency is how often you work out. Is it every day, you taking a day off in between Monday, Wednesday, Friday, Saturday kind of thing. And then of course, that’s frequency intensity is how hard Are you working out as well as the rest in between? So like, a compound lift like a a deadlift or a front squat, right? Isn’t it be a lot harder than like a bicep curl or military press right, the more you activate, the more joints you activate, the harder it is. So you could shift away from multi joint stuff. Or you do multi joint stuff with less weight, okay, and provide more rest time between sets. And then duration, of course, is going to be how long the workout is right? Instead of a 45 minute workout, you go to a 30 or a 20. So you just keep on frequency, adjust the frequency, how many days intensity kind of workout lifts, you’re doing the weight as well as the rest time. And then the duration is the overall length of the workout cutting that down so you can move the lever on those. And I always recommend the easiest first thing is allowing a day off in between to recover. And then keeping the workout shorter, right, Charles poliquin did research on this finding that the cortisol response starts to significantly elevate once you go longer than 45 minutes. So keeping the workout under 45 minutes. And if you’re really stressed probably 20 to 30. And just rely on more circuit type of workouts to get the exercise done. So do three movements in a row, upper lower upper or front back front, however you want to pair it. That way you can get a lot more volume and and exercise accomplished in a shorter amount of time.
Evan Brand: Yep, that’s good advice. I wanted to talk about the gut. And we could probably mention blood sugar, too. I know that when I had gut infections, my sleep was terrible. Now the mechanism of it. I mean, that’s debatable, you and I could try to tease this apart together. I think ultimately the answer is getting rid of gut infections is going to improve sleep in many ways. But I think one of the mechanisms is probably some of the gut bugs possibly affecting blood sugar because the gut bugs are eating and they’re feeding on your nutrition. So I definitely had more hypoglycemia issues. And hypoglycemia, if that blood sugar’s crashing, blood sugar gets too low, you and I’ve talked about this, the adrenals have to pinch hit, basically, and try to help out to get that glucose regulated. So if blood sugar is crashing, maybe you’re not eating enough with meals, maybe you didn’t have enough fat or protein with dinner, or maybe you ate too early. If you ate at five and you’re going to bed at 10 that’s already five hours and the blood sugar may be dropping to a level that’s too low. And then if you compound that with having gut infections, then you really could get into trouble.
Dr. Justin Marchegiani: 100% and like you mentioned earlier, the stress and the inflammation from a gut infection. We see it when we do adrenal cortisol rhythm testing, is we’ll start to see a premature elevation of cortisol in the morning. Now what does that mean for you? Well, we have this natural cortisol rather than people watching on video, I’m going to do some demonstrations. But cortisol comes up in the morning, and then it comes up in the morning but it really increases that first hour of waking isn’t a double from when you woke up to one hour later. So it starts to here’s waking, here’s one hour later and then it gently curves, here’s bedtime and then as you sleep it’s kind of flat and then gently starts to go up like this. So when you have gut infections and inflammation in the gut, and a lot of most infections are on an opposite sleep and wake cycle then we are so the more active they are means more inflammation. More inflammation means Is what more of a cortisol response so that cortisol prematurely starts to rise in the middle of the night. And then that can start to take you out of deeper sleep and cause you to wake up earlier. So, by addressing gut infections, you’re naturally supporting that healthy circadian rhythm. And of course, if we can support natural and influence, natural anti inflammatory support, that also takes stress off the adrenals because the adrenals are one of your number one, anti inflammatory mechanisms, right? cortisol, aka cortisone, and then pharmaceutical, prednisone, are all anti inflammatory mediums that conventional medicine uses for topical skin or asthma inhaled are injections in the joints, right for inflammation. So we have our natural anti inflammatories that we want to work on supporting and utilizing.
Evan Brand: Yep, and we’ve mentioned this, but just to repeat, so the cortisol is downregulating melatonin, that’s the mechanism. So people that just go take melatonin, that may help but I would argue that it’s not necessarily root cause. And so that’s why we’re going to be running these panels to look at the hormones, we’re going to be running testing to look at the stool, we’re going to be running panels to look at the urine and try to confirm what’s going on. Just to be clear for people listening or that are not aware, we’re clinicians, we deal with this stuff every day all day clinically. And so we have thousands and thousands of, you know, case studies that we can report back from and tell you what’s worked and what hasn’t worked. If you go to your conventional doctor in you talk about sleep issues, just to quickly compare and contrast. It’s going to be something like possibly a Lorazepam if it’s an anxiety based sleep issue,
Dr. Justin Marchegiani: -like a benzodiazepine that works on gaba.
Evan Brand: Yeah, exactly. So you’re going to get a benzo which are highly, highly addictive and habit forming, or possibly, you’re going to get something like an Ambien, which in terms of pharmaceuticals, I will tell you some of the hardest drugs for people to get off of are the benzos and the Ambien, which I don’t even know what category Ambien is in, but man, people really, really struggle to get off of that one.
Dr. Justin Marchegiani: 100% so you’re going to have Ambien, right, you’re going to have Lunesta, you’re going to have your benzos They may even be using some SSRIs to increase serotonin, which then increases melatonin. There’s, I think it’s rozerem rwhich is a gaba kind of in that gaba benzo family. So rozerem. You mentioned I mentioned Lunesta, and Ambien, what else is there, I think there’s trazadone is another one that I think is used sometimes for sleep as well. So those are a lot of the common sleep medications. And they don’t really address a root cause. And that’s the problem. And a lot of the sleep medications, like we mentioned, the Ambien or Lunesta, they don’t allow deeper restoration of sleep. So you kind of have like your four phases of sleep, right phase one, phase two, phase three, phase four. And then you go from phase four to three, two ones. This is like once, one cycle is 1234, phase 24321. And you don’t really get to go into these deeper three and four levels, where REM sleep and deep restoration happen. So we want to avoid medications that prevent us from getting into deep sleep. So that being said, we want to make sure we sleep. So we want to utilize every natural mechanism possible. So with sleep 10pm to 2am is that deep physical restoration, where you have good physiological repair, and that’s where growth hormone increases. That’s where we repair structural tissue, and such and bones and joints and ligaments, Hair, Skin nails. And then we have the psychological emotional repair, typically between two and 6am, where a lot of our neurotransmitters and hormones kind of turnover that help us with mood and energy and emotional stuff. And supposedly, a lot of our dreams are us processing a lot of our emotional stress throughout the day, right? So we want to make sure we get to sleep on time, that’s really important, right, the hours before midnight are really important. And we want to make sure that we’re getting the good time of sleep, we want to make sure that we’re decreasing light exposure, which it takes away from our melatonin. And then we want to make sure that we are just having good nutrients on board. So when we’re sleeping, we have the raw materials, amino acids and fatty acids to provide the building blocks to assist in the repair process. Yeah, vegetarians, vegans, they have a lot of sleep issues historically. And I would argue it’s due to the lack of these amino acids that you need to really help fuel some of these neurotransmitters. So back to the I want to just hit that because you hit something really important. And then when vegetarians and vegans get a lot of the amino acids, they’re not really bioavailable. So if you go look at the bioavailability of amino acids in vegetarian vegan foods, they’re not very bioavailable. Now, vegans and vegetarians can get by with free form amino acid supplementation, a high quality pea protein, maybe a rice protein, so they can get by with amino acid supplements, but it’s very hard from a raw standpoint, meaning you’re just relying on Whole Foods to get those amino acids and when you typically do combine them appropriately. You get a ton of carbohydrates. So if you’re more insulin sent or resistant or more Carbohydrates sensitive if you don’t do well with carbs that could cause more blood sugar issues and more sleep issues with that.
Evan Brand: Yep, yep. So back to the drug. The drug name is zolpidem sold under the brand name Ambien anyway, we talked about alcohol A while ago, we talked about like, some of the date rape drugs and some of the bad stuff that people do. Apparently this GOP. Yeah, apparently this drug actually was used or has been used as a date rape drug as well. And so it is a non benzodiazepine. But guess what, it’s a GABA receptor agonist. So it works by increasing GABA binds to the same location as benzos. So tricky little varmints. It’s a non bidco but it binds to the same GABA receptor as a benzo. So to me, it’s a frickin benzo, you know, not not technically but in terms of the addiction potential and the withdrawal and the adverse effects and the dependency it’s it’s no good.
Dr. Justin Marchegiani: So yeah, same thing with Lunesta here, I’m looking at some of the the mechanism of action on the nessa same kind of thing. It has a coupling interaction with the GABA receptor sites. So kind of it’s coupled with like a benzo. So it’s kind of very similar to a benzo and then the rozerem. It works on some of the m two receptor sites, I think some of the same receptor sites that work on melatonin, so I’m pretty sure it’s like a melatonin kind of agonist, if you will. And yeah, right here. rosarium is a highly selective melatonin receptor site type one type two agonist. So what does that mean? agonist means it helps the melatonin in those synapses to be it increases it stimulates it with a little bit and kind of gets a little bit more into gear, if you will. Now, my whole I’d much rather be using melatonin as a whole as I rather just provide more of that building block or more of that raw material to help right and gets more natural than just being an agonist and upregulating the receptor sites to it. And of course, even before that, I’d much rather use a lot more of the amino acids like five HTP, and B six, and providing more of the building blocks. So we don’t disrupt too many feedback loops, or the herbs just to help regulate the adrenals. And then you stay away from this crap completely. But why is how bad it is. So we kind of always start low and then work our way up. So there’s always kind of like a, an algorithm and how we are applying things and even natural we want to do the least invasive to the most invasive if we need it. But of course sleeps is such a huge tenant in our body’s ability to heal.
Evan Brand: Yeah. And why is this not on the nightly news? Well, I mean, Big Pharma is highly involved in the media companies, right? So they’re, they’re not interested in melatonin, which is what maybe a quarter or maybe 50 cents per dose, they want pharmaceuticals, because there’s a lot more money involved. And you can’t patent it, you and I’ve discussed this patent issue many, many times. So they can’t patent anything.
Dr. Justin Marchegiani: When you just look at the mechanisms, right, like, look what they’re doing, like with rozerem, it’s just it’s an agonist on the receptor site. So what they do is they kind of skate the surf, they kind of tiptoe around it and try to figure out, Okay, this is this mechanism is important, how can we monkey around with the receptor site and adjust that and make it better or over, you know, stimulate the receptor site to be more sensitive. So they’re kind of looking at what the the actual mechanism is, and then they try to just skirt the the periphery on it to make it work better, right, which a lot of times have side effects, because that’s what typical drugs, do they have side effects? That’s right. That’s right. So I mentioned the I got into the nutrition piece a little bit talked about kind of the the fat and then just one thing, sorry. And they have to do that. So people thinking, well, I don’t understand like, what’s the point of that? Well, you can’t patent a natural compounds. So when you have things like melatonin or natural amino acid compounds, you can’t patent it. So they know these mechanisms are already helpful. So you hire a whole bunch of chemists to go in there and biochem people to go in there and figure out okay, this is the mechanism, what can we do to create a synthetic compound, maybe we just create like an isomer, or something that looks very similar, that buffers or adjusts receptor sites, but is synthetic enough where they can patent it. So that’s why they they can’t patent natural things. That’s why they they look at already known mechanisms, and they try to adjust it and author it just a little bit. So they can patent it. And it never works as good as the natural stuff. And never will because of the fact that you can’t. You can’t improve upon Mother Nature. You just can’t.
Evan Brand: Yep, I know. I love the herbs. I love them. So I hit on the whole, like, not enough fat and protein piece. And I see that a lot. Like I mentioned the vegetarian vegans. I mean, typically these people are depressed, they’re anxious and their sleep is crap. Now, the one happy vegan listening, good for you, but talk to me in five years, and I’ll be curious to see what happens. But back to the blood sugar piece. So there are some things that you may need to do to help with the blood sugar. That could just be something as simple as eating like a little fat bomb before you go to bed. I mean, it could be like a little piece of some coconut oil or some coconut butter or maybe grass fed butter or maybe I don’t know a couple macadamias are pecans are something that can help just kind of throw a little bit of fat on the fire before you go to bed. Now it can do a huge, huge thing.
Dr. Justin Marchegiani: Correct. Some also do better do really good with a little bit of fat and maybe a tiny bit of carbohydrate, whether it’s a handful of berries, or a little bit of like, honey. And sometimes that can be helpful because the little bit of glucose can help those with the amino acids cross the blood brain barrier. So if you go so low carb at night, sometimes those amino acids can’t cross. And so I kind of go both ways. Try with less sugar. And if you need a little bit of sugar with a little bit of fat and protein, and you can always add a little bit of sugar just to help the amino acids cross that blood brain barrier.
Evan Brand: That’s smart. You know, I’ve tried that like doing a chamomile tea, which is another easy good strategy. I’ve tried chamomile just by itself, and then chamomile with honey. And I will report with a little bit of honey, delicious, but it does help a little bit with the sleep.
Dr. Justin Marchegiani: Yeah, and just kind of just try it on both sides. Because too much sugar can also create blood sugar swings and cortisol spikes when your blood sugar drops. And that can cause problems. So it’s all about finding that right balance. So I always recommend start with none. And then add just a little bit in incrementally.
Evan Brand: Yeah, and we through a lot of people. So where do you start with all this? Well, I think the blue light, the lifestyle stuff, not exercising too close or too intensely before bed. I think all those things are great, getting your bowels regulated, making sure that you’re testing yourself for gut infections and getting those things addressed. And then reaching out to a practitioner like Dr. Justin or myself, because we deal with this stuff. Personally, we deal with this stuff clinically. We’ve done it countless times. And it’s incredibly rewarding what we do, because we’re showing you on paper, where is this issue coming from? You know, some people blame it on their genetics, like oh, my mother, she never slept good. Or my dad Oh, he had terrible insomnia. He’s on antidepressants that are okay, genetics are not your destiny. So I don’t care how your parents sleep or not sleep. That is not your destiny. There are root causes that we can identify. And we can address these we can get them on paper, and we can retest and show you look, your basics is back up great because you needed that because you were also low in serotonin, which you needed more of because both of those ingredients, boom, make melatonin, you didn’t have that recipe. And now on paper, you’re reporting improve sleep, hooray. But look at the labs, we can confirm you fix the mechanism of these neurotransmitter issues and these nutrient deficiencies. And that is just why we do what we do.
Dr. Justin Marchegiani: Exactly. The other thing I would say is going to be female hormones. female hormones play a big role, especially progesterone, because progesterone is a natural gaba chloride channel opener opens those gaba chloride helps flood gaba into the zone, which helps you relax. So female hormone issues, especially for menopausal women can be a big ones, we got to look at estrogen, estradiol and progesterone that’s really important. I would also they’re also kind of like their modulating supplements that can be helpful that may not plug into the root cause. So when I’m with the patient, I’m working them up. I’m trying to figure out what’s the underlying mechanism? Or is it multiple systems meaning is there poor digestion, indigestion, poor gut issues, and then autoimmune stuff with adrenals and thyroid, and maybe some detoxification issues, we try to focus on each of those systems, work on the diet like nutrient dense anti inflammatory, low toxin, get digestion, good, stabilize blood sugar, flood nutrients into the zone. And then we’re going to run organic acids and we’re going to see neurotransmitters, we’re going to see be six amino acid status, we’re going to look at serotonin and dopamine, adrenaline, that can help on the amino acid side. We mentioned things like melatonin, that’s always a later stage always want to do the amino acids first. But then there are things like California Poppy, or like you mentioned lemon balm, or Valerian or CBD as other like natural compounds that are out there that can be helpful, that may help either kind of attenuate that sympathetic response, and may help just kind of upregulate GABA a little bit. It may just have a very kind of sedative kind of relaxing effect, usually working as a natural kind of benzo right and flooding with gaba. So if you plug one of these natural things in, don’t just think that that’s it. Always try to trace it back to the mechanism that drove the issue. To begin with. You really always want to think root cause and then expand out. And if you find a supplement that helps try to always trace it back to what the original mechanism was. Does that make sense?
Evan Brand: Yeah, does man you just like opened up a whole new can of words here. So I’m going to take a few minutes on packet. You mentioned thyroid you mentioned autoimmunity. So hashimotos it’s really common to have sleep issues, because if that immune system is attacking the thyroid, all of a sudden you’ve got some of this hormone leaking out into the bloodstream. So some of the things that you and I will do, yes, we can use the herbs. But one could argue that even the herbs are not root cause because if the antibodies are attacking the thyroid, yeah, it’s great to go and use mother work to calm the heart down. But the tachycardia that’s causing the insomnia is coming from the thyroid and this person is eating gluten. They’re doing sandwiches for lunch, so We got to work backwards on getting those thyroid antibodies down. So that- not so. So that’s my comment there. But then you opened up a whole nother can of worms, make sure I circle back to mold and Lyme and co infections real quick, but go ahead.
Dr. Justin Marchegiani: So just to highlight one thing, when we’re working with patients, we’re always thinking that way, we’re always thinking, Okay, we’re going to try this, try this, we’re going to connect it back to the mechanism of action. But I know a lot of people are going to be listening, they’ll be like, Oh, I’m going to try this supplement or that and they’re writing their list down and what things are going to try, that’s cool. But just you know, if you don’t have that clinicians mindset, you may ignore the root cause. So if you have an issue where you’re trying a couple of things, and you’re not quite getting the results, or it’s a steady issue that’s continuing to happen over the years, make sure you reach out to a good functional medicine doctor, like myself, or Evan, the we can kind of work you through that. But at least try a couple things on your own. But don’t ignore that root issue and get a good functional medicine person to help you. If that issue is more chronic.
Evan Brand: Yeah, because it’s not a deficiency of passionflower. Right, right. So it’s not just like we joke on drugs, it’s not a deficiency of those either. Now, let’s just briefly open up a whole nother can of worms here Lyme mold, co infections, mast cell issues, these things very, very, very much affected my sleep. And so Lyme really affects sleep. So make sure if you have a history of tick bites, or if your partner has it, because it can be sexually transmitted, that you address it, you either test for it, or you just try to go after it using herbs and see if you have a positive or negative reaction. I can tell you with confidence just using Japanese knotweed, for me improves my sleep quality. What’s the mechanism? Well, Japanese knotweed is anti inflammatory because of the resveratrol, but it does help to kill the spire Riki borrelia burgdorferi, which causes Lyme. So so that’s that, and then mold. Mold really, really affects the nervous system. And it will down regulate melatonin, Dr. Shoemaker. He’s kind of like the main medical doc that’s talked about mold for many years, he discusses all the hormones that get affected, your testosterone can go low, you can have issues with Msh. So then you start to burn easily and you can’t get a good tan, and you can get your antidiuretic hormone is messed up. So now you’re up in the middle of the night to go pee three, four or five times a night and people report Well, I sleep fine. But if I didn’t have to pee, I’d sleep better. It’s like, well, what’s the mechanism of the peeing? Is it a prostate? Is it a mold thing? Is it a toxin thing? metals? Yeah, adrenals heavy metal dosterone.
Dr. Justin Marchegiani: You can’t hold on to your fluids. So you’re dumping your minerals all the time.
Evan Brand: So if you’re supporting adrenals, and aldosterone can come back up, right?
Dr. Justin Marchegiani: It’s Yeah, it’s very possible. So supporting the minerals will help because you’re just not going to have the loss of the minerals. So the minerals are really important for your cells to work well, sodium, potassium, and for your electrolytes and for your heart. So those are really important things to kind of keep in, keep in mind, for sure.
Evan Brand: Babesia bartonella, co infections, any can any kind of CO infection, those can affect it. Chronic pain, of course can affect sleep. So if you’ve got some type of an issue like mycoplasma that’s affecting the joints, or maybe you’ve got prepatellar, some kind of bacterial infection attacking the joints that causes pain that causes sleep issues, this is why you need help. You can’t just go by passionflower and assume all your problems are going to go away.
Dr. Justin Marchegiani: Yep, a couple other questions are coming in here live on the chat as we go. Yes, low thyroid hormone can cause sleep issues I’ve seen reports of and some patients who have low thyroid will even add one of their thyroid doses a little bit before bed. And that can help as well. So it just depends if you actually have low tea, you want to take it during the day, but then also sometimes at night, it can be helpful, sometimes just supporting it during the day is enough to spill into night and help asleep. And yeah, things like pregnenolone right before bed can be a little bit stimulating. So anyone that has sleep issues will try to do their last dose of pregnenolone like around 3pm da ga less stimulating, but if you’re on the fence, you know, always do it really early, just to rule that variable out and see if that’s a problem or not.
Evan Brand: Yeah, that’s good. Yeah, progesterone, I experimented with a little bit of that before bed. Wow. You can tell it hits the GABA receptors. I mean, well.
Dr. Justin Marchegiani: Progesterone is great, like a lot of my female patients that need it will do that, you know, an hour or two before bed, and it really opens up the gaba. And if we need we can throw in some extra l theanine along with it, or some gaba itself. And that can be very helpful and really promote a lot of relaxation.
Evan Brand: Yep. So the toxic thing is just the toxin piece. You know, I think it’s something that we didn’t get into much till the end here. But it is something that would be in our standard workup where we’d be looking for these these kind of hidden, more nuanced root causes. And, you know, just to restate, you could go from referral to referral in the conventional medical world, and you’re never even going to get close to the conversations or information that we just provided you today.
Dr. Justin Marchegiani: No, I mean, it’s hard. The conventional medical model is a three to five minute visit. They’re just trying to collect just enough symptoms to figure out what drug they’re going to prescribe whether it’s a rosarium or a benzo or an SSRI or what whatever other kind of mini me new drugs that are out there many meaning it’s very similar to an old drug, just the new name, new Patent so they can re up that seven year patents. And that’s kind of how a lot of conventional medicine works. They’re not really diving in deep, they’re not even really thinking about deep root cause mechanisms. They’re just trying to get you to sleep. And it’s sad, but it’s system that we’re in. And I’m glad that we have information like this. It’s out there at your fingertips so you guys can be more informed and take some action to get to the root cause.
Evan Brand: Yeah absolutely. If you need any help please reach out to Justin or myself, his website is JustinHealth.com, my website, EvanBrand.com. And we love that you guys are here with us so more to come.
Dr. Justin Marchegiani: And put your comments down below. We really appreciate you guys listening, and I want to get some interaction about what you think works for you. I read the comments. So when I get feedback, like oh, this worked or that work, it really helps me because, you know, when you see thousands of patients like myself and Evan have, that’s really how you get good. Like when you start off in this field, you get a really good base of physiology and biochem and nutrition, you apply it with yourself and your family and then patients around you. And then you grow as you get more patients and you get more data points. So it’s very helpful. And then if you enjoyed today’s podcast, please leave us a review, we’ll put a link down below where you can click and you can leave us a review on iTunes, we really, really appreciate it.
Evan Brand: Yeah, share this with all your friends and family on sleep drugs, we can’t legally tell them to get off of it, but we’ll show them a different path.
Dr. Justin Marchegiani: Yeah, and if you’re on benzos really important, that’s a very, very, very slow taper. So if your doctor decides to take them off fast, be very careful. Sometimes these things have to be tapered over the course of a year. So just be very careful. If you’re on drugs and very dependent. You want to do it responsibly and very slowly with the prescriber as you kind of taper down and as you fix the root underlying issues.
Evan Brand: Yeah, well said I mean you’ll listen to this podcast you’d be like well screw those drugs I’m stopping! Bad idea don’t do that same thing with like hypertension medications. I mean, we’ve done podcasts on naturally regulating you know blood pressure and some people, Oh my god, these drugs are terrible. I’m getting off of them. You can you could get rebound hypertension Same thing with the sleep drugs, you know, you can have a lot of issues with the GABA receptor I mean being so saturated with the drug and then you just going cold turkey, these are not cold turkey drugs.
Dr. Justin Marchegiani: Yeah, my general recommendation is get a good foundation, diet, lifestyle, sleep, movement hydration, get that there. Before you go in and ask that prescribed or start dropping the dose slow. So get the foundation right before you make any changes.
Evan Brand: Yeah I mean look, we want people to be healthy, we want them to be drug-free, if possible. And if that’s our goal ang long term plan, we love it but there’s a time and a place. So just hang in there, i know it sucks, people get so mad. I dont wanna be on this drug! They say that so often but they have to. That’s okay, i’m not judging you, it’s okay if you need it know. Let’s get you healthy.
Dr. Justin Marchegiani: Every now and then I find 1% of people having a hard time getting off of it or just can’t get their sleep right, but I would say 99% people are gonna be able to address significantly and improve their sleep. So stick at it, you have a really high percent, so keep it up and goodluck for everyone listening.
Evan Brand: Yep, absolutely. Well let’s wrap this up. JustinHealth.com for consults around the world, and EvanBrand.com. We look forward to helping you. Take care we’ll talk to you later.
Dr. Justin Marchegiani: Have a good one ya’ll. Bye.
Natural Solutions to Heavy Menstrual Bleeding and PMS | Podcast #299
Dr. J is tackling menstrual irregularities and heavy menstrual flow, symptoms, what your cycle should look like, looking at hormones, when to best test, triggers of irregular cycles, and some tips for helping regulate menstruation.
Most women cope with their PMS and irregular cycles like it’s a normal thing, but really heavy menstrual flow can be a sign of something deeper, maybe even estrogen dominance. Heavy menstrual flow can cause fatigue, lethargy, mood issues, irritability, brain fog, hair loss, and most importantly low iron. Heavy menstruation can drive anemia and low iron which is essential to the body, then it can take weeks to replace iron, by the time you feel more yourself the cycle starts all over again. What can we do? Well Dr. J has much to say from the perspective of a functional practitioner.
Dr. Justin Marchegiani
In this episode, we cover:
2:54 Menstrual Issues and Terminologies
11:12 Social Isolation, Supplements and Herbs
15:10 Tests for Menstrual Irregularities
17:44 Fasting as Stressor
20:16 Diet Restrictions
Dr. Justin Marchegiani: And we are alive. It’s Dr. J here in the house. Evan and I will be chatting about menstrual irregularities and heavy menstrual flow. Evan, how are we doing today man?
Evan Brand: Doing really well excited to dive in. This is an issue that many women just deal with. And they don’t really get help with. They just assume that hay, it’s normal to have PMS. It’s normal to have this happen with my cycle where this month, it’s 28 days. And then the next month, it’s 17 days and the next month, it’s 36 days. And I mean, we hear these stories all day every day.
Dr. Justin Marchegiani: 100% and the problem with heavy menstrual flow off the bat, it’s a sign of something else deeper, usually some kind of estrogen dominance. And then what’s driving that right? A lot of times progesterone is falling out too soon in the woman’s cycle. And then you have all this heavy menstrual flow, and that can drive in anemia that can drive low iron and that’s a problem because we need iron to bind a hemoglobin to carry oxygen. And we need oxygen for aerobic metabolism right for our mitochondria today. burn fuel, generate energy and burn fuel. So we need adequate oxygen. So if we have heavy menstrual flow, you can easily see fatigue and lethargy and mood issues. And a lot of times takes a couple of weeks to even replete that iron back up, and then you do it all over again. So it becomes this really, you know, you’re in the boxing ring every month, and you’re just getting beaten up, and it’s really tough. So you got to fix the anemia, and you got to fix that heavy menstrual flow for sure.
Evan Brand: Would you say this is a functional problem, meaning if you go to your doctor and you’re getting conventional bloodwork done, it’s going to get missed or even on conventional bloodwork. Are you going to see certain things pop up? That would be a red flag to even a conventional doctor that they would see.
Dr. Justin Marchegiani: It depends. A lot of times conventional doctors aren’t going to run like a functional iron panel, they won’t run like ferritin or iron saturation or iron binding proteins. A lot of times they don’t do that they’ll run a CBC and they may look at RBC see if it RBC is below four or a hemoglobins in the elevens or dramatic rates in the middle Low 30s they may run that but it just takes a lot. Like the issue has to be a lot more severe for the RBC, hemoglobin hematocrit to be a problem. So, you know, I’ll run a CBC to see where you’re sitting, right? We don’t want the RBC below 4.2 we ideally want the hemoglobin in the 13th, we want to get in the upper Upper 30s. So we want to make sure that’s good. But if you’re using a late stage indicator, the problem needs to be going on for a lot longer to fix it. That’s the issue.
Evan Brand: Okay, let’s go into symptoms briefly. I think this would be helpful for women because they’ll say okay, menstrual irregularity, you know, what, what do you how do you classify that? And then what symptoms would be associated with this? Are we talking to typical PMS issues where, you know, there’s breast tenderness stuff, or are we talking where the the cycle is changing? Where, like I mentioned, you know, some months it’s 28 days, others it’s 36 others, it’s 17? Are we talking headaches? What are we talking?
Dr. Justin Marchegiani: Yeah, so let’s kind of get a couple. Let’s get some terminology stuff out here. First, I find it I’m not sure if It’s an educational issue. I speak to a lot of women, I say how long is your cycle? And the first thing they tell me is how long they man straight for. So it’s this weird kind of disconnect. And I think it’s just people aren’t really educated in school about this. People, most people conflate their cycle is to how long they men straight. So a woman’s cycle is their entire hormonal cycle. Usually it’s 26 to 30 days right from day one’s the first day of leading to the next day one. That’s their whole cycle, right, which is built on a follicular phase right where the follicle grows, and estrogen predominates. It’s built on oscillation where estrogen predominates and progesterone rises. That’s oscillation and that it’s built on the luteal phase, the last half. So think f follicular first, think l luteal last, okay. And then luteal is where progesterone predominates. And a lot of the cycle irregularities may happen because of estrogen bouncing around or progesterone being either too low or dropping out too soon. And so when we talk about a woman cycle, that’s the full cycle when we talk about menstruation. That’s the period right? So most women they confuse menstruation and cycle length. So menstruation is when flow is happening period blood flow, and the cycle is going to be the entire length of that hormonal rhythm day one the first day they’re bleeding blood flow to the next day one, that’s your cycle. So just from a terminological standpoint, so when we’re looking at the heavy menstrual flow and a lot of the irregularities, it tends to happen a couple of days to even a week before we have blood flow. And of course, some women when there’s a lot of estrogen dominance occurring in that progesterone drops out too soon in the cycle and I’m doing a lot of hand gesture stuff so people are aren’t quite following on the auditory side. We’ll put the video link below so you can see the video. But when that progesterone drops out a little too soon in the cycle, that’s where we have a lot of menstrual flow. And this can really mess a lot of women up because of what I said earlier. You’re going to have a lot of low iron here, low low iron, low hemoglobin, and then you’re ability to carry oxygen really get some hair, and that’s gonna make it harder to generate a Robic metabolism and support the mitochondria. Mitochondria needs oxygen. So we need that. So that’s one of the collateral damages of menstrual irregularities is the menstrual flow. And then of course, other things can happen like irritability, breast tenderness, back pain, mood issues, brain fog, but the key thing that that’s going to happen after that is going to be a lot of that blood flow driving the anemia and the low iron, low hemoglobin. And the I was-
Evan Brand: I would Oh, yeah, I was gonna say the fatigue is probably the big one, right? Maybe exercise intolerance. These are women that they feel like they have to do some exercise. Maybe they’re pushing themselves hard, but they just don’t feel like they have enough gas in the tank to get the exercise done. It just feels abnormally difficult to do physical things. And then hair loss is big too. I mean, we’ve seen countless times on bloodwork where women will show up with really low ferritin. And they’ll say that every time they take a shower, I mean they’re losing a clump of hair, you know, per shower, and that’s just insane.
Dr. Justin Marchegiani: Yep 100% 100% so it’s always really good to take a look and test where you’re sitting during the luteal phase like right around day 21. The 22 is usually a good time to test where that progesterone sits to make sure it’s high enough. If you’re having a lot of heavy bleeding early, a lot of times that progesterone just falling out a little too soon in that cycle. And so we may support there’s a lot of stress, we may support the hypothalamic pituitary, go Natl axis, right that’s the brain talking to the to the gonads or to the ovaries in this example or to the adrenals. So we can support adequate levels of progesterone output. And we may use herbs like you mentioned shepherd’s purse, we may use things like chase tree, we may use estrogen modulators like Don Chi or black cohosh may use things like that we may use special phenotypes of Makkah, we may even use byway denticle progesterone as well to kind of carve out and work on supporting that healthy female rhythm too.
Evan Brand: And What led to these issues in the first place? I mean, we’re talking just age, we’re talking stress, we’re talking pregnancies having babies, like the xeno estrogens in the environment. I mean, what are you thinking are some of these big triggers?
Dr. Justin Marchegiani: Um, so in regards to the biggest trigger, in my opinion, is going to be the fact that progesterone can make cortisol. So when women get stressed, their stress hormone is cortisol. So they’re going to take a lot of that progesterone, and they’re going to, they’re going to pull it from their cortisol. All right, I’m sorry. They’re going to take a lot of progesterone and they’re going to pull it down to cortisol. So then that starts to skew the relationship. So stress, takes progesterone shunts it downstream to cortisol that can create some functional estrogen dominance, okay. Number two is just they’re depleting a lot of their cortisol output from the adrenals. And their adrenals are, you know, are making some other hormones but there’s needles are just more depleted. That can be a big thing too. And then three would just be potential Xena And exposure, there’s three big variables there. That’s gonna be from pesticides, right? These chemicals, they kill plants by disrupting their hormonal system and nervous system. So that’s one. Number two is gonna be plastics. Plastic does you know estrogens, right BPA or even some of the BPA free ones have other types of xenoestrogens that aren’t good. And the third one is going to be hormones and meats, animal products were to dairy milks, beef, chicken, right, just the hormones that are given to the animals to fatten them up. And so it’s going to be plastics, pesticides, and hormones in the meat and animal products. So those are the big ones. So of course, eating organics and to be good. Using Pyrex, or glass containers is great, especially when heating plastic isn’t that bad, as long as everything’s cool, and isn’t in the sun, not as big of a deal. Once it’s in the sun and you’re heating it forget about especially a microwave forget about ovens. Obviously, that’s a no brainer. And then of course, um pesticides and pesticides could be in the food Okay, so organic helps that it could also be in the water. So high quality water filter, reverse osmosis, or at least a carbon filter will filter a lot of that junk out.
Evan Brand: Yeah. And people listening, they may say, God, why does everything have to be so complicated? It’s like, Well, we’ve just changed a lot. I mean, you mentioned the adrenal thing. Women now where historically they were in the tribe, and they had other women to help with the kids. Now you’ve got the stay at home mom, parents-
Dr. Justin Marchegiani: -and grandparents, man. Yeah, I mean, that’s back in the day. Think about it. grandparents would be like in their 40s and 50s, probably right. You have kids in your late teens, your kids would have kids in their late teens, that puts you like, you know, that puts your grandparents in their in their 40s, early 50s. And typically, you know, you’d be out earning a living paying for the home and maybe rearing the kids a lot, maybe taking care of the kids. So there was a little bit less stress on the child rearing aspect of it, because you had someone there. And then typically, you didn’t have a big mortgage, you didn’t have all this. So usually One income was enough. So then, you know, one person could help out with the family, grandparents helped raise the kids, one person required for the income. So there wasn’t a ton of stress. And the income back then could be hunting. Right? It could be hunting or fishing, right? It could be doing something that were just really providing food and shelter. And that’s it. That’s all you need it. So our society has evolved and changed, and there’s a lot more financial stress, and some people have to have two incomes to survive to and, and grandparents are older and have their own health issues and can’t really participate on the day in day out of raising kids. So a lot of good things have shifted.
Evan Brand: Yeah, well, then you go further back, and before there was even bills and currency and you had the tribe that was hanging out with each other where you’d have, like you said, multi generational tribes, and then you would have potentially other people that are related somehow or maybe not related. They’re just part of the tribe. And, I mean, you read about these, you know, hunter gatherer societies where you’ve got women that would sometimes be nursing the children of the They’re not theirs, you know. So there must be a shared motherhood experience. And now you’ve got the stay at home mom driving the minivan with the three, four kids running them to the park and then doing the groceries and all that alone. So, you know, I think a lot of the social isolation aspect is really big for this stress component you’re talking about with this whole pregnenolone, progesterone, cortisol, everything getting robbed and diverted. And, yeah, I mean, it’s like, it’s a big hormonal chaos, really. And it’s because the, we know, there was actually a study done on that isolation issue. And that isolation, being socially isolated, was comparable to like smoking a pack of cigarettes a day. In terms of the the toxicity, we’re just not, we’ve never been a species like this. And now with shutdowns and everything going on, you’ve got people even more isolated. I mean, I have a client who’s a therapist, and she said, Man, everybody’s a wreck. And I said, What do you mean? And she goes well, because everybody’s separated from each other people are afraid to be next to one another. She said, I’m hearing all sorts have new symptoms for my clients. I thought Wow, that’s really interesting. So what’s the remedy? Well, you mentioned some of the herbs already some of the adaptogens will use and maka extracts and shepherd’s purse and wild yam and cohosh and chase tree and all those things are amazing. But I think at the end of the day, you’ve got to try to build some type of a community. You know, like Facebook, moms groups are one thing, but you actually have to have like an in person, place where you can sit down with other people have a conversation, you know, let somebody else handle the kids chaos for a minute. While you can just relax. I think we’re all just stuck in fight or flight. And that’s really one of the big root causes is our nervous systems are just so turned on. And especially if you’re watching the news, you’re not turning off. And I think that’s a big root cause outside of the environmental dietary pieces.
Dr. Justin Marchegiani: Yep, I totally agree. There’s some data also Showing that there’s more relaxing, which is a hormone produced by women’s bodies that can relax a lot of the ligaments and tendons. There’s some data showing that there may be more ligament laxity in the last half of the cycle where progesterone is. So just be careful of over exercising or doing too strenuous exercise. During the last half of the cycle. Just keep that in the back of your mind exercise stress could be a big one. We don’t want to be over exercising that’s important. Of course, nutrient density is essential. So nutrient dense, anti inflammatory, low toxin foods are going to be key one because we provide building blocks and two hormones are made from good high quality cholesterol compounds and cholesterol is connected with animal products and that’s usually connected with fat soluble vitamins at Okay, so we got to make sure all those foods are dialed in egg yolks. High quality grass fed beef by the grass that are by last night with some organic green beans was wonderful, right? So you can do all these things with the food good paleo template and you know, line up your macronutrients according to what you need. As a woman, if you’re more of an ectomorph, you’re more lean, you’re more skinny, you may be able to handle some more starch starch on the reg. Right? Every day, you can handle more starch. If you’re more on overweight, you may have to lean more on your non starchy vegetables and less fruit and starts maybe some but just a little bit less. So really get your macros dialed into.
Evan Brand: Yeah, I would say on the supplement side to one thing we didn’t mention would be like calcium D glucoerate could be really helpful. And then also, you know, since we haven’t gone down the rabbit hole yet on this podcast about it, you know, we could briefly mention the gut and how the gut is involved in these hormonal issues and how we’ve had many women that have had issues with their cycles that have spontaneously resolved just by fixing gut infections because we’ve hit on this idea of the beta glucuronidation enzyme being elevated, which causes the research ulation of toxins and hormones due to bacterial overgrowth. So if you’re having menstrual irregularities and you’re not addressing or looking into your gut, you know, you could work on the diet piece all day and still have issues. We have many women that have come to us that they’ve done a great job on the diet. But there’s still suffering. And so that’s where we dig deeper. And then something like calcium D glucorate may be used. And it can do a lot of good really, really quick with the detox piece, even for mold. It’s been helpful.
Dr. Justin Marchegiani: Yeah, so when we test a lot of these, we’ll do a Dutch test. And we’ll look at things like right around day 20 or so. So we can see where progesterone peaks out. And we’ll also look at estrogen levels and ashra metabolism. We’ll look at two methoxy, two hydroxy. Estrogen we’ll look at methylation markers. We’ll look at pirate glutamate, including violence that can give us a pretty good window for impaired on the detoxification side and we can add in phase one, phase two detoxification support whether it’s B vitamins and antioxidants, or sulfur amino acids, or extra binders or extra vitamin C or extra fibers to kind of bind up some of that that’s a really good option to therapeutically support detoxification, as well as just to help excrete extra hormones that may be laying around from some of the other reasons we chatted about.
Evan Brand: Yep, absolutely. So the testing piece, you know, Dutch is going to be important. I would say stool test is going to be amazing. Blood panels could be important. You know, if we did have a history like heavy bleeding, we’re going to look into ferritin do like a full iron panel, potentially thyroid could be important as well. organic acids. I mean, I would argue that be important too, we always run those for looking at the gut piece, the mitochondrial piece, if a woman’s complaining of, you know, major fatigue associated with this wells is related to the iron ore is is related to possibly the mitochondria as well that have gotten damaged by some sort of toxicity issue. So I think those would be top priorities. What about anything else? Are there any other tests that you would you would run to investigate this issue?
Dr. Justin Marchegiani: Well, if there’s a lot of insulin resistant issues, insulin is a big one. So carbs are out of out of whack and they want to look at insulin levels, make sure they’re closer to five, five to sevens ideal. They’re too high, there could be some resistance going on. Of course, I always get worried about pcls right. pcls is primarily driven by high insulin and then that can cause elevations in androgens and testosterone and that can also cause an increase in something thing called prolactin and prolactin can start to dis regulate the HPA axis that can kind of dis regulate the cycle. And again, that’s all supported by getting blood sugar stable, right. dysglycemia is a major hormonal stressor. And I asked them and don’t, don’t jump into hormonal stress and start fasting and doing all this stuff. Get your blood sugar relatively stable, you know, make up proteins and fats as the foundation of your meals. And make sure make sure 100% you’re getting enough nutrition, go look at go look at your chronometer, or My Fitness Pal and look at your calories. Make sure you’re getting enough. Make sure those calories are all nutrient dense, anti inflammatory, low toxin. Make sure you’re getting enough magnesium and potassium and high quality minerals. Very, very important.
Evan Brand: Well, you said it quick. So let me just restate it and confirm to make sure it’s clear. You’re mentioned you’re mentioning fasting as potentially being a big stressor that could make this situation worse, correct because you’re saying if a woman’s already nutrient deprived, or she’s having major issues Potentially too much blood loss. Fasting is something that could throw off blood sugar balance. But also, as you mentioned before, there’s no nutrition and starving. So you’re saying in this case, three meals a day maybe better than doing a fasting protocol?
Dr. Justin Marchegiani: Yeah, the problem with fasting fasting can help when there’s insulin resistance, but one there needs to not be a lot of blood sugar stress meeting up and down, right? So people think like, oh, if I have blood sugar issues, then fasting is great. Well, not if there’s display see me because this glycemia means your blood sugar’s up and down and up and down. And every time it goes up, your pancreas kicks in every time it goes low, your adrenals kick in with cortisol and adrenaline. So there’s stress on those glands. So the problem with that is you want to make sure you buffer that with healthy proteins and fats, it’s like putting a fire going and having putting, you know, twigs and paper on it. If you ever started a fire that way, you’d be feeding the fire every 30 minutes to an hour or even more because the fire would burn out fast. So a log on the fire that stays For hours, it’s like proteins and fats. And most women, they metabolically keep their fire going with twigs, and paper and gasoline, and you just can’t you’re going to be next to the fire all day. Those are your grazers, okay? Or if you’re trying to fast, well, eventually the fire is just not on you’re going to get cold, ie your metabolism is going to decrease. And if you’re already nutrient deprived, and now you’re fasting and not getting enough nutrition, that’s a problem. Now, of course, if you’re going too fast, and you’re compressing your feeding window, the key mistake is not getting enough nutrients. So you have to get enough nutrients. Now, if you’re doing it a day or two a week and you’re already healthy, and you’re getting an overabundance of nutrients those other five days, of course, you get your body can handle that right. But most aren’t in that over abundant state, they’re already depleted. And that’s where it’s a problem.
Evan Brand: Yeah. And you’re mentioning the grazers. I mean, these people are not grazing on grass fed beef jerky, typically they’re going to be grazing on, I don’t know, maybe some gluten free pretzels or something. I mean, it’s going to be more of a A process thing it’s not going to be. I mean, maybe it is maybe you’re grazing on macadamias or something like that, and you’d be okay. But in general, you want to be able to have three solid meals per day. I find, once women do actually calculate how much they’re eating, most of them are under eating.
Dr. Justin Marchegiani: Most are and then also, I’m not a big fan of snacks. Snacks typically mean a carbohydrate, primarily a carbohydrate macronutrient balanced meal, it’s smaller, and it’s primarily carbs and it’s usually not enough. And a lot of times snacks can be used to compensate for a poor meal previously. So I like the word mini meal, because it provides a there’s a balanced like a meal, meaning there’s some protein fat, maybe a little bit of carbs in there. Ideally, you’re doing a mini meal because your next meal is just a longer gap. So like if you had lunch at noon, but you and your husband are going out to eat at seven, well that may be a little bit long for you. So maybe you want like a good protein, fat, kind of keto bar here or a little more Any smoothie like around five o’clock, right? to kind of give you a little bump so your blood sugar doesn’t go super low until you feel good. Now if you’re healthy, you could maybe be able to handle it if you have blood sugar issues, and maybe a little mini meal is good right there to provide balance. Does that make sense?
Evan Brand: Yeah, it does. It does. And you’re mentioning to like the meals should be nutrient dense enough to where you shouldn’t have to snack But yeah, I mean, I don’t go much more than five hours. I will start to get a little shaky if I go six, seven hours. It’s too much for me.
Dr. Justin Marchegiani: Yeah, also just go to chronometer, man, just try to like put a sample me at like people that do omad stuff one meal a day. I’m like, dude, go to chronometer and put all the things you have to eat in that one meal and you tell me if you’re getting six to eight servings of vegetables, you tell me if you’re getting a pound and a half of me, you tell me if you’re getting that much fat, it’s really hard. Like, you’re going to literally be eating like eating probably for over an hour like eating chewing. It’s probably gonna be hard. Oh, yeah. Really full and you’ll probably take a break. That’s why two meals is doable, but you really have to be like There can’t be slack in the meal. It’s got to be a very intentional awesome meal. And you have to do it three meals. It’s relatively easy. Yeah, you know, you have two really good meals and one pretty good one and that you’re there. One is very hard. Yep. Yep. I would agree if you have tummy issues, if you have SIBO and you already have low stomach acid, well, now you’re just now you’re eating all that calories in one sitting. It’s like, Whoa, yeah. And how would you possibly digest and assimilate all that without having any issues to that’d be very, very difficult. It’s harder now people can do it if they have a really chill night and they can just sit around and relax for two three hours and in their lives aren’t that stressful, right? But in their digestion is really good. They can maybe get away with it, but I think minimum two meals is gonna just make your life easier.
Evan Brand: Yep. I just want to point out that if you have menstrual irregularities, you may need to come in and do some specific herbs to address those but sometimes this issue in the same category as many other issues we’ve talked about, where it gets fixed as a side effect of just getting healthy, just running you through kind of our functional medicine workup, supporting and looking at adrenal supporting and working on gut, the mitochondria, the nutrient absorption, the acid and enzymes, the probiotics, sometimes just those simple steps fix this. But if they’re having an issue that’s not resolved, then we can come in with these extra tools. Yep, that and vice versa. And maybe we should mention this to vice versa. You can’t just come in and do the chase tree, or the vytex, or the wild yam or whatever, and call it a day. You can’t do that either, because now you’ve ignored the issues that led to this problem in the first place, whether it was the glucuronidation pathway, or the bacterial overgrowth or the parasite infections and messed up the nutrient absorption which caused the nutrient deficiency which caused the hormonal issue. So you really have to do all of it. But I don’t want this to be Hey, let’s go to the hormone section at Whole Foods, buy a supplement and call it there. You don’t want to do that either.
Dr. Justin Marchegiani: Yes, you want to really get to the root cause of the food. stuff is important. We talked about some of the herbs we talked about even doing a kind of a cyclical augmentation kind of reset by using progesterone accordingly. And of course, we’re supporting the adrenals. The adrenals play a big part. So when I always test, when I test hormones, I’m always looking at female and adrenal together, they tell a really big role. And it’s nice to be a look at hormone detoxification. That’s really helpful too. Because it really gives me a window in all three sides of it.
Evan Brand: Yep. I think I’ve said all I need to say, do you have anything else you want to go into?
Dr. Justin Marchegiani: Yeah, so blood sugar, nutrition, right diet stuff’s very important. The gut plays a big role, because that’s where we digest and absorb all the building blocks to make our hormones. So if we have bloating or digestive issues, that could be a problem. Don’t just get myopic on the female hormones. Don’t you got to remember the adrenals play a huge role. So female and adrenals. And, you know, don’t jump on these fat things. Oh, just fast and do this and you’ll get better. You know, get your nutrition gets your blood sugar. Get it dialed in. And then if there’s things like iron, that’s a problem in the interim, you know, you really want to support that I have a product called Iron Supreme, it’s a bisglycinate iron. That’s a really better iron ore. If you’re more sensitive, a high quality liver, glandular is great. And then obviously eating a lot of high quality red meat before and during menstruation if flow is heavy, just to really make up some of that extra iron if needed.
Evan Brand: You know, good news is you can reverse this is not something you have to live with. So like I said, in the beginning, many women just kind of live with this and they just know hey, I’m quote messed up, you know, my cycle does this or that and they just live with it. But you can get it resolved to where if you track it on an app, I mean, my wife, she’ll track it on an app, and it says, cycles supposed to start boom 28 it’s 28 day cycles. So you know, and before due to birth control and other issues, I mean, her cycle was not always perfect. So you can fix these things. You can adjust them you can modulate them and there is hope.
Dr. Justin Marchegiani: 100% so if you guys want additional help and support, we are available worldwide. Feel free to head over to EvanBrand.com you could schedule a consult with Evan or JustinHealth.com you could schedule a console with myself we’re there to help you. Click down below for links and if you enjoy the content give us a review we really appreciate it EvanBrand.com/iTunes, JustinHealth.com/iTunes, and share with family and friends. And we appreciate you guys for joining. Take care y’all.
Evan Brand: Take care. Bye now.
The Top 5 Causes of Chronic Headaches
Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.
So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.
1. Food Allergens
Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain. Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.
2. Food Additives.
These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.
3. Blood Sugar Fluctuation.
We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings. This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.
4. Gut Infections.
Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.
5. Hormonal Issue.
A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues. That low level of oxygen may also cause some headache issues as well. Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.
Oils That Cause Gut Inflammation
There are various top-causes for gut inflammation but a big one is an oil. The oil you use to cook or bake into foods could be a major culprit to your very uncomfortable gut inflammation. Let’s look at the good and stable oils vs. the unhealthy oils.
If you look at the standard American diet, just even a hundred years ago, your grandparents or your great grandparents, they did not have access to these type of oils. They were cooking with traditional fats. They did a lot of lard and maybe some beef tallow.
If I asked my grandfather, “What did your grandmother cook you and what did she cook it with?” She was not using soybean oil. She was not using corn oils. She was not using rapeseed oil, which is canola. She was not using peanut oil. If they did something fried, it was going to be fried in possibly bacon fat, which came from the pig in the backyard of the farm or it was going to be cooked in some type of like a beef tallow, where the cows were on the back part of the farm.
When it comes down to fats, most plant fats are not going to be the best unless they are cold extracted or unless they are minimally processed to extract the fats. Partly because of the processes of extracting, it tends to damage the fats because the heat and the extraction process also makes the fats rancid and taste bad. There’s a lot of like deodorizing and filtration and different processes to make it more palatable that you would never be able to have at a natural state.
So the best plant fats are:
- Coconut oil because it’s a saturated fat and it’s more temperature-stable.
- Cold-press olive oil and good-quality avocado oil, which is primarily a monosaturated fat.
- Palm oil, which is more in a kind of saturated state.
There are some nut-based and some seed-based oils, but then you start ramping up the Omega-6 and those may not be the best. There are some supplemental oils that are more GLA-based that I’ll give supplementally, like black currant seed oil but we’ll give it supplementally and that’s coming from great sources that are going to be in capsules that won’t be oxidized and such.
Bad fats are going to create a lot of oxidative stress and they are going to deplete a lot of your antioxidant reserves because if those fats are oxidized, your body is going to need a lot of vitamin C and vitamin E to help with the oxidative stress that those fats may cause your body.
Now what it you find a good fish with gluten-free breading so it’s not covered in wheat with some type of non-gluten containing flour, but then you’ve got canola oil. Do you think you’re still going to be net positive in terms of nutrition because you’ve still got the good fish, but yet you’ve got the inflammatory oils or would you say, just get you some grilled fish and then if you want to bread it, you bread it yourself?
There’s a product that we like of sweet potato fries that my wife will do for my son because it’s really easy, but they have a little bit of canola oil in there. So you have this kind of convenience factor where ideally if you could you always would want to put your own fat on there if you could and my easy saturated fat or my easy fat for cooking that’s plant-based would be avocado. I like avocado because it tastes a little bit more neutral. I do not like olive oil as much. Olive oil is better for dressings, but I’ll do avocado for cooking. If you have control over it, you always choose the better fat over the junky fat if you can.
So the interesting thing is like coconut oil and avocado they’ve become kind of trendy and I would say avocado is not going to be a traditional fat meaning, meaning like traditional people were probably not doing it because you’ve got to have some heavy-duty equipment to extract the oil, but coconut oil would be super traditional. I mean, this would be something that has historical use.
Your big fats that are going to be plant-based would probably be primarily coconut. But your biggest ones that I think are going to be used more long-term from generation to generation will be your tallows, your bacon fat, your duck fat, and those kinds of things because saturated fats don’t go bad. They stay good for a long time because the carbon is saturated with 4 hydrogen bonds between them, which makes the fat really, really, really temperature-stable.
Take note of oils are that bad for your gut because they cause inflammation and oxidative stress.