Fatigue, Tiredness, and Lethargy: Link to Gut Infection | Podcast #311

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Tiredness is not a symptom that defines any one particular disease. Rather, tiredness can be a symptom of many different diseases and conditions. Causes of tiredness range from lack of sleep and over exercise to medical and surgical treatments. The lack of energy (lethargy) associated with tiredness can sometimes cause difficulty with normal daily activities, leading to attentiveness and concentration problems. 

Dr. J suggested considering to support protein breakdown by extra amino acids and enzymes. Dr. Evan also added that if you have issues, always reach your conventional Dr. or functional Dr., be tested, find the root cause and guide to fix possible infections that cause you to feel tired before you reach a crisis level.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:10      Mechanisms to Gut Infection

4:05      Where Gut Stressors Come From

12:12     Infections that causes Fatigue

17:41     Probiotics and Beneficial Bacteria

22:32     Supplements to Gut Infection

24:18     Immune Issues

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Dr. Justin Marchegiani: And we are live. It's Dr. J here in the house with Evan brand. Today we're going to be chatting about your gut infections may be making you tired. Many people don't think about how their gut maybe having an impact on your energy, your mood, your emotions, but it's totally true. Most people think, oh, if I have a gut issue, I'm just gonna have bloating or diarrhea or constipation or acid reflux. Oh contraire. We're gonna dive into that today, Evan, how are we doing today, man? 

Evan Brand: Doing really well. How about should I just go straight into my story, then? I mean, I suffered with this thing firsthand, as you know.

Dr. Justin Marchegiani: Yep. Let's do it. 

Evan Brand: So when I was down in Austin, I was losing weight. And I didn't know why I was losing weight. And turns out and I was exhausted. That was that was the main thing. I mean, I was drained, like, it was really tough for me to get through the day. I mean, I was to the point where, at some point, it's kind of embarrassing. I mean, I was like, okay, am I do I have enough energy to cook a meal at night, you know, for dinner, like, the workday just drained me. And so fortunately, after I got the gut infections resolved, I mean, the story is not much longer than that my energy came back online. So I mean, we can say clinically, and personally, that this is a big, big smoking gun for anybody who's been dealing with chronic fatigue.

Dr. Justin Marchegiani: Oh, totally 100%. Now, let's talk about some of the mechanisms why like, you could have constipation, you could have diarrhea, you could have all these digestive issues, that's fine. And it makes sense why some of these issues may be causing problems. Because if you're going to digest a lot of the nutrients that energize you, right, B vitamins, your amino acids, your essential fatty acids to burn them in the mitochondria for fuel, all of these things require optimal absorption, right? So if we don't have adequate enzyme, or acid level or biliary level to break down fats, proteins, and carbohydrates, we're going to have a problem with those nutrients getting into our bloodstream and making their way to ourselves and our mitochondria to be burned for fuel. So that's one big mechanism. And the other big mechanism out of the gates, and we'll kind of expound deeper into each one is the fact that your immune system sucks up lots and lots of resources. So think back to when you maybe got the flu or had some kind of illness. Were you energized? Are you tired? Most people were very tired. Now, why is that? It's because your immune system allocates lots and lots of resources when it's stressed. And it will make you tired, because it'll pull some of those energy resources to put it towards fighting an infection. All right. So if your immune system is caught chronically in that state of trying to fight something, whether it's a gut infection, cebo, or parasite, or just gut permeability issues that are upregulated, due to bad foods, and food allergens, you're going to be really over stimulating and over allocating resources to deal with whatever's happening with the immune system, aka the gut. Don't forget 80% of your immune system is located in the gut, people forget that so important. So if you're over stressing your immune system, you're gonna have problems. 

Evan Brand: Yeah. And so for me, I was taking some immune support, but it was all just kind of a bandaid, right? Because I wasn't focused on the underlying infection. So this time of the year, we're, we're talking in the fall here coming up on winter, you have a lot of people that will say, Well, you know, I really just want to strengthen my immune system. So they'll go and do maybe some extra vitamin C, maybe some medicinal mushrooms, or maybe some other herbs, astragalus, things like that. But it doesn't matter if you do all those if you don't address the infection. So if someone's like, tired and they feel weak, they feel depleted. They feel like they're possibly immunocompromised. Sure, you could do some of the tools, like we talked about those herbs, but really, you got to test first of all, figure out what kind of infections you have. And then step two, is you come in and make a protocol to fix those infections. And not to mention, you know, like h pylori is super contagious. So, I mean, you and I've seen hundreds and hundreds of cases where, you know, husband and wife have reinfected each other. And so we're not doing this to try to make more money. We're doing this to help the family when we say, Hey, what about your husband? What about your wife when we try to get them on board? It's because we know about this potential, you know, cross contamination.

Dr. Justin Marchegiani: 100%. So we kind of look at the gut, and we're like, Alright, where are the gut stressors coming from? So the first stressor we look at are food allergens, because if your immune system is kind of responding negatively to food, that could be a big a big issue, right? And what happens is, when food allergens kind of come in, whether it's gluten or dairy, or just you know, processed grains, or sugars, or even things like nuts, or seeds, or just more allergenic foods, soy those kind of things. Your immune system is upregulated dealing with those foods, and that's going to suck away resources. And also, these foods if you have an allergen to them, if your body's hyper allergenic, meaning your immune system is over responsive. There may be some gut permeability. And gut permeability is like these little tight junctions in the epithelium in the small intestines. They're like this. So imagine you're putting your hands together like you're saying a prayer now, start pulling your fingers apart a little bit, you see the little gaps that happen that's happening at a microscopic level with the tight junction cells in the small intestine. So the more you're stressing your gut lining, these tight junctions open up, like I mentioned, the fingers come further apart. And then food particular we call it antigens, right? These foods aren't supposed to be in the bloodstream at the size they're in. Now you start having these antigens go into the bloodstream at a larger level, and now the immune system's going to start going after it with full force. And that's gonna start sucking up a lot more of your resources. So the first thing when we're working with patients worldwide, we're trying to cut down the food allergenicity we're trying to decrease the immune response by helping the foods not become so bad or stressful on the immune system. So some people coming in on a standard American diet, a paleo template, maybe enough. Some people that are really have an autoimmune issue or Irritable Bowel Disease, we have to go to a paleo template where we're cutting out extra allergenic foods, some we have to even go to a carnivore or some kind of an STD low lower fodmap diet because the bacteria is overgrown, and it's reacting to even fodmap foods like broccoli and onions and garlic like healthy foods, were reacting to it. And so it this whole thing becomes a little bit more nuanced with food, the more unhealthy you become, or the longer your conditions progress. So as a practitioner, right, we're trying to meet people where they're at some people come in at a really easy phase, they're just diets crap. And we can just make a simple change with the Paleo some we have to get a lot more nuanced. 

Evan Brand: So let me ask you, you brought up garlic. I had a woman last week, actually. And she was complaining that garlic was a big issue for her. So we've already cleared out gut infections, and we've done a great job. We've retested we've confirmed that we got rid of all the gut infections, we are doing some leaky gut support, but she says every time I eat garlic, I get really bloated. What would you What would you do? What would you say to that garlic person? 

Dr. Justin Marchegiani: Well, it could be a SIBO thing. So I'd want to test other fodmap foods. So if there's some kind of a gut issue or like a bloat or a motility issue, or a diary or a constipation issue, we're going to be cutting out fodmaps fermentable carbohydrates, fructose, oligo, disaccharide, mono and polyols. And we're going to do that and then we'll eventually do a reintroduction. And when we reintroduce foods, we're going to start with moderate fodmaps first and then go to higher fodmaps. Last, so those foods are higher fodmap. So the question will be How did she do adding in the moderate ones? First, I want to know how she did incrementally adding things in.

Evan Brand: So like apples, she does fine, which was interesting, because to me, I've had a lot more people have issues with apples than I have with garlic. So I thought Hmm, you know, is it really a bacterial overgrowth thing? The stool test didn't really show much in the in the bacterial category. So it's kind of like, well-

Dr. Justin Marchegiani: when people like that, I just want to see is it a one off? Is it just garlic? Or is it other foods like onions and broccoli and avocado, which is a moderate or sweet potato, which is a matar, I want to test more of the moderate fodmaps? Maybe add in some fermented foods like a kombucha or a sauerkraut? Did it happen with those two, if it's just a one off, then it could be some die off, it could just be she's having an issue with that food. So if it's a one off, I don't really worry about one offs, I look for patterns, like patterns or like part of being a good functional medicine doctor, it's pattern recognition, you're looking for patterns, like some patient that can be Well, last week I had this happen or that like, we got to look at bigger picture, we got to have enough data points. So we can look at patterns. Anything can happen one off due to stress or a poor night's sleep, or you got exposure to some bad foods. And now your guts a little bit rocky for a few days. So we got to look at longer trends and really have a lot of good pattern recognition. Part of what we do, we're kind of CSI detectives, and we got to look for things repeating itself, because anything can happen one off, we don't want to change what we're doing, or the programs that people are on, off of just a one off issue.

Evan Brand: And that's what it was, it was a one off and it was kind of, you know, frustrating for me because I'm thinking well, crap, you know, everything else, she's tolerating good and any other problematic foods, I'd kind of put in that same category that we thought would be a problem. They're not a problem. So I'm sitting here thinking, Okay, well, what kind of explanation Can I give her? Because she wants some kind of good functional medicine answer for me, right? And so that's what I told her. I'm like, well, this sounds like just Oh, to be honest, kind of like a food sensitivity, particularly to the garlic. You know, I don't looking at the testing. I told her I didn't really see anything that was compelling to indicate any other sort of issue and all the other foods were tolerated. So I kind of just gave it like a political answer. It was like, wow, hmm. You know. 

Dr. Justin Marchegiani: Yeah, well, we'll come it's possible there could be just a, her immune response is just a little bit more sensitive to if we don't see extra data points correlating to it, then I just tell patients, hey, let's just we'll come back. We'll work on probiotics. We'll work on good re inoculation of good healthy bacteria while adding some prebiotic fibers every month. We can try testing it again. But as long as there's no yeah, as long as there's no, let's just say, family of other foods that are interacting like this, then we're not going to really worry about it too much. But you can always retest, make sure that gut's doing good, but it's possible you have one off allergen issue that's possible. But every month, we can always retest it and see.

Evan Brand: Yeah, good point, I did end up throwing in a high dose, multi strain probiotic. So we're with a high amount of bifido. So we're gonna see what happens. 

Dr. Justin Marchegiani: Yeah, and this person could tolerate fermentable carbohydrates, like sauerkraut and, and maybe a little bit of kombucha it's probably not a fodmap issue, because those things are very, very high in fodmaps. It could be she's killing some stuff off. It could just be she sensitive to garlic. It's possible. Yeah. And so I mean, I just tell patients, hey, you know, that's an artifact, we just kind of make a note on it. When we follow it down the road later on. If things kind of connect back to it down the road. That's nice. But if not, things that are one offs. You don't want to you don't want to one off to derail your whole investigation. 

Evan Brand: Yes. Yes. That's a great point. You know, it's like you're, you're you're like, you know, investigating a crime scene, and you have his weird piece of evidence. That does not make sense. 

Dr. Justin Marchegiani: Yeah. Right. Okay. Well, we'll make a note on that. And we'll come back to it if there's any patterns that they point back to it down the road.

Evan Brand: Yep. Yep. Great. So so small tangent, but really helpful. I think it's, it's helpful for people to see how do you have to think when you're approaching these issues, it's not always black and white, you know, we try to refer back to clinical experience, we kind of sprinkle in some of the data sprinkled in some previous case studies that we've done with people. So it's really fun. But back to the fatigue piece. 

Dr. Justin Marchegiani: So I just wanted to highlight one component, because while you're on it, is when we are talking about these things, because we're clinicians, and we see thousands of patients, we're operating more off of clinical concepts than like rote memorization of like, a fax. And so when people listen to our podcasts, we really want them to understand the overarching concepts of health. If you understand a concept, you don't really have to memorize it, if you're trying to memorize random facts and randomness, and that becomes a little bit convoluted and a little bit stressful. So just try to get the overarching concepts that we're talking about here. Once you get the concept, you never have to worry about memorizing, and it's just there. 

Evan Brand: Yeah, yeah, good. So I just wanted to go back to the to the fatigue piece, because for certain people, there may be multiple layers of infections that are causing your fatigue. So for me it was H. pylori, and then once I got rid of the H pylori, then it was the parasites that were still causing me to be tired. And once I got rid of that, then I did have some Candida that I had to address. So what I want people to know is that if you double down or triple down on something, you know, the guy tells you it's parasites, or the girl tells you it's this, and you pursue that, and you're not better, it's possible that you've, you've missed something. And so I just want people to wrap their head around you, like you say, you have permission to have multiple things wrong at the same time. So you could have a bacterial issue, a parasite issue, a Candida problem, all at the same time. And so you got to make sure you get all the data if you just run a stool test. Candida rarely shows up on the stool test, you and I've talked about this many times. So the urine test will often fill in the blank. So if you had one test done, or your doctor ran this or that, and you feel like you're missing something you probably are so keep, keep digging. 

Dr. Justin Marchegiani: You also there's one study here just looking at h pylori and mitochondrial function, I'll put it up on my screen. But this is important, right? And the reason why it's important, I'm going to just I'm going to do a share here. So if you guys are listening to the podcast on YouTube, you'll be able to watch the video. If you're on iTunes, you know, you have to just click the YouTube link, and you'll be able to see what we're talking about. If not, I'll try to describe it pretty well. But you can see my screen you see my screen. 

Evan Brand: Yep. h pylori affects the mitochondrial function. 

Dr. Justin Marchegiani: So this is important right here. So mitochondria are the powerhouse of the cells. This is really important and the powerhouse of your cell generates ATP for energy. Now, if you look here at the bottom they talked about, they wanted to investigate whether there's an increased mutational load and mitochondrial genome and what they found was there believe that the there's a downregulation in the mitochondrial DNA repair pathway? What does that mean? It means how your mitochondria are repaired and regenerated. It's going to be down regulated, so you're not going to be able to repair your your mitochondria as fast. It's believed to be involved in mitochondrial base excision repair. Our results suggest that these genes A p one and y b one, just know that their DNA is that are involved in mitochondrial DNA repair. They're they're demonstrated to be involved and they're demonstrated to be down regulated when there's an H pylori infection. So it just means that your body's ability to generate ATP which has decreased respiration coupled aptr. So you're not able to generate as much ATP and repair your mitochondria as well when you have an H pylori infection. And this is something that we think is there with a lot of gut infections. It affects your mitochondria. Your ability to repair it, which then affects your ATP synthesis. 

Evan Brand: That is pretty crazy. I mean, especially if we're talking about an athlete who wants to perform right you'll have all these big celebrity personal trainers and stuff and they'll just get people on different diet changes or no, you need to do this exercise or this exercise and they missed the boat. They don't have a clue about H. pylori being the root cause of the of the fatigue or the exercise performance. So yeah, it's just crazy. 

Dr. Justin Marchegiani: And then also, there's a lot of right here, right here one study, I've already looked at it before, if people are having gut issues, and they go to their conventional gastroenterologist, what are they typically prescribing? Well, a lot of times they're prescribing antibiotics, right, and there's a lot of data, bacterial Seidel, antibiotics induce mitochondrial dysfunction and oxidative damage. And so we know this is something that's actually present, where there's damage to the mitochondria with antibiotics. 

Evan Brand: Well, and and, and to be clear, for H pylori, it's not just one antibiotic, it's three or even four, they have what they call quadruple therapy now, which just the name of it scares me, it's literally four antibiotics at the same time. And you and I have both seen patients that have had triple or quadruple therapy done and guess what we retest them, and unfortunately, due to antibiotic resistant bacteria, the infections are still there. So now we have to come in, repair all the mitochondria that were damaged, plus use herbs, which are much, much safer, and in my experience, just as if not more effective, and then we actually get rid of the bugs. 

Dr. Justin Marchegiani: Yeah, she's a summary of your mitochondria dysfunction and oxygen damage induced by bacterial Seidel antibiotics, which is interesting, because bacteria, all antibiotics are bacterial Seidel, so interesting. They use that description. It's mammalian cells. I'm not sure which mammals they use. But they talked about that it's alleviated by antioxidants. Well, guess what, when we use a lot of the clearing herbs that we use, guess what they're rich in, I mean, tons of antioxidants, polyphenols. And that's the benefit, a lot of the herbs that we use, they have a lot of antioxidants in them to help buffer the oxidative stress. Because remember, oxidative stress is part of what happens with the antibiotics. And we have a similar effect with herbs. But the herbs have a lot of antioxidants, which is helpful. Any comments on that? 

Evan Brand: Well, what you're saying makes us look really good, because not only are we giving nutrients that can effectively get rid of the infections, but we're also protecting the system or even replenishing antioxidants, because in general, and the oxidants are going to be reduced because of all the oxidative stress from the infection in the first place. So it's literally like a win win, for us and for the person under the protocol. 

Dr. Justin Marchegiani: Yep. And there's lots of different studies here as well on probiotics and beneficial bacteria, correcting mitochondrial dysfunction with probiotics. There's there's definitely studies on this as well. And again, you know, these are things that we've seen in our practice, like when you see someone get better. So protection of hepatocyte mitochondrial function by blueberry juice probiotics. So there's lots of studies on this, because when you see patients get better with certain beneficial bacteria, after you do an elimination, you're like, why does that work? And so what happens is you see a clinical outcome, patient getting better when you do something. And then you're like, Huh, what could the mechanism B and then you chase it down online? And you're like, oh, maybe that's it? You know, maybe it has to do with the fact that it's helping the mitochondria and people's feel better afterwards? Maybe that's the mechanism. It's possible, right? 

Evan Brand: Yeah. 

Dr. Justin Marchegiani: We have to comment on that. 

Evan Brand: Well, it's a lot of good things happening. And then you mentioned the probiotic piece. So that's going to help even more. So after we get someone on a killing protocol, there's going to be good benefits there, your energy is probably going to get better just based on doing that. And then when you go to the next phase, if we're going to come into the gut healing phase, you're going to get even better than so it's it's really fun for us to kind of paint the picture here of just how how is someone going up, up up up better, better, better? And you've just outlined how so pretty I talked about it right here. 

Dr. Justin Marchegiani: They talked about a collusion the studies show this is BP stands for blueberry juice and probiotic exhibit a synergistic effect preventing the development of a and that's non alcoholic fatty liver disease by protecting mitochondrial function, suppressing the damage of mitochondrial ultrastructure by reducing mitochondrial swelling, right. So mitochondrial damage by antibiotics, as well as we could do the same thing when we search, let's say pesticides, or heavy metals or mold toxins, so we know that gut plays a big role and one helping to absorb those nutrients. But number two, also helping to have beneficial bacteria that modulate these, this inflammation and mitochondrial damage as well. 

Evan Brand: Yeah, yeah. Well said. Excellent. 

Dr. Justin Marchegiani: Well, it's good that just a couple of studies. I mean, when we look at like we look at research a lot differently, so just kind of everyone there. We look at clinical outcomes in patients. And then we chase them back to what the literature says. The problem is a lot of people who are clinicians, they'll look at the literature, and then they'll try to then come up with a clinical like decision based on the literature. And that's sometimes it's really hard to do, because a lot of the PhDs and a lot of the research out there isn't necessarily clinically driven, and maybe driven because someone has a PhD in this area. And they're just they're just studying that topic, because or maybe it's an NIH funded study. Who knows, right? So we're looking at things that are clinically driven, not research driven, because someone has decided to dedicate their life to this topic. And this is the study they're choosing right? 

Evan Brand: Now. It's good that we can kind of pull out some studies to help backup what we're saying. But it's not like we go into PubMed to try to figure out exactly what we're going to do the clinical stuff is really that's where all the magic happens. 

Dr. Justin Marchegiani: Yeah. And some may say we have a confirmation bias and how we look for these things. But we're not looking for out of the blue we're looking for, because we've seen clinical outcomes support something is happening in that direction. And then we use the data, the research to say what could be if positive things are happening in this direction? A to B, what could be the mechanism of why that is? And so we kind of chase it backwards. versus the other way around? 

Evan Brand: Yeah, yeah. And it's just it's a blast. It is fun for you to pull that stuff up. Right? Because, you know, we get we get used to our our methods, we get used to our results. But when you get to see in the literature like that antibiotics, causing mitochondrial damage is like, Oh, yeah, I forgot. That's why we do this. It's Yeah, we're Exactly. We don't want people to get damaged. 

Dr. Justin Marchegiani: And you get confident when you see things repeat itself. Clinically, you're like, Okay, something's happening here. Now what? So you're going at it with a lot more confidence versus like, Hey, I think maybe, you know, I've heard this, it's a hearsay kind of thing. No, you've seen it, you've seen it clinically? Well, here's the confidence.

Evan Brand: Here's the thing that's always fun for me is when we're on the topic of fatigue and gut infections. And so when you have a case where you do the follow up, and someone is reporting that they have significantly more energy, and you didn't give them any energy supplements, you just fix their gut, you just gave them some liver, maybe some enzyme support, some gallbladder support, and then you killed the infections and all the sudden, boom, I'm 20% more energetic. I always smile and laugh simultaneously. Because it's like, This is so fun. We have 20% more energy. And we did zero energy supplements. That's just super cool. 

Dr. Justin Marchegiani: Yeah, it's powerful. Now, if people start feeling a little bit worse, then we got to be very careful. So when people start feeling worse, I'm like, all right, we got to spend more time building up the adrenals, we got to make sure the diets clean, because if someone's got his or, like, if you're putting lots of bad foods in and you're inflaming the gut, then your immune system and also your adrenals may be making more resources to deal with the inflammation in your gut. So we have to decrease the inflammation in our gut and support the adrenals by calming it down. Now, the adrenals have more resources. And of course, we always like supporting the adrenals ahead of time. So then you have natural, your more of your natural anti inflammatories, because conventional medicine when there's serious gut issues, they're going to give prednisone cortisol, well, let's just support your body's ability to make that naturally. And then when we go into a gut clearing phase, then we have more of those resources on board. And then patients are sensitive. I'm titrating the herbs in there slowly so we're not overwhelming the system by killing more, you know bacterial toxins, LPs endotoxins, mycotoxins, we're not overwhelming the lymphatic system that a toxification immune system. So we're going to kind of really titrate things in a little bit slower if you're more sensitive. And we may even add things like binders and glutathione too. 

Evan Brand: Yeah, yeah, the glutathione is good for me. I had to take a break from it for a little while. It was just too strong. It does mobilize toxins to so this is all case by case basis. But yeah, I love glutathione when it works. But when you take too much, that's no good. There's always a right dose. 

Dr. Justin Marchegiani: Yeah, if you're slow, if you're like more sensitive, always start low, work your way up. And then if you're sensitive, you can always start with just a gentle binder first, as long as you're not getting constipated. That's a good first step on increasing things. 

Evan Brand: Yeah, that's great. So let's see here. 

Dr. Justin Marchegiani: Um, the other component, I would say is people that have got issues tend to also have immune issues. We already talked about why 80% of your immune systems in the Galt, that's the gastric associated lymphoid tissue that's in the stomach. And then also the model that's the mucosal associated lymphoid tissue, lymphoid meaning like lymphocytes, white blood cells, and that's in the small intestine. And so if you have a lot of gut permeability issues, if your guts over responding well, what's the most common autoimmune condition that affects people and mostly women, five times more women is autoimmune thyroid. And so if you have an autoimmune thyroid, that could also be affecting your energy because you know your thyroid gland is being attacked and your body is ability to generate thyroid hormone may be decreased. And it's possible that your conventional doctors overlook that. And so knowing that there's an autoimmune thyroid could be affecting your energy too. And if you have an attack, you could feel hyper where you're like anxious, can't sleep irritable, sweating, right? first and then you go into a hypo where you're like tired, fatigued, depressed, right? So you could easily be going hyper and hypo swings based on autoimmune tax of the thyroid. 

Evan Brand: Yeah, and once again, the hashimotos could be a side effect of something else. So even if you go to the endocrinologist, let's say they were a more advanced endocrinologist, for example, hopefully they're running thyroid antibodies TPO, TG maybe TSI. And they're looking at that and maybe they're treating your thyroid giving you desiccated glandulars, or nature thyroid, or just Synthroid or side ml. Even then you see how people can fall between the cracks and not get better. Because yeah, you've kind of cranked up the thyroid that was hypo due to autoimmunity. But you still never got to the gut infection that started at all.

Dr. Justin Marchegiani: BINGO, BINGO, BINGO, BINGO 100%. That's what we got to look at always the root cause. So anything else you wanted to talk about here on the gut and fatigue I did, we hit the thyroid, of course, I alluded to the adrenals earlier, because they play a huge role in regulating inflammation. And we know acute gut issues, they may be, they may be given a corticosteroid to calm down the gut inflammation, that's possible too. So we want to support your body's ability to do it naturally. I would also say supporting protein breakdown. So with maybe adding in free form amino acids, because protein can be very hard on the body to break down. So of course, dialing in enzymes and acids and maybe giving extra free form amino acids. So it's taking stress off the digestive system to be able to access those amino acids as well. 

Evan Brand: I think I think you've hit it all. I mean, I would just say, kind of where do you go next is you really have to get the data. I mean, we've talked about a lot, right. But if you don't have the data, you don't know what you're up against. You don't know what you're doing. So, you know, I think the best advice I could give is if you're dealing with these issues, test, don't guess. And so, you know, feel free to reach out to Dr. J. Justin at JustinHealth.com. And he can run labs on you anywhere in the world and send them to your door and jump on a call and discuss it make a great protocol to help you to get better. Same thing for me my website, EvanBrand.com. And we're available we love helping you all we're grateful to be in this position. So you know, sure you know a lot of you listening or kind of do it yourselfers. That's what led you to be smart and find a podcast anyway. Because you want to kind of educate yourself, but there's a certain point where it's okay to reach out. And I tried to fix myself for a long time. And you spend more money and you spend more time doing that. So you know, feel free to reach out and get a guide.

Dr. Justin Marchegiani: 100% and then you're available at EvanBrand.com worldwide. We're available worldwide and we're clinicians, we have our sleeves rolled up and we're in the trenches every day, dealing with patients. Also, if you're listening to this don't just kind of glom on to one thing. So we see lots of people they're like, they come in like Oh, I know what's h pylori or I know it's Candida or I know it SIBO keep an open mind on what's happening because you have the right to have more than one issue going on at the same time. And for instance, Evans original story was Evan had not could have it wrong if you had h pylori, Giardia and crypto. That's correct. Yeah, yeah, h pylori, giardia crypto, those are some serious infections. Any one of those infections is serious and could could have created the symptoms Evan was having yet he had all three at the same time. So if Evan was like, Oh, it's only H. pylori, you know, he may have missed the fact that grd and crypto were involved too. So go into with an open mind and you have the right to have more than one infection happening at same time. Sad but true. But either way there are solutions to work on it and fix it. 

Evan Brand: I was tired. Man, I was tired. Now that was a that was a that was a level of exhaustion that just doesn't even seem real. I mean, that's how you know something's wrong when you're that tire. But you know, hopefully, with this education we're providing people can reach out and work on this before it gets to that crisis level because it's much easier to pull you out if you're not that deep. 

Dr. Justin Marchegiani: Now Evan can you go to your conventional medical doctor or a gastroenterologist and typically get these infections picked up on? 

Evan Brand: No, definitely not the testing is just so outdated, you know, it's not sensitive, like the DNA stuff we're using. So that's the downside is if you go to the gastro doc down the road, say, Hey, I think I've got Giardia, I heard these two guys on the internet talk about it. They'll probably just laugh in your face and say, Well, you didn't travel to any third world countries. So you don't have it. But if you if you really want to Sally, I'll test you on they'll run the outdated test and then everything comes back negative and then we'll say see, I told you it was all in your head, just, you know, take an acid blocker. 

Dr. Justin Marchegiani: So yes, my opinion is very similar. So the more acute you are, especially with typical gastrointestinal symptoms, the greater chance they'll pick you up, especially if you came back from like Mexico or some kind of a country like Bali where infections are probable, right? But now what do you do? If your infections aren't really gut based symptoms, they're the fatigue or the brain fog, well, then how does that get picked up, you're typically never going to get picked up for that you're more than likely to, to get a psych referral for an antidepressant, right, then to get a gut test, and Evan already alluded to some of the technology they have isn't going to be as up to par. So we have a little bit you know, more access to the DNA technology a little bit more sensitive. And then also like H. pylori testing that they may run a breath test, right? Urea breath test and look for elevated levels of co2, it's possible, but that may miss an infection. And if it's more subclinical, you may need a more sensitive test to pick it up. So if you're listening, and you're like, Hey, I'm gonna go to my MD that may not be the solution, I may not get you the answers you want. And if you don't have the typical gut symptoms, diarrhea, bloating, gas, a lot of stomach discomfort, and irritability, you may not even they may not even want to run a test, because those symptoms don't match with what they think the problem could be. 

Evan Brand: Yeah, yeah. And you know, it sounds like we're like picking on him. Right? And we sort of are and that's fine. I love picking on them, because they're failing people. And it makes me sad. Because I was there I was sitting in the doctor's office trying to get help. And I was told that I just needed an acid blocking medication. I told the doc, no, I feel better when I take it. enzymes that actually increased my stomach acid, I think you're wrong. She said, That's not possible. You're gonna hurt yourself, you need to stop taking supplements stop all dietary supplement, the FDA, blah, blah, blah, blah, blah. And and that was it. And that's when I signed off and said, No, I'm done. 

Dr. Justin Marchegiani: Yeah, and I do recommend, and I think you're in the same way, I do recommend patients that have chronic issues, or acute issues, at least go see your conventional medical doctor just to get checked off that there's nothing glaring that's going on. And that that way, if you work for someone like myself, for you, and then they've kind of already been looked at, and they've kind of already know, okay, conventional medicine is kind of done all they can do. And, you know, functional medicine is the next best option at that point. 

Evan Brand: Yeah, I'm not saying we're the all knowing at all, if you're bleeding out of your butt, you need to go confirm you don't have some type of a bleeding ulcer or colon cancer or you have some type of a polyp issue or diverticulitis and you need colon surgery. I mean, there are certain things that we can't help with. But for these more functional, non pathological issues, we're definitely going to be able to help. 

Dr. Justin Marchegiani: And we can help with all those issues. Once they're stable. If they're unstable, though, conventional medicine does a really good job on stabilizing very sensitive issues. But once they're stable, now what because for the most part, it's going to be just symptom drug management for the rest of your life. Right? If you look at what they talked about, it's, hey, we're managing your gut issue versus let's actually get to the root underlying issue. And sometimes management's good when things are acute and flared. But now when they're stable now what we want to go beyond just who wants to just manage their diarrhea for the rest of their life? That's crazy, right? 

Evan Brand: Oh, God. Well, that happens every day, doesn't it? It's happening today while we're doing this call somebody is in the doctor's office right now about to get an antispasmodic drug for their diarrhea. 

Dr. Justin Marchegiani: Yeah, and that may be fine acutely, but then what's next? So get your health issues under control from a you know, stable standpoint, and then work on the next step with a good functional medicine doctor. Well, everyone was excellent chatting with y'all anything you want to leave us with Evan? 

Evan Brand: No, that's it. We're just ranting at this point. So if you need help, please reach out. JustinHealth.com, EvanBrand.com. Take great care yourself. We'll be back. Have a good one, y'all. 

Dr. Justin Marchegiani: Take care. Bye now. 

Evan Brand: Bye.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/fatigue-tiredness-and-link-to-gut-infections-podcast-311

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