Hey, guys! In this video, Dr. J and Evan talk about addressing gut symptoms via organic acid testing. To start with, Organic acid testing (OAT) became very popular amongst functional medicine doctors and dietitians. It is a urine-based test that gives essential information about the functioning of various bodily systems and to identify possible nutrient deficiencies, gut dysbiosis, and more.
Organic acid testing may be beneficial for people whose symptoms have not yet describe through other stool tests, blood work, or urinary hormone tests. It helps give an immense understanding of nutrient deficiencies, mitochondrial function, neurotransmitter metabolism, detoxification abilities, antioxidant status, and gut health, which trained and experienced clinicians can utilize to dive deeper.
Dr. Justin Marchegiani
In this episode, we cover:
1:07 Organic Acid Testing, Gut Issues
5:17 Candida, Oxolates
10:27 How Lab Results are Interpreted
17:14 Metabolism, Energy Production
24:35 Neurotransmitters
26:06 Detoxes
Dr. Justin Marchegiani: And we are alive. It's Dr. Justin Marchegiani in the house with Evan Brand. Today we are going to be talking about organic acid testing organic acids are wonderful technology that we use with almost all patients to really look under the metabolic hood to see what is going on whether it's functional metabolic issues, deficiencies, certain nutrient deficiencies, gut imbalances, detoxification problems, methylation issues, we weren't able to kind of peel back the onion, so to speak and look deeper under the hood. Evan, how are we doing today man?
Evan Brand: Doing really good excited to dive in! You know, I can say this with confidence, because I've actually spoke to the lab about this that you and I, personally, between us clinically, we are in the top five of practitioners worldwide running the most organic acids testing.
Dr. Justin Marchegiani: Wow, isn't that cool? I didn't even know that. I knew I knew we were up there. But that's really cool to hear.
Evan Brand: Yeah. So So what does that mean? Well, that just means that we've looked at so many of these that we can really get good at what we're doing. And most importantly, we can help you the listener figure out exactly how your symptoms are linked in to a particular body system dysfunction. So we're going to talk today about how the gut, you can find information about the gut via urine. And we talked about stool testing a lot. But in some cases, the urine is actually a little bit better for investigating the gut, which is pretty interesting. So we'll dive into that we're going to talk about energy markers and how your energy and fatigue levels can be tied in also. And the mood category, we're going to get into possibly depression, anxiety, and how that could be tied in or even OCD behavior, depression, winter depression, and then we're going to get into nutritional markers. And I mean, there's just so much information from one cup of tea, it's like magic.
Dr. Justin Marchegiani: Yeah, we can get a lot. And again, when we're looking at gut issues, I always tell patients, we're always going to look at a gut test, like a good high quality gut tasks. You know, there's a couple of tests that we use, but once the genetic test that looks at the gut microbiome infections, h pylori, bacterial overgrowth, inflammation, markers, digestion, markers, immune markers, so we'll always want to look at a comprehensive gut test to see what's going on. But it's nice to look at the organic acids, because sometimes, most of the time, I would say they kind of correlate where we see some kind of bacterial overgrowth, or a fungal overgrowth, it will a lot of times say it on there, I do find the organic acids do pick up fungal overgrowth far more often than stool test to a lot of times, if you're looking at under the threshold level of fungal stuff, we do see a lot of fungal stuff. It's not at the positive level. But if we see it there at all, you know, we typically consider it a problem. And then third, you know, we may not see total congruence, like there may say gut issues on an organic acid test, but not on a gut test. And guess what, if we just see it anywhere once, then that's enough for us to kind of move forward on it. We don't need total agreement. It's just an extra check. It's an extra net to catch anything that could be missing. And of course, we get deeper look in what's happening nutritionally methylation, B vitamins, sulfur metabolism, detoxification, mitochondrial functions, we really get a good window at what's happening underneath the hood.
Evan Brand: Yeah, I want to show you this three year old, if you'll let me share my screen, I tried to click on it, it says you got to enable it for me. But I've got a three year old little girl as a client who has been to conventional doctors, and she can't get help. And the pediatrician, of course, is just saying, Hey, you know, possibly do some vitamin D. And that's really it. Okay, now I can share. So let me pull this up here. Can you see that?
Dr. Justin Marchegiani: Yes, I can.
Evan Brand: Okay, good. So the people watching too, if you're listening via audio, I encourage you check out Dr. Justin's Justin Health YouTube channel. If you're listening and you want to see the visual here, we're going to try to make sure that those doing audio only still get the gist of it. But really, what we're trying to find here are high markers. That's when you really see problems. And you can see for this little girl, this is keep in mind this a three year old little girl. And the parents said that the girl is literally addicted to sugar, and she refuses to eat anything else. And she has a ton of symptoms, skin, mood, gut behavior, just all kinds of stuff and look at this tartaric acid, which is an indication of Aspergillus, growing in our gut, we want less than 3.9. She's 147. I think this is the highest I've ever seen. And sadly, it's an a child. And then of course, arabba knows you and I've talked about that being the gas that Candida produces, we want less than 56. She's off the charts at 226. So right there really high, that's really high. This is the amazing thing in five seconds of us looking at this page, we know this person's already colonized for mold, and they were in a moldy house in Texas had major mold exposure. And when now we know that she's got a major Candida problem. So even if we just had that data and just pursued those two points, we would get a hell of a hell of a lot more results than what you would get if you went to the pediatrician and said, Hey, I think she's got a problem. They're not going to know anything about these tests or these markers.
Dr. Justin Marchegiani: Plus in the conventional medical world, I mean, frankly, you know, candida that doesn't really exist to people like that right. Conventional medical doctors at They're very rarely saying, hey Candida is a problem. Usually it's one of those things. They just say, Oh, yeah, that's just kind of what natural medicine thinks everything is. The problem is candida, but not necessarily. But if we have objective markers that show it, it's good to really know that and conventional medicine isn't typically doing testing that sensitive enough to really pick it up.
Evan Brand: Yeah, and I know you run a lot of the Genova panels. And the reason that I use the Great Plains is just because I like to run the combo a lot when I, you know, I've kind of attracted a lot of moldy people. And so we like to run the mycotoxin combo test. So one cup of tea, and we get two labs. So that's why I do the the Great Plains, but the rest of page one was okay, she didn't show any major bacterial overgrowth, he was starting to creep up there on one of these markers. But overall, it was decent. Let's move on. Let's look at this is where all the fatigue is coming from. They said that this kid is just exhausted. And then they described it as poor tone, where she literally just lays on the floor all the time. Justin, I don't know if you've ever even seen anything this high. I mean, look at these oxalates 677 off the charts. We know Candida is a piece of it, but man, and then look at the I call it succinic. But I think it's actually pronounced succinic.
Dr. Justin Marchegiani: So succinic, yeah, and just so you know, oxalates a lot of times, especially in a kid, it's probably not like, I would never tell a mom like oh my gosh, like most green vegetables have oxalates in it. So I wouldn't be telling any mom like oh my gosh, you need to avoid green vegetables. Unless there was some kind of oxalate crystal issue in regards to kidney or significant muscle or join issues. I would just think that, hey, those oxalates are probably high because of the candida, candida that can really increase oxalate production and decrease oxalate synthesis. So I would lean more on the Candida being the oxalate problem.
Evan Brand: And I think this is huge, because you have some unnamed people writing books and fearmongering people about oxalates. And now you have people paranoid vegetables, like you just mentioned, you've got people that are like cutting vegetables out because they're worried about the oxalates. But you and I've seen personally and clinically hundreds and hundreds of point reductions in the oxalic acid just by treating the Candida so Yeah, I would agree that when we know she's not eating vegetables, so we know that that's not where it's coming from.
Dr. Justin Marchegiani: Yeah. And so we know if they have a Candida issue and they have a whole bunch of sweet cravings, you know, exactly. They're not eating a whole bunch of vegetables. That's not the issue. They're, you know, a whole bunch of crap. And we don't want to give them any more ammo to let their that their kiddo eat crap, right. So we want to definitely get some good nutrition in there, more than likely most of the oxalate issues are going to be from the Candida. Now again, some of the exceptions may be if we have vulvodynia, excessive joint pain from oxalate crystals, crystals, maybe kidney stones, or really kidney pain issues, that could be something really clinically significant. If not, we're not going to worry about the oxalates, we're going to think of that more as an effect than a cause the cause really being Candida and the effect being more of the oxalates as the cause. So I always when I'm looking at these labs of patients, I always have them in their head, draw a line one sides, cause one size effect affects we watch and monitor causes we treat and work on supporting. And so it's easy for people to look at an effect think that is the cause and treat the effect. And then a lot of times the result won't be as good or you do things that aren't necessary, like cut out foods that may be really healthy for your kid.
Evan Brand: Totally Yes, same thing for the citric acid here on 29. For those listening, we're looking at these little triangles, basically, the higher the number goes down in general, the more of a problem or dysfunction we have. And we want citric acid, maybe somewhere around 200 would be moderate. This poor little girl is off the charts almost at 1300. And we know citric acid will go high with Candida and fungal overgrowth in general. But all this succinic acid and malic acid oxic glutaric, these things are off the chart. So this just indicates an insane amount of mitochondrial dysfunction. And that's, that's why this girl is literally so exhausted. She can't go to school, the parents can hardly get her out of bed. And she's three years old. I mean, you know, my daughter, she's four now, but when she was three, I mean, she bounces out of bed and she's just running, running, running, going and putting her bird feeders up. I mean, this kid wakes up with energy. So you can just see, these symptoms that kids face in the parents is think gold. They're just, like bored, or they're just tired, but they don't think Wow, she could have a ton of mitochondrial damage.
Dr. Justin Marchegiani: 100% Yep. 100%. So looking at a bunch of these things here. I think we hit a lot of good things out of the gates. Let me just keep on rolling here. So actually, do you want to hit a little a couple more things? I'm going to show some of my organic acid testing to the second.
Evan Brand: Let me do to show this one page here. So some of the nutritional markers are gonna get, we're gonna see here that she was very deficient in riboflavin. The higher it goes actually the more deficient and then of course vitamin C is in Charlie is just completely toast. And then we've got some other markers ammonia excess and some gi bacteria markers, but overall, the main things I wanted to hit were just massive mitochondrial damage, massive colonization of mold and Candida. So don't think that just because your kid is young That means they can't, they don't have permission to be sick. I mean, I started treating my daughter when she was two because she had parasites. And so I just, I feel bad because you know, these kids, when they're really young like this, they may not be able to express all of their pains and their symptoms. But hopefully there's enough whether it's skin or mood or behavior or, or sleeping issues, that there's enough justification for the parents to reach out, run the labs, and then we can really show them on paper, what their kids just can't verbalize.
Dr. Justin Marchegiani: 100% I think it's really good points. Now, just to kind of give people a little understanding how we interpret how we look at some of the labs pretty simple. So we want some of the markers here on the labs to be in the middle distribution. So if you look at my screen here, can you see my screen?
Evan Brand: Perfect.
Dr. Justin Marchegiani: Okay, good. Excellent. And I just make sure that you can see me as well along with that. Okay. So in general, we want these markers to be somewhat in the second to fourth quintile distribution, when they go on the extreme high or low, we always get a little bit concerned. And we get more concerned if it's near a red area. So there are some of these markers are two tailed meaning, let's say number seven citrate, where there's a red on the left and the right, and some are one tail there say most are one tailed, like adipate subarray, [inaudible] where there's only a red to the right, does that make sense to tail means read on both sides, one tail means read on one side. And of course, if markers are low, and we're closer to a read that matters more, so we want them to be somewhat distribution in the middle extreme highs or lows are more concerning, especially if they're grouped together now. So in this section here, fatty acid metabolism, we see them on the lower side, not as big of a deal, because this is only one tail. But we do keep that in mind. We look in the carbohydrate metabolism, you see you're in the middle here without lactate, which is one of the more important markers, beta hydroxy butyrate, being higher isn't that big of a deal. That's a ketone. That's a ketone. It's not that big of a deal. lactate is a marker for co q 10. Typically, and pyruvate is a marker typically for B vitamins and B complex as well. So this being a little bit low, less than detectable limit isn't that big of a deal, as long as you don't have a whole bunch of them there. But we do keep an eye on it. And I always tell patients chronically high organic acids, that's like a demand issue. So it's like you're making a million bucks a year, but spending $2 million a year you have a lot of income coming in, but your demand for that money for those resources is high. So functionally, we're still in debt, right? And when we're chronically low, especially in areas where there where it's two tailed and red, that's a sign that there's a depletion issue depletion, it's like you're making 10,000 bucks a year. But spending 100, right, you're making a lot less, right. There's not a lot coming in, but but you're still spending more than you're making, right? So both in the end, you're in debt. Okay, that's kind of the analogy I give. And I always tell patients, well, what's the root cause? Like? No, we always want to be focused on the root cause we may be doing palliative support. People can feel better in the moment, but we always want to get to the root cause support now, with organic acids pretty simple. First is going to be diet, and it could be a macro issue, and or micro issue, meaning if someone's eating that looks like a healthy diet, but it's not organic. Well, it may be significantly deficient in certain nutrients, right. If you look at Joel Salatin runs polyface farm, he found he sent his organic eggs to the lab, and they looked at the amount of full weight that was in his organic eggs, it was 20 times more fully in his organic eggs than the typical conventional storebought eggs. So organic matters. It's not just pesticides, pesticides is important. It's a big part, but it's also nutrition. So of course, eating organic makes a bigger difference, food quality makes a big difference. And then number two is going to be absorption absorption can be affected by gut microbiome issues, parasites, fungal overgrowth, bacterial overgrowth, it could be affected by low stomach acid and enzymes and bile salt levels. It can also be affected by food allergies, chronic food allergens, or chronic inflammation in the intestines, can can drive it to number three, just general stress. Stress can be categorized as physical stress, right? you're exercising too hard. Maybe you're too sedentary, maybe you're not getting enough sleep, maybe your emotional stress is off the charts. And that's throwing off your cortisol and your adrenals and your hormones. Stress plays a big role. Number four is toxicity, toxicity primarily from pesticides, heavy metals, mold, toxins, pesticides, heavy metal mold, toxins are biggies. And then number five is genetic. Genetic can mean hey, you just need more magnesium, you need more amino acids, you need more B vitamins than the average person just for who you are. Could be an mthfr issue. You need good high quality full eight, that cheap folic acid stuff is not cutting it. You need more methylated B vitamins. So genetically, there could be just some imbalances in regards to what your biochemical needs. I think Roger Williams wrote a book called biochemical individuality talking about people's need for certain nutrients can be exponentially higher than someone else's. And so those are kind of the big five things out of the gate. Any comments on that, Evan?
Evan Brand: Yeah. So one thing I think it's important to point out is people get really caught up in the DNA and the genetic testing and I'm cool with So I'm cool with it. But I just want to highlight something you said here, which is that we're really going to be looking more at the downstream effect of any of those genetic predispositions here correct meaning, let's say that there is a genetic predisposition to needing some more foliage or some B vitamins upstream, but then that manifests downstream, we're gonna see it here, we're going to see the citric acid cycle, we may see some things off of this carbohydrate metabolism section. So what I'm saying is not that the genetic stuff is useless, but that you and I are going to see the result of those genetic issues here. Is that correct? And the you might not need that genetic data, because you're going to be looking here at what the actual body has. Is that true?
Dr. Justin Marchegiani: 100% Yep. 110%.
Evan Brand: Because you send us the snips, right, well, I've got this snip or this genetic This or this genetic that, but I really would prefer to look at the organic acids, maybe in addition to but if I'm without the genetic information, I still feel confident in what we're going to do and the results we can achieve with just the test alone.
Dr. Justin Marchegiani: Yeah, here's one image. I'll put it on screen. These are two twins here called Otto and Iwa, can you see it? Yep. These are exact twins. Okay, so one engaged in you know, lifting weights eating better the other one? Not? I mean, you can see, look at the difference. Fuller hair for muscles, right? It's same DNA. Remember, twins have the exact same DNA. Right? So this is important. So we know our genetics can change. The reason why I don't like the genetic tests as much as because you could have you could have someone being an alcoholic eating terribly. Someone totally changing their life and and eating incredibly healthily. And guess what? The DNA looks exactly the same. So it kind of it's a snapshot in time. It's not functional does not change based on your your lifestyle decisions. And so you can see here we know, right, this is the same DNA here. This is the these are two German twins, like 1969. Same DNA. Look at the difference.
Evan Brand: Okay, yeah, people on audio people on audio listening, he's showing a picture of these guys, they're twins, you can see same height, same looks everything. But then the guy, one guy is, who knows, maybe 130 pounds, the other guy's like 170, and just ripped shredded muscles.
Dr. Justin Marchegiani: Yep. And so basically, it's the epi genetics. It's it's the functional progress that we're looking at. So just kind of put that there. And again, anyone listening, we're trying to do enough of a good job describing what's happening. So if you're in your car drive and just kind of listen to us, if not, we'll put a link right below to the YouTube video. So if you guys want to engage in the video, feel free. Let me go back to the organic acids, though. So we talked about fatty acid metabolism, carb metabolism, energy production. So we'd like this to be somewhat in the middle seven through 14 is a bunch of these organic acids here. The names don't necessarily matter. citrate, Sr connotates, ISO citrate alpha ketoglutarate, succinate, Fumarate analyte, hydroxy, [inaudible] doesn't matter, right, that's just just focus on what it means these typically correlate with nutrients like B vitamins and CO, q, 10, and chromium, chromium and arginine and cysteine, and B complex and manganese and magnesium and lipoic acid. So when we see deviations high or low, especially a whole section, higher low, that tells us those nutrients are going to be burnt up depleted. And it just gives us a window, what's happening. And we got to look at it in correlation to someone's lifestyle, how good their diet is, how crappy their absorption is all that matters. I always try to look at the top the patient's top two or three symptoms, I try to correlate it to the, to the systems that may not be functioning optimally based on the organic acids. And then I support based on that, because there's a lot of things you could support at all times. At the back page, they'll typically give you a whole bunch of things that were to recommend here. I ignore that. Because because there's a clinical art to this. And we're doing a lot of different things. At the same time. We're not just like running this test. I'm just saying here, take the supplements, we're really trying to look at the whole big picture.
Evan Brand: Okay, I kind of skipped over some of the importance of the neurotransmitters in the beginning. I mentioned we're gonna hit some brain chemistry stuff, depression, and some mood issues. Cool.
Dr. Justin Marchegiani: Depending on how bad your gut health is. Ideally, if we're doing some kind of a really good high quality methylated B 12. Or [inaudible] or hydroxyl and or some kind of something sublingual, usually we can not necessarily need it if we're doing the high enough of a dose and or sublingual. But if someone maybe has really bad Crohn's or ulcerative colitis and bloods coming out of their stool, and we see markers on their differentials, you know, hi MC, ah, Hi mctv Hi, MC, hc, and or high methylmalonic acid, we may want to just do a one off injection to bias time, but most of the time, it's not necessary. Because when patients come in to see us, we're doing all kinds of diet changes and lifestyle changes a month before these tests even come in. So then the time they get these tests in usually we've calmed down most of any acute issues to begin with. Does that make sense?
Evan Brand: It does. Yeah, I just see a lot of these pop up IV clinics going around and people they're paying a really pretty penny for some of these injectable B vitamins versus some of the pricing that you and I offer on some of the our professional methylated sublingual nutrients, it's maybe a quarter of the cost, if not half the cost. And you don't have to get an injection. You don't have to travel to a clinic and sit in the chair. You can do it at home and you can fix it. So yeah, I would agree with you.
Dr. Justin Marchegiani: Yeah, I would say depending on how acute The issue is, maybe that may dictate. And also if you're acutely sick, that may help kind of as a palliative thing, but in general, it's not practical from a day in day out standpoint. And then we have our neurotransmitter. So vanel, Mandalay and Homo vandelay. They're kind of they're two, they're two sides of the same sword so vandal Mandalay, it's a marker for adrenaline, home of analytes, a marker for dopamine. Now in the in the neurotransmitter synthesis pathway, it goes phenyl alanine tyrosine tyrosine l dopa l dopa epinephrine norepinephrine. So what does that mean? It means home of anolyte will eventually home of anolyte looks at dopamine, right? So dopamine will eventually go downstream to adrenaline. It's the next step in the cascade if there is stress going on. So when you support adrenaline, you're also support a dopamine, when you support dopamine, you're also supporting adrenaline. And you may not have both of these out of balance. So in this case, this person is having more of an adrenaline issue. Now, by supporting the adrenaline we will be supporting dopamine. But if you have a chronic adrenaline issue, you will eventually be depleting dopamine, because it just comes from it. It's the precursor, your fan, Amanda lates, the post cursor, dopamine or Homo ventilates, the precursor? Does that make sense?
Evan Brand: So let me say it in another way, you're going to see a depletion of your endorphins before you see a depletion of dopamine.
Dr. Justin Marchegiani: Oh, no, you could see both, you could see a dopamine issue before endorphin. That's gonna be all based on genetics. But if you only see one issue going on, it's just a matter of time before that second issue kicks in.
Evan Brand: I'd say 75 80% of the time, you are seeing both at the same time lower.
Dr. Justin Marchegiani: So think of it as like this, you have two credit cards, right? You're only in debt on one credit card. Well, if you keep up your spending habits, it's just a matter of time before you're in debt on both credit cards. Does that make sense? Okay, just like that, and then five hydroxy. And these are all metabolites. So these organic acids, they're metabolites of amino acids. And these metabolites give us a window into certain nutrients. And so as long as you have an understanding on what the nutrients are and what the area is, the actual organic acid doesn't necessarily matter that much, FYI.
Evan Brand: I think I think of it and kind of refer to it as like the fingerprint of what's going on or maybe the ash in the bonfire, you can see the evidence of what's happened. You're just kind of analyzing the ash and looking at the fingerprints.
Dr. Justin Marchegiani: Yeah, patients usually think of it as like gas in the gas tank. Is it higher? Is it low? I'm like, Nope, it's RPMs and the engine RPMs is overly overly high or really low or really high demand overly low on the on the stimulation.
Evan Brand: Scroll down to that detox marker. I want to see what you can tell us about that one there that-
Dr. Justin Marchegiani: Let me just finished the neurotransmitters real fast. So five hydroxy acid that's a serotonin marker. So serotonin plays roles in motility, mood, sleep, happiness. Another big one kind of urinate plays a really important role would be six right B six helps with the synthesis of all these nutrients. All these neurotransmitters and of course, kind of urinates brother or sister is anther urinate so this person has high xanthine Made in high kind of urinate. So we know there's definitely a B six problem. And B six plays a really important role in neurotransmitters. So if you're just thinking, Oh, I'm going to just take some tyrosine or phenyl. alanine, yeah, probably not the best, okay? Because you need the other nutrients there. And then also picolinate chronically low is a big sign of low amino acids and if we have low amino acids, it could be a catabolic stress issue. You're just burning up a lot because you're you're a lot of Khattab catabolic stress, cortisol imbalances, hyper adrenal stuff, it could also be, you're not getting enough protein, you're not eating enough vegetarian V and not eating enough or you're not digesting enough, it could be all of the above. And then we have our oxidative stress. Oxidation is losing electrons when you lose electrons. And you don't have enough antioxidants like vitamin C, or a or E or good antioxidants like curcumin or resveratrol. Those help donate electrons. And if we are donating electrons, when we lose them, we can create free radical damage and that can chip away at our DNA and cause our DNA to age rapidly. Any questions on that last part?
Evan Brand: No, we're good. Let's run into the detoxes part.
Dr. Justin Marchegiani: Yeah, so this person right here is very depleted detoxification. So the most important markers here are these two, or these two tailed markers at the bottom, pirate, glutamate and sulfate. Very important, they all correlate with Bluetooth ion. So when I see low sulfate and low pirate glutamate that almost always means a glue to phi on depletion. So the big neurotransmitters here are n acetylcysteine, cysteine, taurine, glutamine refining, right? glycine, they all play a very important role in making our tripeptide most powerful antioxidant glutathione.
Evan Brand: Let me pose a question to you that some people will have at this section is they're going to say okay, you mentioned gluta found depletion. So are you saying that there was a toxin issue, maybe a mold toxin that depleted the glutathione and or you're saying that you may not even have the raw materials necessary to synthesize Bluetooth ion, right. So it could be a two pronged issue, it could be a depletion of glutathione due to toxins, plus the inability to make it is that what you're saying? This could show?
Dr. Justin Marchegiani: Yes, so it could be one more variable so one, it could be a combination of exposure to toxins that are stressing out that pathway to you're not getting enough good exposure to sulfur amino acids. Three, it could be not, you're not digesting your protein well, right. And for when you get stressed part of the whole catecholamine adrenaline noradrenaline pathway require sulfur requires sulfur to help with that conversion and metabolism of healthy, healthy neurotransmitters. So you actually need sulfur on the neurotransmitter. So if you're chronically stressed, you could also deplete sulfur that way,
Evan Brand: So each each your broccoli, folks as long as you can tolerate it.
Dr. Justin Marchegiani: Well, more importantly, yes, there's a lot of sulfur there. But more importantly, like your animal protein, like you're gonna get a lot of sulfur in there. But from an amino acid from a bulk amino acid standpoint, you're going to get way more sulfur in protein from a caloric standpoint, as a percentage as a percentage of the food, you're going to get a lot of sulfur and broccoli, but this is just low calorie, right. So you get more from a caloric standpoint with high quality animal products, or honestly, whey protein or college and proteins. Excellent, too, for that, too.
Evan Brand: Yeah, that's what I was gonna say if somebody is listening, and they either maybe were previously vegetarian or couldn't get back into the meats, maybe they were having issues digesting meats, we've got some really good like grass fed ways or some collagen hydrolyzed beef proteins. Those work amazing.
Dr. Justin Marchegiani: Yeah, or even just free form amino acids that are kind of been fermented that still are pretty balanced, they can, they can help get the needle moving on that. And then this to methyl hippuric can also be elevated due to xylene. And xylene can be in drinking water could be smoking, inhalation, vehicle exhaust, now, a different different nail polish those xylenes one of those things that could be an issue up there as well. It's possible it'd be put on the list. I mean, most people we're trying to educate them on healthy products, how you know, good water filtration, good, hygienic products. And then if we look down here below, this is gut bacteria. Now this person only has one elevated gut bacterial metabolite. And I tell patients like what we're looking at here like this is typically bad bugs, usually more on the gram negative side. It's not telling us what the bugs are. Could it be h pylori, could it be klebsiella? citrobacter? Could it be prepatellar morganella. It can be all those things. Right? Pseudomonas, it could be it's just looking at the exhaust. So it's like, okay, a car was was had their engine on they were in the garage, they left you show up to the house, you open the garage, I feel like there's some exhaust in here. Like you may not be able to know Oh, that's a four. That's a Chevy. that's a that's a Toyota, you may not be able to know what car it is, but you can know Okay, something was in here. Does that make sense? And so it just tells us Okay, we got some exhaust of some bad bugs here. And we probably got to work on it. And now if we have the stool test, we can no okay. Yeah, well, you also test the positive for Pseudomonas and klebsiella and H. pylori. So that's probably what that's correlating with. I had a patient last week had a lot of bugs and he Laurie, and there wasn't much elevated at all, I think this is the test. This is the person that had a lot of other big bigger bugs. And that can happen. I tell him, you, we don't need both tests to confirm most of the time they do. And then I'd say most of the time, the organic acids, picks up the de arabba, Anatol, this picks up the the fungal overgrowth before the GI map or the stool test. So it's good to have both, that's a really good marker. And then a lot of times the if we see a lot of bacterial overgrowth here, that a lot of times would correlate maybe with a SIBO breath test where we do a lactulose. And we and we blow into it for three hours afterwards. A lot of times, we'll see a correlation on that as well.
Evan Brand: Yeah, yeah, well said. And I think you made a great point here, which is that sometimes you're not going to get the smoking gun on this test, the stool may come in and provide better data and vice versa. Rarely, the Candida shows up on the stool, though the the oat test is always going to be better for Candida at least 98% of the time.
Dr. Justin Marchegiani: Well, 100%. Now also, with induction, this may also give us a window into bio output, as well as poor protein digestion. So induction issues, you know, usually more purified protein work on HCl, of course, I'm always working on HCl Anyway, I'm just giving you a little bit more of an insight. Usually, with the lactate being on the higher side, that almost always means there's a lot of extra probiotics in the system. So they may be taking a lot of lactobacillus or bifidobacterium. And usually these patients may get more bloated to those kinds of probiotics. And usually that's common with SIBO. So we see a lot of the lactate, that can mean there's other already taking a lot of probiotics, and then that may be a problem. And they may want to switch to a spore based probiotic or even just no probiotics, and maybe even a a low fodmap diet out of the gates. You know, those are different things just clinically, I noticed over the years. And again, when we look at this, we're taking into account the patient's adrenal tests, what's happening with their thyroid? What's happening with their their gut functioning, what's happening with their lifestyle? Have they had their had they had mercury fillings removed? Has there been any mold exposure? What's their diet? Like? What's their digestion? Like? Are they pooping everyday, we're looking at the whole picture. So some people may look at this test totally in isolation, not good. You really want to connect it to everything else that's going on?
Evan Brand: Yep.
Dr. Justin Marchegiani: Anything else you want to highlight there Evan?
Evan Brand: If you haven't had your organic acids test, reach out, let's get it done. Let's see what's going on. This is an amazing test. If I only had like desert island situation, I only had one test to run, I'd honestly probably pick this one, wouldn't you? Or what would you pick?
Dr. Justin Marchegiani: I would because you do get a window, what's happening with the adrenals a little bit you do get a window, what's happening with the mitochondria. And then you also get a little bit of a window in regards to what's happening in the gut and detoxification. So you get a window of a lot of different things. And I love it with kids. Because, you know, kids don't want to get their needle, get a needle in their arm, right. And so it's really nice. This is a urine based test if you want to avoid getting a blood draw. It's a really easy test to do out of the gate. So I do like that.
Evan Brand: Also. And it's at home too, right? So if you got people that are elderly, or just you know, paranoid to go out, for example, in the public and go into a lab, hey, you do it at home, you get it back. I mean, how convenient does it get?
Dr. Justin Marchegiani: Yeah, and then also with this test, you got to be careful if you're chronically low protein. This is running it off of creatine. So if creatine is too low, which is a protein metabolite, you could get some, some false readings on the on the lower side. So you got to make sure there's a protein in the system. And so if you're dealing with someone who doesn't eat much protein at all, you know, we'll typically throw in some freeform amino acids for a couple of weeks ahead of time. That way, those systems at least have the substrate to move metabolically, if you will.
Evan Brand: Yeah. Great pointing out.
Dr. Justin Marchegiani: Anything else you want to say, Evan?
Evan Brand: I don't think so we'll give the links to people. If you enjoyed this, please let us know. I know this was kind of fast, and maybe a little overwhelming, because we're breaking down. But for us, this is something we do all day every day. And of course, for your unique situation. We're going to talk you through what's going on what you need to do, how to fix it. But give us some feedback. So like I said, if you're on Justin's YouTube channel, right in the comments, do you like these video versions, because a lot of times you and I are just riffing on stuff. But if people like the videos, we've got so much stuff that we can uncover. We've got literally 1000s of case studies, we can start reviewing, if you want to see before and after, like, Hey, here's a protocol we implemented. And you know, we're not going to give exact dosing and say, Tell it tell you to do it, but we could run you through what we do, if you like it. So let us know because we really need the feedback to help guide the show.
Dr. Justin Marchegiani: Yeah, and also, we're trying to be different than other people that are talking about these topics, because they're not in the trenches. So we're in the trenches. So, you know, our kind of unique proposition for y'all is that we do this every day, and we want to provide valuable information that's actually actionable. And is it's real, it's something that we're in that this is the patient from last week that I'm talking about here, right? And so we're trying to provide actionable information and if you see this and you kind of get a little bit overwhelmed, it's okay, it's normal to feel overwhelmed. We review 1000s of these tests, it takes a couple you know dozen to kind of get your get your, your feet wet, so to speak. So just an FYI, if you get overwhelmed, not a big deal. If you work with us as patients, you know, we typically go over these things a couple of times and then usually patients have questions a month or two later after the test. We always go back. Part of being a great clinician is you have to be a great teacher. So if anyone feels overwhelmed with it, don't worry, we tend to take these things, boil them down, make sure you have the key action components. As long as you have the action items, that's the most important thing. And if you want to reach out to someone like myself or EvanBrand.com you can reach out to Evan. Evan has the same philosophy you got to have a heart of a teacher. And then Justin Health myself, Dr. J at JustInHealth.com. There's links there for you guys to click. If you enjoyed it, let us know. If you want to dive in deeper. Let us know if you want to support us in any way you can always purchase any of the labs or supplementation from our website. It goes to help fund this show and make it all possible. Evan, anything else you want to say?
Evan Brand: I don't think so. You covered it. And please subscribe if you're not already, you know, I looked at our statistics and a lot of people that listen, they're not subscribed, so make sure you hit subscribe. I think with no ads and all killer, no filler content. This is a much more listenable podcast, I tried to listen to a couple health podcasts the other day. And there was like an ad in the beginning that was like five minutes. And then there's like right in the middle of the conversation. There's like another ad and then like an ad at the end. I mean, I think people take us for granted with our adlis shows I might have to start doing ads just to you know, tell us Hey, didn't you miss the ad free days?
Dr. Justin Marchegiani: I know man to do that with the switch. So if you enjoy it, let us know and support us down below. Alright Devin phenomenal chatting with you today. We'll be back next week everyone share, thumbs up comment-
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