Changes in blood sugar levels may be a sign and symptom of adrenal fatigue. In the early phase of adrenal fatigue, you can see hyperglycemia (high blood sugar) and, in an advanced phase of adrenal fatigue, hypoglycemia (low blood sugar) is the usual presentation.
The thing is, you may not notice a problem with your blood sugar levels, but that doesn't mean it's terrific. It is essential to monitor and know the symptoms of having a diet full of food content that send your blood glucose on a roller coaster ride of high and low levels. These glucose level swings can result in damage to your blood vessels, raising your cholesterol, and put you at risk for heart disease.
Dr. J and Evan recommend having yourself tested (not guess) and checking the food you include in your food template because they can be the reason for your chronic issues for so long.
Dr. Justin Marchegiani
In this episode, we cover:
1:47 Adrenal Blood Sugar Physiology
9:26 Intermittent Fasting, Carnivore / Keto Diets
18:45 How Intermittent Fasting Helps
24:43 Hypoglycemia and Adrenal Stress
31:08 How Mold Affects Adrenals
35:00 An App that Helps Monitor Your Diet
Dr. Justin Marchegiani: And we are live. It's Dr. J here in the house with Evan Brand. Today we have an awesome podcast topic on the queue here, we're going to be chatting about how your blood sugar can weaken and negatively impact your adrenal glands, we're going to be talking about blood sugar, how it affects your immune system, how it makes you either strong or weak, we'll be talking about nutrient supplement changes that you can do to help with that, as well as diet and lifestyle changes. So I'm excited to dive into this topic. This is a relevant topic that we are applying and seeing with our patients every day, especially ones that have adrenal issues, or adrenal and cortisol imbalances. So really excited to chat about this. And what's happened today, man?
Evan Brand: Hey, not too much. Let's dive right in. So let's set the stage for people. This is a conversation that maybe didn't happen. Historically, we didn't have the chronic 99% of the time, we're stressed and 1% of the time we take a vacation, we didn't have that kind of lifestyle historically. And so I think now, you're kind of talking about this with me, before we hit record, the average person is just so toxic, they're so stressed. They're sleep deprived. They're on stimulants like caffeine, and they're having these spikes and crashes all throughout the day, pretty much everyone is on both the stress rollercoaster. But they're also on this blood sugar rollercoaster too. And that really affects the adrenals over time. So that's where I want to set the stage with people is that we're in a society that's doing quick fixes. When we feel a blood sugar crash, we go when we eat the organic cookie. Now it's an organic cookie instead of an Oreo, or it's a gluten free cookie instead of an Oreo, but it's still a cookie, and then you end up crashing again. So I want to set the stage of even though you could be doing paleo or similar diet, a lot of people are still having issues of blood sugar regulation, and we think adrenal is is is one big part of it, which is then connected to the gut. So really, we could make this thing like a three hour episode, but we're going to try to condense it to half an hour.
Dr. Justin Marchegiani: Absolutely. So let's kind of do like an adrenal blood sugar kind of one on one physiology review for people just kind of coming into this. So your adrenal glands produce a hormone called cortisol, right, which is a glucocorticosteroid. Big word right, the first half of that word is glucose, meaning it helps pertain to blood sugar and energy. And so the more your blood sugar debates goes up and down, the more hormones have to be produced to buffer the highs and lows. So the more we keep our hormones snaking along, or we keep our blood sugar at let's say in this example snaking along or stress snaking along throughout the day without big up and down spikes. Our hormones are called to the rescue far less. So. If I eat, let's say one, I'm not eating at all. Let's say I'm fasting, right and I'm not really good at being fat adapted, your blood sugar is going to drop and when your blood sugar drops, that creates a stress response. The first thing that happens on this low blood sugar drop is going to be a spike of epinephrine or adrenaline. Right? So epinephrine or adrenaline is like the key catalyst to wake up and call cortisol. So you get this epinephrine or adrenaline or catecholamines surge again, they are all the same thing. You have epinephrine, norepinephrine, you have adrenaline, you have noradrenaline, you have catecholamines. They're all the exact same thing, same name. They're just meant to confuse people. So just kind of put that out there. If I use these words, they're 100% interchangeable, okay. So you're going to have this surge and adrenaline. And that's going to bring up your blood sugar when it brings that blood sugar up. This is when you may feel anxious. heart palpitations, this is May when you get a little bit dizzy, nervous, sleepless, irritable, right, sweating, you know. So when you start to have when you're on those blood sugar rollercoaster, when this blood sugar drops and starts to come back up, you may have symptoms that make you not feel that well. And so then, of course, what comes up after that adrenaline surge is then cortisol is now going to help bring it up the rest of the way. So think of adrenaline is the it's the, it's the first responder, right. It's the person on the operator line, getting the police ready to come to your home and then the police to come 1020 minutes late, that's cortisol. Okay, they come a little bit later to the show. And so that's important. So when you understand your physiology, that's, that's good. The next component is when your blood sugar goes back up on the high side, that's where you make a whole bunch of insulin. So insulin can make you feel tired, it can make you feel fatigued. Insulin activates a lot of lipo Genesis, that's fat storing lipo, meaning fat Genesis, creating and so when you start to have when you're on a blood sugar roller coaster of high to low blood sugar, okay, this creates this high level of insulin, a lot of label Genesis that creates fatigue. And then of course, when you have a high level of insulin that brings your blood sugar back down, because insulin is opening up the cells trying to get blood sugar into the cells to either burn it or store it. And if you're not active, and your cells are already full of glycogen, and you're not actively doing something like walking or running or lifting guess what your body then shunts and partitions that fuel into the storing phase. So if you're active, great, you'll burn it. If you have muscles that have glycogen storage, you'll convert it to glycogen which is glucose. Storage sugar storage. And if those two capacities are tapped, then we start going to fat storage starts going more to life with Genesis. So we're on this blood sugar rollercoaster. So high blood sugar up high blood sugar up, a lot of insulin drops it down, right, then we have this, this really high drop high to low drop, this then stimulates a lot of adrenaline, catecholamines and then cortisol in the app, this is called reactive hypoglycemia. And then the other type of glycemia issue that we're going to see is going to be usually fasting too much not eating enough low calorie diets, skipping meals, that's more like this, that's your blood sugars like this. And it just starts to drop into this hypo category, you know, maybe below 75. One goes up first. That's the reactive, it's reacting going high and then dropping, that's reactive hypoglycemia, that's typically going to happen due to poor diet, too much sugar, too much carbs, not enough protein on a fat. And then we have just general run of the mill hypoglycemia, usually from poor meal timing, skipping meals, too much fasting, typically low calorie dining. And again, if you're doing a lot of intermittent fasting, but you're low calorie in general, throughout the day, that can easily drive low blood sugar too.
Evan Brand: Wow, well said so the average American, they're experiencing more reactive hypoglycemia because they're on sodas, they're on the Milky Way bar and hiding in their desk drawer at lunch, the person listening to us who's hopefully relatively dialed in, they're going to just be more in the standard, we've just called to us maybe a standard hypoglycemia situation. And then how do the adrenal is play into that? Because what you're saying is happening is that, let's say, and this happened to me, I can tell you firsthand what happened. But what kind of open it up. So intermittent fasting, you're saying that could could drive that and you're saying there, you're kind of hinting at the fact that maybe the adrenals are too weak to help you're seeing the adrenaline can be released, and it'll crank it up. But you're saying, Okay, I got like a recording, stop and start. So just making sure we're good. Okay. So you're saying that, in a normal situation, the hypoglycemia can start to happen, adrenaline should come up, kind of bump you up, give you the little nitrus booster, but you then you need cortisol to push you to the finish line. But you're saying in the case of adrenal stress, the cortisol may not be able to get you up to the right amount. And that's how an intermittent fasting situation could be not good for you. Is that right?
Dr. Justin Marchegiani: Yeah. So then if you don't have good adrenaline output, or catecholamine, output, like so how do we know that as we look at organic acids, if we see imbalances and vandal Amanda later home of anolyte, these are amino acids that are precursors for dopamine and adrenaline. And again, dopamine is a precursor to adrenaline. So when you're constantly stimulating adrenaline, you're actually pulling dopamine down. And dopamine is really important for satisfaction, mood focus, right? So if you're chronically stimulating adrenaline, you're going to have adrenaline issues, you're going to have dopamine issues that can create a whole bunch of problems. We're going to know that because we're going to see an organic acid test showing a lot of imbalances in those catecholamines. And if our blood sugar, if we have very low cortisol, we run a good quality Dutch test we see chronically low free and total cortisol, it's going to be hard for our body to bring that blood sugar back up and we can kind of stay a little bit more hypo. And that can cause that irritability, that faintness, that fatigue, cognitive issues, mood issues, brain fog, it can create all those problems. So if we don't have good when people talk about adrenal is people mostly just think about cortisol. When it comes to adrenal, they don't think about the adrenaline catecholamine dopamine connection. And so when we talk about adrenals, we have to really look at the outer part of the adrenals. That's the cortex. That's where cortisol lives, that's where aldosterone lands because we'll talk about it in a minute. aldosterone plays a big role with minerals and holding on to minerals. And if our minerals go low, like we see in pots, right, which is a postural orthostatic tachycardia syndrome that has to do with minerals being low sodium chloride, potassium, right, that can create a lot of symptoms similar to hypoglycemia. And so we have to look at the the cortisol component, but also the adrenaline the adrenaline tends to happen more in the medulla medulla M for more middle part of the adrenal gland. So it's good to look at both and that's where having a high quality adrenal test that looks at free and total cortisol, as well as an adrenaline, dopamine via the organic acids to look at what's happening with the catecholamines and neurotransmitters.
Evan Brand: So how would this work? Let's say if you weren't doing intermittent fasting, let's say you switched off of that maybe you were having these hypoglycemia episodes, the adrenals. were too weak to give you the cortisol output you wanted. So instead of intermittent fasting now you're just doing like a carnivore breakfast, maybe you're going to do a grass fed steak or maybe you're going to do some pastured eggs or some pastured bacon. Is that enough to pull you out of that? Are you going to need some support? Would you recommend we throw in like a little bit of honey, some blueberries, you know, maybe something else to pull you out of that spike like is meat is meat enough? I guess is the simple question.
Dr. Justin Marchegiani: So what happens with proteins that you're consuming is your body is going to be able to one, it's going to be keto adapted. But again, not everyone's keto adapted, you have to be metabolically flexible to be keto adapted, where you can actually take a lot of the fat, right, you have a glycerol on a free fatty acid, and you're able to break that down, pull off some ketones and start burning more fat for fuel. A lot of people just can't transition to that, because they're very metabolically inflexible. And so protein and fats not going to be a viable source unless someone's really dialed their diet in for two to four weeks, and really had that metabolic adaptation. Now, some people, their their insulin levels just dropped to low, and let's say maybe below four or so or even below two on a fasting insulin test, they may need more carbohydrate. And, again, if they've been doing the diet for a month, and they're in there, they're having good proteins and good fats at every meal. And maybe their carbs are really low, we may want to add a little bit more starch in because sometimes they feel better doing that because it actually blunts the cortisol spike or the adrenaline spike that the body is trying to create to mobilize that glucose. So it's like, we can add a little bit more carbs in via healthy, safe starch. And that blunt some of the cortisol and the adrenaline is being produced to mobilize that internally, some people, their insulin levels are really high. And by keeping the carbs super low, they're bringing their insulin back into the sweet spot, and they're actually good. And then when they add more carbs in, they actually feel worse, because their insulin is going out of balance, and they're starting to get more into fat storage mode. So most people I find tend to be more on the insulin resistance side. So I always default to lower carbohydrate out of the gates, and then fine tune later once they kind of hit the wall. And you know, a good way that to see how you know, if you're hitting the wall or not, is get to a place where you've been doing it for a month or two, make sure your body is pretty good at burning fat, right? So you're eating good proteins, you're eating good fats, that initial keto flu is over right, that first couple of weeks of getting fat adapted headaches, mood issues is over, then you can try adding a little bit more carbs in maybe at night. Have a sweet potato, a little bit of white potato, a little bit of a say starch, see if you feel better or not. If you sleep better, if you have more energy, if your workouts are better, recovery is good, that's a good sign that that's better for you if you don't feel better. Or let's say you're you know, you're very overweight, and you probably want to work on keeping the carbs in check longer, again, the benefit that you have with good fats and proteins, it's hard to over eat when you're eating good fats and proteins, because there's good satiation signals to your brain that tell you to be full. That's like peptide yy, adiponectin. coli cytokinin. There's really good feedback regulations, people are like, well, it's all about calories in calories out, it's like, but not all calories, tell your brain that you're full the same way. So you have to look at the the epistatic regulation of appetite, right and certain neuro peptides are going to be produced with certain foods, you're not going to get that same stimulation, eating pizza eating Pringles drinking refined sugar, you're not going to get it. And that's why it's so easy to overeat those foods, and you never really feel satiated, try eating you know, half a dozen eggs with you know, cooked in butter, it's gonna be really hard to still be hungry afterwards. As long as you don't eat things too fast, where people really go awry with proteins and fats is they eat things too fast, is about a 10 to 20 minute delay in those kind of chemicals telling you you're full. And you really have to give your body that 10 to 20 minute buffer time. So eating slower, chewing your foods up really well, not overly drinking, when you consume those foods, giving yourself five or 10 minutes once you finish your meal before you get seconds. That plays a big role, because it's really easy to overeat with these foods, when you don't give it enough time.
Evan Brand: Yeah, look at the marketing of potato chip companies, veggie candy, just one, they know that you're not going to get leptin and all these other beneficial compounds and tell your body your full. So the marketing companies know what they're getting into, they know you're going to eat a whole bag of chips, because you're never going to get that signal that you're satiated. And that's where you're going into trouble. So let's go back to the adrenals for a minute. So you mentioned running a Dutch panel looking at low cortisol. So what you're saying is if you're going to see a flat panel, or maybe just maybe it's not flat, maybe there is some sort of peak on the cortisol in the morning, but it's very weak. So overall, you would just say there's a low cortisol output, you're saying those people are going to tolerate intermittent fasting less, those people are going to tolerate very low carbs less so they may need a little more bump while they get their adrenals back on board. Is that safe to say?
Dr. Justin Marchegiani: If their cortisol is really low? Yes, it just depends kind of where they're coming from. Right? If they're coming from being overweight, being more insulin resistance, being more tired, being more fatigued out of the gates, always in a default to lower carb. If they're coming from already being at a reasonably healthy weight and being pretty active already. Then I'm going to default to adding a little bit more carbs and so it just depends upon where someone's coming from. So it's always good to look at someone's Samantha type right? ectomorph endomorph mesomorph right. endomorphs like The linemen write in football. And again, this can be like any one, but they're just have a larger, higher propensity to put on weight, write the message, or then they have the ectomorph. This is more of the natural kind of basketball player type, they're just more taller and more leaner, hard to put on muscle, hard to gain weight. And then you kind of have a blend between an ectomorph and an endomorph, called a mesomorph. Think of that as the M for middle, right. And this is kind of more like your linebacker in football, right. And again, these are extreme examples, but helps to kind of tell the tell the story, right? Not everyone's a 300 pound lineman, I get that, right. But people have this propensity to put on more weight. But a mesomorph, someone that's kind of more in the middle, like they could be taller and leaner, but they also can be bigger as well, they're kind of in between. So usually, people are in one of the three of these categories. And usually, if you're more on the ectomorph side, you're going to be able to tolerate carbs pretty well. So that you have to just kind of like you know, see kind of where, where you feel best. And there's a lot of people out there like let's just say let's people on the diet side, I'll just I'll call Chris kresser out, right? Chris? kresser is a ectomorph. Right? suit. You know, Paul jammin a ectomorph. A lot of people out there that like recommend more carbs, more higher carbs, more whole food, carbs? And it's like, well, of course, you're going to recommend that because you're an ectomorph, of course, right? So you have to look at the people that are recommending certain things and look at what somato type they are because certain somatic types are going to have a propensity to handle macronutrients differently than someone else. So it's good to look at that as a general template. But in the end, you got to fine tune it, you got to look at it, my default way of looking at because of insulin resistance is being so prone, because refined and processed foods have been eaten ubiquitously, you know, over the last 20, if you look at the macronutrient trends over the last 20 or 30 years, right, its proteins gone down a little bit fats has actually gone down a little bit. And actually cards have gone up. So when you look at that general trend, we can just assume out of the gates that most people are going to have carbohydrate problems, not protein and fat problems. And if they do have protein in fat problems, it's usually from junky trans fats and or junky omega six refined vegetable oils, not healthy animal fats.
Evan Brand: Yeah, very, very great points. And that's important for people to listen, I mean, you're hearing a clinician speak, you're hearing the clinicians brain, because as you mentioned, if you get into some of these other people that may not be practicing clinically with people, they're going to be able to give you a cookie cutter answer and you did not I was kind of probing you to give me some like buzz wordy, you know, like something I could post on Twitter type answer, but you gave me a clinicians answer. And I hope people appreciate that. Because there's a lot of variants with this. And I know it's frustrating, because when you listen to a podcast, you're like, I just want to be told what to do how to do it. Give me the sparknotes? And your answer is there's not really a sparknotes there are some categories, if you will, that we can put people into I'm definitely probably closer to ectomorph. And so I do better. Like if I do a grass fed steak and I throw some extra organic wild blueberries in with that for breakfast, I feel so much better with that extra little blueberry hit, as opposed to just the steak versus let's say, my grandmother who had an high a one c score, she's going to do much better with just the steak and she's going to go but better lower carb overall.
Dr. Justin Marchegiani: Exactly. So it's good to know, I'm kind of more of a mesomorph I'm kind of in the middle. And I just I look at you know, the problems that we as society have as a whole, generally speaking, and I kind of just create my recommendations to have the largest bang for the buck regarding the average person. And then of course, when patients come in, then you kind of look at them, you kind of look at their height, their weight, you know, especially you see a lot of women, you know, in their 40s. I'm like, well, where were you in high school in college it regarding your weight? Oh, I was 80 pounds lighter. Okay, so we know there's some metabolic damage there. If you put on 80 pounds since that time, right. So then, then it's good to really make sure we we support them being better fat burners, I think the next step I wanted to hit would be intermittent fasting. So someone in the comments here will talk about this, they talked about omad, or one meal a day, I'm not a huge fan of omad. Now people can do it, if they're wanted, they have pretty good adrenals their diets really good and they're very metabolically flexible. Okay, with omad. It's one meal a day. So you need all of the calories that you need in one day in one meal. So number one is you're going to be eating a meal that's like two to three times bigger than what your typical meal would be. Because if you need, let's say, you know, I'm six to 2015 pounds, right? I need like 3000 calories a day, if I'm you know, relatively active, well, 3000 calories is a lot of food at one meal. Okay, it's a lot of food. Because you need your your micronutrients, you need, you know, your amino acids, I need probably at least half a gram per pound of body weight minimum for protein. So I need at least let's say 110 grams of protein, that's a big meal. So one, you need really good digestion, you probably needed over an hour to sit down and actually eat that meal if you're not going to be sick because that's a lot of food to eat at one time. So you probably need an hour to eat it. You need really good digestion really good enzyme and acid secretion. You need an hour to sit down and be able to handle it and you probably can't move much for an hour afterwards because the meal so big, it's it's the equivalent of a Thanksgiving Day dinner. Right? And so you got to be careful with that.
Evan Brand: I think let me just give you a little I'll give you some numbers real quick just to show how hard what what you're describing would be. So for example, I love bison. So if you were to do a which this is going to be your fattiest cut, if you could do a bison ribeye, a 10 ounce bison ribeye, you're going to get roughly less than 500 calories, maybe like for something like 450 to 480. So if I just did it as 10 ounces. So I mean, God, let's say you did 20 ounces, which would be very hard for me to do a 20 ounce bison ribeye, you know, you'd be maybe close to 900 calories.
Dr. Justin Marchegiani: Yeah, and so you'd probably need at least you know, if for me, right, you'd probably want about 25 to a third of your calories coming from protein right around there. And so you'd probably want about that steak would probably have to be about 20 ish, maybe a little more ounces than that. That's a lot to do at one time. And that's not including the six to seven servings of vegetables that you may want to do with that as well.
Evan Brand: And then what Yeah, I was gonna say, and then what else are you going to do? Let's say you did like a cup of broccoli, that's like 40 calories.
Dr. Justin Marchegiani: Exactly. So you need like literally eight cups of that or like, you know, 60 it's becomes really hard.
Evan Brand: Yeah, cuz I see why you don't recommend it. So so your overall, your overall messages, you think maybe two meals a day, you could get away with a one meal a day you think for this type of conversations can be really tough.
Dr. Justin Marchegiani: Yeah, two meals is good. Two meals, you can do it in the morning, I mean, you may want to have like a little bit of bone broth, or something very gentle on the liquid side. Again, if you're just trying to do intermittent fasting, it's easier to do one, I don't recommend it every day. But it's easier to do like, you know, keep your eating window between 12 and eight, or let's say two and eight, I think it's easier that way gives you enough time to have a meal at two o'clock, five o'clock, or let's say to, let's say two o'clock, six o'clock, and maybe a little snack before bed, if you're still hungry, you want to fill in the gap, right? So it's a little bit easier from a nutritional standpoint to get your needs met. Again, if you're having a lot of hormonal issues, I don't recommend doing a lot of fasting out of the gates. Think of fasting as a stressor, it's a stressor on your body, just like exercise is a stressor. So imagine your personal trainer, someone's like super unhealthy. They're out of shape. And you're like, hey, come to my CrossFit class tomorrow, I'm 100 pounds overweight, come come across it, it's like well, you know, with their weight being where they're at, and how inflamed they're at, they're gonna be like, literally in bed the next week, with sore joints sore back totally hurt. So you have to make a recommendation based on what's best for them. So you may say, hey, let's just do like a 10 minute walk tomorrow, right? So a 20 minute walk, let's say a five minute walk after every meal, that may be a better recommendation, right? So think of like the Oh, Matt, or like a lot of this intermittent fasting. That's the equivalent of jumping a very overweight, unhealthy person into CrossFit. It's the equivalent, it's still a stressor on the body. Now, if you're healthy, guess what? It's a stressor that you can adapt from and get up and get stronger. But if you're not healthy, that stressor is going to break you. And so you kind of have to know that, hey, this is an application of stress. And the question becomes, does your physiology have the ability to adapt to that stress based on where you're at now? And for most people that are that we see clinically? No, that's not gonna be the case. Yeah, there's always weather. Yep. I always weather under Should I rather undershoot it have that person feeling better, less or less tired? And kind of in kind of gauge up then overshoot and make them feel worse?
Evan Brand: Yeah, well said. So this is the anti boot camp podcast. You see those boot camp signs? It's like, they'll just come in and they'll just kick your ass on day one. I mean, they don't care. You're 300 pounds five foot tall. 300 pounds, haven't walked a mile in 10 years and they'll just come in and throw you down. Give me 50 them Yes. Boom, boom.
Dr. Justin Marchegiani: Yeah, I mean, if your life if you can come home and just like recline back and chill and read and watch TV or just hang out all day, you're not doing much. Okay, fine. But most people have like, have to work they have to do things, they have to do chores, they have kids and family and responsibility to take care of so it's like their life can't revolve around that right? So obviously with the TV show and that's what their life is, you know, you can get away with stuff when that's what all your focus is. But for most people, you know, that's not the reality that we're in.
Evan Brand: Yeah, and if you want to go another direction with this, please do but I just wanted to bring up one question here that came in the live chat. And for people listening if you want to join us at the time of this recording, maybe we change the schedule but for now we go live every Monday somewhere around 11am Eastern on Dr. Jay's Justin health YouTube channel so if you want to check them out, that's how you can join us in the live chat question here. Does sugar or caffeine effect? I think they meant effect. The sugar caffeine weaken the adrenal is the most. I don't know if they're saying like either one. I would say both are a factor in people going to Starbucks and getting their dessert in the cup, which they call coffee. That sugar caffeine combo, I would say is a super big issue with hypoglycemia and adrenal stress. What would you say?
Dr. Justin Marchegiani: I think it depends if someone's doing a cup of coffee or two in the morning and they're consuming it with some fat and some protein like maybe they're throwing some collagen MCT oil in there. That tends to time release, the caffeine tends to not be as big of a deal because the caffeine is going to be out of their system, you know, by the time they go to bed. So if they're doing a cup or two, as long as they are not getting anxious, anxious or irritable, or Moody, or any of those negative symptoms afterwards, I'm okay with a little bit of caffeine. And again, if you're on the fence, just pull it out or choose something that's more decaffeinated. Choose a coffee substitute, like to Chino, or do a decaf, kameel or decaf green tea. See if you feel better if you don't notice a difference where you're not feeling worse with caffeine, a little bit's okay. And if you want to time release it, a little bit of fat in there and a little bit of collagen, will time release it and just do it in the you know that first hour or two getting up, don't do it in the afternoon hours. If people that get in trouble are the ones that do it usually after lunch, and they're trying to get at that second when between three and five. And then it's it's causing a second cortisol surge at night because that caffeine still in their system around 10 to 11 o'clock at night.
Evan Brand: So what you mentioned is good, but your average person's not doing what you're you're doing. They're wrapped around the Starbucks drive thru, they're gonna go get a venti caramel frappuccino with frickin whipped cream and six pumps of syrup.
Dr. Justin Marchegiani: Yeah, so what we're talking about zero sugar in the coffee, we're talking totally black with the exception of maybe some MCT or, or a heavy coconut cream. Or if you can handle dairy, maybe a heavy whipping cream, some kind of a good fat in there that you can tolerate. Maybe it maybe it's just MCT oil, maybe it's some collagen as well, because that time releases it and really allows it to go in your system slow. Someone on the chat talked about using glucose and sugar to keep their blood sugar stable throughout the day. Like that's literally like going camping and keeping your fire going all day with paper and kindling. It's just it's not practical, because you're never going to get keto adapted, you're never going to become a fat burner, when you're literally relying on glucose to keep your blood sugar stable all day. That's the problem. And that's like, you know, physiologically, the antithesis of health. Because really be healthy, you really want to be fat adapted. So you can help burn can help get energy from fat, it's the most stable energy source, that's not going to require up and down dips. So the equivalent of that is getting energy from logs in a campfire, which burn a lot longer and stronger than let's say kindling a paper. So you just have to look and say, if I'm camping, the goal was I want to really get my heat from those good logs, not killing your paper because I don't have to be feeding it all day long. That's the difference.
Evan Brand: Yeah, and some of this biochemical talk people may dislike to now and like, turn into a zombie. So if you're listening to this, you're like, well, how does this actually change how I'm getting through my day. So that example that Justin's mentioning with the really good fatty coffee versus the really sugary coffee. So this is the person who, like I know, you'll do fatty coffees, like during our podcast, so you're going to be burning clean, and you're going to have a good energy burn throughout the entire morning, versus the person doing the sugary caffeine, they're going to crash Two hours later. And then they're going to go for maybe as this person mentioned in the comments, or they're going to go for fruit or fruit juices or something else, they're going to get that quick hit of kindling again, and then they're going to crash. So when you're at work that you're not going to be performing at your best. I mean, if I were in charge of like a massive company, and I had the ability to give people support, I would say, hey, look, everybody can do a nutritionist console, let's say you had like a warehouse worker. And we found that the output of the warehouse workers were 20% more efficient, if we all had them on more animal based higher fat diets, as opposed to these people. You know, when I used to work at UPS to pay for my college, you'd have these guys who on a four or five hour shift, they pull out two or three candy bars just to get through the shift. And here I was eating just my grass fed ground beef before I went in, and I was stable the whole time. These guys could work for an hour, they got to go do a bag of chips, they go to the vending machine, get the coke, and then they go do the Cheetos. I mean, it was literally it was crazy to watch.
Dr. Justin Marchegiani: Yeah, exactly. And there'll be a lot of people out there. And this is why I talked about this amount of time to people that you're going to see breaking all the rules that I'm saying these are going to be the vegan vegetarians, the high carbers. And when you're an ectomorph, you can handle lots of carbs your body has the ability to take those carbs shunted in Burnet right away. And then these are the people that get energized with more carbs. Like if I if I give you a glass of orange juice and a bunch of carbs, these are the people that want to go out and literally run a marathon because their body handles carbs, and it just fuels them up and makes them so energized. And so we all have vegan vegetarian friends that just literally eat carbs all day, right? You know, you see the fruitarians that are out there. This is a big thing. I think in the 80s. at Apple, there was a big like fruitarian called they all ate fruit was like unbelievable. And you see people that are energized, energized. These are ectomorphs these are people that can handle that I still don't think it's healthy, I think as long term ramifications with insulin and oxidative stress. But people can do that based on kind of their natural genetics, metal type and how they can handle fuel. Most people aren't at that place. And so you kind of have to really look at getting good proteins and fats in there and manage your blood sugar accordingly. And so, the only other thing I wanted to highlight was oh yeah, let's say let's say you're doing a fast like a two day course. free day fast if it's a punctuated fast, and most people want to faster, they're keeping their stress down, they're not going to go work 12 hours a day and deal with stress, because when you're fasting, you're not getting nutrients in your body via vegetables, or fruit or protein. So you're relying on primarily your fat for fuel. And obviously, protein, you're doing what's called cellular autophagy, where you're recycling proteins. And ideally, you're recycling some of those, you're getting some of those for fuel, you're also getting a big bump of adrenaline and cortisol for those couple of days. So you may feel pretty good and pretty alert if your adrenals are strong. And then of course, you're you know, you're getting a lot of the fat because you're tapping into fat, but long term, that's not good, right? Because we know, any person that's been on a long term starvation, like diet, you know, you just look at people will were to post concentration camps that were starved, but no one walks out of that healthy, right? It's impossible. But for a short two to three or four day period, you definitely can. And the key is you have to keep your stress down and under control, maybe do some bone broth, or do some minerals as well to keep your minerals and your electrolytes up. But most people that will still be the equivalent of a CrossFit workout. And if they're metabolically unflexible, that could break them as well.
Evan Brand: Yeah, well said another question here, I have a friend that lives in mold and is super stressed. How does mold affect the adrenals? Well, it is a huge cause of adrenal issues, mainly because it's creating this alert response, it's creating a sympathetic stress, the body's trying to react to it, hopefully, the body's reacting to it, meaning that there is some sort of immune response. And maybe there's some antibodies that come in, maybe there's some detox pathways that are ramping up. So hopefully your body has a reaction, but it's a huge adrenal stress. And I would say, even if they're not living in mold, and you just have mycotoxins in your system, that can be an adrenal stress, or two, I know for me, I had a lot more baseline anxiety when I had just mycotoxins in my system, and I wasn't being exposed to mold, my wife experienced the same thing. So we were doing adaptogenic herbs to help regulate the adrenals. But once we've detox quite a bit using binders, when we've done many podcasts on that, my baseline anxiety is back to the way it was before, which was I didn't have baseline anxiety. So yeah, I can tell you firsthand, it's a big, big factor.
Dr. Justin Marchegiani: Yeah, I mean, the first thing we have to do, if we have issues with mold is you one, you got to get your environment more stabilized, make sure you're able to digest and break down foods and get good proteins and good fats in there. Also, on the flip side, right, I've talked about, you know, some of the fasting benefits and stories, we have a lot of we have a large group of people out there that are carnivores, like they literally just eat meat all day long. And they do amazing, right, and so like, you have to look at both sides of the camp, because their success stories on both sides of the camp. And so you have to understand why someone may have a success story over here, and not over there, or why someone over here has one but not over there, you have to look at it in a kind of non dogmatic type of, of mindset, right? People kind of have their camp and say, Well, this person over here has to be lying. It's like, Well, probably not. And, you know, we've seen 1000s of patients. So I've been able to kind of understand why certain people on the high carb get great success and why people on the extreme low carb, and why somewhere in between tends to be the biggest bang for your buck, right and, and then who are those people that way you can make recommendations and push people to either direction, so they can get better results. Because it's like you're either you either have like my allegiance is to getting the patient the best result not to using a tool to get them to the result, I put enough tools in my tool belt so I can be non attached to the tool because I want the result to get happen for the patient. Some people are really, they're really attached to the tool, and they want this tool to be what gets them the result. And you really have to, as a patient, find doctors that are unattached to the tool, they really just want to get you the result that you're looking for.
Evan Brand: Yeah, well said and, you know, me being an ectomorph, you would think I wouldn't do well with just tons of meats and fats. But I do great, really low carb and there is some discussion of mold and fungal infections and candida overgrowth and CBOE and CFO and some of these things, that people will do better. And I definitely had a history of a lot of gut issues. So I think for me, that's part of the reason I do so well low carb as an ectomorph. But I certainly feel fine on starch and white rice and berries and, and all of that. And I'm kind of lucky, I guess I think it's a blessing to be able to do both, it's a blessing for me to have a grass fed steak with just blueberries for breakfast and feel fine all day. But it also be cool to do some rice with some dinner and have no issues with it.
Dr. Justin Marchegiani: You have enough of a solid foundation with your proteins and your fats and your nutrient density. Where those those a little bit of carbs, it's not gonna be enough, it's kind of like you have a fire going you have a good log already in there. If you throw a little bit of kindling extra in the fire, it's the fire is still gonna be there, right still gonna be strong. And so that's kind of where you're at and the more metabolically flexible you get, you know, but in the end, you got to listen to your body, right? We got we got to be we got to be data results driven, not not dogma driven. And if you feel great doing something, and you know your nutrient density is up and you're in you feel good and you feel energized and you feel flexible and you don't feel inflamed. That's really important.
Evan Brand: Here's what I recommend this podcast is brought to you by Daybook. No, it's not actually brought to you by Daybook. But Daybook‘s a cool app that I have on my phone. And I love it, because I'll pull it up real quick. I love it. I wish I could share my screen on my phone somehow. But anyway, I love because I can just scroll through it. So people don't audio, you're not going to see this at all. And I apologize. But anyway, it's cool, because you can look at it. And you can go may 27, may 25, may 23. And you could just scroll through and you could be like, oh, look on May 3, I wrote here that I did a grass fed steak and a big old bowl of white rice, and my blood sugar crashed. So it's fun to be able to report back. I know there's a million apps out there. But that's just one that I like, because I like to be able to hit the plus button, start new notes, do voice to text, whatever I can and then boom, I can look back, and I'll just be like, oh, here, here's where I messed up. And so I think people have to track this. You're mentioning that listening to your body. If you're busy, you got kids, you got a job, it's tough to know, oh crap, what day was that, that I did the rice and then I did the grain free this and the gluten free cookie or whatever. If you can track it in the app, you can report back, so picking out but that's what I like.
Dr. Justin Marchegiani: I like that. Also, just for my autoimmune patients listening I see a lot of patients that have thyroid issues hashimotos other autoimmune issues, blood sugar fluctuations high to low can definitely increase immune activation. I have a couple of studies here. I'll just kind of give you all the overview just so you could take on what sticks was study right here talking about the effects of hyperglycemia on an inflammatory response. Another one here, the effects of induced hypoglycemia on inflammation and oxidative stress with patients that have type two diabetes that they made diet changes where they restricted calories and gave them Metformin to cause low blood sugar levels. And they saw an increase in immune response, they saw an increase in monocytes, and platelet aggregation, a whole bunch of things right. And so you know, we're talking about inducing low blood sugar in a in this could get out of a study on this directly. But we could do this with a bad diet with hypoglycemia from a reactive hypoglycemic diet, like someone consuming a Starbucks macchiato with extra pumps of Carmel in there and you create a low blood sugar response. That way, you're going to activate interleukins cytokines monocytes immune responses that are not going to be helpful and may even flare up your autoimmunity. And so the more you can snake your blood sugar along throughout the day, with good proteins, good fats and the right amount of carbs for you and your activity level versus up and down swings, the better it will be we know the data on on low blood sugar and the immune response is profound and people that have autoimmune issues, you really have to work on that. Yeah, right here. Although the underlying mechanism remains unclear, increase inflammatory cytokines and leukocytosis are reported after hypoglycemia, suggesting a link between hypoglycemia and in formation. And again, this hyperglycemia will be a little bit different than let's say intermittent fasting, hypoglycemia, but the faster your blood sugar drops, right? The more inflammation, the more your body's gonna create a hormonal response, that's not going to be helpful.
Evan Brand: Makes total sense. Here's a lady grace left the comment for it. She said she used to do one meal a day and two meals a day. And it felt like a badge of honor when I could fast for longer, but I realized it was stressing me out and not optimal for digestion. Probably meaning saying she's not optimal for digestion. Yeah, it's just too much too much at one meal.
Dr. Justin Marchegiani: So you know, if you do that, you know, I think you come at it a couple days a week, make sure you're relatively healthy. Make sure you take some extra HCl or enzymes, make sure you carve out a little more time to eat that meal, so you're not stressed. Also, just just go and run your food through chronometer. Like, if you're getting two meals a day, you know, go go carve out what that meal has to look like you're gonna find it's about 50% bigger on average. And that's just a lot more food and a lot more time and you got to make sure you're not stressed because we all know what happens when you eat a big meal and then you're stressed you feel even worse you feel totally weighed down, you feel nauseous, then your next meal you don't even want to eat it because you're still just upset. So yep, I think we hit today really good. I would just say like understand the connection between cortisol, adrenaline, your immune system, why some people get great results doing different diets and other people right read between the lines be results driven, not dogma tool, modality driven. It's really important right? Check your biases at the door. Outside of that I hope this podcast resonates with different folks if you want to reach out and you want to get individualized help from Evan, EvanBrand.com you can reach out to Evan. Dr. J here JustinHealth.com. You'll see schedule links. We're happy to work with patients worldwide. You know we are in the trenches rolled with our sleeves rolled up dealing with people every single day so we're here to help outside of that if you enjoy the content, put your comments below let us know what you liked the best and please share with family and friends that could benefit it really helps propel kind of our life's mission to help more people every day. Appreciate it. Anything else Evan?
Evan Brand: No that's it Take good care and yeah leave us a review on your Apple podcast app we'd love it if you're on Justin health show or if you're on my show and brain show, give us a review, we'd love to see what stars you think the show deserves. We've got hundreds and hundreds of five stars we'd love to add to it that helps us in the rankings so more people can hear us. So thank you so much in advance and take care yourself.
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