Infections, digestive issues, brain fog and what to do next… – Podcast #61

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Dr. Justin Marchegiani and Evan Brand talk about gut bugs and multiple gut infections in this interview. While you’ll see some symptoms when a person’s experiencing a gut infection, remember it’s not always the case as there are times when people don’t get any symptoms at all. Find out what types of specialty labs to order to test for gut infection by calling your functional medicine practitioner.

Get in-depth information on what the usual suspects are for gut infections and watch out for where you could possibly get them. Learn more about allergy medications and discover the effective treatment protocols to knock out these gut bugs by listening to this podcast.

In this episode, topics include:

3:03 Where do gut infections come from

11:15 Compromised gut health immune system

13:32 Allergies and allergy medications

16:30 Treatment protocols, enzymes and HCl

18:56 Infections and recovery

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Dr. Justin Marchegiani:  Hey, Evan!  What’s going on, man?

Evan Brand:  Hey, not much.  I’m excited I got to talk with you this week.  I was curious if we were gonna get together and do this thing.  I was like, “Oh, man! I need my–my weekly dose of inspiration.” So glad we’re getting to do this.

Dr. Justin Marchegiani:  Vice-versa.  I always enjoy talking to you as well.  What did you have for breakfast?

Evan Brand:  I woke up and my wife said, “Hey, I made some sausage for you.”  So it was just some of the Applegate, no hormones, no antibiotics, sausage links.  Had about 5 of those puppies and just some lemon water and that’s it so far and I’m still feeling good and that was a couple hours ago.

Dr. Justin Marchegiani:  Nice.  Yeah, myself, I did a great little green drink.  So I took some celery and some parsley.  Took a whole lemon, one carrot, some kale, cucumber and about 3 or 4 ginger cloves and I had them all juiced up, but you know, nice coffee-mug size.  I drink that.  Had some coffee, butter, and MCT oil all blended up and then I’m also sipping on a whey protein shake.  So I got a lot of micronutrients in my green drink.  I got some good fats in my butter and MCT coffee, and then I got some extra protein and amino acids in my grass-fed whey protein.

Evan Brand:  That shake sounds pretty potent.

Dr. Justin Marchegiani:  Oh, it was very spicy with the ginger.  I love ginger.  I mean, ginger is phenomenal.  I have it part of my programs with any gut killing program because ginger is very anti-inflammatory.  It’s a prokinetic so people that have delayed gastric emptying or digestive issues, and also keeps the lymphatic system moving.  It’s an anticoagulant so people get inflamed–either things move in the body much slower from a lymphatic and detox perspective so keeping the ginger in there really keeps things moving.

Evan Brand:  Ah, that makes sense.  Yeah, I’ve had some ginger kombuchas–

Dr. Justin Marchegiani:  Love those.

Evan Brand:  Like some home-made.  I’ve had some of the ones that are in the bottles but I’ve had a couple like home-made ones at some health fairs and it’s enough to make you squint your eyes after you drink it.

Dr. Justin Marchegiani:  Yeah, I was quite hot after I drink it.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So that’s what I had.  I’m actually heading to Kansas City this weekend.  What are you up to?

Evan Brand:  I don’t know yet.  I know I’m gonna be here in town.  My buddy, Matt, was in town last weekend from Charlotte, so I think I’m just gonna do a rest and relaxation, engage my parasympathetic mode all weekend.

Dr. Justin Marchegiani:  Very cool, very cool.  We talked again pre-show–we wanna talk about gut bugs a little bit.  I’ve done a lot of shows and posts on parasites and gut bugs.  Again, we’ll try to look at it from a different perspective, so anyone that’s listened to our old stuff it won’t be repetitive.  And again we wanna walk–we wanna have people walk away with some, you know, take home application, but I see a lot of people with gut bugs and gut infections and they don’t even have any digestive symptoms at all.  They have no diarrhea, no bloating, no gas, no constipation, no reflux, none of that stuff.  But on the test we find gut infection.  Sometimes even multiple gut infections.

Evan Brand:  So where do these things come from?  I mean, when I–I first hear that I think of people traveling to a tropical place but I know that’s not necessary to get a gut bug.

Dr. Justin Marchegiani:  Yeah, so I’ll give you for instance.  I had a patient–we can go back in time to let’s say the mid-2000s when this person was in Brazil and they noticed they got sick and things were–weren’t quite the same.  Had gone to multiple different GI docs, after the fact and nothing came back.  Now this person’s main symptom and they some digestive symptoms but their number one symptom was fatigue.  Fatigue.  So we ran some tests.  We did some of our functional, more specialty labs, and this is kinda where it gets hairy because I have a lot of people that come in that have digestive issues and they say, hey I’ve gotten my conventional blood work done or my conventional stool test at my local hospital done and I did not come back with an infection.  Let’s not go this route.  And I say, “Huh.” I’ve done this thousands of times. I’ve had this conversation like it’s Groundhog’s Day, right?  And I’ve seen people come back with infections where they’ve already been tested by their conventional labs and hospitals and they–they come back negative there but they come back positive on mine.  So moral of the story, this guy that had the chronic fatigue came back with a couple different infections and we were able to catch it on the test.  We just started to treat the infection, his fatigue started getting better.  Now if we just relied on the conventional setting, we’d never would have even got the info to know that his person had a major infection and conventional medicine doesn’t look at these infections of even existing in a chronic state.  Infections are acute.  You have diarrhea.  You have, you know, all of the traveler’s diarrhea, you know, things like that, maybe even throwing up and once that’s gone, you’re–that’s it.  You’re over the infection.  That’s kind of the mindset.

Evan Brand:  Yeah and the problem is, even if the conventional model were able to identify it, they’re not gonna be able to properly address it with some of the things we–that we may talk about today as the treatment options for lack of a better term.

Dr. Justin Marchegiani:  Yeah, so there’s an antibiotic out there called metronidazole or Flagyl and we run a specific genetic stool test and we find a lot of people that come back with infections are also resistant to that antibiotic.  I see it all the time.  So you’re typical doctor is just gonna prescribe Flagyl and say “Here you go. Infection be gone.”  But I see a lot of my stool tests that this comes back resistant.  Now before I even was doing genetic testing for antibiotic sensitivity, I already intuitively noticed that a lot of people were being treated with Flagyl and–and metronidazole and tinidazole and other antibiotics like this and they weren’t working.  Like meaning that person would feel a little bit better for a bit of time and then the symptoms would come back so I knew intuitively something wasn’t right and then now with some of this newer technology we can see that there’s actually antibiotic resistance.  So that kinda makes sense, my intuition was kinda proven right and that’s why a combination of herbs specific to what the infection may be is gonna be the optimal way to–to knock out the gut bug.

Evan Brand:  Yup, so let’s dig a little deeper.  Where do these things come from?  You mentioned the Brazil case.  That’s definitely interesting, but say somebody that’s not traveling internationally?  Where are they gonna pick these things up or how are they gonna get into the system and allow to become problematic?

Dr. Justin Marchegiani:  Great question.  So a lot of these infections are just opportunistic, right?  There needs to be some level of immune stress, adrenal stress, stress in that person’s life for these infections to kind of take foothold.  That’s kind of one scenario.  Scenario number two is you just get exposed to a lot of that parasite or a lot of that infection and–and the–the bolus, the amount on that infection that’s there is just overwhelming to the system to begin with.  So it’s typically either a small amount where the body is just not able to handle it because of chronic stress.  A large amount that really overwhelms the body and typically one or two tend to be kind of, you know, in effect.  And then most of the time people go to their conventional doctor and doesn’t come up for the–all the–the many reasons that we talked about.  So reason number one, chronic stress.  Their immune system is somewhat compromised to begin with and then number two, there just a very large amount of the infection there and then what tends to happen is the infection starts to compromise the body’s ability to breakdown food.  So then we have stress in the gut.  The first thing that happens when our sympathetic nervous system starts activating is the inability to secrete hydrochloric acid.  Hydrochloric acid is needed for protein digestion.  HCl for short is what activates our proteolytic, right?  Remember medicine uses big words to make you confused.  Proteo, protein.  Lytic, cutting or break down.  So activates your proteolytic or protein breaking down enzymes called pepsin in the stomach.  The nice low pH of all of that acidic chyme.  Chyme is just mixed up food.  Take the food, put it in the blender, that’s chyme.  When that food comes out that stomach into the small intestine, that nice low pH does two things.  It causes a stimulation of secretion of cholecystokinin which causes the gallbladder to contract and produce bile salts or stimulate the release of bile salts and that CCK also causes the pancreas to produce a whole bunch of lipase which breaks down fat, right?  That LIP, right?  Lipid, that’s the–the fat abbreviation and then it also stimulates the pancreas to produce some proteolytic enzymes–trypsin, chymotrypsin, etc.  So we have this whole digestive domino rally effect here and when the gut becomes inflamed, when there’s stress in the gut, one of the first thing that gets compromised is hydrochloric acid secretion and once HCl secretion gets compromised, enzyme secretion gets compromised, bile salt secretion gets compromised and then foods tend to sit and rot and ferment and putrefy and rancidify creating more stress.  So this–it’s this downwards spiral cycle and then over time the gut lining becomes thinner and thinner, leaky gut starts occurring, more and more food allergy start occurring, and then the patient symptoms get worse and worse and worse overtime.

Evan Brand:  Mmkay.  So you–so you kinda answered that in a long winded way which is good.  So basically–

Dr. Justin Marchegiani:  Sorry about that.

Evan Brand:  So what I pulled from that–if you’re struggling with adrenal stress which I’d say 9 times out of 10 when we run an adrenal test somebody is struggling, modern life syndrome.  So that’s one thing.  So then it sounds like what the stress and the combination of the, you know, the things that are happening from that stress, the lowering of the stomach acid, you can just become more susceptible to these things.  So maybe you are exposed so some pathogens in your food and things like that but they just have a lot easier time of, for lack of a better word, implanting themselves into your system.  Is that what you’re saying?

Dr. Justin Marchegiani:  Absolutely.  And again, these pathogens can come from food, can come from water like cryptosporidium and giardia could easily be transferred in water. They come in food because the person maybe handling that food had some stool or some fecal particles on their hand they didn’t wash well enough, etc. or got some stool under their fingernail–

Evan Brand:  Really?

Dr. Justin Marchegiani:   And then also–yeah, I know, right?  That–that really takes your appetite to another level.  And then the other connection there is intercourse, right?  Sexual intim–intimacy is gonna be a big way that these things can be spread.

Evan Brand:  Right.

Dr. Justin Marchegiani:  You can spread gut bugs–you can spread bugs and then also there’s another level of sensitivity even beyond that where things like H. pylori can even be spread via saliva.  So even interactions that are non-intimate, right?  If you’re–have a compromised gut issue and you’re sharing a drink with someone or you’re giving your child in the cheek or on the lips, you know, non-intimate stuff, you could still potentially spread these infections especially if they have any type of compromised gut activity.

Evan Brand: Yeah, and something you’ve kinda alluded to already is that if you’re under the chronic stress, you’re gonna have a lowered immune system so maybe we could talk a little bit about how immune system, the gut health immune system, how all that stuff, when that’s compromised, you’re at even more risk of struggling with these gut bugs.

Dr. Justin Marchegiani:  Yeah, so it’s really a 5-step process, right?  There’s some type of stress or adrenal stress that’s happening that compromises the immune system, right?  Exposure to infectious material occurs, right?  Lower HCl, lower enzymes, you know, food sits and rots and putrefies and ferments.  You know, food allergy start to get worse.  Leaky gut gets worse.  The immune system starts becoming more and more compromised.  So again, the immune system gets compromised a couple of ways because as the gut becomes more and more inflamed, well, 60 to 70 percent of the immune system lives in the gut.  So if your immune system is constantly being revved up because of inflammation in the gut and because of foods coming in because foods aren’t being broken down and because food allergens are constantly there, lots of gluten, dairy, grains, legumes, things like that, refined sugar, again your immune system will be constantly hyperresponsive.  That’s why you start getting allergies.  Well, the reason why you’re getting allergies is because you’re immune system is so hyperresponsive, so–so up–upregulated and sensitive, it’s responding to anything and everything.  I mean, you may see it with like a someone that comes back from a–a war-torn area like a veteran and they have PTSD, just the–just the, you know, little noise that may happen with like just acti–you know, activity out in the front yard, a car driving by may–may cause that, you know, veteran to be kinda like perk up and really get, you know, hyperresponsive, right?  Because they’re used to maybe bombs going off and–and guns being fired, they’re just very hyperresponsive. So kinda like this veteran, well, our immune system is kind of very much similar to that.  It’s in this war-torn environment and it’s responding now to dander and to pollen and cedar and it’s like it shouldn’t be responding that way.  So one of the big things we see with gut issues and adrenal issues is we see allergies as well.  And that’s part of this whole immune stress sequelae of symptoms.

Evan Brand:  Yeah, and the drug companies if I can harp on them for a little bit, they love that people have messed up guts and parasites–

Dr. Justin Marchegiani:  Love it.

Evan Brand:  And all of that.

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  A lot of money made on–what is it?  Claritin and all those other things that have now become over-the-counter for people.  I’m just gonna–I have a deficiency.  I’m just gonna squirt it up my nose and fix everything.

Dr. Justin Marchegiani:  Yeah, I mean if you understand the mechanisms of how these drugs work, you can clearly see that none of the underlying root causes of these health issues are being addressed.  So like, I’ll just roll through a couple of the allergy medications like Zyrtec or different corticosteroid pills and such, for the most part they work through either an antihistamine activation with their decreasing histamine and histamine is a neurotransmitter that’s produced especially in the gut under inflammatory environments or number two, it’s giving you corticosteroids like cortisol or synthetic cortisol, and the reason why that’s happening is because your body’s been under so much stress that your adrenals aren’t able to keep up with the output of cortisol so keep the fire in your body out.  So because cortisol is low because your adrenals are dysfunctional, HPA axis issues, right? The brain and the adrenals aren’t communicating, cortisol is lower.  And cortisol is like your natural fire hose.  Again in higher amounts it can be a problem.  In lower amounts it can also be a problem because we have these little mini fires that happen in your body and if that cortisol’s not able to come out and put out that fire, fires can s–smolder and just continue to create inflammation and create all these other symptoms that now spin off like allergies and–and skin issues as well.

Evan Brand:  You know that actually really helps me because I didn’t connect the dots.  I had a woman who I had seen struggling in the gym.  Her performance was decreasing.  She was doing CrossFit way too much, so I’m not a fan of 6 days a week anyway of CrossFit, but–so I had her back down a little bit and I just added in some adaptogens.  And she told me that her allergies, her nose was in her head and all of this like, I don’t know what you’d call it, stress headaches, allergy headaches here in the front of the–the skull?

Dr. Justin Marchegiani:  Yup.

Evan Brand:  They–they disappeared after starting the adaptogens.  So I never even made the connection there that I may have been a little bit of load off the adrenals there, therefore, helping the immune system and the healthy histamine response.

Dr. Justin Marchegiani:  Yeah, and we could–we see that all the time when we get the people on an adrenal program, we see allergies significantly decrease.  When we also get people on therapeutic levels of hydrochloric acid and enzymes, we also see allergies go away.  It’s like we’re not even touching antihistamines, we’re not even touching corticosteroids, you know, in a way that conventional medicine does.  We’re not doing things to cover things up.  We’re just addressing the parts of that patient’s physiology that aren’t working optimally and we’re helping to upregulate it so it works better, while at the same time we’re pulling away all of the diet and lifestyle impediments that got them there in the first place.

Evan Brand:  Right.  So let’s a couple minutes about the–the things that need to be in place.  Obviously treatment protocols are gonna be different for every potential patient listening, so we can’t go too deep into that but there are some generalities that are gonna help mostly everyone. So we talked about enzymes.  We talked about hydrochloric acid starting with digesting, maybe a little bit of immune stuff.  I really enjoy Reishi.  I’m sure you’ll–you’ll smile and–

Dr. Justin Marchegiani:  Love it.

Evan Brand:  And talk a little bit more about Reishi.  What else would you like to mention?

Dr. Justin Marchegiani:  So enzymes and HCl are gonna be really important.  Now depending on how you respond to enzymes and HCl, let’s say one or two HCls create irritation or warmness in the tummy; that automatically tells me your gut lining is now very thinned out.  So if you have a response where you’re, you know, you’re feeling warm at just one or two caps of HCl, I’m now concerned that your issues have been so chronic that your gut lining has been thinned and you may need extra nutrients to help start supporting and healing that gut lining. So that’s number one. Now depending on what the infection is, it may affect things differently.  Like H. pylori we know is gonna affect more of the stomach and the upper part of the small intestine where some of these other parasites may be deeper in to the small intestine and then things like SIBO may be handled a little bit differently.  Chronic fungal infections–it’s very rare in my opinion that a chronic fungal infection is the root, root cause.  There almost always is a chronic fungal infection that’s exacerbated by a deeper parasitic infection or a deeper H. pylori infection.  Again, sometimes we see just a pure fungal issue being the underlying cause but a lot of times they come together kind of brother and sister with a parasite or a bacterial infection combined.

Evan Brand:  Uh-hmm.  So no Lamisil needed.

Dr. Justin Marchegiani:  Well, I mean, these medications can be really stressful on the liver.  Sometimes they can be helpful for topical stuff.  Just because when we do some of the herbs, it’s hard for the herbs to get to the skin or get to the toenail but we’ll try essential oils like tea tree or melaleuca and oil of oregano topically first.  We’ll do fungal foot soaks for the toenail and stuff first.  We always wanna exacerbate those first, those options first before we go to any of real stressful kinda liver-stressing enzymes.  I’m sorry the liver enzyme stressing medications if you will.

Evan Brand:  Uh-hmm.  Makes sense. Well, cool.

Dr. Justin Marchegiani:  So in summary, we have a couple different infections. We have a couple different infections.  We have parasitic infections like crypto and giardia and entamoeba histolytica and blastocystis hominis and entamoeba hartmanni, dientamoeba fragilis, the list goes on, right?  So these are some of our bigger infections. We also have infections like your chronic fungal issues, whether it’s candida albicans or aspergillus or the–the rhodotorula species, etc.  And then we have our bacterial overgrowth, whether it’s enterobacter or proteus or, let’s see, we can go down the list here.  Just your general small intestinal bacterial overgrowth, escherichia coli, klebsiella, etc.  These could be our bacteria.  These could be our fungal. These could be our parasitic infections and it’s helpful to know what infection we’re dealing with because how we structure a treatment program and what type of other support we put around it can be very helpful.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  So we know like berberines are very helpful for SIBO.  We know parasitic infections, we really wanna go up on the oil of oregano and wormwood.  If we see bacterial infections like H. pylori, we may use things like mask and other healing and soothing herbs to help that part of the infection.  If we see viral issues like Epstein-Barr or cytomegalovirus which can also affect leaky gut, we may use things like monolauric acid or we may use Reishi or cat’s claw or even silver.  So it’s helpful to know what kind of infection we’re dealing with so we can really periodize a program that addresses it and I see a lot of people with, you know, a lot of these infections and one of the most difficult things people have to wrap their head around is sometimes when we re-test, we actually see new infections come up on the–on the lab.  So it’s like they test, they have like maybe blasto.  We then treat the infection for 60 days.  We re-test and then blasto is gone but now crypto is there.  And this is kinda weird–

Evan Brand:  What’s up with that?

Dr. Justin Marchegiani:  Well, essentially infections kinda work their way proximal to distal in the gut lining.  So they can burrow in deep and as the gut heals from the inside of the gut to the outside of the gut, these infections that were hiding now kind of come to the surface as that gut material starts healing.  So sometimes we can see new infections come up.  Now just–I’ll just talk about my wife for an example.  When I first treated her many years ago, she had blasto.  We then treated blasto.  She came back with H, pylori, re-tested, treated H. pylori.  She came back with crypto, re-tested.  She came back with enterobia– enterobius vermicularis, a worm infection.  Now she had IBS for over 15 years.  Now she does not have IBS now.  A lot of her IBS–I should say all of her IBS was primary from food intolerances, low stomach pH, and a compounding effect of multiple, multiple chronic infections.

Evan Brand:  Incredible.  Yeah, well, I’ll talk about my wife, too, real quick.  The–the cytomegalovirus that we found–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Now the cat’s claw that’s she’s–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Been taking along with Reishi, all the symptoms are gone.  She was having crazy symptoms that most people would freak out about.  You know, joint pain–

Dr. Justin Marchegiani:  I know.

Evan Brand:  Incredible stiffness.  I had to put her bracelet on one day because she was so stiff, she couldn’t really function to do it and you know, she’s 25 years old and now we got this little protocol going and incredible recovery.

Dr. Justin Marchegiani:  Well, I remember a few months ago when you came to me about this and we–we did the testing and we started there and it’s like, “Hey, this is an active viral infection.  Let’s put her on some of these herbs and nutrients,” and it’s like boom! It’s–I mean, a couple months later, she’s better.  Now obviously we don’t ever hinge everything on supplementation.  The diet and lifestyle and the sleep and all that stuff’s gotta be there first.  So if we ever just go to the supplements and we just talk about the supplements, it’s always a given, it’s always 100% given the diet and the lifestyle and the stress management, all of that has to be there.

Evan Brand:  That’s true.  That’s true.  Yeah.  We just assume that you guys out there listening are–are starting there and you’re doing all that stuff first and then now you’re–you’re ready for the extra step.

Dr. Justin Marchegiani:  Yeah, we’re just saying it here again, just so it’s kinda–it’s like–it’s out default template.  So that’s always gonna be out assumed starting point and we’re really just going into the deeper stuff because a lot of our listeners are already on track with that, they really wanna go to the next level.  So we’re just talking about the next level pieces, but make sure you’re not so busy looking down the road and you trip over the–the foundational fundamentals right in front of you.

Evan Brand:  Totally.  Totally.  Great.

Dr. Justin Marchegiani:  So can we just summarize?  Someone’s listening to this, maybe they have some digestive issues, maybe they have zero digestive issues, maybe it’s just fatigue or brain fog and they never thought about the gut being a causal factor because they have no digestive symptoms at all.  What would you say is kinda like your 3 to 5-point take home?

Evan Brand:  Well, I’m convinced now.  The first step is to actually get some testing done.  You and I talked about that a little bit before the show now.  I’m gonna run some tests on me just to see what’s going on, just for curiosity’s sake and see if I can uncover some stuff because my diet’s dialed in and I’m still having some mysterious symptoms.  So I think that’s the starting point for people, definitely making sure that your digestion is good, meaning that even though you don’t have a symptom like, you know, gas or bloating, you could still have a symptom that’s not really a symptom to most people.  Just feeling extremely heavy after a meal, I thought that was normal until I fixed my digestion and realize that’s not normal to feel like you just ate a bowling ball.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So and then lastly just taking the baby steps to support your digestion during this process.  Maybe this is a little bit tangential but I definitely recommend lemon water to everybody.  Just doing a little bit of that and 4-6 ounces of water before meals just to try to help give a mild support, if you’re too early in the game, you’re still waiting to pull the trigger on connecting with us to pull some–some lab test on you and things like that, then that’s a good baby step that I think safe for–for most people.

Dr. Justin Marchegiani:  I think that’s great.  I mean, I think if you got any gut issues or if you have fatigue, let’s say the–the fatigue is gone so far, you definitely want to get the adrenals looked at.  If you’re concerned that hey, you know, you’ve done some stuff already, the gut is next place to look as well.  So yeah, do some of the diet and lifestyle things.  Lemon water or you can even do a shot of apple cider vinegar.  That’s acetic acid before a meal; that can help prime the hydrochloric acid pumps as well.  But again, if you’re having any of these food allergen issues or any of the brain fog stuff–anytime we see brain, you wanna look at the gut.  The gut and the brain are intimately connected.  Anytime you have brain fog or memory issues, it’s almost always connected to the brain inflammation because of the microglial cells become activated and that can create brain fog, and there’s a lot of research supporting that inflammation in the gut equals inflammation in the brain so the first step I would recommend is digging a little bit deeper and getting some of these lab tests ordered through me or you. I know my site is justinhealth.com.  You can click on the Healthy Living Store.  Or through justinhealth.com/shop and you can order some of these lab tests or just get a consult so we can specifically recommend what test to get ordered so you know exactly the–the correct steps to take moving forward.

Evan Brand:  Yeah, I–I say the consult’s definitely the better step because they need to know.  Do they need the 401?  Do they need the 401H?  You know, so–so yeah.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I’d say don’t try to tackle this thing by yourself necessarily.  It’s definitely good to be a-a quantified self n=1, I’m gonna do this thing myself but at a certain point you just have to, you know, put your hand out there and–and it’s not a bad thing to–to have a partnership with somebody in your health.

Dr. Justin Marchegiani:  Yeah, definitely start with the diet and lifestyle changes, incorporate bro–bone broth and things like that.  That’s a really good starting point and then see kinda how much results and improvement you get there first and then–and then take the next step later.

Evan Brand:  Yup.

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

Evan Brand:  No, that’s it.

Dr. Justin Marchegiani:  Hey, man, great chatting.  You have a good weekend.

Evan Brand:  Yeah, you, too.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.

 

 

 

 

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