Leptin resistance and weight gain – Podcast #101

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Dr. Justin Marchegiani and Evan Brand take an in-depth look at hormones that affect appetite and they explain why some people are easily satiated while others get a lot cravings. Discover how leptin is connected to insulin. Listen as they share with us information on how we can control blood sugar better and burn fat.

Leptin resistanceIn addition to the hormones, learn about toxicity and how you can improve the environment and why clear air is important as well as clean water. Find out why keeping fructose consumption to a minimum can greatly help and what types of fruits you should be eating more (or less!) of. If you are struggling with weight loss, this podcast episode is for you.

In this episode, topics include:

00:50   Hormones

04:00   Toxins

06:34   Weight loss and detoxification

17:31   Diet and food recommendation

26:53   Summary








Dr. Justin Marchegiani:  Evan brand, it’s Dr. J, man. How you doin’?

Evan Brand:  I’m doin’ great. What about you?

Dr. Justin Marchegiani:  I’m doin’ pretty good, man. It was really hot down here in Austin. I was on the boat last weekend doin’ a lot of water skiing, trying to stay cool.

Evan Brand:  Yeah, I’ll say I don’t miss the 110º days. I’m happy with like 85-90.

Dr. Justin Marchegiani:  Yeah, it’s not getting that hot. It’s probably like 95-99 kinda thing.

Evan Brand:  I was dyin’ last—was it? I guess it was almost a summer and a half ago, 2 summers ago there. It was incredibly hot. That was when the drought was still there. I think it’s a lot better now, isn’t it?

Dr. Justin Marchegiani:  Yeah, it’s much better now. Absolutely.

Evan Brand:  Cool. Cool.

Dr. Justin Marchegiani:  Well, how your weekend?

Evan Brand:  It was great. I don’t even remember what I did but I know it was good.

Dr. Justin Marchegiani:  Well, I know we talked pre-show. We were gonna talk about some of these hormones that affect appetite, two for instance being leptin and ghrelin. And these are two hormones that have a major effect on energy balance. So leptin is one of these hormones that helps kinda with satiation and the more leptin sensitive you are, the—the more apt you are to be satiated and do not have these massive cravings, and leptin and insulin are 2 hormones that work together. So when we talk about resistance, like leptin resistance or insulin resistance, they kinda are connected because insulin is this hormone and it helps kinda open the doors in the cell so to speak so we can get nutrients from the bloodstream into the cell so the cell can essentially use it for energy. Now insulin, too much of it can drive, open the door so it goes into the fat cell, right? It can go into the fat cell and it can cause fat storage and the more that insulin bell is rung so to speak, the person that starts to, you know, open that door becomes less, you know, more resistant to open that door and the more resistance we have with insulin, the more that blood sugar accumulates in the bloodstream and the more blood sugar gets converted to fat, the less we burn our calories for energy. The more we store our calories and the more resistant we are to burning sugar. So essentially that’s insulin resistance and the whole downstream effects then affect leptin because leptin is higher in obese patients, same as—same with insulin resistance, and the more leptin resistant we are, the more appetite kinda gets away from us and it’s more out of control and we’re more likely to eat bad foods which then perpetuate the same problem again.

Evan Brand:  Right, and these the people that they can graze all day and they never get satiated. You’re just constantly eating. You’re never really getting that full signal of, “Ah, I feel good. Now I’m gonna go back to life.” You’re just constantly—you’re the person who if you open up your desk drawer right now, maybe you got a protein bar in there. Maybe you got a candy bar, maybe you have some other type of snack food. You could potentially have some leptin resistance if that is-if that’s you. I’m all about being prepared. If go on a hike, I’m gonna bring some jerky, some nuts, some other foods. But it’s not, I don’t have to snack all day every day.

Dr. Justin Marchegiani:  Exactly. Exactly, that’s the big thing. So we keep insulin and leptin essentially in balance, doing the same things. Some of those are gonna be one, keeping refined sugar out of your diet or at least out 80-90% of the time. If you’re obese, you have a BMI that’s, you know, upwards of 30-35. You have waist that’s greater than 40 inches as a male, 35 as a female, that’s a pretty good indicator off the bat. More than likely you’re obese and more than likely you have this whole insulin-leptin resistant pattern happening. Now—go ahead.

Evan Brand:  I was just gonna outline some of the—the main factors here that are influencing people and their hormones. One is the diet which you’ve already touched upon. That’s gonna be influencing these hormones. Two and three, are going to be toxins. So whether this is like environmental toxins like endocrine disruptors you know hormone—hormone disruptors here or just things that are going to trigger our nervous system be—to—to act up. So if you have adrenal issues, it’s likely that you have some other hormonal issues that could be tied into this and you’re having the blood sugar crashes. You’re not getting satiated. Maybe you’re getting lightheaded when you stand up. Things like that.

Dr. Justin Marchegiani:  Yeah, absolutely. So we really wanna make sure we keep the refined sugar out of our diet. Excess fructose. Fructose is one of these major fruit sugars but we really see it higher in high fructose corn syrup. So these are gonna be almost of all our refined junk foods are gonna be very high in fructose which are gonna drive this whole insulin resistance mechanism from happening.

Evan Brand:  And I doubt most people listening to this show are consuming high fructose corn syrup intentionally; however, if you go out to restaurants somewhere you get a decent quality meat but then you do some type of sauce with it. I guarantee the sauces are gonna have some corn syrup in there. So is it gonna kill you if you do one dose of it? No. But if you are having issues with your weight then you may have to a little bit more dialed in.

Dr. Justin Marchegiani:  Yeah, and a couple of the patterns we’ll see on blood work when we see like excess fructose is we’ll see higher cholesterol and cholesterol by itself being higher, you know, mid-200s and up, is not necessarily a bad thing. But we’ll also see the elevations in triglycerides with it.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So typically over a hundred for the triglycerides is a pretty good sign or even more specific is a triglyceride to HDL ratio that is greater than 2. So what does that mean? That means, well, if your HDL is at 50, that’s the so-called good cholesterol. Not really good cholesterol but that’s what everyone knows it as. That should be around 50 in this example and if your trigs are let’s say greater than 100, well, there’s your greater than 2:1 ratio. You have over 2x more trig—triglycerides for short—than we do have for the HDL.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  That’s a pretty good sign off the bat. We can also see elevations in blood pressure as well. And one of the things we’ll even start to see is we’ll potentially see even things like slightly elevated liver enzymes. We’ll see that in—in NASH—nonalcoholic steatohepatitis—that’s basically liver issues like this liver kind of disorder that we see in alcoholics but it’s a non-alcoholic version.

Evan Brand:  Wow, it’s amazing.

Dr. Justin Marchegiani:  Absolutely, any comments on that, Evan?

Evan Brand:  Well, so I wanted to talk about people that are struggling that weight loss. That’s mainly who this—this episode is geared toward. It’s important to learn about these hormones in general, but if you are having with weight loss, you and I both, we help people with that, but it’s not the first priority. A lot times we have to get these other foundations in place. We have to build the house, build the foundation, build the walls, get the adrenals in check, try to optimize the function of the gut, before we come and focus on weight loss. But the issue with these hormones here is that people are not able to detoxify and so if we look at your fat cells, your fat cells are gonna be storing all of these toxins. So whether this is hormones, whether this is various pesticides and other chemicals, whether this is chemicals from your conventional skincare products, maybe before you went all-natural with your skincare products—hopefully you’ve done that—you still have the residual impact of these toxins in the fat cells. It’s not like they’re just gonna magically leave the fat cell and flush out of the body. So when we’re talking about these hormones, you know, getting the adrenals healthy, getting the gut healthy, those are our first priorities, and then after that we wanna try to help to improve your elimination of some of these toxins so that these hormones can work better—these insulin cycles, these leptin cycles, and so if we’re talking things like magnesium supplements, we’re talking things like vitamin C, maybe some charcoal, maybe some physical exercise, too, to get these fat cells burning up and excreting the toxins, so whether it’s something like yoga if you’re really adrenally fatigued, Justin and I both are not gonna tell you to do a CrossFit workout. So it could be some yoga, it could be massage, some body work, it could be some infrared saunas—I like near infrared saunas, those are good, massage and then other detox stuff. I know you talk a lot about amino acids helping to detox. So there’s that route, too. Basically we’re trying to just help the liver do its job a little bit better so that it’s not so busy focusing on all these toxins. Like the average person out in America, in the world, their liver is so busy just trying to keep up with all the toxins that re coming and the onslaught of toxins from the food, the water, the air, the soil, etc. that your body can’t process the hormones the way that it needs to. So really detoxification should be a daily thing, but also it should be an intervention that we’ll use at the right time when a person’s foundations are in check.

Dr. Justin Marchegiani:  Exactly and you mentioned a couple of things regarding toxins and obesity, there’s one article here that was written by Dr. Mark Hyman. He was quoted as saying that “toxins activate neutrophils”. Now neutrophils are the largest percentage of blood cells in our body—our neutrophils, and these will typically upregulate with bacterial infections especially. Now these things will increase these various inflammatory cytokines of the, you know, the Jeopardy words for them are TNFα, interleukin 6, and they promote insulin resistance, they affect a couple of these different mechanisms such as PPAR and nuclear factor-kappa B and they create inflammation and that’s one of the big things they do and they create inflammation by suppressing cytokine signaling. Now what’s the big take-home there? A lot of different big words but what that means is inflammation makes your body hard to be satiated and makes your body more likely to store fat. That’s the big take-home right there. So infections drive inflammation. Inflammation will then affect some of the cytokine signaling and more likely to make you leptin-resistant. When you’re leptin resistant, you’re less likely to be satiated. When you’re less likely to be satiated, you start eating more foods that are gonna be detrimental to your health and to your weight.

Evan Brand:  Yup. So if we’re trying to do chicken or egg here like I always like to do with you, we could start at the top of the food chain with just some type of chronic stress, right? So whether this is like an environment stressor or emotional stressors, something that’s contributing to the leaky gut situation in the beginning, now the gut’s leaky, so now these toxins can get into the bloodstream even more driving up more inflammation. Then let’s say someone picks up a parasite infection, now they have even more inflammation. Now the, let’s say they had something like Blasto or H. pylori, now their small intestine’s damage, so there’s more inflammation there and now their completely inflamed, maybe they jumped on an acid blocker, maybe they jumped on aspirin. So they’re becoming more toxic. Now the liver can’t keep up with what it’s doing because it’s trying to flush out the acetaminophen, right? So it’s crazy how things can spiral out of control. So I guess if we zoom back out and then try to look at the take-aways, the foundational supplements are very helpful. So if we’re talking about our foundations here. This would be something like probiotics. If it’s the right time for you to use them—not always should you just jump on a probiotic—some fish oil, some good fatty acids for inflammation. I would say some glutamine could be really helpful for this. Some trace minerals could be helpful. What about you, Justin? What do you think about like foundational supplements? What would be something like a—a generality that we could make for people that—that have everything else in order?

Dr. Justin Marchegiani:  So we’re already assuming that sleep’s dialed in, right? Because we know leptin and sleep’s pretty important. By the way, leptin is secreted by your fat cells, too. So the more weight you have on your body, the more the downward essentially gets worse and worse. So like if you’re leaner, you already have a big advantage, right? But if you’re leaner, you already have more muscle and you already are more insulin-sensitive. So it’s kinda this like downward cycle where the more overweight you are and the more problems you have, the more feedback mechanisms feed back in to make us more insulin resistant, more leptin resistant, more cravings. So the problem becomes even harder to deal with, the more overweight we are. Does that make sense?

Evan Brand:  Yeah, I—actually I’m glad you brought that up because I almost forgot to mention it. I actually did, when I was writing REM Rehab, I actually did some research. It was a study from the International Journal of Endocrinology and they looked at sleep deprivation. So people that got 4 hours of sleep per night which hopefully most people listening are getting more than 4 hours, but when they had that—that little of sleep, their leptin levels decreased. So people were gonna be less satiated and then their ghrelin levels, their hunger hormone was increased by 28%. Even after the subjects were given a sleep compensation of 10 hours per night the following 2 days. And then it said that it increased their carbohydrate cravings by 45%. So there’s a few different numbers there, but if you’re sleeping poorly just a few nights per week, it sounds like here, that’s enough to really destroy these hormones. So if you think you’re doing everything great during the day but like you mentioned, maybe your sleep hygiene’s not in order and you’re not sleeping restfully, that’s going to be driving up these hormones and you’re gonna wake up with carbohydrate cravings instead of wanting say some good sausage and eggs for breakfast instead.

Dr. Justin Marchegiani:  Yes, and when I look at leptin resistance, Gary Taubes had a great analogy years back I—I spoke with him and he said, you know, stick your thumb out, right? Imagine a hammer comes down and that hammer whacks your thumb. Now all of the swelling that happens, these various interleukins and cytokines and all these different pathways that are happening underneath the skin, you know, that’s like leptin and all the TNFα and all the interleukins and the PPAR, you know, gamma agonists, all these different fancy Jeopardy words, that’s what’s happening underneath the skin. But he said, insulin resistance is the hammer and then the hammer hitting the skin and that initial response, that’s leptin, and then everything else kinda spirals out of control. So he’s like, “Well, my focus is on the hammer.” Other people they go into all the little dominos that knock over many, many times down the road. So if we look at the top 2 things, I put more of my focus on the hammer, and then you can say that maybe leptin’s the—the next domino that falls over after—after insulin if you will.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Does that make sense?

Evan Brand:  Yeah. That makes perfect sense.

Dr. Justin Marchegiani:  So looking at that, really simple, we keep fructose to a minimum. If you’re significantly overweight, you know, 30-50 lbs more, keep fructose under 25 to 15g a day. You know?

Evan Brand:  What would that look like? Explain people how would that actually be like a handful of blueberries per day, what are we talking?

Dr. Justin Marchegiani:  Well, my patient have access to the member’s area on my website and other there I have a specific handout that kinda outlines all of the fructose that are gonna be in every type of food source. I’m gonna pull it up here and I’ll—I’ll read a couple of things off it right now, but typically vegetables aren’t gonna have very much fructose, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  So you’re gonna be pretty good with fructose on a vegetable standpoint. Now–

Evan Brand:  Yeah, if you’re doing something like a Paleo template or if you have to go the AIP route, you’re gonna have that dialed in. You’re not gonna have to worry about that.

Dr. Justin Marchegiani:  Yeah, and I did an article I think last year on Is Fruit Bad For You? And I think I outlined that in that article.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  But let me just give you, for instance, if you do something like strawberries you get, you know, 1 cup of strawberries is 3.8g of fructose. If you–

Evan Brand:  Wow, and nobody’s eating 5 cups of strawberries per day.

Dr. Justin Marchegiani:  No, that’s—that’d be a lot, right? Maybe—even if you did 1or 2 cups, I mean you’re still only at 8, not a big deal.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  But then when you go over to like watermelon, that’s 11 or you go over to like mango, that’s 16 for a half a cup. So you just gotta be more careful of like the tropical more sugary fruits, so I just say if you keep to medium to lower sugar fruits which are gonna be berries, even an apple will have about 9.5 so you just gotta be careful. If you do an apple and 2 servings of berries and maybe a banana, now you’re in the 30 range. So you just gotta be careful with that. So just keep to the moderate to lower sugar fruits, especially your berries, lemon, lime grapefruit, passion fruit, green apple, maybe an orange. You’re gonna be pretty much okay.

Evan Brand:  I wild harvested, wild foraged some blackberries last night. We went on–

Dr. Justin Marchegiani:  Nice.

Evan Brand:  We went on a hike and I found a couple blackberry bushes, they’re not all the way ready but there were a few, like at least maybe a half dozen of black ripe blackberries.

Dr. Justin Marchegiani:  That’s awesome.

Evan Brand:  It was amazing.

Dr. Justin Marchegiani:  That’s awesome. Very cool.

Evan Brand:  Some—my fructose level was approved.

Dr. Justin Marchegiani:  Yeah, you just gotta be careful of your FODMAPs, that’s one of the only berries that have a higher content of FODMAPs in it.

Evan Brand:  Blackberries?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s my trivia for the day, Evan.

Evan Brand:  Good.

Dr. Justin Marchegiani:  So kinda recapping, like you have the diet piece in, like if you’re significantly overweight, you know, 50 pounds plus for a man, 30 or 40 for a female. You know, keep that fructose down. Keep it below 25, ideally below 15. That’s number 1. Cut all grains out. Because remember inflammation plays a role on leptin and we know grains have things like lectins in there. It has phytates that block minerals. There’s a significant percent of the population that is non-celiac gluten-sensitive, right? Where they have genes that are creating inflammation and inflammatory response in their body because—that their genetics, the gluten proteins, whether it’s gluten in wheat, barley, rye or it’s the other grains that are cross-reacting with it. And so we have the diet piece dialed in. We’re eating good proteins, fats, and carbs, that’s great. And now we make sure the—the quality is up, right? We’re making sure we’re eating organics, because we know that toxins can create leptin resistance. So the easiest way to decrease toxin exposure is make sure you’re eating organic. Make sure it’s clean fats. Make sure your proteins, antibiotic and hormone-free. Make sure your water is filtered, right? We know certain drugs have an increase on obesity, potentially affecting weight gain and leptin such as like the MAO drugs, the monoamine oxidase anti-psychotics, or lithium or the SSRIs, these are like the serotonin reuptake inhibitors.  So-

Evan Brand:  I’m sure you and I have both heard that stories a dozen times of women that jumped on an antidepressant and they gained 20 pounds.

Dr. Justin Marchegiani:  Uh-hmm. And also their libido goes in the tank, too.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So that’s all—so that’s hormonal-related, also neurotransmitter-related it sounds like.

Dr. Justin Marchegiani:  Absolutely. Remember hormones affect the reuptake systems in the brain. That’s why women will take birth control pills that kinda even out their hormones so their mood balances out, too. So we can do that naturally by fixing why their hormones are out of balance which typically is driven by some adrenal stress and some blood sugar stress and some infection stress and a lot of times, they’re swimming in a sea of estrogens because of our environment with chemicals and toxins and fluoride in the water. So if we clean up our food, we clean up our water quality. We balance our blood sugar. We make sure we’re not overdoing fructose even with super healthy things, like if you’re having 2 or 3 servings of berries at every meal, and then a banana at night or this or that, then you get your 50g of fructose. You gotta be careful with that.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So you just gotta make sure that we have the blood sugar under control, and then remember protein and fats and are gonna help with your appetite more because the big issue with leptin, it’s that kind of like inhibitor valve for our appetite and we know certain things like adiponectin, peptide YY, CCK cholecystokinin, these are really important hormones that help tell us we’re full.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And when we eat high quality meats and fats, like proteins and fats, we get that feedback signal better. That’s why, if you think about it, how many people have gone and just eat a dozen eggs in the morning?

Evan Brand:  Never.

Dr. Justin Marchegiani:  No, but–

Evan Brand:  Unless they’re trying to do Rocky-style and they put them in a blender, but that’s not eating them.

Dr. Justin Marchegiani:  Yeah, but how many you know have eaten a whole box of cereal?

Evan Brand:  A million.

Dr. Justin Marchegiani:  Yeah, I mean, it’s very common or a pizza, late night pizza?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? Try looking at that like, you know, pizza and imagine it like a steak that big or something, right?

Evan Brand:  That’d be insane.

Dr. Justin Marchegiani:  Yeah, you wouldn’t be able to do it. You give me a 16–20-oz steak, you’re done. That’s it.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  But with a pizza, you’ll eat that whole thing, and everyone’s had that experience, especially everyone that’s gone to college. They—they can recall those—those memories of their time. So the reason why is, right? Well, if you go back to the Pringles commercials of the 90s, I’m dating myself, remember that—let’s see if it’s in your subconscious, Evan? Once you pop–

Evan Brand:  You can’t stop.

Dr. Justin Marchegiani:  That’s it. See you got, man. And that’s the thing, right? What they’re saying is, once you eat this carbohydrate-rich, not to mention the MSG, monosodium glutamate, which actually–

Evan Brand:  Which, appetite-stimulant.

Dr. Justin Marchegiani:  Yeah, but it also doubles and triples your insulin levels. There’s research on that and if you’re doubling and tripling your insulin levels, guess what you’re doing to your leptin levels?

Evan Brand:  Yeah, that’s not good. Also, you know what, another thing which most people don’t think about, too, is you’re hyperstimulating those brain cells, too. So you’re causing neurotoxicity or revving those little brain chemicals up so you’re getting high from it, too. It’s crazy. It really is.

Dr. Justin Marchegiani:  Now we can have this podcast be like a couple hours on this topic, but that’s why we talk about like an organic, whole food, kinda Paleo template, we automatically cut out like the MCG.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We automatically cut out like the aspartame and the crap to it. So there are articles linking MSG to leptin resistance because of the extra insulin and the extra leptin. So remember when we talk about eating good, organic foods, we’re automatically getting insulin resistance under control and we’re automatically as a result—remember the Taubes analogy, right? Insulin’s the hammer, leptin and all the other cascades are the effect after the fact that we get leptin under control and then we get your willpower under control. I mean, you can choose the right foods and you can feel satiated.

Evan Brand:  Yup, well-said. So I think maybe just wrapping this up then. We talked about the diet. We talked about looking for infections, because if the diet’s clear and we know that that’s not your cause of inflammation, then we have to look for the other sources, too. So we talked about adrenals–

Dr. Justin Marchegiani:  Uhmn.

Evan Brand:  You brought that up.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  You brought up the gut, ruling in, ruling out infections with people, that’s a big cause. Any other hidden—hidden causes of inflammation like if we’re talking besides gut, besides adrenals, besides exogenous endocrine disruptors?

Dr. Justin Marchegiani:  Well, I would just say the fact that we are exposed to toxins in the environment outside of just what’s in our food, right? Just stuff we’re breathing, I mean God forbid, but there’s 2 billion pounds per year of pesticides dumped in our environment even if you’re not eating it, you may still be getting it in via water supply or just run-off, who knows? Pharmaceutical drugs are in the water supply now. So if you don’t have a really good water filter, there’s probably some ways you’re gonna get exposed to it. If you’re walking downtown, like I was in Austin over the weekend, well, you walk by–

Evan Brand:  Water traffic.

Dr. Justin Marchegiani:  You walk by a big truck that has a whole bunch of, you know, exhaust coming out. I know Dr. Kurt Woeller mentioned with you in your one year interviews that he’s seeing a lot of gasoline like benzene and gasoline molecules in some of the organic acids testing, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah, so we’re getting exposed to this stuff and some people may need extra detoxification support. They may need extra antioxidants and extra phase 1 and phase 2 detoxification support in their diet because of the accumulation of these toxins, so we may have to stack on top of a good diet and on top of a good lifestyle, specific extra supplements to help fill in the gaps what’s going on.

Evan Brand:  Right, yeah so you’re saying basically in a perfect world, if we didn’t have this toxin exposure, maybe the diet would cover us but in the modern world, it’s just not. I’m almost convinced that—that I could be classified with someone with like chemical sensitivity.

Dr. Justin Marchegiani:  Right.

Evan Brand:  I mean, if my wife and I walked past someone with like extreme amounts of perfume on, I get an instant headache. So I think there’s probably still some liver stuff going on with me. I probably need to up my antioxidants. So you’re saying we need to counteract this. In a perfect world, if we had, you know, 100 acres of forest to live in and then we had a perfect diet, our toxin load would be less and the antioxidants we get naturally in the food may be enough, but if you’re in rush hour traffic and you don’t have your recirc on in your car and you’re breathing that stuff in, you need the extra antioxidant support.

Dr. Justin Marchegiani:  Exactly, there’s a phenomenon known as TILT, toxin induced loss of tolerance. That’s where you get, you know, sensitive to certain perfumes and things like that, just because your body has lost that tolerance because of the cumulative effect of the toxic load that you’ve been under. Now I think with you, it’s probably just that you get so used to being healthy that when you get exposed to some chemical, you’re just really in touch with it like a lot of people find that with sugar. Like they don’t eat a lot of sugar then they get exposed to like maybe a sip of soda or they eat one of their—their kid’s like fruit snacks, and they’re like, “Whoa! That was way too much sugar.” And it could be just that like–

Evan Brand:  So you’re thinking it’s maybe not dysfunction. It might just be that I’ve got back to baseline of pretty low toxin exposure and then when I do, the body’s like ding, ding, ding!

Dr. Justin Marchegiani:  Yeah, that’s kinda how I look at them. My analogy to my patients is well, it’s like saying that you—the alcoholics has a stronger liver than you just because he gets drunk off of 20 beers and you get tipsy off of one.

Evan Brand:  If I took 1 shot. I’m—I’m almost toast.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  So if you ever take me out to drink, you’ll know that.

Dr. Justin Marchegiani:  That’s—that’s really good. I’ll have to—that’s good, next time I’ll fly you in here to Austin, I—I know you’ll be a cheap date at least.

Evan Brand:  Yeah, exactly. One shot of tequila for example, I’m done. That’s it. Game over.

Dr. Justin Marchegiani:  I hear you, man. I’m very similar. I don’t need much alcohol, maybe one or two and I’m—I’m just, you know, gently buzzed. You know?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Just enough to like kinda like lubricate the conversation, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  Oh, actually a lot of people, they have to drink to have my level of social lubrication. Like I’m so socially adequate as—as I am naturally, that most people have to drink to get to my level of being able to have a conversation.

Dr. Justin Marchegiani:  Nice. I will give you 5 Paleo brownie points for that one, Evan.

Evan Brand:  I—I pride on that one.

Dr. Justin Marchegiani:  Very cool. So kinda just summarizing that whole TILT phenomenon, that tolerance induced loss, or that toxicant induced loss of tolerance, the more toxins that you get exposed to and the less ability your body has to excrete them, the more you’ll have this TILT-ing going on. So what Evan was saying before right on, diet and lifestyle’s like solid, very, you know, very important. If you’re in a city area, you may want to think about getting a really good high quality air filter. I have one by Advanced Air in my store that I recommend and use. So justinhealth.com/shop and it’s my air filter over there. I think Evan may have one, too. So a good air filter especially if you’re in the city. Clean water, organic food. If your gut’s not working, remember if you’re—if you have an infection and your gut’s not working, you’re not absorbing nutrients, that means you’re not absorbing the antioxidants and the sulfur-based aminos to run your detox pathways adequately so we may have increased oxidative stress and—and lower nutrients to run our phase 1 and phase 2 detoxification. So get your gut looked at. Run a good quality organic acids test to see if you have enough nutrients to run those pathways. If not, fill in the gaps, supplement a really good diet so you can be at optimal function.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Anything else, Evan?

Evan Brand:  Yeah, I wanna direct people to stateoftheair.org. It will take you to lung.org, the American Lung Association and you can actually go to stateoftheair.org and you can select your state and then you can look at the particle pollution because some of the biggest offenders are in the summertime when ozone is created from all of the exhaust and car fumes and things like that. We actually had some high air quality alerts in Lowell last week and it was in the high risk category. So not just, you know, how sometimes they’ll say elderly people need to stay inside or very young, it was saying even the average person should be inside because the ozone level was so high and then you also have something that’s more damaging called PM2.5 and then PM10, really, really small microns that’s from other like industrial operations, those were high, too, in my state, in my county. So look it up. Look up your state. Check out your county. We had an F for like several, several, several days out of the past few weeks which is just horrible. Surprisingly, even Los Angeles was better. I guess due to the—the ocean air over there.

Dr. Justin Marchegiani:  And that’s stateoftheair.com?

Evan Brand:  Stateoftheair.org.

Dr. Justin Marchegiani:  Ah.

Evan Brand:  And you can—and you can go and you would just go for—and look up Texas and just look into—I can’t remember the name of the county now. What county is Austin in?

Dr. Justin Marchegiani:  That’s Travis county.

Evan Brand:  Travis, that’s right. You can look up Travis or some of the outer, it’s there.

Dr. Justin Marchegiani:  Okay, cool. Oh, just summarizing–

Evan Brand:  You have–

Dr. Justin Marchegiani:  What? Go ahead.

Evan Brand:  I was just gonna say, people so check that out. Check out your air quality because it’s not to say you need to live in a bubble but it’s something to consider and–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  It’s another factor. There—there’s not one thing that makes you or break you which is why you and I have these discussions every week because people can always make little improvements to—to their environment.

Dr. Justin Marchegiani:  Yeah, exactly. And then also, people that are, you know, cigarette smoke goes without saying, hey, if you’re smoking marijuana, too, remember there’s still incineration that’s going on there with the plants or with the—the wrapping paper if you’re doing a joint. Remember there are polyaromatic hydrocarbon (PAHs) or heterocyclic anion compounds that you get to the incineration, so remember that’s adding to that, you know, oxidative load, right?

Evan Brand:  Yup, so use the vaporizer if you’re gonna, you know, consume it orally. If you’re gonna do topical, if you wanna do soft gels–

Dr. Justin Marchegiani:  Do it oil.

Evan Brand:  CBD oils, yeah, tinctures.

Dr. Justin Marchegiani:  Or you can do in a tincture, so those are safer ways to do it so you don’t get the incinerating compounds there.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And also we touched upon it but why does exercise help? Exercise helps because if you’re doing the right exercise, it puts on muscle and the more muscle you have, the more insulin sensitive you are, right? The more you have these little GLUT4 receptors that reach out in the muscle and they pull sugar in better so the more sugar you’re able to pull in, the less insulin resistant you get. So muscle makes you more insulin sensitive by having more GLUT4 to pull sugar in, but also when you’re doing the exercise itself, you—you’re pulling that blood sugar out of your bloodstream and burning it up, too, which is gonna make you more insulin-sensitive as well.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  So toxins in your food, clean water, clean air, diet, lifestyle, exercise stuff, and then we also mentioned the guts and the supplements that may be needed extra if we have extra stuff going on. That’s where patients should see their doctor, their functional medicine prov—practitioner or physician, and/or reach out to us because we see patients like this all the time and we are experts at treating these issues.

Evan Brand:  Absolutely, well-said.

Dr. Justin Marchegiani:  Evan, great day, man! You were on fire today.

Evan Brand:  Alright! You, too, man.

Dr. Justin Marchegiani:  Love it. Take care.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Buh-bye.



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