Dr. Justin Marchegiani and Evan Brand engage in a very informative discussion about low body temperature. Learn how different potential stressors like thyroid issues, adrenal issues, gut health, autoimmune conditions, nutrition and low calories cause low body temperature. Find out about the role of micronutrients in thyroid hormone conversion and be aware of the medications that have a negative impact on mitochondrial function.
Gain information about the different foods, including modifications in macronutrients, and various supplements, which will improve your health and prevent different stressors that are possibly causing low body temperature.
In this episode, we cover: 
03:27 Thyroid issues
07:05 Beneficial Nutrients
14:14 Toxins and Medications
22:51 Food and Supplements
33:46 Calorie Intake
Evan Brand: Hey man, happy Monday! We’re talking all fair about that shooting this morning so my mom, she worked right next door last night at the Hotel Luxor which was uh— right next door to that shooting event in Vegas. So I called her this morning and she’s safe and sound and she got released, so she's home, hopefully sleeping. I'm sure she's extremely adrenally stressed at this point, but hopefully she's resting and settling down from all that.
Dr. Justin Marchegiani: Yeah. Lots of empathy for all the people out there going through that. It must be just incredibly stressful.
Evan Brand: It’s insane.
Dr. Justin Marchegiani: It’s just so difficult. So wishing everyone, you know, speedy recovery from that. That is just so difficult and man, everyone's adrenals are revved up from that, right?
Evan Brand: I know.
Dr. Justin Marchegiani: So let's go into some stuff here where people, we would get— put some information out there about improving everyone's health.
Evan Brand: Yes.
Dr. Justin Marchegiani: Uh—and just continue to empower more people. So let’s dig in, brother.
Evan Brand: Yes. Yes, so you and I want to chat about low body temperature, which is something that so many people have. I've had it in the winter for a long time. I’m hoping that since I work so much, my gut and my adrenals that I don't have it this winter but cold hands, cold feet you know that had been something that I mentioned going on with me for—for several years. I know there's a lot of different causes that you and I wanted to go through. So how should we open this thing? Should we talk about hormones, thyroid, how do you want to lay the groundwork?
Dr. Justin Marchegiani: Oh, we look at body temperature. Temperature is probably one of the best indicators of your metabolism, right? Because the more energy you have, typically the— the better your temperature is. And so typically, you’re gonna have symptoms of cold temperature which are gonna be cold hands, cold feet those kind of things. Also, fatigue, but now there’s also objective ways that we can test your temperature. You know, with the thermometer, obviously. We can do axillary temperature, which is armpit. 97.8 to 98.2 is—is Fahrenheit is a pretty good range to be in. Or 98.2 to 98.6 orally. And so you can kind of assess your temperature. You can do it in the morning and then you can also do it in the afternoon as well. Kinda do it just for before eating. That gives you a pretty good indication but if your metabolism is low and your temperature is low, it could be caused by an interplay of different things. We’ll go into it. It could be thyroid issues. It could be adrenal issues. It could be gut issues. It could be nutrient issues. It could be mitochondrial issues. So all of these things are potential stressors that could be driving that problem.
Evan Brand: I’d say number one is probably thyroid issues. Wouldn’t you suspect because so many people we talk with they have adrenal issues with them on top of that there is a thyroid problem. Like maybe elevated reverse T3, whether you’ve got that blank bullet going on or they just got a low free T3 or like you and I’ve chatted about with adrenals, you've got the conversion process that happens where you take the inactive T4 hormone, you convert that to active T3.That conversion process gets messed up if you've got chronic stress. And chronic stress as you mentioned, could be gut infections, it could be emotional stress, could be chemical, heavy metals. It could be circadian rhythm stress if you're working third shift, for example. That could be enough to change this whole cascade. Wouldn’t you say?
Dr. Justin Marchegiani: Oh, yeah. Hundred percent. I mean, again, all of those things can be intimately connected. The first we look at is thyroid because thyroid hormone has a major effect on our metabolism. And our metabolism is the sum of all chemical reactions in the body. And our metabolism is pH driven, right? So if our pH becomes too alkaline or too acidic, like you know blood pH, which exists in a very fine-tune range, right around 7.35+ or -1/10 of point there. And if that pH shifts up or down, that can affect how all of our enzymes in our bodywork. So that can affect temperature and there's things like—uh like a diabetic coma, right? Where blood sugar can go to he— or too low typically. If someone’s type I dependent and they don’t have insulin, they don’t get sugar into their cell, which can create ketoacidosis. And that can really, really drop that pH and that put you into a coma. So our pH is very driven and has a major effect on our metabolism, so, totally.
Evan Brand: So let’s hit on—let’s hit on the thyroid peace. Now autoimmunity is something we talk about so much. Would you say a common symptom of someone with Hashimoto's, for example, could be low body temperature or possibly even a fluctuating. Maybe their low body temperature if they’re a bit underperforming but then couldn't they just bounce right back and get actually hot if they bump into hyperthyroid. If they're in the Hashimoto's state, and things are still fluctuating.
Dr. Justin Marchegiani: Yeah. So, if you're having Hashimoto's and your immune systems constantly attacking your thyroid, your thyroid hormone can spill.
Evan Brand: Right.
Dr. Justin Marchegiani: Coz every time it’s attacked, hormone spills out. Eventually those follicles run dry and you're not gonna quite have that hyper kind of symptoms. So in an acute attack, hyper symptoms may be increased temperature are common, right? You can have like PVC’s periventricular contractions. Uh—you can have, you know, kinda this—kinda heart palpitations. Your heart’s kinda beating erratic and hard, uh—anxiety, night sweats, irritability. These are all hyper thyroid symptoms. You feel warming, right? You feel excessive warmth or temperature. But then, in a chronic state, that will eventually lead to a hypothyroid kind of environment, where your body temperature just gets very low.
Evan Brand: So someone has had Hashimoto's for quite some time, let's say there's been a pretty significant tissue destruction, you would say someone will not end up being hyper long-term with Hashimoto's. It’d probably be hypo long-term.
Dr. Justin Marchegiani: Yeah. I mean you can—hyper feels very similar. Hyperthyroid Grave’s feels very similar to a hypothyroid autoimmune attack. The difference is with hyper, typically, there’s a specific antibodies or immunoglobulin compounds that come back. So with Grave’s, you’re seeing TSI immunoglobulins or you're seeing thyroid TSH receptor site antibodies. So that’s what’s typically common in Grave’s. And when those things are high, it's accelerating the thyroid hormone to produce excessive amounts of thyroid hormone. So there's like a production stimulation where with the autoimmune attack, from like thyroglobulin antibodies or TPO antibodies is it's more the spilling of a thyroid hormone out of the thyroid. It's spilling out where the antibody attack from Grave’s, it's stimulating the thyroid to produce more.
Evan Brand: Exactly.
Dr. Justin Marchegiani: With Hashimoto's, you’re not getting the stimulation. You’re more or less getting that spilling effect, which eventually, you know, will run dry.
Evan Brand: Got it. Got it. Okay. So we hit the autoimmune piece. What else would go on thyroid-wise that will be an issue with temperature regulation?
Dr. Justin Marchegiani: Well, again, there’s also certain nutrients that have a major effect on thyroid uh—conversions. So we know things like selenium are super important for thyroid conversion. So someone may have decent thyroid levels from a T4 perspective, uh— but they may not have that activation, right? They may not have that conversion uhm— that’s so important.
Evan Brand: So could it just be the lack of trace nutrients, trace mineral selenium, zinc— things like that activators.
Dr. Justin Marchegiani: So here, we are live on Facebook now, too with the low body temperature podcast. So getting back onto our common thread. Yeah, micronutrients like selenium are gonna be important for thyroid conversion. It's a five—the enzyme that converts T4 to T3 inactive thyroid hormone to active thyroid hormone is a 5 deiodinase enzyme. It’s also important with glutathione and detoxification. So, yeah, that's totally uh— important micronutrient that will affect thyroid activations. So when we look at thyroid function, we’re looking at are there blood sugar fluctuations? Are you eating grains or foods that are gonna cause that thyroid antibody attack that could cause the hormones to spill out and eventually deplete the hormones? Your thyroid follicles carry about four months of thyroid hormone. So again, if you have a chronic Hashimoto attack, where the thyroid hormone’s spilling out faster than you can synthesize and make more, then you're going to definitely get to that depletion state where you’re gonna go hypo from a temperature standpoint. You’re gonna go almost hypothermic. That temperature will drop below that 97.8 – 98.2 armpit temperature wise or 98.2 to 98.6 and I'll put a handout down below to my uh— metabolic temperature handout. So people can actually track their temperatures and it's basically a graph of three different lines. And then the top brackets where you want your temperature to be through which ranges 97.8 – 98.6 We want to be checking off daily that your temps are in this bracket not the bottom or the very bottom.
Evan Brand: Got it. Okay. So what else? Should we talk about the nutrients next?
Dr. Justin Marchegiani: Should we talk about the nutrients, right? Vitamin A, we talked about uh— zinc, copper, selenium, magnesium very important nutrients for thyroid conversion. Now if you’re eating a whole food diet, you’re gonna be typically pretty good. If you're having enough HCl and enzymes, you’re gonna be good as well because we need those type of compounds to be able to ionize the minerals. So it's the diet component. It's making sure we have the ability to break down the foods in our diet that are nutrient dense. Uhm— number three is making sure our stress response is okay because stress hormones will affect thyroid conversion. Cortisol being hyper— very high— will affect thyroid T4 to T3 conversion that inactive to active thyroid hormone. Also, if cortisol is too lo from chronic stress. So there's this, kinda Goldilocks effect that we see here with thyroid hormone kinda need it to be not too high, but not too low to have optimal conversion. Does that makes sense?
Evan Brand: Yeah. It does. Well said. Let me mention about the gut, too, coz you just hit on the fact that you've got to have absorption. So even if the diet’s good, which many people listening to us, they probably already dialed in like a Paleo template but they could still have this symptom. You may want to check for infections. Coz like Justin and I talk about almost every week at some level, there could be an H. pylori, bacteria, yeast, fungus, something going on in the gut that’s stealing your nutrients or preventing you from optimally digesting. And then that issue is compounded, if you've been taking any type of anti-acid where acid blocking medication something simple as Tom's or something more strong like a prior was it Prilosec or Zantac.
Dr. Justin Marchegiani: Yeah. So, yeah. Totally.
Evan Brand: Keep that in mind. If you're looking at your medication list and that includes acid blockers and you have cold body temperatures, it’s probably cause you're not digesting your foods therefore the thyroid is not getting fed the nutrients it needs.
Dr. Justin Marchegiani: Totally. And also a lot of medications could affect your mitochondria. Just Google antibiotics and mitochondrial function, you’ll find that antibiotics can negatively impact mitochondrial function. And you’ll also find that other medications can impact the mitochondria. And the mitochondria is like the little powerhouse of your cell where it generates a lot of ATP, which is that currency of energy in which your body runs. So that's really important and also an important nutrient call carnitine really helps that mitochondria utilize fat for energy, generate ATP out of that good fat, you know, it’s called uh—beta oxidation where you’re generating energy from fat. And carnitine is an important nutrient primarily made from methionine and lysine. Now, I did a video call why vegan and vegetarian diets can make you fat? Now—no—don’t make you fat. But you know, why they the can—meaning it's not a hundred percent. But if you’re insulin resistant and you're doing it the wrong way, where you’re emphasizing maybe too much carbohydrates, not enough protein and more gut irritating foods, yeah, it can definitely predispose people that have an inflamed guts and work more on the insulin resistance side to gain weight. And one of the big things is that when you eat certain animal rich amino acids, there are some plant ones as well, you activate the cells in the brain that are called—hold on, one __my notes—uh—tenocytes. And these tenocytes are receptor sites in the brain in the third ventricle area of the brain. And there's a direct blood flow between them and the hypothalamus. These tenocytes, one, they sense satiety but the big thing that senses satiety for them is arginine and lysine which are really high in animal-based foods. So these amino acids really get that sense of satiation so that means you're one, gonna have appetite regulation. Coz when you actually start feeling full, you tend to not eat all the crap, right?
Evan Brand: Yup.
Dr. Justin Marchegiani: So the more you can keep your cravings in check, the more you eat healthier foods because you got control over your biochemistry. You're not reacting. You’re acting based on what you know you need to be healthy. But those amino acids are primarily gonna be higher in animal-based foods especially lysine as well.
Evan Brand: Yeah. Well said. So in a roundabout way, if you are a vegetarian or a vegan and you've got low body temperature, it could just be something as simple as a carnitine deficiency. I mean you could probably get a little bit in beans maybe—
Dr. Justin Marchegiani: A little bit in beans, a little bit in almonds, a little bit in plums and avocados, for sure.
Evan Brand: But even then, once we talked like—we talked all the time, digestion of those foods is probably not very good and the concentration of those is gonna be much less as opposed to a grass-fed beef.
Dr. Justin Marchegiani: Yeah. In my video, I talked about, you know, if you are a smart vegan where you're not emphasizing a lot of the grains, you’re doing safer starches, you’re getting lots of fats from avocado, olive oil, coconut oil, you're supplementing DHEA in the form of algae, right? And if you're getting B12 uh—supplementation and you’re getting a good multi- in there and you’re getting lots of— you're getting some protein supplementation in there, maybe from pea or hemp, right? You may be okay on a vegan-vegetarian diet, but it's just— it's still less than optimal just because of the fact that you gotta go through such extreme lengths to get high-quality protein sources without all the carbohydrate. Coz vegetarian-vegan diet’s typically are packed with 60 to 80% carbohydrates for that 20 to 25% of protein you get.
Evan Brand: Yup. Well said. You hit on the mitochondria, too. We should take that a bit further and talk about more toxins. You hit on antibiotics, some mitochondrial issues there. Makes perfect sense. We work with people all the time where they say, “Oh Justin or Evan, as soon as I took a round of antibiotics, all of a sudden things went bad.” And it could be temperature –temperature issues, it could be sleep problems, it could be gut issues, digestive problems. And so also with mitochondrial issues, we've got toxins. So if you're not using 100% organic, that's an issue because glyphosate and these other pesticides and herbicides, fungicides and insecticides— they all compound with each other. So it’s not that one chemical by itself will kill you, but if you get a little bit of glyphosate from your non-organic berries, you combine that with a little bit of conventional vegetables coz you did a salad at a restaurant, you combine that with in antibiotics that you're getting from meat. If it's not labeled “no antibiotics” you stock all those upon each other, you've got some bad mitochondrial problems here that you need to fix. And we can measure the—
Dr. Justin Marchegiani: Yeah. The enzymes that are needed to help move those gears that kinda crank around that mitochondrial Krebs cycle and then flow in so the beta oxidation process. Uhm— you need certain nutrients. You need B vitamins, you need magnesium, you need zinc, the healthy levels of amino acids. You also don't need all the toxins— the aluminum, the pesticides, the glyphosate. So those things can kinda gunk up the gears of that metabolic machinery. So it's not only what those gears need to keep it lubricated, but what it is we don't need to put in that will prevent those gears moving. So it's a combination of avoiding certain things, right? And again, the medications are a double-edged sword. I’m not saying don't use them. I’m saying just really make sure they’re— they are prescribed specifically for what you need. And it’s the last case kind of thing with antibiotics. We really want to go to herbs and botanical nutrients over antibiotics. They may have a time or place, but we want to use it only when we've exhausted other options.
Evan Brand: Yeah. Well said. And you and I were talking off air, we can quantify a lot of this stuff, too. So you’re talking about measuring your temperature. We can quantify what's going on in the gut, right? We can test the gut, we can test the thyroid with—with blood using functional reference ranges and using functional numbers that conventional doctors don't use. They’re only going to detect disease. We’re going to detect the issues before disease occurs. We’re gonna look into the gut so we could test you for infections. We could test the adrenals, look at your free cortisol rhythm so the uh— HPA axis, the hypothalamus, pituitary adrenal axis, you hear us talk about, you know, that is a factor in all of this. If your brain is not connecting the signal to the adrenals and adrenal to the thyroid, that whole system gets often chronic stress. And it's up to us to figure out when we talk about stress what's in that bucket. Is it just your job, your bad boss, your relationship, the divorce you’re going through? Is it that stuff only or is that stuff plus chemicals in the diet, plus nutrient deficiencies, plus infections, plus not having enough quality meat in the diet. You see how these things can all add up.
Dr. Justin Marchegiani: Totally. And just to kinda look at the thyroid component again, there’s dysregulation up top where the TSH is either high extreme, higher extreme, low. Now it can be extremely low because you're on thyroid hormone and the body needs more thyroid hormone. The body is sense— sensing more thyroid hormone in the brain, but there's less than the actual tissues. So that you're keeping the thyroid hormone higher, but that's keeping the TSH low. That’s step one. The TSH may be low because of HPAT access dysregulation. That hypothalamus pituitary and that adrenal thyroid axis. There's some kinda short-circuits happening in there because of the stress— the emotional stress, because of the physical stress, because of the chemical stressors. And we have to address those while we support the nutrients to get this hardwire back on track. We can also have low T4 levels. Coz if T4 is low, we’re gonna have low T3 over here. So we got to make sure the nutrients for T4 in there like I mentioned before the vitamin A, the zinc , the copper, magnesium, selenium, uhm— amino acids, tyrosine and potentially iodine. As long as we know that there's not uh— autoimmune attack that’s the lease active going on. And then number three, after that, we let see how the T4 to T3 conversion is. If T4 is good, how does T3 conversion look? Is it this big drop off? Or also is there a very high amount of reverse T3 because of that stress? All those can make a big difference. And then one person ask here—James asks, “Well, is hypothyroid and hyperthyroid hypo and hyper kind of the same for treatment?” Yes and no. With hyperthyroid from a TSI thyroid stimulating immunoglobulin or TSH receptor antibody attack, we’re more concerned about coz it tends to be more chronically high which can increase the chance of a thyroid storm and then potentially a stroke. So we take that very seriously. We refer that patient out to their medical doctor uh—for monitoring. We don’t want—we wanna make sure there’s not a stroke going on. But typically, the treatment will be, you know, PTU. Uhm—basically uh—propylthiouracil or methimazole. Things to basically block iodine uptake to make thyroid hormone. Or though— you know, typically, go to a thyroid radioactive thyroid kind of ablation or even a thyroidectomy. I’ve had patients where we’ve been able to avoid those because we give nutrients to help modulate the thyroid response and modulate the autoimmune response like carnitine, like blue flag, like lemon balm, melissa uhm—into certain adaptogens. They could also help kinda dampen that response. There are some protocols that even show higher amounts of iodine can block that sodium uhm— iodine's import that transfers iodine into the thyroid. So there’s a couple of different protocols you can use to help. And of course, all of the diet and lifestyle things are the same. But we take the Grave’s autoimmune attack a little bit more seriously just because of the repercussions of it not being treated appropriately, what will happen, we really want to sidestep those.
Evan Brand: Yup. Well said. So get the TPO antibodies checked. Get your eTG antibodies checked, you talk about the TSI. Now, have you seen where TPO TG would be high at the same time as TSI? Where it’s gonna look like Hashimoto's and Grave’s at the same time?
Dr. Justin Marchegiani: It could. I've seen it before. Yeah. It definitely can. So get—we’re gonna really get patients on an autoimmune protocol to help lower any autoimmune attack from the food, from the gluten, from the leaky gut. And we’ll also work on blood sugar stability coz high and low blood sugar fluctuations have a major effect on the immune system.
Evan Brand: Yup.
Dr. Justin Marchegiani: Now another person asked here, the reason why you know I'm such a huge fan of how we do our podcast is coz it’s literally on the go and we’re infusing questions from people on YouTube here right into the conversations. So it’s like—remember those books you read when you’re like a kid and you read it and it’s like, “Oh, if you want the character to do this, turn to this page. If you want the character to do this, turn to this page.” You can totally change how the book goes.
Evan Brand: Yup.
Dr. Justin Marchegiani: Well, it’s kind how our podcast are. So interjecting here uhm—, Gerald asked, “What about T3? How does T3 work?” Well number one, T3 can just help support low T3 levels. And if there's some kind of conversion issue, that can kinda biased time to fix the conversion aspect, number one. Number two, giving that T3 in the Wilson protocol uhm— that can have some effect on clearing out the receptor sites. So that now the T3 works better and binds better uhm— in the future. You can do that by starting low and then tapering up, holding it and then tapering it back down. In the Wilson protocol, Dr. Dennis Wilson does that with time-released T3. But we do a glandular's in it. That can still be helpful as well. We’re using that as a way of clearing out the receptor site but were also not, you know, thinking that that’s gonna be the only issue. We’re also banking that there’s other things that we’re gonna be fixing that will allow it to be a long-term solution, right?
Evan Brand: Got it. So you’re saying the thyroid glandular's can be used for low—a low T3 situation. That's the fix that's going to get you better enough to keep moving the needle in other departments.
Dr. Justin Marchegiani: Correct. Like in my line, we have Thyro Balance which is a—a really glandular uhm—nutrient thyroid support from a glandular perspective. And then we have that we have Thyro Replete which is nutrients for the conversion. So there’s some herbs that help with conversion like coleus forskohlii and ginseng and then we have the nutrients for conversion that I mentioned—the vitamin A, magnesium, copper, zincs, selenium—all of those—and tyrosine's. We wanna make sure all those are in there. Uhm so we hit it from all angles. I mean if we knew exactly what that missing like nutrient component was, we could hit it more practically. But it's too difficult to do that.
Evan Brand: Right.
Dr. Justin Marchegiani: You’re better off using multiple methods to hit it. That way the patient can get better faster.
Evan Brand: Agreed. And you mention the adaptogens. I'm so glad you did. We use those all the time. I take them every day in some shape or form, whether it's ashwaganda, holy basil, shoshandra. There are so many options and people ask, “Well, can I just take a bunch of adaptogens and fix myself?” Uhm— it doesn't work like that. You just want to use them as one piece of your toolbox. You still want to be getting to the root cause. So adaptogens are life-changing but if there's root causes, you can take all the adaptogens in the world and it won’t fix you.
Dr. Justin Marchegiani: I’m gonna take my ashwaganda right now—
Evan Brand: Perfect.
Dr. Justin Marchegiani: A little bit of immune support. But I mean, like yeah, if you're doing okay and you’re like, “Hey, Dr. J and Evan talked about some ashwaganda and some of these nutrients. I want to try it out.” Fine, go ahead. But if you're actively having issues that are you know, the symptoms that we mention here whether it’s on the hyper or hypo side, you really want to get someone on board to help guide you because it's never just one magic bullet. It is—it’s a whole bunch of things that we’re doing together. And the more chronic it is, the more you have a you know, that momentum working against you. You got overcome that inertia to stop that— that snowball effect and start pushing it back uphill. So, yeah, if you're in pretty good shape, fine you know just try some of these things. But if you're in not so good shape, you want to reach out, for sure.
Evan Brand: Yep. Cool. Oh, we got time for one more question. Uh James said, “It’s not a thyroid question.” He’s taking an antibiotic for root canal this week. “Will this affect the result of organic acids test and stool test if he collects the samples while antibiotics are still in the system?”
Dr. Justin Marchegiani: I mean if we’re doing some of the genetic base testing, it shouldn’t have an effect on it. If we’re doing a stool base to antigen-based testing, then it would.
Evan Brand: Right.
Dr. Justin Marchegiani: So you should be okay but we’re doing the G.I. map which is you know, what my go-to is. It should be okay according to the lab. I try to avoid it— doing it. So I would say in a perfect world, if it’s not gonna delay your treatment, I would say get to the antibiotics give it like a day or two to let it wash out and then do it. But if uhm— timing doesn't work out, just do it, get done.
Evan Brand: I would also look at Mercola root canals and read about those. I mean maybe you're too far down the rabbit hole and you can't avoid the root canal. But you know there are some other options you may have available if you've got a good biological Dennis maybe will sit down with you and say, “Okay, root canal’s option A but maybe there's a option B C you could look at too because we've had a lot of people to come to us with infected root canals and maybe Jessica can speak on this a bit. But I've seen it as a big needle mover for people.
Dr. Justin Marchegiani: Yeah. There’s a book by Ramiel Nagel that talks all about root canals. It is highly recommended. You take a look at it. Uh— fat-soluble nutrients, vitamin A, vitamin K are very helpful. Uh—oil pulling that kinda help extract any toxins that may be in there and you don't want a root canal you want to get the tooth pulled out. Uhm— you want to get an implant put in using biologically appropriate material. You don't want the gangrenous tissue still in the system without the blood flow. And the immune response to be able to get it is just a harboring place for a whole bunch of bacteria and viruses to hang out.
Evan Brand: Right. Yeah. Well said. So James, look into that. Maybe it's not too late. Uh—hopefully, you’ve got some other options you can pursue it’d be much— much safer and much healthier in the long term. That way, you don't have a hidden dental infection. There's a guy named, Simon Yu that you and I should reach out and interview. He’s over in St. Louis he talks a lot about hidden dental infections. I think that’d be a good show.
Dr. Justin Marchegiani: Okay. Absolutely. Hundred percent. So couple of things we wanna talk about. Oh, also carbohydrate, I think is important. Again, my bias is towards a lower carbohydrate template—Paleo template. And again, I hate the word “diet” because it assumes something is temporary and it assumes that it is fixed; where a template gives us flexibility and modification and may change day to day. It may change uh—meal to meal. I tend to be very lower carbohydrate my first two meals of the day and then after that, I may increase in carbohydrate at nights uhm—you know a bit of the starchy based. So I’m very strict during the day. It's high-quality. It’s— set—it’s 60 to 70% fats, the only carbohydrates are vegetables and then good proteins and then I go higher at night. On the carbohydrates side, maybe a little bit of sweet potatoes and some butter and cinnamon or maybe I have a—some dark chocolate or have couple more berries than I normally would. So there’s that component. So I always go lower carbohydrate to start because so many people are insulin resistant just because of the fact that we eat too much carbohydrate and were inflamed. So I always go lower carbohydrate to start and then typically, patient will do be better and will feel better because insulin resistance can affect T4 to T3 thyroid conversion, which can cause lower temperature. Now, in the double edge side of the fence, if people go too low insulin, they may also get poor thyroid conversion as well. So just like I mentioned cortisol has a major effect on thyroid conversion. Well, guess what? Insulin has a major effect on thyroid conversion. Type I diabetics— guess what? With low insulin levels coz of the autoimmune attack to the beta cells of the pancreas, they have low body temperature. So if you go too low carbohydrate, and this is for certain individuals not everyone, I know people are gonna be like, “But I’m low carbohydrate and I felt great and it reverse my low temperature.” I get it. Again, there are exceptions to every rule. There are tall Chinese people that play basketball even though they are more shorter in the population. There are exceptions to everything, okay? We got to get that in. So yes, there are some people that a low carbohydrate diet, the majority I would say would help partly because our consumption of refined carbohydrate and sugar is higher, but there are some people when they’re chronically load, they may increase that carbohydrate just a bit. And that ups the insulin a little bit which then helps that thyroid conversion. They’re like, “ Dude, my hair started to grow back better, my temperature’s better, my energy is better.” Boom! You at least now figure it out for you. So exceptions to every rule, figure it out. And uhm—if you feel great going low-carb, great, keep it there, hang out. But if you start getting some of those hypo temperature symptoms, then we’ll just ratcheted up a little bit. And I primarily ratcheted up starting at night.
Evan Brand: Yup.
Dr. Justin Marchegiani: They'll still get the benefit of keeping it lower carb during the day.
Evan Brand: Well said. I mean that's me in a nutshell. I went very, very, very low-carb ketogenic, I guarantee. I was probably ketogenic most of the time and then I started to get cold and so I added in some starch with dinner and all of a sudden my body temperature’s perfect now. I feel good. So uh—if I go too low-carb again, it may come back or if there's a huge piece of stress on my plate, the low body temperature may come back. But for now, I've been able to reverse this and been able to clear out all the infections with your help in terms of protocol a couple of years ago getting rid of all my gut bugs, plus supporting adrenals, getting the diet dialed in, getting my sleep improved, blacking out my room. All of those things are still important. So I hope this has been helpful. I gotta run. You've gotta run, too. Uhm—or are there any last questions that we could answer? I closed out the chat window. Uh there’s just one thing I want to say is it’s not about being higher carb or lower carb, have a –have a foundational template which you— which you go back to and then you can customize it. And then if you increase carbs, you can still get some of the benefits by having that first 20 hours of your meals relatively lower carb, higher fat, moderate protein and those last four hours you pop up a little bit and so you can still get some of those benefits. If you're like, “Oh, I feel better with higher carbs.” You can still get the benefits of the first 20 hours of your day kinda in that ketogenic state and then pop up the carbohydrates later. So it’s not an either or thing. We can kinda straddle the fence but we want to customize it. I don't give a crap if—if low-carb is your missing link and being low-carb all the time helps you, that's what we’re gonna do. If being low-carb and a little more high carbohydrate helps you out, I don't care. I’m all about the results and not about what tool I have to use to get the job done.
Evan Brand: Yup. Well said. For me that looks like the breakfast like a pastured sausage, maybe a handful of macadamias, maybe a handful of organic blueberries. Lunch—I probably do some leftover steak and veggies like a big thing of broccoli with some butter. Dinner— that's when I may do some type of pastured meat, a little bit of some veggies and then starch, so it could be a medium-size baked sweet potato, butter, cinnamon. That's all it takes and I feel good. So just to kind of give people an idea what is that look like. That's what it looks like.
Dr. Justin Marchegiani: Totally. That’s great. And a couple of questions here. Uh— Stephanie talks about menopausal women with lower estrogen and a low estradiol vaginal tablets. Well, this is interesting because typically low estrogen can cause hot flashes. And why does that cause hot flashes? Because typically the FSH and the LH starts to rise in the pituitary which is that signaling hormone trying to yell to the ovaries to make more progesterone and estrogen. So when LH and FSH primarily FSH goes high, that can create some vasodilation effects and create the hot flashes. So by giving a little bit of thyroid—giving a little bit of uhm— female hormone support, we can drop down that FSH then we can also modulate the receptor sites with some herbs as well to help with how flashes. Whether we use maca, or we use dong quia, or black cohosh or raspberry root, or shepherds purse. There’s different nutrients or herbs we can do to help modulate that. So again, you could still have hypo, low thyroid issues, but have menopausal issues because of the low estrogens, which could drive the hot flashes up. So it’s kind of a conundrum. The hot flashes may—may overshadow this low thyroid thing over here. So as we get the female hormones fixed, you may notice the low thyroid comes back later on because it's just not a secondary issue and the primary issue is the menopause. Once that's ruled out, now this one comes to the surface.
Evan Brand: Got it. Well said. We should probably do a whole show just on low estrogen if we haven't.
Dr. Justin Marchegiani: I think that’d be great. I mean, I see estrogen dominance is a big problem.
Evan Brand: Right.
Dr. Justin Marchegiani: Where estrogen –the ratio of estrogen is higher than progesterone, right? So progesterone should be like this 25 to 125 times more than estrogen. But if that ratio starts to creep up where estrogen gets higher, that’s estrogen dominance. The problem is a lot of people, though, where that ratio—they’re estrogen dominant, progesterone’s slow but estrogen is also low. So they get this estrogen dominant, but also low estrogen sums at the same time. So it’s kinda like this conundrum. It’s like this little tug of war that’s happening there.
Evan Brand: Wow. Put it on this to do list. It sounds like it’s gonna be a fun one for us to dive into more. And I've probably got some stuff to learn from you on that topic as well.
Dr. Justin Marchegiani: I think it's great. Well any last questions, comments, or concerns, Evan?
Evan Brand: No. I think this has been good. People, you got to get the testing run because if you don't test, you've guessed. So if you’re trying to figure this out on your own, even if you're not working with Justin or myself, then get the test run. Find a functional medicine practitioner they can take care of you. We are accepting new clients, so if you do need help, feel free to reach out justin health.com evanbrand.com We run these labs on all of our clients because it's the foundation. We've got to have the data. We’ve gotta have the puzzle pieces on the table; otherwise, you can’t move the needle. We could throw a bunch of random stuff at you might help, can’t hurt, but we want to get you better. There's a systemic process that we do step by step by step to take you through this. So happy to help. Reach out if you got questions and thanks for tuning.
Dr. Justin Marchegiani: Oh! One last thing, man. I forgot to add. This is so important. Low calories.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Just not eating enough calories will cause low body temperature. It’s shown to cause a low level T3. Now this is important because if your diet is 25% crap Ola and let's say you're eating 2000 calories a day and then we switch you over— we switch you over to a uh— autoimmune kinda Paleo template, but you're only able to—to—to switch over 75% of your diet because you don't—you don't have enough you—you can't replace all the crap that you're eating with the good stuff, right?
Evan Brand: Right.
Dr. Justin Marchegiani: Because if you’re eating a whole bunch of crappy carbohydrates and stuff and then you replace it with a whole bunch of really good vegetables or lower sugar foods, well guess what? You’re probably didn't replace the calorie amount either. So now you got this 25% calorie deficiency. So now instead of having 2000 calories, right? Now you're having 1500 calories and maybe metabolically you need 2000 calories. Now you’re 500 calories in the hole which means your 500 calories deficient of various nutrients. So now your metabolism goes low coz there’s less fuel. That's important. I see a lot. So you gotta work with someone that really can make sure you're exchanging the foods and you're getting enough calories as well. Coz calories equal nutrition. if you're eating real foods.
Evan Brand: I'm glad you mentioned that. That’s such a simple but common issue. If you're going AIP, you are going Paleo, you're eating real foods, you could have an entire plate full of broccoli and it may only be 50 calories.
Dr. Justin Marchegiani: Exactly.
Evan Brand: Yeah. Dude, great job. Way to kill it.
Dr. Justin Marchegiani: And of course, the infections like you mentioned can really suck down the energy. Of course, acute infection, you know, you’re causing a fever, right? Because the immune system’s trying to up regulate itself because a lot of the bacteria and crap there uhm—they’re like—they’re mesophilic. They—they thrive in a medium temperature. So when you go a little bit higher, you can actually kill them off with a higher temperature. But these chronic bugs can really deplete the energy the body and create this kinda lower temperatures as well. For sure.
Evan Brand: Yeah. And I went—I went to low-calorie for a period of time, not intentionally, not on purpose. It just happened. I was eating meats, I was eating veggies and I track my calories for a few days and I was eating m—and my activity level and all that. I was probably 4 to 600 calories deficient. So just added in an extra tablespoon of butter here and there, half of an avocado here and there, handful of nuts and seeds. And I was right back up to where I needed to be.
Dr. Justin Marchegiani: Like here’s a seesaw right?
Evan Brand: Yup.
Dr. Justin Marchegiani: So if like carbohydrate is here, if carbs go lower— this is fat over here. The fats have to go up.
Evan Brand: Yup.
Dr. Justin Marchegiani: If you keep the fats here, you keep the fats on—on this side low, and drop the carbohydrates, that's where the problem happens. The fats also have to go up. That’s the biggest issue. Proteins typically stay in the middle. Typically, proteins only go up if you’re doing a whole bunch of protein powders because proteins and fats are intimately connected. Uh so if you’re eating real whole foods, you know, it's hard to get just proteins in whole foods, unless you're doing maybe like venison or rabbit or like boneless chicken breast. But if you’re eating full fat foods, you’re gonna get fat. And then if you’re adding fats to your vegetables, you’re gonna get extra fat without the protein there as well.
Evan Brand: Yeah.
Dr. Justin Marchegiani: So keep that at the back of your head.
Evan Brand: Perfect.
Dr. Justin Marchegiani: Anyone listening here, give us comments below. Give us some shares. Give us some likes. We want to hear thoughts in the comment section. If you’re listening to us on iTunes, that's great. Click below and subscribe to our YouTube channel. You can see Evan and I’s mugs going back and forth in our little combos here. And then you can give us some comments below here on YouTube. We love the see the feedback. And Evan, hey man, you have a great day. We’ll talk soon.
Evan Brand: Take care.
Dr. Justin Marchegiani: Take care. Bye.
Evan Brand: Bye.
References:
https://justinhealth.com/products/thyro-balance
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