Skin Issues from Die-Off and Food Reactions | Podcast #249

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Food has a major impact on the microbiome, and the microbiome has a major effect on the skin because the more we put stress in our gut, our body will use a major means of detoxification to deal with that stress and inflammation. Inflammatory foods have the biggest effect on the skin.

Dr. Justin and Evan talks about food reaction or die-off reactions affecting the skin. Our skin is also sensitive to food but it depends on what do we eat, where we eat, and a lot more. Read more about it here.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

02:30 Inflammatory foods

12:07 Histamine

17:13 Environment on eating

27:17 Effects on skin with regular bowel movement

35:31 Go chemical-free


Dr. Justin Marchegiani: And we are getting ready to go live here in just one second. And we are live. It's Dr. J. Here in the house. Evan, how are we doing, man? Do you have a good weekend?

Evan Brand: I am doing wonderful. We finally got some rain. We've been in a drought for like a month. The trees, instead of turning like yellow and orange, they're just going from green to dead. So we finally got like tons of rain last night. I was in fresh water in my pond. So everything is good.

Dr. Justin Marchegiani: That's great, man. Excellent. I know we chatted pre show that we were going to talk about food reactions and or die-off reactions affecting the skin. I think this is really important to see a lot of patients that may have skin issues, whether it's some food, whether it's from got bacterial imbalances and whether it's from addressing or knocking down gut bacterial imbalances. So usually everything interplays. I have an interesting study I printed off over the weekend and it's all about the food and food inflammation affecting the gut microbiome. And we know that food has a major impact on the microbiome. We know the microbiome has a major effect on the skin, because the more we put stress in our gut, our body will use our major means of detoxification to deal with that stress and inflammation, whether it's to the kidneys and out the urine, whether it's out the gut, whether it's from the guts, from liver, gallbladder into the stool and out the gut that way or through the liver. So we have three major pathways. And then, of course, the fourth one is going to be skin skins. And to be the fourth one with exception of breath, you know, breath breathing, you'll have some there, but the skin will be the next one. And the more other means of a toxic location are stressed, the skin isn't to be leaned upon more. So the first thing is to work on other systems that detoxification less that lessen the stress load of things going in. So we have input and output skin is primarily use on the output side of the equation. So the first thing we can do is do things to support the output, but no one root cause is decrease. All the things coming in on the input and we'll kind of break what that equation looks like. Input output down.

Evan Brand:  Yep. So in other words, the skin should not get involved with detox, but it can pinch hit, if you will. If it has to. If the other systems are so compromised and then you see a skin issue, you know that you've got some work to do.

Dr. Justin Marchegiani:  Exactly. So I would say the first thing is inflammatory foods are going to have the biggest effect on the skin and some of it's not even detoxification. Some of it just can be autoimmune. And just through general inflammation in the skin, cells can be affected. So we can have reactions, dermatitis, various dermatitis, which just means skin inflammation. It's hilarious. People go to the dermatologist and they're like, oh, you have a dermatitis as well. I know that. That just means my skin's inflamed. Of course, it's red. It's puffy. I know it's inflamed. I don't need you to just give me the Latin version of that same description. Right. It's crazy. So, yeah. So you have various dermatitis is awful like colitis, which is the follicle is inflamed. Right. And then the next thing would be various autoimmune things which could be rosacea, which now is an autoimmune component, eczema, autoimmune component, psoriasis, autoimmune component. And then you have different rashes that could be fungal or bacterial in Batigo or ringworm could be bacterial and various tinnie versus color or in the scalp you may see separate dermatitis or cradle cap or dandruff. These all have potential fungal bacterial implications. And psoriasis and eczema and rosacea. I had significant rosacea as a child. And then in school, I mean, I've notarization now, but that was strongly tied to gluten for me. So food can have reactions from an autoimmune standpoint and then just from driving inflammation. And then the next thing foods and do is like the scientific article that I talked about earlier and has a major impact on the gut microbiome and that has a major impact on gut permeability. And the more permeable the gut is, the greater chance of more autoimmunity. But the greater chance that food will have more inflammation in the body. Because now that undigested food particles are actually getting into the bloodstream and creating more inflammation. And let's not forget, I want to highlight one thing. When you actually swallow food, it's in your tummy. It's actually still considered outside of your body. So then when you start having more gut permeability and then undigested food particles get into the bloodstream. Now there's a greater chance of more inflammation in the body. Go ahead.

Evan Brand: Yeah. So we should probably mention histamine as part of this. Now, we've done a whole show. We did a whole podcast on this, which I think was really good all about histamine intolerance. But I just want to briefly mentioned that part of this whole cascade of problems that you're talking us through histamine could be a variable or a factor. So if you've got this eczema rosacea piece that could be worsened and if you have a histamine intolerance, which histamine intolerance, once again, kind of like the dermatitis issue that you discussed, that is a byproduct of something. Histamine intolerance doesn't just exist in a vacuum. It's happening because of something, so you've got to work backwards and figure out why are you having this reaction in the first place? It's not just go on a low histamine diet. That may be part of the solution, but why do you have to do that?

Dr. Justin Marchegiani: Exactly. I'm going to go pull up here just a couple of pictures that y'all can see. And again, if you're using Google image to, let's say, kind of follow some of these skin reactions, just make sure you type in like mild or whatever, because Google image tends to show you the most pathological extreme version of most of these conditions. F.Y.I So you can see here is just some you take care of some hives, you can see kind of these raised little circles here. These are your typical hives, so you can see that. And then of course, your tenia tinnie aversive color. I'll just type in mild so we don't get the crazy extremes. So typically you see almost a little bit of hyperpigmentation happen. So this is your skin, it's actually lightening up. That's tenia. It looks very similar almost to vitiligo. So vitiligo goes in autoimmune condition. That's what Michael Jackson had that destroys the pigment. So vitiligo mild. Let's go look at that real quick. That basically destroys the melanin, the skin that's autoimmune. But if you look at vitiligo, that's actually very similar. So you can see kind of some of that hypo pigmentation, right?

Evan Brand: It's a lot more common, man. You never see anybody with vitiligo. Now, almost every time I go out in public, I see somebody like, oh, that just tells you the world's become more toxic. There's more compromised gut barriers.

Dr. Justin Marchegiani: Yeah. And then you can see here, you know, various tenia here where it kind of is a little bit of hypo pigmentation. That's pit psoriasis versus color similar. Again, we're just kind of going over the common things. We have the various infectious rashes. And then, of course, we have eczema and dermatitis, which are going to be eczema verse, I should say, psoriasis, which are similar to autoimmunity. So you could see typically here we go right here. So you can see psoriasis a little bit more raised and flaky eczema is a little bit more flat to the skin, but they look very, very similar. You need a good dermatologist to kind of help diagnose that. But the nice thing is because it's autoimmune. You know, we're gonna be doing similar similar things to fix it.

Evan Brand: There's a good versus right there. Right there. What's it say? Go look right there. There's like a little. That one. Yeah, that one.

Dr. Justin Marchegiani: I'll do that next. So you can see psoriasis a little bit more flaky and white eczema a little bit more red.

Evan Brand: Here's our friend, Dr. Jackers pop up in Google Images. Good. Good job, Dr. Doctors. All right. Here. Yeah. Image that that red one that you're on right now.

Dr. Justin Marchegiani: That's this one here. Oh, good. Oh, yeah. Yeah. Great. Yeah, that's good. Awesome. Chronic. Lifelong common adult. Autoimmune. The thick. Silvery scales. So it's really that the silvery ness and then the Eczema's a little bit more red. All right. And then if they had any actions, can cause that as well. I know with with your wife as well as mine, eggs were a big reaction from my kiddos down the breast milk side. So keeping that in mind is really helpful. Sometimes autoimmune, even when a mom's breastfeeding can make a big difference with any other skin issues you wanted to look at while we're here.

Evan Brand: I think those are the most common we encounter.

Dr. Justin Marchegiani: I'll say one more thing. It can't those is not your is interesting because a lot of skin stuff that we'll talk about in a minute on those too mild so we don't get the crazy stuff. As you'll see it, a lot of times you'll see it. It's very common in African-American women. But yeah, and I think it's because they're just more sensitive. Carbohydrate wise is a lot more like insulin resistance issues in the African-American community. But obviously it's everywhere now. But you'll see it a lot. It's just a pigmentation issue around the back of the neck or like you'll see it in the armpit area right in here. Here. That's from hyper insulin. That's from hyper insulin. So too much carbohydrates are going to see a lot of that. Why is that important? Because if you're consuming too much insulin. Insulin is actually going to drive up your body's sebaceous glance and it's gonna cause you to make more sebum and that sebum is actually had impacts on your oil in your skin and that oil is going to feed the bacteria and that bacteria can cause cyst and acne and skin issues. So it's really important when we look at food, we keep one, the insulin levels down or at least within what you need. OK. If you're more insulin resistant, that means you have to keep the carbohydrates lower. More vegetables, less fruit and starch. The next one is looking at the inflammation component of the food, keeping the inflammation down. Could that be being autoimmune? Yeah. If you have autoimmune genetics and you're seeing skin issues popping up that have an autoimmune connection like the ones we just talked about. Yes, some people paleo is enough because paleo, which is cutting out just grains, legumes and dairy, maybe allow some butter. It's focusing on Whole Foods, meats, vegetables, maybe some fruits, maybe some safe starches, some good fats, except the junky refined process to make a success. That's usually enough for most people, but some have to go to that paleo template to point out that auto immune template to get that next inflammation buffer.

Evan Brand: Yeah. Like nightshade for were an issue for me for a while, surprisingly with my skin because I would do some of these sauces, you know, just combos of like Jalapeno peppers and tomatoes and all that. And I would have mild rashes that would pop up on my face when I had gut infections. I couldn't do salsa for quite a while. So I was also probably eating it with organic blue corn chips at the time. So it could have been corn as well.

Dr. Justin Marchegiani:  Could have been corn. That's why you got some better brands out. Now, the CSA brand makes a good yuga cassava based flower, which are the same things that can be excellent and it's a safe tuber and it's gonna be grain free. So you have options like that. So we always start with the diet. Number one, we may do the autoimmune 2.0 next. We also have to look at the gut because gut permeability through either inflammation in the food, poor digestion or despotic bacteria. H. Pylori, various parasites. All those things can make a big difference. Knocking those down and depending on what comes back, we're gonna create a protocol to address those different things. So of course, we're not going to go into each things with other podcasts to deal with that. So feel free and take a look at any of our gut bug or Cibo or parasite podcasts. More info. We'll try to put maybe some links in the references, but keep that in the back of your head. Any any thoughts on that?

Evan Brand: Yeah. We'll think about when you and I first became friends. About five years ago, my skin was a mess and I had gut bucks. So I. Yeah, like you said, we're not going to go super into detail, but my diet was good. I was paleo for 3 to 4 years. My skin was still messed up and it was because of my gut bugs.

Dr. Justin Marchegiani: It had three different infections in your gut that were big. Yep. Yep. You have three different big infections. Next thing I wanted to highlight on top of that, what you mentioned, histamine now histamine, the you to carry your stuff, the more inflammation in your gut. Remember 80 percent of your immune systems in your gut and your gut than your mouth gastric. Associated lymphoid tissue and in the stomach. And then mucosal associate olympe with tissue in the small intestine. The more those immune cells are revved up, it's gonna be the Basia fills the basia fills when they go outside of your thinking, outside of when they go outside of your blood, into the tissue they create. Matt, they turn into mass cells essentially, and those mast cells produce histamine. So the more your immune system is aggravated and revved up, the more those base officials will move into and migrate over to mass cells and produce histamine. So think of histamine as a natural byproduct of inflammation.

Evan Brand: Makes sense. Yeah.

Dr. Justin Marchegiani: And histamines vasodilators, it opens things up think about it, right. If you bump your eye or bump your head. What happens? Things swell. And why is that happening? It's happening because the swelling visodilates allows the immune cells to aggravate and calm down the inflammation. The problem is, if it's not an acute response, meaning I bought my elbow, it's isolated if it starts to become a systemic issue. Well, now you have systemic histamine issues and now that may manifest as you carry a hives on your skin. It could manifest as tonight's headaches, right? My migraines, dizziness, those kind of typical Hy-Vee kind of symptoms. And so you really have to get everything under control and maybe even look at cutting out histamine on top of everything else. But we don't go there unless we've already done everything else. And the clinical presentation lead us in that direction.

Evan Brand: Yeah. Like you mentioned, a lot of times, we don't have to go there because we're addressing root causes and mold is a big trigger, too. I learned that firsthand with histamine. I was having tons of Marcel slash histamine reactions, just weird things, weird symptoms I'd never had before. Now that I've started to detox mold, I'm having less and less what I would consider histamine reactions. And I'm also doing some herbal antihistamines that I continue on a regular basis that really, really helped calm things down. So I'm glad you made the distinction between histamine is a good thing, but when it becomes systemic histamine, that's not a good thing.

Dr. Justin Marchegiani: Yeah. Typically anything acute is OK because it's designed for a reason. It's the chronic out of control reactions. We want to really kind of attenuate and calm down because those are the things that are going to be driven by, you know, diet and lifestyle and chronic stressors. So the chronic stressors, we want to make sure they're on our radar so we can neutralize them.

Evan Brand: Yep. And testing is key. So if you've been to your as you mentioned in the beginning, just like my wife, we took her to a dermatologist and they said, oh, yeah, you know, this is this or this is just a generic, you know, fancy term and didn't have any root cause measures, didn't talk about changing personal care products, didn't talk about the diet and talk about food allergies. None of it. It was just, yep, your skin sucks. Here's some steroids topically. Same thing with the gut. So if you go to a gut doctor and they say you have gastritis. You're no closer to the answer than you were when you walked in.

Dr. Justin Marchegiani: Exactly. It's hilarious. People go in, they just get the Latin terminology like, OK. Like, I go to the orthopod. My knees hurting. You have arthritis in your knee? Well, of course, that's his joint inflammation of the knee. Right. The root cause is not talked about. So regarding skin, sort of, especially with people that have diets to be the first thing to get. And you have to really be 100 percent on the diet to see how much improvement you're going to get. Now, there is more nuanced stuff. Sometimes you're going to have issues where eggs or nightshade or nuts could be a problem. And that's where if you're not getting the benefit of Paleo 1.0 or just the regular paleo template, this is where an autoimmune template would be utilized next. So first level is paleo. Second level is auto immune.

Evan Brand: Gm because of the chocolate to the chocolates kind of in that same category with chocolate or.

Dr. Justin Marchegiani: Coffee or coffee too, with histamine. Most don't have to go to that level to get the benefit. So people that are listening, you don't have to do autoimmune first. If you know you have an autoimmune issue already diagnosed, then jump on the autoimmune as a shortcut.

Evan Brand: Yep.

Dr. Justin Marchegiani: Number two, make sure you're digesting and breaking down your food and your chewing your food up good enough. Make sure you're chewing your food off. You're not hydrating with food, with meals. I mean, you can have a couple ounces of water as well as some pills. That's fine. But you should not be hydrating and trying to actually consume water during those meals to hydrate. Do that 10 minutes or so before two hours after and then make sure you're really dialing your enzymes and acids so we can better break down those foods. A lot of people in a lot of gut bacterial issues, they create stress in the gut that stress and inflammation in the gut activates the sympathetic nervous system response which will decrease your own internal enzyme, acid and gastric secretions because of the internal stressors. You could be on a beach totally in a Zen like state, but your microbes may be stressed.

Evan Brand: Yeah. Let's talk about the environment of when and where you're eating. If you're driving a car trying to eat a chipotle, a burrito, that's a terrible idea. If you're in for me and I think other people experience the negative effects, but maybe they're just not cognizant of how it's affecting them. Noisy restaurants. If you go out to a nice steakhouse. But they got freakin a million people there and they got music cranked up so loud. You have to yell to talk to the person across the table from you. That's a sympathetic stressor. I don't care how nice the steak is. You're probably not going to digest it optimally. Think of our ancestors when they were eating a zebra. They're sitting on the edge of a cliff. You don't hear friggin anything except the birds. So it's just not natural to be in a closed building with so much noise where your body is like, alert, alert, alert.

Dr. Justin Marchegiani: Yes.

Evan Brand: You're turning off enzymes and turning cortisol.

Dr. Justin Marchegiani: And there are things you could do. I mean, you could put you could put on some meditation, music or some some by neural beads, something like that. You can work on your breathing and you could kind of like kind of control everything coming at you input wise. That would help. You could focus on gratitude. All these things activate the sympathetic s deep breaths in all breathing to the nose to activate the parasympathetic. But yeah, one hundred percent control the environment. Number two, you don't have that much control over the environment than you do extra things regarding the music. What you're focusing on, the breathing, the breathing is the biggest thing. Anytime you get into a stressful situation, program your body to just breathe deep and breathe through the nose, because the first thing that happens when stress occurs is shallow breathing coming from the mouth and chest. So if you know that and you can just control the breathing and make it come to the nose and keep the belly moving and still do those four to five seconds in and out, then you're gonna be set. You're going to have a big control on your sympathetic nervous system.

Evan Brand: That's good advice. Yeah. I think I forget that sometimes, you know, I hear like the super loud environment. I'm like, oh, god, it's so loud in here. And I probably jump into sympathetic. I can probably try to counteract it better, but I'd still rather sit in the middle of the woods and eat a sandwich, you know?

Dr. Justin Marchegiani: Hundred percent. Hundred percent. First thing that happens. Is anyone listening? Just focus on the breath. Breathing in through the nose. And then you can go up to the nose to where, out to the mouth. That's fine. The most important thing is into the nose. That's the most important thing in about four seconds in hold for a second. Four seconds out. Hold for a second. That's perfect. That's great. Now, enzymes, acids, controlling the environment, parasympathetic versus sympathetic nervous system response, right? Parasympathetic. So the break and the relaxation, sympathetic side, the gas, the acceleration that go, go, go, go, go. So we gotta make sure that's under control. Got to be 100 percent in the diet. Start on paleo. One point I'll go to auto immune 2.0 and then I would say look at what's going on with the gut as you address that, make sure we have detox support in place. If we're having reactions, detox support could be just adding the IRBs in very slowly so we don't kill things off too fast. The more debris we kill off, it's like the equivalent of putting imagine your detoxification or your immune or your lymphatic system is really poor or not doing well. That's like me taking my coffee cup and like saying, hey, this is your trash can like put your trash from your house and that this is your trash can. So we know if you do that, this is gonna be overflowing before the morning's over. Right. So that overflowing is gonna be symptoms, skin issues, headaches, joint pain, all of those things. So number one is we can take the cup up and change, you know, take the garbage out. A lot of times to make sure it doesn't overflow. And we would do that through lymphatic support. We would do that through titrating the herbs. And very slowly we would do that and through binding support. We may do that through sulphur, amino acids and or glutathione or extra antioxidants to support phase one or extra for Amano's for phase two. It would depend on each patient so we can taper it up so we don't put too much garbage in. Number two, we can support the lymph, which essentially allows things to move better and then support that detoxification. And as that gets better and we support those systems, it's like we're kind of bringing in a new garbage pail instead of the cob. Now we have the bigger mug and then we have the small garbage pail and the bigger one. And so we kind of upgrade each time as we titrate things up and support the limb, support the detox, support the binding support and elimination.

Evan Brand: Yeah. And it's always a little bit of a seesaw, right. Like when you say it like that, it sounds so easy. It's like take lymph. Take Lemp support. IRBs take liver support. IRBs take glutathione and you'll be in good shape. But the truth is, when we're working with people, it's highly individualized because depending on how long you've been sick, depending on how many layers you have to your illness or your symptoms, you may not be able to handle it. For example, if I do too much glutathione, I feel bad. But if I do none, I feel bad. So I think of it like it's like a tightrope is kind of my analogy. So it's like if you do nothing, you fall off the tightrope to the left and you're symptomatic. If you have it dialed in perfectly for you, you're walking the tightrope to the finish line. But if you do too much, you fall off the other side. And so like as people get better when we're doing follow up calls, we may be tweaking the dose. Whereas before they could only handle 2 capsules of a liver support complex with milk thistle and beet powder and artichoke and all that. But now they can handle four capsules. And so it's not where we want you to just like go to Whole Foods, buy a liver supplement and expect it to make all your problems go away with your skin. You've really got to have a coordinated plan. And as you get better or as you get worse or new stressors come in, you've got to back the dosing down. So like for me, when I was going through gut work, if I was really stressed, I couldn't handle the full dose of anti parasitic IRBs. I had to cut it in half. And then when I was less stressed, like you and I talk about this idea of like do things on a weekend when you're not a stress and try supplements, it's the same concept with this other of the detox pathways.

Dr. Justin Marchegiani: One hundred percent. So it's pushing catch, right. Push, meaning we're stressing potentially stressing out already talk system through various killing and then catching is we're eliminate we're supporting our lymph ah detox, our phase one, our phase two to and making sure we're actually having regular bowel movements. We're making sure all these things are happening so we can eliminate things. And when we talk about binders, binders aren't perfect. Imagine you have a whole bunch of iron filings on the table and I just take a magnet and I just kind of pull it through. Will the magnet grab every single iron filing there? No, there's going to be some stragglers. Right. But it's going to grab a good chunk. So think of that as like charcoal or bentonite clay or activated charcoal or zehle light or citrus, packed ends or corella, whatever binder we use for whatever that iron filing is, there's got to be some debris left behind. That's why we want to do multiple doses the day and we want to taper up. So we're not overwhelming our system with too many iron filings, so to speak. The iron filings be being reminiscent of the debris that's left behind.

Evan Brand: Yeah. So just to say it the other way, you can make yourself worse by doing too much. Binder's right. It sounds really sexy. Let's bind to the toxin. I mean, it's going to take tons of charcoal. Mm hmm. I made myself worse. I was doing like six caps. A child. You couldn't hold more things out. You could pull more things, that's why we taper into everything. Yeah, I did like six capsules of charcoal for a while and I felt amazing. I was like a new man. And then I went up more like eight or 10 capsules a day and it was too much.

Dr. Justin Marchegiani: I got to remember, you call me that night. You're like, man, I'm feeling really dizzy. And.

Evan Brand: I think that might have been the day I did a double dose of glutathione.

Dr. Justin Marchegiani: That was good. And you're right. I think I talk all about maybe doing more charcoal to counteract that. Yeah. I remember the charcoal.

Evan Brand: Same thing, though. I like in that situation, charcoal was the remedy. But before charcoal was the was the provocation, if you will. It was the bad guy because I did too much in my analogy of that. One is like you have a bad girlfriend and you're kicking her out of the house. And so she's like taken the pictures off the wall and throwing them down the hallway like there's this collateral damage of you kicking her out. Same thing with the toxin when you're dragging the toxin out, especially if you have a permeable gut barrier. I think if it is like these toxins reabsorbed back into the bloodstream, like the goal is pull them through the intestinal tract. But if the intestinal tract is compromised, you're gonna have re absorption. So I can't prove this 100 percent. But my theory and thought on this is that if your gut barrier is in better shape, we measure the secretory IGA. The gut is less leaky or not leaky, hopefully. And theoretically Binder's would be more tolerated versus someone where we see a super leaky gut. Binder's may make them worse. They may need to titrate very slowly. What do you think? What's your thoughts on that?

Dr. Justin Marchegiani: I think you're 100 percent right. Everything you have to ease into it. And that's why we always start with diet and hydration digestion first, because that's where most people's stressors are coming from. And we want that foundation kind of just dial them, because if they're able to digest and break down their food better, then they're extracting the antioxidants and the B vitamins and the sulfur amino acid from their food. And if we're breaking it down, then they're getting those nutrients in. There's less stress that the food kind of fermenting and rotting behind. And then we're making sure that they're having regular bowel movements. So we're eliminating toxins and then we're making sure we're getting enough hydration. The solution to pollution is dilution. And then if we're also more sensitive, we can lean more on the talks vacation from sweating. We could do infrared near infrared sauna. We could even do just some gentle red light therapy, which can help with skin issues, too. On the outside, it can really help reduce the inflammation of the active skin lesions. These are really good ways to kind of start things out. We can progress from Paleo 1.0 to autoimmune 2.0 if we need, and that's probably one of the first good steps. Any any feedback on the foundation steps, Evan?

Evan Brand:The part about pooping regularly. You briefly mentioned it, but that could be literally the biggest piece of the puzzle is simply just addressing chronic constipation in someone. If they've been doing diuretics like coffee and teas and they're not getting enough water, I can't tell you how many times you and I've seen people's skin improve just by getting them to go poop two to three times a day versus they used to poop every other day or some people once a week, which is just scary. It's like what you're eating three times a day for seven days and only one poop comes out per week. That is terrible. No wonder he got bad skin.

Dr. Justin Marchegiani: Oh, I know. There's a famous gastroenterologist named Match knock-off mecs knock-offs quoted his famous quote, As life and death starts in the colon. And part of that it is just being able to have regular BMR and move your stools at least 12 inches a stool a day. If not, you are gonna have what's called auto intoxication, right? Auto meaning self intoxication, self poisoning from not pushing the debris out of your body. That's like not taking out your garbage for a couple of weeks and the flies and maggots start to come home. The rest of the speech speak and that's not good. So we have to make sure those foundational things are done. I can't underestimate water, right. The solution to pollution is dilution so that 10 times fast. The solution, right. The solution to pollution to toxins is dilution. So you deluded down. Right. So more water helps make everything go round. Right. That's really important. Let's talk about lymph. Some a big fan of making sure the lymph is supported. So there's various tinctures that we use professionally, different lines that we use. There are some individual IRBs that we can do. low-hanging fruit is going gonna be ginger. Ginger is really, really excellent with lymph. So is red roots and so was burdock. Those are my two or three favorite kind of limp supports the kind of keep things moving outside of various tinctures that we use.

Dr. Justin Marchegiani: I've got limb support right here on my desk. So one that I didn't even know about maybe a year ago was Cleaver's. And so my lymph blend is, yes, red root, which is also great for the spleen. We love using Red Root for Lyme and co-infection. Eckard Neisha would also create a sedative. Yep. And then we've got the Cleaver's. And then this other one that I didn't know about is Baptista like like you're getting a baptism by your root. And so. Here's a funny story real quick. I think stories are helpful because like we get an educating mode, then I think people like story time. OK, so, you know, I had tested for some bartonella antibodies and for Busia and so I was playing around with some of these Bartonela and bebesia herbs. And within about half an hour of doing that, I got a super bad headache. And I thought, you know what? I wonder if this is lymphatic related. Maybe I'm killing off these pathogens and my lymphatic system is overwhelmed. So what did I do? I took three shots of lymphatic blend of verbs. And guess what? The headache magically went away. I didn't do anything else. I didn't drink a ton of water. I didn't take charcoal. All I did was go from taking the Basis Bartonella killers to take an extra lymphatic support. And the headache disappeared. And I was like, oh my God, this is a miracle. Like the lymphatic system is super underrated. And I think it's the missing component to a lot of people's detox protocols. 

Evan Brand Doing that I got a super bad headache and I thought you know what. I wonder if this is lymphatic related. Maybe I'm killing off these pathogens and my lymphatic system is overwhelmed. So what did I do. I took three shots of lymphatic blend verbs and guess what the headache magically went away. I didn't do anything else. I didn't drink a ton of water I didn't take charcoal. All I did was go from taking the BCA Barton fellow killers to take an extra lymphatic support and the headache disappeared and I was like Oh my God this is a miracle like the lymphatic system is super underrated. And I think it's the missing component to a lot of people's detox protocols. 

Dr. Justin Marchegiani: Interesting I 100 percent agree. By the way the Baptisia herb is the same thing as wild Indigo my g i clear too which is my H pylori killer I have wild Indigo or Baptista in there and then also my g clear for which is my bigger bug killer. I did formulate that with burdock root. Burdock root is very very very good and then some of the female hormone herbal supports will actually have red root in it because red fruit is excellent for limp so women premenstrual t into menstruation may get a little bit more swelling little retention red you can be helpful and the next one that's really good is poke root poke root is really good especially for mastitis poke root is excellent. 

Evan Brand: So here's some here's something interesting when you start to up regulate these detox pathways and you up regulate lymphatic drainage your pee smells way different I don't know how much you've played with lymphatic support but when I start bumping up limp support and liver support the urine will just smell way different especially red root because I believe red root specifically is one of the ERs that helps to drain the excess ammonia and a lot of these bacterial pathogens you and I are talking about we can measure the robotic acid on the organic acids panel and that'll show ammonia at all. So when you drain this stuff out you can smell the change like if you're human pee smells like Cappie to me you know you're on the right track of draining that excess ammonia out of your system. 

Dr. Justin Marchegiani: H pylori will also convert some of the protein metabolism into ammonia as well and ammonia is very alkaline too so it actually will disrupt digestion. That's part of the reason why or how H pylori makes you gut less acidic because part of their urea metabolism from urea to urea right H pylori makes this enzyme called Ureae. You know it's an enzyme because of the ASC at the end and ureae hits the urea which is from protein metabolism and spits off CO2 and ammonia that ammonia is got a p h of eleven so that decreases your stomach acid levels makes it less acidic so digestion goes downhill and then you have higher CO2 levels hence the the CO2 Urea breath test will come back positive for H pylori so yeah one hundred percent and typically I'm not a big person that has a lot of die off my big die off symptom will be a little bit of fatigue and a little bit of skin stop but some people have significant die off issues and the more your health is kind of gone downhill the more you may have die off symptoms and he's gonna have to be aware of that. 

Evan Brand: What do you say the longer you've been sick too. I think the timeline of time is a big role. 

Dr. Justin Marchegiani: Yes because I think it takes time to get your immune system hyper reactive like that takes time. Yep absolutely. Anything else you wanted to work on addressing now. Before we go into some questions. 

Evan Brand: Well why don't we just mentioned the testing then that we would be using to investigate these issues. There's not like there's not a lymphatic test to measure your lymphatic system. You know you can really just look at symptoms you can look at any potential edema as you can have people do like self lymphatic massage and if they get better or worse from it you know lymph is a factor you've got swollen lymph nodes you can look at some of the clinical signs but there's not like a test where you go and pee in a cup and it says your lymphatic are not working we're primarily going to be looking at other markers to indicate the system as a whole select organic acids testing is always part of our workup genetic stool testing is always part of the workup blood testing can be helpful because you mentioned some of the specialized white blood cells we may look at those to gauge the immune system overall but without the data you're really just guessing and checking. So that's why I say don't just buy a liver support figure out what the heck is going on first. Are you recycle leading toxins like are you. Are you bringing toxins through an open loop where you're getting them out or is it a closed loop like [inaudible] issues that are too high due to bacterial overgrowth that's a big issue the big mechanism we fix. 

Dr. Justin Marchegiani: Yeah. So input is going to be decrease all the toxins coming in. Organic food whole food making sure you're digesting your food enough water decreasing all you know having high quality food decreases the antibiotics decreases pharmaceutical load in the food because animals or plants were sprayed with them if not organic and then also enough water right solution to pollution is dilution so that's kind of our first starting point and we can also look at our hygiene products right skincare soaps deodorants make sure we're not rubbing a whole bunch of toxins on it make sure we're pooping regularly at least 12 inch of the stool really good solid poopy policeman number four in the Bristol a days ideal and then we can kind of work on pushing things out whether it's cleaning out the guts supporting phase one or phase two detoxification phase ones to be more B vitamins and antioxidants Phase 2s and to be more sulfur amino acids including my own and then our various binders that we may use depending on what's happening and then various lymphatic support and then of course we're going to work with patients and dial that in 100 percent and the diet's got to be really really really solid. 

Evan Brand: Yeah. Please don't wear scented products. It destroys me but it destroys you too. So. Your laundry detergent. Think about it you're wearing those clothes all day and your skin is absorbing that. So if you're wearing you know Tide detergent it's garbage. Get rid of that crap go free and clear. Even if you're not going with more of the quote like organic brands even your conventional mainstream laundry detergent brands now make free and clear. Like all is a very cheap brand. They have four in clear words not synthetic fragrance. Stop using dryer sheets. Use wool balls if you have to. They last forever. 

Dr. Justin Marchegiani: That's what I have. I have the wool balls. 

Evan Brand: I'm sure that those won't be staticky. So you and I were kind of chatting about it off air. The chemicals that people wear on their clothes. Ninety nine out of 100 people in my experience have a smell to them. So whether it's a cologne a perfume a dryer sheet a laundry detergent. It's toxic stuff going into your skin so you could just have your diet dialed in. But what are you doing everyday you're spraying your neck and your wrist with this perfume that you think other people want to smell. That goes into your bloodstream. Those are toxic chemicals. I've had clients that are in the perfume industry and they can hide thousands and thousands of chemicals under that quote fragrance term. So there's actually a documentary about fragrances. I think it was called stinky but it was just about how dirty the industry is of chemicals and none of this stuff is tested on humans long term. It's just it might smell quote good but you don't know what the heck it is. 

Dr. Justin Marchegiani:  Absolutely and I had a patient who had some skin issues this last week and a lot of her gut symptoms got a lot better and she was improving in other ways but her skin was still lagging behind. She did a little bit of research and she found that she actually had a skin parasite and this could be. Let's say I call it put it on the X Factor category where if you're doing a lot of the foundational things and maybe a lot of the first level gut stuff and you're still not seeing any improvement in the skin. This would be a good area to look. This is a parasite is called Demo decks and it can create inflammation in the follicle and there are some various ointments or topical things you can put on your skin actually help some of these things. 

Evan Brand: Ask Is this something that you would fix from the inside out with into microbial. 

Dr. Justin Marchegiani: Well you do it on the inside but these things live on the follicle of the skin so you have to topically apply things to get these things under control. There are some formulas that have some herbs in them like a stragglers in such them oriental medicine type of herbs but it's going to be more topical. 

Evan Brand: And what's the conventional medical model say about this. What are they doing. 

Dr. Justin Marchegiani: You know what. I don't even know what the conventional medical model is because it's so undiagnosed it tends to be missed. 

Evan Brand: I've seen tiny mite. I've seen this on people violations. 

Dr. Justin Marchegiani:  They go on the eyelashes. But again the key thing is that these things tend to hit people that are gonna be immunocompromised. 

Evan Brand: Yeah go into that pub med right there. Let's see with that in 2014. Yeah. Yeah. Let's see what it says. This is interesting. 

Dr. Justin Marchegiani: So this is a potential vector. I kind of put in the X Factor category so you people are on top of it so it's a various might and they can live and they can create inflammation. So look it's a tiny parasitic mites that live near hair follicles but they can affect the skin as well, they say. 

Evan Brand: They say like quick treatment but it didn't say anything about treatment. 

Dr. Justin Marchegiani: Let's let's see what kind of let's say we got here for treatment. Yeah. So here you go. Another useful feature is the composite the the scale but mine. Yeah. Escape aside lindane or lindane. Oh I think lindane is pretty darn toxic now. 

Evan Brand: I've heard of lindane and I don't know whether to lend lindane as well. 

Dr. Justin Marchegiani: And lindane I'm pretty sure. So you can see they get on their skin as well. So they have it here as well so there's a little mites in here but I'm pretty sure lindane is pretty darn toxic. I mean you see it is that any other treatment options. Yep. So there's there's various methods but I'm pretty sure lindane is pretty darn toxic. So you gotta be careful though. But in general there are options there and there are some natural ones as well. 

Evan Brand: Oh yeah. There you go. Yeah right there on right go up on Wikipedia. There it is. When lindane agricultural insecticide. 

Dr. Justin Marchegiani: Yeah. So you're putting an insecticide on your on your skin. 

Evan Brand: When it absorbs. You know it's going to absorb and. 

Dr. Justin Marchegiani: Absorb and go through your body through your liver. For sure. Yep. But there are some herbs that are out there that are in Oriental kind of soft type of form that you can topically apply as well. 

Evan Brand: And then you think approaching antimicrobials in the gut would probably help this. 

Dr. Justin Marchegiani: I think you should still go through everything and then potentially try a good topical thing on the backsides of it. 

Evan Brand: I hate to go on lindane. I mean I guess if you're miserable, you've got to do what you gotta do. 

Dr. Justin Marchegiani: Well I would do the topical things first that are gonna be more on the healthy side. I'll see if I can pull it up here in a minute. There's some good topical ones that are out there that may be good options. I'll have that. 

Evan Brand: I actually had a client that brought that it brought that to me. She said I have a think she said it was scabies I guess that was the same thing scabies and one of the same family on her on her eyelashes. And nobody had any answers so I just suggested coconut oil because I figured coconut oil was a sort of an antimicrobial antiviral and I just had to rub coconut oil right here on the top of the eyelid. And she did get somewhat better it wasn't complete resolution from that alone though. 

Dr. Justin Marchegiani: Interesting. Interesting. I'll pull up a couple of things here that people can do. 

Evan Brand: We didn't talk about coconut oil but I think that would be a good first line of defense. Topical solution. I mean we use that for my daughters our first daughters cradle cap because coconut is sort of an antifungal in time microbial the carpet like acid in the model Lauren in there. Those are both really good. Really good topical but also internal. So eating coconut oil could help too. 

Dr. Justin Marchegiani: Yes exactly. And yet the medication that this person tried and didn't have to get success with it was basically just a sulfa a sulfur and zinc oxide cream. 

Evan Brand: Interesting. And it worked. Yep. 

Dr. Justin Marchegiani: Exactly. Worked very well. So it was a sulfur kind of and zinc oxide cream. It's exactly what it was. 

Evan Brand: That seems easy enough. 

Dr. Justin Marchegiani: Yeah. I put up a couple of the the visual people can see it. So they can have some good options. 

Evan Brand: Was that like a prescribed thing or is it something you could just get over the counter. 

Dr. Justin Marchegiani:  This was an over-the-counter thing. 

Evan Brand: Wonder how sulfur would do that. Maybe it just kills it. Maybe the thing can't breathe in sulfur. 

Dr. Justin Marchegiani: Yes sulfur has a natural antimicrobial effect. Let me go pull up my screen here. 

Evan Brand: All right. 

Dr. Justin Marchegiani: So here's one for the demo decks. Can you see my screen yet. Yep. I see it it's got some crazy Chinese letters on zinc oxide sulfur supplement. And again this website is demodex so it's And it has a lot of good options for topical demodex and this was shared to me by my patient. That's right. So it's good. I want to put it out there. It's an X factor it's not though it's not gonna be the first thing you go to. 

Evan Brand: Go up go down just a hair. I like it said something in the description go down just a little bit. 

Dr. Justin Marchegiani: Oh I'm sorry. Yep. It's going to be zinc oxide and sulfur. 

Evan Brand: OK so it says here. I mean they're talking a lot of stuff microbial fungal demodex they're talking it can soften epidermis. It can't be in the treatment of acne as well steroid induced rosacea. 

Dr. Justin Marchegiani: Yeah I mean topical zinc isn't the be great. The nice thing about these things you can do it for a lot of other things so it be worth giving it a try. Here's another one as well. And I asked me endemic X cream. I mean you could see this thing has a couple of herbs in here as well. We try to find the ingredients. 

Evan Brand: We learn so much from working with people clinically. Yes so so great. 

Dr. Justin Marchegiani: Simone roots. Moneri seeds Bristol Chinese carnations. A couple of different things and I sensed experiments aren't the best but I mean hey you know this is designed to be the cute type of treatment. So hopefully that gives some people a couple of ideas here. Is a good option. 

Evan Brand: Very cool. This is the stuff we learn by working with people. You're not going to find this at your dermatologist's office. 

Dr. Justin Marchegiani: No is great my patient was able to share that with me and we were able to get it out there and it's not going to be the first thing that people who have skin issues should go to. But if you tried a lot of things. Hey put it in your back pocket. Give it a try. This thing is we're all results driven. There's no there's no dogma here right. It's all about getting results. 

Evan Brand: Yep I think that's all we need to cover. I hit the testing I don't know if you wanted to say anything about testing that you do there is like patch testing and stuff like that but you know we're not dermatologists so we're not running patch testing. 

Dr. Justin Marchegiani: Get the gut dialed in. Feel free and go see a good dermatologist to just get things ruled out. If they kind of give you the diagnosis the diagnoses that we've already talked about fine you know that makes sense isn't to be things like Perry oral that can be caused by other issues whether rubbing too much experimental stuff on your skin or as a female. Birth control pills can cause Perioral dermatitis. That's a unique situation because more topical things like coconut oil can actually make it worse. So just keep an eye on that it's always good to at least get a diagnosis to know what you're dealing with and that way you can make sure the root cause is under control. 

Evan Brand: I just wish dermatologists were more root cause. 

Dr. Justin Marchegiani: They aren't at least if you get the diagnosis though then you can listen to this podcast and try to connect to the root cause. 

Evan Brand: But if you're listening if you're listening and you're a paleo dermatologist please reach out to us. We would love to speak with you. 

Dr. Justin Marchegiani: We'd love to speak with you. Love a good referral base for these kind of things. Excellent. Any questions Evan you want to dive into. 

Evan Brand: I don't haven't pulled up. So why don't you tell me if there's any good ones. 

Dr. Justin Marchegiani: Yeah there's a lot of things we kind of already addressed.I keep on having boils under my arm every time I shave usually resolves on its own. Is there an underlying issue I should worry about. I mean it just depends. Obviously there's a follicle inflammation issue that's happening. If it's only happening with shaving I mean these are some kind of lubricant that you could put in maybe use a coconut oil or shea butter or just some kind of a natural soap lather that will provide a little bit more support from the friction. If it's only happening from that so hard to say there Sebastian writes in. Thanks for all the awesome information. Always this is goal I've gone through a lot of what you guys are mentioning awesome and know how it all unfolds and the causes. Thanks so much Sebastian and then Sean Rice and I had a reoccurring sub dermatitis in the beard area past four years sent in Genova dis biopsies and suspect it's Candida. Yeah so there's some really good antimicrobial shampoos that you can do topically but you want to hit on the inside and out. And again I have them on my site just in health outcomes. I shop on recommended products I have some Amazon links to some of those creams and soaps there. 

Evan Brand: I would love to see you grow a beard I've never seen you grow a beard. 

Dr. Justin Marchegiani: It's been a while man. It's been a while. I think it's been about six years. But yeah I may pull it off this winter we'll see. 

Evan Brand: When I when I tried to grow a beard. I notice I always touch my face more and I think back and contribute to what this guy was mentioning with his skin. Anytime I got a lot of hair I'm always touching my face and who knows what's on your skin oils and bacteria and other things. 

Dr. Justin Marchegiani: That's totally true. Sean writes in very clean LCD based whole food diet but I think I need to eradicate with antimicrobials. Yep that's the next step Sean Ashley writes in can candida die off make you dizzy and weak. Yes it can. It totally can. New dive systems come and go like last couple hours then go away and come back. Yeah I mean they can definitely oscillate for sure. Evan you agree. 

Evan Brand: Oh absolutely and if you're you know if you can go you know drink more water as you said dilute and then go pee and take lymphatic support maybe some kidney support. You have a global movement. Maybe that will help lessen the die off but also when I feel bad I'll do just a little bit of charcoal. 

Dr. Justin Marchegiani: 100 percent which can cause dry big flaky patches in the hairline that's gonna be your substrate dermatitis which tends to be more fungal based. Can Diop be exacerbated by passing hard and dry stools. I seen people that do pass stools either they have an issue meaning intensive intensification or they actually feel better so it can definitely the passing of things can definitely shift what's happening in your gut as well. Dennis writes It is their first but it's bad for your health. Yeah they are basically it's an aluminum molecule that's dehydrated that that then expands and clogs the poor and makes it impossible for you to sweat these welds there. So definitely not good. You rather have something that allows you to sweat but has natural anti-microbial qualities that kills the bacteria that produces the not so nice smell. You know you can do that with shea butter or coconut oil or very very much very certain parts of the coconut oil like a public acid tends to be more anti-microbial. Sean says that high morning cortisol and very high DHEA some sort of got dysbiosis as well will sort of dressing will be the connection. Well inflammation in the gut causes inflammation in the body and in your stress handling system tries to deal with that. Aaron writes in Is there a relation between skin disorders and chronic Lyme. Definitely can be lyme is a stressor on the body and that's the stressor on the liver and detoxification and that can easily affect the gut as well. Anytime you have inflammation in the body it's a major stress ball in your stress bucket and when you're stressed buckets full systems in your body don't function optimally. And people that have Lyme can have other co infections like Evan knows about like the busier about Nella. 

Evan Brand: Yeah and you know those are all immune suppressants. Right. And so when your immune system is depressed bacteria viruses fungi those can all take the forefront and take you down. So part of resolving that would have to be supporting the immune system while trying to remove the microbes or at least get the microbes back in balance. There's this debate about whether you can fully kill Lyme. I don't know. 

Dr. Justin Marchegiani: Yeah we can definitely least knock it down so it's not as big of an issue on the immune system for sure. And then regarding dry.. Barb writes in What About dry issues with skin like water lesions so first thing is make sure we have enough collagen and good building blocks to have healthy skin right cultured amino acids are great. And then if we're having like some kind of skin tag type of things one make sure the insulin is under control because more insulin will cause those contacts. And the number two you can always get like a little cotton ball and sop it up with apple cider vinegar and then like that kind of like get a Band-Aid or like a wrap and wrap it up against that lesion and a lot of times it will fall off. You can also make like an apple cider vinegar tumor type of like pull this and then put it on a Band-Aid or end a cotton swab and then tape it to your skin that can help those lesions just kind of fall away. 

Evan Brand: Maybe a little bit of tea tree mixed in with that would be good. 

Dr. Justin Marchegiani: A little bit of Melaleuca or a tea tree. Yep that's great too two thoughts on CBD pretty talks. I mean it's not going to be what I would use for detoxification but has other good immune benefits mood benefits anti inflammatory benefits but it would be my first thought. For detoxification. 

Evan Brand: CBD is like the new raspberry ketone remember I like five years ago there was raspberries Down where. 

Dr. Justin Marchegiani: Yeah yeah yeah. More the the green coffee extract right. That was the big one. Things get really trendy right. Sean writes in do you treat patients outside of Texas via phone and email. Yes I do. Evan does as well. So see Evan. We see patients all over the world and for myself see patients in Texas and all over the world. You are welcome Sean. Evan anything else you want to add today. 

Evan Brand: I think I said we can wrap it up. 

Dr. Justin Marchegiani: And they just a little thing we always put it out there every time if you guys are enjoying this podcast give me a thumbs up. We'd like to know in the comments that you guys have done that haven't been successful. I read those comments and I take that information and I incorporate it into my kind of mental tool bank so to speak and apply it as necessary. So let me know your comments or what's helped you. What makes you feel better and if you enjoy it share with one person that you know in your life that could benefit ninety nine point nine percent of people we help. We do it without even seeing them. And that's the power of internet. We appreciate you guys spreading the good word. 

Evan Brand: Yep. Take care. We'll see you all next week. 

Dr. Justin Marchegiani: Have a phenomenal week y'all. Take care. Bye now. 

Evan Brand: Bye bye.

Dr. Justin Marchegiani: Bye.


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