Functional Medicine Approach for Urinary Tract Infections (UTI) | Podcast #356

One of the most common human infections is one that people rarely speak about. Urinary tract infections (UTI), also known as bladder infections, impact 10-20% of women at least once a year, and the specific treatment intervention is prescription antibiotics. Middle-aged women with chronic conditions like autoimmunity, dysbiosis, and hormone dysfunction are regular patients in functional medicine, so regular taking of antibiotics could pose a problem.

Dr. J and Evan talk about that when optimizing microbiome health, hormone production, and immune tolerance, it is crucial that bacteria are allowed to thrive, and antibiotic use poses a warning to that opportunity. With that said, if urinary tract infections (UTI) are among the most common conditions physicians see, and we are attempting to avoid circumvent antibiotic use, what functional medicine approaches do we have?

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
6:31 – N-Acetylcysteine in protecting the urinary bladder
11:17 – Foundational strategies in keeping the urinary tract healthy
17:10 – Antibiosis versus the association of N-Acetylcysteine, D-mannose, and Morinda Citrifolia fruit against UTI
19:11 – Men’s role in preventing UTI

Dr. Justin Marchegiani: Dr. Justin Marchegiani here with Evan brand. And today we are excited to talk about functional medicine approaches to address UTI or urinary tract infections. My immune system is just a little bit under the weather, so I’ll be channeling my inner Barry White today. Really excited for that. Evan, how you doing man? 

Evan Brand: Hey, pretty good. Yeah. I hope you feel better and get back to kicking butt, which you’re still kicking butt but most people would call it in but I’m glad your brain is working enough and we’re gonna get this thing done. So, 

Dr. Justin Marchegiani: I haven’t had a sick day over a decade. I don’t, I don’t plan to have a sick day ever.  

Evan Brand: Good. Good. Good. Alright. So, now, uh, with UTI, I mean this is something that’s extremely common. We see it a lot in young children because their poop gets in to their urinary tract whether they’re wiping the wrong way or whether this is a young child that’s still using diapers, so I’ve seen it with our children, we’ve worked on our kids. I’ve seen it with a lot with the kids I worked with clinically. And then adults we see this a lot, where a lot of it is due to sexual transmission. I mean we’ve seen many cases where if we support the female, the male is the vector and the woman start to get almost resentful towards their husband because they know every time, they have sex they’re gonna end up with UTI. So then, that really affects their sexual health and their relationship. And so, today’s podcast hopefully will encourage people to take this seriously and we’ll have some strategies you can implement to get both you and your spouse if that’s what’s happening and better shaped where this is a non-issue. 

Dr. Justin Marchegiani: Do we have any data on the semen quality, the semen quality affecting, uh, urinary tract infection of females?

Evan Brand: I’m gonna look it up but I know clinically and I know you’ve seen the same thing that we hear that story all the time of where everything is fine and then boom they have sex and then all of a sudden it’s they have a UTI. 

Dr. Justin Marchegiani: Yeah. I know in, um, in men 

Evan Brand: So, here’s the study right here, semen culture and the assessment of genitourinary tract infections in the male. It says here is, uh, contributes approximately 50% of the cases.

Dr. Justin Marchegiani: Yeah. I wouldn’t be surprised if nutrient deficiency has a lot to do with it because I know zinc is very high in semen, right? Um, very important for the health of the sperm and I know zinc also has anti-bacterial, anti-viral qualities to it. So, I wouldn’t be surprised if someone’s more nutritionally deficient they’re gonna have less zinc in the semen and that less zinc will make it harder, make it easier for bacteria and other critters to grow. So, just a thought, again, you know, we try to, you know, high level thinking, you know what’s the mechanism, look at all the downstream signals that could be one component though. 

Evan Brand: Yeah. It’s talking about these different types of bacteria in this male study talking about how it plays a role in genital tract infections and some of these are natural inhabitants of the male urethra which can contaminate semen during ejaculation. So, there’s your answer.  

Dr. Justin Marchegiani: So, it’s almost like men could have a subclinical kind of UTI. 

Evan Brand: Exactly. 

Dr. Justin Marchegiani: That could be affecting it. So, if you’re a female having chronic UTI issues, you have to have your partner looked at or addressed. And we’ll talked abour natural strategies of course keeping sugar down is going to be one of the big ones because one of the biggest bacteria involved in UTI is gonna be E. coli. E. coli you’ll see high in bacterial imbalances in the gut, you can also see some, I think some Pseudomonas in some as well as some Klebsiella but it’s mostly gonna be E. coli.

Evan Brand: They were talking about E. coli and even Mycoplasma in that study, which kind of interesting. 

Dr. Justin Marchegiani: Yeah. Exactly. I know, um, yep, that’s a big one for sure. 

Evan Brand: Some part, you know, some families or couples, they’ll end up just going to using condoms because obviously that’s gonna work and that’s gonna prevent the critical transfer but really the better thing is to get the health of your spouse improved and so, if you’re a female who’s done some of the conventional strategies, let’s kind of go into that now. Some of the conventional stuff that’s being done and we’ll compare it to the functional strategies but if you’ve done some of this stuff and you’re still struggling that’s when it’s time to get your spouse on board. And I know, you and I, we really like to work with couples and we like to get the whole family healthier together because we find that if we just focus on the female that her results are not as good and you know, this actually kind of carries over into H. pylori and all the work, you and I do with gut infections because we see cases where a female will use herbs successfully to eradicate certain infections in the gut. She’ll then get reinfected from the spouse even not into sharing cup, spoons, drinks, kissing and then they’ll get infected. So, as much as I can, I’m trying to bring the husband on board into these health protocols. 

Dr. Justin Marchegiani: Yeah. So, a couple of things out off the gates that men can do to help support the women is cut the sugar out of their diet or at least drop it down to the point where you’re not growing some of the microbes in the urinary tract. That’s helpful. You can also add some things in. Like ginger is actually very helpful so maybe some ginger kombucha can be good or some really strong ginger tea is wonderful. You can also add a little bit of Manuka honey because there’s a lot of data on Manuka actually decreasing E. coli and Staph in the urinary tract. So, these are some simple kinds of easy things. You can even take some raw cranberry juice. Raw cranberry juice is very high in D-mannose, which is a large sugar molecule. The body does not digest but it creates like, uh, magnet-like effect. It’s like dragging a magnet across a surface and grabbing iron filings and pulling them out. Think of the iron filings is the E. coli and so it kind of pulls them out. So, those are some easy simple strategies for some men out of the gates is ginger, cranberry. I would say just make sure you’re hydrated enough, right solution to pollution is dilution, Manuka, and keeping the sugar down. Those are excellent strategies out of the gates. 

Evan Brand: Yeah. And NAC, so we wanted to talked about NAC because NAC has been pulled from Amazon and this nutrient is getting harder to access as just a regular consumer. Fortunately, we work with professional companies, so we still have access, we still do manufacture NAC-Glutathione combos but there was a paper that we have here on NAC and the cool thing is I know you’re taking NAC right now.  

Dr. Justin Marchegiani: Yep. I’m taking up to four grams a day to help biofilms if in the sinuses, it also, um helps with decreasing virus replication in case I have any viral stuff going on. I think I have personally just a little, uh, rhinovirus. That’s what I personally think and then outside of that, um, increasing glutathione, antioxidant support, biofilms, helps with mucus, so it keeps the mucus kind of flowing from. So, it’s, so it doesn’t, um, impair oxygenation and blood flow. 

Evan Brand: See, if you can pull up or highlight that paper, I just shared on the screen there. You know, for folks listening you’re just missing out on this part of it, but that’s okay, we’re just trying to just show you at least maybe a couple of studies a week. That kind of 

Dr. Justin Marchegiani: Yeah. If you’re listening, yeah and if you’re listening here, we’ll put the video link below, so don’t worry about it, just come and check about it later and we’ll put the link down below. 

Evan Brand: All right. So, this is titled, N-Acetylcysteine Protects Cells from Bacterial Invasion, I like how they call it an invasion, and Displays Anti-Biofilm Activity against Urinary Tract Bacterial Pathogens. So, long story short, they discuss using antibiotics, which were really, we can dive into that. But really that is the conventional approach with this stuff, and the problem with antibiotic resistance problems and so you’ll have women that’ll do these formulas whether it’s in this study they’re talking about cipro which is dangerous stuff. I don’t like the sound of cipro at all, for many of the potential permanent tendon issues and other side effects associated with it. 

Dr. Justin Marchegiani: Yeah. Cipro’s in the fluoroquinolone family which can negatively impact mitochondria and connective tissue so if you’re gonna use antibiotic, try to use one, not in the fluoroquinolone family. Maybe amoxicillin, a tetracycline, just talk to your MD if you’re gonna go that route, to avoid that antibiotic at least. 

Evan Brand: Yeah. But here’s the conclusion, NAC is a non-toxic, antibiofilm agent and can prevent cell invasion and formation by uropathogens. So, once again, NAC for the win. This stuff is incredible. 

Dr. Justin Marchegiani: Yep. And again, with antibiotic is like I’m always about, let’s do the more natural things first and kind of go, least invasive to more invasive, right? And antibiotics to be the top part of the more invasive side. 

Evan Brand: This is interesting, I guess this was an Australian researcher, doctor who put this study together. They’re saying here that in Australia, you know, there’s an estimated 150 million infections and this is 12% of hospitalizations. 

Dr. Justin Marchegiani: UTIs are?

Evan Brand: For UTIs

Dr. Justin Marchegiani: Wow. Holy smokes. 

Evan Brand: And 30% of all women have a recurrent episode of UTI and then of course the problem with the UTI, right, UTI kind of sounds like, oh it’s not too bad. But I mean this stuff gets up and infects your bladder that gets really bad and then it can even farther ascend and then infect your kidneys and then that’s when you get into a really big trouble and that’s where they talk about sepsis and some of these other literally and potentially fatal infections from UTI. So, when UTI is kind of one of those, it sounds like, it’s just like this easy, not a big deal, but it can turn into a big deal. 

Dr. Justin Marchegiani: Yeah. So, just kind of like out of the gates, like what are the symptoms of UTIs, right obviously, like pain, pain during urination, you can see a lot of cloudiness in the urine, right? Potentially, even blood in the urine. It can have a really strong smell as well. It can even create pelvic pain in that area that pelvic or pubic area for sure. It can also move up so women have a very short urethra unlike men, that urinary tract can go to the bladder very very easy just because the distance is really short, so once it goes to the bladder, right, you’ll see pelvic pressure, you may see blood in the urine, frequent painful urination, lower abdominal discomfort and then it can continue going up from there into the kidneys. That’s where’s you’ll start noticing a lot of back pain, flank pain, um, you may notice starting to get chills and fever and maybe nausea and vomiting. And usually, once it starts to get into bladder into the kidneys, you know, you may want to look at seeing conventional medicine for the antibiotic at that point, definitely in the kidney. But, I mean, I think if people can be educated about this and be on top of it, I think you can avoid a lot of that upstage, um, conventional need for medications.

Evan Brand:  Well, like many other things that we’ve talked about. Early treatment is key. So, if you can come in and hit some of this stuff hard with D-mannose, your N-acetylcysteine, we use these cranberry extracts very effectively. You and I have also used some professional formulas that contain hibiscus and parsley and horsetail. So, the goal really, I think is to try to break down into like three main categories. So, you go the biofilms, breaking components like your NAC for example or you could add in like natto, Cerezyme or some sort of other proteolytic systemic type enzymes maybe even lumbrokinase would help. So, that’s your number one is your biofilm busting. Number two, you’ve got your antimicrobials that you and I use like bearberry, barberry maybe even clove or oregano might be helpful. Silver, I think, is worth to mention. And then, I would say the third mechanism of action is the anti-adhesive properties so you’re really trying to help flush things out. So, that’s where just hydration comes in. 

Dr. Justin Marchegiani: Yeah. Mannose. 

Evan Brand: And some of these herbs, 

Dr. Justin Marchegiani: Mannose too. 

Evan Brand: Yeah.  

Dr. Justin Marchegiani: Because that’s gonna pull, that’s gonna help pull the E. coli off like iron filings, right, like I gave that under the gates. So, just couple of foundational things. We’re kinda, we’re kind of hitting some of the meat here, I want to just kind of make sure we set a good foundation. So, out of the gates, women are gonna be more prone because of a couple of reasons. Okay. Number one, we talked about the intercourse and the injection of semen that may either have bugs in it or it may just essentially expose a weaker urinary tract so of course the first thing is hydration if you’re a female and getting up after the sex, getting vertical and going to the bathroom. Get that urinary tract moving, get’s some hydration in you. That’s a really good first strategy our of the gates and of course if you’re prone to having UTIs, you may wanna have a powder of D-mannose like we mentioned or some of the formulas that Evan mentioned, some D-mannose, Uva Ursi, um, parsley is excellent maybe a little bit of silver but you can just start a little bit of D-mannose, a little bit of cranberry extract and a little water and drink that before bed or you know, after a, um, interaction like that. The next thing is, if you can look at the hormones, right, hormones can play a big role so you have the high, you have the low. So, women that have very high levels of estrogen especially women that are on birth control pills that’s gonna shift the urinary tract pH based on the high levels of hormones, that can make it easier for the E. coli to grow because E. coli does not like an acidic environment. And when you started to make the environment more alkaline, right, you usually hear alkalize or die well not necessarily. The urinary tract if it’s alkaline can actually grow bugs, so birth control pills can actually cause the bug to grow to the alkalinity.  You can also see the opposite, right, the goldilocks effect. When women go into menopause and their hormones drop, low hormones can also have an impact on the immune system in the urinary tract and that can cause, it can be more, you can be more prone to have UTIs if you’re menopausal with low progesterone, low estrogen because that plays a role in the environment and the immune system and the IgA levels in the urinary tract and so not too hot, not too cold, right? Not too much hormones, not too low hormones, so birth control pill on one side too much, menopausal issues, low hormones on the other side. You really need to work with a good functional medicine person to get the hormones dialed in it, may not be a simple, hey take to something that you may have to fix the hormones too. 

Evan Brand: Yeah. Good call, good point, bringing that up. And that’s more of like a longer-term thing. That’s like if you’re trying to get well and stay well, that’s stuff we’re gonna be looking at. So, is it possible to come in and use some calcium D-glucarate or something like that to help that pathway and get rid of the excess estrogen? I think it could help but is it going to like acutely get you out of the UTI maybe not so I think it’s good you’re mentioning to have a plan meaning like a long-term health functional medicine health plan that then prevents you from having to do some of these acute strategies we’re talking about.  

Dr. Justin Marchegiani: Yeah, I mean there’s a palliative kind of, um, non-root cause support that we have but we try to always package in the palliative stuff with lifestyle changes that make it more holistic and make it more root-cause and then we also dive into the hormonal aspect and also, I would even say gut aspect. I’ve seen imbalances in the gut bacteria, shift and influences the urinary tract microbial balance too. So microbial imbalance in the gut has a way of shifting microbial imbalance in the urinary tract and it could be just 80% of the immune systems in the gut and that’s having a major effect. It could just be some of this stuff’s working its way down there through moving the intestinal tract. It has a way of shifting or migrating or moving in some way, you know, those kinds of things. But either way look at the gut, that’s where a lot of the immune system is. Look at the hormones, look at medications that could be influencing these things. Look at hydration, those kinds of the root, I think starting situations, you really wanna have your head wrapped around. 

Evan Brand: Yeah. In regards to testing you can do this at home. They have companies that make at home UTI test strips that you can do, where you just urinate on the strip and you’re gonna be able to test your leukocytes and they have a little reference range that you can look at and basically the dark on most of these it’s purple, the darker the purple, the more severe the infection is. And we had incredible results with our daughter using some of the D-mannose, we some chewable versions, we did some of these herbs mixed in some apple sauce and we retested using these little pee strips and I want to say, I’d have to ask my wife to confirm, it was either two or three days, we completely got it from a deep dark purple indicating a very intense UTI to nothing. It was completely white. So, the brain is called azo, A-Z-O. And they also make other things, I think they make like ovulation strips and that kind of stuff for more like female health. But this urinary test strip, you’re looking at maybe ten bucks for a pack of these. So, if you do have suspicion or if you’ve had chronic UTIs, this is something that I would recommend you at home because so many times you and I hear a story of a woman having to schedule an appointment, get into the doctor. Yep, I have a UTI. It’s like you could have done that and figured it out at home in two minutes for 10 bucks. The accuracy is very very good. 

Dr. Justin Marchegiani: Absolutely. 100% And of course, um, there’s some tests if you do like a uroscopic or a microscopic urinalysis, you know, we’ll be looking at leukocytes, we’ll be looking at protein in the urine. We’ll be looking at pH, we’ll be looking at potentially bacteria. E. coli, looking at the actual microbes in the urine, that’s helpful and then obviously just from a diet, just for me a lifestyle strategy. This is obviously going to pertain more to kids, right? Just teaching your kids how to wipe the right way, right? Females, front to back, kind of common sense, but kids obviously develop blood habits and that could be a simple, easy lifestyle methodology. They can, they can fix that problem and just getting more water, more hydration, if, um, kids have a compromised immune system due to the too much sweets, um, obviously artificial sweeteners like aspartame, Splenda, those can impact the microbes as well. Those things can compromise the immune system and shift the micro, the micro, um, kind of balance, microbiota balance in the gut and in the urinary tract. 

Evan Brand: Yeah. Let me show this one more thing. Do you mind bringing this, highlighting this paper? 

Dr. Justin Marchegiani: Yeah. Absolutely. 

Evan Brand: There’s one more that we wanted to show people, this was just titled, Prospective study to compare they said antibiosis, they’re talking about antibiotics versus NAC, D-mannose and Morinda fruit and the conclusion of the study at the bottom here, D-mannose and NAC resulted in similar to antibiotic therapy. So, even if somebody wants to nitpick and argue, well antibiotics are like

Dr. Justin Marchegiani: Better. 

Evan Brand: They’re not. They’re not. Now, I’m not saying that in a severe situation where your kidneys are affected and you’re going septic, I’m not saying, I’m going to try to do this, but I’d be doing all of it, I’d be doing the mannose, the NAC maybe the antibiotic if I had to, but I mean, based on the stuff you and I’ve seen clinically based on more than what we’ve looked at in these papers alone. I mean, the cool thing about PubMed too, is you’ll be able to have related articles pull up like you could go into this one. D-mannose and Hibiscus and Lactobacillus probiotics. You know.  

Dr. Justin Marchegiani: Yeah. Probiotics are gonna have a major influence as well due to the acidification of that area. I mean, you can depend, depending on where you’re at, you could potentially even do intervaginal probiotic, you know, you could put the capsule in let it dissolves or you can mix it in, uh, with little, a little bit of aloe or shea butter or coconut oil, something that’s gonna dissolve and um, you could essentially mix it in, you know freeze the cube or refrigerate the cube so it’s solid and then insert intravaginally and that will kind of dissolve and then it will contain some of those nutrients to help support the vaginal canal and depending on where you’re at for some yeast you could even do that same thing with boric acid too. I recommend some kind of a carrier though, just so, it’s uh, just so, it’s not as abrasive if that canal or that tissue is really sore or irritated it just provides some moisture to that area as well and won’t irritate it. And if you’re unsure test the, test the moisturizer whether it’s aloe or shea butter or coconut oil, test it before you put any of the extra stuff in it, so you know, if that’s a problem at all.    

Evan Brand: You know, what I’ve also seen to be beneficial, I’ve seen some homeopathic vaginal suppositories for UTIs. I don’t know much about them, but I’ve had women try them and they have worked, when everything else failed, so I think you should be open to it. And the probiotics are game changer too, as you mentioned, you could do intravaginal with the capsule it’ll just dissolve or just oral probiotics has been helpful so as you mentioned the gut, you know, that’s something we’re gonna look at. So, if we see a female who suffer with UTIs and we see she’s got a lot of issues on her stool test, you know, we can’t say directly, hey this is why you have UTIs. But if we fix the stuff in the gut, chances are high that they’re gonna suffer less and less frequently from UTIs. It’s really, really important as you mentioned you got this vaginal microbiome, you’ve got the oral, you’ve got the gut, you’ve got the skin microbiome, so, I mean if anywhere there’s dysfunction or dysbiosis going on, I think they can affect the whole system. 

Dr. Justin Marchegiani: Absolutely. And then, men play a part of the role, you know, in this whole thing. So, get your sugar consumption down, better hydration, could always throw in a little bit of ginger or cranberry kombucha that’s a really easy simple thing. Just to add in as a routine. Sometimes, it’s easier to add things to a routine than pull things out. 

Evan Brand: Well, think about how many men, you and I have seen and work with over the years with gut issues so, I mean getting their gut straightened out too is gonna be my goal because I’m sure that’s gonna affect what’s we’re seeing in these paper zone like semen quality, and they’re not passing these microbes, you know, via sperm. So, man, you gotta get on board. Women just I, you know, I feel bad for them because they take a lot of the blame, they take it upon themselves like there’s something wrong with them and in many cases, there definitely are issues with the dysbiosis and the female but in the men they kinda get off the hook so, we’re calling all the men out here, you gotta get involved too, you gotta get your health involved. If you’re over there, eating pizza while your wife is sitting here cooking a paleo meal, you gotta get on board because, you know, this is a team sport here. 

Dr. Justin Marchegiani: Yeah. And you can always use a barrier method if not, right, that’s an easy way at least in the interim and then also just getting the hydration up and avoiding the sugar can make just a huge difference. Sometimes, it’s not even 100%, just an 80 20 can make a huge difference on that. 

Evan Brand: I know how men are, being a man, so if the wife says, uh, honey you’re gonna have to use condoms for the rest of our, uh, sex life, I think that’ll be a, easy quick motivator to get them on board and they’re natural. 

Dr. Justin Marchegiani: Totally. Yeah. I find like kind of in the men sphere, there’s like two kinds of men. There’s like the men that are like biohackers that are like always into like optimal performance trying to improve and get everything kind of optimized in their health and their life and their come some guys that they kind of just, they’re  a little bit more slow to the punch and they’re motivated by what the rest of their family is doing, their wife’s doing, and then their wives kind of get them on board, there’s like kind of two classes like that, I think me and you tend to be more in the biohacker class and we see a lot of biohackers that are in, right, you know, that are really motivated and they’re all about performance, performance and then some their wives are more on that side of the fence and the wives kind of get them motivated but most of the time though, once someone can see their life improve and usually if you get healthier, you don’t just improve in the urinary tract, you improve in cognitive, mood, libido, energy, digestion, so women, if you can get your husbands on board, they’re gonna see a lot of buy and hopefully other areas and hopefully you’ll be able to get them a long-lasting buy in which is really important for energy and just, you know, people being, um healthier which is important. 

Evan Brand: Yeah. Well said. We can mention this comment here that came in the live chat and then we can wrap it up. We’ve kind of hinted at this but we didn’t say it directly, when we talked about UTIs, I mean a lot of times, we are referring to the bacteria but in many cases there’s a yeast component too, so there’s a fungal component, here’s the cool thing though, you and I are always using blends and these blends are not only antimicrobials but also anti-fungal, anti-yeast. So, someone in the comments here wrote that they kept getting UTIs even after getting treated until they started yeast treatment and that’s a cool thing. Think about if you come in with antibiotics, so let’s just quickly compare the conventional and functional approach. You come in and do the antibiotics, those are not anti-fungals, but if we’re using something like bearberry, barberry, berberine, cloves, silver, Saccharomyces boulardii probiotics, we’re creating an antifungal, anti-microbial, anti-parasitic protocol all in one, which is awesome because sometimes we’re killing multiple birds with the same stones and that’s why we love what we do. 

Dr. Justin Marchegiani: 100% and of course, you know, a good history will kind of figure this out, based on you know, if you have a new sexual partner or not, STDs always can be a thing, so we’re looking at Chlamydia, maybe Gonorrhea, right? And so, these types of infections, I think we could probably see some improvement with some of the natural things especially if we add in silver and such but these types of things, if you’re not having results, they may require a special kind of antibiotic, if that’s at play. And so, obviously, you know, it’s gonna be history dependent, if you’re in the steady relationship then that may not be a thing or if you’re not sexually active that probably isn’t gonna be a thing but it’s always good to kinda keep that in the back of your differential list of things that you kind of work up through from least likely to most likely. 

Evan Brand: Yeah. Good call. So, on that NAC paper, it actually did talk about Chlamydia and it talked about the mycoplasma and there was a couple others in there and it was talking about the anti-adhesive, anti-biofilm properties of the NAC. So, even if it were STD, I think NAC is something you’d still wanna implement. 

Dr. Justin Marchegiani: Yeah, I mean, usually you’ll gonna see some level of discharge too with some of the STD stuff but worst case, you know, you can just tested try some of the simple things out of the gates. A lot of times the history will tell you, especially if you know, if you’re, um, had intercourse in the next day, you know with your husband or partner and the next day you’re starting to feel some issues, then it’s probably gonna be on the E. coli side of the fence which is 90% of the time, so you know, if you have 90% odds with something, we’re gonna go with that out of the gates for sure.  

Evan Brand: Yeah. Okay. So, testing strategies just to summarize, you could do the at-home test strips for this, we think a good stool test would be, in order to figure out what’s going on with you’re gut and how’s that affecting your microbes down south same with your partner, if we can get them on board, get your stool looked at, a urine test is helpful too because we’re gonna be able to look to Candida overgrowth and other types of fungal colonization. So, we like the organic acid, so an oat, a stool and some of the at home test strips, I think that would be a great starting place because you could do other things, blood work, and as you mentioned like the urinalysis and like in the conventional lab, you could do that too. But you might not, if you do these top three. 

Dr. Justin Marchegiani: Absolutely, and then the big symptoms that would differentiate an STD over UTI are gonna be like more systemic symptoms, so like nausea, fever, swollen joints, sore throat, symptoms that are kind of gone more systemic and of course there can be some localized symptoms that can be more severe like extreme discharge, severe rash in that area, blisters in the genital area, but look for more systemic type of symptoms that could be driving that. 

Evan Brand: Okay. You’re saying more systemic symptoms would be what? 

Dr. Justin Marchegiani: The ones I just mentioned, so pelvic

Evan Brand: No, would be a UTI?

Dr. Justin Marchegiani: No, that’s gonna be more of an STD, so think of STDs are more severe therefore the symptoms are more severe. They’re more systemic. So think of systemic symptoms are things that are more severe, localized symptoms, right, that means the microbes haven’t spread as much and they’re less severe, so more severe think of the STDs. 

Evan Brand: Got it. And then you mentioned in the beginning if the UTI is more severe that’s were the back gets involved in the case of the kidneys, you know, there are people that, they perish due to UTIs if they go septic so obviously, you would have a lot more issues than you would know by then. You’d be in real bad pain.

Dr. Justin Marchegiani: Absolutely. Yep. 100%. And again, like you know, UTI, on a desk, can go to the bladder and then the kidneys and then, you could have a fever, you could have these things, so as a UTI gets more severe that could definitely drive the symptoms up as well. But usually, what people can see it because it’s just following that urinary tract, it’s going from the urinary tract to the bladder, to the ureters and then up to the kidneys. So yeah, usually you can see that and feel it, the pain starts to move up. Well, anything else, you wanna add? 

Evan Brand: No. I’m just gonna say, we work with this issue all the time. We’re really happy to help people and to provide solutions to what have been a major issue. A pain, an issue and like I said with people’s sex life and with just people’s personal health. I mean this is something that’s a big burden for a lot of people especially women. So, we’re really happy and fortunate to have outside of the box tools that we use with great success and we don’t only back it up with clinical experience, we backed it up with some of the research we’ve dove into and the professional formulas we use are tried and true. So, if you need help, please reach out, we’d love to help if you wanna reach out to Dr. J you can at justinhealth. If you wanna reach out me Evan Brand, you can do so at and we both work worldwide via facetime, phones, skype and we send products to your door, so if you need to get any of these labs done, investigate you, it doesn’t matter if you’re in California or Oregon or Michigan or Florida or New Mexico or Australia or Canada or Europe, we can do it, we can help and we work with people around the world, we have for decades so it’s just a true, true pleasure to get the hands-on experience with this issue because I think the most empowering thing is to know that you’re not a victim meaning you’re not just going to have to go on antibiotics. That’s just the foghorn of the conventional approach, and it’s just so empowering and inspiring to know, there’s other ways, other tools, there’s other approaches that are very, very successful. 

Dr. Justin Marchegiani: 100% Yeah and if you guys enjoyed it, There’ll be links right there to work with us. Hit that thumbs up, helps the search algorithm improve so more people can see our information and give us a share, give us a comment, write us a review, we’ll put links below to do that. Thanks, y’all, you guys have a great day, we’ll talk soon.   

Evan Brand: Take care. 

Dr. Justin Marchegiani: Bye Evan. 

Evan Brand: Bye. Bye.


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The Importance of GI Testing and the GI Map | Podcast #259

Today our topic is on the importance of gut testing. This kind of testing is kind of what we use in our functional medicine processes. It can pinpoint the precise and accurate levels of different types of microbes in your gut. Know the pros and cons of gut testing and why it is very important. Check this podcast we have with Evan Brand.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:36 Contributing factors to Gut Inflammation

11:30 H. Pylori

14:31 Overgrowth category

26:13 Immune System Health

36:34 Antibiotics


Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand hope everyone is doing fabulous here today, we are going to be talking about the importance of gut testing. Super, super important is a couple of modalities that we use kind of at our functional medicine tool belt. And gut testing is super important. We’re going to kind of go in the ins and outs of gut testing why it’s important. We’re going to break down some of the GI map actual testing as well. And we’re going to go through what a typical test looks like. What we’re actually assessing what we’re looking for infections, functional analysis, other intestinal health markers, like inflammation IGA levels, beta glucuronidase, steatocrit, elastase we’re going to break it all down. We’re trying to bring everyone actionable information that you know a lot of doctors, a lot of people you see online, they’re not releasing things So a lot of the stuff they talk about, it’s kind of theoretical, and it’s not really applied. So everything that we’re talking about today has actually been applied with thousands of patients so hoping everyone enjoys. So while we’re on the topic, Evan, how are you doing today, man? 

Evan Brand: I’m doing pretty good. I’m trying to look for a stool test. It’s like really bad because it’s more fun right when you see ones that just have tons of infections on there, and I’ve got it I’ve got a good one here that we can dive into. I was just trying to find one with a high beta glucuronidase because that was one key point that I wanted to talk about with you is that many people are sick because of having high Beta glucuronidase which is an enzyme that goes high due to bacterial overgrowth in the gut. And so many people talk about, Well, you’ve got to take calcium gluconate right? People discuss calcium gluconate as a supplement to help lower high basically granted days now this is like your average person at the grocery store is not gonna have that This conversation but we’re talking in the functional medicine world, if you’re working with a practitioner, they may look at you. And if they know what they’re doing, they may say, hey, yeah, you should probably do calcium gluconate. But that’s not the root cause the root cause is figuring out. Why does this person have high beta glucuronidase in the first place? Yeah, we can take nutrients to lower this and we can take nutrients to lower inflammation. We always have to work backwards. So why don’t we talk about the backwards piece? What what are the contributing factors to the gut inflammation? We’re seeing what are the contributing factors to the Secretory IgA being low? Why does this happen?

Dr. Justin Marchegiani: So first thing first is we have to do an adequate history. How did we get here? That’s like the first question that everyone needs to be asking themselves, and their functional medicine doctor needs to be kind of reviewing with them. So a lot of people, there’s usually a history, that portion that reveals this. So when I come in and I do a history, I do a timeline history. I try to figure out how the person got here. So there’s two scenarios, there’s either the person got to this position where they’re sick and not feeling well, acutely. I was in Mexico, I ate some bad food. Now I’m sick, or most of the time, there’s a chronic insidious bit to it, where there’s been some stress, emotional stress, physical stress, chemical stress, bad food, poor digestion. And then the kind of stress has been going in a downward pattern health symptoms have been getting worse over time, and then boom, they get sick, acutely, but it’s not really acutely, there’s been a downhill kind of spiral the whole time. So number one, there is totally acute, feeling great. And now they’re not number two, it’s this chronic downward decline, boom, they get sick. And that’s a number three is it’s just chronic, and there’s no timeline. There’s no event at all. It’s just a gentle downward slope. So three ways that kind of health symptoms unfold, one very acute to a downward decline followed by an acute Episode and it could be a couple of acute episodes by the way may not be may not be one. And a lot of times there could be an autoimmune flare involved in there. And number three is it’s just a gentle downward decline with no acute episode. So those are the big three scenarios. So we have to really look at Hey, when was the last time you remember yourself feeling good? Walk me through the timeline over the last 1015 years? When did things start to go sideways? Was it when you were eating some bad foods and gluten? Was it when your diet was poor? Was it when stress or sleep was poor? Was it when you started going through menopause or having some hormonal issues? Was it when you had a thyroid flare? What was going on when all this stuff happened? And those are the important questions because we have to connect the dots to the root cause. So when we ask questions about symptoms that are downstream, we’re actually looking upstream to the root cause that cause the symptoms to manifest. So there’s a different mindset. Most clinicians and doctors are looking at, hey, what medication can we do to cover up that symptom or even what supplement or nutrient or herb can we use? used to cover up that symptom, but we’re actually we may be looking at that too, but we’re also looking upstream as well.

Evan Brand: Yeah, a couple other triggering factors. Divorce is huge. So any issues with marriage whether someone just had a bad marriage and needs to divorce but they haven’t yet they did get a divorce. Like I had a woman last week who developed Hashimoto, she developed thyroid antibodies after her divorce, she had blood work done before she had no antibody, she went through crazy stressful divorce fighting over who gets the kids and all that, and then boom, you look at the labs, and then there’s the antibodies that showed up as sort of a response to the major stress.

Dr. Justin Marchegiani: Yeah, of course. And ideally, when you deal with marital stress, ideally, you’re on top of it and you seeing a counselor to help and it’s always easier to mend it than to walk away some situations you can some you can’t but we always recommend getting some kind of counseling there to help to help on that side of the fence. And then of course, you know, death of a loved one is going to be a big one. Even things like moving and a lot of times moving may be tied to a promotion. Or a good thing. But believe me, it’s very stressful. We look at what’s called the social adjustment questionnaire, moving death of a loved one death of a child’s even more. You know, affairs, divorce anything on the relationship size really big. So those are going to be important things you want to look at from an emotional stress standpoint, because those can be a big thing. And they put stress on the adrenal glands. So hey, we just want to make sure that we’re addressing it, we’re processing it, we’re seeing a counselor, we’re seeing a therapist, someone to work on it. Maybe there’s subconscious stress, maybe we’re working on EFT or NLP or EMDR techniques to deal with PTSD from that trauma. So we have things like that, right. And then, of course, like in your timeline history, we’re also going to be looking at was there a leak in your house? Was there any mold exposure, things like that? Because that’s a big environmental poll. Hey, do you feel better when you leave your house for a week? You know, barring the fact that you may be on vacation and stress is lower. If you just leave your house for a week you feel better. So we like to have Those kinds of timelines, because that can. So I digress. But that can set you up for a whole bunch of gut issues. So when we talk about gut testing, it’s never just the gut myopically. We’re trying to connect the gut to underlying stressors that have been accumulating for years, if not decades, that got you to this position to begin with.

Evan Brand: Yep. Well said Well said, Yeah, the mold piece is huge, you know, because people move so you have the stress of moving, but then you’re moving into a house. It’s moldy. So you and I mean, countless times now we’ve seen people where it’s like, Okay, what happened in the last few years your health went downhill. Well, I moved two years ago. Oh, okay. When you moved into that house, did you get worse? Yes, I did. Okay, let’s test it. Boom, there’s a big smoking gun. And now we know, just with the help of some of these laboratories that look at mycotoxins, they’ll tell you straight up. The papers look at mycophenolic acid, a major mycotoxins it damages the gut barrier. So this is a new cause of leaky gut beyond infections. Also, it promotes the growth of Candida which disrupts your gut and your brain function and efficient moats the growth of Clostridium bacteria, which we often see. So now we have the root cause of the root cause meaning, okay, these people keep treating Candida maybe with the natural path where they do herbs to kill Candida, and then it keeps coming back. Why is it coming back? Well, now I know mycotoxins are one of the big triggers. But let me share my screen. Let’s go into this. I’ve got two different. I’ve got two different ones here that I want to that I want to talk through with you. Let’s do and so two different situations, both of the people had similar symptoms just in terms of mood issues, depression, anxiety, but the one on the right here on my right here, this is the one that’s moving. This one is– 

Dr. Justin Marchegiani: I just want to highlight I want to just highlight one thing here for people. So this first page here, a lot of the path is on the first section bacterial pathogens. These are typically food poisoning type of pathogens, C diff toxin A and B. When you have both is more serious. You can get these from antibiotics, hospital setting primarily Campylobacter and then a lot of the E. coli Whether it’s the endotoxin genic hemorrhagic Coli, or the O 157, or the various Shigella toxins, which are part of the E. coli spectrum, salmonella, cholera, your stinney is kind of like a parasitic bacteria, these are usually going to be food poisoning situations with the exception of C diff more hospital setting, or antibiotic setting. And then, of course, the parasite section is others on page four on this test, but these are some significantly big ones, crypto, and to me, but his political histo for short giardia. And then, of course, some of the viral issues with it, the viral issues with tend to be more self limiting, but the biggest here are going to be parasites and more of the food poisoning or hospital based infections above. All right, go ahead.

Evan Brand: Yeah, and I’m going to make a pretty link which is a link that will redirect you because if you’re listening on audio, this is not going to be as exciting. So if you’re, if you’re listening to my podcast, you can just type in and I’m going to make the link MAP. So, that’s going to take you to Justin’s YouTube channel where you You can view this if you want to kind of follow along. But yeah, so on this on these two particular cases, nothing showed up on on page one. Everything’s below detectable limits. A lot of times we’ll see crypto and Giardia. Though if we’ve got somebody that’s got weight loss or weight gain issues, we’ve got stomach cramping, we’ve got diarrhea. And the interesting thing is to this time of the year when we’re talking towards the end of November, we’ll have a lot of people that will come to us with more acute issues. And when we look at the acute issues, a lot of times the noroviruses will show up and we can give some support but a lot of times those things just have to run their course.

Dr. Justin Marchegiani: Yeah, a lot of times are self limiting. We can do things like high dose silver, so my line will do GI clear tree which is a silver compound or nano silver. We can also do monell Lauren as well to kind of help knock those things down. We can even just do high dose oil of oregano so my lines Yeah, clear fives in emulsified oil of oregano very high dose that can be helpful shakhter threes and nano silver. So a good nano silver a cool little silver can be helpful and a good mana lard which is an extract Coconut, all had great antiviral benefits too.

Evan Brand: Yep, so here’s page two. Now as I mentioned the one on the right here, this person is more sick symptomatically. And we already see one reason why you see the H. pylori at the top of page two here. And this is like an exponential scale. So goes he 345, whereas the person on page two, they’ve just got a lot of stuff going on with their normal Flora being too low, you’ve got some that are showing up too high. But obviously page two here the H pylori is going to be the biggest smoking gun for this person on the right.

Dr. Justin Marchegiani: So let’s kind of hit it one by one. So we have the H. pylori section. So one thing to highlight is the standard deviation, I have a lot of patients that freak out that don’t quite get it. So, you know, unless you take in a stats class or a physics class. It’s weird, right? I wish the lab didn’t use the standard deviation, meaning either the five either the four, whatever. So when you see the reference range, the reference range is either the three. So the average person will look at this and say, Oh, well, the range is greater than one. This is 1.2. That’s only a little bit It not not necessarily, because this is either the three over here to the right, and this is either the five, so to equal it out, you have to move the decimal place to the right three times. So when you move it to the right once now becomes 12, either the four, and then when you move it again now becomes 120, either the three. So now when you look at it, it’s actually 120 times above the normal limit. So that’s important because if it’s 120 verses, only one time above, that tells us the infections probably a lot more serious from an overall load standpoint. Does that makes sense? It does. And people confuse that. And it’s okay. It’s not normal, right? Unless you take in those classes, you know, you’re not going to know it. So if people look at it first time around, it’s just confusing. The lab could do a better job at that, but that’s where we’re at. And then if you look at the virulence factors below, these are cytotoxic proteins that are produced by the infection. So you can see this person on the right and people listening will have The link for these labs so if you want to click on the link and follow along and look at the lab with us, we also have video format. So if you want to see the video version, it walks us walk you through it that way. So you see these virulence factors. So one of the bigger ones is going to be the VAC gay, the gay and the CAG. The most, most research on those two, but these are cytotoxic proteins that are being produced by the infection that give it greater chance of inflammation, ulceration, cancer, etc. So it just it tells us the infection stronger That’s all it is. It’s like oh, this infection has a little bit more muscle or meat behind it so to speak. So you could still have problems without the virulence factors being present. But if we see virulence factors in a strong amount of H. pylori, well then we know that this infections probably a lot more serious, we have to handle it, you know sufficiently But either way, if we see even a borderline number on the H pylori, then we’re still going to address it and make sure we knock it down any comments there.

Evan Brand: I’ve seen multiple people that have had a history of stomach ulcers. And those people with a history of stomach ulcers do tend to show up with some of the virulence factors. And there are some papers on that we’ve got a white paper on this where we can look at the different virulence and see what they’re associated with some is long term inflammation, some is long term infection, some is increased risk of stomach cancers, and the Safageo cancers and all that. So these are very helpful. And if we do see them positive, we always put a huge emphasis on him.

Dr. Justin Marchegiani: 100% Next we have the normal bacteria. And so this is normal, good flora. You know, I should say normal beneficial Flora in the gut. So like when I say that there are two that are probiotic species like you know, well, the ones you think of as probiotics those are going to be your lactobacillus and bifidobacterium species. And there’s a lot of different lactobacillus there’s lactobacillus para kci, acidophilus rotary right. Lot of different kinds of bifidobacteria, long gum, etc. So there’s many different species, bifidobacteria, the lactobacillus kind of lumped all those into one. These are what we consider our probiotics. And everything in this section is a normal bacteria. So when you see achra mantium, you send affiliate high, okay, that’s on the higher side. Is that an infection? Is it a despotic bacteria? Not necessarily. We’re not going to worry about it too much. These things kind of take care of itself. And I’ll go into that. You can see this person has a lactobacillus is low, right. So that’s a beneficial bacteria. So I’m already leaning into the fact this person probably has a dysbiosis, meaning higher amount of bad bacteria in relationship that good bacteria. And so you can see here below, this is the types of bacteria and then the phyla. Think of phyla as family. And there’s two general families of bacteria. There’s the bacteroides family, think bacteroides beautiful, and then from mek kinase think of for mek kinase as fat Now what does that mean? from mek kinase bacteria tend to have the ability to over absorb calories. So when we see higher amounts of mek kinase over absorption of calories, and again, some of the studies on this or week or more MySpace studies, higher levels are for mekinese increase weight gain in mice due to calorie absorption. Think of bacteroides is beautiful, helps, it does the opposite of gaining weight keeps you leaner and healthier, right. So, we don’t judge a lot on these markers, because these could be off if we have a lot of bad bacteria or infections. And I can already see below a little bit, you can see the despotic bacteria section, there are some bacteria that are already off. So because we know that a lot of that normal bacteria may be off so we don’t really worry about it. It’s more of an effect, not necessarily a cause. So we keep it in mind. And as we clean things out and we add prebiotic fibers and we change the diet. A lot of times that stuff by itself will kind of come back into balance itself. We don’t really get too myopic on that.

Evan Brand: Any comments on this overgrowth category as we? Yeah, so let’s move on to the overgrowth category. We talked about how this person on the right is definitely more sick and symptomatic, as the person on the left says my internet connection is unstable. I don’t know if I got choppy on you for a minute. It should be fine now. Good. Okay, so you see the Pseudomonas over here on the right Pseudomonas SBP, Pseudomonas Aeruginosa, you see the staff, little caucus different species of that. You see streptococcus is real high. So even just looking at a numbers perspective, looking at the number of different species of overgrowth bacteria, you could see the one on the right is obviously a bigger problem.

Dr. Justin Marchegiani: Exactly 100%. And then the big thing I like to look at is, look at the standard deviation, I see which ones have the same standard deviation that are positive. So off the bat, you can see the staff is 1.08, but it’s got one standard deviation above so it’s 10 x higher so that’s like an 11. So fives the reference range elevens not bad. Next thing I look Look at this step six are greater than one. So nothing’s like jumping out super high, Bacillus 7.5, either the five, one point and so nothing’s really super high. Now I go over to the patient on the right. Um, let me see if I can what jumps out at me here. So you can look at this was Yeah, Pseudomonas, for instance. Right? That’s 3.468 of the five, the reference range 1.08 of the four. So what’s that? Really? That’s really 34.6? Well, so the Pseudomonas is really high, that’s 34 times above, that’s a big deal, right? So I try to look at and say which ones are are mildly elevated in which ones are significantly elevated, what does significantly mean 10 X or above 10 extra above I considered to be significantly elevated. Now we’re not going to do anything specific to target one bacteria of an over another. We have specific herbal blends that will use to work on knocking these bacteria down. And again, these bacteria can produce methane and hydrogen gases. That can disrupt motility can cause constipation, cause diarrhea. So you want to keep these in mind. Now, a lot of people are like, Well, can this Tell me if I have SIBO? This is a common question. Yes and no. So we know that certain bacteria like Pseudomonas or strep or citro, bakkar, or Prevotella are associated with SIBO. We know that according to the literature, but we can’t specifically say because we don’t know exactly where the bacteria came from, right? So imagine you squeeze some toothpaste out of the toothpaste tube, and you want to know, hey, well, what part of that toothpaste tube was exactly in the middle portion of a two? Well, it’s hard to know once it all came out, right. So, with a SIBO breath test, you can know because when you swallow lactulose, you know, and you blow in the tube every 20 minutes, you know, based on the time it takes for that lactulose to enter the the large intestine, you know, kind of where it is. So it takes about 120 minutes to get into the colon or the large intestine. And once that lactulose breath test is done, so you kind of know if it’s within that hundred and 20 minutes that it’s probably in the small intestine. So we need a breath test to really confirm SIBO overgrowth in general to be exact. Can we say that it’s probably a SIBO overgrowth when we see certain bacteria? Hi, yes. So we tend to use terminology like hey, you have a just a generalized dysbiosis. And we can treat it and address it and retest. We can also do SIBO breath testing so we can be more accurate with lactulose. And know exactly potentially where it could be based on that timing scheme that I mentioned. So with lactulose, you’re blowing into a tube, and then you’re so you’re blowing into a tube, you get a baseline, then you swallow some lactulose and then you’re breathing into every 20 minutes. So you’re going to be able to get about, you know, about six to eight readings before you know it’s in that colon. Does that make sense?

Evan Brand: It does, and we just did a whole show on that. So go look back just a couple episodes ago, we did a whole podcast on SIBO bacterial overgrowth parasite, so check that one out. Now. Here’s what section I want to point out here, which is the fun guy yeast category. You see here that both of these people tested negative or supposedly negative for Candida SBP Alba cans, geo tricon micro spurt, and these are different fun guy. Micro spurious technically considered a parasite, but it’s, it’s confusing. So it’s in the fun guy category. Now, here’s the interesting thing. I don’t have these right in front of me to show you know, these false negative for candy candy is really tough to find in the store. We’d like to measure the organic acids like tartaric acid, and [INAUDIBLE] at all on the urine. So these are false negatives. So people ask about what’s the accuracy? Well, this test is very good, but it does have the issue of missing Candida quite a bit. And I can tell you because I remember these cases, both of these people had major candida overgrowth, it just didn’t show up. So you can’t This is why a lot of people they’ll try to save pennies and only do one test when they’re looking into their functional medicine history. But you can’t you gotta have all the puzzle pieces because all Otherwise, we may only be using antimicrobial herbs and not antifungal herbs and in this case, that would be what would happen we would have only used the bat the antimicrobials and not antifungals. But I can tell you, after looking at the urine of these people, they needed the antifungals. So we got them because we had all the picture. The picture was complete with the urine and stool, not just the stool

Dr. Justin Marchegiani: 100% so just kind of looking above real quick. The gi map can tell us generalize dysbiosis it can give us a pretty good guess that there could be small intestinal bacterial overgrowth SIBO based on the bacteria we see, but it can’t 100% confirm SIBO. So just trying to get people to wrap their head around that. That’s a common question I get. So I’m going to refer my patients to listen to this podcast for more Intel, but to be exact on the SIBO we need that protest. The next is a biopsy. Most people are not going to do a biopsy when there’s less invasive testing like a breath test available. And now adding to your point about the fungal overgrowth. The first thing we look at to assess fungal is clinical symptoms. Do we have any fungal toenails or fingernails? Do we have any dandruff issues in the hair? Do we have any tinea versicolor rashes on the skin? Do we have any history of athlete’s foot or jackets those kind of things. And of course that tells us there could be the gives us a higher chance that there could be fungus in the gut. That’s number one. Number two, we’re going to want to address that either way with specific herbs and obviously we want to hit it topically because sometimes fungus on the body or hair or scalp or skin or growing area or anywhere else still may be a problem and we may have to hit it topically that’s really important to note. And then we also have the [inaudible] which is going to look at fungus from the organic acid perspective and the organic acids a urinary test and that gives us a little bit more of a systemic window into either gut bacteria or yeast. And so that’s another test that we tend to combine with this because I’ve seen a lot of people come back clean on the yeast or fungus the very elevated, that’s important to keep an eye on.

Evan Brand: Yep, all the time. So we’ve seen much, much worse than this page 4 here, there’s a lot of other cases we could have pilfer through but just these are just the to be pulled up today. And according to this, you see that the only thing on the parasite and worm category was the person on the right here had some didn’t to me but fragile list which, according to the lab, they would say this isn’t a normal range. Now, we’ll probably end up killing this just as a byproduct of using the herbs to knock out the other bad guy. So this will probably disappear on a retest. But a lot of times we do see stuff pop up on these pages here blasto and cyclospora and [inaudible] there’s some other bad guys on here that can help drive up these inflammation markers. Now, if you go down to the bottom section here, I told you in the beginning, the person on the right had way more way more symptoms, they were way more sick and look here at the calprotectin level, the inflammation level, you know, we’re well above 400 here. So this is super, super inflamed gut and I’m surprised at that. IGA was as good as it was here the IGA expected to be lower, but it wasn’t. So either way this person needs help major.

Dr. Justin Marchegiani: Exactly. So just recapping, we have the parasites, these are all significant. So please have a parasite that’s close to being positive. So this one, this person here with the D fragilis, at 2.51, either the, either the third, versus the range being 1.08 of the five, I’m not worried about that, because this is essentially, let’s move it over to the left twice. So we’re looking at point o two, five, and then that’s one or greater, so not really worried about that, even though comes back positive, not worried about it, but it’s far below the reference range. If it was maybe 50% below the reference range or greater, you know, 50%, or up meaning point five and up even five same as the reference range, then you know, we’re going to work on treating that for sure. And so we have all these parasites here we of course, we have worms and we have different protocols for worms or for parasites, and we different protocols. If someone has A worm, a parasite, fungus, and bacterial overgrowth together and we may sequence things differently. So there’s a lot of different combinations and how we may hit things depending on what else is coming back. You know, any comments there Evan? 

Evan Brand: No, this is all good. And then what do you want to say about the immune system health here?

Dr. Justin Marchegiani: Yeah, so let’s kind of hit one by one. So sciatica it’s very important if we can’t break down fat that tells me that we have poor biliary output. If we have poor biliary output, there could be stones or sludge in there that could be from estrogen dominance. It could just be from inflammation in the gallbladder. It could be from poor stomach acid levels from gut stress and from CBOE and from infection, so we have to follow the six hours we remove the bad foods we replace the enzymes acids and maybe bile salts, if we have increased levels of sciatica because we have to be able to break down fat. Remember, bile is anti bacterial, right? So if we don’t have enough bile, and we’ve had chronically low bile sciatica will be higher and if sciatica tire that means Biles lower long term Biles antimicrobial So with lower levels of bile for long term that can actually drive bacterial overgrowth, so we want to make sure it’s the adequate adequate. We want to make sure elastase is good if we have low enzyme output, it automatically go to the fact that we probably have low hydrochloric acid too. And we’re going to stop them at HCl and enzyme separately. If we see sciatic right there, we’re going to add an extra biliary support in ox bile as well to help with fat Breakdown.

Evan Brand: Let me mention here what with the H. pylori infection, I’m kind of surprised have two things on this one on the right here that the secret is below detectable limits, because a lot of times we see H. pylori, and hi stay out of crit on the same panel, and then the IGA I’m surprised the IGA is not lower, meaning the gut barrier is less than tech. So maybe that means that the person was doing really good with diet, but I don’t think so with the calprotectin being so high. I don’t know, maybe it’s a relatively new infection. The IGA is better than the physical fast, not there. I don’t know. We don’t have to know every detail of why things show up the way they do. But it was just surprising to see that.

Dr. Justin Marchegiani: Exactly. So I mean, it’s important. So when we see you could have digestive issues and some of these markers couldn’t look, okay. So we have is that there’s an art and a science to what we do. So it’s not just Well, the test says there’s therefore, you know, we’re not going to give you support because we’re not treating a piece of paper, we’re treating a real life human being. So we have to look at the total picture, we have to look at the labs, we have to look at clinical markers, clinical indicators, hair quality, nail quality skin color, we have to look at the whole picture, right? If we see poor nail and skin and hair quality, well, we’re thinking this probably some digestive issues, especially with breaking down fats and protein, even if this test says we’re okay. Yeah, so next thing is we look at beta blocker on a day that tells me there’s probably some bacterial overgrowth, which made it look around and this gets made by bad bacteria. So we like to look at that as well as the other markers for bacterial overgrowth like the actual bacteria themselves. And then of course, that’s going to screw up estrogen metabolism. So we may, if it’s a female or a male, when they were having high amounts of estrogen symptoms, we may give things like calcium to glue great. But a lot of times just fixing the digestion and getting extra sulfur nutrients in there can help a lot of that so we can start breaking down and escorting out those re metabolized hormones, those research questions, we may give extra fiber a vitamin C as well. It just depends but when I seek beta glucuronidase high I’m thinking hormonal issues and I’m thinking also bacterial overgrowth issues too.

Evan Brand: Yeah, just general toxicity because you’re really circulating toxin. So when we see mycotoxins high, if we look at chemical toxins high, we know that person is really circulating all their toxicity. So we really have to prioritize that when we see it high.

Dr. Justin Marchegiani: Exactly. And then the next thing is ocula. Of course, if we see an H pylori infection, you know, we’re thinking Oh, hey, is there an ulcer? Is there any blood in the stool is already redness in the stool? Most of the time, we see That’s going to be in the stool. We’re thinking, hey, maybe there’s just hemorrhoids, right? Those hemorrhoids veins in the in the anus, they get inflamed, but people chronically bearing down. And sometimes a little bit of blood can come out through those veins. And that’s not necessarily as big of a deal as let’s say, an ulcer in the upper gut track, or something in the small intestine like a dwan ulcer So we have to kind of draw a line between ulcerations in the intestinal tract, and maybe a little bit of blood coming out from the hemorrhoids. So of course, if we see any blood, we asked, Is there a history of hemorrhoids? And most of the time, there’s Yes. If we’re not sure, then, you know, we’ll look at Hey, is there any anemic patterns, they’ll be 12, low iron, run a full iron panel as well run it run a full CBC with indices, so we can get a window to make sure it’s not affecting the overall blood and iron levels and hemoglobin levels. Okay, any comments there?

Evan Brand: We’ve seen a really high and these cases it was zero, but we’ve seen it high and it’s a great, very helpful piece of the puzzle.

Dr. Justin Marchegiani: Exactly. And the next thing I would say is the ga levels and again IGA, it’s good to look at we don’t go all in an IGA. If we see extreme high, we’re thinking maybe there’s an active infection and the immune system is going after it. If we see low, we think maybe there’s some chronic stress and that immune mucosal barrier has been weakened due to inflammation from food infections, poor digestion, emotional stress, etc. We don’t go all in though. So it’s not like, Hey, this is low, we have to, you know, go all in and target that. It that’s a, I call these peripheral markers, meaning they’re an effect, not a cause. So the IGA is going to go up because of other things, that’s not going to be a problem in and of itself, we have to look upstream to get to the root issue. So we keep it in mind, but it’s not going to be something we get so myopically focused on.

Evan Brand: Yeah, and it’ll often it’ll often self regulate. So if it’s, if it’s too high, and you fix the bugs, it’ll go back to normal. If it’s too low, and you remove the infections, damaging the mucosal barrier, then it can come back up on its own, and sometimes it does need special care, but a lot of times it does self regulate.

Dr. Justin Marchegiani: Exactly. Exactly. And then again, we have the gluten antibodies. That’s a big deal because if we are gluten sensitive, and we’re consuming foods that are making us weak and jacking up our immune response or weakening our immune response, that’s a problem. So of course, the gluten markers are a big deal and we gotta keep that in mind. And it may not just be cutting out gluten, and you know, avoiding wheat, barley and rye, right, which are gluten grains. Really, that’s basically adding, maybe cutting out all grains because glutens just like brothers and sisters in a family, they may look similar to their aunts, their uncles and their cousins, right, there’s a family resemblance and so our immune system still sees that family resemblance to other types of gluten grains, like rice or oats or corn, or even pseudo grains like quinoa. So we may have to cut out all grains and go 100% grain free. And then of course, the other X Factor is going to restaurants that could be grains or flowers or thickeners and sauces. So if you’re going out to eat and you’re trying to be 100% green Free, you know, stick with steaks stick with things that don’t have sauces on it unless you know exactly what that sauces.

Evan Brand: Yep, well said the calprotectin look at the huge difference here. I mean, despite both of them having bacterial overgrowth, we see calprotectin here at a three, no issue. And then over here we see 400, which is really high. We’ve seen higher but I mean, that’s, that’s a significant problem. And I would say this is more of a, an effect as well, right? I mean, you’re not going to say, Hey, we’re going to submit specifically go after calprotectin however, I often do, I often will throw in, I’ve got one I called gic with two, which is just a straight aloe extract, I often will if it’s this high throw in just a little bit of some aloe or something else to try to hurry up and give down even while we’re working on the bad guys. Yeah.

Dr. Justin Marchegiani: calprotectin is basically c reactive protein, which is a systemic inflammation marker for the blood. It’s a systemic inflammation marker for the gut. calprotectin is produced by the white blood cells in the guts and in and around inflammation. Here’s the thing you You can still have inflammation in your gut in your tummy, and not have high levels of calprotectin. So it’s not a catch all. It’s not perfect. But if we see calprotectin is there we know we keep that in mind, there can be some false positives regarding calprotectin. And of course, there can be false negatives, meaning not that calprotectin is high, but it came back negative, but more like you still have inflammation in your guts. It’s just not coming up coming back with calprotectin. So it’s not the be all end all but if we see it high, it can lead us that there could be some Irritable Bowel Disease like Crohn’s or ulcerative colitis, or microscopic colitis, which is important to know people that have Irritable Bowel Disease, right. Those types of conditions that I just mentioned, they have to be more strict and they have to be more extreme with the diet and like Evan said, we’re going to be adding in more healing and soothing compounds aloe ggl l glutamine. We’re going to be adding a bone broth, things that are soothing for that gut lining to calm down the inflammation of course. That’s that’s an effect not a cause. So we’re still going upstream to all of the things we just talked about earlier.

Evan Brand: Yeah, like that you mentioned here, so this person, you, you’re not going to necessarily get them off the hook just because they’re calprotectin was low as if they’re reporting gut inflammation symptoms, there’s like major bloating or there’s burning, or there’s just stomach pain, we may still use gut healing nutrients, and now with this person, even though they didn’t show up, hi. So I like the point you make that it is kind of an art and a science, because there’s a lot of people that they expect to look at the number and then have a game plan just based on the number but it actually goes deeper than that.

Dr. Justin Marchegiani: Exactly. And I see a lot of people that are doing these tests on their own, and they’re trying to self treat. And it’s a big, big mistake, because you have to look at the clinical picture. I have people that want to reach out to me and just want me to review the test. And I’m like, No, I need to know the whole clinical picture. I need to know everything about that patient, their history where they’re at, and then I connected to the results. So you have to look at everything, and people really make a big mistake. And that’s why you You want to have a good functional medicine doctor that can connect the history to the labs super important.

Evan Brand: Let’s talk about the antibiotic resistance just for a couple minutes and then I gotta run but on the right here, let’s talk about this one because this is the person who did show up with the H. pylori. How would you approach this page if let’s just say that everything we’re positive and they’re going to go to their gastro doc and they’re going to say, hey, gastro, Doc, I’ve got h pylori, but now I’m showing up they don’t but let’s say in this case, because we’ve seen it a lot. amoxicillin shows positive Clarithromycin fluoroquinolones also positive positive positive then what?

Dr. Justin Marchegiani: Yeah, so when we look at when we look at some of the markers here, for instance, these are different families of antibiotics. So for H pylori, there’s what’s called triple therapy that’s come Amoxicillin Clarithromycin Omeprazole, right, amoxicillin, Clarithromycin or antibiotics. So they’re looking at resistance of the H pylori to the antibiotics so obviously nothing came back there. Then you have the floor Quinn alone family which is sometimes us that’s going to be you know, this is has a lot Side effects in the literature with mitochondrial damage. fluoroquinolones are also known to destroy ligaments and tendons, lot of Achilles tendon ruptures associated with these we really want to avoid fluoroquinolones at all costs. So fluoroquinolones will be it will have a Quinn lucquin Cipro, those kind of things got to be careful with those tetracycline as well. It’s not going to be not gonna have the same side effects as the fluoroquinolones and then we have different families of antibiotics, right. So b lactamase is going to be things like they’re going to be penicillin derivatives, that’s going to be cephalosporin etc, typically, penicillin derivatives. So if we see, be lactamase positive, you know, then we want to probably want to avoid if we’re going to go down the antibiotic route, the penicillin derivative antibiotics again, for us, it’s not a big deal because we’re not using antibiotics like a conventional medical doctor would. So it doesn’t really help us a ton, but if people have gotten out of In the past, and we say, Hey, you know, you haven’t gotten better, it’s nice to connect the fact that hey, there may be some genetic resistance.

Evan Brand: So you know, yeah, because we’ll have people that say, hey, look, Dr. J already did triple therapy and then they come to us and guess what they showed positive for all the ones that they did in the triple therapy. So it’s at least nice for us to be able to explain to them why they failed in the past and sometimes that alone just makes people feel better.

Dr. Justin Marchegiani: Exactly. And then we have the macro lives down here, which essentially Clarithromycin up top is a macro slide. So, these are different families, they use these at the top because these are the most common, they call it triple therapy or prep pack is what you said about us, but clarity myosins in the macro lives family, so you have like zero Max Azithromycin, Erythromycin, you have Clarithromycin by x and these are different macro lies and then you have vancomycin by itself. So, these are different anabolic families that are going to be used to address the infection, but we’re not using that but it’s nice To know if there’s resistance and connect it back to the history, or anything else you want to add there, Evan,

Evan Brand: I would just say, the point that you already said, but I’ll say it again is that you can’t just look at this lab and expect someone to review this lab for you and make a protocol. And if they do offer that service, I would be skeptical that service because that’s not how it works. You can’t just look at this and have a full picture. And then hey, I’m going to make a protocol based on these numbers and get you better if you’re just in a vacuum you’ve got you’ve got no history, you’ve got no no information on sleep and diet and stress and relationships and you’ve got no clue what they’ve done that’s helped and no clue of what they’ve done. That hasn’t helped. I mean, I just don’t want people to focus on that by itself. You got to have the full case history you got to have the full review because you just won’t get better if you don’t,

Dr. Justin Marchegiani: history is half labs or the other half. And really important is anyone listening to wants to take the next step. Feel free to reach out to Evan brand at you can reach out to Dr. J at We’re available for consultation worldwide if you want to dive in. And if people aren’t ready to take the next step just use this information. It’s totally free get your health better if you have family or friends that could utilize it as well just give us a share Sharing is caring. We appreciate it. Put your comments down below if you’re enjoying it. Let us know what you think. I know Evans gotta run to a patient I do as well. So Evan, wish you the best. It’s Thanksgiving day week. So you have a great Thanksgiving Day with your family and everyone listening have a phenomenal Thanksgiving as well. Everyone, you guys take care. 

Evan Brand: You too. See you later. Bye. 

Dr. Justin Marchegiani: All right. Bye.


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Blood Sugar | Podcast #194

Welcome to another functional medicine podcast with Dr. J and Evan Brand! This video talks about blood sugar, and other relevant things revolving around it, such as symptoms, Insulin resistance, Cortisol response, and nutrition. Stay watching for additional information about the benefits of fasting and the influence of the gut to the body’s blood sugar.

To effectively listen to what the body needs, knowledge is essential for knowing why it’s doing what it’s doing, so keep subscribing for more videos. Don’t forget to share!

Dr. Justin Marchegiani

In this episode, we cover:

01:12  Mood, Blood Sugar, Insulin Resistance and Fasting

06:43  Total Fasting Benefits

11:00  Gut Influences Blood Sugar

18:50  Precautions in Taking Antibiotics

22:00  A1C Test


Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here. Welcome back to the podcast. Evan. Evan Brand, my friend, how are we doing today?

Evan Brand: I’m doing great, man. I’m excited to chat with you. We came up with the idea of chatting about blood sugar. It’s a low hanging fruit that people still don’t dial in, but yet they want a Silver bullet to fix their problems but their blood sugar is still not addressed. It’s like, you can’t skip that and go to this magic supplement if you want to be truly happy and healthy.

Dr. Justin Marchegiani: Yeah. I mean, the whole goal of blood sugar stability is not relying on your hormonal system to buffer the high’s and low’s, right? Blood sugar goes too high, right— the pancreas has to come out and drop it down. Blood sugar gets too low, the adrenals have to come out and punch in some adrenaline or cortisol to bring it back up. Maybe even a tiny bit of Glucagon, right? So, you get these hormonal roller coasters where your hormones— like, imagine— Let me just— Let’s say this. Like you’re driving a bumper cart, right? But you’re driving it so smooth that you’re not bouncing off the ends, right? So, most people, they basically pinball or bumper cart their blood sugar through the day, and they’re chronically relying on their hormones for either side. The problem is, there’s implications, and in your mood and how you feel, and in your body when you do that. When you bump on the Left Rail— Let’s call that Left Rail Insulin, that’s gonna increase Insulin, which can then drive and grow your fat cells. And they can also, for females, increase risk of PCOS. It can also cause cells to grow at an abnormal rate ‘cause Insulin’s a growth hormone, i.e. cancer cells. There’s an inflammatory nature to higher or Hyperinsulinemia type of uh— environments because of cells growing, and because of inflammation, and because of the fact that high Insulin tends to shut down the lipolytic enzymes. Lipolytic means the enzymes that break down fat and utilize it for fuel. So then now you become basically relying on sugar for fuel. So this is the analogy of going camping and starting a fire with twigs and paper, and you’re literally feeding the p— twigs and paper in all night long. You can’t even go to sleep because the fire keeps on going out and then you freeze. So we want to rely on foods that allow us to drive down the center of this bumper cart aisle and not have to crash on each side, and then deal with the hormonal issues that may happen because of it.

Evan Brand: Yup. So, tell people what that would be like. These are like the banana and cereal breakfast people.

Dr. Justin Marchegiani: Yeah. So, number one is starting your day with a whole bunch of refined carbohydrates. My— My belief, based on physiology, is we have the our higher levels of Cortisol in the morning. So, we naturally have more mobilization of carbohydrate in our liver from our liver from a Gluconeogenesis or from just mobilizing glycogen in the liver or glycogen in the muscle. So we have more internal sugar in our bloodstream just because of our cortisol levels. So my philosophy is to consume less carbohydrate in the morning at higher quality protein and fat that keep that fat from the nighttime moving, and instead of having fasting, it’s kind of like a nutritional Ketosis where we’re putting nutrition in our body but our body’s still tapping in to our fat reserves, kind of like a starvation state. The difference is, with adequate nutrition our body’s more likely to tap in to the food in our bloodstream versus our muscle tissue in our lean structural mass.

Evan Brand: Yup. And with mood— I want to bring that up. You may be hungry by 10:00 AM and you’re not able to go in between meals. Like, if you’re— if you’re listening, if you’re unable to go from breakfast to lunch and you have to snack in between, that’s a sign that your blood sugar is off. Other signs, we could say, irritable, if you’re shaky, if you get stressed out, you get hangry if your meals are delayed. That’s a sign that blood sugar is off. You mentioned the Insulin pee. So that could be excess body fat if you’re Insulin resistant. What else would you like to add to the list of symptoms? Anxiety, I know, is a big one that which—

Dr. Justin Marchegiani: Anxiety and mood issues. Because of that those bumper cart rails— It’s like the third rail on the sub— on the subway, right, where it’s— there’s like, you get shocked, instead you get depression, you get mood issues. If you’re a female on the high Insulin side, you could get PCOS. As a guy, you’re gonna increase Aromati— uh— Aromatization, which is more Estrogen. And you could get, kind of Comastia, man boobs, just you know, moody or more emotional because guys shouldn’t have that amount of Estrogen in, so it really screws up their hormonal physiology, and that can cause all kinds of different issues. And, you know, just to kind of like outline it, like we want to eat foods that are nutritionally dense but we want to continue to keep our body in more of a fat burning state as a— as a overall percentage, right? And there’s a lot of people out there pushing a lot of fasting or Intermittent fasting or just fasting in general, and it’s like, there’s no magic in eating nothing. There’s no magic in it. Now, there’s some therapeutic benefit. The problem is, most people that are significant Insulin resistant, you’re typically not Insulin resistant from eating a whole bunch of nutrient dense foods. You’re typically Insulin resistant because there’s too much— you know, too much carbohydrate, and especially from refined, processed types of foods. So there’s not gonna be a magic in “Okay. Let’s cut the carbs down by giving you nothing” because you’re still also not providing the nutrients to run those pathways at the same time. So you have one side of the fence where you’re eating a whole bunch of calories that are driving— that are processed and that are driving Insulin resistance. Those calories have also high calories, low nutrition. And now the  magic is, “Let’s eat nothing,” which also has no nutrition. Now, the benefit is, there’s also a lot of inflammatory compounds in these foods.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So people do get benefit because the inflammation does go down, because no— nothing has no nutritions but it also has no inflammation. It also doesn’t have anti-inflammatory foods on the other side. So, we’re missing the nutritional density. We’re missing the anti-inflammatory nutrients and the anti-inflammatory fats, the Omega-3’s, the antioxidants— those kind of things as well. So, my thing is, let’s get the— let’s get the nutrition in there. Get the blood sugar stabilized so we’re snot bouncing off these third rails that are causing all these hormonal swings and emotional mood issues.

Evan Brand: So, it sounds like you’re saying you want to graduate someone up to maybe an Intermittent fasting plan. You might not just take somebody that went from eating garbage to straight Intermittent fasting. But they hear about Intermittent fasting ‘cause it’s trendy, so they don’t go and dial in blood sugar first. They’re just like, “I’m gonna go fast. I’m gonna get off McDonald’s or whatever garbage and go fast,” and they wonder why it doesn’t work. Is that what you’re saying?

Dr. Justin Marchegiani: Yes, a hundred percent, as we need nutrition around our system. And there’s lots of people out there that are promoting just total fasting, and there’s a lot of people out there that I respect and I like, and I get where they’re coming from. Let— Let’s go over the total fasting benefits.

Evan Brand: Yeah

Dr. Justin Marchegiani: One, if you’re massively Insulin resistant, yes it can help. The difference is, well, you’re still not putting the nutrition in your body to run those systems. If we look at glycolysis and our Krebs cycle and Electron Transport Chain, it requires nutrients to run. So, my— my philosophy is, let’s get those nutrients in there. Number two, there’s a benefit because you’re not eating a whole bunch of inflammatory glutinous foods that may have a lot of in— inflammatory reactions ‘cause those foods aren’t good themselves. My thing is though, “Let’s try to get the nutrition in, and let’s also cut the inflammation out as well.” The third thing is that someone’s gut’s really, really, really messed up, that’s— it could be helpful ‘cause then you just dope anything in which can let the gut heal a bit.

Evan Brand: Uhmhm—

Dr. Justin Marchegiani: Now, my thing is, there are other types of diets out there, like the GAPS Diet, or even an extreme kind of elemental kind of GAPS diet where you’re still getting nutrition in but you’re using cooking and processing methods to pre-break down those foods and nutrients so they’re much easier to take in to the body. So there’s— this tends to be a couple of different ways where you can parse this out and try to make it work.

Evan Brand: Yeah. more people think, too, that the fasting is gonna cure everything, but as you mentioned, you’ve got to have these different amino acids. These are creating neurotransmitters that are creating hormones. So, fasting is a stress. It’s a good stress but some people may be too weak for it. So you mentioned the adrenals already but, I know I found, for me, when my adrenals were wrecked, and I try to do Intermittent fasting, I did not feel well. I was sleeping horribly. I had anxiety throughout the day. So for me, I would say, the— the disclaimer amy be, “If you have adrenal stress, you may be unable to adapt to this fasting protocol.”

Dr. Justin Marchegiani: One hundred percent. So, number one, fasting is a stressor on the body. Right? We know it’s a stressor ‘cause our body will produce hormones to downregulate our metabolism. Just go type in Hypocaloric diet and Reverse T3.

Evan Brand: Yeah.

Dr. Justin Marchegiani: You’ll see Reverse T3 levels go up. You’ll also see even Cortisol levels go up. Why is Cortisol levels going up? Because your body is trying to start breaking down structural tissue, muscle, etc., to get nutrition from it. It’s like, you know, you’re in debt. What’s the first thing you do when you’re in debt? Let’s cut the phone bill. Let’s cut the cable. Let’s, you know, maybe cut down on that, you know, the— the superfluous, extra expenses that aren’t— you know fundamental. What your body sees muscle is kind of that extra IPhone expense. It sees it as maybe the takeout food from the— you know, from the Sushi restaurant down the street. It sees it like that. Now, we know muscle has really great effects in performance and aesthetic and overall health, so we just make sure that income’s coming in so we can sustain it, right?

Evan Brand: Yup. That’s a great analogy. Another thing too is the Cortisol’s probably a motivating factor, ‘cause in ancient times, if you weren’t eating, your body thinks, “eventually you’re gonna starve and die.” So it’s probably gonna motivate you and maybe give you a little bit of the anxiety to push you like, “Hey. You better go hunt because you can’t just be starving like this all the time.” So, uh— There are benefits, but—

Dr. Justin Marchegiani: One hundred percent. So like— There’s like one camp that’s like— that’s fast their way to health. There’s no magic. It ain’t nothing.

Evan Brand: Right.

Dr. Justin Marchegiani: Right? If that’s the case, you know, every concentration camp victim in World War II would have the secret to health. That’s just not that way, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: Now, there’s therapeutic benefits once you hit optimal health, and this is where most people in the podcast— they won’t get this far to hear it uh— because they’ll just see the title and just run. But once you hit the level of optimal health, that’s where you can play with uh— Intermittent fasting. I prefer Intermittent fasting more because you’re still getting adequate levels of nutrition to run those pathways. You’re just compressing the feeding window. Right? If you need 2,000 calories of whole food nutrition but you’re choosing a six to 8-hour window to get that in, well, great! So then, you get this 18-hour window where there’s very relatively low levels of Insulin, which can then help increase cellular autophagy, which then can help recycle proteins and have maybe some benefits in extending telomere length. I get that. Right? But let’s get to a place where you can do that and still function, and your nutritional density is super, super high.

Evan Brand: Yep. Well said. Is there anything else we should say about blood sugar? The gut influences blood sugar too. We do find it with a lot of people with gut infections, which is something we test everyone for, with parasites, bacterial overgrowth, etc. Kind of like this fasting thing you’ve mentioned. Some of these gut bugs are stealing your amino acids. Lyme and some of the coinfections with that can take amino acids too. So, if you do have gut bugs, that may be part of the reason why your blood sugar is crap. SO if you’re trying to do adrenal stuff, you’re trying to do fasting work and you can’t adjust, you’ve got to get the gut looked at too.

Dr. Justin Marchegiani: One hundred percent. Right? So a lot of these, let’s just say, uh— microbes or infections, they like processed sugar. Processed sugar is really easy for our body to— to process, right? It’s really easy to take in and to utilize it for energy, and it’s— it’s kind of has its addicting-like effect that can boost up Dopamine. So these critters get that and they produce chemicals inside your body that causes you to crave it. So— That’s why I see a lot of people like, “Oh! Well, just eat what you like and do this, and listen to your body.” O— How do you do that? How do you do that if you have infections or yeast overgrowth or bacterial overgrowth, and these critters are causing you to crave certain things that may not be right for you but may be right for them. That’s where knowledge needs to come in so you understand why your body’s doing what it’s doing. It’s like these uhm— like the metabolic typing questionnaires of like uhm— you know, the 2000’s, where I use that people do these metabolic typing questionnaires, which are great! And you find out if you’re a protein type, a carb type or a fat type. The problem is, the— the pi— the patient’s gut microbes would take the test for them, not necessarily them. [laugh]

Evan Brand: Exactly. I mean, if I ate what I felt like eating when I had a Candida overgrowth, I would ate gluten-free doughnuts all day.

Dr. Justin Marchegiani: Yeah! So there needs to be an educational component there, and I think a lot of people kind of mess that one up, and they kind of get more kind of intuitive on it. But it’s good to have that. But you’ve got to be in a— in a balanced place to use your intuition if not the chemicals, uh— or the— the microbes in our body will produce things that will cause us to override that.

Evan Brand: Yup. Is there anything else we should mention on— on the blood sugar conversation?

Dr. Justin Marchegiani: Oh, yeah. So [stutters] I’m like the analogy king, right? That’s kind of like, you know, you meet someone for the first time. The first couple months, or maybe six months to a year, you’re in this massive honeymoon phase, right? And you just— Everything is just amazing, right? It’s kind of like that with these kind of infections. They’re just— They’re keeping you on this honeymoon phase with all these carbohydrates and all these excess refined sugar, and you may not be able to listen to what your body really needs.

Evan Brand: Yup. Yup. That’s for sure. So get tested. If you have gut bugs, fix those. If you have adrenal issues, fix those because it’s tough. It’s tough to stabilize blood sugar if you have adrenal stress. Like you said, your adrenals can come in and pinch hit. But if you have weak adrenals, you’re getting shaky, you’re having panic attacks, you go to your psychiatrist and you tell them you’re having anxiety issues. How many times are they gonna mention blood sugar?

Dr. Justin Marchegiani: It’s very rarely mentioned. And then also, the— the nutrient density aspect too, right? So, plants are great. Plants aren’t quite as nutrient dense. The only exception for that is if you juice them.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Right? Five hundred calories of Kale is 16 cups of Kale. Very hard to do that in a day, let alone a sitting. Five hundred calories of grass-fed beef is eight ounces of meat. When I go to a Steakhouse, I’m putting down a 60-ounce steak, not an 8-ounce…

Evan Brand: [laughs]

Dr. Justin Marchegiani: …steak. Alright? That’s not a problem. Try putting down 16 cups of Kale.

Evan Brand: Oh my God. Let me mention this while you’re on that topic. I ha an—

Dr. Justin Marchegiani: Now, [crosstalk] I’ll drink— I’ll drink some green— green veggie juice that’s got six or seven pounds of vegetables juice in there.

Evan Brand: Yeah.

Dr. Justin Marchegiani: But I’m not gonna— I’m not gonna uhm— dilute myself, thinking that I’m gonna have 16 cups of Kale on an actual plate today.

Evan Brand: yeah. Since you mentioned it, let me bring it up. I had a new client…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …last week. Uh— She’s been a Vegan for two years, and guess what? She just got diagnosed with Type-2 diabetes.

Dr. Justin Marchegiani: That’s the problem with Vegan Vegetarian diets. Thay work fo— And again, I’m not an “all or nothing” guy.

Evan Brand: Yeah.

Dr. Justin Marchegiani: I can say who these diets are great for. People that are more Insulin sensitive, they’re more ectomorph. They tend to like— They take in carbohydrates. They get this propensity to want to exercise and do work, and they— and they love the longer distance exercise. They do well with it. They tend to have uhm— you know, this ectomorph kind of longer skinnier type of body type. They burn fuel really well. They do pretty good with the higher carbohydrates as a percentage, right? Sixty-70%, they do well with it, right— which is kind of the percent of carbohydrates in the food pyramid. Kind of interesting. So they do well with that, right? And, you know, a lot of the good ones, like ____[15:25]. A lot of times to— to keep the muscle on, they have to do some kind of supplemental protein. So do— they’ll do like a pea protein or a hemp protein. They’ll do a high quality protein that doesn’t have all the crap on it too, and they won’t rely in a lot of the soy. So that’s kind of how they get away with it. But people that are more Insulin sensitive, it’s hard to get adequate levels— I’m sorry. The people that are more Insulin-resistant, it’s hard to get adequate levels of protein out of Vegan vegetarian diet. If you do the Math, and you put like the rice and the beans and all that stuff in there, it’s hard to get less than 300 grams of carbohydrate a day and get that half a gram to the quarters of a gram per uh— of protein per pound of body weight. So you’re looking at 300 grams of carbs a day.

Evan Brand: That’s crazy. I know I had her run some of her numbers and it was close to that. I asked her like, “What’s your breakfast, lunch, dinner?” It was just vegetables and pretty much beans like every meal. I was like, “Good Lord!”

Dr. Justin Marchegiani: Yeah, and if you’re do— if you’re doing 2,000 calories, and you’re doing, you know, 300 grams a day, that’s 60% carbohydrate.

Evan Brand: So her A1C level was a 6.7. So, right there, type-2 diabetes, and she’d been promoted a Vegan diet by some nutritionist, and she tried it. And two years ago, she was eating tons tons of uh— chicken and pastured turkey and blah-blah-blah kind of more Paleo template. She felt great. But this lady says, “I promise you’re gonna feel so much better if you do Vegan.” They just started to feel terrible, hair was falling out. The lady said, “Just keep going. Just keep going.” And then now, just last week or the week before, got the diagnosis type-2 diabetes and reach out to me. And I said, the first thing you could do, let’s add in some animal protein just a little bit, just to see how you feel, like half a palm size portion of chicken. She’s like, “Oh my God! Just the idea of meat again sound so good to me. I already feel more relaxed thinking about it.” So it’s like—

Dr. Justin Marchegiani: Yup. People tend to lose the craving of meat because they don’t process it and digest it. And then the Vegan Vegetarians, the— they compare the nutrient density. They— they do it uhm— fraudulently because they compare an unrealistic amount of vegetables that someone would eat in a meal…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …or even in a day, to a realistic amount of meat that someone could eat in a meal. Eight ounces of meat’s pretty realistic. Even my wife will have an eight ounce fillet at a nice Steakho— Steakhouse and she’ll be able to eat it, and she’s relatively small, right? But putting down 16 cups of Kale is quite difficult. The only exception is— is if you do some juicing.

Evan Brand: Yup. Yeah. Powders. There are some like greens powders…

Dr. Justin Marchegiani: Powder is what?

Evan Brand: …I don’t know.

Dr. Justin Marchegiani: But still— I mean, that still you’re kind of processing that in too, and you’re not getting some of that fiber, and, God forbid, you had some carrot to that, then you— you’re adding a lot of sugar as well. So you got to be careful with that. That’s a double-edged sword.

Evan Brand: Yeah. We had a question about the type of the gut testing. UH— We do a couple different ones. The ones we use a lot i the GI Map from Diagnostic Solutions. You could check out Justin’s site. You could get testing there. Uh— We run that on everybody and it’s really, really good ‘cause it’s DNA-based, so it’s gonna find infections. You do it at home.

Dr. Justin Marchegiani: One hundred percent. I love it. Any other questions that we can pull here that are pertinent to today’s talk? So guys, if we’re doing a podcast, we always appreciate keeping the questions uhm— you know, try to tangentially associate  them towards the talk. And I get it. We don’t label our talks. We are like functional medicine improv, right? You see comedy improv actors. We’re functional medicine improv uh— professionals, so we don’t— we don’t typically plan things out too far and ahead. So I— I get it. It’s a little spontaneous.

Evan Brand: Yeah. Tho—

Dr. Justin Marchegiani: Anything else, Evan, you can…

Evan Brand: Well…

Dr. Justin Marchegiani: …see there?

Evan Brand: …there was one question that we could hit on uh— just because it— it tied into the gut a bit. “If you must take an antibiotic, what precaution should one take to protect gut health?” I would say, first, if you must take an antibiotic, who says you must take one? Like, I believe I just had Strep Throat over the weekend. My wife looked at the back of my throat. It was yellow and white. It looked nasty. It sure felt like Strep. My throat was hurting, and I’m just doing high-dosed herbs, different types of antimicrobials. If I would have went to a doctor, they would have put me on antibiotics. So I think, first, you have to really evaluate. If you must take an antibiotic, is that for real? Like, are you gonna die if you don’t or are there herbs that you can integrate into it?

Dr. Justin Marchegiani: Yeah. Find out the scenario and— and if there’s an option to do like an oil of Oregano, or Silver, great. If for some reason, whatever that scenario is— let’s say, it’s a car accident, right? Or let’s say, you know, someone’s doing a procedure for you and saying, “You have to o antibiotics and if you don’t take it, I’m not gonna treat you.” Right? Then, I would look at doing probiotics during and after. And there’s some benefit in the research, too, actually doing it uh— during as well. So, just kind of keep that in the back of your head.

Evan Brand: Yeah. Justin’s selling different probiotics. I do too. You could just check at our sites, He’s got several., I got several. We use professional healthcare companies to make all of our products. So you want to make sure that they’re legit. If you just go to Whole Foods and you buy a probiotic, we can’t guarantee the potency of it. You definitely want to go for practitioner grade for probiotics.

Dr. Justin Marchegiani: Cool. And then—

Evan Brand: That was—

Dr. Justin Marchegiani: And then I see uh— a question from a patient here. I’ll answer the uh— the question here. Uh— “Heavy eyes, headaches, fatigue, brain fog, currently taking Thyrobalance— two morning, one in the afternoon. PMS, increase in cycle length shortened but the menstruation longer, estrogen problem, so it depends. This patient, I can remember last time we chatted was doing pretty good. So the question is, “Was there a backslide or not?” If there was a backslide, I want to like dig a little bit deeper into stressors or diet stuff. Uhm— But we may want to put like an Adaptogen in there. And I— I don’t have this person’s protocol up in front of us so…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …maybe some Estrogen-modulating types of herbs like some Maca. I use a product called Femmenessence that I get great results with. And then, of course some adaptogenic adrenal support. Then, make sure all the foundational stuff is dialed in. But I can’t go any deeper without, you know, uhm— doing a one-on-one but I hope that helps.

Evan Brand: Maybe some liver stuff too, like sometimes with the…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …cycle being off. Sometimes it’s just— you could throw a little, simple liver support in, a milk thistle, burdock root, dandelion— something like that— maybe some dandelion tea. It’s in that category— stuff that might help and can’t hurt.

Dr. Justin Marchegiani: Yeah, and then this person’s also mentioning that they started some GI Clearing, some gut killing herbs as well. The liver, the immune system, and lymphatic system could be a little bit stressed, so couple things you can do like a 3-7 days supplement holiday. Kind of come off for three to seven and rev back up slowly. Also, make sure binders are in there, like uh— activated charcoal or some bentonite clay. And then we can always put the ginger tea in there, and just kind of gradually in— you know, inch it up slowly, just so you can— if— if there’s uh— a p— basically, a point of no return where these things start. You can at least figure out where that point is and then just err on one side away from it.

Evan Brand: Yep. I think that’s good advise.

Dr. Justin Marchegiani: Yeah. Awesome. Great.

Evan Brand: [crosstalk] I think we’re out of time.

Dr. Justin Marchegiani: …for the great feedback. Excellent and I think we had a great chat today, Evan. Is there anything else you wanted to mention at all or add?

Evan Brand: Uh— Just get— get your— get your A1C tested. Like if you are concerned about blood sugar, if you’ve got Type-2 or Type-1 Diabetes in your family and you’re kind of paranoid about blood sugar, you could go to a pharmacy. They have a test kit called A1C now, and you can get a test kit for like 20 bucks and it’s a simple finger prick you can do at home to test your A1C, which is like your average blood sugar over the last couple to several months. And you could check it. I mean, you could have a— a doctor run this— you know, via blood too. But you could just do an at-home finger prick if you’re curious. And I know Justin has a glucose monitor. He tracks his blood sugar, and— Hey! There it is.

Dr. Justin Marchegiani: Right here. So— A nice little 20-dollar glucose monitor. Do a functional glucose tolerance test, not the conventional one where they give you 75 grams of a— a sugary solution. Because if you’re not like a so— a soda drinker, uhm— it doesn’t mimic anything in reality. Right? So, 20-dollar guy, gets some strips. Test your fasting. Uh— Do a fasting, one-hour, two-hour, three-hour. Choose a random breakfast, a random lunch and a random dinner during the week. Sometimes people can, like I mentioned earlier, they can mobilize a lot of carbohydrate ‘cause of the healthy Cortisol response. So, your blood sugar in the morning may not necessarily be high because of your diet. It may be high because of a Cortisol response, which is known as the Dawn Phenomenon or the Somogji effect. Very, very similar. One’s because of a hypoglycemic response. One’s ‘cause of a adrenaline Cortisol response that kind of cause the same thing, just the different— a different domino starts uh— the reaction but the results are pretty similar.

Evan Brand: Yeah. Yeah. So uh— The functional testing, what number are you looking for?

Dr. Justin Marchegiani: Uhm— So below a hundred uhm— on the fasting side. You know, 80 to 90 is ideal but below a hundred. And then, within one hour below 140, my preferred is 120. And then two hours uhm— below 120 or my preferred is below a hundred. And then three hours, definitely below a hundred back to around a fasting level. [crosstalk] That kind of gives you a window because most people, you know, during the day, they’re being challenged by the food they’re eating, and that’s what’s driving the Insulin resistance. That’s also the x-factor because Insulin resistance can also be driven by not sleeping enough.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, the sleep aspect is there. Lots of studies on college students. They were, within two weeks of sleep restriction, they were able to make them prediabetic.

Evan Brand: Oh my God.

Dr. Justin Marchegiani: So sleep resistance, and then why, right? Well, part of it could be because there is research that sleep deprivation can deplete Magnesium. Magnesium’s very helpful for blood sugar as well. So there’s lots of potential. And then also the Cortisol response. Cortisol then mobilizes more blood sugar ‘cause of the stress that’s happening from the mild sleep. So there’s like a hormone response that can cause it, and then there’s the stress that depletes certain nutrients and these nutrients are also important for blood sugar stability. So it happens in a couple of different angles.

Evan Brand: Yep. I’m sure we could chat further but we should probably wrap it up. So check out, if you want a consult with Justin, check out his site, If you like to consult with me, We look forward to helping you guys, and we’ll be back next week for some more fun.

Dr. Justin Marchegiani: Give us a thumbs up. Give us a like. YouTube— Subscribe is not enough for YouTube. You got to hit the— the bell button. So smash that bell for us. Hit the thumbs up.— And then, Evan’s got the Candida Summit as well, which is going on now. So make sure you subscribe to that.

Evan Brand: Yeah.

Dr. Justin Marchegiani: My link is

Evan Brand: [crosstalk] Just wrap up. Just wrap up. But if you guys want to go buy the event, I had a guy this morning, a new client who purchased my Upsell Talk, which is where I did an hour case review of reviewing a client’s labs and making a protocol. The guy said that that Upsell video alone was worth the cause. So if you want to buy it, use Justin’s link, Go check out that event and you can get that talk, or you can see an hour behind the scene, which we never reveal.

Dr. Justin Marchegiani: Yeah. And then, do you have a uhm— a link for my Thyroid Reset Summit?

Evan Brand: I don’t.

Dr. Justin Marchegiani: crosstalk] Want me to get you a link so when— when you’re on the podcast here, you can promote it.

Evan Brand: Nah, that’s fine. Use your link. People can have them. Go for it. Go register for Justin’s event. It’s gonna be awesome.

Dr. Justin Marchegiani: Awesome, man. Hey! It’s been totally real, Evan. Great chatting. Let’s talk real soon.

Evan Brand: Take care, man. Bye.

Dr. Justin Marchegiani: You too. Bye.



Clostridium Difficile and Leaky Gut – Podcast #174

In this video, let’s join Dr. Justin Marchegiani and Evan Brand as they talk about the link between Clostridium Difficile and Leaky Gut. Clostridium Difficile is a bacteria found almost everywhere and can cause symptoms like diarrhea, fever, and abdominal pain.

Watch this video as the two functional medicine experts share their thoughts on how this disease can affect your health and what you can do about it.

Dr. Justin Marchegiani

In this episode, we cover:

01:50   Biggest Risk Factor of CDI: Accumulative Antibiotic Exposure

05:32   Mood Issues Equals Gut Issues

07:47   The 6R Protocol

15:23   Fecal Transplant is an Experimental and a Palliative Therapy

21:10   Top Symptoms of Clostridium Difficile


Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here with Evan Brand. Evan, how are we doing today, man? Happy Monday.

Evan Brand: Happy Monday to you, the best day of the week. Uh– We’ve got a short limited time but we wanted to dive in and chat about gut infections and how this can affect mental health. We test everyone’s gut. We run a stool test on everyone, organic acids testing on everyone, or nearly everyone as much as possible, because there’s a lot of different markers that conventional doctors are never going to test. Therefore, you’re never gonna know what’s going on unless you can get these specific functional medicine testing run. And, one thing that we see a lot of is Clostridia. And- So, you and I we’re reviewing a little bit of the literature before we jumped on here, that the Clostridia bacteria, oftentimes people are gonna know about C. diff. You’ll hear about Clostridium difficile or C. diff. very commonly spread in like nursing homes and hospitals. A lot of times, it’s causing diarrhea. And there’s actually people dying of this because it’s actually become antibiotic-resistant. So, if you get Con– if you get a conventional doctor to diagnose and treat you for C. diff., it’s gonna be antibiotics. But the problem is, these antibiotics are working very very minimally. You know, they’re working– I don’t have the statistics but it’s not often that– that they work. And then, they come in a second, or a third, or a fourth round of antibiotic, and they still can’t get rid of it. And the things that we use, whether it’s Silver or Oregano, or garlic, or berberines, and barberries and berberries– there’s so many different natural antibiotics out there that we can use, and people don’t talk about this. So, that’s why we’re here to talk about it.

Dr. Justin Marchegiani: In one of the biggest things that predisposes people for C. diff., Clostridium difficile, is antibiotic exposure. I mean, I have one uh– journal article, basically talking about the cumulative antibiotic exposure is the biggest risk factor for Clostridium difficile infection, CDI. So, again, we know antibiotics are used kind of like candy in the conventional medical community. So, you know, the big thing that we’re trying to do is like, (1) let’s always try to do natural herbal botanicals first because, number one, they have a lot of antioxidants to them. Number two, they tend to have effects that inhibit the reflux, or the efflux pumps. And these efflux pumps are– Imagine a canoe with a hole in it and imagine you’re sitting in the canoe. You’re bailing out water, right? As water comes in to the hole, you’re bailing out water back out into the ocean. That’s kind of what efflux pumps do. The hole in the canoe is the antimicrobial or the antibiotics coming in, and then, the efflux pumps are bailing that water out. So, the benefit that we have with the efflux pumps, or the benefit that we have with the natural antimicrobials is we don’t have that– that pail, bailing out the water. We don’t have the critters bailing up the water, so it can take on water faster and we can essentially s– uh– sink the canoe so to speak.

Evan Brand: That’s crazy. Well, let’s chat about the brain a bit. So, there’s a lot of complicated uh– neurochemistry involved and we’ll keep it as simple as possible. If you just Google for yourself, Clostridia brain chemistry or Clostridia HPHPA, this is something that you can find– this picture. And what happens is normally, your neurotransmitters, like Tyrosine, are supposed to get converted into Dopa then into Dopamine. But what happens is, when we pull up your stool test and your organic acids, if we see that you’ve got elevated HPHPA– That’s organic acid that will show high on an OAT Test, a urine test. If you have this bacterial infection, what happens is, your Tyrosine doesn’t get converted into the Dopamine like it’s supposed to because there’s an enzyme. And Justin, maybe you can clear this up too, if I’m– if I’m interpreting this wrong. But these Clostridia species, they create an enzyme, and it’s called Dopamine beta-hydroxylase that causes the Dopamine not to break down properly. So then, all the sudden, you‘ve got aggression and rage and irritability and Schizophrenia and Autism, and all these other things that show up, because this enzyme is cranked up due to the bacterial infec— due to the bacterial infection. Then, you have excess Dopamine. Then, you go crazy. Is that how you interpret that whole cycle?

Dr. Justin Marchegiani: Well, yeah. I mean, if you look at the– uhm— the cycle right– So, we have Phenylalanine, which comes from Tyrosine, and then Phenylalanine can go down into these various Clostridium difficile metabolites. And then, from thee, that Dopamine hydrox— Dopamine beta-hydroxylase enzyme helps convert it downstream. And then, from there, it can also go into Norepinephrine, as well. So again, that’s important because any type of gut [inaudible] affect enzymes in the body, which can affect neurotransmitter conversion. But, number two, Clostridium difficile also causes a lot of digestive issues, especially Diarrhea. So, we know that if there’s Diarrhea happening, that is a good chance that we’re not gonna be able to break down, assimilate, utilize and absorb a lot of the nutrients that we’re taking in our uh– body through our diet and supplementation. So, that may also create more issues, ‘cause then we have less building blocks. So, I definitely see being a two-way street, some of these enzymes may affect optimal conversion of Dopamine in the brain. Remember, Dopamine can’t cross the blood-brain barrier, right? A lot of these amino acids do. And then, these amino acids get converted locally in the brain. And then, we also have the absorption component as well, which is really important.

Evan Brand: Yep. So, if you’ve got mood issues, a lot of times, you’re gonna have gut issues at the same time. When I had parasites, I had H.pylori, I had bacterial overgrowth. I didn’t have C. diff., luckily, but I had other species. My moods were– were not good. And even though, I’d done the Paleo diet for a long time, 80 percent of symptoms were better, but I didn’t get that final 20 percent symptom improvement until I fixed the gut. And Clostridia’s just one one of those things that show up. You mentioned other bacterial overgrowth. A lot of times, we’re not gonna see Clostridium in vacuum. We may see Candida, we may see mold, we may see fungus or fungal toxins, we may see parasites, we may see H. pylori, which is another type of bacterial infection that suppresses stomach acid. And this thing can get out of control. So, if you do have gut symptoms or you do have mood symptoms, whether it’s like aggression, irritability– you feel like your fuse is shorter than it should be, of course, there’s a factor in adrenals. There’s a– a liver component to this. There’s a thyroid component. We could probably chat about. But really, the– the take home messages, you’ve got to get tested for this. And uh– I’ve seen a lot of false negatives too– and maybe you can speak on this. That a conventional testing that is not as sensitive as what we’re using can miss these infections. Can you speak on that?

Dr. Justin Marchegiani: Well, again, the GI Map Testing that we use, we also look at C. diff., the toxin A and the toxin B. These are various toxins produced by these critters, and if you have both of them, A and B, the– You know, that’s gonna be– means you have uh–   a more virulent infection. You need to get treatment A.S.A.P. for that. But you may just have one toxin over the other, A versus B, or B versus A. So, that can give us a pretty good window what’s happening. And, you know, we have the Clostridium difficile species or other species of Clostridium as well. So, on these tests, we’ll see other species that are there but we really want to look for the various toxins that are present as well, ‘cause that’s gonna really cost a lot of the issues. And in conventional medicine, they’re typically using like Vancomycin to treat it. In the natural medicine world, you know, we can use berberines. We can use antimicrobial botanicals, right? There’s also specific probiotics we can use, like Saccharomyces boulardii and specific Lactobacillus species, like the Lactobacillus rhamnosus species. Now, in the the probiotics that we use, like in my Probio Flora, right. We have the rhamnosus in the Lactobacillus all in there together. And we’ll, typically, also hit it with very high dose Saccharomyces boulardii as well. But even before that, Even before we get to step five in that Six R protocol. First R, remove bad foods. Second R, replace enzymes, acids. Third R is gonna be repair the gut lining and the hormones. Fourth R’s removing the infection. So, we work on the fourth R, using a lot of the herbal botanicals to help remove the infection. Fifth R, we work on repopulation. So, again, we hit it in a lot of different steps to make sure we can knock it out fully. We don’t just rely on one antibiotic, because we do know that one of the biggest riks– risk factors for Clostridium difficile infection is cumulative antibiotic exposure according to literature, right?

Evan Brand: Yep. Yep. Well said. Let’s chat about protection a little bit. I mean, let’s say that you have to go visit a friend or a family member in a nursing home or a hospital, what could you do to maybe prevent yourself from picking this up? Because this Clostridia can be airborne.I mean, are you talkin— like, I’ve heard some people spraying Silver, like around their nose, their ears, their mouth, just trying to have like a general barrier. I mean, putting on a facemask, like, what do you do? How do you prevent yourself from picking this infection up, or at least, how do you reduce your risk?

Dr. Justin Marchegiani: Well, number one, uhm— a lot lof it’s gonna be spread in the– in th– in the bathroom, right? Because people have a bowel movement that’s particulate. Maybe they don’t flush, and they can aerosolized out of the toilet seat.

Evan Brand: Oh, gross.

Dr. Justin Marchegiani: …of course, keeping the toilet seat close– Those kind of things. Ideally, you know, trying to avoid a lot of public restrooms. When you have to– to utilize a bowel movement. Or at least just make sure uhm— you know, it’s fully flushed, right? Fully flushed– all that stuff. And uhm— you do your best with that. But that’s how…

Evan Brand: You know what’s crazy?

Dr. Justin Marchegiani: …I–

Evan Brand: The most of the public bathrooms, they don’t have lids on their toilet seats. So you just think of all these hundreds of people going in a public bathroom. There’s usually not a toilet seat. They flush it. That stuff’s going everywhere. Have you seen those studies where they’ve used like– I don’t know if it was a thermal imaging camera or like a UV Camera or a blacklight, and they can see like a the fecal matter is like 10 feet away from the toilet? Have you seen those videos?

Dr. Justin Marchegiani: [sigh] I’ve not seen that. I think it’s got to be getting better today, because a lot of the uhm— toilets kind of flush automatically.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, there is that benefit, right? As soon as someone gets off the seat, it flushes within a few seconds.

Evan Brand: True.

Dr. Justin Marchegiani: That– That’s better than someone just letting it sit there for a long period of time. Of course, you know, physical contamination is gonna be the big one. So, just touching stuff and not washing your hands– I think it’s good to have one of those uhm— I think it’s EO. EO makes one, but you can get them at Whole Foods. They’re kind of like a– alcohol, herbal…

Evan Brand: Yeah.

Dr. Justin Marchegiani: essential oil kind of rub you can get to spray or the gel. So I think it’s good like, once you’re out, like just kind of do that. You know, use a little bit of that gel or that spray as well. Just because, now you’re out. You haven’t touch anything, and that gives you a good chance of knocking that stuff down. So, I’ve no problem with that. That’s gonna help significantly.

Evan Brand: Yeah.

Dr. Justin Marchegiani: …wants that component dialed in.

Evan Brand: Yeah. Good advice. ‘Cause if you’ve got it on your hands and maybe you scratch your nose or you touch your face or something, and then you’ve get it into the bloodstream.

Dr. Justin Marchegiani: Exactly. And of course, just having a stronger immune system, right? A lot of these things happen when your immunocompromised. So, when you have poor diet, when you’ve poor– that’s when you’ve poor sleep, when you already have a compromised gut issue, these things can happen. So, they very rarely happen just out of isolation. Uhm– you may have other infections and then the C. diff– an issue. You may have other infections that came about because of chronic antibiotic use ‘cause antibiotics can cause rebound overgrowth as well. Or, if you’re using antibiotic– I don’t know, like an H. pylori infection. You’re doing triple therapy, right? A lot of the other uhm— things that are also used outside of Achromycin are gonna be Proton Pump Inhibitors, right? But what does that create? Low stomach acid environment. That’s gonna set you up to not breakdown proteins, be able to break down fats and ionize minerals. So that creates more problems down the road, right?

Evan Brand: Yeah. Well said. So, if you’re on an acid blocker, this conversation should perk your ears up a little bit. Pay attention ‘cause you’re at a higher risk for these infections. We see it every single week between us both. We’ve seen thousands and thousands of gut bugs. So, uh– acid blockers or uh– also birth control pills, too. We know that can affect the gut microbiome a bit. And also, uhm— yeast infections, too. So, if women have had yeast infections, they’re gonna get put on like a Diflucan or a Nystatin, or some other pharmaceutical. That could also change the microbial balance, and you get Clostridia that way. So, basically, any intervention that’s knocked out the good guys is gonna put you at risk, you’re saying.

Dr. Justin Marchegiani: One hundred percent, and just stay out of hospitals. Really, just stay out of, you know, conventional hospitals. I mean, if you have family member who really get sick, and you have to go, totally get it, right? But if you have the ability to wait ‘til someone’s out of the hospital, wait ‘til they’re out.

Evan Brand: Yeah. I mean, my wife uhm— her mom was in the hospital uh– what was it?– maybe a month ago. She had a lung nodule. They couldn’t figure out if it was cancerous or not, so they just took her in anyway and did like a long nodule surgery. And my wife wanted to go into the hospital, but I was like, “With the baby? We just can’t chance it.” So, she told her mom, “Hey, look. We’re just gonna wait it out.” And, it only took an extra day or two for her to get home. Nobody’s feelings were hurt, and she still got to visit her outside of the hospital environment. I mean, the last thing we wanted was, my wife bringing home some type of bug and get the baby sick, you know. So, we just didn’t take the chance.

Dr. Justin Marchegiani: Oh, totally. And, if someone’s in the hospital ‘cause of some, you know, severe reasons, right? Of course, you want to go, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: But if it’s like a severe life and death kind of thing, you know, try to utilize Face– FaceTime or Skype in your smartphone. That’s a good way of connecting ‘cause that– The biggest thing is being in hospitals and getting an antibiotic exposure. And guess what– yes, to the people that get the most antibiotic exposure are who? Right? They’re in hospitals.

Evan Brand: Oh, yeah. Yeah, rational.

Dr. Justin Marchegiani: These are people that are sick and they’re coming in to the ER. They’re coming in, right? ‘Cause the more chronically they’re comin in, typically, more antibiotics are prescribed. Because well that’s really the biggest thing that, you know, conventional medicine has with people that are sick.

Evan Brand: I know, IV is, too. [crosstalk] IV antibiotics. I mean, that’s just. I can’t believe how often that’s dispensed and distributed. It’s kind of scary.

Dr. Justin Marchegiani: A hundred percent. So, in general, like, we look at this from a functional medicine perspective. We can kind of like, zoom in on one type of thing here, which is C. diff., but when we were looking at things, we’re looking at the whole picture. So, C. diff. may be a part of your clinical picture if you have diarrhea or digestive issues or have leaky gut. So, maybe saying is C. diff an issue? It may be. But it may also be a combination of C. diff., H. pylori, and Blastocystis hominis. So, you– everyone has the right to have more than one issue going on at the same time.

Evan Brand: Great.

Dr. Justin Marchegiani: So, they’re just gonna keep that, you know, in the back of your head. A lot of these issues aren’t binary. They’re aren’t on-off. You know, one or the other. You can have multiple different things happening. And of course, the longer these gut issues are present, the more there’s a– an absorption or a bottleneck of nutrients getting into your system. That’s gonna affect your neurotransmitters. That’s gonna affect your adrenals. Also, potentially affect your thyroid, if your not maximally absorbing Selenium or Iodine, or Copper. And then, we know what the whole uhm— what the whole neurotransmitter thing in Dopamine, right? We look at the HPHPA. B6 is very important for Dopamine metabolism. And if we have dysbiotic bacterial overgrowth, that internal production, the B vitamins are gonna be down. And we may not quite be able to absorb the B vitamins in our diet, partly because of the increased transit time, right?

Evan Brand: Yep.

Dr. Justin Marchegiani: And, there’s toxicity and inflammation in the gut, your colon and your intestine’s soaked up a lot of water. Why? It’s doing it to dilute the– the infectious debris so it can flush it out. It’s diluting it and then flushing it out. But, what also is diluted and flushed out is also gonna be all of these micronutrients that are in your intestines that may not have enough time to assimilate, as– absorb and be utilized yet.

Evan Brand: Yep. well said. And then, we’ll give a mention here to fecal transplant. I mean, this is still kind of an ex– uh– e– e— I would say, experiment/ex– uh– I can’t even say the word, Justin. What is it? Experimental therapy?

Dr. Justin Marchegiani: Yeah. Uhmhm–

Evan Brand: Because I’m seeing people that are getting fecal transplants, and there is cool literature that after one, if not two, maybe three of the most fecal transplants, where you’re taking stool from a donor hat does not have C. diff. You’re transplanting that with a capsule of, usually have very, very deep-frozen stool– very, very cold frozen stool, in a capsule form. The C. diff. infected patients swallows that. Theen, within one, two, or at the most, three fecal transplants, the success rate is over 95 percent of curing C. diff. The only thing is, I’m having people that are saying they are getting personality changes, and that they’re starting to have a different preference for music. And if they’re craving fast food when they never craved fast food, and that they’ve gained weight or they’ve lost weight, because we’re finding out these gut bacteria are very unique. And you can take somebody’s gut bacteria from an obese person that doesn’t have C. diff., put it into your– you who’s a skinny person and also, you get obese. And, it’s because you took someone else’s microbiome and out it into your gut. So, I think it’s a– absolute last resort and a lot of the antimicrobials and protocols that you and I use for parasites and other bugs, we’re gonna kill C.diff. in the process of that. So, if that were unsuccessful, maybe, fecal transplant is necessary. But, man, I don’t really want to change my personality, or become obese because I took my bacteria from someone that, that had a– a personality that I didn’t like, or something. I mean, that just sounds– that sounds crazy to me.

Dr. Justin Marchegiani: Yeah. And again, when you do a fecal implant, you know, it– it’s gonna have effects that aren’t gonna be, potentially forever. Because z– when you put bacteria in your gut, it tends to be more transient and pass through.

Evan Brand: Okay.

Dr. Justin Marchegiani: You know, that kind of a microbiome that you have in the beginning is kind of what you have. You can influence it and nodge it in a direction, and a lot of these things tend to be more transient. That’s why, you know, you can’t just take a probiotic once and then get the benefit forever. You’re taking it but then also, may be getting fermented foods in your diet. Those kind of things to alter it. Maybe you’re taking some probiotics, a bottle of it, every quarter or so, once you’re doing really well and you’re getting fermented food in daily. But, again, I look at, like a fecal implant is kind of like a palliative thing.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, if I’m seeing an improvement with symptoms, and we’re able to knock the infection down without having to do a whole bunch of antibiotics, I think it’s beneficial. My thing is, if you have C. diff. and a whole bunch of other infections, and you’re still eating poorly, or you have other food allergens in there that are causing leaky gut, I see the fecal transplant is kind of like rearranging the deck chairs on the Titanic, so to speak.

Evan Brand: So– [crosstalk] yeah.

Dr. Justin Marchegiani: It’s not quite fixing the root cause better than antibiotics, in my opinion. So, we’ll have to just keep an eye in, and see how these things are– are looking in the literature. It’s the same thing with a lot of these docs that are using the helminth or worm therapy. Right? Uhm– They’re using and stuff to kind of modulate the immune system. I see a lot of that as being palliative, right? If not, we’d see people in third world countries that have lots of parasitic infections and worms, you know, have super robust health, right? Obviously, there are also malnourished and have really poor water supply. But I can imagine an infection driving and improving someone’s health. I ju

Evan Brand: Agree.

Dr. Justin Marchegiani: I just that– For me, I just have a hard time wrapping my head around it. I think it can push the immune system in one way or the other. And because, let’s say, you’re immune system was on this side, maybe more TH2. And now, you push it, more TH1, by giving a helminth or a worm. Then that can shift the immune system more to equilibrium, and you feel better. I don’t think it’s still the root cause, but I, my mind, I always like kind of look at things, “Okay. We have palliative therapies that just fix symptoms, and then palliative therapies that are more natural with less side ef— side effects, right?” Like so– Like, think of a headache, right? Palliative for headache, what’s that.

Evan Brand: Advil.

Dr. Justin Marchegiani: Magnesium, curcumin, right? Well, palliative that’s natural [crosstalk] side effects.

Evan Brand: O-kay.

Dr. Justin Marchegiani: Curcumiin, uh– Magnesium, B6, right– the various– you know, rosemary, ginger, right? Natural palliative things, without side effects. And then the other side, we have Ibuprofen that kills 20,000 people a year, taken properly.

Evan Brand: Yep.

Dr. Justin Marchegiani: So, I look at like palliative and then what’s the risk reward on those palliative things. So, I kind of put the fecal transplant more on the safer side versus like some of these other medications that kill many people, taken properly. So, we got a palliative– safe palliative, unsafe risk-reward, and then also what’s the root cause. So, in functional medicine, we always delineate all three of those.

Evan Brand: Yep. Well said. Well said. Uh– I think we could probably make this conversation longer, but since we’re out of time today, I think that was efficient. You’ve got to get the diet dialed-in. When we’re talking to you guys, we’re always assuming you’re following something like a Paleo template, organic pasture-raised  meats, organic veggies, high-quality berries, maybe some nuts and seeds, if you’re not on an AIP diet and you can tolerate those, you’re getting to bed on time, you’re getting out with the Sun, you’re getting exercise, adequate hydration, no sodas, no– you know– fake fructose in the diet, you’re not skipping meals, you’re getting your adrenals checked out, you’re thyroid, and then you’re jumping into this conversation. So, that’s all the prerequisites required to– to have on-board before you really start diving in to a gut protocol. So, uh– if you want to learn more, we’ve got hundreds of hours of content on this. Keep looking around. Go on Justin’s site, his personal site and blog, where you can also sign up for functional medicine consults. That’s And if you’d like to reach out and schedule a consult with me, you could do the same thing at And make sure you hit Subscribe on Justin’s channel here. Keep the tribe growing, and hit the bell. You’ll get the notifications. We’re gonna be back with you guys next Monday, around the same time. So, stay tuned for more.

Dr. Justin Marchegiani: Absolutely. And just remember, top symptoms for a C. diff. are gonna be watery diarrhea, fever, loss of appetite, uh– belly pain, nausea– these are all symptoms of other kind of infections, too. So, you know, it’s easy for people to– to read about one thing and say, this is me, right? You see it a lot with Lyme– Ly– Lyme disease– those kinds of things. So, you keep that in the back of your mind. Uh– washing with hands and soap, [clears throat] tends to be more effective than just using alcohol. Keep that in the back of your mind. If you’re visiting someone in the hospital, you know, wear the full gown get-up. You know, that same kind of gown that they’d wear. People that had MRSA wear that get-up as well.  So, if you’re gonna see someone, you know, that’s an extra wha— extra, well uh– protection as well, on top of that. Anything else you want to add there, Evan?

Evan Brand: I think that’s it. Get yourself tested. Like I said, reach out to one of us. If you need to get some functional medicine stool testing or organic acids testing done, we look for this. We see it thousands of times a year, but there are natural solutions. So, keep digging. Don’t give up and we’ll talk wiith you guys next week.

Dr. Justin Marchegiani: Absolutely. And then, anyone that’s asking questions here, try to keep it on topic. If you’re going off the deep and talking about things that we’re not chatting about, save that for my daily FAQs, uhm— that way, I can answer you there. I may do one today, so look. I’ll try to put it up in the YouTube queue, so you guys can be aware of it. And someone writes in about Eosinophilic gastroenteritis that can either be from severe food allergies or from other parasites. Allergies and parasites can increase Eosinophils. So, keep that in the back of your mind. Hey, Evan, phenomenal chat today. We’ll be right back here. I’m gonna do a video in a bit. I’ll post it up on YouTube later on today, and I’ll mail you back later on for a live FAQ, so stay tuned. If not, Friday mornings are gonna be when I do that. But look later on today. Evan, phenomenal chat, man. We’ll talk real soon.

Evan Brand: Take care. Bye.

Dr. Justin Marchegiani: Have a great Monday. Bye.


Sinus and ear infection solutions – Podcast #133

Dr. Justin Marchegiani and Evan Brand plunge into a discussion about ear and sinus infections and how nutrition either boosts our immune system or makes our bodies susceptible to infections. Be well informed about the products and natural solutions they have used in successful treatment of infections they have encountered with young ones and adult patients, too.

If you have kids, pregnant, breast feeding or planning to breast feed, listen very well and get loads of beneficial information regarding the importance of breast milk, high-quality and nutritious diet, as well as supplements for the mom that may affect the babies in relation to infections. Also, learn more about recent research in antibiotic use and its possible negative effects in our ability to fight off infections.


In this episode, we cover:

02:47      Ear Infections

06:23      Antibiotics and its side-effects

10:26      Nutrition and the importance of breast milk

13:22      Allergies

18:26      Natural Solutions & Product Recommendations








Dr. Justin Marchegiani: And we’re back. We’re live on YouTube and Facebook. Evan, how we doing today, man?

Evan Brand: Hey, what is going on? Good old technology.

Dr. Justin Marchegiani: I know. Excellent. I guess you got the memo. It’s the uh—blue polo day.

Evan Brand: Yes, sir. Happy Friday.

Dr. Justin Marchegiani: I love it.   A little—I got my Lulu lemon on. We gotta get them as the show sponsor of our clothes.

Evan Brand: I agree. That will be a great sponsor.

Dr. Justin Marchegiani: You gave me that idea the other day. So I like that. I’m gonna jump on board with it.

Evan Brand: Yes. So this idea we’re—we’re gonna discuss today, we’re gonna discuss some allergy issues, sinuses, ear infections, which a lot of this could apply to children, but adults, too. I mean this is something we deal with all the time, we hear about all the time.

Dr. Justin Marchegiani: Totally.

Evan Brand: A lot of fear mongering all the time about ear infections and that’s one of the most common reasons that children are getting put on antibiotics. That’s like their first exposure to antibiotics as they get an ear infection. So we should dive in. This is gonna be fun.

Dr. Justin Marchegiani: 100%. So if you’re listening on Facebook, I’m gonna pin down a link so you can access the video on YouTube live. Coz YouTube live is where we’re gonna have the back and forth until we get the Facebook setup. So Evan, how’s your day going, man? It’s Friday morning. I’m really excited.

Evan Brand: It’s great. I’ve got the window open. It’s gonna be 80° today, the birds are chirping, the grass is green and growing. I can’t complain.

Dr. Justin Marchegiani: I love it. Oh by the way, I have an awesome announcement for uh—just for me, and you, an the listeners. My wife and I will be expecting our first baby this fall. So we are super excited. It’s a boy, too, so—

Evan Brand: That is awesome.

Dr. Justin Marchegiani: Hence why I’m wearing the blue today. The baby blues.

Evan Brand: Love it, man. Congrats.

Dr. Justin Marchegiani: Thank you. Excellent. Well, what did you have for breakfast, Evan ?

Evan Brand: Did I eat today? Yeah. I ate. I had bison jerky and some matcha tea.

Dr. Justin Marchegiani: Matcha. Love it.

Evan Brand: That was it. Actually, I just finished out the Matcha and now I’ve got some vitamin C here. I’m drinking about 3 g of vitamin C with some good clean water and that’s it. I was gonna do some berries this morning. My wife got some blackberries yesterday but I decided against it. Just went with the bison jerky, so I’m probably in a slightly ketotic state right now, which I feel pretty good and my brain is working.

Dr. Justin Marchegiani: That’s excellent, man. Very, very good.

Evan Brand: How about you?

Dr. Justin Marchegiani: Today I had some high-quality coffee with some butter and some MCT. I put about 10 or 20 g of collagen in it. And after the podcast today, I’m gonna make a nice little uh— green drink. Add a little MCT to that. You know, some fresh organic, green vegetables, maybe a little carrot to sweeten it up. And add some more collagen onto that just so I have some good fats and good protein and some good uh—micronutrients. So really, really excited there.

Evan Brand: Sound good, man. Sounds good.

Dr. Justin Marchegiani: Well, let’s dig in. We talked about yesterday, kinda in our—pre set up for the podcast about talking about sinus and ear infections. The natural solutions we can do to help address sinus and ear infections. So what do you think about that?

Evan Brand: Totally. Yeah. Let’s hit it. Like I mentioned in the beginning. Ear infections are gonna be the common reason that kids and children are gonna be put on antibiotics. A lot of times, ear infections are preventable which we can talk about because food allergies are gonna be one of the most common causes that you can modify. And so, we can talk about the influence of dairy, your sugar, your fruit juices, your grains, your gluten, your sodas. I mean all these things are impacting your immune system that can set you up for potential ear infections. And honestly, a lot of children that you and I work with, likely have tubes put in because the doctor fear mongers them and there’s actually no evidence that ear tubes actually even work that much. Mercola has got a great of studies about this showing that, in the short term, the ear tubes, they get put in, can reduce the time with the middle ear infection. But it in the long term, there is no longer benefit of tubes. And so, you know, when I quote one of the studies here, “The said tubes and watchful waiting does not differ in terms of language, cognitive, or academic outcomes.” Basically they don’t do much. And a lot of times—what about the adenoids, too. I mean a lot of people get their adenoid removed for these things. That seems a bit extreme.

Dr. Justin Marchegiani: Yeah. And I can speak from personal experience because I tubes many, many times. I had chronic ear infection that the child. Now here’s kinda the vicious cycle, right? Because we talked about—And we’ll put here, we have some really good studies that we’re gonna put down below. Looking at the microbiome connection. That’s kinda the gut microbiota and its connection with healthy ears, right? Healthy ear, flora health, right? So if we have ear infections, because of other reason which we’ll go into, and then we start taking antibiotics for those ear infections, that then disrupts the microflora. And that creates further imbalance that will perpetuate more and more frequent ear infections down the road. So you see the vicious cycle that conventional medicine really throws down is they’re not addressing the root cause of why these things happen in the first place. And then they give medication that actually works to treat the symptoms in the short run. But then actually perpetuate a need for more of that intervention and more of these problems. And then I can’t tell you how many patients— patients that I see that have been on more antibiotics throughout their life tend to be sicker and have—they’re the hardest to work with because of chronic gut infections, chronic gut inflammation and extreme food sensitivity because their gut microflora is so screwed up. So we really want to mitigate the use of antibiotics only to like absolutely must-haves. Now, if I go back in time and look at the things that drove me to have all the ear infections, gluten and dairy was huge. And part of the being reason why is I think that it affects the microflora, it creates more of an inflammatory environment but it also is gonna affect lympha—lymphatics. Coz I remember my ears always feeling like there was crap in it. Like I would like go swab it when I was younger and there’s gonna be so much junk in it. And my ears always felt full. So I do believe the research show some lymphatic increases when these inflammatory foods are there. So to live with all this fluid that interplay between the tissue and the blood, and the more sluggish that is, right? The more viscous that gets, that can create the ability for these—for that stuff to hang out longer and potentially perpetuate uh— infections. So making sure those foods are out. Go ahead, Evan.

Evan Brand: Yeah. So before we get into the functional approach to all of this, you know, we should talk about some of the side effects. So you mention what happens with antibiotics and now there is research that shows that antibiotics cause permanent damage to the DNA. So this is not something benign where you’re on the antibiotic for 4 or 6 or 8 weeks or even like a 7-day pack. This is lifetime impact. And I think we should probably add the question to our intake form when we’re working with our new clients. How many rounds of antibiotics have you—

Dr. Justin Marchegiani: Already on my intake form.

Evan Brand: Over—over your lifetime, though. I mean, yeah, a lot of times I’ve had people people would not even have a count because it could be in the dozens of times. I uh— typically like every 2 to 3 years, like what’s the last two to three year history of antibiotics? But I feel like we should almost say over the life, how many have you had?

Dr. Justin Marchegiani: I have that exact question on mind. I have one patient like a month or two ago, they said between 0 and 5 years of age, they had 120 antibiotic prescriptions.

Evan Brand: Oh my god.

Dr. Justin Marchegiani: Like you gotta be kidding me.

Evan Brand: That’s—that’s. I mean they are passed out like they are

Skittles, which is unfortunate now. Now, let’s talk about side effects. I mean if you are getting tubes, for example, then you could potentially have hearing loss from that.

Dr. Justin Marchegiani: Totally.

Evan Brand: I’ve read about some cases of hearing loss, you’ve got calcification of the tissue in the middle ear, and then also getting the, adenoids removed which I don’t know why, but the they—they always tell, “let’s go ahead, remove your adenoids, too as we put in these tubes.” And then—I mean, you’ve got risk of hemorrhage, you’ve got bleeding issues, you’ve got potential infection sites that could pop out where you got the surgery removed. I mean, it’s just crazy. My wife when she was a nanny down in Austin, the kids that she was a nanny for, everyday, literally if the kids were fussy, the mom would say, “Hey, if ever they get fuzzy, just give them Ibuprofen or Tylenol and Motrin—

Dr. Justin Marchegiani: Terrible.

Evan Brand: Or give them– And just because they’re fussy. And a lot of times, she said, “I would try to not give them the dose. I would act like I’m dozing them the medication.” But my wife knew what it was doing to their guts. And, of course, these kids get sick, they get up on antibiotics then both kids had tubes, then both kids had their adenoid surgery. It’s just crazy. So, yeah. Let’s talk about diet. I mean you hit on gluten and dairy, food intolerance is gonna be huge, and also, for me a big one is gonna be—which if you’re an adult now, it’s too late. But whether you were breastfed, or whether you are formula-fed because breast milk is like the most ultimate super food ever.

Dr. Justin Marchegiani: Absolutely. So you hit a couple of things that I wanna backtrack on for the listeners. You mentioned the adenoids. And the adenoids and the tonsils are the first vessel for the lymphatic system to come in contact with—with our environment. So the adenoids are kinda like in the upper sinus back area, where the tonsils are in the back of the throat. So it’s like tonsils – adenoids. And they’re that first— first vessel for the lymphatic system. And that lymph is designed—think of it as like the fit—the air filter in your house, or the filter in your pool. It’s really designed to pull out a lot of that crud. Now the thing is, if we’re constantly driving a ton of inflammation, and a ton of crud’s going in there, it’s like getting a smoker in your house. What’s your air filter gonna look like in a couple of weeks? couple of month? It’s gonna be black. Now what’s gonna happen when that air filter gets so clogged that the pressure is increasing and now the HVAC and the heater has to work so hard now the heater is heating up, i.e. were having infections, right? Well, guess what conventional medicine would do? They would say, “Let’s just pull out the air filter and put a new one.” Right? But in—in the real world, example, right? When you pull the tonsils out and the adenoids out it’s gone. You don’t put a new one in, right? So it’s like, “Let’s just pull out the air filter and leave nothing there.” Because now nothing get’s clogged, right? But holistically and functional medicine-wise we say, “Hey! You’re smoking at my house, get the hell out, right? You’re clogging out my filter! Get out of here! Right? That’s kind of the solution. Now the smoke is coming from the smoker in your house but in a real world example, it’s coming from a lot of the foods—uh— especially refined sugar, it’s coming from refined dairy, it’s coming from gluten, of course, and obviously getting, you know, lack of breast milk is going to be huge. I did not get a chance to have breast milk that long as a child, alright? Did not. Only a couple of weeks. It’s kind of like that thing I really wish I could go back in time, and like, “Mom you need to breast-feed me longer.” She said, “Look I didn’t want it, whatever.” I’m a baby. I didn’t know any better. C’mon. But in general, that’s what I would’ve wanted to have happen. But the breast milk is a big thing, right? Having that breast milk, for at least that for six months minimum a year, World Health Organization says, 18 months. I try to at least get all my patients to do a year. That’s super, super important for starting the cascade of good microbiome health and thus, affecting the ear, too.

Evan Brand: Yeah. Now if you’re an adult and like myself, too, I was formula fed for most of my baby years. I mean there’s nothing we can do now but to work forwards. So this is involved – this is getting the testing run now. So if you’re an adult, and you’ve had ear infections, or you had your tubes in, or you had the adenoids removed, well, you—you gotta get yourself tested because 9 out of every 10 clients that we test, we’re gonna find some type of issue in the gut. And this is bacterial in nature, which could be for previous antibiotic use. This is yeast so we’re talking, Candida mainly, we’re looking for albicans and SPT—

Dr. Justin Marchegiani: Yup.

Evan Brand: Although there is about 20 different species of Candida. And then we’re looking for parasites, too, because anything that’s gonna damage the gut barrier, can also leave you susceptible to ear infections, sinus problems, any type of allergies. Because your gut is basically the foundation. So, you don’t necessarily have to go straight to the ear which we’re gonna talk about some ear treatments that you can do to fix your infections and these problems. But a lot of times, do you agree this has to start in the gut. We’ve gotta make sure that you’ve got a healthy gut, and a healthy blood brain barrier, and a healthy—uh – basically a sealed-up gut, for lack of a better term.

Dr. Justin Marchegiani: 100%. It all starts in the gut, it all starts with the food. Now, I see people, I seen parents online and I—I jump on there, and they’re like complaining about their kid’s ear infection and I’m just like, “Alright, I’ll be a good Samaritan doctor.” I’ll be like, “Hey! Do this, do that, and it’s always ignored.” Like, I look at all the likes and the comments, people are like “Oh! Poor thing! Get this done! Get antibiotics!” And then my comment that actually addresses a solution goes like, unanswered, kind of ignored because it actually involves making some changes. So, people— I think people are getting the idea that the conventional solutions for these things aren’t working and are creating more problems. But uhm—you know, it’s definitely some extra effort that you have to do, but in the end, I remember of having tubes and chronic ear infections for so long up into my— even early teens. It was terrible, I was miserable! Now I didn’t get a lot of the sinus stuff, my brother got a lot of the sinuses. But in my opinion, whether its ears or sinuses, it’s just the weak link in the chain. The same mechanism that’s affecting the sinus issues is the same thing that’s affecting the ear issues.

Evan Brand: Yup. Well said.

Dr. Justin Marchegiani: What about allergies too? I mean you and I talk a lot about the stress bucket, and so what you and I were talking about before we went live is, how many people have allergies? And it’s almost per trade, is it’s a “normal thing”, but I always tell people just because something is common, like saying ear infection or sinus issues or allergies that doesn’t mean that it’s normal. And you’ve got these Claritin commercials and you’ve got these other pharmaceutical drugs to get on TV, and they make it seem like everybody needs—everybody needs that, everybody has allergies. The outdoors, it—it’s just a crazy environment, there’s grass, and trees, and flowers and oh my god, you’re not meant to live outdoors. You’re meant to live in your little bubble, and anytime you go outdoor, well, you need our pharmaceutical protection. And that’s just crazy. If you do have environmental allergies, there’s likely some deeper stuff going on. That could be adrenal related, it could be gut related, the yeast, the bacteria, the parasites. It could be detox problems, if you got sluggish liver, if you’re not digesting your foods well, if you’ve got food sensitivities, so you’ve not remove the gluten and the dairy from the diet, that stress bucket’s full. Then you go outside and then you do get allergies which gives you the sinus problems and maybe that gets worse and worse and turns into some type of ear problem. We have a question, from—let’s see—Genesis, on here, he said, “Why do my ears ache when it’s windy?” What’s your take on that? To me, I would just say go you get your gut check. But I’m not sure why that would happen.

Dr. Justin Marchegiani: Yeah, that’s kind of—that’s kind of vague—uhm—typically, the more inflamed certain parts of the body are, the more sensitive to certain things it will be. Like if I have from chronically inflamed to shifting my manual car may create some elbow inflammation. Now, is the shifting of the car really the problem? No. It’s the roomful of gasoline or the roomful of gas fumes and it’s that small little match that— that burns down the house. Even though the match went off, it’s with the inflammatory environment of all the gas fumes that are hanging out. That’s the issue. So I was always look at the underlying inflammatory environment that’s setting up the milieu to then when that spark goes off to create that issue. And that spark essentially being the wind there.

Evan Brand: Yup. Well said. I wanna go back to not just making it an anti-antibiotic podcast but I do want to mention the fact that—that even the US Center for Disease Control and Prevention they write that ear infections will often get better on their own without antibiotic treatment. Taking antibiotics when they’re not needed is harmful. Un— unwanted side effects like diarrhea, rashes, nausea stomach pain, more serious side effects can occur.

Dr. Justin Marchegiani: Right.

Evan Brand: Which can include life-threatening allergic reactions, kidney toxicity, severe skin reactions. And each time your child takes antibiotic, the bacteria that live in the body ,skin, mouth, intestine. And now we know that there’s a microbiome of the ear. Isn’t that crazy?

Dr. Justin Marchegiani: It’s crazy. The microbiome of the ear. Everywhere. I mean vaginal canal, gut, everything. It’s all—It’s interconnected, for sure. So also, couple of side effects with the antibiotics that we really need to talk about is the mitochondria.

Mitochondria are like these little power houses of the cell that generate ATP which is the currency of energy in which our body functions. And that’s so important for optimal energy. I mean, Dave Asprey has got a book coming out or it’s coming up very soon. He’ll be here in Austin next week. And its called, Head Strong and it’s all about basically improving your mitochondria. And your mitochondria is so important. Just google “mitochondria and antibiotics” you’ll see a strong connection. We put some of these links in previous podcasts. I’ll let the viewers do your homework. I will post a reference section on the bottom. Antibiotics and mitochondria, you’ll find significant disruption of the mitochondria with antibiotics. And obviously, it’s dose-dependent, right? The more you do it, the more you use it, the potential that increase has to happen. So that’s another mechanism. Now, we can talk about some solutions. Any thing else you want to address, Evan, before we actually dig in with some solutions?

Evan Brand: Sure. I’d like to just pile on top of the mitochondrial thing you mentioned. You know, a lot of clients come to us with brain fog and chronic fatigue as well as a starting place and maybe they’ve had these type of infections but they’ve also got chronic fatigue. And you’ve just brought the word “mitochondria” so it sounds like to me, we could infer based on someone’s use and history of antibiotics that we can infer. Well, here’s a root cause of chronic fatigue is the mitochondria that’s been damaged from antibiotics. So that’s really gonna make us have to do a lot more work on supporting mitochondrial health, but then getting the gut back in check, too.

Dr. Justin Marchegiani: Absolutely. And also, cortisol. I mean if—if we’re bringing babies into this world that are adrenally-depleted, again, this is kind of weird but if a woman is stressed, especially that during pregnancy, you can put on certain you can activate certain epigenetics that will start exacerbating or stimulating that babies adrenal in the third trimester. And the more stressed that mom is throughout pregnancy, you’re activating certain epigenetics, but also in the third trimester, gonna be stimulating the babies adrenal glands. So if you bring a baby into this world with a lot of adrenal dysfunction, off the bat, they may have an inability to regulate inflammation in general coz they’re not spitting out enough cortisol. Now we don’t ever want to treat a baby directly, you know, supplement-wise. We would do it by getting the mom really healthy. Uhm—the only thing I recommend to a child, probably off the bat, if they’re having issues, is probiotics. And then we could talk about maybe some homeopathic drops, or some natural solution to be put in the ear topically uh—to hit the area very focused versus do a systemic kind of atom bomb dropped.

Evan Brand: Yeah. Well said. I thought that was crazy 3-4 years ago when I heard the fact that you can basically steal your—your baby your fetus’ adrenal glands. This is why some women report feeling so good during pregnancy and some of it could be that they’re deriving some of their boost from the adrenals of the baby and then you give birth. Now instead of having four adrenals that your thriving energy from, you got two adrenals just—you’re driving energy from. And some women have kind of that postpartum either Hashimoto’s or some type of postpartum depression. So yeah, that’s a trip. There was a question here, “Can your sinuses get clogged for years?” I mean I would say, “Absolutely!” What do you think? If you’ve got these uhm— food allergies in your diet for years and yeah, you could stay clogged up all the time.

Dr. Justin Marchegiani: Yeah. Absolutely. So that congestion can happen. Now we also have to look at physical structure issues, especially in the nasal area. So being a chiropractic doc, you really want to make sure that you are well-adjusted like make sure you at least see a good chiropractor once a month and make sure your cervical spine and everything is doing well, number one. Number two, you may have some turbinate issues with these bones up here in the spine. You may need a technique called “nasal specific” where they put these balloons up and they can help declog any of these turbinate issues whether from trauma or malformation. And again, Weston A. Price talks about poor nutrition. One of the things that happens is narrowing of the middle third with this area— here is broken into a third – a third – and a third. And the more nutritionally-deficient the parent was that brought you into this world, this middle third starts to narrow. So one of the biggest signs of gluten sensitivity and poor nutrition is a narrowing middle third and a very large upper thirds. So when you see people walking down the street with that big forehead and you see that smaller middle third, with that smaller lower third, gluten deficiency, poor nutrition of the parents, big time, off the bat. So again, some of this we can’t really change, right? Like the parent stuff, that’s all epigenetic stuff. But we can at least be aware that we’re bringing kids and babies into the world, right? We got to get the nutrition dialed in. That’s number one. Number two, uhm—chiropractic’s helpful on the spine as well as the nasal canal and nasal specific. And also, acutely, chiropractic can be great for the—uhm— for the canal of the child. The person with the ear issue. Now when you’re younger, the ear canal tends to be more parallel, right? So it won’t drain as well. You have that—that draining angles. So one of the things that some chiropractors will do is, pull my ear front out, they’ll do a specific adjustment where they rotate the ear, they pull it, they rotate it in clockwise and they tug. And that tug kinda opens up the uhm—the nasal canal and will allow some of that junk to drain. Now, is that root cause? No. Is it palliative without any— without very little side effects and no— not affecting the microbiome and inflammation? Yes. So it’s a really good from a palliative perspective. Again, spine, really good. Nasal really good and then the ear adjustment, that’s the next really good step.

Evan Brand: That’s great. Now what happened with my wife, I believe, I don’t know if we were swimming in the ocean, or where we were, but she came home and her ear which is clogged. And we thought, “Man, this is gonna turn into an ear infection.” Coz she had this water that was just in her ear for like a week. And I said, “Justin, what do I do?” And you said, “Evan, you’ve gotta go get these—these eardrops. Do you remember that?

Dr. Justin Marchegiani: Yeah. Yup.

Evan Brand: And—

Dr. Justin Marchegiani: That was the Citricidal Eardrops. Those are great. Little bit of grapefruit seed extract in there. Those eardrops are phenomenal. Also, men, Hydrogen Peroxide, 3% it’s like two dollars at your uhm— drugstore. Just a little cap for that, it will bubble like crazy. Leave it in there till the bubbling stops and then you can dump it out. That was my go-to ear infection. I was waterskiing on Lake Traverse two years ago and I took a header. And I perforated this eardrum and uh—whole bunch of you know, bacteria and crap from the lake got in there. And one of the things I did was hydrogen peroxide and I diluted with a little bit of silver. So hydrogen peroxide – silver. That way, I could just clear that crap right out.

Evan Brand: That’s amazing. Now when-when you did that to your eardrum, was there any other bad side effects? What happened?

Dr. Justin Marchegiani: Just the side effects of a perforated eardrum. It’s irritated, it’s inflamed. Uhm— when you have an ear issue, man, it screws everything up because just sounds that come in are just like balance, just you’re over hyped up. So everything is irritating and kinda bother you. That my wife just leave me alone for a few days but then we just gonna do all the good things that help with the inflammation and all the good healing nutrients. I use the uh—the Similasan’s. Similasan’s, they have a really good homeopathic eardrop that we used. I use the Citricidal eardrops. I use some silver and I used some hydrogen peroxide and I kinda just rotated those. And growing up, hydrogen peroxide was absolutely phenomenal for the ear coz it’s just so cheap and it’s great. And actually that’s a natural—uhm— flu or cold kind of cure because they say a lot of ways that viruses kinda vector into your body is through the ear. So just doing like a little capful of that 3% hydrogen peroxide, it can really knock out potentially any viruses or bacteria making their way into the body.

Evan Brand: I think I told you when I met with one of the—the higher-ups at designs for health, which is a professional healthcare company if people are listening. I met with one of the higher-ups and he said he travels like 250 days a year. He’s always concerned about picking up sinus infections or ear infections from being on airplanes all the time. And one of his preventative measures was he was taking the silver in a spray bottle and he would spray his ear canals.

Dr. Justin Marchegiani: Yup.

Evan Brand: Then he would spray his nose, right? You know, kind of like a barrier protection around his holes of his— his nostrils in his ears. And the guy never got sick, so—

Dr. Justin Marchegiani: I love it. Totally make sense. So, off the bat, we kinda have the preventative stuff with the mom to baby, and stress in the adrenals. Obviously, try to have a vaginal birth. It’s gonna be essential because the activation of the bacteria in the vaginal canal and how that affects the child’s immune system. Number two, if you can’t get, for some reason, emergency happens where the cord gets wrapped around the child, the child’s oxygen levels drop and you have to have a C-section or the baby’s breach, number one, see a chiropractor beforehand. Get Webster technique to get that baby to go headfirst. But let’s say you can prevent that. Number two, go in there, and again, the doctor and the midwife probably won’t do this. So you have to get in there, get in there with a good swab. Swab your wife’s vagina area and then afterwards, when that baby comes out, you swab the baby with it because the baby would be getting exposed to that, anyway and now it’s not. So do a good swab, put it in like a little baggie and then after the C-section, then you— when you’re doing skin-to-skin, have that baby all swabbed on. Now don’t tell the— the doctor or nurse what you’re doing coz they’re probably look at you like 10 heads. And this is—you know, I told my OB about this ahead of time, she’s like, “Oh, well, you know, you can do that, but just keep it to yourself. We don’t have a problem with it, but you just keep it to yourself.” So that’s what we’re doing if that does happen. So have a back up plan, ideally.

Evan Brand: Totally. And why? Why—why would they— why is it have to be so hush-hush, I don’t understand what the deal is?

Dr. Justin Marchegiani: Well, it’s – in conventional medicine, there’s a conveyor belt man. Like here is what you do, here’s the cookbook, great. 1-2-3-4-5. And anytime you put a kink in that step, or something that disrupts that flow, you know, everyone perks up and it’s like, “What—What’s happening?” You know. So the more you can just lull them to keep that procedure going uh—it’s ideal.

Evan Brand: Makes sense. Yeah. Yeah. I had a client who—I’m trying to—who it was—it was either yesterday or the day before and she actually went to her conventional doctors to show the lab test, the organic acids test and he’s like, “This isn’t even a valid test. I’ve never heard of this before.” It’s like just coz you never heard of organic acids testing, doesn’t mean it’s not valid. You try to say that uh—instead of the herbs that were gonna use for Candida that she should just be using a Diflucan and— which is a prescription which is just unnecessary, so—

Dr. Justin Marchegiani: There can be a lot of side effects with Diflucan. I tried it before the—with the uh— with the fungal infection in the past. Coz I just was trying all these different things and one of the side effects I found was lightheadedness. That drug cause a ton of lightheadedness, insane.

Evan Brand: That’s scary.

Dr. Justin Marchegiani: Yeah. And there’s some research that it can cause neurological problems, too. So I mean, some people it may not be a bad thing, uhm— if you’re combining it with herbs and everything else and it’s just a part of the program, but just as like a, “Hey, you know, don’t change your diet, don’t do anything else, just take this.” —probably not gonna be the best long-term solution.

Evan Brand: Yup. So I think—I think we —we’ve we kinda jumped around. We jumped into some—some solutions and side effects and all that’s— I mean really diets can be first step, getting a nutrition plan in place it’s gonna be more like a Paleo or autoimmune paleo diet, potentially getting rid of your grains, your sugars, of course your sodas, your juices gotta go, pasteurized dairy—it’s gotta go. I remember for me, with my skin, you were like, “Evan, even though it’s organic grass-fed cheese, you still gotta cut it out.

Dr. Justin Marchegiani: Yeah. Your skin look so much better compared to last year.

Evan Brand: I know. So I had to get rid of it, even though I miss it and it was delicious. I rather feel good and, you know, have— have better skin. So you’ve got a get out the— the dairy except for butter. Sometimes you can do okay with butter and the wheat. I mean we talked about that but any type of gluten issues you’re gonna be creating the intestinal permeability. Even if you don’t have celiac, doesn’t matter. The gluten is still gonna affect the gut which is therefore going to make you more susceptible to ear infections and allergies and sinus problems. Uhm— secondhand smoke, we talked— you talked about that a little bit, that analogy. But yes, uhm— there is research that secondhand smoke also increases the risk of ear infections for children. So if you’re going over to a family’s house or someone in the family smokes—

Dr. Justin Marchegiani: Yeah.

Evan Brand: And then when you hold the baby, uhm— don’t let them do that. Also, if you are gonna bottle feed for some reason, apparently, bottle-feeding while lying down increases your risk of ear infections. That’s something that I just learned this morning with some research, but it makes sense.

Dr. Justin Marchegiani: Yeah. Yeah. Absolutely. Also, the quality of the food that the mom eats has a huge effect on the baby, okay. I’ll give you an example, alright? My neighbor —her child had a really difficult time sleeping continuously, up every half-hour. The big thing that they did is they pulled out eggs, and it was one nightshade family made up of eggs and tomatoes. And that one tweak, change the composition of the breast milk and the baby slept like just magic. So quality of breast milk is incredibly important and is dependent upon what the mom eats. So if you’re having issues with your child off the bat, even if it’s just sleep or ears, get your diet super, super clean. Super, super clean. Just because you’re feeding a baby or growing the baby, it’s not a license to eat whatever the heck you want. Nutrient density is incredibly important. With my wife being pregnant, we— we’re doing lots of things to increase nutrient density. She gets exposure to a little bit of liver everyday. Uhm— she does a green smoothie with organic vegetables in the morning, we mix in some MCT oil there. We do some collagen. She gets some Pasteur-fed eggs and Pasteur-fed bacon from time to time. And she’s eating 3 solid meals a day. And then get one good, healthy, organic shake in there. And really mitigating stress, and some probiotics and some magnesium to keep the bowel moving. So when you get pregnant with the hCg and all that stress down, it can create some issues with regularity. So that’s — I don’t wanna go too much on that, that’s a separate podcast. But, you know, we could just— we could do a podcast marathon and be here for 8 hours—I think, it allows us to do 8-hour straight, so we should uh—we should push that one time.

Evan Brand: We could. We could to a marathon.

Dr. Justin Marchegiani: Yup.

Evan Brand: So we—we hit on the—the eardrops, there’s garlic eardrops, too that I’ve read about. I’ve personally not use those. I’ve only used the uh— grape seed extract. Also, breast milk for eardrops. If you have a small little dropper, you can use breast milk for your drops, And it’s gonna be safer, less expensive, far better than antibiotics. Also, I don’t know if read about this, but coconut oil eardrops apparently exist, where basically I mean, all I would—I wouldn’t buy a specific drop, I would just take a load of the coconut, heat it up a bit, and then put into a container.

Dr. Justin Marchegiani: Exactly.

Evan Brand: You’re gonna get the caprylic acid in there. Which is probably gonna be the best thing. What else you—you got capric acid in there, or two that maybe gonna acts as a natural antimicrobial.

Dr. Justin Marchegiani: Absolutely. So let’s kinda go through some of the sinus stuff. So, off the bat, with the sinus, you can do Xlear, too, which is great. Xylitol which is an anti-biofilm kinda type of sugar alcohol and it also has an effect of being antibacterial. So that’s excellent.

Evan Brand: What is it called?

Dr. Justin Marchegiani: Xlear or X-Y-L-E-A-R. We’ll put links below the video and in the transcription, we’ll put some amazon product links, too. So if you guys wanna support us, you can get some of the things that we’re talking about through our affiliate links.

Evan Brand: Perfect.

Dr. Justin Marchegiani: And these are things that I usually that I bought and used, too. Anything we talk about and recommend are things that I have personally done myself or have seen my patients do it with great success. So what you’ll read, though—we’re all about clincial results first. So Xlear is great, or Xylear, however you pronounce that. Next is gonna be—Dave Asprey’s got a good bulletproof sinus rinse which is really good. You got a big salad bowl. We’ll put the link for this, too. You put a whole bunch of—just gently warm water in there. You do about a quarter of a teaspoon of some high-quality salt—sea salt in there. And a couple of drops iodine for the most part. And then you’re gonna dip your head upside down, and then you’re gonna breathe or you’re gonna suck that in to the nose. Keep your mouth out of the water, of course. Suck it in to the nose. So it will kinda feel like you’re drowning, not the nicest feeling, uhm—but that will be really, really helpful. So half a teaspoon of high quality sea salt for every cup of water. That will prevent bacterial overgrowth. You can add a little bit of iodine in or a little bit of Xylitol. So basically, you’re gonna do the whole little dippy bird, a little—tip—tip your head back. Don’t tilt your head back or you’ll gag. So keep your spine parallel to the floor and then you’re gonna breathe in to the nose. And I will put the protocol down below. So blink your eyes a few times. The iodine will sterilize the lining of your eyes if you get it in your eye. So be careful with the iodine in your eyes and that will significantly help clear out. And I will put protocol down below as well. Next, you can do a Nasaline, as well. And I’ll do the Nasaline with the Neti Xlear or the NetiXlear, which is potassium biocarbs, some salt and uh—Xylitol, and a little bit of uh—I think that’s pretty much it. And it goes into the solution, and then you can pump it through with a Nasaline which is basically a plunger for your nose. So a Neti Pot’s one thing but you just pour it and it’s gravity that goes through. The Nasaline, it goes through in one nostril and it’s a plunger where you push it. So you get full contact of the sinus canal and then will go through and rinse that everything with full contact.

Evan Brand: That seems way better than the Neti Pot. I’m glad you brought that up because—because my wife she did the Neti Pot and something happened. I think she—she had some weird drainage and I think that that actually lead to her getting like kinda an ear pain from the Neti Pot. So what you’re talking about sounds way better.

Dr. Justin Marchegiani: Well, think about it, right? If this is like your sinus canal, right? And we’re putting water in there. The water is just gonna hit the bottom part, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: For the most part. But if you get plunger in there, and you’re plunging it with actual pressure, it’s gonna have full contact of that sinus canal. So better chance of getting all the debris out.

Evan Brand: And that’s called what?

Dr. Justin Marchegiani: That’s called a Nasaline. We’ll put the link below. We’ll put the uhm—with the references. That’s gonna be great. That’s a really good product that I had a lot of patients used with great success. So you have the Bullet Proof Sinus Rinse, you have the Nasaline. If you already have the Neti, you can feel free and use the Neti. And the key things is just using the minerals using the Xylitol and/or adding some iodine. And/or just adding some silver. Like a simple thing you can do, too, is just lie back, ten drops in each nostril, three to the four times a day of high-quality silver. You know, in my line, it’s GI Clear-3 that we use and that has the 15 to 20 ppm of nano silver, not colloidal, but it’s nano. And again, don’t worry about argyria or turning blue with that. That’s gonna primarily happen from your homemade silver products.

Evan Brand: Why is nano silver better than colloidal? You got a lot of people promoting and selling colloidal out there but can you tell us why nano is superior?

Dr. Justin Marchegiani: Just the structure of it. It’s a different structures of a colloidal structure. It’s nanostructure so you’re gonna get better absorption for the most part.

Evan Brand: Sounds like it’s gonna be tinier the way that it’s gonna be structured.

Dr. Justin Marchegiani: Yeah. And you can go look at—I think it’s Dr. Gordon Peterson. He’s an immunologist that’s talked a lot about this kind of silver and he’s helped formulate that kind of silver. So the nano silver, in my line, GI Clear-3, is the one we like uh—to help with that.

Evan Brand: Love it. Should we answer any couple of questions. We had a question about goat cheese. For me, dairy is dairy, regardless of the animal. I’d say pull it out especially if you’re—you are struggling. You’re better to just go completely dairy free for 30 to 60 days.

Dr. Justin Marchegiani: People asking the questions, try to keep pertinent to the uh— podcast so we can connect it here. And then regarding ghee—ghee is definitely a good first dairy to add-in. So if you’re dairy-sensitive, you pull the dairy out for a few weeks to a month, and the first thing you add back in should be the ghee. Ghee is clarified butter so they suck out the lactose part. They suck out the casein part. All you got is the butter fat. So you have, basically, you know, very little casein, maybe microscopic levels and very little lactose. So you— it’s gonna be even better than butter, per se. An then if you do go with ghee, then you can try a little bit of grass-fed butter which will have very tiny amount of lactose and very tiny amounts of casein which may be acceptable level for you.

Evan Brand: For me, I could to the good quality grass-fed butter without a problem.

Dr. Justin Marchegiani: Cheese, though—ee—cheese and even raw milk, man. I don’t do good with those. I just—I really don’t. Skin breakouts, gas, bloating—not good. But I can do great with ghee and great with grass-fed butter.

Evan Brand: Isn’t it amazing, though. I mean just that one simple swab you got on me, you’re like, “Evan , man, you’ve gotta get rid of the cheese. Coz I would talk you through, you know, we’re kinda—you and I will talk off-air about what you eat, what do you do in diet-wise and what’s working and I told you, “Man, I’m doing this organic cheese.” And I don’t know if would say I was having sinus issues, but I definitely had some—I guess I would call it head pressure. Basically, kind of like a mild headache in the front of my—in the front of my head. I did not know that that was caused from dairy. And it was.

Dr. Justin Marchegiani: Your skin looks a thousand times better since you cut a lot of that cheese out.

Evan Brand: Yeah. I feel good. And I cut out corn, too. Now, I will do a little bit of some organic—blue—uh—blue corn chips maybe once a month or something now. They just taste so good.

Dr. Justin Marchegiani: Alright. That’s one paleo demerit down there.

Evan Brand: Hey, I know you’ve done some corn in 2017, right?

Dr. Justin Marchegiani: A little bit. Well, I mean—obviously, it’s a Mexican restaurant, called Maddy’s. And we’ll do a little bit of their gluten-free organic corn chips that are like in a plastic bag. So it’s totally a waste, there’s no cross contamination. So, I will, from time to time, as a little reward. It’s Friday, you know, a little—little NorCal margarita, a little bit of Dr. J’s Moscow Mule. Yeah. Absolutely. Love it. Add it to the list.

Evan Brand: And now is that—are—or now is that blue? Or is that—is that yellow corn? I may be one up on you in the blue here.

Dr. Justin Marchegiani: Uh—Yeah. I think it’s probably just the yellow. But it’s least organic and GMO free which is essential.

Evan Brand: Totally—totally.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maddy’s is good and what was it—Tacodeli down there in Austin. They’ve got organic, pasture-raised pork shoulder tacos.

Dr. Justin Marchegiani: Unbelievable.

Evan Brand: Have you had those?

Dr. Justin Marchegiani: I’ve not. Tacodeli?

Evan Brand: Oh my, god. You’ve gotta go, man. It’s off uh—I wanna say it’s off of 360. Shouldn’t be too far from you. And they do organic uhm—they do organic tortillas as well and pasture-raised pork, so.

Dr. Justin Marchegiani: Love it. Love it. Very cool. So let’s kinda summarize, alright? So you’re coming into this here and you missed the whole 45 minutes chat. So what are the key take homes? Diet, of course, refined sugar, dairy, gluten, grains—cut that out. If that’s not enough, you can go do an autoimmune template where we cut out, nuts, seeds, nightshades and eggs. You’ve left meat, vegetables, maybe a little bit of low, sugar fruit, maybe a little bit of starch and healthy fats minus dairy and uhm—nut and seeds. So that’s our good first step that we need. Now, after that, there are some preparation and things we can do ahead of time but may not help you in the moment. That’s the healthy pregnancy, that’s the stress, that’s getting the vaginal canal in contact with the baby on the way out to activate the immune system, that is the good quality breast milk, that is all that good stuff there. And keep them mom’s nutritional density high when she is breastfeeding because that becomes the building blocks to a lot of the uhm—raw material in the breast milk. You know my expression is you can’t make chicken salad out of a chicken shit, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: If you got crappy quality ingredients going in that mom, guess what, you can’t make this awesome breast milk with bad ingredients. So let’s really keep the quality high. Next, we have for the sinuses, you have structural issues, you can do the nasal specific chiropractic technique, you can do adjusting of the spine, and the whole—the neck as well, especially the upper cervical area and then adjusting Eustachian tube to help increase the angle to allow the ear to drain, right? Now we have the rinses for the sinuses. We have the bulletproof rinse, we have colloidal silver uhm—for the sinuses. And we also can do hydrogen peroxide in water, 50-50 split and do drops in the nose, 4x a day, 10 drops. And then we also have the ear. We can do Similasan Homoeopathic, we can do the Citricidal; we can do the Hydrogen Peroxide; we can also do the silver. And then you can also do a little bit of garlic oil in there, as well. What do you think, Evan? I think we just like hit it all at once.

Evan Brand: Yeah. That was good. And treat the gut, too.

Dr. Justin Marchegiani: Of course. And the best things—the supplement you can use on your baby if they’re newborn, Infantis Probiotic. Infantis is a specific type of probiotic. One that we like is Ther-biotic Complete for Kids. That’s a great one uh—for kiddos. And—and that can be powder so you can just put in on your finger and then you can just put it in the gums or if you’re breastfeeding, you can put in the nipple area and have the child, get it from that. And also, give it to the mom and it will help with any potential translocation via the breast milk as well.

Evan Brand: I will say one last thing about breast milk and this is probably gonna only apply to maybe just a few listeners, but there are breast milk donation services out there, where for some reason if the mother is just too busy, she is working too much, I’ve seen women going and getting breast milk from other moms. I would never do that from my baby because who knows what that moms diet is like. Who knows how much glyphosate is in that. If the mother is not eating organic. We know, I just chatted with Dr. William Shaw in my podcast, you know, we’re talking about parts per billion of glyphosate which is what’s used a non-organic produce. Parts per billion being enough to disrupt uh— gut bacteria and kill beneficial bacteria in the gut which can lead to these ear infections. And so for me, I would never ever, ever, ever unless there’s was just something so wrong with the mother that she could not feed the baby—her breast milk. And she had to get another mom’s breast milk, I would literally have to do an interview process of that— of that mother. Is your diet organic? Are you eating gluten? Are you eating dairy? Because that’s gonna—breast milk is not all created equal, like you mentioned.

Dr. Justin Marchegiani: Yeah. I mean, it’s really simple. You just pay a little bit more money. You—you provide that food for that mother who’s donating the milk if that’s your only option.

Evan Brand: Yeah.

Dr. Justin Marchegiani: I mean, for the first 6 months. What you’re doing there, for 6 months to your kid is a better investment than paying for college or any of that. That’s like the best investment. So if you’re in that position and you have to do that, then definitely find someone. You know, the Lalecheleague’s a really good reference for that. But really find high-quality breast milk, if you need. There’s some Weston A Price recipes where you can do some home-made breast milk with liver extract and cod liver oil and raw milk or raw goat’s milk. But then also, like if the mom can’t breastfeed, it’s typically something wrong from a stress perspective and from a diet perspective, so really look at getting the diet fixed. I see a lot of women who go low fats have problems with producing breast milk. So—

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s really, really important. And then don’t quit. Like, don’t quit. Like can you imagine, like evolutionary times where like food’s like, you can’t feed. You don’t have like formula, you didn’t have all these things. So you couldn’t breastfeed your kid, like what would you do? That was it.

Evan Brand: You’re done for.

Dr. Justin Marchegiani: This is it. They can’t eat solid food, right? Too young, what do you do, right? So maybe there will be another woman in the tribe that you give the baby off to and they would lactate for you. But ideally, you gotta get the diet right, you gotta get the stress right and then also, make sure that the inflammatory foods are out of there so the highest quality nutrients are coming through.

Evan Brand: Yeah. It sounds like we have to do a whole breastfeeding.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Or optimal baby podcast.

Dr. Justin Marchegiani: Yeah.

Evan Brand: But I’ve heard many women, who they’ve completely just given up on breastfeeding because they said they were too stressed or too busy or something like that. But you really gotta try to modify that to make it possible because—

Dr. Justin Marchegiani: We’ll do a whole podcast on this. We’ll do a whole podcast on it. There’s a lot of nutrients and stuff you can do like fenugreek, you know, uh—mother’s milk tea. Just all kinds of things. And also, get a doula. If you’re having a hard time, get a doula. There are so many things. Like most women, it’s like, “Oh, I tried and it’s done.” No, get a doula. Like try for days, use—get someone who’s done it. So many times, they know all the tips and tricks to make it happen.

Evan Brand: Yup. Totally.

Dr. Justin Marchegiani: And that’s coming from someone who wasn’t breastfed ideally long enough. So I’m really passionate about getting that information out there.

Evan Brand: Me too. Me too. Well, we’ll send people back to your website. They can type in, to check out Justin and schedule consult with him. We deal with this stuff all the time, every single week, in the clinic. And my website or just google our names: Justin Marchegiani Marchegiani Evan Brand. You’ll find us and make sure you subscribe here on the YouTube channel. Justin have over 25,000 subscribers on YouTube. Congrats. Whoo—

That’s uh—make sure we push that closer to a hundred grand because this is important information that is not readily available. Even in 2017, somebody’s gonna go down the street to the clinic, and maybe regret the mode of action that was taken. So we want to save you from that.

Dr. Justin Marchegiani: Absolutely. Any other questions you wanna answer in the queue there, Evan? I don’t think so. Was there any for you?

Dr. Justin Marchegiani: Uhm—again, someone said- Sam asked about Probiotics for a 7 year-old. Well, I’d probably still go with the Infantis. But you know, you’re gonna go, you’re gonna have a blend of Lactobacillus, Bifidobacterium Infantis in there . So you’re probably good with that one. I recommended it.

Evan Brand: Yeah. And I would say for a 7-year old, too. Believe it or not, I had a three-year-old girl but I just had her stool test back and she had 2 parasites and Candida and bacterial overgrowth. So, I mean, if the seven-year-old has got symptoms go ahead and get a—get a GI Map stool test on her I wouldn’t be surprised if she’s had antibiotics her seven years of life. She might have some type of overgrowth already. And you just don’t wanna come in and just try to fix it with a probiotic. A lot of times, that won’t be enough. You can’t just out probiotic your way out of an infection, unfortunately.

Dr. Justin Marchegiani: Absolutely. And the easiest way to get kids to eat healthy. And again, this may, you know, sound kind of patronizing, right? But it—it’s a 100% true. Number one, don’t have crap in the house. Clean out all the crap in the house. Number two, you have family meals together and you will role model what good eating looks like. Mom and dad, they sit down to have their meal and they role model what it looks like. And the whole idea, you know, once the kid’s eating solid food, and they actually have teeth and they can chew and stuff, the whole idea behind baby food versus kids food, once they—once the mastication’s dialed in is ridiculous, right? They should be eating adult food and just, you know, cut it up small and make it really easy to digest. But those foods need to be done as well and you just role model it to the kids. You just parrot it back and the kids want to be like the mom and the dad. And they’re gonna wanna just do what the parents are doing. So you role model it and you create a really good environment and family meals.

Evan Brand: So we’re in those something funny uh—and we’re getting off topic but it’s Friday so we’re having fun. Uhm—

Dr. Justin Marchegiani: It all connects back to that because if you don’ get to diet, right? Then you’re gonna have sinus infections and ear infections all day long.

Evan Brand: A 100%. So it is on topic. Yeah, for sure. So my wife and I, we were discussing last night, “When do you make the transition from baby foods over to solid food?” You know, from pureed foods to real foods. And well, she said, “They tell you.” And our daughter, she’s starting to fuss about the pureed foods. And she’s trying to grab of mom’s plates. So like last night, for example, we some steam broccoli, we had some peas and carrots that we did for lunch, with our veggies and we did some meats. And we gave her her own little plate of peas with some butter on there and some carrots, and some broccoli. And she ate it up—insane. And she’s 10 month old, I thought, “Oh, my lord, look at her appetite. She’s probably starving to death waiting for real food.” She’s like, “I’m sick of this pureed crap. Give me some real food.”

Dr. Justin Marchegiani: Exactly. Plus the teeth are coming in. So it’s a natural progression, right?

Evan Brand: At six months, you may start to add in some smooshed peas, some smooshed avocados, 95% of it doesn’t get in the mouth. It’s more of that tactile play experience. But eventually it gets in there and the teeth come out. And then you can start introduce it. And you’re doing a great job with how you’re doing it. Keeping it mashed, keep it simple, staying away from the hyper-allergenic food. That’s great.

Evan Brand: Yup, yup. So we have uh—we gave her a little bit of chicken yesterday, too, which she did fine with. It was very plain, not much seasoning on it.

Dr. Justin Marchegiani: Yup.

Evan Brand: Just some—some baked—pieces of some baked uh chicken thighs and she loved it. She ate it up. So it’s a lot of fun—a lot of fun—

Dr. Justin Marchegiani: I love it.

Evan Brand: to eat healthy.

Dr. Justin Marchegiani: Awesome, man. And well, it’s great little Friday, here in Austin. I’ll be uh—doing a little waterskiing this weekend.

Evan Brand: Nice.

Dr. Justin Marchegiani: Really excited about that. Any plans for you? Well, uh—we’re gonna go scope out—scope out some eco-friendly uh—paint and flooring options. And figure out what we can do about—about this house, so—

Dr. Justin Marchegiani: I love it, man. Excited about it. Keep me posted.

Evan Brand: Sure.

Dr. Justin Marchegiani: And everyone listening, we appreciate your attendance. If you like these live ones, these live podcast, give us feedback. Let us know; like it; share it; give us a five-star review on iTunes as well. We’ll put—we’ll repost them on iTunes. If you listening on iTunes right now and you wanna see Evan and I go back and forth, duking it out in the flesh, click the link below so you can watch the uh—YouTube link. And uh—we’re excited to continue to do more of these and share more information.

Evan Brand: Take care. Have a great weekend.

Dr. Justin Marchegiani: Evan, my man, take care, buddy. Bye.

Evan Brand: Bye.


Products mentioned:

JustinHealth GI Clear-3


Dave Asprey’s Bullet Proof Sinus Rinse


Citricidal Ear Drops

Similasan Homeopathic

Infantis Probiotic

Ther-biotic Complete for Kids

Hydrogen Peroxide, 3%

The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.