Autoimmune Protocol – The Paleo Way | Podcast #312

The AIP diet is an elimination and reintroduction protocol which aims to reduce inflammation in the gut, heal the gastrointestinal tract and in turn, reduce overall systemic inflammation. It is a diet targeted specifically at autoimmune diseases. We have Dr. J and Evan chatting about the benefits of this diet and how it can bring our body to a healthier state.

One of the biggest benefits of the AIP diet is its ability to alleviate inflammation, which is key to reducing symptoms of autoimmune conditions and promoting better health. Eliminating a few specific foods from the diet and filling up on nutrient-dense whole foods instead can have a powerful effect when it comes to inflammation.

Check out the podcast below for more info!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:42       What is Autoimmune Paleo

8:14       How is it Beneficial

21:18     How to’s in Food Sensitivity Issues

26:22     How Paleo Helps in AIP

31:03     Goal of Decreasing Immune Stress

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Dr. Justin Marchegiani: We are live. It’s Dr. J in the house. Evan, how you doing today man? 

Evan Brand: Doing well, let’s dive in. Let’s have some fun. We’re going to talk all about autoimmune paleo, which is the template that we push a lot of people towards, not because we’re some dogmatic attached to our cards kind of people, but because we like results. We like clinical success. We like people to get better. We like people to reverse their health issues. We like people to take back their health, we like people to get off their medications when their doctor allows them to. And autoimmune paleo is by far the best template you and I’ve ever implemented clinically, which has given us those various types of success. So where should we start? 

Dr. Justin Marchegiani: Yeah, so off the bat, what is autoimmune paleo, so it’s a good starting point. It may not be good for everyone out of the gates, it just for me, it depends, right? I see a lot of patients that are sick and then have done a lot of things. And this is like the next logical step. If people were coming in to see me and they already have, let’s just say have a really kind of crappy kind of standard American diet. I may just start out with a Paleo Diet out of the gate. So we have paleo right that’s like no grains, legumes, dairy and then like kind of butter maybe like acceptable within that range that and then obviously no legumes, grains, so no grains, legumes or dairy, butter, acceptable meat, acceptable vegetables, non starchy veggies, and then of course, good healthy fats, right, not seeds, dairy based fats, animal fats are all acceptable. Okay, and then we have paleo I call it paleo 2.0, which is the equivalent to an autoimmune paleo template. And you notice how we use the word diets not. We use the word template, not diet. I don’t like the word diet, because diet is it’s very inflexible. This is what you eat, where a template gives you the ability to adjust things. So I like the flexibility within the description template. So an autoimmune template versus the Paleo template. paleo is no grains and legumes, no dairy. autoimmune is no nuts, seeds, nightshades nightshades, being tomatoes, potatoes, eggplants, peppers, and eggs. And so within that, that template, we’re still going to be having healthy proteins, healthy fats from animal products, fats that are not seated dairy free, but healthy animal products, other fats like olive avocado, and palm and coconut are all great. And then carbohydrates, from fruits from vegetables, minus the tomatoes, potatoes, eggplants, peppers, and we can adjust the macros accordingly, proteins, fats, and carbs. So that’s kind of a good first step out of the gate. So paleo, and then paleo 2.0, which is going to be on one and paleo and these are all paleo template, autoimmune template out of the gates. 

Evan Brand: Yeah. And people don’t necessarily need to get stuck on the 2.0 the AIP forever. Okay, so this is not a podcast to say, look, everybody needs to do this. As Justin mentioned earlier, you know, we’re working with a lot of people clinically who’ve been to 510 20 practitioners before us, they’ve been on every diet under the sun, they’ve done every treatment under the sun, whether it’s natural pathi, homeopathy, functional medicine, doctors, conventional doctors, they’ve already been through the wringer. So in our patient population, it’s a bit more skewed towards the autoimmune because of the type of people we’re seeing. Now occasionally, we’ll get people in that are just Healthy People that want to feel better, or athletes and those people are not as compromised. And so for those, maybe we’re just standard paleo, and there’s a lot more flexibility. So just want to make that distinction because I don’t want your average person who doesn’t really have any major concerns thinking they need to go, you know, stick with AIP for life.

Dr. Justin Marchegiani: 100%. Now, what if you don’t have an autoimmune diet? What if you don’t have an autoimmune disease? Should you do an autoimmune template? Well, here’s the deal, autoimmune template, really, the goal is you’re cutting out any food that has a higher chance of being hyper allergenic, right, there’s a lot of data on these different studies with nuts or seeds, that they can they have one anti nutrients in them, right oxalates phytase, either they affect protein digestion, mineral absorption, and they can be irritating on the gut lining. So there’s a lot of hyper allergenicity increased immune activity. So the and then they also have maybe potentially more omega six fatty acids that can drive down more of the pro inflammatory pathway. So the goal is that we’re trying to reduce some of these anti nutrients that have a negative impact on the gut lining. And the number two, we’re trying to increase nutrient density. Alright, so we’re choosing foods that are higher and better fats, right? fats that are polyunsaturated fats that are more polyunsaturated, they can be damaged and they can be oxidized, right so animal fats, coconut oil, saturated fats, not so much. And and then just the just the gut permeability aspect. So we see nuts and seeds fit that criteria. Eggs potentially even though eggs are awesome and so nutrient dense with a good vitamin A and fat soluble vitamins and cholesterol in the yolk, especially, they’re amazing. So sometimes those compounds can be a little bit more allergenic. So can the nightshades with the alpha solonian compound and they’re in the saponins. They can be a little bit More irritating on the guts get into the joints create inflammation. So it depends. The goal is really that it’s just a nutrient dense, anti inflammatory and then low in toxins, but more importantly, plant toxins, anti nutrients. 

Evan Brand: Yeah, well said and the reason you’re bringing up the lectins. And some of these other compounds of these foods are because they’re going to contribute to increased intestinal permeability. So when you’re talking with anyone, whether it’s rheumatoid arthritis or some other autoimmune disease, there’s always a domino that has to fall which is that the gut is leaky, this increased intestinal permeability has to take place. Now we’ve gone into the details of why that can happen from the infection perspective, low stomach acid, food fermenting in the gut, bacterial overgrowth, parasites, emotional stress, overtraining, we’ve tried to hit a lot of these different variables that can go into the leaky gut. But you can also have all the lifestyle infection piece dialed in, but if you’re eating, let’s just say, you’re doing salsa on your, you know, cassava flour, tortillas and your grass fed ground beef, but you’re just doing, I don’t know corn chips and salsa all the time with it, it’s possible that a lot of those lectins like you may get from your nightshades like your tomatoes and peppers. Those can irritate the gut lining contribute to that leaky gut and then that’s going to increase your autoimmune risk. Or if you’re already autoimmune, it may potentially flare you up depending on what’s going on. 

Dr. Justin Marchegiani: Absolutely, there’s one study that came out looking at people that have potential autoimmune genetics, they have the likelihood to make 10 times more IGA antibodies against certain foods than healthier foods. And in this one study, it’s called food intolerance and patients with a manifest autoimmunity with manifest autoimmunity observational study, in the Journal of autoimmune review, they talk about that the IGG level for specific foods were higher in the patient control group and the control group. So if these people that had autoimmunity they had more antibodies, and what they found was they saw a significant increase level and IGG. That’s a type of antibody that’s produced. And most doctors only look at IGE, which is anaphylaxis type of allergy response, immune response. And that’s like you need the epi pen for that right and so this is kind of IGG there are other types of responses that aren’t even in that IGG IGA, IGM IGE category, and so IGG isn’t the be all end all by the way. But they found that casein cow’s milk weekly and wider the eggs, rice, even some nuts and what and walnuts and almonds tend to have more of a allergenic idg response. They found no antibody reaction with vegetables and fish and meat products. They seem to be very immunoglobulin neutral. Guess what we do with an autoimmune template or a paleo template, we’re cutting most of those foods out. Obviously, with autoimmune, we’re focusing cutting the eggs out and the nuts and the seeds out to that’s it’s about decreasing the immune response. People that have a lot of autoimmunity, their immune system is sucking up lots of energy and lots of resources, because it’s responding to all this food in a negative way. And so the goal is we’re just trying to calm down the immune system. And then those foods aren’t there. We don’t have the gut permeability. Therefore the the body can use those resources better versus having the immune system hyper responding.

Evan Brand: Yeah, well said. Now, one other point to why would this be beneficial to do or to go down this rabbit hole and as I mentioned, maybe not forever, right? Maybe temporarily, we pull out eggs for me, I pulled out eggs for a long time when I had gut bugs. I had an Louise on the podcast and we talked all about gallbladder and eggs and how there’s a big factor there where eggs can irritate the gut, you know, just based on the gallbladder issues. And so I pulled them out and now I can tolerate eggs, no problem duck eggs, I tried experimenting with those for a while some argue duck eggs are a little easier. quail eggs I played with those a little bit. You know, I can’t say that I’ve noticed a huge difference among the different types of eggs. But I think it’s a cool experiment when you try to get into the reintroduction phase where you’re going back to paleo 1.0 and adding eggs and things back in nuts. For me, same thing, I used to get really, really bad headaches from walnuts, so I cut those out for a while. If I do a little bit of those, I’m okay. So the good news is your body can calm down. And that’s one thing that this diet will help you do is it’ll help you to identify your trigger foods. Because if you’re just eating a bunch of different stuff, and your diet is too varied, and if you’re not tracking it, you don’t have a clue. If you go and you have a salad, where you’ve got walnuts and pecans and cranberries, and tomatoes and whatever on your salad, you’re not going to have a clue what’s irritating you but if you go AIP for a bit, now you’re going to know hey, you know what, as soon as I add it back in those tomatoes, boom, my joints hurt. And then you’ll have a much, much more clear path. So if anything else, it’s more helpful to use the journal plus reintroduce foods and it can be amazing. That’s how you really figure out what you tolerate what you don’t. 

Dr. Justin Marchegiani: Yeah, I tell patients you don’t really know how dirty you get until you get really clean. Right, once you’re really clean, and then you get dirty, you’re like, Okay, I get it. I’m dirty right now, right? What does that mean? We want a clean baseline. So what’s the clean baseline? In my analogy, the clean showers the baseline. And in regards to the food, that’s the autoimmune diet, the autoimmune diet is the clean shower, it’s getting really clean. So then when we start to one, maximize the diet, usually people are going to see benefit within a within a couple of weeks, and or a month, and I always like patients to kind of plateau, some or plateau within three, four weeks, where they may see a lot of improvement and joint pain or energy or brain fog. And then it’s like, Okay, good. Now they’re kind of like running out of steam in regards to their initial jump and improvement. So I want patients to typically be on the diet for four weeks and the plateau for at least one week before they do any reintroduction, some autoimmune patients, they continue to see significant improvement week after week, and it may last a couple of months. So patients that are like that, I’m a little bit more strict on what they’re under reintroduction. Now, it’s usually not that big of a deal. Because if you get those kind of results, those results speak for themselves, and they really motivate you a ton. So it’s not like twisting an arm to get someone to follow that diet longer, because the results are guiding us that we’re on the right track. So I tell my patients, if you’re gambling and you’re on a streak playing poker, or blackjack, I’m not going to pull you off the table. Right? I’m going to let that streak roll a little bit. Same thing with the diet. So if you have a lot of success coming out of the gates, I’m gonna let it roll. I’m gonna let you plateau. And then we have a specific reintroduction protocol, and how we add foods back and I’ll go into that in a minute. 

Evan Brand: Yeah, well said and, you know, there’s not a lot of money involved with this, meaning you can’t really make money just by getting people to eat meats and veggies. So the problem is, there’s not too many studies. Now I don’t know if you want to pull it up, but I just sent you one in the chat. For those watching on video, they may be able to see this. It’s a PubMed study here. It was in the inflammatory bowel disease journal 2017. As I mentioned, there’s not much money in this right. So it’s probably going to be few and far between clinical trials on autoimmune diets because there’s no drug involved and Big Pharma isn’t going to pay some random guy to do a diet trial. Right. But anyway, this was a study on patients with Irritable Bowel Disease. And they did it for six weeks, followed by five week maintenance. And it just goes into the results here it talks about significantly improving people with ulcerative colitis, and significantly improving Crohn’s disease. C reactive protein, they said didn’t change much. But the calprotectin, which is a marker we measure on the stool panel, it improved from 471, which is high was to 112 at week 11. And also Wow, those that did drop. I mean, that’s a lot. I mean, you’re talking hundreds of points, just put died alone. And then it says here among those with follow up endoscopy at week 11. improvements were also noted in a simple endoscopic score for Crohn’s disease and a Mayo endoscopy sub score. So we’re not obviously running that we’re not doing scopes on people, we’re running stool panels. But I’ve seen the same thing. I had a guy who had calprotectin above 1000, it was insane. He had pan colitis where it was the whole colon and you know, pretty much the whole intestinal tract was involved. It was pretty sad. But just with now, technically, in his case, we didn’t do just diet, we did a lot of really, really potent aloe extract. But I mean, we were able to get calprotectin down hundreds and hundreds of points within a few weeks. So there’s the proof.

Dr. Justin Marchegiani: 100% those are all excellent points. So a couple people in the chat here Andrew Hill wrote in that we got to be careful with tapioca because it’s a similar cassava similar to latex and yeah, if you’re a sensitive person, we may want to even cut that out for a few weeks before we add that in. Technically that may be allowed, right cassava yuca, tapioca. And that same kind of family. I think it’s the same thing. There’s different names, but that may be something we want to work on excluding others may just be some of the spices, you know, like pepper, some of the nuts or seeds or spices that are something that you don’t eat, but it’s more of a topical kind of thing on the food. Got to be careful over that if you’re really sensitive, usually foods going to have a dose dependency. So the more of that food you eat, the more the immune reaction will be exacerbated due to its we keep an eye on those things for sure. Riley wrote in that we know basically one of the no take on the food sensitivity test, when does a food sensitivity test become beneficial? So my issue with food sensitivity tests, is most of them come back with some level of autoimmune foods on there for people. Okay, that’s number one. So I always look at test, does it change the treatment? So most are going to have some of these foods on there, number one, number two, if it doesn’t have those foods on there, would a patient still benefit from cutting those foods out? That’s the important question, because your immune system may be responding in a way outside of a typical IGA G or IGA test. There are other tests out there that look at like the MRT or the Alliance akt look at other type of T cell intermediary responses, which could be it. But I still know people that run these tests and they have patients that test perfect for gluten. And then now you’re in this conundrum is do you allow your patient to eat gluten now because the test says gluten is fine, because we know there may be an immune response happening in the body outside of what’s being tested. So that’s why I don’t like it because you can give a lot of false sense of security that you can eat gluten or other grains. Number two, I’ve seen benefits cutting those foods out, even when it says it’s fine. So for me, it doesn’t change what I’m doing enough for the value for the cost. And I’d rather use that money on another lab or a stool test or supplementation that’s going to be more root cause supportive. 

Evan Brand: Well said, I’m going to take that as my soundbite. So anytime somebody says, Evan, why won’t you run a food sensitivity test dummy? I’m going to say, Well, my good friend, Dr. Justin said it better than me, and then I’m going to play them your little soundbite you just did because it was it was so good. But I agree. And that’s exactly what what I do is I just tell them, Look, save your money. Let’s go AIP. And then let’s do reintroductions plus you journal. And we find that that’s going to be far better. I mean, when you look at gluten, for example, I have seen people where it does show up as that it’s going to be okay. However, they know when they eat it, they don’t feel as good. They feel a little brain fog, they feel bloated. And that didn’t show up on paper. So then they’re confused. And then the husband goes, See, I told you you’re crazy, eat a pizza, and then you just get yourself in trouble again. 

Dr. Justin Marchegiani: So yes, now where food allergy tests may be helpful. It doesn’t quite fit into the patients that I see is if a parent is trying to help a child and or a family member who is totally on is totally uncompliant and resistant to doing anything. And if we can get some lab data saying to avoid these foods, that may help with leverage, but most people are coming to see us they’re they’re investing a lot to work with us. So they’re pretty darn compliant. If we say don’t do that, let’s save you some money. They just typically listen to us. Yeah, well, number two is if you’re already at a great, great super high level of health, and you want to see if there’s any maybe weird foods there, then that may be helpful to look and see if any other foods that are there. The problem is if it says don’t eat raspberries, and then you eat blueberries, what’s the chance that blueberries and now on the list next month? Right? That’s where it becomes this like whack a mole where you’re like, wow, like one and the other one pops up over here. And you’re like, crap. 

Evan Brand: That’s a very good point. Yeah, the compliance and the leverage. I mean, that’s the reason that we do some of the testing in regards to the infections too, because somebody will say, Hey, I feel like I’ve got this, I want you to just give me a parasite protocol. I think I’ve got parasites with you know, you and I’ve covered this before people come in, and they have this idea of what they think’s wrong with them. And we, they just want us to pursue that rabbit hole with them. So we’ll come in and we’ll use the data first look on the paper. You know what, actually, no, we think this is a bigger priority over here. And then we circle back. So yeah, that’s that’s a great point.

Dr. Justin Marchegiani: Absolutely. So I think it’s, uh, you know, we want to always look at you know, the root cause why you’re sensitive to these foods, of course, you want to be fixing the gut that’s gonna be ideal. Whether it’s SIBO or H. pylori of bacterial issues, you want to work to the six hours because patients have a chance of having increased risk of food allergens when the food’s not broken down properly. So adequate levels of enzymes and acids chewing your food masticating your food Well, not overly hydrating when you eat adequate enzymes, adequate acids are all very helpful at being able to break down the food again, if you love it, rotate it. If you’re eating beef every single day over and over again, your chances of a beef allergy goes up right but you saw the study I just mentioned earlier, that study showed much less chance of animal products and vegetables causing an allergen right so that we cut out the big foods that are going to be the highest risk. Now. Outside of that there’s a reintroduction plan that I infuse with my patients when it’s time. So we add each food back in over a two to three day period. So we’ll start with egg yolks before eggs ghee before butter, one not one seed one Nightshade at a time. And typically a very small amount of food on day one, a little bit more on day two. And if we have no negative symptoms, then usually we’re good we can go to the next food if we’re on the fence, we can have a day three where we eat a larger amount of food because the response tends to be dose dependent small amount of bad food for you. Small amount of symptoms, larger amount of food, larger amount of symptoms and then if you stair step the dose up usually the symptoms go up as well. So if you’re on the fence, it gives you that ability to be confident that you’re sensitive or not. And we go right down the list. 

Evan Brand: Yeah, so give me a little bit of concrete like view how would that look? So today’s Monday when we’re recording so let’s say you want to add back in almonds for me you’re gonna have me do what have you? 

Dr. Justin Marchegiani: Yeah, so let’s just start in the right order. So egg yolks before eggs, so I may go and I may poach one egg, poach it, it comes up. I’m keeping the yolk a little bit soft. Why I don’t want to oxidize it. I trim away the egg white egg white tends to be more allergenic, feed it to my dog, have the yolk How do I feel? That’s a good if I do. Okay, let’s do two yolks tomorrow. Trimming away. Good. Excellent, great. Awesome. Very good. Next day we’re going to add in the full egg. Now we’re going to do a little omelet, right, but we’re not going to overly, we’re not going to overly cook up the egg yolk, the egg white, I’m sorry, we’ll keep it so it’s, you know, the whole eggs blended but it’s going to be a little bit more wet because we don’t want to overly oxidize the cholesterol on the proteins that are in there. Right? oxidized cholesterol and protein tend to be more hyper allergenic higher immune response. And then if we’re good there, then we go to gi waggy. Keys, clarified butter, less lactose, less casein, right? The casein and lactose have the biggest problem. If you can tolerate ghee Great, now we go to butter The next day, same kind of stairstep so my sensitive patients can handle ghee can’t handle butter. So we always want to start with the least allergenic to the most. So if we can handle one egg yolk but not the egg, guess what we at least have an egg yolk in our diet. If we handle the egg, the GI but not the butter we at least have some of that good butterfat clarified gi back in our diet. So we always go least to most, where if we did it the other way around. You wouldn’t have been able to add the food back in. 

Evan Brand: Yeah, that’s great. Okay, and then when do you bring in some of the nuts, the seeds? How do you do those any particular order you found better or worse. 

Dr. Justin Marchegiani: So I would just start with like, if you’re gonna do almonds, you could just do one or two almonds, right? And IDN sprouted is a little bit better, right where it’s soaked, and that can deactivate some of the anti nutrients, the lectins, the phytates, right, the oxalates. So you can do a couple of almonds, maybe one teaspoon or tablespoon almond butter. And the next day you can double or triple that dose. See how you feel if you’re okay, that’s a good sign. But of course, deactivating some of the anti nutrients can be helpful too. And then the next day, let’s say pecans are in your routine. Try pecans, try pistachios or walnuts. And again, if if you’re not eating those foods on the reg, it’s not that big of a deal, right? Just try to choose the nuts or seeds that are more on the regular things that you’re doing more on a daily routine. 

Evan Brand: And of course we want to make sure these are organic. We want to make sure these are fresh. I advise keeping your nuts in the freezer like I keep my pecans in the freezer. And they taste so good frozen to like I’ll take pecans out of the freezer do a little bit of maple syrup. Oh my god, you talk about delicious. 

Dr. Justin Marchegiani: Oh totally. Yep. 100%. Now here’s the other deal too. So then we have let’s say you’re able to get nuts or seeds or nightshades or eggs back in right you get everything back in. Do we ever allow grains now I always just tell patient it depends on how significant a patient is. If we know someone has diagnosed autoimmune condition I always try to stay more on the grain free side I hate the word gluten free because you can be gluten free and eat lots of process rights and oats and corn and that could be a problem right? Because the problem means are are the umbrella the problem? You know umbrella gluten is one prolamin under that umbrella, right? The most common one is the wheat, barley and rye that gliadin prolamin. Then you have horizen in which is rice, you have a vignette which is oh right you have seen what you have seen which is corn. So these are still like brothers and sisters of the Glee and protein. So just like someone you may see someone, a brother or sibling, and you may be like, Oh, you must be so and so you look just like him as a family resemblance. Well, your immune system has that same kind of resemblance with other proteins that are cousins and brothers and sisters of gliadin. And so your immune response can be triggered. Also, there’s a lot of data in the non celiac gluten sensitivity research that grains, even if you’re not allergenic to them can still increased gut permeability. And the more you increase gut permeability, the greater chance you have of creating more inflammation or triggering autoimmunity. Now, what does that mean? Does that mean never eat grains? It just means my general recommendation is always try to be grain free if you can have a substitute. If you’re relatively healthy, good health and you have no autoimmunity. Could you eat some grains that have gluten here, they’re probably you could probably get away with it, you know, and it probably wouldn’t be that big of a deal. I wouldn’t recommend it being a staple because those foods, they’re still inflammatory. They still have a lot of nutrient blockers in there. And they still aren’t nutrient dense. So I still much rather, I’d much rather see someone have some white potato over a bunch of wheat, right potato is actually pretty nutrient dense and has a lot of potassium in there and a lot of good minerals. I rather have someone do that over over gluten. Complete gluten full, if you will, grains, but it all depends where you’re at, the healthier you are, the more versatility and adaptation you have, the more unhealthy you have or the more diagnostic autoimmunity you have, you really want to be careful. A lot of times it’s just not worth it. Some people they eat some gluten, they’re inflamed for a week, it takes them days to get back on the wagon. So it depends upon how long it takes you to get back on the wagon. And if you have a known thyroid issue, there’s some data saying that autoimmune response can last for weeks and even months so it’s just not worth it depending on the damage that may occur. Dude after the fact. 

Evan Brand: Yep. Well said and yeah, he’s talking about like the gluten cross reactivity issue. So like, for a while, you know, I had a lot of people doing corn because they thought, Okay, I’m gonna, I’m gonna be okay. But turns out they weren’t. Okay. So in a lot of cases, yeah, we do remove the corn if I do a much rather see 

Dr. Justin Marchegiani: much rather see cassava or you could chips over anything with corn or anything else like that. So that’s much better like this yet they brands pretty darn good. Or just a really good white potato chip like the boulders make a good one with avocado or coconut oil that’s really good fat. On the potato side.

Evan Brand: I’ve noticed the same thing. Yeah, potato for some reason, even though it’s still potentially cross reactive. I’ve noticed it is better tolerated than corn for most people. So that’s good. Maybe it’s just a lower count or maybe a slightly different compound in there. 

Dr. Justin Marchegiani: Exactly. And I use a lot of root vegetable chips. So I’ll do like a lot of turnips, rutabaga, or sweet potato, like a lot of root vegetable, like grain free type of stuff. And that tends to be pretty good. But the nice thing is, once you kind of work through that autoimmune template, you should get a lot of confidence in what you can or can’t handle. And then once you’re at a high level, if you’re if you’re going off the reservation too much, you’ll start to feel it. And that usually gives you a pretty good idea that you’re probably doing too much for you. So our goal is to get you feel really clean. And then once you’re really clean, it’s kind of easy to notice when you’re getting dirty. 

Evan Brand: Yep, yep, well said. And the whole point of this is what well, it’s to give you relief is to get you to feel better is to get your brain to work better your joints to feel better your sleep to be better your food reactions, your gut, your, your everything. I mean, the skin, the brain, I mean, this literally can affect every body system here. So we really want to focus on what’s the end goal. It’s not just tweaking this just to tweak it make this like an obsessive OCD type thing because it can get a little crazy. No, it’s to get you to feel better. And then while we get you to feel better, we’re working behind the scenes on these other root causes. Because it’s very unlikely that someone became sensitive to all these foods just out of nowhere, right? There’s something that triggered it. And Okay, so we’re getting you simmering, okay, we got your diet, just you Okay, we got that pillar of the house in now, while that’s sitting there, simmering. Let’s work back here. We’re going to work on this, this this over here, and then boom, now we go back to this diet. Good job, you’ve been holding steady. Okay, now let’s bring normal quote normal things back in and then people tolerate him. So that’s kind of the whole rationale. That’s kind of our mindset behind this whole thing. When we’re working clinically. It’s not just the dietician, approach. Here’s the diet have a good life? It’s okay, well, why did you have to go to this level of specificity in the first place? And that’s the real question. 

Dr. Justin Marchegiani: Exactly. And also, people want to start having more grains on the regular, I would say make sure your health is really great and stable. And I’d also say if you wanted to be more certain, run an HLA dq test for gluten sensitivity, if you have to or ate on there, you definitely want to avoid the gluten, one or three is going to be a little bit less. And then I think four is the only true genotype that is not gluten sensitive, you could still have other problems with the anti nutrients that are in there, or the higher amounts of fermentable carbohydrate, but that’d be my one test that would say just to really know that make sure there’s not a genetic issue. If you’re going to put it in there and more in the regular for me, my big cheats are going to happen. If I go out for sushi, I may have a couple of rolls. But usually I like the Alaskan roll that has like a lot of salmon, and a lot of avocado, and then there’ll be a little bit of white rice. So when I typically cheat, it’s going to be getting some white rice for sushi. And but I typically use coconut aminos and a soy free soy sauce and MCT oil and I’ll typically do extra enzymes and extra charcoal during those meals to mitigate the inflammatory response. So it’s a kind of couple of little tricks that I kind of do. If not for me, I just I just feel too good. I don’t want to have a setback. So there’s enough substitutes for me where I can engage in that substitute still feel really good and not have a problem? 

Evan Brand: Yep, they are. Well said. 

Dr. Justin Marchegiani: Anything else you want to add Evans? Oh, one more thing. I wanted to say. What if autoimmune paleo is not enough? What does that mean? So some patients they may have to do carnivore, they may have to do a variation of an autoimmune paleo, low fodmap SCD template where we’re cutting out fermentable, carbohydrates, even some of these really good fermented foods. Or we may have to be cutting out foods that are high in salicylates and females, that may have a little bit higher amount of anti nutrients that, you know, things that could be on the vegetable side, right, or fodmaps, like broccoli, and let’s say onions and garlic, things that are have good benefits, we may have to cut out other foods. And again, we see a lot of patients that come in that have done a lot and that are very sick or have a lot of gut inflammation, we may have to go to that extreme. We may even have to do an elemental diet or a carnivore diet. So everyone’s a little bit different and they come in from different places. But if an autoimmune diet does not work for you, there’s other things that we need to work on it. You’d really want to work with that practitioner at that point, because your health issues are a lot more nuanced. 

Evan Brand: Yeah. And hopefully you’re not hopefully you’re not to that level. But just know that if you’ve done this and you’re still suffering The number one, there’s probably underlying triggers you haven’t identified yet things that are really aggravating your immune system or the gut. So we need to try to find those triggers. And then number two, you can tweak this thing even more to get you stable, the whole thing, the whole goal is to get you stable. So we can work on root causes here. So it’s not just diet and done, just remember that.

Dr. Justin Marchegiani: 100%. And also, what’s the goal of this diet, right, I always tell patients, what’s the goal is that we don’t have like a goal in mind. Most people, when they make a diet change, they kind of just go to this place in their hand, like it’s forever. And they kind of have like a little mini funeral, like how I miss my potatoes, my, or my seeds, they kind of have this really this kind of state of mourning, where it’s really sad and they’re depressed, I always tell my patients, the goal is to one first, increase your nutrient density in your diet, number two, to decrease inflammation overall, right, and then three, to decrease a lot of the toxins, whether those toxins or plant based toxins, whether those toxins are you’re not eating organic, and you’re getting pesticides, and chemical toxins, all those things are valid. And the goal of that is that now decreases the immune system stress, and that the immune system stress starts to go down. There’s less autoimmunity, there’s less inflammation in the body. And that kind of starts creating this snowball effect where your body can start to heal as we start addressing infections, supporting the adrenals addressing nutrient deficiencies, calming down the immune response by addressing infections and using probiotics and other nutrients on that side of the fence. 

Evan Brand: Yeah, you made a great point, which is the emotional piece. So we could do a whole part two podcast on this if people want. We’re going into the whole rationale scientific part of that. But if you’ve got a woman who is addicted to her cookies, you’ve got to work through the emotional stuff, too, right? So we could come in with all these rational, very scientific studies and things you have gone into, right? It sounds really attractive and really scientific. But then you got the emotional bubbles popping up. And people are going Oh, no, but what about this? And what about Thanksgiving? And what about this and my family and I love to do go eat the popcorn at the movies, you know? And so then the emotional piece is hard. So you have to work through that with people. And we do we have those conversations. So on the face of it, it sounds all easy, right? It’s like, okay, just boom, boom, boom, boom, boom, you’re great. But then, once you actually sit down at the plate, and you’ve got that fork there, then the emotional stuff comes up. It’s the the husband or wife making fun of you for your choices. I mean, that’s a common one. It’s if there’s a divorced family, it’s the child going to the other part of the family, where the other family member doesn’t believe in this and say, This is all quackery. And then they come home after eating pizza all weekend, and then they’re in an autoimmune flare, or you go over to the parents house. And, you know, they think it’s a joke. So they still try to serve you bread and butter, you know. So there are some things you have to work through on the family emotional side, but you know, it’s definitely something that’s, that’s possible. Everybody can do it. 

Dr. Justin Marchegiani: Yeah, where I see it a lot, you know, well, meaning grandparents that feed their kids cookies, their grandkids, cookies, you know, or like, they want to spoil them a little bit. That can be really tough, too. But yeah, you got to get everyone on the same page. And in general, you got to have a plan. And if you’re having a lot of cravings, most of those cravings, a lot of the protein orphans, which are like opiate like compounds in grains and dairy hit that same opiate receptors. So those foods can have a lot of addictive qualities to it. And a lot of people they’re used to operating on a blood sugar rollercoaster, so their blood sugar goes up and down, up and down. Because not enough good protein or fat in the meal or they’re not, they’re going too long between meals. So really working out the blood sugar. A lot of times if someone switches from a standard American diet to an autoimmune diet, the two big mistakes they make is one, they’re not getting enough calories from their autoimmune diet, therefore, they’re chronically hungry, which creates cravings. So you have to make sure you’re getting enough calories or nutrients. The second thing is they may go to low carb for them. So if someone’s needs a little bit more carbs, and they’re at a relatively more healthy way, they may come in go really to low carb, and that may cause more cravings too. So you may have to just add in some good, healthy, safe starches to fill that carb void if those carbs are a good place for you. My default set is always lower carb, higher fat, and then kind of work through that over time, because most people have more insulin resistance and going lower carb out of the gates helps resolve a lot of that. 

Evan Brand: Good points. Good point. Yeah. And the gluteal morphin stew. I don’t know if you said I think it said the other thing that 

Dr. Justin Marchegiani: Yeah, the protein orphans are gluteal morphemes. These are like the opiate like products like that are in gluten or the KCM orphans in the dairy. 

Evan Brand: Yeah. So when people say oh my god, I’m addicted to my whatever, they’re not joking. You literally are and there can be some sort of a withdrawal from it. And then also from the neuro transmitter perspective, that’s something we’re going to look at on organic acids testing. So if we see for example, whether it’s low endorphins, low dopamine, low serotonin, we may come in with specific amino acids to try to repair and rebuild. And that can be a good let’s call it a nutritional support band aid for the brain chemistry, which is causing the underlying craving in the first place. So rather than say, hey, go from the gluten cookie to the grain free cookie, it’s okay. Yeah, maybe you do that. But we’re also going to give you a little bit of some DLP a or trip the fan or something to help the brain because the brain is involved with this too. This is not just the gut, the brains involved too. So we’re, we’re thinking about all these variables as we go. It’s kind of a moving, it’s like, I don’t know, maybe a good NASCAR analogy, you know, it’s like the, the guys are coming on and changing all the tires and we’re doing that in every category. So it’s the brain, it’s the gut, it’s the immunity it’s the adrenals we’re we’re simultaneously working on all of these pieces and then boom, you succeed you feel better. So I think we should wrap it up if you’re ready too.

Dr. Justin Marchegiani: I think we can’t man that we did a great job kind of outlining everything this will be a good reference for my patients as well that you know, just kind of want more intel on the autoimmune side. If you’re listening to this and you want to dive in deeper and you’re feeling a little bit overwhelmed with some of the diet changes out of the gates definitely reach out to myself for Evan, EvanBrand.comand there’s a little link there where you can click the schedule or myself Dr. J. At we’re happy to help you. We have experienced doing this for over a decade with thousands of patients. And if you’re ready to take that next step, we’re here to help you all if not just utilize all this free information and just kind of execute on it and make yourself healthier. We really appreciate it. 

Evan Brand: Yeah, if you’re a do it yourselfer, that’s fine. But for me, and you and many others, it’s better to have a guide, it’s better to have the data test don’t guess get the information, know what you’re up against. So you can figure out and when we say test, don’t guess we’re talking the root cause stuff. We may not run a food panel out of the gate, but we’re gonna run a gut panel out of the gate figure out what infections could be causing these issues in the first place. So thanks for tuning in. We appreciate you guys and we’ll be in touch. 

Dr. Justin Marchegiani: Put your comments down below. Let me know your success on an autoimmune diet. Really want to know and thanks for sharing. You guys. Have a good one. Take care of y’all.


Audio Podcast:

The Carnivore Diet: Eating ONLY Meat

By Dr. Justin Marchegiani

The Carnivore Diet has recently gained a lot of popularity. In essence, the diet is very simple: just eat meat. The concept of eating only meat can be hard to wrap your head around- it goes against everything we’ve been told: fresh fruits and vegetables are important for well-being, meat causes heart disease, without fresh produce you can get scurvy, etc. Today we’re going to review the Carnivore Diet and debate some of the most common misconceptions.

What is The Carnivore Diet?

It is a high protein, moderate fat, and virtually zero-carb diet. The diet consists predominantly of meat, although some people allow other animal products such as butter and eggs. No fruits, vegetables, or grains allowed. While a common result of this diet is weight loss, people primarily start eating carnivore to address autoimmune conditions.  

What to Eat?

At its core, the Carnivore Diet is a meat-only diet. However, like with all diets, there are some grey areas. It is up to each individual to decide what works best for them. Since a large portion of those who start this way of eating do so to overcome health challenges and autoimmune issues, many choose to stick to meat-only. However, others choose to include other animal products as well.

Listen to Dr. J’s podcast with Caitlin Weeks (Grass Fed Girl) sharing her experience on the Carnivore Diet!

Foods Accepted in the Carnivore Diet

The staple food of the carnivore diet is beef: ground beef, steaks, simple sausage. Those who follow this diet report feeling the best and having the best results with beef. Other foods allowed on this diet include:

  • Poultry (chicken, turkey, etc.)
  • Lamb
  • Pork, bacon
  • Fish
  • Organ meats
  • Lard, tallow
  • Eggs
  • Bone marrow
  • Salt
  • Butter
  • Bone broth
  • Water

The grey area includes animal products such as yogurt, milk and cheese; as well as teas and coffee. Whether or not to include these items is completely up to each individual!

Meal Plan for Carnivore Diet: 1 Day of Eating

Here’s an example day of meals for someone on the Carnivore Diet. Keep in mind, this is structured after the typical 3-meals a day template most Americans abide by. However, most people on the Carnivore diet find that they can go much longer between meals. Meat is full of fat and protein, which can keep you satiated much longer.

Breakfast: Three eggs cooked in butter with a few slices of bacon.

Lunch: Rib eye steak.

Dinner: Hamburger patties with cheese.

Notice the lack of snacks; one of the advantages of the carnivore diet is the fullness factor of the high-protein consumption. Some people skip breakfast, others choose to eat just 2 meals per day (ex: the first around 11 AM and the second around 5 PM).

Benefits of the Carnivore Diet

It’s important to note that this way of eating has not been heavily studied, so most evidence is anecdotal. Many people suffering from extreme autoimmune conditions have found solace in the Carnivore Diet. When nothing else could provide them relief, meat was their saving grace.

This diet is thought to heal due to the anti-inflammatory aspect of eating meat. In a sense, this is an extreme elimination diet which gets rid of any possible food sensitivities or triggers. The Carnivore Diet has reportedly cured autoimmune conditions, depression, binge eating, and chronic pain.

Click here to work with a functional medicine doctor to get to the root problem of your health concerns!

Will the Carnivore Diet Meal Plan Help With Weight Loss?

Those who have tried the Carnivore Diet to heal their chronic illnesses rarely even mention the weight loss, because for them, it seems insignificant compared to the feeling of being healed after years or decades of living in illness! But nonetheless, the Carnivore Diet has also been shown to dramatically help with weight loss and muscle toning.

There are many reasons why the Carnivore Diet is so effective for weight loss. Firstly, you’re eating mainly protein and fat, which provide satiety and it eliminates mindless eating.

Additionally, you’re more than likely to switch into ketosis on this diet. When you’re in ketosis, your body is burning fat for fuel, rather than carbohydrates. So your body will essentially use the extra fat you’re carrying on your body to give you energy!

Health Risks of the Carnivore Diet

There are several myths and common concerns regarding this diet:

“Too much meat can cause kidney problems.” This is more of a concern for people who have preexisting kidney conditions. If you are going into this with strained kidneys or kidney disease, then your filtration system is already impaired and higher amounts of protein may be an issue. But if your kidneys are healthy, then the protein should be just fine!

“Eating only meat causes scurvy.” A common misconception is that eating only meat can cause vitamin deficiencies. First of all, meat does contain small amounts of vitamin C. Secondly, in a carbohydrate diet, we only require 10 mg/day of vitamin C to prevent scurvy. What’s more— research shows when on an all-meat diet, we require even less vitamin C to stay healthy.  

“Won’t you get super constipated?” Those on the Carnivore Diet have reported that, although it may take a week or so for your body to adjust, this diet does wonders for their colon and bowel movement regulation!

“Isn’t meat bad for you?” Please read our article on red meat’s supposed link to cancer. Essentially, the study that went viral was sensationalized, and there were a lot of factors that were overlooked. It is my firm belief that grass-fed, organic, free-range meats are healthy for you, no matter what diet you’re on! Quality matters.


If you decide to try the Carnivore Diet, be sure to choose fatty cuts, and don’t be stingy with the salt! Follow your intuition- if you want to throw a slab of butter on top of your steak, or want to choose the fattiest meat cuts you can find- do so! Don’t start this diet primarily to lose weight, and then start counting calories. Your body requires fat and plenty of electrolytes to stay healthy. If you skimp on the salt, you will notice. Headaches will probably be your first clue! Additionally, be sure to drink plenty of high-quality water (filtered water, or spring water if it’s available!). You might even consider sprinkling some salt into your water to keep yourself hydrated.

Who is the Carnivore Diet For?   

As we’ve noted, people with chronic illnesses and autoimmune diseases are among the finest candidates for the Carnivore Diet. If you have been suffering from undetermined food intolerances, you might consider the carnivore diet as a short-term elimination diet to uncover your trigger foods.

Anyone with kidney disease or eating disorders should think twice before diving into the Carnivore Diet. We advise anyone considering this way of eating talk to a functional medicine practitioner to better advise on an individual-basis.

Is the Carnivore Diet right for you? Click here to ask a functional medicine doctor!



Understanding the Benefits of Adaptogenic Herbs for Your Adrenal Health

By Dr. Justin Marchegiani

Stress is at the root of many modern illnesses. Though some stress is necessary for keeping your immune system agile and for helping you stay alive in dangerous situations, prolonged and persistent stress can contribute to anxiety, insomnia, heart disease, leaky gut, adrenal fatigue and many autoimmune conditions.

Unfortunately, most of us are exposed to chronic and persistent stressors, such as long hours at work, traffic, and worrying about finances. While some stress is normal, its impact on your health can be minimized by managing and relieving stress in a healthy manner. More and more people are turning to adaptogens for stress relief and adrenal balance!

What Are Adaptogens?    

Adaptogens are herbs and plants which have been used for centuries in Chinese and Ayurvedic healing traditions for helping the body react healthily to stress. Non-toxic in nature, adaptogens manage all kinds of stressors whether they are chemical, biological or physical. They help to balance the body and support the adrenals.

While some adaptogens are used for stimulating the body and enhancing mental performance, others are used for their calming effects. Adaptogens can boost strength and vitality, combat adrenal fatigue, and treat various issues- from asthma to infertility! These special plants and herbs can also support the natural circadian rhythm of the body and help promote more restful sleep.

Click here to work with a functional medicine doctor to get to the root problem of your health concerns!

How do adaptogens work?

To understand the working of adaptogens, you need to look at the “HPA axis”. Your hypothalamus is the part of your brain which recognizes stress. When you are feeling stressed, your hypothalamus sends signals to your pituitary glands, which signals to your adrenals to produce and release stress hormones. This is known as your Hypothalamic-pituitary-adrenal or HPA axis.

Chronic stress keeps your HPA axis engaged on a constant basis. This can affect your sleep, mood, immune system, blood sugar, thyroid, appetite and much more, which has a bad effect on your overall health. Being in a constant state of biological stress is also quite taxing to your adrenal glands and micronutrient reserves.

Your adrenal glands have to work extremely hard to keep up with the demand of being constantly engaged. Chronic stress can fatigue your adrenals, leading to adrenal dysfunction and burnout.  

Adaptogenic herbs promote a more balanced response to persistent stress. They also help regulate the production of stress hormones and cortisones, which protects against adrenal fatigue and HPA axis dysfunction. By modulating cellular sensitivity to stress hormones, adaptogens encourage a healthier response to stress overall.   

The following are some of the best adaptogens which have been studied for their positive effects on stress relief and adrenal balance.

Ashwagandha is a powerful adaptogen which has been shown to reduce inflammation, calm the mind, and lower blood pressure. It also enhances the activity of immune cells which help to fight off infections and cancer.  Its anti-inflammatory effects help to relieve pain associated with arthritis.

Ashwagandha boosts adrenal function, and is a favorite for balancing stress hormones, enabling anxiety relief, and increasing energy in those who are suffering from adrenal fatigue.

How can adaptogenic herbs help you? Click here to ask a functional medicine doctor!

Maca is both an adaptogen and superfood which makes it unique. It is grown in the Andes Mountains. Maca is a root vegetable which is rich in protein, calcium, fiber, magnesium and amino acids like arginine and glycine. It has been used medicinally for centuries for improving mood and symptoms of adrenal fatigue.

Maca regulates hormones by increases hormone production when your body is under-producing, and brings down hormone production when your body is over-producing hormones. With continual use, maca nourishes and enhances the function of the pituitary gland and hypothalamus, which helps to restore the adrenals.

Maca is very tasty and can be taken both as a food or in supplement form. It has a nutty, butterscotch-like flavor which can be mixed easily into smoothies or even baked goods for a strong energy boost!

Ginseng Chronic stress can contribute to inflammation and trigger many illnesses on account of an imbalanced immune response and hormone dysfunction. Ginseng has the ability to greatly reduce chronic stress by regulating the HPA axis, and decreasing depression, anxiety and other HPA axis related disorders.  It can also help to prevent autoimmune disease by suppressing proinflammatory cytokines which are generated by chronic stress.

Rhodiola Excessive cortisol (primary stress hormone) can cause depletion of your nutrient reserves, impair your memory, and can have damaging effects on your blood sugar, blood pressure and metabolism. Rhodiola is an adaptogen which has been proven to lower the secretion of cortisol during stressful situations. It can increase energy and concentration in people who have been suffering from adrenal fatigue. It also has anti-depressive and cardioprotective effects.

We hope that this article has helped you better understand the benefits of adaptogenic herbs for your adrenal health. Do you use any adaptogenics? Let us know your favorites in the comments section!



Skin Health and Autoimmunity | Podcast #202

The skin is a window into what’s happening in the gut. While it is true that a lot of potential skin irritants are everywhere, one might try to consider that everything going on on the inside is reflected on the outside.

Watch the video and learn about skin issues, effects of gut health to skin, autoimmune conditions, and effective ways and preventive measures to make the surface reflect the way we wanted it to be.

Dr. Justin Marchegiani

In this episode, we cover:

01:00    Gut health mirror the skin

06:09    Administer nutrients inside-out

11:02    Topical irritants

15:27    Bowel movement affects skin health

17:48    Histamine issues, genetics, and excessive insulin

20:38    Autoimmune domino effect


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani, hope you all had a fabulous weekend. I’m in a house here with Evan Brand. Evan, how we doing my friend?

Evan Brand: Happy Monday man. Hey look, I was talkin’ about the sunny weather but I’m gonna complain today it’s rainy and grace guys so, today is a good day to just hang out. I’m gonna sit by my infrared Sauna lamp that I have here and just try to stay warm.

Dr. Justin Marchegiani: Hey, that’s wonderful man really good idea. Well, I’m excited to dig in today in this topic of Skin Health and Autoimmunity.

Evan Brand: This is huge!

Dr. Justin Marchegiani: Yeah it’s a powerful topic. I mean, we know that the immune system and the gut are intimately connected ’cause about 80 percent of your immune cells live in your gut and the MALT and the GALT the– mucus associated lymphoid tissue, lymphoid meaning lymphocytes which is another name for–for blood cells or wh— white blood cells and then we have our–our GALT which is our gastric-associated lymphoid tissue that’s in the stomach and then the MALT is in the uhm— small intestines. We know the guts and the immune function interact totally and then we also know that– uhm— the guts mirror the skin. People that have inflamed gut– uhm— dysbiosis infections malabsorption that shows and manifest itself in the skin we have pathologies that can even manifest from various rashes from lupus rashes uhm— erythema to– psoriasis, to vitiligo, to eczema, other types of various dermatitises to alopecia with the hair uhm— so– I mean you name it, right. The skin is a window into what’s happening in the gut.

Evan Brand: Yeah, I’ve got some statistics here. Was a good way to open up. This is from the CDC; this is actually 6 years old so it’s probably even worst than what this study shows but they were looking at from 2010 to–or from 2000-2010, the percentage of children aged 17 and younger with eczema or any kind of skin allergy and the levels across basically all races pretty much doubled, just from 2000 and 2010. So I bet 2010 and 2020 we’re probably gonna see an even more rapid spike of skin issues. I mean I can’t tell you when the last time I went out in public and did not see someone with the skin issue, I mean you go to a shopping mall, you go to a grocery store like you’re gonna see skin issues. It’s a very very common thing and even just look back at some of my old YouTube videos. I remembered Justin you saying, “Man I bet you got something going in your gut” ’cause my acne used to be so bad on my chin–

Dr. Justin Marchegiani: Yeah.

Evan Brand: –it was all the dysbiosis in my gut. So, we’re definitely gonna chat about that today too about infections.

Dr. Justin Marchegiani: Yeah, you even have a lot of rosacea too which is a sign of inflammation on the skin. Now, that’s important because when I see someone that has some kind of a skin issue that tells me that there’s some type of autoimmune or internal inflammatory thing happening inside the body especially the gut. So when I see skin issue the first thing I look at is potential food allergens. And we would move someone to like a paleo-slash-autoimmune-paleo template. And then we know other nutrients are really important so if we have poor digestion the chance of us breaking down fat-soluble vitamins like Vitamin-A go down. We know the ability to digest and absorb and assimilate zinc goes down. Healthy fish oil fats like Omega-3 go down. Vitamin-C which is really important for that collagen matrix goes down. Biotin which is a– uh– a– a B-Vitamin family. Selenium, uhm— Silica, uh– Vitamin K2, uh– sulfur amino acids, Vitamin-E, Vitamin-D, of course a lot of our collagen amino acid which are very high in proline– hydroxyproline, glycine which are really important building blocks for the skin so we need to absorb and assimilate and utilize all of these important nutrients. And we need good digestive function, we need a– gut lining that’s not inflamed, and we need enough adequate enzymes and acids to be able to break everything down. And of course, dysbiosis, SIBO, bacterial overgrowth, fungal overgrowth, and or parasite infections that H-pylori, could easily be a– a factor that prevents that from happening optimally.

Evan Brand: Yeah I was gonna say let me take you down to zinc rabbit hole a little further ’cause this is really important based on my history–

Dr. Justin Marchegiani: Uh-huh.

Evan Brand: –the skin issues. I had H-pylori, I showed up positive with a– on my second test on my stool. I first showed up a parasites, cleared those out. Second round on the re-test, you know, Justin I see this every single week on lab results, you know, sometimes we clear out a client’s gut of some infection, and then on the re-test a new infection shows up. And that’s what happend for me, H-pylori showed up. And– so if I was eating grass-fed steaks, I was eating Bison, I was eating all– all these really good high quality pastured meats. However, I was not getting any of the zinc to be cleaved off of those meats because how poor my digestion was. And also, there’s a marker we look at called calprotectin. My levels were elevated so I had gut inflamations. So even if– I had good meat, it’s not about what you eat, it’s about what you digest from what you eat which why we always hit on the acid and enzyme piece so much, so for me– I mean, I could’ve uh– could’ve used supplemental enzymes and I did but that’s not– that’s not the– that’s not the root cause. I had to dig deeper so, you know, we tried to compare conventional, naturopathic functional medicine like a naturopath, may say, hey, you know, you may need some extra acid and enzymes but they may never go to the next level of investigation  which is hey, do you have infections that we have to– fix that explains why your acids and enzymes are low in the first place. And then, just a quickly compared to the conventional medicine approach that these type of skin issues whether they’re autoimmune or not, it’s gonna be all the garbage that you probably already know about. A steroid creams, and– immunomodulators, antihistamines, what else do the conventional docs do? It’s not good, it’s– I mean, it doesn’t work–

Dr. Justin Marchegiani:Yeah, I mean you have your antibiotics, you have your immunosuppressants, you have your uhm— corticosteroid which kind of fit into that same family. And then you have your synthetic Vitamin-A type of uh– retinol, and then you have the internal Vitamin-A that’s synthetic which should be like the uhm— not– not the tetracycline; the tetracyclines the common antibiotic Evan, and then you have accutane which is a Vitamin-A analogue and you gotta be careful if you’re a woman because if you get pregnant while on that you can have birth defects ’cause it is tritogenic.

Evan Brand: Oh my gosh.

Dr. Justin Marchegiani:Those are the common things for the most part. I mean it’s gonna be antibiotics, immunosuppressants, corticosteroids, they’ve the vitamin– and don’t get me wrong, the Vitamin-A could be helpful. I’d recommend using Vitamin-A on the skin. Try to do it with retinoic acid natural derivatives which you don’t need a prescription for and that can be really helpful because it can provide uh– important building blocks for collagen elasticity and then you can even do a topical Vitamin-C as well. Of course, we wanna get all these things internally, right? But if we do it inside out, then we get a winning team what we can get results much faster is that we can topicly hit something. You can bring those nutrients directly to that area. And then if you can internally do it with good quality fat-soluble vitamins from animal products, from liver, from healthy grass-fed vital with a Vitamin-K2, of course, collagen either from bone broth or collagen shake. I mean, these can all be amazing uhm— resources to get extra nutrition in for your body.

Evan Brand: Oh and here’s the thing I wanna point out: you have to do both. You’re talking about– okay, sure, do the topical stuff. Great. Instead of steroids, maybe do topical Vitamin-C serum, maybe some topical Vitamin-A. But you still always have to work backwards towards the gut. So first step, if you have skin issues, get your gut check, get a stool test done because it’s very likely that you have some type of dysbiosis going on. Here’s the thing that’s crazy to me, I said you’ll get put on the antibiotics for a skin issue, it’s like , “Okay, your gut is the problem”. So we’re gonna come in with antibiotics, we’re gonna kill even more of your good bacteria, we’re gonna mess up your gut even more to try to fix your skin. I mean, that is such a backwards mindset.

Dr. Justin Marchegiani:Exactly. So couple of other autoimmune condition: we mentioned psoriasis, we mentioned vitiligo, uhm— we mentioned eczema which is now in the last year or two starting to be thought of as an autoimmune condition. Rosacea is now starting to be thought of as an autoimmune condition. There’s a– dermatomiositis which is another type of condition where that dermal layer is starting to become significantly inflamed as– there’s Epidermolysis bullosa – another condition. Again, these conditions they have the same underlying mechanism as inflammation. The difference in the diagnoses is how the inflammation manifest.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If it manifest with psoriatic symptoms, right? Then that’s psoriasis if m– if wer— manifest in eczema symptoms. And eczema and psoriasis are very, very similar typically psoriasis is a little bit more flaky, it can peel, and– and get bloody a little bit easier. Uh– vitiligo is gonna be autoimmune that affects the melanin in the skin and then so if you’re doc for skin complexion, you’ll see your skin go white. Think of like Michael Jackson, right? When he started wearing the– the glove on the left hand, right? In the 80’s, that glove was to hide the first sign of his melasma or let’s just say not his melasma his vitiligo. Melasma is another skin issue that tends to be form hyperpigmentation primarily from hormonal issues like the birth control pill, or uh– being pregnant, they call it pregnancy mask. Again that’s not in the autoimmune camp, that’s more of a hormonal thing, but gut function can have an impact on that because digestion is really important for– healthy digestion’s really important for metabolizing hormones ’cause it goes and gets pumped out the liver, to the gall bladder back into the intestinal track. And if we have bacterial overgrowth like uhm— dysbiotic bacteria like in SIBO, that can produce an enzyme called β-glucuronidase, and if you go to Google and type β-glucuronidase and estrogen, you’ll find that β-glucuronidase uncleaves conjugated estrogens. Conjugated means there’s a protein bound to the estrogen so then it can get metabolized. When it de-conjugate to the– pulls the estrogen off that protein, and now it can go back in systemic circulation and have a hormonal-like effect. So, things like gut function can play huge impact with hormones and those hormones can easily impact your skin as well.

Evan Brand: Oh, and you tied it all together in the end that’s wonderful.

Dr. Justin Marchegiani: Thank you! That’s it.

Evan Brand: See. So here’s the thing out there people realized: you can measure this stuff. We measured β-glucuronidase on every single stool test and here’s the really-really fun thing that Justin and I love so much about our jobs – is that within 6 weeks, we could see β-glucuronidase come down by 500, 600, a thousand points, you know. We may see someone at 3000 which is too high and this means, hey look, they’re recirculating not only hormones but could be toxins too that get conjugated as you mentioned. And so that’s not good and this is why someone has like a heavy metal toxicity problem but they have dysbiosis. You have to fix the gut too because to detox effectively, you’ve got to have that open-loop system, not a closed-loop system. So when we come in with probiotics in usually phase 2 or phase 3 just depending on what our protocol looks like, we’re gonna see β-glucuronidase drop. We’ll typically gonna use some enzymes, you mentioned the liver support; liver nutrients can help, sometimes methylation nutrients can help. Uh– one thing we forgot to mention so far about skin is the topical irritant, so why don’t we chat about that, like soaps, shampoos, conditioners, perfumes, artificial fragrances– oh my God! I should have took a picture– I could have put this on my Facebook page man, it would have went viral. These two girls, we were in Target, we were gonna take the baby in the Target to go look for something. I remembered what it was. And these two girls were in the parking lot, and I saw ’em with a huge bottle, and they were spraying each other and I thought, “Oh, what are they spraying?” And so I just say, “Oh, whatever”. But we get into the store, we’re standing right next to these girls, I thought I have to ask them what this is. I said, “Can I ask what you all are spraying on each other?” And they’re both, “Ha-ha-ha” they both giggled, and she goes “Get it, it’s in your purse show ’em”. And they pulled it out and it’s a giant bottle of Glade air freshener, apple cinnamon scent. And I just looked at it–

Dr. Justin Marchegiani: Oh my gosh!

Evan Brand: –[laughs] I just looked at it and I was like, “So you’re all using air freshener as perfume?”, and they’re like “Yeah!”, and I was like, “Okay”. I should have said, “Can I take your picture that’s so cool and then post it online or something”. But I jus

Dr. Justin Marchegiani: Yeah, it’s like a warning right? Hey, do not take this.

Evan Brand: –so I mean, we could go into the reasons I– on my– if you just look up uh–

Dr. Justin Marchegiani: Uh-huh.

Evan Brand: If you just google “Uber fragrances ban” or something, you can read it. I did a whole like 20 different studies on my– on my petition about the different artificial fragrances and the phthalates and all that endocrine-disrupting things in those so, I mean, please don’t spray yourself with air freshener that’s just insane.

Dr. Justin Marchegiani: Yeah it’s a whole bunch of junk in there and a lot of these things, you know, if you’re female, a really big concern because you have a hormonal rhythm to your– to your monthly cycle and that can easily be disrupted. Men as well, because men, you know, they’re hormone rhythms more flat line but there’s a lot of Xenoestrogens in the environment from plastics to pesticides to fluorides, uhm— to various components in– in cooking compounds uh– soy, those kind of things, right. You don’t wanna be a soy boy. These type of Xenoestrogens are everywhere they can affect guys but they can really disrupt women’s cycles because when you start dosing up high amounts of estrogen, that can start to decrease follicle-stimulating-hormone FSH, and then when that hormones starts to decrease, then you don’t have the signaling to the follicle, that grow a healthy follicle, and then that can disrupt the whole entire estrogen, progesterone rhythm from the follicular phase to ovulation to the luteal phase, to menstruation, to starting all over again.

Evan Brand: Yup, so not to go too off of that topic ’cause you were– you were going somewhere good–

Dr. Justin Marchegiani: Yeah.

Evan Brand: –but I just wanna restate. Make sure you clean up all your personal care stuff. It could be your lotion, it could be like I said, shampoo, conditioner, you can go on the environmental working group and you can look on there. Uhm– Justin also likes the skin deep uh– reference, you can just–

Dr. Justin Marchegiani: It’s the same thing– it’s a different branding, yeah–

Evan Brand: A different branding, okay.

Dr. Justin Marchegiani: Yup. And I– I use a brand called Marie Veronique, she’s a great brand– she’s a great uhm— biochemist out of Berkeley California and she creates a lot of these skin– skin products, you know, homemade in small batches. And she basically puts a lot of high quality nutrients in supplemental form and a lot of her creams, and she’s really good, and she comes typically one of the lowest on the environmental working group. But just take, there’s a handful of good brands. Uhm– there’s another one called Michelle’s, and that’s a decent brand that’s out there. I think uh– Jessica Alba’s brand, I think it’s the Honest Company–

Evan Brand: Yeah.

Dr. Justin Marchegiani: –it’s one product I think that comes out really good. They have a patients telling me they have a good ___[14:25] I think it’s a moisturizer. But just take a look at it and see. And uhm— uh that’s very helpful because you can get– they’d a really good uhm— retinol product, they’ve a really good Vitamin-C and uhm— a kind of immuno acid, ___[14:39] acid I think compound. And then they also have some oil-based products that are very high in Vitamin-K2 and a lot of these really good essential fatty acids which are good for your skin. You know, we just wanna be holistic. Do that, but make sure you have the diet dialed in first. If you are on a budget, work on the food stuff, work on the internal nutrients first. And then if you have extra resources and you wanna allocate, go to the external stuff second. I find it’s the opposite. People are going to the external stuff first and the diet’s not dialed in yet. Do the opposite, internal stuff first, collagen, bone broth, anti inflammatory diet, all the nutrients and minerals that I mentioned, get that dialed in, get the gut cleared out, get the bacteria cleared out, make sure you’re digesting your foods, and then– and it also make sure motility’s moving. You’re having a– passing 12 inch of a stool at least a week. I mean– a day, I’m sorry, not a week. 12 inch of the stool a day, obviously at least 7 a week. That’s really important ’cause if you’re not having that good healthy bowel movement, you’ll be reabsorbing toxins–

Evan Brand: You gotta poop folks.

Dr. Justin Marchegiani: And that’s gonna be then be pushed out the skin, right? The solution to pollution is dilution, and, your skin is a mirror of what’s happening in your gut.

Evan Brand: And then also the solution is pooping, ’cause if you’re not pooping, you’re gonna have skin issues. I’ve– I’ve– I’ve literally seen people improve their skin issues just by pooping from once every 3 days, to pooping every day, their skin got better just by giving them some herbs to help things move along a bit.

Dr. Justin Marchegiani: Yeah, and if your skin is excessively dry across the board, I always look at essential fatty acid intake, as well as digestion like–

Evan Brand: Oh yeah.

Dr. Justin Marchegiani: –number one, are we getting enough of these good fish oils, uh– these good Vitamin-K2, these good saturated fats from healthy animal products, coconut oil, avocados, mono and saturated palm – are we getting enough of these? Are we able to digest it? How are your stools looking? Are your stools sinking or floating? Right, remember that old expression, you know, oil and water, right? They kind of wanna separate so, you have a really fatty stool because you didn’t break down your fat. You have water, so the stool, will sit on top and float more. It’ll maybe look more clay colored and blond as well so, if you’re seeing that, that’s a big sign that you are not breaking down your essential fatty acids properly. And that we really got to ratchet up the enzymes, the HCL, and or maybe more bile salts and or lipase– lipase, meaning, li– lipid, lipid-based enzymes.

Evan Brand: Yup, well said. Your poop has to sink. It’s very common. I mean, 90% of the time when we run a stool test on people, we’re gonna see elevated steatocrit. Maybe it’s not off the chart but that’s a fecal fat marker we look at. You know, I’ve seen people as high as 35%. Meaning, 35% of their poop is fat. That’s crazy. You do not want that. Ideally, it’s like below detectable limit.

Dr. Justin Marchegiani: A hundred percent.

Evan Brand: What’s the high stew scene on steatocrit? Do– do you know?

Dr. Justin Marchegiani: I’ve seen it uh— in the– and they operate in the mid to upper 20s before.

Evan Brand: Okay, okay.

Dr. Justin Marchegiani: And these people are you know– you know, they’re having– they’re reporting back, “Hey how are your stools looking?”. “Oh they’re floating.” All right, you know there’s an issue. I don’t need a lab at that point to tell me but most of the time we’re gonna see, you know, increase in steatocrit, when we see those clinical symptoms.

Evan Brand: Yup. The only of the thing I wanted to mention was the histamine issue, and, makes that– we’ve hit on this another podcast but that with uh– gut bacterial, like bacterial overgrowth that does mess up your ability to break down histamine from the diet. So that’s why some people say, low histamine diets help. But that’s still not the root cause. It’s just that those malabsorption and dysbiosis issue causing you not to digest your histamines or break ’em down rather.

Dr. Justin Marchegiani: Correct. So, when you wanna– when we get deeper into like the diagnoses, just remember, the diagnoses is a manifestation of inflammation and how that inflammation is presenting itself. Inflammation that presents in certain ways gets classifieds as one condition, versus another. A lot of times the underlying way to go about it is very-very similar. And a lot of times the nutrients are very similar. So don’t think like, “Oh, I have vitiligo, and this person has psoriasis”. It’s like a totally different thing. Now in the eyes of the dermatologist it may be, right? ‘Cause they may say, “Oh we’re gonna give you some kind of bleaching compound”, or some kind of immunosuppressant where, over here, it’s like “Oh, we’re gonna give you more Corticosteroids or something to help keep the itching down, right? ‘Cause they’re different types of diseases where the similar autoimmunity, inflammatory mechanism happening on the inside, and of course genetic predisposition, kind of, you know, allows one disease to express itself over another.

Evan Brand: Yeah, well said. And then the ge

Dr. Justin Marchegiani: The genetics.

Evan Brand: –and then the genetics are always, you know, they’re– they’re malleables. So, don’t just say because my mom got “XYZ”, I’m destined to get that. That’s not true. It’s– it’s– it’s more likely, but it’s not guaranteed.

Dr. Justin Marchegiani: Yup, a hundred percent. And then a couple things you can see too is– uhm— Akantosis Nigrikans is another one. And you can just google it, but you have a hyperpigmentation that’s commonly caused by excessive insulin–

Evan Brand: Ahh.

Dr. Justin Marchegiani: –so if you’re doing a lot of insulin lot of modifying carbohydrates you can see the Akantosis Nigrikans. Uh– on the back of the forearms you can see the Keratosis pilaris–

Evan Brand: Yes.

Dr. Justin Marchegiani: –it’s like there’s little bumps that pop up, and that can happen because of essential fatty acid deficiency. So if you have poor digestion or gut infections, that can be a big issue. Of course we have a Rheumatoid arthritis which you may, you know, you may be able to see the– the joints, hypertrophy in the fingers and the IP-joints, in the– the metacarpophalangeal joint, you may see a hypertrophy because there’s autoimmune attack, and there’s a lot of inflammation. We may see that as well. And then of course like autoimmune thyroid issues, we can see a lot of dry skin with autoimmune thyroids especially in the neck too. And that can easily be from, you know, the same underlying mechanism. So, if you have an autoimmune thyroid, you could easily have some dry skin because that’s gonna be a big connection in Vitamin-A and, these essential fatty acids are important for thyroid function as well.

Evan Brand: Yeah my uh– my brother-in-law, it’s my wife’s sister’s husband, he’s got a triple AMI. He’s got type-1 diabetes, he was diagnosed as a teenager, then he went on to develop Hashimoto’s, then he went on to develop Alopecia. So once the autoimmune domino effect starts to happen, you can start to rack up the autoimmune diseases and that’s why some clients come to us and like, “Look, I’ve got six different autoimmune diseases at the same time.” It’s the same thing. Once that leaky gut takes place then you get the leaky skin, the leaky heart, the leaky brain, the leaky everything. So, it’s very, very-very common to hear multiple autoimmune issues but the good news is, you can take a lot of this stuff and turn it around. So, just get your testing done, I mean, that’s the first step, dial in the diet, all of– all of the stuff, you know, pick a step; just don’t be paralyzed, just pick a step.

Dr. Justin Marchegiani: Yeah, and also excessively pale skin. We– that could be an anemic, lo– low B-12 and or Iron. And there could be a Pernicious anemia where it’s affecting the intrinsic factor in your stomach, so you’re having a harder time absorbing B-12. And or just low stomach acid, when you’re being vegetarian, you may not get enough B-12 or Iron and then that could leave your skin more pale because red blood cell counts low, your hemoglobin’s low. Hemoglobin, the heme, and the myoglobin help bring a little bit of uhm— color to your skin as well. So you could look excessively pale if you don’t have enough iron and or B-12. And of course, the iron and B-12 issues can be caused by low stomach acid, not enough animal protein or animal compounds. And or the autoimmunity that affects the intrinsic factor or the parietal cells in your stomach.

Evan Brand: Yup, well said.

Dr. Justin Marchegiani: Well, any other issues you wanna address here. Of course we talked about histamine briefly, and then again that all connects down inflammation. The more inflamed you are, the more histamine-sensitive you are. Did a podcast with uhm— Yasmina Ykelenstam, the low-histamine chef. We talked about this. She harkens the fact that– yeah, cutting histamine out may help. Doing kind of natural histamine to granulate also may help, uhm— doing histamine enzymes like D– Di– Diamine oxidase may help as well but we have to cut down the inflammation. So it still comes down to getting rid of your unique inflammation wherever it’s lingering.

Evan Brand: So here’s the thing that I just found out. Uh– a couple of weeks ago is that Yasmina– is– she’s no longer alive.

Dr. Justin Marchegiani: What happened?

Evan Brand: She passed away a few weeks ago.

Dr. Justin Marchegiani: I didn’t know that.

Evan Brand: Yeah. If you go on–  I think it was on her Facebook page. Uhm– and then I saw her uh– whole– her obituary is to– she’s the healing histamine check, right? Yasmina Ykelenstam, sounds like that?

Dr. Justin Marchegiani: Yeah.

Evan Brand: Yeah, yeah.

Dr. Justin Marchegiani: That’s really sad.

Evan Brand: Uh– it was breast–

Dr. Justin Marchegiani: [crosstalk]…last year she was really ___[23:14] and healthy.

Evan Brand: It was breast cancer; it says her on the– on the uh– obituary. She was 43.

Dr. Justin Marchegiani: Oh that’s really sad.

Evan Brand: That’s amazing that you got to chat with her.

Dr. Justin Marchegiani: Yeah well, I– I send my condolences to her family. That’s– that’s really sad, but she had a lot of great information that she provided and I’m hoping that, you know, she was able to help thousands of people during her–

Evan Brand: Right now hopefully her legacy will continue on.

Dr. Justin Marchegiani: Yeah. Absolutely.

Evan Brand: Well, good. We gotta wrap this thing up but check out If you wanna reach out to Justin, you can get help around the world. Doesn’t matter where you are. So, we can help you figure this stuff out. If you wanna reach out to me, you can check out my site, We always love your comments, your feedback. And we look forward to helping you soon.

Dr. Justin Marchegiani: There any questions you wanna answer here Evan, I know, we kind of really, you know, on time constraints. Other than that, you saw that you wanted to highlight?

Evan Brand: I didn’t see any.

Dr. Justin Marchegiani: Okay. I think we’re on the right track here. Uhm– anything else you wanna say?

Evan Brand: Not today, just– get– get help. Don’t give up.

Dr. Justin Marchegiani: And I’ll be back here later on this week guys for a live Q and A, so we can get some more questions and answers. I may even jump on today if I can if I have time. But you all here make sure you subscribe, give us a thumbs up, give us the share, give us the bell. And we will all chat real soon. Have a phenomenal day.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care


Trends in allergy prevalence among children aged 0–17 years by asthma status, United States, 2001–2013 Study

How to incorporate an autoimmune plan – Podcast #71

In this podcast episode, Dr. Justin Marchegiani and Evan Brand get into an in-depth discussion about autoimmune diet and its foundations. They put together pieces of the puzzle to help us better understand how to incorporate an autoimmune plan. During this interview, they shine the light on an autoimmune diet and shares how we can use a Paleo template as a foundational piece and modify it. 

autoimmune planGet inspired to stick to this plan to help heal your gut and reduce inflammation so the body can start healing. Find out how following an autoimmune plan can make a big difference. Learn how to reduce dietary stress by just taking it easy on yourself during this process which is a time for healing. Discover the ways to make it easy to follow the plan when you listen to this podcast.

In this episode, topics include:

1:24   What is autoimmunity?

3:28   Causes of autoimmune conditions

4:34   Paleo Diet/Template and AIP

21:40   Lifestyle piece and daily life application

25:00   Planning and preparation










Podcast: Play in New Window|Download



Dr. Justin Marchegiani:  It’s Dr. J in the house today with Evan Brand.  Evan, what’s going on?

Evan Brand:  Hey, man, we’ve had a great day so far.  We’ve been productively working behind the scenes.  I don’t think people comprehend the amount of work that it takes to get this content out to them.

Dr. Justin Marchegiani:  It really does.  Not only the content but how to display it.  I’m trying to do some redesign stuff on my site to make it a little more user-friendly and we’ve also been talking about doing more periscope, scoping if you will, which will give patients and different viewers the ability to watch us live and ask questions and get instantaneous feedback.

Evan Brand:  Yeah, so search for us.  By the time you hear this, Dr. J will have his periscope going. I’ve got my periscope going, search for me.  I’ve got followers on there and I’ve never even told anybody that I have it.  So that’s pretty cool.

Dr. Justin Marchegiani:  Yeah, my periscope name is justinhealth, all lower case, no spaces.  I imagine yours is what–notjustpaleo or evanbrand?

Evan Brand:  Yeah, either way.  They can search your name and find you or they can search your tags.  It’s the same for me.

Dr. Justin Marchegiani:  Got it.  Great.  Well, today we talked about in the–the pre-show that we wanted to talk about the autoimmune diet.  The kind of the first steps of treating an autoimmune condition.  And again, check out the last podcast on leaky gut that just came out recently because leaky gut’s really gonna be one of the underlying mechanisms in which autoimmune conditions start.  So just kind of back up a bit, so autoimmunity is nothing more than your immune system starting to attack self and depending on what tissue is attacked, that’s basically the diagnosis you get.  So if you start attacking your myelin and your nervous system, you get MS.  If you’re attacking the midbrain where your dopamine is produced in the substantia nigra in the back of your brainstem, that’s Parkinson’s.  If something happens, let’s say, in your peripheral nerve, that could be Guillain-Barre or even polio potentially, but typically Guillain-Barre.  Also thyroid, Hashimoto’s, pancreas, type 1 diabetes.  If it’s your–end of your colon, it’s ulcerative colitis.  If it’s your small intestine, it’s Crohn’s, right?  So you can just go–the list goes on.  If it’s the microvilli in your small intestine, right?  The little vacuum cleaner that suck up nutrients, that’s celiac.  So you can see all of these different conditions basically just get a fancy name based off of what tissue is being destroyed.  It’s kinda like how medicine works, big fancy diagnosis, I mean, if you just said, you have autoimmunity of your intestine, it would be a lot easier to understand that than say Crohn’s.  So that’s kinda how conventional medicine works in labeling things and now the next step, the first piece of the puzzle is obviously gonna be the lifestyle and the diet piece.  Because when we have an autoimmune condition, this leaky gut phenomenon is happening.  You can go back to that old podcast but that’s where the tight junctions in your gut–imagine a zipper, imagine that zipper being nice and tight, or the analogy we gave in the last podcast as interlock your fingers like you’re saying a prayer and imagine pulling those fingers apart just a little bit so you see daylight, or imagine the zipper just being zipped down just a bit, that’s like that tight junction.  It starts to open up and undigested food particles, bacteria, infectious material can start to go into the bloodstream and create inflammation and the immune system is hyperresponding and in the process, this thing known as molecular mimicry occurs where we start to attack other tissues or other proteins that look similar to what’s floating in the bloodstream.

Evan Brand:  Yeah, so maybe we should talk about some of the causes, too.  I mean, you talked about the lifestyle stuff getting on in check–a lot of people, I’m just gonna reel some of these off, now this is not an exhaustive list, but these are some of the things that you and I have both been trained on, the cause, you know, the “splinters” of autoimmunity.  So you get the emotional, cognitive stress, unhealthy coping patterns, you got poor nutrition, you got GI stress, adrenal stress or burnout, you got hormone stress which, you know, you work with hormones all the time, it’s massive for gut issues; inflammation like we’ve already talked about and then toxins.  And you know, we’re talking about the diet, so obviously we’re not gonna have time to cover all of those, but taking baby steps in each direction is the only way that makes sense because it’s not one magic thing that’s gonna fix you.  It’s not one poisonous thing that’s causing you your issues, it’s a combination of likely dozens or hundreds of different causes that are all adding up to cause this condition.

Dr. Justin Marchegiani:  Exactly, exactly.  So the first piece of the puzzle that we’re gonna really put as our main focus on today’s podcast is gonna be the diet piece.  And everyone that’s probably come in here has already heard of the Paleo diet and if people listen, they know that I don’t like the word diet.  Alright, one, the first three letters of the word have the word “die” in it.  That’s–that’s not a pretty good way to do it and most people beca–the word diet kinda has a connotation of it being a temporary thing.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It’s not like long-term thing.  So I like template and lifestyle plan.  So Paleo templates are really kind of good approach.  It’s like the foundational piece and everything from there can be modified from a Pal–a Paleo template, whether you go to GAPS or Bulletproof or autoimmune or SCD or whether you do a low FODMAP.  All these things can be adjusted based on that template.  So today we’re gonna really shine the light on an autoimmune diet.  So first off, Paleo is kind of the foundation which is cutting out grains, legumes or dairy and Paleo kind of has another couple of side elements to it whether it’s primal, where you allow butter or a little bit of cream or whether you’re strict Paleo where there’s no butter or cream.  Now most people who are Paleo, they can handle some good high quality grass-fed butter or some high quality cream, but again there’s an individuality there. Talk to your functional medicine doctor about that if you need help on it.  But when we go to the autoimmune piece, we really graduate to really being 100% grain-free.  So no corn, even no rice essentially–

Evan Brand:  That’s sad.

Dr. Justin Marchegiani:  Yeah, I know.  And–you see, rice and corn are a couple of big ones, obviously no oat.  Oats, a common cross-reactive one because of the avenin that’s in it.  And then you have all the other types of grains there that may–may connect in with it.  So like the big gluten-free grain are gonna be like–the big gluten grains are wheat, barley, and rye.  Those have the–the primary gluten in it and then every grain outside of wheat, barley, and rye is technically considered gluten-free, so we really cut out all of the gluten-free grains.  That would be the rice, that would be the oats, that would be the corn, and anything else that you can think of that would fit in there, even potentially sorghum, all those things.  Anything you wanna add there, Evan?

Evan Brand:  Yeah, I mean, it’s tough.  It’s definitely a strict protocol for people and it’s not something that most people have to do, just we’re talking about a percentage of people that are trying to specific battle some type of illness and you have to be strict.  So a lot of people like to talk about the “Oh, the 80-20 rule”.  And the 20% of their diet, where they’re “cheating”, they’re eating like Oreos and crap and that doesn’t really work for this type of scenario.  You can’t really apply that same logic.

Dr. Justin Marchegiani:  Exactly.  And again, when you get healthier, my kind of approach is I eat AIP or autoimmune-Paleo about 80% of the time, and then I’m pretty much Paleo the rest with, if I cheat, I’m still gonna still cheat with a gluten-free grain, right?  I’ll try to do with either with a coconut flour or almond flour ideally or, you know, a rice flour. So I try to, even if I cheat, it’s still gonna be gluten-free.  So we talked about the grain piece, we’re grain-free on an autoimmune diet where in a Paleo approach, maybe some white rice is okay, even maybe some corn is okay for a cheat.  So AIP, no grains.  Also no legumes in a Paleo, same thing with an autoimmune-Paleo.  Dairy, we’re gonna cut out butter, cream, and even ghee off the bat.  Some AIP plans allow ghee but again, there’s still potential for some proteins getting in there so we wanna cut out ghee as well.  The next piece is nuts.  Nuts and seeds, we’d wanna cut out the nuts and seeds, so no almond butters, no almond flours, nothing like that.  Next is gonna be nightshades.  Nightshades are tomatoes, potatoes, eggplants, and peppers.  So if you’re getting that chipotle bowl where you’re putting in all the peppers and stuff, and onions and all that salsa, we wanna cut that out off the bat.  And then the last piece of the puzzle is really cutting out the eggs as well.  So you look at Paleo, what’s Paleo?  It’s basically, you know, gluten-free, ideally no grains on a Paleo, no legumes, and maybe a little bit of the safety area that we talked about.  We’re here, we’re doing no grains, no legumes, no dairy, also no nuts, no seeds, no nightshades.  Nightshades are tomatoes, potatoes, eggplants, peppers, and also no eggs.  Evan, break it down.

Evan Brand:  Yeah, I mean, it’s–it’s definitely strict but it has to be because we have to remove any potential chance for anything to disrupt that gut because the process is, we’re trying to heal up that tight junction where these undigested food particles and these toxins that are getting through and causing these conditions are not causing you the condition anymore.  So I know it may feel like, “God, what’s left to eat after all this?”  But once you get the results, you’re gonna be convinced and you won’t have to–it won’t feel like such a struggle. But I have, you know, I have talked with a few people where they’re like, “Man, this is actually kind of tough starting out.”  But it’s just like anything else, it’s a snowball effect.  You know, once you get it into effect, it becomes second nature and there’s not as much resistance in you sticking to this plan.

Dr. Justin Marchegiani:  Absolutely and again, it takes no more effort to do the right thing than it does to do the wrong thing, okay?  I mean, is going to McDonald’s easy?  Yeah, but like the results that you’d get and how you’d feel afterward is just terrible.  I could–I could never do that.  So it takes no more effort to do the right thing than the wrong thing.  You just gotta start making a habit.  Get that habit going.  So off the bat here, like our goal with this is really to reduce inflammation.  Once we reduce inflammation, the body can start healing.  And if we’re working with a patient and we kinda get them on adrenal program so we’re supporting inflammation reduction because a lot of people who are autoimmune, they’re adrenals are typically not responding well.  They’re in adrenal dysfunction stage 3 where they’re cortisol is very low, so they can’t put out that fire, that internal inflammatory fire.  They can’t create inflammation, I mean, they can’t create energy because they’re too busy fighting inflammation, so they’re tired and then because there’s inflammation in their guts and in their body, it typically makes it way to the brain because leaky gut equals leaky brain and they have brain fog.  So most people always have this fatigue kind of brain fogging happening and they have a hard time with regulating inflammation so there’s typically maybe a thyroid issue along that line, too, and/or a mitochondrial issue where they can’t generate energy.  So this first piece with the autoimmune plan makes a big difference.  And I saw a handful patients just this last week that already came in to me, they were Paleo but we just went to the extra autoimmune step and it made a massive difference.  Like it really made a huge difference.  They noticed 50 to 80% improvement off the bat, because there were some nuts or eggs they were eating that were really making a big difference.  Some patients we even have to go the extra level and they hate me when we do this, which is go low FODMAP as well as AIP, and that can really sting but with some people it can make a massive, massive difference.

Evan Brand:  Yeah, so have you–this is a side note–we were talking about adrenal dysfunction that’s always happening.  Have you even tested anyone that does not have some level of adrenal dysfunction?  Because I haven’t seen one perfect result yet.

Dr. Justin Marchegiani:  I’ve seen a handful of people that have really good adrenals and then we look at their thyroid side by side, I mean, their thyroid’s really in the tank.  So every now and then we see someone with good adrenals or relatively good adrenals and they’re just–thyroid is absolutely in the tank.  And sometimes it’s both, right?  And that is both the thyroid and the adrenals.  Sometimes it’s just the–the thyroid, but for the most part, 95% of the time, it’s the adrenals are gonna be in the tank because they’re you’re stress handling glands.  They’re the glandular intercept between the sympathetic nervous system and your body, right?  Your nervous system responds and it creates these hormones via the adrenals to manage stress.  So that’s how your body connects with the outside stressors via the adrenals, and the adrenals respond to sympathetic nervous system, right?  So if people remember from, you know, high school anatomy or biology, right?  You have the Fight or Flight.  You have the parasympathetics which are the relaxation and digestion, that’s when you’re sleeping, you’re engaging in parasympathetic.  And when you’re stressed, right?  Think of spidey sense going off, right?  That’s the Fight or Flight.  That’s like the gas.  The parasympathetic’s the brake.  So most people when they’re engaging that gas pedal that their–their parasympathetics, right?  That’s the Fight or Flight, same word describe the same thing but that’s really stimulating the adrenals to go–to go to work.

Evan Brand:  Yeah, a lot of people are stuck in the sympathetic, I mean, the modern world, they–that’s a conversation for a whole another podcast, but the goal alongside with this diet thing is that you’re able to reduce the stress a little bit, so we’re reducing the dietary stress by just taking it easy on yourself during this process.  It’s a time of healing and a lot of people, they want to heal and they wanna still run and do all their CrossFit at the same time.  You gotta have a balance when you are trying to slow down the–the rate of catabolism of your body, you know, your body eating yourself away.

Dr. Justin Marchegiani:  Absolutely.  So most people, right?  That are going AIP, well, if you’re doing whey protein, cut that out.  We’ll do beef protein or we’ll do pea protein or we’ll do collagen.  If you’re doing legumes, cut it out.  If you’re doing eggs, cut it out.  Choose a different meat.  Choose some pre-cooked sausages at Whole Foods.  If you’re doing dairy, go to coconut oil.  Cut out the seeds.  Cut out the nuts, right?  So my diet this morning was 30 grams of collagen.  I did some–some coffee with some butter and MCT.  So if I was trying to be, you know, more strict, I would have cut out, probably the coffee.  I wouldn’t even have had it, right?  I may have just done a chai tea with some MCT.  That could have been my alternative.  For lunch this morning, I have some chicken thighs and I have some coconut oil and sea salt and some non-starchy veggies.  That’s a nice–good AIP meal.  And then for dinner tonight, I’ll probably go out to dinner, but I’ll get some kind of a steak or fish, baked or sautéed, and I’ll typically make a request for olive oil or–or I’ll–I’ll even–I’ll do butter a lot of times because I still do really well with butter and add some good vegetables and maybe–maybe a little bit of starch if I’m o–if I’m okay with it.  And then after that, if I’m doing sushi, I actually bring my coconut aminos to the sushi place.  I don’t do the tamari even.  I’ll bring my coconut aminos, and I’ll have my nice, you know, sashimi or if I decide to do a roll like a California or a spider roll, I make sure it’s gluten-free, very minimal amount of white rice, if it–that’s a cheat for me.  But if I’m not cheating, we just do sashimi.  Maybe a nice seaweed salad and bring my coconut aminos.  So there’s ways you can do it.  It’s not that hard and I always tell patients, it’s our job isn’t to get you to be like a Puritan, right?  Like you need to be so puritanical with your diet.  Our job is to get you feeling better.  Once you feel better, then now you’re kryptonite detector is–is heightened.  So you’re gonna be able to sense where you’re kryptonite is.  I wish it was easy like with Superman where it just glows green, right?  Gluten, there it is, it’s glowing green on the table, right?  You kinda just see it, you’d know.  But we don’t have that today.  You have to get clean first.  Because once clean, then you can appreciate when you’re dirty.  So I always tell patients, you can ignore reality but you can’t ignore the consequences of reality.  And when you’re already fla–inflamed and tried and not feeling well, you’re kryptonite meter is so low, it’s so dampened, you’re not gonna know whether you’re eating–what you’re eating is good or bad until you’re really super clean for a couple of weeks to–you know, 3-4 weeks, maybe a month, before you notice that significant difference.

Evan Brand:  I’m gonna start borrowing that analogy. That’s a great way and a fun way to get it across.  So I’ve just told people that you’re gonna become more aware.  You’re–you’re–you’re consciousness towards your food gets heightened and you may go to take a bite of something or you may even go to take a supplement one day and that supplement jumps out of your hand, or you go and you’re about to pick up that fork, and you’re like, “Whoa, something doesn’t feel right.”  That’s your inherent wisdom that it takes a little bit of time to tune into that self.  But it does come.

Dr. Justin Marchegiani:  Yeah.  And then like my biggest pet peeve and this is like because, you know, when you see a couple of thousand patients and you hear the same thing over and over again, it gets a little annoying but my biggest annoying thing that I get from patients is this.  We get them on an autoimmune diet, and yes, it’s restrictive, right?  And patients are feeling better and they’re like, “But I wanna just go back and it’s so restrictive.”  And I, “Okay, great.”  I go, “Let’s–let’s map out what you would be eating if it wasn’t so restrictive.”  And it’s like, “Well, I want a bagel in the morning or maybe some bread, or I want some cheese or some yoghurt.”  Okay great, so let’s break it down.  “The only thing I’m hearing you adding in is grains and dairy.  That’s it.”  So a lot of times when patients want to add stuff in, it’s really the grains and dairy piece.  Even if we’re not even AIP, let’s say it’s just Paleo.  And you think with their, you know, their moaning or their irritation that they would have the, you know, the palate of a world-class traveler, right?  Trying all these different foods and this and that, but they really just want these simple foods that really isn’t adding that much variety, and I always tell patients the reason why they have that desire is typically because their prodynorphins or these gluteomorphin compounds or casomorphin compounds that are in these foods that hit into that morphine receptor and really cause that–that craving.  I mean, it hits the same receptor as heroine and Vicodin. So a lot of times when people are saying, “I want a whole bunch of more variety,” if you look at their diet, there really not a bunch of variety in it.  The average person only eats 12 foods.  So if we’re just saying, “Hey, let’s eat these 20 versus these 12,” there’s still more variety in which you’re–in which you were getting to begin with, you’re just not eating these crappy, addictive foods and you’re just getting that–you want that opiate kind of stimulation from those compounds.

Evan Brand:  Yeah, it’s all the brain chemistry.  They’re not really wanting that food.  They’re just wanting that hit.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Yeah, so I’m like, “Hey,” you know, if you were–if you said you were world-class traveler and you’re having all these different things that soufflés and this, it’s really the same stuff.  It’s just instead of eating something that’s a little bit more nutrient-dense and anti-inflammatory and low toxins, we’re eating something that’s pro-inflammatory, nutrient-poor, and the last word there–and toxic, right?  The glutens, our lectins, and things like that.  So first things first, go AIP.  Get clean, right?  You can’t appreciate being dirty until you really get clean, and then you’re like, “Ooh, wow, this feels nice!”  And then once you’re clean, then you can kinda step down into a more Paleo approach, but you gotta remember, if you add foods back in, you gotta do it once every 3 or 4 days.  Eat a little bit to start because, well, if you’re eating a bad food and you eat a lot of it, the more of it is gonna create a more, you know, intense reaction.  So let’s have a less intense reaction, add a new food every 3 or 4 days and work with your functional medicine doctor on how to add these things back in so, you know, you–you know that, “Well, maybe if I add these nuts back and maybe it’s brain fog is the symptom.”  It may not be a digestive symptom which most people reach for.  They’re like, “Oh, it’s gotta be a GI symptom.”  No, it could be icky joints.  A patient last week, 90% of joint pain gone on an AIP, 90%.

Evan Brand:  For me, it’s when I go from–so say I’ll pull out dairy and then I’ll introduce raw dairy, say like some raw cheese or non-pasteurized cheese and then I’ll come in and add some pasteurized dairy, boom! I’m super brain foggy so that’s my experience.  I don’t get GI symptoms.  I just–it doesn’t happen but the next day or even 48 hours after, it puts you in just sort of a haze and it’s like, “Man, I need to wipe the windows on my brain and clear this thing out.”  And then I go another 48 or 72 hours without it and then I’m back to where I was.  So it’s–it’s really interesting to see how mind-blowing how one little swap like that could be in your overall cognitive performance.

Dr. Justin Marchegiani:  It is and the AIP for some–I had a girl yesterday–didn’t do anything.  I had a guy the day before, 90% improvement in just a week, and some people are in the middle.  I’d say the majority of people have a significant benefit but you–it’s like you gotta–you wanna go to the first floor, second floor, or third floor of that house as you build it, but you gotta start with the foundation.  And if you skip that AIP foundation and you’re reaching for all these fancy tests, you could be spending thousands of dollars on stuff that may have been addressed with just the diet piece and if we don’t have the diet piece in there, you just, you’re not–you’re not gonna get your bases covered.  You’re not gonna have the blood sugar.  You’re not gonna have the nutrients.  You’re not gonna have the–the nice anti-inflammatory state.  You’re not gonna have the toxins down, so you have to have that.  You have–you can’t go to second base without going through first base.  So consider, first base as like the diet piece and then in the diet, we can even call the lifestyle piece which is meal timing, you know, not going more than 5 hours without eating.  Because of the blood sugar piece, even if you’re eating the right foods, but you’re not–you’re going too long, that blood sugar swings are really gonna stimulate your immune system and also your adrenals which could flare up your autoimmune condition and make it worse.

Evan Brand:  Let’s talk about some of the application like what you can do in your daily life that’s gonna make this things easier.  Do you cook a lot in bulk?  That’s been something helpful for me, like if I’m gonna cook a steak, I’ll just do 2 steaks.  I’m not saying like the meal prep where you’re cooking 20 different boxes of food, but I will cook maybe double.

Dr. Justin Marchegiani:  Got it.  So when it comes to this stuff, you know, you got money or you got time.  You get one of the two things, right?  So if you don’t have time because you’re working so much then you’ll have a little more money.  So then I typically, I work a lot because I’m–I’m really busy helping patients and creating content to help people all over the world, so I–I invest in a Snap Kitchen here in Austin, whereby 5 or 6 pre-made local Paleo meals and I’ll–I’ll have them in my freezer and I’ll thaw them out and they’re all local that week and I’ll typically do that for either lunch or dinner and then my wife and I will cook a meal or two and we’ll make that in bulk so we have some food that we can go to and then I have easy meals like pre-cooked sausages that are organic or you know, the smoked salmon or smoked tuna, and then I have like some salad greens that I can grab.  I have some salsa or I have some you know Mark’s Paleo or Mark Sisson’s Mayo or some avocado and some stuff that’s really easy that I can make in 5 or 10 minutes like that, or I have the pre-cooked meals or my wife and I will actually take a half hour out and make a nicer meal that has a couple of servings so we can go to town the next few nights after.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  How about–

Evan Brand:  That’s good, too.

Dr. Justin Marchegiani:  How about you?  And then in the morning, I have like my good clean protein powders, I either have a beef, a pea, or a collagen or I combine them.  I have my–my butter coffee with MCT and then I’ll also have eggs in the morning and/or pre-cooked sausages or leftover dinner.  So those are my 3 to 4 that I–I go to and the thing is, you know, I practice this stuff.  I have an autoimmune condition so I go to the utmost you know level of compliance as much as I can. One, because I just feel darn good and then two, I’m just trying to be a role model for my patients so when my patient talks to me, I’ve been through, I know exactly what it takes and now that I’m here, I put so little time into it, it’s so easy.  For me to start buying and eating crap food would actually be harder for me.

Evan Brand: Yup.  Yeah, I’m–I’m about the same, I mean, I get some local grass-fed jerky that’s really good.  It doesn’t have any wheat in it.  I keep that on-hand. I love to just go get a big bag of some juicy, tender jerky.  Sometimes I’ll buy like some grass-fed beef sticks that don’t have any nitrates, anything like that.  Those are always cool to have on-hand.  Sometimes the Epic bars, I’ve got those Designs For Health, those professional bars now, pretty good.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So I’ll go for the–the grab and go stuff, I mean, if I’m just gonna go head out for a hike and I got too busy to–to eat a full lunch, you know.  I–I do break the eat a big meal rule sometimes and just go for, you know, some 30 to 40 grams of fat and protein snacks, and I feel good.  I always try to keep a bag of organic pistachios around if I am doing nuts and I’m feeling good with them.  Pistachios, oh man, super good.

Dr. Justin Marchegiani:  Yeah, and again, the key is like we’re not trying to make people perfect but get to a place where you feel good and then you can always cheat a little bit, you know.  You wanna practice the fundamentals first and then once you get good and you’re like, “Alright, I’m feeling pretty good and you’re getting a little cocky about it.”  And you can–you can cheat a little bit here and there, if you wanna do some intermittent fasting or you skip a meal by accident.  No biggie.

Evan Brand:  Well, what–what we’re really saying I think overall is it’s preparation.  If you don’t have enough time or you don’t actually sit down and plan this, “Oh, I’m gonna go buy these pre-made meals,” or “Oh, I’m gonna buy an extra couple pounds of some veggies this week at the market or the store, whatever.”  If you just add that one little bit of planning, I find that people do so much better because if you ask them about their–their food, it’s like, “Oh well, I was too busy.”  And they just never prioritize this stuff.  So maybe this is the–the takeaway for people is that if it’s been tough for you to adapt and to change and get into your groove, totally okay.  Just sit down and try to make a little timeout for yourself and you know, say, “Look, I’m gonna block out 30 minutes and I’m gonna figure this thing out.”  We’re either gonna find a local place that’s gonna make good meals like Snap Kitchen, which that–man, I do miss Snap Kitchen–

Dr. Justin Marchegiani:  That’s good.

Evan Brand:  Yeah, or you know, that you’re just gonna go a bunch of food in bulk and cook it, so–

Dr. Justin Marchegiani:  Absolutely.  And you know what, the money excuse for me doesn’t fly.  I was a poor college student.  I was given $15,000 a year to live off of and in the Bay Area, I had, I think $500 left over at the end of the month.  So all I had was 500, 400 went to food, 100 went to social.  So I gave myself $25 a week to spend on social activities which you know, that’s not much, and I–I allocated $75 to $100 on food a week.  And I bought chicken thighs in bulk, by the family pack, I bought–instead of going organic, I bought like a free-range kind of a local egg that was a little cheaper.  I did tuna.  I did salmon.  I did some of them canned or I bought them, you know, bulk from Costco and I just, you know, bought a lot of like my spinaches, or my–my veggies either at the local Farmer’s Market or I just got them at Whole Foods or Trader Joe’s in bulk.  And I was able to do it.  Another big cost-saver was getting the–the veggies frozen, too.  And that was a big help.  And I buy the organic ones, too.  And a lot of times, sometimes the fresh ones after they are a couple days’ old, you only get a day or two out of them.  So unless you’re gonna eat them that night, it’s just not gonna work.  So I barely had any money to my name when I was a–a college student, even a doctoral student, and it’s funny because in school, so many of the kids I went to school with are so unhealthy because they just weren’t allocating–they didn’t have the right priorities right with their food–with their life, right?  They were putting it more into social or events and then letting, you know, their cellphone and everything else at the end.  I didn’t even have a smartphone until I graduated because I’m like, well, I’ll put $120 a month into better food.  So I lived it.  I was in college for 9 years.  So I kinda know how to do it.  I was under the gun, so I prioritized it.  So I could help people with it, I lived it, so now the key is if you’re under, you know, the gun financially, you can try to buy these meats.  You can ever go free range if you have to.  Good, better, best.  You can do the frozen vegetables and if you’re hurting on time, too, like I’ll go after my last patient, I’ll go to the gym–well, before I go to the gym, I’ll throw some chicken thighs with the skin on in the oven, I’ll let it cook for 50 minutes to an hour.  I’ll put some vegetables on low and I’ll leave it sautée very slowly with some coconut oil and sea salt.  I’ll get a Mediterranean blend over at Whole Foods that’s frozen.  I’ll let it sit on there for 45 minutes, go to the gym, come back, dinner’s ready.  Five-minute prep time and then it’s back and ready to go and then I have it in Pyrex so then when it’s done, guess what?  Put the lid on it.  And if you wanna really get hardcore, again, if you’re a bachelor this works.  If you have a wife or girlfriend, it won’t work, but you can just eat right out of the Pyrex and then put the lid on and you’re done and there’s no dishes, but you know, once you get family involved, you gotta put it on a plate.  You gotta be a little bit more civilized, right?  So I get it.  Those are 2 options depending on where you live.  I–I am little more civilized today now that I’m married, so I put it on a plate and get my nice silverware out and cut it up, but before that wasn’t the case.  So that gives you some options how to do it easy and kinda use the in-between time.  Use the time you’re at the gym or use the time you’re showering at night and getting ready for bed.  Use that time and it doesn’t take more than 5 or 10 minutes to prep.  That’s it.

Evan Brand:  That’s good advice.

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

Evan Brand:  No, I mean, not, it’s just funny that you’ve–you’ve been there, done that, because I–I’m still, when Hannah’s gone and I’m at home working, you know, from the home office, I’ll go eat out of the Pyrex but when it’s home for dinner time, I gotta pull it out and put it on a real plate.  It’s just hilarious you called that out so accurately.

Dr. Justin Marchegiani:  Oh, Pyrex is the best invention.  I remember in school, in doctorate school, we–a couple of colleagues and I, we’d sit in the back at the lectures and we pull out our Pyrex and everything will be slow, like the silverware will kinda be in the bag and you kinda like jingling and everyone would just turn because we’d be the guys in the back of the room eating our organic meal during the lecture.  And you know, we’re always trying to multitask because I can eat and learn versus then taking my lunch time to have to eat.  I can do it during class.  So I always try to multitask with food.  And if you take these principles, you know, with the cooking and cook while you’re showering or cook while at the gym, you can save a lot of time and you could still eat this autoimmune type of plan to start and then add some of foods back in once every 3 or 4 days after to see what works.

Evan Brand:  Yup.

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

Evan Brand:  No, that was great.

Dr. Justin Marchegiani:  We’ve broken it down pretty well, right?

Evan Brand:  Yeah, yeah.  I mean, sure I can blab, but I think that was great coverage there.

Dr. Justin Marchegiani:  Hope everyone listening to this enjoys, we try to provide real-world examples, and just know when you’re listening to us, we apply it.  You know, we’re the real deal, you know, we’re going through, we’re doing it, we’re practicing it.  One, so we know it, and two, so we can be an example and so our authenticity really shines through in the–in the podcast.

Evan Brand:  I will say I–I had a consult with a girl this morning and she was talking about how she had been to several different naturopaths.  She lives in Hollywood and she had been to several different naturopaths there and none of them, ever, ever, ever addressed the diet.  She said that she was put on a liver detox program and she was put on some digestive enzymes that did not include betaine and she was set on her way and a thousand dollars later, she never had follow-up, she never got better.  And that’s–that’s mind-blowing to me that there’s so many people out there that are out of the conventional model because, you know, everybody is demanding it nowadays like this is where this is the future of medicine is going.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  And it–it has to because, you know, the patients are demanding it but it’s amazing that you can be out of that conventional model and still be so far away from the functional medicine model that we’re talking about and so many people are still dropping money and they’re–they’re losing their hope or their faith in this, for lack of a better word, alternative system that is kicking so much ass if they would just find this sort of realm that we’re talking about today as opposed to the naturopath–conventional naturopath where you just throw a homeopathic remedy or et cetera at the problem and hope it goes away.

Dr. Justin Marchegiani:  Yeah, I mean that’s analogous to seeing a contractor building a house without a foundation.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It’s like, “Oh my God, that thing’s gonna blow away.”  Right?  It’s gonna be so rickety inside there and it’s the same thing.  So make sure your doctor’s always emphasizing a good foundational nutritional base and again, remember if you’re diet even is perfect but you don’t have the digestive capacity to break it down because of low stomach acid, low enzymes because of maybe an infection or SIBO or H. pylori or fungal overgrowth, you gotta get that fixed, because even that could really prevent the diet piece from optimizing itself because you just–you can’t break down the food into its constituents so you can encompass them into your metabolism.

Evan Brand:  Yeah, even adrenal stress.  I mean, if people are trying to eat on the go or they’re not really paying attention, their scrolling on their phone while they’re trying to eat and you’re not actually giving the signal down to secrete hydrochloric acid, that’s a big deal, too.  So I try to tell people, “Look, sit down.  Enjoy yourself.  Take a breath. Ah, I’m so grateful for this food and then eat it.”  As opposed to, “Oh yeah.”  And then you move on to the next thing.  Make it a point to like put your blinders on.  I’m eating.  This is meal time.  I have to nourish my body.  Okay, now I’m ready to go back to the busy world.

Dr. Justin Marchegiani:  My man, my man.  On that note, I’m gonna have a nice dinner or a nice lunch here–it’s lunch time here in Austin.  Chicken with a–with coconut flour on it and some nice vegetables and some ground-up cauliflower and it’s a pre-made one from Snap.  So I’m gonna do that, I’m gonna heat it up.  I’m gonna have that and then I got a patient, so I’m–I’m ready to fuel myself for a–for a great Friday and to a good weekend here.

Evan Brand:  That sounds good.  I have bison steak thawed out that I have to cook and I’m gonna do some broccoli, some steamed–steamed broccoli, throw a bunch of pink salt and butter, and nosh it.

Dr. Justin Marchegiani:  So the question is, are you gonna eat out of your Pyrex now that Hannah’s at work?

Evan Brand:  No, this is gonna be on a plate.

Dr. Justin Marchegiani:  Oh, okay, wow.  You’re stepping it up.

Evan Brand:  I’m gonna plate it today.

Dr. Justin Marchegiani:  Okay, kudos, Evan!  Alright, we’ll be in touch next week, man. Take care. Bye.

Evan Brand:  Bye.

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