How to Reduce Inflammation and Improve Joint Mobility | Podcast #359

When you think of joint mobility issues, you’re probably thinking of inflammation. Inflammation is a process in which your body’s white blood cells and immune proteins help protect you from infection and things like bacteria and viruses.

In this video, Dr. J and Evan Brand discuss that your immune system triggers an inflammatory response when there isn’t anything to fight off in some diseases. With these diseases, called autoimmune diseases, your body’s immune system damages its tissues. Your body responds as if normal tissues need to be fought off. These are all linked to diet modification and testing that needs to be done to make you health better.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 –  The benefits of movements to joint mobility
5:23 –  The benefits of ergonomic chairs and tables for your back
18:56 – The vital role of proper diet for better joint mobility of reduction of inflammation
30:04 – The anti-inflammatory benefits of ginger for joint health

Dr. Justin Marchegiani: With Evan Brand, we’re gonna be going into reducing inflammation in the joints and how to improve joint mobility. We’re gonna be talking about it more from a biochemical kind of metabolic inflammation standpoint. So excited to dive in on that topic. Evan, how are we doing today man? What’s cooking? 

Evan Brand: I’m doing pretty good. I was telling you about my shoulder. I was lifting some heavy things over the weekend and my shoulder got a little tight on me. I thought, oh oh. So, uh, that spurred the idea of this conversation and I hit some arnica homeopathic 30c which worked very well. It’s not necessarily the root cause but it has been helpful and you know I wasn’t trained on homeopathy so this is something you and I have kind of dove into in our personal lives with our kids and such and it’s been a game changer. So, I mean, out of the gate, I think that’s something to have on hand even if you don’t know biochemically your root cause, what’s going on, at least you could remedy your situation, feel a little bit better well and buy some time while you’re investigating. 

Dr. Justin Marchegiani: 100% So, when I look at joint issues right, you have physical inflammation that’s being caused by physical things, right? The most common things are going to be either over exercising too much, probably less common on that and the other one is just very poor posture, right? So, the easiest thing out of the gates is you’re either sitting in a really poor chair that has very poor lumbar support, right, lower back curve support or cervical curve support. So, the easiest thing is just getting a really high good quality rated ergonomic chair especially if you’re sitting a lot, right, that has cervical support and lumbar support, that’s super helpful. In that way that part of the spine is supported. Ideally, being able to stand a portion of your day. I mean, right now, I’m standing. I don’t think you are. So, I stand at least half of my day. I have a treadmill that I’ll slide it under there. I have a Cubbi stepper. So, I’m always trying to keep some movement in there. I get about 15,000 steps a day so it’s very helpful to be able to move, get some steps. That’s helpful for the joints. The disc in the joint get hydration through inhibition. So, the joint has to pump and move to get hydration into the joints. So, movement through the joint is super helpful. So, being able to stand for a portion of the day, sit a little bit with good support, getting some movement, super helpful. And then depending on the kind of where you’re at, if you have inflammation, if you have pain, I mean, you can do some simple core kind of postural functional movements to strengthen that area. I mean, one of the things I like, uh, is a book by Eric Goodman called Foundation Training, where he just does some simple posterior chain work like a standing prone cobra with the chin pull back, right, that activates the deep cervical flexors here. I mean, you can bend down to a 45-degree angle like this for 30 seconds. You can also bring it up like this and get the whole posterior chain activated and then you can also reach down and then create traction with the spine so go look at Eric Goodman’s work. He is a, just that these three or four movements called the founder that, those are really good movements to get the posterior chain like this, like this. Simple stuff out of the gates. And so, I like that to get the posterior chain, good stability with your chain, investing good money on your desk chair. Get sine ability like a stand desk to be able to stand up throughout the day even if you’re just kind of moving going back and forth. These are super easy ways to kind of get simple movement through your spine during this, you’re not sitting all day. And if you’re sitting all day, at least invest in a really good chair and try to get some of the stand desk where you can go up and down.

Evan Brand: I do this little bar stool too and that way I could just lean my butt on it. So, I’ll just put my butt on that but I’m still standing. I’m just kind of leaning back on it. I know there was some really expensive thing, I can’t remember the name of it, a few years, I think Marxism was promoting it but it had like rocks. It has this thing that he learned. It was almost like a pogo stick with a seat and so it was like this imbalanced chair. You’re sitting but you’re standing but there’s some like rocks on the floor and so he’d put his bare foot on the rocks. I don’t remember what it was but this is kind of my homemade version of it, this little bar stool that It’ll just kind of leave off kilter. In that way my butt’s just taking a little bit of load off because if I just try to stand all day, my back hurts. So, standing all day just doesn’t work for me but with a little bit of lean, it helps.  

Dr. Justin Marchegiani: Yeah. They have these, um, these little, they’re called like wobble board chairs. There’s one called the Luna standing desk tool. It’s kind of like that, it’s kind like a pogo stick, right, but it’s got a flat surface, that’s kind of oblong so then you’re kind of sitting on that. You kind of have balance so then it activates the core but then you can kind of move around, kind of get some movement in your hips which is good for your spine. You can also just get like a Swiss ball, right? Just sit on one of those in that way, you can get some movement. And you won’t have so much support in the back so you really have to activate your core, activate your back so you can sit up there straight. That’s good, nothing wrong with that so that’s helpful. You probably wouldn’t want to do it all day because you’d be really keeping these muscles active all day but it’s nice if you’re at a desk, you can at least bring that in and bring the wobble board stool type of chair in there. These are a couple options, you know, minimal cost to bring in some good core activation. And when I say core, core is everything. It’s like the whole core thing is your back, it’s multifidus, it’s your iliocostalis muscles, right? It’s your longissimus muscles, it’s obviously your TVA, it’s your rectus abdominis, it’s your oblique, transverse, external, internal oblique, right? It’s everything around your back and front abdominal area. 

Evan Brand: People may be listening and go ‘God, why does that be so complex, I gotta get to this fancy chair or this or that’. Because, we didn’t really evolve if we were sitting like this all day staring at a screen. I mean, we’re just not really built for this, so it’s no surprise that we see so many people with mobility problems. I mean, I’ve been to several different physical therapy people over the years, just for random injuries and aches and pains and they all tell me that in their careers, these are people that have worked 20, 30, 40 years. They’ve seen just the rise of younger and younger people having worse mobility because they’re just sitting at a desk all day and how it’s shortening the muscles. I think it’s the hamstrings, right? It’s shortening the hamstrings when you sit all day?   

Dr. Justin Marchegiani: Well, I would say it’s probably shortening the hip flexor muscles, right? Because the hip flexors, right, when you flex the hip, you’re shortening that muscle so you’re creating that muscle shortens and that muscle, its insertion is on the lesser trochanter in the hip flexor in the femur muscle, in the femur, uh, bone so the lesser greater trochanter muscle, the top part of the femur but then it inserts, no, that’s where it inserts. Its origin is I think from L1 to L5 on the spine. And so, when you have tighter hip flexors, it pulls super tight on the origin which is going to be L1 to L5, I think, transverse process, and even the ribs.  So, it’ll pull really really hard on that back and so a lot of times, your chronic lower back pain is gonna be from the shearing force from really tight hip flexors, that’s part of how lower crossed syndrome happens, right? Lower crossed syndrome is nothing more than super tight hip flexors on one side and on the other side weaker glutes and weaker lower abdominal muscles. Weaker abdominal muscles, weaker glutes because you’re not using glutes to step up or squat or lodge and then you’re getting these shorter, tighter hip flexor muscles and that’s the lower crossed syndrome, right? One cross is weak and loose or weak and tight, that’s your hip flexors, the other one is, um, weaker, that’s the glutes and that is the lower abdominals. And so, this is common and so people talk about investing a lot of money in beds, right? I have a nice Tempur-Pedic bed, that’s pretty expensive. I know you have a nice bed as well but we spend just as much time in bed as we do sitting in our chairs all day, so I think, you should, people should have, you know, enough money invested in a really good chair that has good postural support. You can go to like different ergonomic stores. There’s one in Austin called Human Solution on Anderson Lane. They have a lot of great options. I got my stand desk from them. They have some really good ergonomically certified chairs that are excellent, that have the cervical support as well as the lumbar support. These are really good options to kind of start out of the gates. So, kind of my thing is start with like, you know, the easiest buy-in, right? The easiest buy-in out of the gates is upgrade your chair, maybe get some swiss ball that you can sit on, maybe get your desk, get your stand desk so you can go up and down throughout. These are just some simple, easy investments. And if you already have these things and you wanna get more kind of biohackerish-like we are, I have a Cubbi, little pedals here so I can pedal. I have my little, um, I actually got a new treadmill desk that’s under my desk that’s lighter and it goes four and a half miles per hour and I have a remote, I can just hit it. 

Evan Brand: Spell Cubbi. 

Dr. Justin Marchegiani: C-u-b-b-i. And then my other treadmill, hold on, let me go look at real fast. And my new treadmill desk is Rhythm Fun. I’ll put the links down for Amazon below. Take a peek at. But the cool thing is the remote because you can just kill it, turn it off, turn it on. Without having to go touch it. 

Evan Brand: Now, if you don’t sit at a desk all day, congratulations. Hopefully, you’re out working in the field or something like that, you know, years ago, I was working in the woods and building hiking trails and restoring different natural, you know, natural areas, nature parks and stuff but man, it killed my back. I mean, it was a lot of work, a lot of labor and not much pay at all, could raise a family on that wage. So, if you are out and you’re physically great, that’s awesome or if maybe you’re just doing that in your free time, maybe that’s counteracting your desk work. I mean, that’s what I try to do, it’s even in the middle of the day for lunch, I’ll just try to go out and walk around even if I just like hiking up and down my driveway. Just something simple, just to break it up. And I forgot what her name was, it was, uh, Joan Vernikos. I had her on my podcast probably almost like 10 years ago. I think she worked with NASA or for NASA, but anyway, she talked about the importance of just standing up and sitting down and just the change in posture was more important than anything. She said, it wasn’t necessarily the actual exercise, it was just breaking up you’re sitting. So, if you’re sitting for 20 minutes and then you can stand for 10 seconds, that was enough she said to, you know, positively impact your mobility.  

Dr. Justin Marchegiani: Yeah. I mean, adding another 90 degrees of extension onto my hip flexors, right? If your hip flexors right at your leg to your hip you’re at 90 if you’re sitting. Well, if you’re standing you go to about 180, 160 – 180 right? So, I create more length to my hip flexor which means it’s less likely to get tighter and shorter and create lower back pain. And so, that’s the easiest thing, so there’s a lot of different buy-ins, right, so like we’re not trying to give a one-size-fits-all, we’re trying to say okay if you already have a good desk or already have a really good ergonomically supported chair, maybe upgrade into a stand desk or just get a simple physio ball. Ideally going from sitting to standing is ideal. So, I would say good chair, then go to a good desk and then if you wanna add a physio ball or a wobble chair, that’s great. And then, if you wanna go to the next level and get a treadmill that slides underneath, I think mine was 500 bucks which is great though. My other one was a Rebel Desk treadmill that I used for five years, I just got rid of it because of the belt, just like almost I wore though and I’m like doing the math. I’m like all right it’s about the same cost to repair it as to get a new one. That goes a little bit faster and I get the remote. So, that’s kind of where I’m at. So, there’s a lot of different buy-ins. Now, that’s kind of like the lifestyle exercise movement standpoint and remember, I’m not saying crazy exercise. I think the more you can get movement throughout the day that’s non structured is better. Meaning, if you can get 10, 15 thousand steps throughout the day where it’s non-structured throughout a 10-hour, 12-hour a day that’s good because if you just exercise for 30 minutes and you sit on your butt for 10 hours, is that really that good? You’re still sitting down not moving for 10 hours, that’s still not great. So, if you can get a little bit of movement in and you can also have a lot of unstructured movement, that’s even better, I think overall. 

Evan Brand: I would say so, I mean, I certainly can tell you the days that I exercise and then sit for too long, I’m just as stiff as if I did an exercise compared to times where I’m moving around throughout the day. So, yeah, I think throughout the day is better. Let’s get into some of the chemical stuff too, some of the infection stuff, I mean, I’ll tell you personally with some of the stuff I’ve had from tick bites. whether it’s Lyme, Bartonella, Babesia different things that create inflammation and affect blood flow, I would tell you that there are some waxing and waning periods like where hands, feet, knees, hips, that kind of thing can get tight and so I think, ultimately, you gotta test not test. So, you and I have talked about this before. Not all testing is a hundred percent accurate but we do feel that the DNA connections report does give us a pretty good read for different types of Borrelia that we can look into Lyme then some of the co-infections which the name co-infection kind of sounds like it always comes with Lyme, I do believe some people just have Bartonella or Babesia. And those things can really affect people in terms of mobility so for me, things like Japanese knotweed are very helpful and I take a tincture of Japanese Knotweed and of course we’ll mix that into some of the other stuff we’re gonna dive into but you have to investigate this. So, if you’ve got mobility stuff or if you sit for a while and you get stiff or if you’re having issues just making a full fist, you can’t fully get those fingers in, make a full fist, there’s probably something there, infection-wise.    

Dr. Justin Marchegiani: Well, anytime you create chemical, so I kind of look at like, all right, we have structural inflammation and we kind of just talked about postural things like things that you’re gonna be doing sitting, standing kind of lifestyle habits, so not like going to the gym like, right? That’s kid of like our physical but you know more lifestyle. Now, we have our chemical and the more inflammation we put in our body, the more it decreases blood flow to tissues, the more it exacerbates prostaglandin 2 and arachidonic acid which are more pro-inflammatory. It’s gonna decrease inflammation, decrease blood flow and then we, when we, sorry, increase inflammation and decrease blood flow, decrease oxygen, so when we do that, the tissue starts to become less pliable, right? So, think of like beef jerky, very like not pliable, like you have to rip and tear it. The more inflamed you become, the lack of blood flow that you have, right, the lack of nutrition to the muscles, the more your muscles become less pliable, less like a nice raw beef tenderloin and more like beef jerky. That’s not good. So, when you do movements, you’re more likely to tear and injure tissue. And obviously, if you tear muscle, that’s more vascular tissue, it has good blood flow so it can heal better. But as soon as you start affecting cartilage and tendons and ligaments, that tissue is very avascular, very poor blood flow so it’s gonna be very difficult for that to heal. So, big things that we can do is, you know, more vegetables less fruit and carbs so keep your carbs in check. Again, if you’re more active, you can do more carbs, be very careful of your Omega-6 vegetable oils, ideally, you know, two to one on your high-quality saturated fats, really important and then you can do on your vegetable side, you’re better off doing your mannose, right? Avocado, olive oil, be very careful of your nut and seed-based oil and your omega-6 like sunflower, corn, soy, canola, very inflammatory and of course things like gluten, processed dairy, processed grains, sugar, these things are gonna drive more inflammation, they’re gonna decrease blood flow and just when the more inflamed you are, it just, it can create a lot of inflammatory molecules going through the body and they just make your body more stiff, more inflamed. The more stiff you are, you can’t get full range of motion, your tissues start becoming less pliable and easy to tear and injure and you feel just more stiff throughout your movements. 

Evan Brand: Yeah, well said. And then on the conversation of Lyme, for example, I mean, we know that Borrelia, in general, likes to eat up your collagen, I mean, it’ll really try to hid out in joints and such, so I think, collagen supplementation may be helpful too, just trying to replenish some of what’s eating up. But then, you just got to clear some of the infections, I mean, I’ll tell you, if I’m doing some of the anti-Borrelia formulations whether personally or clinically, people can move better. So, if you’ve had tick bites if you grew up anywhere, almost anywhere in the U.S. except for maybe Nevada or New Mexico, supposedly there’s not many ticks there. But beyond that, if you have tick bites from childhood, I mean that could be a factor to look into. This could be a dormant infection that’s left you alone for 30 years and then all of a sudden, you got exposed to mold or you had a death or a divorce or a move or a major job stress or even just the pandemic that’s been going on. And some of that stress people out of the sudden, boom, they have these major joint problems so who knows, there could be a trigger but like you said, it could just be, over time lack of blood, inflammation together. So, what about, like..

Dr. Justin Marchegiani: All these things modulate the immune system, right? And so, like, what you’re gonna see is you’re gonna see an increase in arachidonic acid, which a lot of these things are come from meat, so it’s not bad to have too much arachidonic acid but if we increase prostaglandin 2, that’s a more proinflammatory pathway. So, vegetable seed oils, omega-6, too much arachidonic acid but if you balance it with omega-3, high quality grass-fed meat which is very high in GLA. It’s not necessarily the fact that you’re getting it, it’s more of the ratio of where you at with the others and so that’s why, really what’s gonna tip you over is the processed sugar, the hydrogenated oils, the trans fats, the soy, the canola, the sunflower, too much nuts, too much seeds, that’s gonna tip you over and put you into a more proinflammatory state. And then the more sugar you eat, the more grains you eat, the more your tissue starts to become less pliable. Now, I have a history, like, doing applied kinesiology work and using percussion work, and um, chiropractic work. I remember working on a patient and they literally, their tissues literally felt like a bag of cement and this person, like, couldn’t like, so we would use a percussor, we’d do some soft tissue but we, I noticed that when we got gluten out of that person’s diet and grains out of that person’s diet and sugar out, the tissue quality totally changed and it’s like if you’re inflamed and you have such poor movement, you’re not gonna want to move but then if you don’t move the tissue gets tighter and if it gets tighter then now you restrict your range of motion and you’re, it’s a vicious cycle, right? So, you kind of have to get some movement in there, you have to loosen up the tissue, you have to make the diet changes so you get better blood flow but you got to work into it because if someone’s coming in, really inflamed and they go too over the top, they may create so much inflammation that they have a paradoxical reaction to feel worse, so you really wanna ease into it. And so, if you’re not used to walking, just walk a little but try to exercise just enough where you repeat it. That next day, you may feel a little bit sore but you can still function, you can still do all the things you do. If you feel too sore the next day, where you can’t do what you have to do, you probably did too much. So, just enough to feel it and know you did something but not enough where it affects your you being able to function.   

Evan Brand: Yeah. I got a few physical therapists clients and they tell me straight up that they know they’re never fully gonna get their patients better because of their diets and these people are coming in, you know, they’re eating like a subway sandwiches as they walk into the physical therapy office, so the physical therapist doing the best they can but they know just listening to us that they’re never fully gonna get them better without the diet changes and then they’re like well that’s out of my scope of practice. I can’t, you know, educate them much on diet so I’ll try to hint at it but yeah. It’s sad because you see billions and billions of dollars being spent per year on physical therapy, occupational therapy, physical rehab, that kind of stuff, people maybe had car injuries, for example, where there was a traumatic event that led to this mobility problem but then they never fully recover because they go right back eating the RB sandwich, you know, the roast beef and the bread and the ketchup and they never fully get better. So, I think, there’s a place, hopefully, people pick up on this, you pass this information onto maybe a physical therapist, get people off of grains, get people off of dairy, at least temporarily of dairy. I think butter, there’s maybe a place for that in most people’s diets. But I will tell you personally, I’ve seen the changes in my own family members if we can get them off gluten or off grains even for a month, we see improvement and so it’s just this doesn’t make money for people, I mean, there’s so many pharmaceuticals that people are taking instead, right? What’s the conventional approach for these issues like Aspirin, Tylenol, maybe Aleve and maybe some anti-inflammatory steroid drugs, right, I would say in severe cases, those are being useful. 

Dr. Justin Marchegiani: Yeah. I mean, you have your, like NSAIDs, which are gonna be like your Ibuprofen, your Advil, your Aleve, right, I think your Aleve’s kind of your time-release Ibuprofen, right. These are gonna help with the prostaglandin 2. And then acutely, you know, for a couple of days, if something happened that may not be a bad idea. The problem is if you’re chronically needing these medications that’s the problem. And then you have your acetylsalicylic acid, that’s your aspirin and then you have your acetaminophen, which is Tylenol, again Tylenol blocks the pain receptors so it’s not an anti-inflammatory. Aspirin is a mild anti-inflammatory. Ibuprofen is an anti-inflammatory. And then you keep on going up into the steroids where you actually get an injection, the problem with that is after one or two injections, your anesthesiologist or your pain doctor will tell you, yeah, we’re gonna start to break down tissues and cartilage and tendons, that’s not good either. And so, I tell patients, you know, one, you don’t wanna jump on injections right away because you want there to be some pain signal to tell you you’re doing too much when you’re rehabbing. So, it’s good to have some pain signals that will tell you, ‘hey I’m doing too much because the problem with this medication is it covers up the pain and then you may be doing things in your life movement wise, it’s actually creating more pain but you can’t feel it right. So, then of course, you go up the ladder and you’ll eventually be on opiates and that’s the problem and that opiates are very addicting, it’s just basically telling it’s blocking the brain’s ability to perceive pain and then essentially the longer your on an opiate, um, you know Suboxone, of course, you have the incredible, your morphine post-surgery, you have Fentanyl which is like incredibly higher version above your oxytocin which is like time-released opiate, it rewires the brain and you start to need more of it to then block that pain signal and then that creates more addiction right. So, you really wanna not be on these pain medications. Now, my problem with physical therapy and chiropractors is that a lot of times they can apply therapy that does not fix the underlying issue. So, chiropractors are very notorious for just, you know, adjusting a segment of the spine and creating some movement on that spine and calling it a day, right? But, if the person’s inflamed from their diet and lifestyle, that’s not helping it and also the soft tissue component should be addressed. So, when I was a chiropractor doing these kind of work, we would do like, percussion, I’d have a percussion instrument, just a couple of minutes to get the tissue warmed up and that way when I would adjust, I wasn’t having to adjust through all this soft tissue that was so hard, the soft tissue was more loose and I could move that segment and I’d always talk about how we get some better movement in the spine with exercise too because you wanna, you don’t want only movement in that spine to be through adjustment right? And so, getting these soft tissues under control using some active release techniques to help lengthen the muscle, help break up fascial adhesions, super, super helpful and so physical therapy, they’re notorious, oh I have knee pain, let’s just focus on that knee, maybe they do like an anti-inflammatory you know, uh, Russian stim or microcurrent or ultrasound, that’s good from an anti-inflammatory standpoint but physical therapy is common, we just only exercise that joint, we only stretch that joint, that’s it. They don’t look at the instability above and below the joints. Joints are very rarely just become unstable at that joint unless it’s an acute injury, someone took out your knee, it’s usually there’s instability either above and below so a good chiropractor, PT person will make sure the joint above and below is doing well. If I see knee issues, I’m gonna make sure there’s good glute activation, I’m gonna make sure that the hip flexors are facilitated, they’re not overly tight, I’m gonna make sure glute mi, glute max, all the adductor muscles in the middle are doing good. I’m gonna make sure the tip fib joint at the ankle has good stability. I’m gonna look at everything above because if there’s instability above and below that knee can compensate and have to work harder. So, I’m gonna make sure all the muscles around the knee, the glutes that stabilize the hips, the hamstrings that go to the glute that go up to the hips and also help stabilize the knee, the sartorius, the gracilis, semitendinosus, and semimembranosus, make sure everything is stabilized. 

Evan Brand: Yeah. You and I have coached many different, uh practitioners, a lot of them chiropractors and so many of them tell me, I’m just straight up sick of cracking backs for a  living because they know they’re gonna have to come back every week, they’re gonna crack the back again and then they’re gonna send the patient on their patient on their way and they’re never gonna get better and when I was working out of that brick and mortar practice and I started doing functional medicine consults, doing lab testing, getting all of the existing patients in the clinic, simply to make diet changes, it was funny but I guess not so funny for his bottom line, the chiropractor I was working for because, now instead of Betty needing to come in every week, she’s like no I’m fine doctor, I’m gonna come in in two weeks or three weeks or four weeks and it’s because the underlying inflammation was improving based on me fixing the gut, getting the diet improved. So, it’s kind of funny because people got in this routine of like, I’ll see you next Friday. It’s like, she shouldn’t need to be cracked again next Friday, you’re cracking her today, like what the heck.    

Dr. Justin Marchegiani: Yeah. It just depends how acute. If it’s an acute episode, you know, you’re gonna need to do it more frequently the first couple of weeks but if it’s more of a chronic thing, yeah you gotta get the soft tissue under control, or you gotta get the systemic inflammation in the body to the diet under control. And if you’re a chiropractor, you definitely wanna look at upper cervical, right, C1, C2, malalignments can create a lot of problems so that you definitely want to make sure that’s kind of crossed off your list because that can really cause a lot of issues and that could be a root cause as well but most people, it’s like poor posture, poor sitting, not enough movement, crappy diet, lots of inflammation and then of course, you know, muscles can also pull joints out of alignment too and cause them to feel sticky too. So like, I find the best chiropractor are like the applied kinesiology chiropractors because they would like use a percussion instrument even just for a minute or two is huge or they would do like origin insertion work, they would do like SOT technique, which uses blocks to get the hip alignment better I found those techniques were really helpful for chronic back issues and then when you have disc issues too, like you need to pump that back whether it’s a flexion distraction technique to help open up that disc, whether it’s an inversion table or whether it’s an inversion table or an inversion device for the neck that goes over the door or cuff to kind of create that negative pressure to pull that disc in off the nerve roots can be super helpful but then you got to get the muscles train down the road so a good PT or a good postural program like you can start with Eric Goodman’s foundation training. There are a couple of really good PTs online that are excellent, Bob and Brad, they go, they do a lot of nice postural videos at home stuff that are very helpful to people that are in pain. So, those are good guys, I’ll give them a, you know, a hot tip. Anything else you wanna highlight on the structural stuff we can go talk about the supplements next. I think that’s a good kind of ending point. Anything else, Evan? 

Evan Brand: Now, let’s move into the supplements, I had already mentioned like some of the enzymes, so I mean, we’ll use some of those and we often use these in combination, I mean sometimes people are taking so serratiopeptidase or I’m even personally doing lumbrokinase, I do a lot of lumbrokinase too because that’s like way more potent than serratiopeptidase and so we use that for blood flow problems with some sort of coagulation issue so whether it is an infection or mold toxin, Lumbrokinase, it’s a game changer.

Dr. Justin Marchegiani: But I want to hit that one. I wanna just hammer that one spot for a second. If you have poor blood flow which diet and infection can drive poor blood flow, if we can’t get the blood flow improve, we’re not gonna get the inflammation out and nutrition and oxygen in so ginger, the enzymes getting your diet under control, one of the biggest things that helps coagulation, if we decrease coagulation, we improve blood flow, we improve blood flow, we improve oxygen, we improve nutrition, we work on pulling inflammation out, that’s like a foundational mechanism to getting pain under control.

Evan Brand: Yeah. Well said. And there’s a lot of issues we’re seeing with post-viral coagulation issues or even acute coagulation issues, so make sure if you get some viral stuff going on, you gotta be knocking some if that too and we’ve seen people that are having chronic issues months and months later. So, to be honest in the time that we’re under I am personally staying on and recommending a lot of clients stay on some sort of enzyme just as an ongoing coagulation support, I think it’s a very, very smart insurance policy.  

Dr. Justin Marchegiani: Correct. And when we talked about these enzymes, for people that are listening at home, these are enzymes you take with food, we’re talking about enzymes we take an hour away from food on an empty stomach, you know, some of the best ones are gonna be the Lumbrokinase the nattokinase, the serratiopeptidase. Some are really good at taking them, um, enterically coated so they break down in the small intestine away from food so they get into the bloodstream. These enzymes can one break up scar tissue, they improve blood flow and they also can decrease a lot of interleukins and cytokines that are flowing in the bloodstream. So, if you’re chronically inflamed and you have a lot of these cytokines and interleukins in the bloodstream, these chemical messengers from inflammation, it can actually start to break them down a little bit, which is good. So, that starts to relieve pain. Now, if you get to the root cause, where you’re getting some movement, you’re working on your posture, you’re working on sleep and diet. This is powerful because now that starts to accelerate healing even better faster.   

Evan Brand: Yeah. And these are proteolytics so when you’re like researching these proteolytic enzymes as opposed you said the ones you’re taking with food are digestive, so they’re still called enzymes. 

Dr. Justin Marchegiani: Two different things and they cost a lot more too than digestive enzymes. They’re not the same price. 

Evan Brand: Right. Yeah. Like Lumbrokinase, I mean a bottle of it, retail on the one we use which is the Bolouke from Canada RNA. It’s like the best one, as far as I know right now. It’s like 98 bucks a bottle retail. So, it is pricey but man it’s incredible stuff, I mean in terms of hands and feet, my blood flow is incredible. That plus beet powder, which is maybe another thing I’ll go ahead and mention now increasing blood flow, I do like beet powder and I will use some of that supplementally. Yeah. Arginine, citrulline, I’ll take some those in liquid form and I’ll mix those together and drink it all down. Those can be very, very helpful. You mentioned ginger too, let’s talk about ginger because you’ve talked a lot about ginger for like nausea and digestive benefits but you and I were looking at some of the papers on it and it does have a lot of really anti-inflammatory benefits too. So, that’s kind of cool, we’re saying that it’s a digestive aid but also a systemic inflammatory aid, correct?   

Dr. Justin Marchegiani: Yeah. I try to add things into protocols that just have a wide net so I love ginger because (1) it’s a natural bitter, so it will stimulate digestive juices, (2) it’s an anti-inflammatory so it’s very calming, (3) it’s a prokinetic so it helps the digestive tract empty because if your have like some kind of chronic inflammation or gastroparesis, food and acis can sit in there too long and create burning, (4) it helps with coagulability so it helps with coagulation so it decreases it, so there’s less clotting so you improve the blood flow, it also helps with blood pressure as well. So, a lot of and then also it’s an antibiofilm, so if we’re using ginger, um, to help with like, you know, killing it, it can actually help strip the biofilm, which are the protective shields that bacteria use to prevent themselves from being killed so it helps with the biofilms which allows the herbs we use to be even better and again the enzymes we use also help with biofilms too. 

Evan Brand: Yeah. A cool study here was just saying that in rat models of liver cancer, ginger extract counteracted oxidative stress and inflammatory damage and it restored levels of superoxide dismutase catalase glutathione and prevented an increase in COX2, which is one of those pathways you and I were talking about that like some of the natural NSAIDs work on, ginger is basically a natural COX inhibitor. 

Dr. Justin Marchegiani: Yeah. It modulates, right? The problem with a lot of the COX inhibitor drugs of the early 2000s like Vioxx COX is called cyclooxygenase enzyme 2. That enzyme is also very important for repairing the gut lining and repairing the heart. So, if you block that all together like Vioxx did, you can destroy the heart and the gut lining, so with herbs it tends to more modulate not overdo it but bring it down in a modulatory kind of gentle way, kind of like an adaptogen works for adrenals and cortisol and stress. Shut it down but it pushes it in the right direction. 

Evan Brand: That’s an awesome way to think about it. So, ginger is an anti-inflammatory adaptogen? 

Dr. Justin Marchegiani: Yeah. Yep. 

Evan Brand: Pretty cool. Okay. Let’s hit the others too because there’s others we use in blends, how about some of the polyphenols like the quercetin, the rutin, the resveratrol, the rosemary. I talked about Japanese Knotweed earlier, the main benefit of the knotweed is because of the resveratrol in it.   

Dr. Justin Marchegiani: That’s Japanese knotweed. That’s very helpful. Yep. 

Evan Brand: It’s amazing for like rheumatoid arthritis, like I said Lyme type of arthritis, which a lot of RA probably is Lyme but it’s been not properly diagnosed. So, I love those. I personally take some sort of that all the time. You know, quercetin, I love too, it’s in the vitamin C family. I love it because it’s a great mast cell stabilizer. So, if you are dealing with mast cell activation in the case of mold toxin or Lyme or Bartonella, Babesia, Borrelia, Mycoplasma, any of these things, even viruses that are triggering mast cell problems and you have all this histamine out in your system, the quercetin is really gonna calm that down so that’s why I love it. And you can do too much of the good thing but in general something like 250 to 500 milligrams 3 times a day of course for me is a game changer. 

Dr. Justin Marchegiani: 100% I would say next, we could do curcumin much better off to take it liposomally that’s very important. So, liposomal curcumin also, you know, make sure you cut out nitrates, nitrates and of course grains and refined sugar can create joint issues, so you’d be surprised how many people that have many chronic issues just making those changes help. So, liposomal curcumin for better absorption. 

Evan Brand: Why the nitrates? Will you riff on that for a minute because nitrates..

Dr. Justin Marchegiani: The alpha-Solanines, their compounds, their anti-nutrients in the nitrate family, tomatoes, potatoes, eggplants, peppers, these alpha-Solanine can get into the joints and they can kind of create a lot of inflammation similarly with people that have oxalate problems. Oxalates can get into the joints. These oxalate crystals and create a lot of pain issues in the joint tissues, in the muscle belly too. Now, again, I don’t go into oxalate restriction out of the gates because there’s a lot of healthy foods that have oxalates in them. Spinach and green vegetables. So, if someone’s coming off of a processed food diet, the last thing I want them to do is not to be worried about oxalate because that restricts a lot of vegetables. So, I don’t worry about oxalates out of the gates if someone’s diet’s crappy. So, I would just, I would work on their diet very clean and then potentially in some organic acid test that we do, we could see if oxalates are really high. If do they have a history of kidney stone problems, those kinds of things are helpful.  

Evan Brand: Well, yeah, don’t forget to mention too, Candida, I mean we’ll see oxalate. 

Dr. Justin Marchegiani: A ton from a kid’s problem. 

Evan Brand: Yeah. So, I’ve seen people on like a low oxalate diet for years, they still show up off the charts and they’re having these joint pain issues, we simply just fix the yeast overgrowth or the fungal problems and then the oxalate markers go down and their joints are better. So, make sure that when you’re doing a work-up on these type of issues whether it’s mobility or pain or otherwise, make sure you’re looking for these fungal colonization markers, you’re looking at the Candida, you’re looking at some of the bacterial overgrowth because all of these things are gonna act as we’ll just say toxin in the bucket and if you get this infection plus that infection plus yeast then you really have much, much higher chance of having these problems and you go take the ibuprofen, you’re not knocking any of that stuff out. The yeast is still there.   

Dr. Justin Marchegiani: 110%. So, the oxalates, maybe more of a yeast issue, not necessarily an oxalate problem. So, something we add to our list, we can use, uh, things like Boswellia or Frankincense, very, very helpful, very good. Again, these things, how they’re working is they’re primarily modulating interleukins, they’re primarily working on cytokines, reducing some of these inflammatory compounds they may be working on the COX enzyme C-O-X-2, they may be working on nuclear factor beta, right? These are different inflammatory signals or chemical messengers, uh, may be working on prostaglandin E2, so they may be helping a lot of these things. So, we have to make sure if we use supplements though we’re not just covering it up like a band-aid, we’re actually trying to get to the root cause. So again, herbs tend to be better than like an ibuprofen long term because these things kill tens of thousands of people a year, not in the right way. Go look at Wolf et. al., 1998. New England Journal of Medicine Ibuprofen kills 19,000 people a year taken incorrectly. So, using these medications like Ibuprofen or NSAIDs in the short term may be fine, it’s the long-term use because you’re not getting to the root underlying issue. The nice thing is if you use the herbs and the natural things, long-term, there’s virtually no negative impact using those but again we’re not still getting to the root so use the herbs and the natural stuff long term to get to the root, get to diet things, that’s your best kind of foundational things. We can also add in some CBD oil, which is very anti-inflammatory. Anything else you wanted to highlight supplement-wise?  

Evan Brand: I would say magnesium would probably be one other one that’s located.. 

Dr. Justin Marchegiani: Great muscle relaxer

Evan Brand: How about, also, some of the herbal muscle relaxers too, I mean like Valerian and Passion flower, there’s some benefit from these. There is kind of a dual purpose, right? You could use it for sleep. Yeah, poppy would be good too. You could blend all those as kind of a sleep but also like a pain remedy and then I like topical magnesium also I love the Epsom salt bath. I like it more in a float tank though. I mean, Epsom salt bath, you’re like what a couple of pounds at most whereas a float tank, you’re getting 800 pounds, so just not eating.. 

Dr. Justin Marchegiani: I still absorb a ton though; I just do my fit. Just like a scoop or two but I still feel a huge difference but I agree if you can do the float tank, great, but if not that’s still a good in-between at home. Try it out for sure. 

Evan Brand: If I was like super stiff and I’m like my God, I can’t move, I’m going in a float tank because, I tell you I’m so flexible in there like when I first get in that so folks listening, this is basically like a large bathtub with 800 pounds of salt give or take. Super filtered water, it’s warm, it’s your body’s temperature, you take a shower, it’s usually at a spa setting, you get in there, you float on the surface of the water, you have your own little private float tank or float room usually and you’re just floating there and you’re there for an hour and your nervous system relaxes, they’ve used it for trauma and PTSD, so in terms of mental benefits, there’s incredible anti-anxiety benefits from it, but for physical too also, I tell you man, when I’m in there I fell, I mean, I feel like I’m made of jelly like, I mean I can just move so much better. One of my things. 

Dr. Justin Marchegiani: I would say, that, you know, from a nutrient standpoint amazing, a good myofascial release massage person, a good active release chiropractor, some kind of soft tissue technique, even if you’re doing, um, you know, foam rolling or get one of the hypervibe percussive tools at home. Just something to improve pliability, add in some of these nutrients that we mentioned CBD, curcumin, resveratrol, anti-inflammatory, I think also incredibly underrated collagen, I mean I do my true collagen 20-40 grams a day, um, collagen is a building block of your connective tissue that we don’t get a lot of because we’re not getting the knuckles and the bones unless you’re doing lots of soups with the whole carcass in there, we’re not getting these nutrients. So, adding extra collagen is essential for good building blocks or your joints and connective tissue.  

Evan Brand: I would agree. I mean, a forgotten nutrient that we just don’t eat in our diet, you can’t get that at a steakhouse, I mean, you’re just getting lean muscle. 

Dr. Justin Marchegiani: Unless, you’re getting bone marrow, unless they cut the long bone and they have all the marrow for you and eat that, that’s the only way you get it. Work in soup but most people aren’t getting it and so we’re getting more muscle meat, so that’s a good step out of the gates. I mean, I had my little coffee here, I had 30 grams of collagen this morning. People aren’t getting it. 

Evan Brand: Sweet. So, regarding 

Dr. Justin Marchegiani: A lot of anecdotes of patients, a lot of anticipations of just getting more collagen and changing their diet, huge chronic joint pain just shifting. 

Evan Brand: Oh, yeah. And yeah the diets used. So, yeah, I mean, labs, I mean we’re gonna look at stool, we could look at urine, we could look at blood too but you know but this is part of a work-up that we do, so if you need help please reach out. I’m sure we could get to something that hasn’t been found, I mean, even the Prevotella infection we look for in the stool like 75% of cases of Rheumatoid Arthritis are linked to in certain studies this Prevotella infection, which is the bacterial we test for. So, you’ve gotta look for the microbiome type issue, you gotta look for the deeper stealth infection issues, intracellular parasite type issues. There’s a lot of stuff too but we just have an approach to it, you know, we kind of peel back the layers here and we get to the root of it so if you need help, you can reach out. We both work worldwide with people via video and phone calls so you can reach out to Dr. J, it’s Justin at or me, Evan Brand, and like I said we work online so we’re very blessed to be able to help people in every nook and cranny of the globe and it’s a wonderful thing to be able to help people find things that they never found in 20 years of suffering and we just love to provide that, I don’t know, the pot of gold at the end of the rainbow, I suppose. 

Dr. Justin Marchegiani: 100% and you just mentioned some bacteria issues and different joint issues we know ankylosing spondylitis, which is an autoimmune issue that affects the lower back, your Klebsiella is a common bacterial imbalance, we’ll see affecting the lower back and causing AS that’s another issue, we kind of add to the list so very powerful. So, yeah, again, justinhealth,com for me, we’ll put the list of recommended products and different herbs that we use in our practice clinically if you wanna support, uh, the podcast and support us, feel free click down below, look under the references and you can get all these things that we recommend for our patients and ourselves right down there. Anything else, put your comments below, we really appreciate you interacting, sharing with family and friends and most people that we interact with, we don’t even get a chance to see and they get benefit so we love to hear your stories and your success. Evan, anything else man? 

Evan Brand: Yeah. If you’re on apple either on Justin’s podcast or mine since we will publish these episodes on each other, make sure you give us a review, we would really love it on the apple podcast, it helps to keep us up in the top of the charts of health and fitness so we can provide real root cause functional medicine strategies, there’s millions of people out there suffering and maybe a fraction are gonna get to hear this so please sharing is caring. Leave us a review, tell us what you think the show deserves and we’ll love you forever. 

 Dr. Justin Marchegiani: Thanks guys. Have an awesome one. Take care. Bye. 

Evan Brand: Take care. 


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Audio Podcast:

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:

Leaky Gut and Autoimmunity – Dr. J. Podcast #161

Dr. Justin Marchegiani and Evan Brand dive into a discussion about the link between gut infections and autoimmunity. Gain knowledge about leaky gut, how it occurs in the body and it’s connection to Hashimoto’s.

Explore the different stressors which affect gut health and contribute to a weakened immune system. Learn about Dr. Justin’s 6-hour template, which includes his expert recommendation regarding healing, nutrient and supplements.

In this episode, we cover:Leaky gut and autoimmunity

00:34   Leaky Gut and Autoimmunity Connection

04:05   GABA and the Blood Brain Barrier

06:48   Hashimoto’s and Gut Health

12:23   6-hour Template

22:40   Thyroid Health: T3, T4




Dr. Justin Marchegiani: Hello, ladies and germs! Dr. J in the house. Evan, how we doing, man? How was your Holidays? How’s your Thanksgiving?

Evan Brand: Holidays were great. Let’s dive in. I know we’ve got a short limited of time. But we’re doing this on the fly because this conversation of gut health and gut infections and autoimmunity is huge and hardly anyone is talking about this. Conventional doctors don’t have a clue about the link between gut infections and autoimmunity, so dude, let’s dive right in.

Dr. Justin Marchegiani: That sounds phenomenal. So we talked about in the show, kinda chatting about leaky gut and autoimmunity, which is really important because leaky gut is kind of like one of the primary mechanisms of autoimmunity kinda starting, which is kind of gastrointestinal permeability cells in the gut called the tight junctions. They start to unzip, kinda like you unzip your coat on a hot day and undigested food particles can get in there in this kind of creates this uhm— cascade of reactions call molecular mimicry, where certain food proteins— the surface proteins on these foods are similar to surface proteins of the thyroid or the brain or the pancreas, the beta—the beta cells of the pancreas, whatever. So you have this kind of immune system getting primed to similar proteins in foods which then prime the immune reaction for the immune system. It starts attacking these tissues in the body. So that’s kinda one of the first defenses is this autoimmunity leaky gut, molecular mimicry and that while they gut’s leaky, you have undigested bacterial compounds also getting in there, too. And then kinda just perpetuate and windup that immune system. And then also make it prime to—for other infections that kind of slip in there because the immune system now has weaken. Other infections can slip in. And typically, we’re gonna have a lower stomach acid environment so you’re gonna have less sterility in the stomach coz that low pH really prevents a lot of bacterial and critters from growing. But now that pH is like, you know, it’s like walking over to the dirty picnic tables and normally you spray it down with maybe some bleach. Or let’s say in a healthy version, maybe a really good antimicrobial essential oil. But now, we don’t have that because of the stress from the gut.

Evan Brand: Yup. Well said. Now, Hashimoto’s for example, is probably most common autoimmune condition that we’re going to see and deal with and that probably you guys listening are aware of. Leaky gut has to take place for Hashimoto’s to happen. That’s one of the dominoes that happens. So you’ve got the leaky gut situation. You possibly got the gluten in the diet. You got the immune stress, which could be internal or external. So bad boss, bad spouse, bad relationships, bad job— those are kind of the big dominoes we see. And when you all those up together, that’s how you get autoimmune disease. It’s really just that simple.

Dr. Justin Marchegiani: Totally. And then we have people on the live chat here. And again, this is a great reason why you should subscribe to our YouTube channel—justinhealth. Uhm because we have these podcast going live as well and we’ve also incorporated other technology in the background to get a higher quality audio versions. So if you want better audio, you can subscribe to Youtube, but also check out our podcast uhm—Evan Brand, notjustpaleo and then beyond wellness radio myself. So just keep that in the back of your head. And then your question was—I just missed it. We talked about—Oh, yeah! Leaky brain. Leaky brain is connected as well coz we have these live questions coming in. And so we are multitasking like it’s no tomorrow. So leaky brain’s important because we have these called astrocytes or the brain blood or the blood brain barrier which is kind of the interplay between systemic blood and then the passing over to the brain. And we have the cells called astrocytes. And again, same thing, when we have gut lining integrity, it tends to affect integrity of the lungs, integrity of the sinuses, integrity of you know, vaginal wall area, urinary tract. So you have people that have gut issues—gut integrity issues. It almost always can cause sinus issues, brain fog, brain issues, UTI issues, bladder issues, right? So you have all of that mucous membrane barrier, it’s gonna be compromised throughout the body not just the gut. But the guts kind of that first major domino that falls and then everything else tends to follow along with it.

Evan Brand: What you think about the GABA test for the blood brain barrier, where you take like a 500 mg GABA and if it works and you get relaxed, that says you have a leaky brain. Do you agree with that?

Dr. Justin Marchegiani: I’m not sure I buy that because I’ve seen people that do—that are really healthy and that do well with GABA.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And they, you know, symptomatically, they’re doing pretty good. They’re eating well. Again, certain supplement companies have kinda put that out where they have a GABA challenge. They say, “Hey, GABA is this really big amino acid compound and it shouldn’t go through that blood brain barrier; therefore if it does, that means your major blood brain barrier is permeable.” I’m not sure I buy that. I think it’s something to keep in mind, something to try. I have a lot of patient that have gut issues and they’re sick and that use GABA or will only give them GABA and they don’t notice much benefit either.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, you know, how do you sparse that? That’s hard.

Evan Brand: I know. Who knows, man. That’s a good question.

Dr. Justin Marchegiani: Everyone tries to be a little bit trendy and nuance in this functional medicine field.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they wanna make a name for themselves.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And I get that from a marketing perspective, but just looking at the clinical application, I’m not sure there’s ton.  But, heck, if you have GABA and you want to try it and you get uh—benefits, that’s great. I notice a little bit of improvement with GABA. Like when I take it, I feel little but relax. I also do that with Ashwagandha as well. I feel it with magnesium. Someone chimed in and asked if magnesium can be taken with Ashwagandha. Yeah, sure. I’ve no problem with that.

Evan Brand: Works great.

Dr. Justin Marchegiani: Hope everyone’s listening had a great Thanksgiving, too.

Evan Brand: Yeah. Tesa wants to know, “Have you reversed your Hashimoto’s, Dr. J, by healing the gut?”

Dr. Justin Marchegiani: Well, so we have to be careful when we say reversed, right? So have we decrease the inflammation? Have we address underlying issues that made people susceptible to having autoimmune attack? And we—can we lessen those and decrease them to the point where we are no longer symptomatic because we have the inflammation down or quench enough? Yes. I’m just very careful because you know, eyes in the skies and people listening in they’re— they’re looking for that the cure the cure-all word, right? We just got to be careful. We don’t cure anything. We support the body’s ability to—we support the underlying stressors that cause the issue to begin with. And we support the underlying systems that weren’t functioning well. And then the body can start to get these symptoms under control because the symptoms are just a manifestation of the symptoms— the systems not working. Symptoms occur because systems aren’t working. Systems breakdown because of underlying stressors. As functional medicine doctors, we come in, we fixed the underlying stressors, we support the systems that aren’t working and then the body starts to heal itself, right? The body’s on autopilot. We just got to get the stressors in the systems work. If the system’s working, then get the stressors out of the way.

Evan Brand: Yup. Well said. So you had some— you had some gut bugs and things going on, do you care to talk about your story for a minute with the – Hashimoto’s?

Dr. Justin Marchegiani: Yeah. I have—I have a low level of Hashimoto’s kinda in the background, I had elevation antibodies TPO and thyroglobulin antibodies and you know, I had some adrenal stress going on. And I just really worked on fixing the gut issues, which I had a handful parasites—Blasto, uhm— yeast, significant yeast overgrowth and H. pylori. Addressing those, fixing nutrient issues to help with the antibodies, fixing the digestion, fixing gut bacteria balance is of course working on stress reduction, sleep, all those important diet and lifestyle things. And again, the antibodies for me are just still slightly elevated, but there they’re in a range where you know, functionally my thyroid is not beaten up to the point where I need any thyroid hormone. My TSH is in a pretty good place and my T3 levels are pretty good. I actually have to go on for test real soon. So, yeah, I mean it’s possible to—to address the stressors and the system dysfunction to the point where you may not— you can call yourself cure. We just won’t call you cure for me, a functional medicine perspective.

Evan Brand: Yeah. Agreed. I need to get my thyroid panel run to. You’ve been pushing me to do it.

Dr. Justin Marchegiani: Yeah. You should.

Evan Brand: I need to do it. I mean you and I both have had these infections. I had H. pylori as well. I had a Crypto, Giardia and yeast and Pseudomonas Aeruginosa.  So, you know, that’s a fun thing about Justin and I. We both had all the things that we deal with in the clinic. So when you guys are looking to work with somebody, it’s— to me it’s a lot more honorable if you’ve had somebody that’s been in the trenches themselves, where we had to fix us to keep going to help other people. I think that’s always pretty cool. Uhm— what else I know we would have limited time, but what else should we mention here about kinda this autoimmunity piece, the gut piece. We mentioned the leaky gut, we mentioned some of the triggers just in a roundabout way. So Candida, bacterial infections, parasites, H. pylori, low stomach acid, gluten in the diet, dairy, possibly eggs, other food sensitivities. These could all contribute to that permeation of the gut barrier; therefore, causing the situation.

Dr. Justin Marchegiani: Hundred Percent. So, let me just kind of answer some of the things that you’re talking about while injecting some of the live questions we get. That’s the reason why the show is so unique compared to other shows coz we are off-the-cuff. This is the real deal here. So some patients are talking about having a lot of mucusy stools, right? And uhm— wanting to know where they should go for help, right? Of course, I recommend coming to see either myself or Evan, but typically one, we want to make sure food allergens aren’t driving this, right? Number two, we want to make sure we have enough digestive support on board to help those foods be broken down enough. So if there’s fat maldigestion issues, of course, adding in more bile salts or more lipolytic enzyme, right? Lipase— things like that. Uh— protease—proteolytic enzymes, right? These are all really important. And then, of course, once we can have the deck kinda dialed in, if foods are still a problem even with that, we may make them more palatable. We may go with more crockpot kinda GAP specific carbohydrate kind of eating template, where the foods are just easy—more processed via cooking, they aren’t raw, they are peeled or mashed. We’re decreasing salicylates and phenols and potential gut irritants so those foods can be consumed better. And then, of course, we’re gonna look deeper at the hormones because hormones have a major effect on inflammation and energy. And a lot of people that have gut issues, their guts are inflamed, we have to support the inflammation of the gut lining. And then, the big one is getting rid of the infections.

Evan Brand: Yup.

Dr. Justin Marchegiani: And that’s where you know, we’re probably go next.

Evan Brand: (laughs) Yes. You’re right. So uh—Cent50 here, who asked the question. Yeah, the loose, mushy stools, I mean that was me. I had Cryptosporidium, I had Giardia, I had H. Pylori, I had bacterial overgrowth. Until my gut issues were addressed, just FYI, I had IBS for 10 or 15 years of my life and conventional doctors had no solutions for my—my stools. And it wasn’t until actually cleared out the infections that my bowels and my stools became normal again. And so, yeah, you got to get yourself tested. Justin and I run several different companies. Uh—stool testing just depending on you know what—what we’re looking at. But, yeah, get a comprehensive stool test. Your conventional doctor may be able to order through your insurance, if you tell them you want diagnostic solutions Lab, it’s unlikely. You probably have a functional medicine guy like us to run it for you. But either way, once you get the diagnostic tool, you can fix this pretty quick.

Dr. Justin Marchegiani: There’s a lot of healing nutrients. So like, when we work with the patient, we kinda follow that 6-hour template— template that I’ve created over the last decade or so. There’s a lot of ones that are out there— three hours, four hours. In my opinion, a lot of them stink and they’re the wrong order. So the six that I’ve created and began to follow as well, in my opinion, is the exact clinical order which I follow things. So the first hour is removing the bad foods. And again, it’s not cookie-cutter because that maybe just getting someone from a standard American diet to a Paleo template. That may be taking someone from a Paleo template to an autoimmune template. Maybe someone on an autoimmune template and the Paleo template taking them to a GAPs or specific carbohydrate diet or low FODMAP template. I had patient last week who’s been Paleo for three or four years—chronic pain, chronic issues, chronic mood issues, chronic sleep issues. We took him from a Paleo template to an autoimmune-Paleo template and all of the symptoms went away in one week.

Evan Brand: That’s it.

Dr. Justin Marchegiani: This is someone that’s like already been on point for a long time and we just pulled out a few foods. So we have those— that kind of progression because you’d be surprised, the smallest things that we do have a huge effect. And it’s like, whoa! you would’ve thought I would have created the awesomeness protocol ever and found a you know, this hidden infection that everyone missed and got rid of it for that kind of improvement to happen. But sometimes it happens, we’re just removing some food. So, first, I remove the foods, second, I replace enzymes, acids, digestive support, bile salts, too. Third hour is gonna be repairing the gut lining. It could be also repairing the thyroid and adrenals and sex hormones, too. Fourth hour is removing infections. That’s where we go after— bacteria, parasites, uhm—fungal overgrowth. Those kinda things. We may even go after co-infections future podcast on that soon enough. Fifth hour, repopulating or reinoculating probotics. Some of these nice and beneficial bacteria. They’re transient. They only hang out for a month or so and pass on. So, getting some of that it in there periodically is helpful. Sixth hour is retest. We want to make sure infections are gone. And maybe even address family members too to make sure they are not being passed back and forth you know, playing hot potato.

Evan Brand: Yup. Well said. Riley asked a question about—he said, “Evan is your IBS completely healed now after addressing anything?” Uhmm—kind of a confusing question about addressing anything. Yeah, I don’t have IBS anymore. I’m infection free, no more H. pylori, no more parasites, no more bacterial overgrowth, no more yeast overgrowth and I feel good and feel completely normal, which was an amazing thing because after so long, you know, it took me to be so long to get here.

Dr. Justin Marchegiani: Totally. And with your situation, right? Like if you start eating bad foods again and your immune system got compromised, you may have another critter or two that pops back. You may have some inflammation from the food and such. And then those symptoms, they start coming back, right? So it’s not like a cure, like, “Hey, you have scurvy. Here’s vitamin C.” And then as long as the vitamin C is there, you’re good forever, right? It’s like, “Hey, there may be other stressors that may cause the systems to weaken again and those IBS symptoms start to occur, right?”

Evan Brand: Oh, Totally! Yeah. I mean I could go— I could go out to a restaurant and get some type of contaminated food and all the sudden creates a leaky gut situation. Maybe I pick up a gut bug, maybe I was eating while stressed during a week and I didn’t chew my food good. And then I picked up a parasite and have to start all over again. So, yeah, definitely, you know, you could always backtrack. You’re—you’re never permanently in a good place.

Dr. Justin Marchegiani: Totally. And again, one thing I see out there on Facebook, and I see it marketed, and it’s–  I have to call—I’m not  gonna call anyone out directly—

Evan Brand: No, come on. Do it.

Dr. Justin Marchegiani: I’ll call out the concept. But lots of people, they’re like, “You gotta heal leaky gut. Here’s a gut healing program.”

Evan Brand: Yeah.

Dr. Justin Marchegiani: And if you look at it, a lot of times, you know, it’s bone broth or just a lot of healing nutrients and a lot of probiotics, right? And maybe a little diet change. But if we go look at the six hours, what are they really doing? They’re doing the third hour, maybe a little bit of the first, maybe a little bit of the second, maybe a little bit of the fifth, right? They’re kinda skipping around. They don’t have a system and how it’s being integrated a lot of times. And I would say 99% of the time, it ignores going after and getting the infections fixed. Totally ignores it. Because you know, these people are recommending a general program to like thousand people at once in a huge kind of a webinar kind of style, right? Well, how do you get all the types of testing and customize everything in that format? You can’t. So it’s a very general kinda overview approach. And in my opinion, it’s going help some people, which I think is great. It’s admirable. But it’s also gonna  a miss a lot of people and those people that don’t get help may lose faith in functional medicine or say, “This is not for me.” So I’m just kinda calling that out because think about it, right? If the root cause of what’s going on is an infection component and you’re doing let’s say the first, second, third, fifth alright but you’re not getting rid of the infection. Well that’s like me giving you this healing aloe, right? You get a sunburn, you come back from the beach, I give you this aloe, right? The underlying cause of the sunburn is the— is the sun. And then you go back out the next day and you get sunburned again and I just give you more aloe. That’s the equivalent of what a lot of these people are doing. Well, just have some more bone broth, have some more of glutamine, have some more of this healing compound for your gut lining. So we got to get to the root cause. A lot of people are just being very general out there. And you know, the listeners of our show will get it and say, “Hey, I see that the missing piece there.” And that’s why we have those six hours that way coz then you can look at it and you can say, “Hey, this is a really specific way we go about addressing things here.”

Evan Brand: Yeah. Well said, man. And that’s the food is medicine, people. And we love the food as medicine people, but that’s why you know, we pursued functional medicine because the food is just the first step, right? It’s just one pillar of the house. It’s not gonna hold the house by itself as a single column. And also, I want to mention the order—the order of operations. If somebody just go straight to bone broth and probiotics and L-glutamine, that’s the wrong order. And sometimes people get worse. They’ll come to us and say, “Oh, Justin and Evan—“

Dr. Justin Marchegiani: Yup.

Evan Brand: “I took XYZ probiotics coz I heard it on a podcast or a blog and I felt terrible and I had a flare up of my condition. Can you explain what happened?” Yes, if things are just terrible in the gut,. sometimes you have to hit the reset button. You can’t immediately just add in all these probiotics and expect it to work. Sometimes we have to fix the balance first and eradicate the bad guys before the good guys can come back in.  So that’s why the order of operation is just a second when Justin said it’s so important. And this may explain why you’re spinning your wheels even though you’re all—you’re doing everything about the Paleo gurus are saying to do.

Dr. Justin Marchegiani: Yeah. We just want to make sure everyone’s educated. I mean, we have some people out here, they’re chiming about, “Hey, I really want a functional medicine doctor but I don’t have the—the money for it.” Well, guess what? The best thing that you can do right now is be listening to our podcast coz all this information is free.

Evan Brand: Yup.

Dr. Justin Marchegiani: We’re providing tens and thousands of dollars for free information off of people and I get messages all the time. “Hey, made a couple of these changes or recommendations and my autoimmune condition for 10 years is gone.” Right? I didn’t cure him.  I promise. I didn’t cure him, right? The body just heals itself, right? We got to say that as our disclaimer. But that’s you know, what’s that worth. When someone is you know, seeing a rheumatologist for 20 years on lots of expensive medication that’s tearing up their gut and their body and creating more symptoms than they’re actually helping. What’s that worth? So just utilize the pickup as much of the free intel as much as possible. And then you know, allocate some savings or HSA or flex spending. So if you want to dig in deeper, that’s an option. But utilize as much of the free stuff as possible because the diet is the foundation.

Evan Brand: Yup.

Dr. Justin Marchegiani: 50% is gonna be the diet so work on that first. Once you max that out, and you’re seeing some decent results, then you’d want to go in deeper. You can reach out, for sure.

Evan Brand: Yeah. And you can contact likely so. You can contact your conventional doc and try to get some stuff run through insurance. But it’s likely that they don’t have accounts with these functional labs and they likely just aren’t going to do it. Fut if you’re really lucky, you’ve got a really good M.D., you may be able to push push push push at least get the lab so you have the data. Now what you do with the data? Well then maybe that’s where you come to a functional medicine guy that can help in terms of creating a protocol. But getting the data should not be impossible.

Dr. Justin Marchegiani: Totally. And a lot of functional medicine docs that do a podcast or websites, I find that they take information, they wrap it up and they try to make people feel so confused where they walk away from the podcast or the video, being like, “What the hell just happened? What I do now ?” And they walk away feeling less certain. I want to make sure no one walks away from any podcast or video I do, gaining more certainty. And at least walking away with one action item that they can add into the repertoire of whether it’s a lifestyle or a supplement or just a different perspective on the6 hoir healing so they get better and they feel more confident.

Evan Brand: Yeah. I watch a couple of functional medicine videos like over the weekend and they were like hour-long videos I made it through 10 minutes. And I thought, “This is not gonna help me at all.” So I decided to turn it off. So let’s do it, let’s do our action steps and summary here.

Dr. Justin Marchegiani: So of course, we have our six hours, right? So everyone listening kind of our general feedback is gonna be a Paleo autoimmune template to start. And again, depending on where you’re at, that maybe really a lot of— really overwhelming for you, cutting out grains, legumes, dairy and primarily having healthy fats, proteins, uhm more veggies and fruit instead of starch. And having healthy fats like you know, if we’re doing a Paleo, maybe a little butter or ghee. If we’re going fully AIP, no nuts, no seeds, no dairy. Just coconut, Olive oil, may be avocado oil, some healthy animal fats. And that will be a good starting point for people. And then again, an AIP or an SCD or autoimmune diet, again, I’m just kinda laying out the Paleo template to start coz that’s probably the easiest buy in without pre qualifying anyone. I would say that after that, at least getting some digestive support going there. And again, you know, the ones that we formulated, we recommend the most coz we’ve put our stamp of approval. High-quality HCl or enzymes. In my line, it’s HCl supreme or enzyme synergy or I’ll add in the liver supreme for extra bile support for digest energy. And Evans line—Evan has a similar products as well. Uhm— so that’s a good starting point there. And then seeing where you’re at, I think is the next step coz there may be infections, there may be other testing that has to go in deeper. So I think if you can get that, that’s number one. And then I think if you can just make sure the hydration component and the sleep component is dialed in next, that’s a good second step. And that gives most people of really good you know, path to go down and if people are listening, they’ve already done that and they’re like, “what’s next?” well, that’s where I think you’d want to reach out and do a little bit more testing because that’s what I think the infection component and/or the hormone component and/or the nutriend malabsorption component from the infection could be the next vector we’d really have to put up in our sites, so to speak.

Evan Brand: I’m gonna address one comment here and then I’ll bring up a question then we could uh—we could wrap it up. Leslie mentioned the diet’s the foundation which kinda sucks no more pigging out in the middle of the night. The good thing is that could be related to infections. I mean for me, for example, when I had parasites, I would get these food cravings that just didn’t make sense and it wasn’t me. It’s these bugs. They are stealing your nutrients, they want food so they’re cannibalizing your muscle tissue and when you’re eating, they’re messing up your ability to digest especially coz I had H. pylori. My stomach acid levels were lower. I was basically hungry all the time and I was losing weight. Getting to like a scary point of weight loss. So really, the diet is not too hard once you just address your gut bugs, that— the whole like binging type thing on food, it really doesn’t happen once your gut is healed, once your adrenals and your thyroid are helped out and your blood sugar’s more stable. It’s not an issue. I mean you could fasted for a long time and feel stable. You shouldn’t have to get hungry or go on a crisis stage. Justin, a question for you. Uh—some doctors say T3 doesn’t matter; they don’t test it on Thyroid labs. The person’s taking T3 now slowly increasing. Would you be lowering T4 when adding this?

Dr. Justin Marchegiani: Well, I would typically be adding more than likely a T4, T3 put together so there’s gonna be a combination of both. Most doctors don’t care about uhm—T3 because the major pharmaceutical companies, Abbott’s the big one, that has a patent on Synthroid is a synthetic T4. It’s easier to monitor uhm— giving a T4 the half-life’s five days, so it’s really easy. It’s not like a T3, which could potentially have more side effects. Uhm—and it’s patentable, right? It’s the basically tetraiodothyronine with the sodium salt on it. So that’s how they get the patent to it. Uhm—again, they don’t m__ it because that’s just not what they do. They give you the T4, they get the TSH back in range. All your thyroid symptoms could still be present. Cold hands, cold feet, anxiety, mood issues, hair thinning, you know, gut here fitting things you know, gut stuff, constipation all could still be there, but if the TSH is in range, they’re happy. They checked off the list, you’re gone. So that’s where you got a dig in deeper. You got a look at the T4, T3 conversion. You got to look at the autoimmunity. You got a look at the nutrients. You gotta look at the adrenal conversion, the gut conversion connection and the liver detox conversion connection, too.

Evan Brand: Yup. Yup. Should you ignore TSH? No. It’s definitely worth factoring TSH in. You just don’t want to use that as the end-all be-all only marker. But you— but when you have the free T3 and the reverse T3, the TPO, the TG antibodies kinda all the stuff we run, the TSH makes a lot more sense when you got a full picture.

Dr. Justin Marchegiani: Yeah. We like to keep TSH in the equation and look at sometimes people come in with the TSH that’s perfect, but their T4 T3 conversion sucks. And then what do you do? You know when you’re treating the TSH or are you treating the actual patient? So we’ll try to increase thyroid hormones, see if symptoms change and we’ll try to support HPT access communication with specific herbs. And of course, stress modulation and getting infections— getting rid of infections coz that can really mess up the HPT access, the Hypothalamus Pituitary Thyroid connection.

Evan Brand: Yup. For sure. Uh—Leslie and a couple other comments about you know, where to go next? Well, I mean, you know, if people may say, “Oh, we’re biased.” But the answer is get tested. Our philosophy is “Test, don’t guess.” So if you’re confused, you’ve got symptoms that don’t make sense, get tested. That’s the first step. You can look at adrenals, thyroid, gut, get all the puzzle pieces laid on the table. That way you’re not just buying random supplements that you might not actually need. We’ve seen so many people with 20 and 30 supplements that they’re taking and they still feel terrible. And we cut that down to five supplements because it’s based on labs and all of a sudden people get better. So you know, save up your money for that. Maybe you don’t go buy the next newest supplement you hear about. Maybe you— you focus on investing into some testing first.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And you can check it out on Justin’s site. It’s You can look at the supplements, the labs on there. Same thing on my site, and we’re happy to help. So, feel free to reach out.

Dr. Justin Marchegiani: Totally. And also, couple of people asked about Dr. Gundry’s The Low Lectin Protocol. I think it’s the plant paradox. Again, my thing is if you’re just going to a Paleo template, you’re gonna cut a lot of those lectins out. If you actually cook some of the plants, some of the starches,  some of the vegetables and lower the lectins even more, if you still have a lot of gut issues, upgrading it to an autoimmune protocol, you decrease lectins more. If we still have issues and we can move to a specific carbohydrate or GAPS protocol and we decrease lectins even more. So it just depends on where you’re at cooking knocks a great chunk of that out and just going to a Paleo template, where we’re cutting out grains, legumes, dairy and focusing more on non-starchy veg, uhm— lower glycemic, low sugar fruits and safe starches that aren’t grain-based, you’re gonna have a huge effect and grains, where most of the lectins and irritants come from. So again, that— my opinion matches people making things a little bit more complicated than they have to be.

Evan Brand: Marketing.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: I mean, he’s done a good job that book is spread.

Dr. Justin Marchegiani: Yeah. It has gone viral. Everyone asked me about it all the time. I can’t get a go of a— one day without a patient asking me about it. So I have to follow it. I think I found it on fast reads on Amazon. So I got a—like uhm—abridged version of it that I’m siphoning through.

Evan Brand: Nice.

Dr. Justin Marchegiani: I’ve got a couple of services where they do these summaries. And it’a great.  I mean I get 90% of the information.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Suck it up in a half hour and I’m like, “Oop, got it!” That’s it. On to the next one. Well, any other questions you wanted to answer here, Evan?

Evan Brand: I think that’s everything. I think that’s all we can—we can chat on today and we’re gonna do a podcast soon on co-infections. We’re gonna talk about Lyme, Bartonella and Babesia Uh—Justin and I, I mean, we’ve literally got the books like right here that we’re—we’re diving into.  We wanna make sure we’re the most educated and current up-to-date with our information before we broadcast to you guys. So make sure you hit subscribe on Justin’s YouTube channel while you’re at, hit subscribe. And uh—we’ll be back again soon.

Dr. Justin Marchegiani: Totally. And one last thing. Patient asked here—person asked here on the chat list, uhm—“How do you—how do you choose your functional medicine doctor? How do you trust them?” He said, “I can’t trust them. How do I choose them?” Well, number one, I think they should have some kind of content out there whether its video, audio and/or blog post where you resonate with their information. Like their philosophy, their information, you should resonate. I find most patients are the biggest reason why they don’t get better is because, number one, compliance, and number two, they’ve been burnt and the past or they failed in the past and therefore they’re kind of priming their subconscious to fail again. So they don’t follow through and they’re off to the next one other, you know, they’re making a 180 move in can’t see someone else because some little thing happened. They’re not following through enough. So I think keeping—one, making sure you choose someone based on their philosophy and the information and making sure you resonate at an emotional level and just a logical level. Here’s the plan, generally speaking, right? And then number two, making sure you’ve given enough time and then follow through uh—for it to work.

Evan Brand: Yup. Well said. I’ll address— address this last question, then we’ll roll here. Uh—Is it common to have to go through a few rounds of infection killing protocols? Yes.

Dr. Justin Marchegiani: It can.

Evan Brand: You can. It took me a couple of rounds to go through, some herbs to knockout things coz I have multiple infections. When you’re trying to kill five or six or seven things at once, yeah. I can’t take multiple rounds. Why is that? Depends on the person’s immune system health or stress levels, how long they’ve had infections, the amount of damage that’s there, how much inflammation is there, are they sleeping well, do they have a good diet. You know, there’s million factors to answer why that— why that could be. Hope that helps.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Andrea is asking a question about his father’s prostate cancer. PSA levels are rising rapidly. Can we cast opinions or advice?

Evan Brand: I can’t. Justin?

Dr. Justin Marchegiani: That’s about thyroid, it’s about uhm— prostate issues?

Evan Brand: Yeah. Prostate. Prostate cancer this drug—Enzalutamide had been recommended for father’s prostate cancer PSA levels are rising rapidly. Can you cast opinions or advice?

Dr. Justin Marchegiani: Well, let me describe– I have one formula here that’s been helpful. Yeah. I have one compound here that I’ve been using here, just I had a couple of supplement companies reach out and I’m using it. It’s the pomegranate extract, and the flower pollen extract and its cranberry extract. So cranberry, pomegranate and flower pollen. This is an excellent support. Lot of research behind those extracts as well. Lycopene is phenomenal, getting adequate levels of selenium 200 mics a day is phenomenal, enough zinc as well is phenomenal saw palmetto’s great. These are excellent compounds that help. Lycopene is phenomenal as well. Again, the diet has to be in place. You want to get the lifestyle things going and again, these things don’t grow overnight. They probably taken decades to kind of move. So coffee and Coffee enemas may also be helpful to kind of early push detox in a faster more acute kind of way. But some  couple of compounds that I mentioned are phenomenal and wouldn’t hurt getting them on board in the meantime.

Evan Brand: Yeah. And look at my podcast I did with the lady named Dr. Nasha Winters.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: She did a book that’s called, “The Metabolic Approach to Cancer” She— she had cancer herself and she’s been holistically supporting people with cancer for about 20 years. So uh— look up Nasha Winters and uh look up her book and you could implement some strategies there hopefully.

Dr. Justin Marchegiani: Also, get the insulin levels under control. Make sure fasting insulin is five or below at least. That’s important because insulin is gonna cause a lot of cells to grow and then also making sure xenoestrogen exposure is mitigated, right? Don’t drink out of plastic bottles, avoid pesticides and GMO’s and glyphosate and Roundup. These are chemicals that you’re gonna get from conventional foods. Obviously, eat organic, right? Pasteur-fed meats. Again, these things— I shouldn’t have to repeat them, but I just can’t assume that everyone knows these stuff.

Evan Brand: They don’t. Not everyone does. So, yeah, keep repeating it and keep preaching. And I think that’s all the questions. So we did— we did really good. That was fun.

Dr. Justin Marchegiani: I heard a quote back. It’s a quote from the 1940s, where Joe DiMaggio was interviewed and they said that Joe said, “We noticed that you sprint on and off the field every single time at full speed no matter what.” And he said, “Well, there may be someone coming out to see me for the first time ever that seeing me play the way I’m playing and I wanna play at 100% every time.” And then maybe some people that are coming out for the first time seeing us play here, and we want to make sure that they get that information that we may assume that other people uh— may have, right? The equivalent will be like us jogging on the field, so to speak, if we just assume that.

Evan Brand: Yup.  Well said. Well, reach out if you need help. You can schedule with Justin. if you’d like to schedule consults with us. We should have some availability in the next 3 to 6 weeks or so. So just take a look and  we’re happy to help you soon as we can.

Dr. Justin Marchegiani: Oh, by the way, I’m adding in the Mimosa Pudica as well. So I’ll be reporting back on that in the next couple weeks. I think you as well Evan. So we’ll chat about that.  Again, I just got that in stock. That’s the Para-1 in my store. I think you have it in your store as well. So, we’ll put that in the show links, too. So that’s a cool new herb that we’re working on. We have a couple other herbal compounds in the mix that we’re using for different types of co-infections that we’re researching uhm—in the background, too.

Evan Brand: Awesome.

Dr. Justin Marchegiani: Hey, Evan, great chatting with you, man. You have an awesome day. We’ll chat soon.

Evan Brand: You too. Take care

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.



Reversing Autoimmune Disease

Reversing Autoimmune Disease

By Dr. Justin Marchegiani

When your immune system response can’t distinguish between your body and any toxins you’ve ingested, the result is called ‘systemic inflammation:’ when your body attacks its own tissues. Your body might intend to fight off an infection or an allergen, but instead points the attack at your joints or your thyroid, or maybe even your whole body. This is how autoimmune conditions, such as arthritis, celiac disease, thyroid disorders, and lupus, begin to grow.

Causes of Autoimmune Disease

Causes of Autoimmune Disease

Autoimmune diseases typically stem from one of the following causes:

Genetic Predisposition: While your genes alone do not condone you to a fate of autoimmunity, having a family history is a good indicator that you should be proactive in preventing an autoimmune disease from developing.

The pathogenesis of autoimmune disease is multifactorial, meaning, just because you may have inherited the genes for an autoimmune disease, it does not necessarily mean you will develop one. Studies have shown that some combination of genetic and environmental factors are what ultimately cause or prevent autoimmunity from developing. In this article, we are going to break down some of the ways to prevent this from happening.

Leaky Gut: Food allergies, toxins in our food and environment, stress, gut dysbiosis and an inflammatory diet are causes of leaky gut. Leaky gut occurs when the gut lining is compromised, allowing large food particles and toxins to leak into the bloodstream, causing inflammation and autoimmunity.

Autoimmune conditions affect at least 50 million Americans, as well as millions more worldwide. However, autoimmune disease seems to exist almost exclusively in first-world countries. This is possibly linked to the diversity of the microbiome: in developed countries, we are regularly exposed to antibiotics and consume genetically modified foods laden with pesticides. These contribute to reducing the diversity of our microbiomes. Those in less developed countries have a wider range of gut flora, and don’t suffer from the same autoimmune diseases.

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Trauma: Overwhelming stress or trauma, whether it be physical or emotional, such as a difficult break up, the death of a loved one, or a car accident, is enough to send your body into overdrive and trigger autoimmunity. The immune response due to physical stress (injury) causes profound inflammation, which is known to trigger autoimmune disease.

Up to 80% of people note that they experienced uncommon emotional stress before the onset of their autoimmune disease. Stress-related hormones are presumed to cause immune dysregulation, resulting in autoimmune disease. Stress can be responsible for more than just the onset of autoimmunity, it also feeds continues a vicious cycle of feeding the condition.

Prevention and Reversal of Autoimmunity

Prevention and Reversal of Autoimmunity

  • Eliminate any foods causing allergies or sensitivities. Here is a breakdown of what an elimination diet entails. Basically, by eliminating foods that are potential allergens, you’ll learn what your body feels like when you aren’t ingesting inflammatory foods. Then, you add back foods gradually and are able to pinpoint which foods are triggers for your autoimmunity or other issues you may have been experiencing.
  • Heal your gut to reduce inflammation. Your gut houses 70% of your immune system. If you don’t have a healthy gut balance, your immune system will be severely affected, contributing to autoimmune disease. An elimination diet can help you learn which foods are serving you and which are hurting your gut.
  • High quality probiotic supplements, eating and drinking probiotics in the forms of kombucha and sauerkraut, and drinking bone broth will all support a healthy gut!
  • Proper vitamin D levels. Research shows a strong correlation between vitamin D deficiency and autoimmune disease, cancer, and other serious diseases. This article studies the link between vitamin D and autoimmune disease in depth. Getting time in the sun, as well as supplementing with quality vitamin D, are ways to reverse and reduce risk of developing autoimmunity.

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  • Glutathione, the “master antioxidant,” helps your body detox any toxins you ingest. Glutathione is also a major player in immune system regulation, meaning it plays an important role in autoimmunity.
  • Zinc is essential for white blood cell production, and provides powerful immune system support (maybe you’ve heard zinc recommended to get over a cold quickly). In fact, studies have shown that those with a zinc deficiency are more susceptible to developing diseases.
  • Get good sleep will lower inflammation, heal your body, and reduce cravings for carbs, sugar, processed foods, and other junk that contributes to autoimmunity.
  • Magnesium A deficiency in magnesium increases production of proinflammatory cytokines, raising your body’s total level of inflammation, a trigger for autoimmunity. Magnesium deficiency is rampant in our society due to chronic stress, soil depletion, and high-sugar diets, so it is important to supplement with magnesium.
  • B vitamins support your immune system, hormones, sleep patterns, and much more. Vitamin B12 plays a role in your body’s production of white blood cells, which are essential components of your immune system. With lowered white blood cells, you are much more susceptible to illness, including autoimmunity.
  • Reduce stress Studies show stress can act as both a trigger and a modulator in autoimmunity, and stress-reducing techniques (yoga, meditation, massage) are viable treatment options.
  • Activated charcoal can be taken if you have consumed a food you are sensitive to, or any less than ideal foods. Activated charcoal binds to toxins to protect your body from inflammation.

If you are dealing an autoimmune disease, or have suspicions, please schedule a consultation with a qualified functional medicine doctor to assess your needs and help you heal.

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