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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

02:30 Inflammatory foods

12:07 Histamine

17:13 Environment on eating

27:17 Effects on skin with regular bowel movement

35:31 Go chemical-free


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Makes sense. Yeah.

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

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

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

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

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

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

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

Evan Brand: Yep.

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

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

Dr. Justin Marchegiani: Yes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Interesting. And it worked. Yep. 

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

Evan Brand: That seems easy enough. 

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

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

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

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

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

Evan Brand: All right. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Bye bye.

Dr. Justin Marchegiani: Bye.


Audio Podcast:


Hashimotos Root Cause Solutions With Inna Topiler | Podcast #237

Hashimotos is an autoimmune disorder in which antibodies directed against the thyroid lead to chronic inflammation. Also known as chronic lymphocytic thyroiditis, Hashimotos is the most common cause of Hypothyroidism in the United States.

Get a wider picture on Hashimotos’ root causes, symptoms, and solutions, and how can other issues with thyroid or gut affect your overall body health. Find out what Dr. Justin and Inna Toppiler talked about here.Inna Topiler

Inna Topiler – MS, CNS

In this episode, we cover: 

0:50 Eczema patient, oxalate issues

05:31 Moderate or high oxalate foods

10:19 Inflammation bucket

14:57 Hashimotos Symptoms

30:41 Solutions


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani, welcome back to beyond wellness radio. I have clinical nutritionist, Inna Topiler in the house, you know, as part of my thyroid reset summit, which was excellent. Make sure you get access to that, but you know, welcome to the podcast. How are you doing?

Inna Topiler: I’m good. Thank you so much for having me. I’m excited to be here.

Dr. Justin Marchegiani: Well thank you. It’s great. We’re doing it via video. So if you guys are listening to the podcast, make sure you subscribe to the Youtube Channel hit the bell, hit the subscribe button so you can get access to these awesome podcasts and video as well. So what’s going on with you, and I know you’re a clinical nutritionist, you’re kind of in the trenches every week with patients. Just is there a memorable patient or case that kind of comes to mind the last week or two we can kind of break down for the listeners?

Inna Topiler: Absolutely. So I am typically, I’m seeing, you know, probably about 1520 people a week. And then I do research and I do my podcasts. And working on the summit the other days. And so people usually come to me after it, probably similar to you after seeing two, three, four, sometimes even 10 different practitioners. So I’m kind of their health detective and I’m solving a lot of mysteries. So, um, lots of cases come to mind, but actually I’d like to tell you about one. Uh, she, um, is 30 years old and she was having a lot of Eczema and a lot of rashes and she’s been to numerous dermatologists and have taken, I can’t even tell you how many rounds of steroids and um, antibiotics, topical creams, you name it. And you know, it’s a very frustrating thing when your skin’s always itchy and red and uncomfortable. And a lot of it was on her face too, which I mean, that’s how you present to the world. So it’s, um, you know, it was great in a lot of issues for her and she’s tried everything and she, but essentially came to see me, she’s already gluten free. She was dairy free, you know, she was doing a Paleo type diet. So she was doing in her mind everything she was taking probiotics. She was paying, you know, $50 for this like very special probiotic yogurt. I mean she was doing it but yet unfortunately her symptoms were not any better. Um, and so we did some testing, we did an organic acid test, we looked at foods and what was very interesting for her, the issue actually wasn’t that she was sensitive to a food. She was actually sensitive to compounds in food. So as she was trying to be healthier, she was eating a lot of leafy greens. As you know, we all hear Kale, it’s good for us. And um, cauliflower and spinach. Um, and she was eating because she’s changed to more of a Paleo template. She was eating things made of almond flour and she was having a lot of sweet potatoes cause she wasn’t eating starches. And when we looked at it, we said, okay, well she actually had high sulfate on her organic acid tests and she was living a lot of sulfur, but she was also consuming a lot of foods that had, um, oxalates in them. Um, and oxalates are, they’re almost like these crystal x structures and they can really affect our body negatively. She also had elevated Billy Rubin. And what’s interesting is Billy Rubin has to go through this one specific pathway in the liver to get metabolized. And that same pathway is also what conjugates the oxalates and also a lot of carcinogens and estrogens, estrogens from the environment.

Inna Topiler: So not to make it too complex, but basically, if you guys can think of a, uh, you know, let’s say a drain, right? And we have the faucet that’s on. So if the drain is open, the water goes through where everything goes down. But if the drain is clogged, you have the faucet on, it backs up, and eventually the sink overflows. And that’s what was happening with her. So, even though she was doing all this sort of right things and you know, she did the Paleo, she was taking probiotics, she looked at all that and it really wasn’t her issue. So once we actually changed her diet and um, believe it or not, I had her removed green juices even though I know we hear that it is so beneficial for us, but it was too much Solfa for her. She was using tons of Kale and spinach is for sharing. It was too much sulfur. She was also eating spinach almost every day in a salad. And while spinach has a lot of benefits, it is very high in oxides. A Cup of spinach has 300 milligrams of oxalates, which is a really high amount. And so, and just so you guys know, if someone has issues with oxalates and if you have that sort of club drain and things aren’t going through, it’s recommended that you eat less than a hundred milligrams of oxalates per day.

Dr. Justin Marchegiani: Oh three times. That would just the spinach exposure alone. Right?

Inna Topiler: Exactly.

Dr. Justin Marchegiani: I’m just con– So, it’s a couple of questions here is off the bat it was the issue with the sulfur, was it more the oxide? It sounds like it was more of an oxalate issue.

Inna Topiler: It was more of an oxalate issue, but the sulfur kind of tends to go hand in hand. It seems like she was dumping sulfur in the urine and she didn’t actually have enough in her body. So we had to make sure that she wasn’t overdoing it. But sulfur is found in so many different foods and we can’t remove all sulfur. So, you know, they were kind of intertwined, so we had to make sure that she wasn’t overdoing it, but still getting some and then making sure that we’re working on the liver pathways to process that.

Dr. Justin Marchegiani: Totally now, a lot of the organic acid tests sometimes correlate a lot of the oxalates with yeast or fungal overgrowth. Did you see a yeast or fungal overgrowth with this patient’s [inaudible]?

Inna Topiler: Such a great question. Yes we did. It wasn’t that bad, but it was there. Um, and actually, um, to let you know, but that when we started to address her diet, we didn’t even get to the yeast yet. We just started changing the Diet. We took out almond, we replaced it with other nuts. We took out the spinach, her rashes disappeared.

Dr. Justin Marchegiani: So basically you kind of pulled out maybe like a list here of all your moderate and higher oxalate foods and you used, did you just focus on cutting the high ones or even the moderate ones?

Inna Topiler: I just focused on the high. Um, so many foods have oxalates and she was already so restricted. I didn’t want to overwhelm her too much. So we kind of spinach, we cut out almonds and we lowered potatoes —

Dr. Justin Marchegiani: and almonds and what are good replacements for those?

Inna Topiler: Um, so, um, you can do, um, I mean all of the — See, the problem is that with leafy Greens, uh, some of them are not gonna have as many oxides, but they’re going to have a lot of sulfur. So then we don’t overdo that. So I had her do more things like Romaine lettuce and then we ate other vegetables, asparagus, green beans, Zucchini. It’s okay not to always have leafy greens. I think that her body just needed a break from those. So we really focused on other vegetables.

Dr. Justin Marchegiani: What about Kale, does Kale works? Kale. I mean I think it’s obviously higher sulfur, but it’s a lower oxalate one, right?

Inna Topiler: It is.

Dr. Justin Marchegiani: Just cut the nuts out. And you were kind of not alternative–

Inna Topiler: We did coconut. Um, we also looked at other nuts like walnuts that are not as high in Oxalates. And then she wasn’t actually necessarily sensitive to the grains, at least not from what we figured out. So she was doing Paleo because she thought that it was healthier, but it wasn’t really helping. So we actually put in a little bit of a millet. Millet is really low in lectins. So a lot of people that don’t do well with grades can tolerate that. And then we put in a little bit of rice and she was okay with that. Of course, obviously everyone is different. So it doesn’t mean that everyone can do that. But in her case, it was better to have a little bit of the grain, um, and lower the amount of potatoes that she was doing because otherwise it was all potato or almond flour based stuff. Another thing we did was cassava flour. I’m a big fan of cassava and again, I mean you want to do it in moderation because if you have a lot of it that can be higher glycemic. But we did use it in some baking and she was doing cassava flour tortillas and that worked well too. And that’s grain-free.

Dr. Justin Marchegiani: Awesome. I know the oxalates can kind of get in the joints too and kind of crystallize and um, and create pain and inflammation. Was this patient presented with any of those symptoms at all?

Inna Topiler: No. So for her it was more the skin issue and I think that, yeah, I do have another person who was having that issue with their joints. Um, she was in her mid forties and she was feeling very arthritic and she said to me, I’m not that old. What’s happening here? And she went to see a rheumatologists and they tested for rheumatoid arthritis. He did all the testing that came out negative and she also was eating spinach, pretty much every day we cut that with for her. All we did was cut spinach and her [inaudible] went away. Another thing I want to mention is related to that is people sometimes don’t realize, and again I’m not trying to bang up on Kale or spinach. I mean obviously there’s benefits. I’m not saying it’s bad for everyone, but sometimes people also don’t realize that a lot of leafy greens, even though they do a fiber, they can back us up a little bit. So if you’re eating a lot of Greens and a lot of cruciferous vegetables and you’ve, if you have constipation, just be mindful of that. Especially if you have thyroid issues because you know there’s a correlation with that. Um, you may want to lower that and that can help.

Dr. Justin Marchegiani: Can cooking foods also help one, break down some of that fiber, but also help lower the oxalates a little bit. You look at strategies and trying to take some of those raw oxalates and maybe cook them down a little bit to help decrease the amount.

Inna Topiler: Yeah, that definitely helps. But I think initially it does help to try to cut more of it out. Um, plus you know, it helps with the rotation because people get into a rut, as you probably know. And you know, they have spinach and okay, this is good for you. I’m gonna eat it every day. Okay. They’re still, yeah, let’s get from an eat it everyday. So it’s nice to rotate. So I think, yeah, if you’re eating a lot of something, it’s good to give your body a break and then we’ll add back slowly. And the cooked versions are definitely going to be better.

Dr. Justin Marchegiani: Yeah. If you love it, rotate it. That’s a good edge. I like that. And what happened to her skin? So how did that progress? Did you have to go deeper and, and do, you know, work through the digestive system and you find the gut infections? How did her skin progress over the, you know, a bit of time here.

Inna Topiler: So what’s really great is that all of the rashes went away as soon as we changed the foods. And I mean, as you can imagine, she was just ecstatic because she’s been dealing with it for so long.

Dr. Justin Marchegiani: When you say rashes, you mean the Eczema, right?

Inna Topiler: Well, it was Eczema and rashes, so it was kind of a combination. So it was like rashy itchy bumps and then the dry scaly spots that —

Dr. Justin Marchegiani: Did you see any connection at all with histamine with her.

Inna Topiler: Yes. Um, and I think, I don’t know if you agree, but I feel that the histamine is just a temporary reaction because everything else is flared up. I don’t think that she would have that problem longterm, but a lot of the foods that have oxalates like the spinach is going to have histamine as well. Um, and we did lower some Kombucha and some yogurts that she was doing.

Dr. Justin Marchegiani: Yeah. I find the same thing. Like you have your stress bucket or your inflammation bucket. I did a podcast, they on allergies and we talked about, you know, here’s your bucket and we have all these different antigens in there. And when you’re already topped off and off, sometimes just those simple histamines could be an issue, but if your bucket was lowered, it wouldn’t be a problem. And a lot of those foods are still really nutrient dense and who doesn’t like Bacon and Kombucha. Right. So I totally get where you’re coming from on that.

Inna Topiler: Yeah, exactly. Exactly. Um, I think also, um, when you look at the histamine reaction, a lot of what goes on in the gut is going to affect that. So if you’re got some mass and if there’s dysbiosis and overgrowth and Sibo and everything else, you’re going to be more likely to react to them. So it’s kind of like same analogy as you’re get in with the bucket, but in addition to the food intolerances, there is all this infection that’s in there too.

Dr. Justin Marchegiani: 100%. And how much better is her skin now? She half is you almost a hundred percent gone.

Inna Topiler: It’s 100%.

Dr. Justin Marchegiani: Oh Wow. That’s awesome. Anything else you have to do with the skin stuff?

Inna Topiler: Um, well we are starting to address, um, there some SIBO, the yeast, we’re working on that, but the skin cleared up just from the food and it’s not always the case. I mean obviously everyone is different so sometimes you have to look at everything until you see improvement. But in her case, um, she was lucky and it was really nice that just the food alone clear it up. Now that doesn’t mean we’re done. There’s obviously still stuff going on and she was experiencing some bloating and some discomfort that’s still there, which made sense. She was a little bit upset about that at first cause she said, okay, my skin’s better, but why is this still there? So I had to tell her, well, we just started, we still have a lot more work to do. So one thing at a time.

Dr. Justin Marchegiani: Yeah. It’s always interesting when you work with patients because as a clinician, I mean, you know, there’s a bunch of levers you’re going to be pulling, right? Diet, stress, hydration, exercise, looking at the gut, looking at the hormones, right? And you may not know one of those levers make may get you 90% of the way there while the other couple don’t move the .. lot. And it’s hard to know which one it is because you have so many experiences where summits evenly spread out some, it’s just that one lever and everything is right. You notice that too.

Inna Topiler: Mhmm. Definitely, definitely.

Dr. Justin Marchegiani: And its always a surprise.

Inna Topiler: It is. And sometimes when I talk to someone I could Kinda tell like, all right, I don’t know if it’s my intuition or just looking at the test could be my logical brain, but I’m like, ah, I think it’s going to be over here. Sometimes I’m right, sometimes not. But yeah.

Dr. Justin Marchegiani: And what is your Mr average patient look like as she is? Is it female 35 40? What’s the Avatar right in there? What other, what other major issues are you seeing the patient’s coming in outside of just the skin issues? Is there another type of pattern that just, it’s constantly knocking on your office door.

Inna Topiler: A lot of fatigue. I see a ton of autoimmunity and you know what they say, you attract what you yourself have or had or I’ve dealt with. And so I’ve, uh, I have Hashimoto’s, which I’ve been able to successfully reverse. I still have some antibodies, but they’re a lot better than where they were —

Dr. Justin Marchegiani: Saying you’re a man. I’m in the same booth as you. What was your most recent thyroid test? You remember your personal results?

Inna Topiler: I do. I test mine every, you know, probably two months or so. Um, so just to give everyone a little bit of a history, my antibodies, when I first tested them, and this was back when I’d probably go in 20 years, when I was in my early twenties, they were in the seven hundreds, which is very high. And that’s when I was like, okay. And then over the years just with doing detox and working on my gut, working on metals, they’ve shut up to as high as 6,000. So that was my ultimate high. I’ve gotten them. Yeah. So I’ve gotten them, uh, to the 200 mark now. That’s the lowest they’ve ever been. Um, and interestingly enough, and I want to touch on this because I think this is an important piece. I’ve done everything. Literally like all the cleanses, um, took, took out all the metals that all the nutrients, um, worked on my gut and basically I was as perfectly as I could be and my antibodies were around 450 and they stayed there for awhile. They flared up postpartum after I had my son and then they went back to the 450 mark and I kinda thought, okay, this is just my baseline and you know, it’s better than 6,000. But then I started meditating and I got a lot more into the mind, body aspect and just seeing the importance of all of that. And without changing anything else, I was still doing the same diet, the same nutrients. My antibodies dropped under the 200 points. So that’s what got me to the 250 mark.

Dr. Justin Marchegiani: Wow. How about your thyroglobulin? Where are those coming back positive at all?

Inna Topiler: Mildly. So were added, vary anywhere between like 30 and 80. They never really got above a hundred.

Dr. Justin Marchegiani: Okay. Got It. I’ll go over mine with everyone. Just to be transparent. Are you, do you need thyroid hormone? You know?

Inna Topiler: I do. So I take a very small amount. And that’s another thing I wanted to mention really quick. As a nutritionist, I always try to do things naturally. And for the longest time I was very against taking thyroid medication. My TSH was always borderline. It was always in like the waterline normal lab, you know, optimal range. It was not borderline, it was out. I was in like the 4.5 um, range and by T4 was a little bit on the lower end. MIT three was always low, was in the 70s but I always said, you know what, this is my job. I need to do things naturally and I’m going to do that for myself. And finally, I mean years later I talked to someone and you know, cause every practitioner needs their own practitioner, right? We can’t take care of ourselves. We need someone to help us as well. And I decided to do a little bit of supplementation and it was so life changing. I can’t even tell you my hair started growing, my energy improved that I wasn’t feeling bad, but I just felt so much better. And I take, I do a compound it two 43 and I have 52 T4 and 13 micrograms of t three so really like not a very large dose, but what an amazing effect that has.

Dr. Justin Marchegiani: That’s great. That’s awesome. Yeah. I ran my blood tests here two weeks ago. My TSH, I don’t, I do not need thyroid support because of my labs. We’ll go over it. TSH was 1.81 so it was below two below two and a half. T 4 free was 1.4 which is good. A T4 total was 8.7 which is good. We want between six and 10 ish. If you, you know, Well if you don’t agree and let me know too, she had three total was 103 and T3 free was 3.5.

Inna Topiler: Those are great numbers!

Dr. Justin Marchegiani: Yeah, they’re pretty good. TPO antibodies. I’m, I’m keeping them below 16, 15 ish. So those were in the sixties or seventies. A couple of years back. Thyroglobulin has popped up to 74 though. So that’s a little bit on the higher side for me. When these labs were done, um, I ate a little bit of a gluten free dessert the night before, so my glucose was a little bit high in the morning, 105 and my insulin was a little bit high at 11. So right now I’m tightening up the gluten free dessert stuff and, or any dairy in my diet and I’m trying to go a little bit lower carb. I’m going to be testing my insulin and all my antibodies next month. So, you know, as clinicians we like to monitor our own stuff and kind of benchmark our own stuff too. So that’s just for transparency’s sake. That’s where I’m at.

Inna Topiler: Thanks for sharing.

Dr. Justin Marchegiani: Yeah. Cool. But it’s good though. I think it’s great as a clinician that you have your own challenges because it causes you to really look deep. It causes your patients, I think to know that you’re trying to practice what you preach as well. And I think it’s tough too because like I’m in a place where I’m like, I don’t want to take thyroid hormone, but I also understand, you know there’s probably a delineation of when you do, obviously you crossed that. Can you walk us through, what’s that threshold? Is it, are you looking at TSH? Are you looking at a T3 threshold? What are you looking at the say, hey, I need thyroid hormone.

Inna Topiler: So for me I looked at both of those. So while TSH of course is important, if you know with Hashimoto’s that can sometimes fluctuate and if my T4 and T3 was normal, I wouldn’t have done it. But I had the very textbook pattern. My TSH was elevated slightly, my T4 was slightly low a, my TSH was 4.5 so it was out of the optimal range. My total T4 was five point. I mean that, we’re going back years now, but it was under six, it was like 5.8 and my T3 was 70.

Dr. Justin Marchegiani: All is your T3 free.

Inna Topiler: Uh, like 2.7. I mean it wasn’t terrible but–

Dr. Justin Marchegiani: It was under this lower side for sure. Yeah.

Inna Topiler: Yeah. Um, you know, and because of the pattern that if it was just one of the numbers, then I would think, okay, maybe I’ll just wait and see. And I’ve tried a lot of natural stuff and I’ve tested it in the numbers were always showing up that way. So it wasn’t just, you know, cause the TSH will fluctuate. Things can happen from day to day. This was consistent month after month. And knowing that we need thyroid hormone for every cell in our body. And this is something that people may sometimes not realize because we think, okay, thyroid is important for our metabolism. It’s important for temperature control. But there’s just so much more than that. We need it for our brain, we need it for our feet. I mean we need it for our gut, for everything. And I actually realized, wait a minute, I’m being so hardheaded here, like I’m going to do things naturally. I’m not going to go on this. Meanwhile, I’m actually harming my body. If I don’t have enough thyroid hormone, then my guts not going to heal the way that it’s supposed to and other things are not going to work. And I’ve tried a lot of natural stuff. Now here’s the thing, I’m not saying anything against natural stuff. That’s always my first resort with everyone. Um, it’s just that because of fresh tomatoes for awhile and my thyroid was damaged due to it, I need it. Not everyone does, but you know, it’s just looking at everything and weighing it out. And I think it’s important because sometimes people can, you know, go too much one way and then kind of forget about everything else on the other side.

Dr. Justin Marchegiani: Yeah. A lot of people come into this thyroid game and they’ve kind of caught their thyroid or their immune system beating up their thyroid like 10 years into this relationship. And it’s like, okay, you’ve been beaten me up for like 10 years and there may be some functional tissue that’s not quite producing that hormone like it was, you know, a decade ago. So that’s where you kind of have to replace things. But a lot of times, you know, you may be able to replace some of that functional tissue by doing all the things that we’ve talked about. We’d be all in the thyroid summit that we talked about, but gluten and the leaky gut and supporting some of these nutrients, but sometimes there’s just kind of the gap, right? And that’s kind of where you have to really be real. Look at the TSH, the look, how much is the brain talking, and then look at the actual hormones and say, Hey, are we at least getting to mid range or so? And if we’re not, then we got to look at a bumping that up, especially if we have low thyroid symptoms, like your cold hands or cold feet, maybe thinning eyebrows, mood issues, motility. What kind of, what were your low thyroid stuff?

Inna Topiler: Uh, cold hands and feet. Yup. Um, hair loss but not so much loss where like, you know, it was falling out. It was just really thin and brittle. Yeah. And you know, it was interesting too, it never grew past my shoulders. It was just like the end when I was younger. It did and then it just stopped like it would get here and that’s it. And since then, you know, my hair swell, I’ve cut it recently but it’s way past my shoulders now. So that was kind of an interesting thing. I did have a little bit of the eyebrow thinning fatigue, irregular cycles, issues with motility. I mean, not terrible, but just, you know, things are just, we’re not 100% and when I optimize that, it all just completely aligned.

Dr. Justin Marchegiani: And was there like as you went through kind of like adding various things in and dressing various systems? Where’s there a couple of things that was like, oh, this really accelerated this or this really accelerated that?

Inna Topiler: Um, how many before doing thermos and I did a lot of stuff to really balance my body, still cleansing out the yeast. I had a lot of Candida, a lot of mercury in a lot of copper. Yeah. Clearing the Candida was huge. I mean I had a lot of IBS symptoms which got so much better than motility stuff was still a little bit off, which the thyroid helped with. But overall the dissension against the bloating in that, that way better with the candida. I had to tell a cop on a ton of mercury and that was not an easy road. I mean it was probably a year or two year and a half process, probably even more two years of detoxing that and I did a combination of some culation um, along with some other methods. Um, so that really helped a lot too.

Dr. Justin Marchegiani: That’s great. Excellent. And what made you want to go compounded with your thyroid versus like an armor or Nature-Throid or WP?

Inna Topiler: So that’s a really good question. And um, what happened to me was interesting. I actually went on West steroid. That was the first one I went on and I, uh, I still like kinesiologist back in the day and he muscle tested me and he’s like, oh, this is great cause I was back then I was like, okay, I’ll just do armor because that’s what everyone was doing. And he said, no, no, the WPS can be better for you. So I’m like, okay. I did that. And um, and I felt really good. That’s when my hair started to grow back and my energy was good, I felt great. But then I tested my antibodies and you know, before starting that there were in the four or five hundreds they went up to 3000.

Dr. Justin Marchegiani: Woah! Holy smokes.

Inna Topiler: And I thought, hmm, okay, that’s kind of weird. And I thought maybe it’s a fluke. I waited another six to eight weeks, retested 3,500. I’m like, okay. Did another couple of months where he tested above 5,000 the lab didn’t quantify when it was above 5,000 so I’m like, okay, well obviously something changed here. And I’ve talked to a bunch of different practitioners and colleagues and I knew that there was something in the WP that was affecting in, even though there’s not a ton of research and even though people say you can take it, it’s fine, you know, there are um, you know, studies that show and I think, you know, anecdotally like in my case as well, they, because it is a natural substance. If your body attacks your on fire and he can then attack the armor of the WP. And of course it doesn’t happen to every person. Not saying everyone Hashimoto’s can’t take it, but I was the one or 2% that it happened to.

Dr. Justin Marchegiani: Yeah, it’s rare. I have not seen the patient like that, that bumped that high because of it. I’ve heard from other colleagues though, I always retest because I’m always looking for it. You know, it’s like a, it’s like the, the, the, the metaphorical Unicorn you hear of it and I’m always looking, but it’s great that, you know, you actually went through that and you saw it and did you go right to compound or did you notice you had the same effect with armor and P or nature throid too.

Inna Topiler: Um, so what I did, and interestingly enough also I talked to a few colleagues and what they were saying is, well, if you feel good then don’t worry about it. And I just did not really agree with that and I guess I feel good, but there’s inflammation going on. So I wanted to, once I realized that it must be that I wanted to get off right away. I–

Dr. Justin Marchegiani: How did you feel though? I’m just curious. What happened to your thyroid symptoms?

Inna Topiler: Gone. I felt great. Hmm. Yeah, I felt great. No issues at all, but I just knew that these numbers don’t look right and if the inflammation is silent, but it’s there. So I, if I had more time, I was also trying to get pregnant at the time and I just didn’t want to kind of mess around with stuff. If I had more time I probably would have tried Armour just to see if it was different, you know, if there was something in the WP versus the armor. But I said, you know what, let me not waste time here. Let me just go to a synthetic. And I didn’t want to do Synthroid and Cytomel just because there’s some other additives in there. And my doctor that I was working with worked with a pharmacy that was nearby the [inaudible] Compound and it was very easy. I know sometimes it could be difficult if your doctor’s not open to it, but I had someone that already had a great pharmacy, um, that they worked with. And so I did the compounded synthetic T4 T3 and I have to tell you, and this is, I know it sounds weird because you’re like, how can this happen this fast? My antibodies dropped from above 5,000 to a thousand and then they went to 400 within two months.

Dr. Justin Marchegiani: Wow. Did you try the, the tyrosint for the synthetic T4 that’s clean?

Inna Topiler: I didn’t, I just went right to the compounds. Okay. Because with the tire scene I’d still need the T3 and —

Dr. Justin Marchegiani: Then you would really want to put it together.

Inna Topiler: Yeah, exactly. And it’s all in one pill so it’s easier.

Dr. Justin Marchegiani: Are you open or are you curious to try adding it back in and see what happens?

Inna Topiler: Not really. Only because you know, I mean, and I, I definitely play Guinea pig a lot and I try stuff, but I got my antibodies down. I really don’t want to take any chances, have them going back, ever–

Dr. Justin Marchegiani: Do it. That’d be an amazing blog post to, to do it. Cause this is really good because you mean as a clinician you hear about these patients but sometimes you don’t really see them or sometimes you know, a lot of doctors don’t retest. I always retest after someone’s given a thyroid hormone support and that’s amazing because that’s a huge jump. I’m blown away right now. It’s amazing learning experience for everyone though. Awesome. Yeah.

Inna Topiler: It really is. And again, I mean I, for everyone watching, I don’t want you guys to think that that’s going to happen to you. I mean there’s a small percentage of people. It’s not everyone who has Hashimoto’s, but it’s worth looking at because it is possible and it’s amazing how quickly that happens too.

Dr. Justin Marchegiani: What other strategies can the listeners kind of utilize or apply regarding reducing their antibodies outside of just changing thyroid support? Cause most people we’ve kind of recognized that may not be helpful. There’s a lot of data actually showing that things like WP or thyroid glandular can lower antibodies. In your case it was the opposite. But what other strategies have you done or you’ve seen work with patients?

Inna Topiler: Well, I think that when we look at antibodies, we want to look at the immune system, right? Because that’s the immune system being confused. Um, you know, it’s not your thyroid’s fault. It’s the immune system that’s producing those antibodies. So we really want to look at the triggers and everyone’s going to have different triggers. But we all want to look at different infections. So whether it’s Epstein borrows, recommend that people test that and see to make sure it’s not reactivated or that you don’t have a lot of past antibodies and you can test for that by doing VCA, igm, VCA, Igg, um, and the EBNA. And, um, so look at that cause that’s just such a common infection. Yeah.

Dr. Justin Marchegiani: You’re saying run the viral capsid antigen, the nuclear antigen. Would you also run the early Antigen for the EBV Epstein?

Inna Topiler: Well, the early one, I guess if you’re feeling sick, um, if you’re not yeah, to activate, if you’re not feeling sick, you could just run the other ones to see. And um, you know, there are things that you can do, um, specific antioxidant, zinc, selenium and Acetyl cystine lysine to help your body to fight that. Um, you know, also look at toxins and I’m sure you guys probably talk a lot about this on the podcast, but you know, things we’re putting into our body everyday. So, of course our food, but also what we’re putting on our skin, what we’re drinking, our water from, the type of water that we’re drinking. That’s all really important. Um, and um, you know, with food, obviously making sure that you’re not eating anything that you’re sensitive to and that can change. You might be sensitive to certain things at certain times of your life and others at others. So doing food sensitivity testing, looking at things like food compounds, like oxalates are so far. And then the other big thing is stress, um, and the adrenal glands. And I think that we all talk about stress and we all know, okay, we need to stress less, but a lot of us aren’t really doing anything about it. And we kind of just blame it and say, okay, well let’s just stress. But you know what? Yes, it’s just stress, but we still have to support it. And so I think there’s so many techniques. Meditation has been really, really life changing for me. And, um, I learned it from Emily Fletcher with this Eva. Um, really, really liked that technique because she talks about that you actually don’t have to quiet your mind. And that was so interesting for me because I’m a perfectionist, and so every time I try to meditate, I’ve tried not to think, and by trying not to think, I would think more. Yeah. Right. So then I felt like I was failing and I’m like, why can’t do this? Why would I do something that I fail at every day? I mean, any intelligent person is going to have that thought. Right. And so she teaches that the job of meditation isn’t to quiet your mind. Um, it’s kind of like she says, you know, you tell, you can’t tell your heart not to beat, so you can’t tell your brain not to think. Um, the, you know, so she kind of does it with a mantra and she has this technique of doing it that I found to be way easier than anything else I’ve tried, which is why it’s been so successful for me. And that’s changed so much for me in my health.

Dr. Justin Marchegiani: Can you walk me through what that looks like? So, okay. You sit down. Can you just kinda just walk me through your flow?

Inna Topiler: Sure. So, um, you know, and again, it’s not a meditation teacher, so there’s, there’s more to it than that–

Dr. Justin Marchegiani: But people I think value it coming from just an everyday person that’s done it but also gotten great results. I’m really intrigued with the antibody immune response you had by doing it. That’s amazing.

Inna Topiler: Yeah. And I think with that, and I’ll walk you through the technique in just a second. I just want to tell you what the antibodies, I think what was happening to me is whenever I would see my antibodies high or I don’t feel well, sometimes I feel achy or just off, I would call it my sort of quote unquote autoimmune symptoms. I would right away start to obviously get nervous and then think, okay, what do I do? Which supplement do I take? What food do I cut out? I need to do this, this, and this. So it was a lot of doing and while doing is good, I didn’t want to say anything negative about that. I was almost like getting in my own way, if you will. So I would be doing so much that I actually wouldn’t allow my body to rest. And I really needed to remember that the body does know how to heal. We just have to get out of our way and give it a chance. And because I was always doing and so active, I was actually elevating my cortisol by freaking out, so to speak about all of the stuff that was happening. So what meditation did, and what I do now is if I start to not feel well, and Emily actually talks about this in her course. So if you feel like you’re getting sick, the first thing you do is go get your buns in the chair. So then you could take that 15 minutes and actually get out of your own way, not thinking about every supplement to take. And again, you still have to do that, but allow your body that 15 minutes so that it could do what it needs to do and then go take the supplements and the other things that you need to do. So it’s a combination. And so with the technique, she walks people through a little bit of mindfulness for the first, um, minute or so where you just tune into your body so you listen to what you’re hearing. You can see what you’re seeing with your eyes closed. You can smell your surroundings, you can taste to see what the taste in your mouth is. That just brings you more into your body. Um, and then the way that she teaches is to do with a mantra and everyone actually gets a personal mantra, um, through her course. Um, but if we just take a word, let’s say, um, like we could use ohm for example. And so what people would do is it would close their eyes and then in their mind they would just say the word ohm and they would just repeat that with their eyes closed over and over again. Um, and it’s something that shouldn’t be super loud. It could just be like maybe slight whisper or just, you know, you can hear yourself saying it or, um, you can just kind of repeat it like very, very softly in your mind. And what’s nice about that is it gives you something to concentrate on. Um, and then if you go into some type of a daydream and you don’t realize, that’s okay. But if you realize that you’re not saying your mantra, then you want to go back to it. And that’s kind of the difference between if you don’t realize you’re still meditating, if you realize and you choose to stay off, then you’re off and you want to bring yourself back. I mean, obviously there’s more to it. Like I said, I’m not a meditation teacher. This is just her technique that I’m using. There’s more to which is a book and a course that people can learn from. And I don’t get paid for this. I just like her work. So I mentioned it again. Um, but it’s really, really helpful. Um, another thing that I also found very helpful in the mind body front is, um, uh, one mentor of mine, his name is Dr Mario Martinez. He has a book called the Mind Body Code, and he also has a workbook that’s an audio called the mind body code. I highly, highly recommend that. Um, what he talks about is that oftentimes a lot of our emotions can be stored physically in the body. And we all have different wounds that we can be wounded by, you know, our parents or society when we’re younger. And, um, some of the wounds that are really common are shame, abandonment and betrayal. And most of us are gonna have at least one, but probably all three at some point in our life. And you know, with portrayal doesn’t have to be something really, really major, but even minor betrayal can count. And then shame is something that, you know, we’re exposed to since childhood. I mean, even as toddlers, you know, if our parents says, don’t do that, um, you’ve been a bad girl or you’ve been a bad boy, that shaming. But of course it could happen to a higher degree as we get older. And shame can really affect the thyroid and autoimmunity because, um, you know, our thyroid is in our throat. That’s our fifth shocker. That’s our expression. And so when you feel shamed, um, that can really suppress that voice. And so there’s a big correlation there. So I did some of that work, um, with him. And you know, people can also, if they’re interested in that they can get the audio book and the workbook. Um, it’s very inexpensive and there’s a lot of great information with that.

Dr. Justin Marchegiani: I think we really touched upon some really excellent concepts. He really connected the dots here. Great clinical experience or feedback with the antibody increase with the glandular support. Is there anything else you know, that you want to highlight here for the listeners that you think is extra valuable you want to add?

Inna Topiler: You know, I think what I would want to add is, you know, for people that are watching, listening to this, that have health issues, you really want to make sure that you have the right mindset. Um, because when we look at people that get better, those that have a positive outlook and a mindset that they can figure out the answers and then they can heal, do better than people that are unsure. And of course for a lot of people it has been a long road and you guys may have dealt with a lot of stuff and may have gone to many doctors that perhaps were not helpful. And sometimes it is hard to keep the face if you’ve hit a lot of roadblocks and walls along the way. But if there is a way to just really believe that you can, um, because the answers are out there and there is hope, um, you know, we just have to have that notion that it is possible because it is, you know, usually if you’re experiencing a health issue, there is some type of a reason behind it. Like, things don’t just happen out of nowhere. Sometimes we don’t know what it is and we have to test and dig. Um, but if you can have that knowing that the answers are out there because they are, it’s gonna help you in healing.

Dr. Justin Marchegiani: I 100% agree when you’re in pain, right? Pay attention inside. Now that’s the acronym. So it’s always, instead of looking out, look in. So that’s really good feedback, you know, where can the listeners find more about you and what you do and the information that you produce and provide?

Inna Topiler: Absolutely. So I actually just recently launched a podcast. It’s Health Mystery Solves, and we had a great interview that went live a couple of weeks ago. So that’s a, you can subscribe on iTunes or it’s Um, I also have a virtual practice, complete nutritional I have lots of blogs, but I think probably the main thing is going to be the podcast because there’s new content every week.

Dr. Justin Marchegiani: That’s awesome. Yeah, I’m on the podcast, so everyone go over and listen to our interview was really great and thanks for this awesome information. Look forward to connecting with you again. So, you know, thanks so much.

Inna Topiler: Absolutely. You’re welcome. Bye Bye. Have a great day. Bye.


Audio Podcast:

Improving Gallbladder Function with Functional Medicine | Podcast #216

Digesting fat is so important for one’s hormone growth and for healthy cell membranes as every single cell has a lipid bilayer. If one wants to be a good fat burner on a ketogenic template, it is really important to have great gallbladder function.

In today’s podcast, Evan Brand and Dr. Justin Marchegiani talk about utilizing functional medicine principles and assessment to figure out how one’s gallbladder is doing. Listen as they talk about what can one do about it, the common gallbladder symptoms, root cause solutions, and how can one get better from these symptoms. Stay tuned for more!Evan Brand

Evan Brand

In this episode, we cover:

00:35    What is Gallbladder?

04:47    Consistency of Chewing Foods

08:16    Bile Surgeries

14:18    Autoimmune Issues that Affect Gallbladder

17:28    The 3 F’s of Gallbladder Issues

20:26    Some Advises if Your Gallbladder was Removed

26:32    Comprehensive Stool Test


Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani, welcome to today’s podcast. We’re gonna be talking about utilizing functional medicine principles and assessment to figure out how your gallbladder is doing. Also talking about what we can do about it, what are the gut- what are the common gallbladder symptoms, what are root cause solutions, and how we can get you better. We know, digesting fat is so important for your hormone growth, for healthy cell membranes. Every single cell has a lipid bilayer. And also, if you wanna be a good fat burner on a ketogenic template, it’s a really important we have great gallbladder function. So Evan, welcome to today’s podcast, man!

Evan Brand: Hey man, thanks for having me.

Dr. Justin Marchegiani: Awesome. Well, let’s dive in brother. I’m excited to- to dive in. So, first off, let’s just first dive in just to kinda physiology 101: what is the gallbladder? Why is it even so important? So, off the bat, gallbladder is kinda in this upper right quadrant here just beneath the rib cage, ‘kay? If it’s tender in that area like they’ll do a- a palpation that’s called Murphy sign, uhm, in that area where they’ll look for tender type of gallbladder issue where the gallbladder’s inflamed. But the gallbladder, it- it basically concentrates bile at about a 15 times above than the common hepatic bile duct in the liver wood. So when you’re having your gallbladder removed, that common hepatic bile duct up in the liver just drips bile all the time, it’s not specific, it’s not during a fatty meal, just kinda hits, and you can definitely have some bile acid diarrhea issues. When you have a gallbladder it concentrates that bile 15 times and then allows it to come out and time it, it- it squeezes, it contracts, and s- puts up that bile especially during a fatty meal ’cause you have these hormones in your stomach when that food- when that uhm, kind, that mixed up food in your stomach gets released into the small intestine. Uh, the nice acidity of that stimulates this uhm- neuropeptide called cholecystokinin or CCK for short. And that cause the- the gallbladder to contract and stimulate all these bile release which helps with fat digestion. If we don’t have a gallbladder, we’re not gonna be able to breakdown fat optimally through biliary concentration.

Evan Brand: Yup. So, you’re in to that fast, I’m just gonna repeat it so it gets into some people’s heads.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: So, you say, when your- you put food down the hatch, especially fat, it enters the digestive tract, the body says “Okay, boom. There’s fat in here now, I’m gonna start making CCK”, and that comes from your duodenal, and I believe the jejunal as well, and then- it- to respond to the CCK, then the gallbladder goes “Oop, CCK is in the neighborhood, now I’m gonna release my stored bile because we’ve got fats to take care of”. So then the bile, or they call gall, will start working on these fats and then turning those fats into usable fuel.

Dr. Justin Marchegiani: Yeah, think of emulsification is like you have a greasy pan, and you put a drop of like soap, right, like some- some dish soap like dawn dish soap, and it kinda breaks it up, it emulsifies it. Think of that’s what’s happening if you got this greasy pan in your stomach, which is all the fat in your stomach going into your small intestine, that emulsifies it and allows your body to break it down and absorb it. It goes in these little things that form uhm- a- uh- a- a- a micelle, and that allow it to get into your body and be able to utilize it. Now, going up one kind of marker is hydrochloric acid levels. This is even important, this is more important because hydrochloric acid stimulates, it lowers the pH, and a nice low pH triggers cholecystokinin. So, we also need good pH function, good hydrochloric acid function and then that then, in the small intestine really gets the bile going, and then we also have some enzymes in the pancreas called lipolytic enzymes, lipase enzymes that also help with the pacre- with the- with the gallbladder in the- in the bile digestive process.

Evan Brand: Well, you make a good point, ’cause when we jump into this conversation, if we’ll look at the whole digestive cascade, as a big row of dominos, when you get to CCK and you get to the gallbladder, you’re really talking 3 or 4 dominos down the list but it’s good that you went upstream first to the mouth, where that’s where you’re chewing your food – hopefully you’re chewing your food, you’re not rushing through your meal. That’s why I don’t like things like chipotle, I enjoy the food itself, but it’s all soft, it’s mushy, meat and rice and guacamole, and you can just shove it down the hatch and you really have to chew the stuff. So, if I eat a soft meal, I still try to be very condescend about chewing, chewing, chewing, chewing, tellin’ the digestive system, “Hey, something’s coming down the hit- down the hatch”, but, you make the point about HCL. It’s why it’s so important when we- uh, talking about gallbladder symptoms which we’re getting to in a minute, to look for, and to treat if you have them, H-Pylori, and other infections ’cause, if H-Pylori is reducing your HCL levels, well, you can’t go straight to the gallbladder. I mean, you- you can, you can take bile salts to help it, but you didn’t fix the root cause, it was H-Pylori.

Dr. Justin Marchegiani: Exactly. So, kinda highlighting, we went from the gallbladder. What’s happening at the gallbladder, upstream to HCL, and that- that also activates other enzymes in the stomach called pepsin, and also gets the pancreas producing lipolytic fat breaking down enzymes, and then proteolytic protein breaking down fat enzyme, it’s- it’s very rare that you just have fat by itself, typically fat, protein and cholesterol tend to come together. And then, up one stream above is the chewing part. We wanna make sure we’re chewing our food at least 32 times, that’s about one chew per tooth, right, you have 32 teeth, so think of 32 chews, 32 teeth. And in general, getting your food’s to like an oatmeal like consistency, like- if you’re having a food that’s kind of more predigested like a chipotle meal, you gotta just make sure you at least chew to that good oatmeal-like consistency, and try to be in a relatively stress-free environment because the parasympathetic nervous system is really important for HCL secretion, thus enzyme secretion, and thus, uhm- bile secretion because we need that nice acidity, we need the enzymes, we need the digestive secretion. And for a sympathetic state, all that blood flow is going out extremities, our arms and our feet to run, fight and flee. So, it’s very important that we have good parasympathetic, so good breathing, gratitude, being in a quiet kind of relaxed setting to start our digestive processes.

Evan Brand: You know, I was trying to find some research on this, I am just gonna guess based on the mechanisms we discussed, that people on acid blocking medications probably have more issues with gallbladder. Would that make sense, ’cause let’s say you don’t have H-Pylori infection but you’re on an acid-blocking drug, isn’t that gonna just down-regulate this whole process we’re talking about?

Dr. Justin Marchegiani: Yeah, we need good acidity to trigger that CCK. So, that totally makes sense, right? And then we need- to be able to break down god fats. What are good fats? Well, we have our mono unsaturated fats are gonna be things like olive oil, avocado oil, and then maybe even some nuts and seeds. We have more saturated fats which are gonna be animal products, right? Grass-fed beef, uhm- any of our like, you know, fish, chicken, beef stuff, you’re gonna have omega-3 fats which are on the polyunsaturated category. Omega-3 is more polyunsaturated, and then you also have your saturated coconut oil which I think is your only plant fat that’s saturated, maybe that and palm I think are the only 2 big saturated ones that are plant-based. So, we have our saturated fats, right? Coconut, plant-based fat- coconut, and animal-based fats. We have our mono-unsaturated which typically are gonna be uh- a lot of the olive oil, potentially avocado oil, we have our polyunsaturated, a lot of times which are fish, and then maybe some of the nuts and seeds kind of fit into that monounsaturated category omega-6 kind of category as well. And then we have our uhm- Vitamins-A, D, E and K, “ADEK”, these our fat-soluble vitamins. So if we don’t have good bile-support, we’re not gonna be able to break fat down by the minute which is really good for our uhm thyroid function, it’s good for our skin, right? Higher dose Vitamin-A is great for skin that’s why they use uhm- Accutane which is- is a Vitamin-A analog to shrink the oil cells on the skin, also great for our eyes. Vitamin-D obviously great for our immune system, we make it too from the sun. Vitamin-E is great for our heart, it’s a natural antioxidizing, great for inflammation. Vitamin-K is really good is found in butter fat. It helps get calcium into our bone, right? Vitamin-K2, consider activated- a- activated X by western price, really important nutrients. So, these fat-soluble vitamins, we really need good gallbladder function to absorb them.

Evan Brand: Yeah, and if you don’t have a gallbladder, we’ll get into that in a minute, you know, I was just looking up, uh- reading the bile, the surgeries that people get. When you get into the gallbladder world, gallbladder surgery is just such a huge, huge money maker and it’s done often times in cases where it didn’t have to be done. And I told you we need to get a lady on whose uh, got a specific website about protocols for people with gallstones to try to help give them relief and to save their gallbladder. But another surgery which is crazy to me is called fundo- fundoplication, and it’s what they do to relieve chronic acid reflux. The surgeon tries to recreate your lower esophageal sphincter, by taking the upper portion of your stomach and wrapping it around the lower part of your esophagus and sewing it into place.

Dr. Justin Marchegiani: Wow.

Evan Brand: That just seems insane to me, they call it anti reflux surgery. How many of those people, just have H-Pylori infections that were put on acid blockers, therefore that LAS, that lower esophageal sphincter wasn’t working properly, or maybe they had a mineral deficient or maybe it was a ___[09:18] issue and structurally, that could get adjusted, but instead, they go get their stomach wrapped around their esophagus and sewing together. That’s insane!

Dr. Justin Marchegiani: It really is, and that’s kinda what conventional medicine does. They can go to some extremes to fix things that in my opinion are much more foundational and much more simple. And most of the time I would say 99% of the time, the surgeries aren’t root cause, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So if we look at the conventional side, we have things like a HIDA scan which is like a nuclear image, they swallow s- solution that’s nuclear, and uhm- they kind see kind of biliary function, right? You want typically a 33 to 40 percent kind of dejection fraction that’s normal, on the gallbladder. So, you can look at that with the HIDA scan, you can even look at, an ultrasound, uhm, to give you a window of the inflammation in the gallbladder. It’s not gonna give you how much uh, bile is flowing to the duct but at least give you- okay it- it- is there- is it stagnant, or just stuffed in there, is it inflamed. You can kind of get that sense as well. A lot of times they’ll do some conventional testing, ’cause if your gallbladder is inflamed, and there’s an immune response, you may see white blood cells uh- on the higher side, right? Uhm, you may also see certain liver enzymes, ALT is a common liver enzyme, AST is another enzyme that can be effective in the skeletal muscle, you can see GGT, think of the “G” in gallbladder, GGT is a big gallbladder enzyme. Bilirubin is a byproduct of red blood cell metabolism that comes out in the gallbladder. With high bilirubin, we may have some- some backed up gallbladder bile issues. And then a- also, I think alkaline phosphatase is another big one that we may see on the higher side. So, we’re gonna see bilirubin on the higher side, alkaline phosphatase on the higher side, and then we’re also gonna see potential HIDA scan issues, that can- those are- HIDA scans more like pathological.

Evan Brand: Yep.

Dr. Justin Marchegiani: There are a lot of people that are in between that may be okay on the ultrasound or maybe okay on the HIDA scan and we can use some of this functional test as well. Uhm, but really important we gotta dig to the root, underlying issue on what’s going on there. And again, AST is more skeletal muscle but there’s some crossover with the liver, ALT is more liver. Think of the “L” in ALT as liver and then the alkaline phosphatate is a big gallbladder one, also a big one for zinc. Alanine transferase or ALT, asphotate transferase, and then alkaline phosphatase for ALP.

Evan Brand: Well, the good thing is, a lot of the blood markers you just mentioned are pretty standard. So, even if you’re not working with the functional medicine practitioner like one of us, you may be able to get your doctor to just run these labs, refer back to this podcast and look and see if you have an elevation. Now, the only problem is, the conventional reference range for blood testing is very bad. So, you may be quote, “normal” by your doctored standards but our reference ranges maybe tighter. So if we start to seal your ALT or your AST enzymes go up, it may not be up enough to flagged. So, that’s why it takes a trained eye to look at these numbers and see, and we’ve seen it time and time again, we get somebody on gallbladder supplements their AST and ALT go down. So, it’s amazing to see, we gave this nutrient, “boom” look at the blood changing just based on this nutrients, it’s really cool. Let’s talk about symptoms now, I think we’ve given a good-

Dr. Justin Marchegiani: Yeah, just to highlight one thing, you just wanna get that CBC done at- which is a complete blood count, and then also a CMP – Comprehensive Metabloc Panel profile, and it’s important, you need to work with a good functional doc because you may be okay in a lot of these areas and you still may have issues, so now what, right? So you don’t wanna just rule it out ’cause some of these testing are good, you wanna look at subjective symptoms, connected to the anatomy, connected to how your stools look, right? If we have fatty stools, blond stools, excessive amount of wipes to clean out your- you know, to clean yourself after going number 2 or just, you get skin marks on the toilet seat, we’re probably not breaking down fat. And again, if you have too much MCT oil in the morning, that can also do a tube instead as a laxative effect. So, you gotta look at it the trend in general, clinical symptoms, subjective symptoms, and then lab symptoms to really make a complete picture of what’s going on.

Evan Brand: That’s a good point ’cause my AST and my ALT on my blood looked perfectly fine. But when I had parasite infections, I had that low right side pain under my rib cage where my gallbladder and liver are. Your gallbladder is kinda tucked in with your liver under there, so if you look down at yourself on your right side up where that rib cage, if you’re having pain there, when I had parasites, I had ton of pain there, my blood looked perfectly fine. So I don’t want, like you said, you don’t wanna give a- a false sense of hope just ’cause your blood looks okay. There may be other functional problems that you’ll find by looking at stool testing for example. But let’s hit- let’s hit-

Dr. Justin Marchegiani: Yes.

Evan Brand: -on these symptoms, because you mentioned some but we needed just go through symptoms here and tell people, “okay, what would you be experiencing?”.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: So, you mentioned, fatty, greasy stools-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: You mentioned it takes a lot of wipes to clean your butt, you mentioned the skid marks in the toilet which if everybody is going on a high-fed diet these days, sure, that may be okay but if you’ve got gallbladder problems to start and then you try to go on to ketogenic diet and you don’t feel well or you don’t lose weight and you’re complaining to your doctor, that may be the part of the problem is gallbladder.

Dr. Justin Marchegiani: 100%. Also, autoimmune issues can affect the gallbladder as well. Gluten’s a big one, it creates those condition called primary biliary- what’s that last?

Evan Brand: I think you call it cholangitis.

Dr. Justin Marchegiani: Yeah, primary biliary cholangitis. I mean, typically just “PBC” for short. But basically you can have some scla- scarring of this uhm- on the- the kind of biliary tubes that go out of the gallbladder, and as well as the- you know, the gut- the liver goes to the gallbladder, the gallbladder kind of comes out together with the pancreas and comes out the sphincter of oddi, or the hepato biliary kind of ampulla, and that- that can kind of scar and it can sclerose, it can kind of have uhm narrowing of the- of that vasculature. Of course, it can back up, and if that backs up, and those enzymes can’t get out you can have pancreatitis as well. But that’s an autoimmune condition where your body is attacking a lot of that tubing that goes up to the gallbladder and maybe even can help with the pancreas, and that can narrow and prevent a lot of that stuff from coming out. So of course, gluten is a big component because that can really activate a lot of au- autoimmunity and you can also have a leaky gut, you can also have a leaky gallbladder which does aggravates more autoimmune attack because things that shouldn’t be out in the bloodstream are out and that exacerbates the immune system going after it.

Evan Brand: Yeah, so let me just read a few sentences on these whole PBC thing ’cause I think this is critical. We know, even just this is just standard you know, medical textbook stuff that says “it’s the most common among women”. And we know that Hashimoto’s is more common in women and men. So it says here, “the cause is not clear but we know it’s more common in people with…” guess what, “…hashimoto’s thyroiditis”.

Dr. Justin Marchegiani: Yes.

Evan Brand: So, it says here, “An autoimmune cause is- is thought possible because more than 95% of people with PBC have certain abnormal antibodies in their blood. These antibodies attack mitochondria. What triggers these attack is unknown…”, of course they say that but it may be exposure to a virus or toxic substance A.K.A. ‘gluten’, maybe dairy, I mean, you and I talk so much auto about- about autoimmunity so I’m glad that your brought this up because, you know, these people may have these symptoms, and they’re not gonna know what’s autoimmune in nature, they may just get the- the knife and say, “Hey, we’ve gotta pull this gallbladder out”. Not necessarily, what if we can shut down this autoimmune attack?

Dr. Justin Marchegiani: 100%. Also, here’s the bigger issue too. Okay, great, the gallbladder is removed, your digestion is now forever altered. I’ve yet to meet a conventional patient of a gallbladder procedure, whether surgeons that “oh, by the way, you’re gonna have to add in HCl, pro- or- lipolytic enzymes and bile salts for the rest of your life”. I’ve never really heard that, at least bile salts seem to be added in. I would say HCl and enzymes too, but I’ve never heard someone do that. Now, your digestion is forever altered, do you think there’s a connection with now you’re not being to breakdown cholesterol optimally ’cause that’s gonna be in the bile, right? The bile is 97% water, then you have some cholesterol, and cholesterol salts as well, and you also have some toxins coming out, that’s why if you have uhm- poor, you know, gallbladder-emptying, then you’re not getting rid of potential toxins that are in there too. So, we gotta be emptying that gallbladder. If we’re not breaking down Vitamin A, D, E, and K, if we’re not breaking down our fat-soluble vitamins, which I just mentioned, if we’re not breaking down cholesterol which is the building block for all of our hormones, do you think we’re gonna have problems ladies, uh- as you get into your 40’s and 50’s, with menopausal issues, perimenopausal issues, PMS, and we know the main connection, it’s kind of a slang but, I’ve heard many uhm- let’s just say general surgeons say it, it’s the 3 ‘F’s’ of gallbladder issues: fat, female and forty. And that’s the time to- late 40’s, early 50’s where hormonal transitions happen, and if you can’t breakdown those nutrients, you are setup for a menopause uh- of “hell”, so to speak.

Evan Brand: Yeah, in terms of side-effects, possible side effects of gallbladder remover- removal, it could be anything from pancreatitis, to increased risk of choline cancer to increased digestive sy- symptoms like heartburn, could be constipation. So, we’ve seen people that- they don’t feel well, after they get the gallbladder removed. And uh, like you said, there’s no surgeon out there saying, “Hey, I’m gonna put you on this comprehensive digestive support protocol, after we remove it”, no, they’re gonna you out with anesthesia, cut that bad boy out, and send you home in a day or 2. Uh, there’s a- a whole lists symptoms here I’m looking at now, symptoms of- uh- symptoms after gallbladder removal. I’ve had women have gallbladder attacks, but they don’t have a gallbladder. You know, it’s like, “well, how the heck does that happen?”. So, you know, the- the- the removal is not the “cure all”. Anything from nausea to gas and bloating, distension, burping, belching, feelings of fullness, heartburn, barrett esophagus, diarrhea, dumping syndrome, weight gain. There’s a whole article here all about post gallbladder removal weight gain happening.

Dr. Justin Marchegiani: And part of the reason why women get targeted so much – I hate to say it – is the estrogen. The estrogen kind of makes things sluggish and slow, it kinda takes- it kinda makes it turn into molasses. So, things really are very sluggish, very viscous, and of course, that can affect gallbladder and bile flow. Women that are on, you know, uh, birth control pills, that’s gonna- in- obviously increase estrogen levels, obviously just being stressed, right? You’re gonna take your progesterone, you’re gonna shoot it downstream to cortisol, and that’s gonna basically cause estrogen dominance there because you’re already starting to lower progesterone in relationship to estrogen. You’re getting estrogen in the environment from the conventional meat products, uh, water, plastics, chemicals, hormones in the meats as well, and then you’re also gonna be just getting it, just from uhm- being a woman, having 10 times more estrogen than a man. So, you’re- you’re already predisposed, and then when you add stress to it, it’s going to exacerbate it uh, big times. So, you really wanna make sure that you’re fixing the- like if you’re having- if you know you have a gallbladder issue, you also need to be going after the- the hormonal issues as well. And then we can dive deeper into the food allergies stuff too, so you gotta go after the hormones, gotta make sure you fixed the estrogen dominance, you gotta make sure you fix the digestive aspects, and then we can go into foods later.

Evan Brand: Well, I’m sure there’s gonna be a ton of people that are just yelling at us right now through they’re podcast app or YouTube or wherever they’re listening to us, and they’re saying, “Well, this is not fair, I already have my gallbladder removed, so what the heck do I do now?”. So, do you wanna address that now or should we talk about that later?

Dr. Justin Marchegiani: Yeah, so, off the bat, the underlying mechanism that was driving that inflammation in the body’s still there. Just the end target, the end uh manifestation of it is removed, but now other tissues may start to, uh, have issues, then also if you don’t fix the underlying uhm, digestive im- impediment which is, your fat-soluble vitamins, your cholesterol, your hormone building blocks are now gonna be thwarted in their digestive processes. So, you have to fix that to prevent compounding hormonal issues, 10, 20, 30 years later, number 1. Uhm, and then so obviously this- so- err- if you’re- if you still have your gallbladder, we wanna keep it by doing a lot of the preventative things. But on the food side, I outlined this in a couple of my gallbladder videos are down in the past. But there’s some common foods that are even uhm- let’s just say paleo-approved, but should probably be looked at- look at removing. So, of course we have the refined sugar in the guts. That’s kind of a no-brainer right here. But, uhm, in order of kind of like uhm, the most likely offender are gonna be eggs.

Evan Brand: Yes.

Dr. Justin Marchegiani: So definitely autoimmune template, cut out the eggs, pork, onions, chicken turkey, milk, coffee, corns, beans, nuts, apples, tomatoes, peas, cabbage, spices, peanuts, fish, rye. I’m gonna link my article that goes into this. So, everyone’s probably like, “Say it again!”, no, I’ll put the link below, don’t worry, take a look at the article, alright? But, I have them in most likely to offend to least. So, if you’re overwhelmed after hearing that like, “What the hell am I gonna eat?”. Just start with the biggest 3 or 5, or look at that list and say, “What are the biggest 3 or 5 that I eat on a daily or weekly basis” and just pull that out. Once we get the inflammation under control, we support HCl, we support enzymes, we support bile salt production, we look at the gut ’cause sometimes there can be infections like H-Pylori and giardia, and of course SIBO in and around that ___[22:31] that can exacerbate everything too. So, we get the infections clear, if we get the acidity and the enzymes dialed in, if we cut out some of the common offending foods, we may be able to start adding some of these foods in overtime. But I find pork’s a big one, eggs are a big one, those are like my- my 2 biggest right there off the bat, and they’re kind of paleo-friendly too.

Evan Brand: Yeah, eggs are huge and people over-eat them and, if you have gallbladder issues, uh- when I interviewed Ann Louise Gittleman, she said the same thing, she said eggs are the biggest offender. I’m like, “Wow, I thought that was just me”, no, it’s- it’s a real thing, and then also onion. I think she said onion are ready-

Dr. Justin Marchegiani: Yes.

Evan Brand: But that was- that was a problem for me when I  had parasites and I would try to do like stir or fry and throw some onion in there, I’d end up with that lower right side stomach pain, I’m like, “What the heck is it”, or if it was I had parasite infections but, the other- the other part of it was the onion. So, yeah, I at least temporarily, like you said going on an autoimmune protocol while you’re working with your practitioner to fix the other underlying causes, you’re gonna be in good shape if you do that.

Dr. Justin Marchegiani: Onions are also a ___[23:28] too. So there could be some underlying SIBO or small intestinal bacterial overgrowth going on as well. So, you gotta look deeper at everything. So, kinda like piggy-backing everything, alright? Women are gonna be the- more bigger offenders ’cause of the hormones, because of the- you know, the pregnancy prevention with the birth-control pill, so you have that, right? So we gotta fix the hormones, fix the hormones, number 2, cut out the foods, at least paleo to autoimmune paleo with those additional 3 to 5 to 8 foods I just mentioned. Get enzymes dialed in, get acids dialed in, and definitely bile salts added in, and if you already had your gallbladder removed, definitely do all 3, and those that up and watch your stools and make sure your stools go floating to sinking, right? Oil and water mix, so if you had the stool, with the whole bunch of undigested fat, and oil and water mix, the stools stay on top of the water, they don’t sink. So, you wanna see the stools sink, and ideally you wanna be able to clean yourself, you know, 3 to 5 wipes on average, and you wanna make sure when you flush, you’re not seeing big skid marks all the time. If you’re doing some MCT oil in your coffee there may be some issues there, too much of that can cause some undigested MCT, so be mindful of that. So, foods, acid, enzyme, bile salts, get the infections cleared, and if you’re a woman, get the estrogen dominance fixed, get the hormones balanced.

Evan Brand: Yup, and, how can you do that from a testing perspective, we mentioned the blood, but I’ll just throw a few other components of this in. Number 1 is the stool test, so we’re always gonna be running a PCR stool panel, or gonna be looking for all this. As you mentioned, we’re gonna look at H-Pylori, we’re gonna look for giardia, we’re gonna look for cryptosporidium, blastocystis hominis, there’s a ton of different bugs, there’s worms, there’s parasites, there’s bacterial overgrowth we look at, there’s candida that we look at, that’s all done with the combination of  stool and urine testing. And on the stool, there’s a couple markers that we can track, obviously, you looking in the toilet is gonna be the best way to track. Well, we like numbers, you know, Justin and I like data. So, when we look at steatocrit, which is a fecal fat marker that usually is expressed as a percentage. I like to see it, you know, 10% or below, we’ll see some clients, they’re 30, 35, 40 percent steatocrit, that means they’re not digesting their fats at all, and they while I’m doing a ketogenic diet and I feel like crap, it’s ’cause they’re not digesting anything.

Dr. Justin Marchegiani: That’s it.

Evan Brand: So, we gotta get that steatocrit down, and how you do that, well, one, clear the bugs too, supplement, and then, what was the other part of my brain? The blood, we talked about the blood, we talked about the stool, oh, the beta glucuronidase. So, beta glucuronidase at enzyme on the stool test we look at, that enzyme gets messed up due to bacterial overgrowth. When we see the enzyme is high, that’s when the estrogen dominance probably becomes more problem- problematic because now, they’re re-circulating the hormones. So, we do some like a calcium d-glucarate or a DIM, or something else, maybe a broccoli seed extract to try to get, or could be probiotics, could just be clearing bugs, taking care of the SIBO, the glucuronidase goes back down, and now all these quote, “estrogen-dominance symptoms” just disappear, and it’s really fun to see that.

Dr. Justin Marchegiani: 100%. So, kinda highlighting the test again, look at your symptoms, if you have pain in the upper right quadrant, under the rib cage, if you have problems breaking down fat, if you’re seeing a lot of your fat, your stool sinking or floating on top, not sinking. If we run a ho- comprehensive stool test and we see a lot of uhm, steatocrit, undigested stool, we see that greater than 10 or 15, whatever that lab marker is right in that area, we got problems, and then we gotta dig in deeper, and this could be the reason why you have hormonal issues too so we have to highlight that. Is there anything else in this topic Evan that you wanna go into that we haven’t gone in deep enough?

Evan Brand: I don’t think so, I would just tell people that if you feel discouraged, or, you know, you’re facing surgical removal of your gallbladder, I’m not saying the gallbladder can always be saved. I have a friend of mine, she’s in her late 50’s, maybe early 60’s at this point, and she was having major, major gallbladder pain, and I told her about taking digestive enzymes, but the pain just continue to grow. So, you know, I said hey, you might have to, you know, go to a doctor and get this checked out. This is very recent, so she did. And her gallbladder function was basically nothing, and she went in and she had to get surgical removal and because of with so much inflamed tissue around her gallbladder they couldn’t do the- the- the uh, laparoscopy, where they just give you a small- a small uh surgical side, they had to really cut her open like 6 to 8 inches, they hadn’t take out the gallbladder, and the surgeon told her, that her gallbladder was so heavy, full of stones that it felt like a concrete block. He said there was no way you were gonna save this gallbladder. So, I think there is a point of no return, where surgical removal does happen, we’re not shaming anybody or making fun of anybody if you got your gallbladder removed, that sucks, like she had to get it out, there was no turning back. And now, you know, she’s got tubes coming out of her stomach to drain her bile until she recovers from the surgery. So, obviously, that’s an extreme case but man, uh, you know, it can- it can get to a point where surgery is the only option but we’re just trying to help you before you get to that point.

Dr. Justin Marchegiani: Yeah, so if we don’t have enough, if you don’t eat good fats, then we don’t have good gallbladder flow, then, what happens is, it’s like not changing the oil. A lot of that bile uhm, and that cholesterol can crystalize. And then overtime those crystals can- can produce more and more crystals. And then imagine these little crystals that are like- a little mini or- miniature-like porcupines. And imagine that gallbladder contracting, it’s like giving a- a big porcupine a nice hug, right? Probably not the best thing. So, that can create a lot of inflammation, and the more little porcupine you’re having your gallbladder, the bigger issue every time you have fat that contracts. And then also, we can have potential pancreatitis because of it ’cause those gallstones can eventually produce, can block the bile flow, and that can stop pancreatic enzymes from flowing into the small intestines. So, that can create more inflammation. So, the more this thing, err- there’s more of this issue, the underlying cause goes unaddressed, the more the inflammation accumulates, accumulates, accumulates, accumulates, there may be a drastic solution of cutting out the gallbladder. Now, I would say, the vast majority of the time, it can be saved. We have to make the food changes, uhm, we also do a lot of gallbladder bile support, we’ll also use things like phosphatidylcholine, we’ll do beet root powder, we’ll do taurine, we’ll do dandelion, we’ll do artichoke, French trees, or herbs that’re designed to help to help one thin out bile flow, they can smooth out the little crystals, so imagine like kinda coming in there and smoothing out all the little porcupine barbs. Uh, that way they aren’t as sharp, and then we can be very careful with our fat consumption, maybe we do the tiniest amount possible. A lot of the coconut fats are easier to process and digest. So, maybe we’ll do more coconut fat, we’ll just do- just the- the largest amount of fat we can handle without issues, we up the enzymes, we up the bile salts, and then we give a lot of those herbs to smooth out the bile flow, thin out the bile, and smooth down the crystals. We’ll even do some- some like extra phosphorus drops to even thin out the bile uhm stones as well.

Evan Brand: Yeah, I do beet powder every day. You know, part of that for my circulation issues dues to all the mold in my body, so- so the beet powder’s been really helping. But, you know, back to my friend, you know, she was, she’s a woman, she’s over age 40, she does have excess weight, you know, she is overweight, she is very sedentary, uh, she did have some familiar health issues as well, you know, any- any family history of uhm- diabetes, other type issues like that can- can increase the risk of gallstones which then increase the risk of these problems, so, if you were to take all of the things you don’t wanna be sedentary, you know, overweight, uh, etc., poor diet, she had all those things against her. So, I’m not gonna- I’m not saying that everyone’s gonna end up like that with her case which is extreme but, you know, I just wanted to point out, hey, sometimes there may need to be a surgical removal. But, we just- we wanna try to prevent that. Statistics I found say there is about uh- 3 quarters of a million surgeries every year for gallbladders.

Dr. Justin Marchegiani: Exactly. Then we kinda talked about, our women- right- our- our fat, 40 and female. The big issue is, estrogen is a big uhm cause of kind of making the- the gall uhm, making the bile more sludgy, so is insulin. So, insulin is also another stimulating factor, this is part about I think where the fat comes in there, because the more weight you have typically is more insulin-resistance, insulin’s that hormone that sticks sugar into the cell, converts it to fat, so if you have more insulin, that’s a greater likelihood of making the bile flow more sludgy. So, if you have high levels of insulin, that’s gonna slow up the bile flow, and then if we have uhm, high levels of estrogen or just estrogen dominance, that’s gonna sludge up the bile flow as well.

Evan Brand: Yup. I’m sure we could keep going on this topic all day but, we should probably wrap it up. Reach out if you do need help, you can go to, and Justin’s summit is coming up very-very darn soon. So, I don’t know when you’re listening to this, if you listen to it in the future, and you already missed out, well, you can purchase his summit, but if you’re listening to it ahead of time, his summit is going live very soon, in two weeks at the first week of March. So, go to Go register for Justin’s event, it’s gonna be awesome, I interviewed him, which I thought was probably one of the best interviews possible, and interviewed me, and I talked about some other stuff that he hadn’t talked about. So make sure-

Dr. Justin Marchegiani: [Crosstalk] …interviews too.

Evan Brand: Thank you, thank you [crosstalk].

Dr. Justin Marchegiani: …for sure.

Evan Brand: So, so go register, uh, it’s- it’s gonna be probably one of the biggest events of the year called Thyroid Reset Summit. So,, go check it out and to run through health talks which is like the apple of summits, they do a great job of putting things on, and there’s, I don’t know what, 30 other experts on there. So-

Dr. Justin Marchegiani: 30 great experts. And also, I’m giving way the first uh- 3 to 4 chapters of my new book coming out, the thyroid reset. That book will be coming out in the next uh, few months here, so, get your free intro copy and then I really appreciate you guys picking up the book as well. Get me up there on the Amazon ranking so we can help more people, I appreciate it. And also, just to finish with this uh, article, here, the uhm conclusion, very important here for gallbladder issues, just to tight home, repeat yourselves a lot because repetitions some other skill, here’s the conclusion, insulin resistance is a risk factor for the incidence of gallbladder sludge and stones during pregnancy and after. And then it says insulin resistance may represent a causal link between obesity, overweight and gallstones. So our big mechanisms here, just kind of- f- coming in full summaries, if you missed the whole entire podcast, if you get this one thing, you got it. High levels of insulin, increased gallbladder sludge. High levels of estrogen, or estrogen-dominance, increased gallbladder sludge. Inflammatory foods, right, that drive insulin and inflammatory foods that are paleo friendly like, pork, like onions, like eggs, like coffee, maybe an issue, and then of course the low HCl levels, uhm, the low-fat diet, uh, all of those things and eating in the stressed out environment, those are gonna be your big 3 or 4, then also infections, giardia, gluten-sensitivity, SIBO, all of those things are gonna drive, probably the big 5 factors. Infections, insulin, estrogen dominance, low HCl enzymes, and then hidden food allergens. Those are your big 5 factors of this gallbladder issue here.

Evan Brand: Yeah, well said. And I love my friend to death but my wife and I were driving in the parking lot the other day, and she’s- and- and then we see our friend who just got her gallbladder taken out, and she’s sitting in the Taco Bell Drive Thru, and I’m just like, “No, that’s exactly what got you in this problem in the first place”. So, the diet is so critical, you can’t skip it.

Dr. Justin Marchegiani: Hundred percent, excellent. And for anyone enjoying this, I’m gonna do another live Q&A here tonight, this at- you know, the very end of the day, probably around 5, 6 o’clock here central time. Make sure you subscribe to the YouTube channel, we do a lot of live Q&A. So, go to If you’re listening to the channel now, make sure you hit that bell, that gives you the notification. So, if you’re on your phone, it’ll pop-up as it ___[35:35] doing a live chat. Even if you’re not around for it, just your little- little question in. So, we do a live Q&A, it’s op-in question, if there’s a topic, keep your question to that topic, if it’s a podcast, we may or may not get to questions ’cause we kinda get in our flow state and uhm, we may just be really focused on our conversation.

Evan Brand: Take care.

Dr. Justin Marchegiani: Hey Evan, you have a good one, take care.

Evan Brand: You too, bye.

Dr. Justin Marchegiani: Bye everyone.




Skin Health and Autoimmunity | Podcast #202

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

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

Dr. Justin Marchegiani

In this episode, we cover:

01:00    Gut health mirror the skin

06:09    Administer nutrients inside-out

11:02    Topical irritants

15:27    Bowel movement affects skin health

17:48    Histamine issues, genetics, and excessive insulin

20:38    Autoimmune domino effect


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

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

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

Evan Brand: This is huge!

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

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

Dr. Justin Marchegiani: Yeah.

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

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

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

Dr. Justin Marchegiani: Uh-huh.

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

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

Evan Brand: Oh my gosh.

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

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

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

Evan Brand: Yeah.

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

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

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

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

Dr. Justin Marchegiani: Oh my gosh!

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

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

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

Dr. Justin Marchegiani: Uh-huh.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: A different branding, okay.

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

Evan Brand: Yeah.

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

Evan Brand: You gotta poop folks.

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

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

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

Evan Brand: Oh yeah.

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

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

Dr. Justin Marchegiani: A hundred percent.

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

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

Evan Brand: Okay, okay.

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

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

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

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

Dr. Justin Marchegiani: The genetics.

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

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

Evan Brand: Ahh.

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

Evan Brand: Yes.

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

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

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

Evan Brand: Yup, well said.

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

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

Dr. Justin Marchegiani: What happened?

Evan Brand: She passed away a few weeks ago.

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

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: Yeah, yeah.

Dr. Justin Marchegiani: That’s really sad.

Evan Brand: Uh– it was breast–

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

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

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

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

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

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

Dr. Justin Marchegiani: Yeah. Absolutely.

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

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

Evan Brand: I didn’t see any.

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

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

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

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care


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

Creating a Healthy Home | Podcast #201

We all care so much about the sense of wellness around our home. But sometimes no matter the cleaning that we do, we wonder why we still feel not comfy, and healthy. Chances are, we’re missing out important details – details on molecular levels.

Today’s podcast talks about molds, air filters, the scents that we wear, even the healthiness of waters we drink. Watch this video as Dr. J and Evan Brand give us the geeky advice in creating a healthy home.

Dr. Justin Marchegiani

In this episode, we cover:

01:15    Mold Issues

02:41    Air Filters and Paints

14:30    Bug Sprays

16:49    Chemicals in Water

20:02    Air Filter Systems

27:10    Enhancing Detoxification

32:23    All About Scents


Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani, Evan how we doing today my friend?

Evan Brand: Life is good! Look, it’s like 88 degrees in October this is unreal in Kentucky everybody is like freekin‘ out, but– I’m loving every second of it.

Dr. Justin Marchegiani: Excellent man! Love to hear it. So, what’s going on? any other updates for me on the health front? Let’s cook ’em.

Evan Brand: Hmm… Not too much is cooking I’m still working on my course as you know our time these days is so valuable and limited that its– I had this idea in my head like I was gonna get this thing done by the fall and then here it’s comin’ out on the fall and I don’t have it done. So, I know we’ve chattered off here about our– our courses that we’re working on and we just have to make time to do it. But that’s my only update and in terms of projects everything else is just– stay busy with the clinic and us keeps spreading the– spreading the good word, I mean, we get so much good feedback that I know we’re on to something great and we need to keep goin’ until– I don’t know when, I– I don’t see an expiration date for– for– for when our hustle stops.

Dr. Justin Marchegiani: I hundred percent agree with that, that make sense to me. So, we chat about in the pre uh– show here that we wanna chat more about kind of healthy home, creating a healthy environment, air water and such, uh– in that realm so, why we don’t dive in? Go ahead.

Evan Brand: Yeah. So, the reason I– I brought this topic up is because I had a guy who– uh– came to me for his wife’s health issues and what he noticed is that everytime they left the house, her symptoms would get a little bit better. So, even if they went to the grocery store for an hour, if they went to their parent’s house for a night or two, you know his wife’s joint pain, her brain fall, her energy levels her symptoms would all change, it would get significantly better. We’re talkin’ 60-70% better just by leaving her house, okay. So, some would say well maybe that’s EMF, maybe that’s magnetic fields, maybe that’s charged electricity, maybe it’s this or that. And turns out it was a mold issue. And so they had mold in their basement that they weren’t aware of–

Dr. Justin Marchegiani: Uh huh…

Evan Brand: –and I guess that mold was circulating throughout the whole HVAC system they got a test on from the E– E as an Evan, M as in Mary, S as in Sam, L as in Larry. em–, they’re like the mold scientific laboratory. They got a test kit from them and the mold levels in their house were off the chart. And so they’re moving. Because they already had paid somebody to remediate and it didn’t work. So– they just decided to downsize anyway into a smaller house ’cause their house didn’t need the size than it was but now they’re moving, and so hopefully she gets better but man, this just goes to show you, no matter how perfect your supplement protocol is, if you got an environmental–

Dr. Justin Marchegiani: Uh huh…

Evan Brand: –issue, like molded home or other toxins in your home maybe bad paints or lead or whatever else, you can still be sick despite having a good supplement protocol and all the lab testing and all that.

Dr. Justin Marchegiani: Yeah, hundred percent agree. The couple things that I do with my home is I got a couple of different air filters. I have uh– an advance air– air filter I have uhm— an Air Doctor one as well as a Molekule. So, I have three different air filters and they work really well, keeping the environment good, I mean, for a while, I just didn’t need to even have an air filter in my office and I’m like, “Wait a minute, I’m in this– couple hundred square foot room like most of my life, like let’s make sure the air quality is phenomenals“. That’s one thing I’ve done in the last handful of months to upgrade some of the air filters, get more of them and, that’s made a big difference, I mean I definitely feel like uhm— I’m breathing cleaner air, uhm— you know, you’d walk into– your office and you kinda’ feel like “Hah! I just kinda feels a little bit, you know, just not fresh, you know, not super fresh and that’s really improved which I– I do enjoy that. And then of course, uhm— the water filtration aspects’ great, I mean I have a whole house water filtration set up, as well as a, under the counter reverse osmosis set up with a– a post filter that adds minerals back. And those are the two big things, getting the air right, and getting the water filtration right. I like the whole house, ’cause it takes care of everything, and if I’m in like, you know, upstairs, like in– don’t have to buy shower filters for all the showers like and, just drink out of the water in my– in my bedroom at night if I need to. But I typically, you know, ninety percent’s gonna be consumed through my under the counter reverse osmosis, and it’s doubly filtered right through the whole house and then through the countertop.

Evan Brand: Yeah, your hair, your– skin, your nails, I mean you can see a lot of like, physical improvements too. People say, “Well why is it so important to filter the air?”. Well we hit on like the mold piece, VOCs are another thing, the Air Doctor that you and I both use, uh– that does filter out– VOCs which is great so if you did for some reason have like a toxic paint that’s off-gassing, you can’t filter some of that. Now I would say it’s best if you can go in and use like a mineral-based paint. The one I use is called Romabio— R-O-M-A-B-I-O, they’re out of Georgia–

Dr. Justin Marchegiani: Ain’t that water-based though?

Evan Brand: oh, it’s potassium. It’s literally like ground-up potassium, and you mix it with water and then you paint it.

Dr. Justin Marchegiani: So it’s water-based

Evan Brand: I guess so, yeah ’cause you mix. It’s half and half.

Dr. Justin Marchegiani: Okay.

Evan Brand: You take this bucket they give you, you add water, and then you put it on.

Dr. Justin Marchegiani: Yeah, I mean it’s tough ’cause you go water-based, it definitely doesn’t quite last as long.

Evan Brand: Ahh.

Dr. Justin Marchegiani: The oil-based paints, they have a lot more VOCs but they get hard. They get really firm afterwards and it becomes more solid so its– you know, double-edged sword. We’re having some painting on this week so– guess what, we’ll be out of the house for the weekend, just we’re– goin’ on a family trip. So– when I’m gonna have my air filters crankin’ anyway and–

Evan Brand: What are you gonna, are you doing any– are you doin’ any special brand or what are you– what are you looking into for paint?

Dr. Justin Marchegiani: Oh I just use the standard Sherwin Williams uhm— because it– it works really well and it last long. Cause for me it’s like, there’s gonna be VOCs, but I’m just gonna run the air filtration and keep the windows open.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And I’m not gonna be in the house so– that way when I’m back, I’m good to go.

Evan Brand: And I don’t know, it’s like cause that stuff’s gonna off-gas after it’s dry, or do you think that the off-gassing is not as much?

Dr. Justin Marchegiani: No, it– it’s after 7 days, it’s– it’s done.

Evan Brand: Really?

Dr. Justin Marchegiani: But I mean having the air filtrations gonna– you now, mitigate it. Cause that, the air filtration will mitigate all the VOCs.

Evan Brand: True. I just was more paranoid than you so I just got the mineral-based stuff. It’s still on the walls so far but if it– if it fails then I’m– I may switch over to something else.

Dr. Justin Marchegiani: Well it depends like if you’re doing wall stuff, water-based paints’ fine. If you’re doing like cabinets, or things that are opening and closing, and getting wear and tear, that’s where you want like, an oil-based paint.

Evan Brand: Okay, we just did walls.

Dr. Justin Marchegiani: Yeah, so for like a harder door that’s being opening and– opening and close or cabinets, uh– for your walls I think water-based is probably fine cause you’re not– you know, there’s not wear and tear on the walls.

Evan Brand: Okay, okay, good point. So– so let’s go back to the water piece, you know, I was mentioning like hair skin, nails, you know, we have a lo– a lot of compliments from people that– that do start to filter their water, they’re like “Man! I didn’t know my– my hair would get better”. So for example my wife and I with her skin. In the winter time, we used to put on lotion all the time. Now, I never have to put on lotion. My skin is so much more– I would say regulated I guess with– with– the– the filtered water that we bathe in so I had to recommend it if you don’t have it already if you don’t want to invest in a whole house filter. They’re really not that expensive, they’re, you know– with plumbing, paying a plumber included, maybe a thousand bucks for your whole house. And the one I have from the Pelican System, it last for 5 years before you have to change it so– that’s pretty awesome. But if you don’t wanna do that, you technically could just get the shower filters. Justin and I have talked about different brands, the Berkey one is what I like, the Berkey shower filter. And it reduces I think like 98% of the chlorine and some of the other chemicals.

Dr. Justin Marchegiani: Got it, yeah, I mean I thi— I think those are gonna be, you know, very very important kind of things that you can do to help improve health. Now, I mean– with the air you mentioned we have the VOCs that we’re cuttin’ out, we’re also cutting out potential pet danders. Uh– wh– what else are we removing ___[07:20] the air filtration?

Evan Brand: Well, I think the Molekule – correct me if I’m wrong, cause you have one, I do not – is– I believe that thing kills viruses and bacteria too. I do remember reading something on their sales material about killing pathogen so, I mean, not that random people that are sick are coming into your house but if you’re concerned about living in– a place where– you’re– let’s just say you’re having people come in or out, or maybe you’ve got roommates or something, I’d like to have something that kills bacteria and viruses too, and I believe that system does. What about molds? Didn’t they say something about molds’ pores that it can kill too ’cause it’s like a Zepa instead of a Hepa filtration?

Dr. Justin Marchegiani: Yeah it has this– electrical component to it that– that actually kills a lot of the viruses and a lot of the compounds and it has the– the post-filter afterwards. So it has this component there using light where it kills a lot of these compounds and then it goes to the post-filter. So I mean that’s this interesting new technology so, you know, I have all three of these different kinds of filters. So I’m experimenting and trying them out but, I think it’s something that’s noteworthy; I think a lot of people are using it; also it looks really nice. I like it. It just really– it’s like a nice piece of furniture that sits in the corner and it’s taller and skinnier so– it doesn’t take up a lot of room. A lot of these air filters that look so steril and medical–

Evan Brand: Yes.

Dr. Justin Marchegiani: –where it’s like “Oh, man! It’s just appalling seeing it in the corner of your living room”. Uhm–

Evan Brand: [laughs]

Dr. Justin Marchegiani: But this new– I like this one. And the other ones, we just hide iin the corners in our bedrooms but this looks really great and it does filter out the viruses. There’s this uhm– this– this– light kind of compound to it that really makes a– a big– a big difference. So I mean–

Evan Brand: [interrupts] Okay. So I– [crosstalk]. I wanna chat about testing a little bit you know, people are like okay, “Is my home toxic?”, “what can I do to test?”. Well the – that’s a mold laboratory – I think they also do water testing as well. So just check out and you can actually order test kits from there. They have facilities all across the U.S. and maybe internationally, I’m not too sure on that part, but you can do a mold test. I believe what you do is you collect a bunch of dust, like let’s say on your dresser. You just scoop some dust into this, and you send it off, and they’re gonna let you know what the contents of that are. So that’s the first step in terms of testing. The second step is to test your body. Uh– Justin and I use a test from Great Plains, it’s very good called a MycoTox Panel and you can actually test for Ochratoxin and– Stachybotrys and all sorts of other potential pathogens that could have come from food but could also come from environment. And then also, we ran a panel called the GPL-Tox which is a chemical profile test done via urine, and we looked for certain chemicals. One that I look for all the time is Perchlorate. And Perchlorate, is– it’s– crazy how many people in Florida have this chemical off the charts because of rocket fuel. When you use rocket fuel, I guess Perchlorate is an ingredient in rocket fuel. So people that live Cape– where Cape Canaveral is, where they’re lau– launching a– rockets and such, the people that I– I’ve worked with near Cape Canaveral, their Perchlorate levels are off the charts. And on the lab, it says, it disrupts the Thyroid’s ability to produce hormones; and– you and I were looking at some research earlier, the mechanism of this is it’s inhibiting the iodine uptake. So it’s almost acting like fluoride or bromide what it sounds like. Well maybe it’s blocking this receptor and then iodine can’t do its job so– uh– that’s– that’s huge and– and– where this Perchlorate come from, well if it’s not from rockets then it’s from fertilizers, it could be coming from bleach, but then it’s also in your tap water. The good news is, some of the filtrations we talked about can actually filter out Perchlorate. So literally, every single day if you’re drinking your tap water at your house and the fridge filter does not count, because the fridge filter does not filter Perchlorate–

Dr. Justin Marchegiani: Exactly.

Evan Brand: And you’re cooking, let’s say like you’re doing some steamed broccoli, you put that water in there, that water is now coated all over in your steamed broccoli– that’s Perchlorate, and you could be eating little small bites of Perchlorate every day and you wonder why your thyroid doesn’t get better when you take thyroid supplements. So this is the level of– specificity you have to have in the modern world and I don’t get paralyzed by it, I mean you and I focused so much on action steps that– some people are like, “Oh my God the world’s so scary and dangerous”, but it’s like, there’s an action step associated with this though.

Dr. Justin Marchegiani: Yup, a hundred percent. So on the water side, you know, we just really wanna make sure at least and under the counter– slash countertop filter that– you know, that has a– a tank that can filter everything out really well. There’s a couple of cheaper options if we need as well. Of course, we can always go to a whole house which makes it even easier because in all rooms, and everywhere, and showers are taken care of as well. Uhm– there’s various air filters like I mentioned, the– the Molekule, they have– the– the Peugeot technology which is interesting. That’s the– the phyto-electrical– uhm— component one. That’s the newer technology that’s just come out in the last couple of years. So, with that, the Peugeot is the photoelectroche— electrical– electrochemical oxidation. And it– basically uses light to break some of these chemicals down. So it uses basically an oxide component and oxygen component. It creates C02 water trace elements as– as it reacts with the various virus or component and actually kills these things. So that’s kinda’ cool. And then we just have our basic Hepa Filter technology that just– is– you know, down to a 3-micron level that filters these components down, so we have that as well. Uhm–

Evan Brand: The reason it’s good that we also have the Air Doctor and we recommend you all get one too is because, that one filters down to .003 microns, so most Hepa systems especially something you wanna get at like Walmart or Target, filters down to 3 microns, but like car exhaust and diesel for example, a lot of these industrial pollutants, those are actually 2.5 microns in size, meaning that a 3 microns’ system won’t work. You’ve gotta go smaller, you’ve gotta get .003. So that’s the– that’s the specificity, you gotta pay attention to, cause if you go to Target and you get a Hepa filter for like a hundred bucks, yes it’s better than nothing but we want you to have no pollution, no car exhaust floating around in your bedroom.

Dr. Justin Marchegiani: Exactly. Yup, 100%. So, I mean, lookin’ at that, is there anything else you wanna talk about in the chemicals like the Perchlorate, I think it’s really powerful because that’s just the component like you mentioned with the rocket fuel that can kind of come in there and bind in and it– it– affect iodine, the uptake into the thyroid gland and iodine’s used to make thyroid hormone. Remember T-4, T stands for thyroxine, the 4 stands for the number of iodine molecules. And then you have this iodination process where all these iodine molecules are bound up. And then you have uhm— the enzymes, the ___ [13:40] uhm— comes in, pulls off an iodine and makes T-4 to T-3 which is your active thyroid hormone. So we need a healthy iodine but, you know, we also make– need to make sure that chemicals aren’t coming in and blocking the uptake. And a lot of uhm— a lot of toxins that are again aquarium based, they put stress on the liver, and when the liver’s stressed, that’s gonna deactivate the amount of these enzymes that are being produced cause these enzymes come from the liver and they help activate, take the T-4 and convert it to T-3. So if we have more liver stress, it’s gonna affect the conversion enzymes. It’s also going to affect the iodine uptake as well, so it’s couple of different mechanisms. We have the iodine uptake, and then we also have the conversion of the thyroid hormone.

Evan Brand: Yeah, the other thing I wanted to mention in terms of like home toxins, are like bug sprays. Lot of people talk about bugs whether it’s like ants, or roaches, or wasps, or bees. And a lot of these insecticides, these also are tested on the GPL-Tox. And I see most people add elevations in these toxic chemicals. So if you’re spraying for bugs, even if you’re not doing it, and you’re hiring a “bug man” to come and spray. I had one client– she was off the chart with the Permethrin category of uh– toxins, and she said, “Yeah, I’m scared of spiders every time I see one I call the ‘bug man’ and have him come just bomb my house.” And I was like, “Oh my Lord…”. So– there is a uh– a company, I th— I don’t know if it’s the brand name or the product name called Orange Guard that we have used with great success, it’s like an orange peel extract and we had a–

Dr. Justin Marchegiani: Yep.

Evan Brand: –we had an ant problem at our old rental house and so I just sprayed the perimeter of the house with an Orange Guard, it smelled delicious like oranges and it got rid of the ants in like two days and there was no toxins in walls.

Dr. Justin Marchegiani: Yeah in my property here we use the company called “Chem-Free” and they came out and they use some essential oil blends and, a lot of times like for the bees, they would use like a peppermint oil type of blend, and they use that for like the cockroaches as well, and they would spray. That one’s good. I mean, I like it, because a lot of these components, they aren’t super toxic, or they aren’t gonna be as toxic on the essential oil side, and– you can– and they worked. They actually knocked some of these uh– insects and roaches down which is great so you can still have– you can still have y– you know, the effectiveness of knocking some of these animals out but not creating the toxic environment as well.

Evan Brand: There’s another company that you can look up, you can even get them on Amazon. They first were revealed on Shark Tank it looks like, but it’s called the Wondercide. And Wondercide they had like natural pet care products but then they have home pest protection stuff too. So they do have like uh– a p– a peppermint insect repellent. And they have like an indoor pest control, and then they have an outdoor one which is what I use for all the ticks, because the ticks are really bad in Kentucky; and it’s a cedar oil. So you hook it up to your water hose, and you just spray it, and it makes your whole place smell like cedar, which if you like that smell, good. And– we did see reduction in ticks for sure. It didn’t cure it, like it’s not gonna magically eliminate bugs but it sure repelled them.

Dr. Justin Marchegiani: Totally, yup. I think that’s great. [crosstalk]

Evan Brand: So Wondercide– Wondercide, if people wanna look it up they have like organic soaps and stuff like that too but mainly I’m talking about for their home protection.

Dr. Justin Marchegiani: Excellent. You know, what other compounds are we worried about people getting exposed to that could be an issue. And of course we have the pesticides from our food, uhm— we have ate with the chlorine based water. Not just the chlorine but the chloramines that may form as well. So that’s one of the nice things that filtering out a lot of the chlorine is the chloramine compounds also get reduced. We have the reduction in fluoride. Remember, fluoride can have an effect of blocking out that thyroid receptor side as well because it is a halide. It’s in that 7th row on the periodic table of elements and that could be a problem. And remember, the fluoride in your water isn’t just fluoride, it’s Hydrofluorosilicic Acid so there are other nasty components that are in there. It’s not just like oh– uh– sodium fluoride, it’s other stuff that’s uhm— in there as well. So if you go look at it in your water filtracing— water filtration center, you’ll see it’s got this number, I think number 4 on there which by the CDC it’s– means it’s pretty darn toxic.

Evan Brand: Yup.

Dr. Justin Marchegiani: And again I would say they dilute it down to a certain amount part per million but still uh– not good if you’ll look at the amount of part per million in– two phase, right. You’ll look at the pinky side of it, read the back of it, it says, “do not swallow”. It’s– it’s got a poison control label on the back of it. So I– I’m very careful on fluoride. Just go to PubMed, you’re gonna see a lot of studies on fluoride decreasing IQ poi– I– your IQ by 10 points. Uhm– studies up in Great Britain, study that came out about 2 years ago, looked at fluoridated communities and non-fluoridated communities and drew correlation of more thyroid diagnosis or diseases, diagnoses, in communities that have more fluoride consumption. And we know the mechanism potentially could be that these fluorides, the halides that’s then blocks out the iodine and we need iodine for this iodination process to make thyroid hormone, right?

Evan Brand: Yup. And the– the other chemical I forgot to mention so far, lot of it is being banned and removed but it’s Triclosan or Triclosan, and that comes from a lot of your conventional soap, it’s an antibacterial. There’s studies on that showing that it does reduce your uh– T-4 level. So it does reduce thyroid hormone levels. If you’re washing your hands 5 times a day, let’s say you’re a nurse or something in a hospital setting, you’re using this conventional toxic soap, that’s not good. That means it’s no surprise that a lot of people in the healthcare field themselves have issues, I mean, some of it could be the toxic soap they’re using 20 times a day. And then all the skin care stuff that’s in the– that’s an easy one we test for all those chemicals. Nail polish, on that chemical profile test, they look for nail polish, they look for resins, they look for hair dyes, lot of women dye their hair, and then cosmetics so– gotta make sure all that stuff’s clean. If your shampoo or conditioner has like artificial fragrances in it, we know those fragrances can hide Phthalates and all sorts of other endocrine disrupting hormones.

Dr. Justin Marchegiani: 100%, absolutely. So the air stuff we talked about, the VOCs, right, the vo– volatile organic co– compounds, right. Uh– we just talked about, you know, a lot of the pet stuff, the allergenic stuff, the mold stuff a lot of these good– the better filter can filter out some of the mold, of course we have to figure out where that molds coming from, so you may wanna do an ERMI Test, to see if there’s any mold in the house, or if you can visualize or see it, it’d be good to have that remediated by an expert– typically use some concrobium on it afterwards to help, but you really wanna get someone that can remediate it, it–  if it’s an issue. Uhm– so that’s on– another component there. Anything else on the air side, the air allergen side Evan?

Evan Brand: Well I was just gonna– I was telling you before we got on air here. I brought– maybe you should look into this. It’s really this fun, you don’t need it but it’s fun. The uh– IQAir system, they have a portable air quality monitor system and I can test the levels instantly of the CO2 level in the house as well as the pollution level. It’s looking for the 2.5 micron molecules so I guess in the city or to be– pretty helpful but where I live, you know, there’s not much around to– to pollute the air. But what I’ve noticed is, in the morning, you know, you’re breathing all night, so you’re exhaling a lot of CO2, and we know that CO2, once you hit like a thousand parts per million I believe, the– headaches, fatigue, can start to happen, and my C02 levels in the home typically in the morning are about 1500. And if we just open the windows up, for 10, 15 minutes, we can get the CO2 levels down by like a thousand points. So we go for like the red category to the green category in this meter. So I mean, that’s free, first of all to open your window. Now if you live like in India, and your air is so toxic, you probably don’t wanna open the windows. But if it’s a decent air outside, and– you could open the windows, that alone, is something that could significantly change how you’re feeling.

Dr. Justin Marchegiani: 100%. Yeah I– hundred percent agree. Uhm– anything else with the water component. Of course, we talked about all the different compounds in there, now the big things that I use, one of the good ones that I like is the Air Doctor, that’s a good one. If you go to my site, I have the Air Doctor as well as the advance air setup those are both good units. If you go to and click on Justin Health approved products, I have some links to those, and again, Evan and I only gonna recommend products that we actually use. I think it’s important that you actually use the product and you believed in it, I think it’s great. Uhm– it’s nice to have people that are guinea pigs that can kind of sign off on it as being a good product which is great, so if you wanna purchase that, you can do that, you can get more information there. Uhm– the other component is the Molekule, is a nice one. It’s a little bit more expensive. So the other two, the Advanced Air and the Air Doctor, are about half the price, that’s a good first step if you’re tryin’ to get your foot into the– into this area of cleaning out air quality and improving it. If you wanna go a little bit more whole hog then the Molekule’s a– uh– a better option uh– on top of that, looks a little nicer as well. So those are my top three. Now there are some whole house systems but you gotta look at the fact that, you know, I like the fact that I can bring my unit with me if I were to travel, if you– if you’re moving, those kind of things and maybe a little bit more difficult to– pull it out, install it so you have to look at you know, are you gonna be in a long term. And also it’s nice to be able to bring it and put it right in your room and be able to have control over it.

Evan Brand: Yup, well said, and a– the whole house system is I mean, they do exist on the market but I do not heard too many good things about ’em. I know they can work but I think it’s better off to just have a purifier in your room because it does. In this, maybe this is just like theory or marketing talk but in theory, the– HVAC system has to work harder because when you’ve got a– a whole house air filtration system sitting on top of your– what do you call that, your– What’s the name of that Justin like where the fan is connected to your HVAC system?

Dr. Justin Marchegiani: Yes.

Evan Brand: A blower, where it’s connected to the blower? You have to–

Dr. Justin Marchegiani: Yes.

Evan Brand: –that blower has to blow harder through all the multi-layers of the filter. So it makes that system work harder and make shorter the life of it. [crosstalk]

Dr. Justin Marchegiani: Yeah and you also– yeah and you also have these vents and things. There’s a lot of– there’s a large distance between where the air is coming from and getting cleaned out, and then through all of the vents to where it gets to your room. It’s just nice having it purified right at the spot where you’re at, so it doesn’t have to really travel more than a few feet to get to you.

Evan Brand: Right. Yeah, so, that’s what I would do. And I have test– that’s cool thing. I’ve tested Air Doctor and all the other systems to discuss with a portable monitor. The lower the number the better. The number coming out of the Air Doctor it’s a zero. So, I know that it’s legit, pure air coming out of it which is great. [crosstalk]. Yeah you gotta check it out man. It’s uh– if you just type in IQ Air, and you type in– it’s called Air Visual Pro, I’ll put the link up in the Hang Out for you.

Dr. Justin Marchegiani: Oh great!

Evan Brand: I’ll send it to you. I don’t think the– the– the listeners will be able to see this link but I’ll send it to you. But it’s called Air Visual Pro, and– you know, I’ve got a practitioner account with them so you do get a slight discount as a practitioner. And uh– and that’s what I have and it’s just a little small thing, and it’s like, you know, smaller than a computer but it runs on batteries and I just– I just– I’m ___ [24:15] with it man. I’ll take it to the restaurant and say, “Hey what’s the air quality in your…”, take to my friends’ house and say, “Hey, what’s the air quality in your house?”. It’s just fun.

Dr. Justin Marchegiani: Oh, that’s really cool! Oh wow. Amazing. I wonder what the– what 2008 Olympics, was it 2010 in China? What they had in Beijing?

Evan Brand: Oh gosh.

Dr. Justin Marchegiani: I heard the air quality was just absolutely terrible. I– I just see on the IQA website it has one looking at– at Beijing, versus the one looking at the office in the Beijing has the ratings that are to the roof meaning mo– more toxicity.

Evan Brand: Yeah the cool thing is there’s an app with that uh– device as well so you can check your air quality and see how it compares to like other cities. It’ll show you what’s the tiniest air, what’s the most toxic air, and– and people they can, if you want, you can have that thing hooked up to Wi-Fi which I didn’t but, that way you can upload your data and people can see it around the map, “Hey, here’s this guy in– wherever, and here’s his air quality”. So it’s pretty neat.

Dr. Justin Marchegiani: Love it. Anything else you want to address here so far Evan? What do you think? Anything missing?

Evan Brand: I– I think– I mean– we’ll always do a part 2, part 3, you can never stop talking about toxins but I think we’ve covered a lot today. Clean up cosmetics, look at yourselves, look at your shampoo and conditioner, don’t dye your hair– Now there is an organic hair dye but I don’t know anything about it. I know it exists, so seek out like organic salons, don’t get your nails done like, “that’s bad”, like maybe go to an organic salon. I measured a nail polish resin every single week in clients, the women who get their nails done every week on the GPL Tox, their certain chemical is off the chart. And it just– it causes headaches, nervous system issues, thyroid issues, so– I don’t– I’m– I’m a guy so I don’t get my nails done so maybe for women, they’re like, “Oh my God, I have to have them done”. Maybe there’s a better way to do it I just don’t know of any.

Dr. Justin Marchegiani: Right.

Evan Brand: But– but look at it, get the GPL To– if– if you have– if you’re a woman listening, and you don’t believe me, run a GPL-Tox, look at your toxic load, and then maybe you’ll believe me. Right.

Dr. Justin Marchegiani: Or it’s this you know, do your best to find a higher quality organic salon that has some products that are gonna be less toxic. And, or– if you need to, just– take some extra antioxidants and or glutathione before you go or at least support those path while you still spread it out. A lot of those toxins are gonna be more water soluble, so it– it’s not something that you’re gonna like hold on too as much, so if you take good detoxification support you’ll secrete it pretty fast. And you just try to find you know, I know like some of the salons my wife would go to there’s like a small little upgrade where they can– choose an organic product that’s less uh– toxic low. So that’s a good option–

Evan Brand: Yes.

Dr. Justin Marchegiani: –if you– have that.

Evan Brand: Yup, and a– I interviewed doctor Shaw, the guy who invented that toxic lab, if you wanna hear more about detox, just look at fandbrandwilliamshaw, S-H-A-W, calls and that interview, because we chatted all about mitigation strategies, and then also more about like you said glutathione, NAC, uh– precursors for detox, amino acids to help detox, sweatings, saunas, so that’s a good one.

Dr. Justin Marchegiani: And also one of the things that shaw said from that interview if I remember correctly, you tell me if I’m wrong, he said something like one of the best things you can do to e– to enhance detoxification is to to sweat more.

Evan Brand: Yeah, that’s a– that’s a– it was a number one thing. He personally did not use a sauna, all he did was he– likes to go for runs and ride his bike outside and sweat. And he keeps his chemical levels tested and they’re always relatively low. He said, he did not see more of a benefit unless someone was too sick to exercise. To exercise and sweat, versus sauna and sweating. He said the whole near infrared, far infrared, the whole– debate about it all, he said sweating is the key, it didn’t matter how you achieved it in his words.

Dr. Justin Marchegiani: It’s interesting too because remember, Shaw also– didn’t really eat organic either.

Evan Brand: You know, that guy he– he taught at restaurants every single day.

Dr. Justin Marchegiani: Yeah, so there was a differen— I mean, I find that with a lot of my– my PhD researcher friends, there’s kind of a disconnect uh– with what they’re studying and applying it in their real life. It’s kind of this weird thing. I f–

Evan Brand: I agree.

Dr. Justin Marchegiani: –I forget uhm— I think it was Alessio Fasano? He used to be a gluten researcher over at Harvard, he’s got a lot of uhm— you know research on gluten and how it increases ___ [28:07] which can create leaky gut. Yeah I’ve seen– I’ve heard people that have gone out to dinner with them and they’ll order a big freakin’ ball of pasta, and eat it right in front of you. You’re like the premier glutton researcher and you’re talking about how gluten creates you know, gastrointestinal permeability a.k.a leaky gut, and you’re sitting there eating a bunch of gluten?

Evan Brand: Tell me about it, that’s a [crosstalk]–

Dr. Justin Marchegiani: You know, here’s the deal, like if I’m gonna cheat, right, I get it, like I may cheat sometime, I always try to just do to a gluten-free cheat, and I’m sure it hel— aren’t gonna cheat in front of people that are health-oriented or patients, I wanna be a good example. If I’m gonna cheat, it’s gonna be like, you know, no one’s gonna be seeing me, so to speak right?

Evan Brand: [laughs]

Dr. Justin Marchegiani: So the fact that you’re– you’re doin’ it openly in front of people means that you’re probably doin’ it a lot more frequently…

Evan Brand: Right. I know. Well doctor Shaw, I was blown away by that, I said, “So you eat out everyday?”, he said, “Yeah, I don’t pack my lunch”. And I thought, “Man, so you’re getting glyphosphate exposure everyday”, and we know parts per billion is enough to damage gut bacteria and affect mitochondria. I mean, that just means bold to me so, I don’t know man, I guess they always say once you uh– there’s– there’s a saying about this I– I don’t know the exact saying but something along the lines…

Dr. Justin Marchegiani: That you don’t want to bless or something? [laughs] or–

Evan Brand: well, well, no, he used to say–

Dr. Justin Marchegiani: He knows. He’s not– he’s not– he’s not ignorant but I guess, there– there is uhm— what is it, there– there— there’s knowledge is power, but– but true knowledge is applied, uh– no, uh– knowledge is power only if acted upon it, only if applied. So you could know all these stuff but you gotta truly apply it to get the benefit right.

Evan Brand: We– well the saying, I was thinking of was something along the lines of like your hero, like a lot of times people have like a hero, or an idol like, “Oh I really look up to this person”, and then they figured out how they truly are, and they’re not what they think they are. There was a movie about that, I don’t remem— oh, w– wait– it was uh– it was that– it was called “The Fault in Our Stars”, it was a book, it was a movie about the girl who had cancer and she loved its author, and this author, she was just obsessed with him and she goes to meet him and he’s like a miserable alcoholic drunk.

Dr. Justin Marchegiani: Yes.

Evan Brand: Did you see that movie?

Dr. Justin Marchegiani: I– I saw that movie, that’s a good one and the I think– yeah, I won’t give the spoiler but that was a good movie, yes.

Evan Brand: Yeah, so– so– yeah, so– maybe your— your idol may not have as dialed in as even you do.

Dr. Justin Marchegiani: 100%. Let me just add one la– last thing, so, the–

Evan Brand: Yeah.

Dr. Justin Marchegiani: –the key things that we’re lookin’ at on the– on the water side, of course, are gonna be– fluoride, chlorine, uh– pharmaceutical drugs, whether it’s birth control pills or statins or antidepressants, people flush things down and it’s hard to get those filtered out.

Evan Brand: Yup.

Dr. Justin Marchegiani: Uh– we’ve mentioned the chloramines,

Evan Brand: Hard drugs–

Dr. Justin Marchegiani: And–

Evan Brand: There’s hard drugs in there.

Dr. Justin Marchegiani: Hard drugs, potentially heavy metals, mercury, lead, parasitic cyst and or infections debris, so those are gonna be the big things on the water side, and on the air side we have the asbestos, right? That’s can create the– the Mesothelioma cancer, we have– various dust mites, uh– pollens, fungus, bacteria, viruses, we have the phemaldehyde, right?

Evan Brand: Poten– [crosstalk]

Dr. Justin Marchegiani: Yup, we have the uh– the PBDE– the– what is it, the–

Evan Brand: It’s a PDB–

Dr. Justin Marchegiani: Pyrrhotites.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah, PDBEs, yeah. uhm— the wha— what does it stand for? Help me out, uh it’s– it’s a– it’s a bromidated compound. Polybrominated diphenyl ethers. [crosstalk]

Evan Brand: So that could be– in your couch cushion, that could be in your the– your office chair, that could be in your children’s pajamas unfortunately, which is ridiculous,

Dr. Justin Marchegiani: Yeah. They put a lot in the– the kids’ mattresses, so we spend extra money to buy an organic wall mattress that didn’t have the flame retardants…

Evan Brand: Yup.

Dr. Justin Marchegiani: And we also spend extra money to not get the flame retardants in– our babies’ uhm— not stroller, what are they call, not the– what’s the terminology the–

Evan Brand: The car seat?

Dr. Justin Marchegiani: A, the– the carrier– the carrier. So there was one brand I think it was uhm— I think it was Uppababy, I think it was the Henry, it was the only one on the market last year we bought and it did not the PBDEs the flame retardants so we did the Henry one, we did an organic mattress that didn’t have any flame retardants. And of course we have– we have uh– a fire alarm in my son’s room so if there’s an issue, we’re gonna know. We don’t need a– heaven breathing toxic chemicals for such a– a low-risk issue.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Then we have the leads, especially if you have houses before 1978– 1978, lead could be used in that. We have various pesticides esp– especially spread out on the lawn, or if you live on the golf course there could be a potential pesticides going in that way. We use various uhm— phthalates which could be from vinyl flooring, it could be from shower curtains, it could be from detergents it could be from the PVCs in your piping, it could be–

Evan Brand: Oh.

Dr. Justin Marchegiani: –from the food packaging.

Evan Brand: Here’s a– here’s a PSA man, this is the biggest announcement ever, please, everywhere I go in society, I smell people’s terrible laundry. You go in line in the grocery and you stand behind somebody in their flower-fragrance on their laundry. It didn’t used to be like that back back in the day, I don’t remember smelling people’s laundry.

Dr. Justin Marchegiani: Dryer sheets man. People use, like a– we have the most hypoallergenic uhm— cleanliness detergent, I mean we have one I think, we upgraded, we’re using seventh generation like un-scented but we upgraded one more beyond that. If you go to we searched the number one brand on there, just zero smell. People are using one, they’re using– laundry detergents that’s got a whole bunch of crap in, but then they also use a dryer sheet on top of it. And it is like–

Evan Brand: So that’s what it is…

Dr. Justin Marchegiani: It’s the dryer sheets.

Evan Brand: Oh my.

Dr. Justin Marchegiani: It’s totally disgusting, I mean, oh my gosh, it just gives me headache.

Evan Brand: I get yeah– I get an immediate headache and part of me thinks well, does that mean I have a leaky brain, or does that mean that I’m just sensitive to it because it’s a toxic chemical. I feel like everyone should get a headache from it because it’s toxic.

Dr. Justin Marchegiani: Well for me it just smells nasty. It’s just so overpowering– it’s so overpoweringly– str– overpoweringly strong. It’s like people that need to– consume very high sugar foods. Like for me, my taste buds get overwhelmed, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So it’s kinda like that I mean, I think you just– you get a little bit uhm— you know, the less alcohol you drink, a beer kinda gives you a little bit buzz, it’s kinda like that, the more you gotta exposed to it. I imagined that probably it wouldn’t be an issue.

Evan Brand: So here’s my– here’s my– here’s my couple announcements–

Dr. Justin Marchegiani: Sure.

Evan Brand: –and then I know we gotta–

Dr. Justin Marchegiani: Sure.

Evan Brand: –we gotta wrap up. Switch over to free and clear, unscented laundry detergent, even whole food cells, their own brand of organic laundry detergent it’s all plant-based and packed in so I they help the grease and all that crap. How do you close– Go fragrance-free, and then, do a fragrance-free or free and clear dryer sheet if you absolutely have to have it. We personally use the wall balls on our dryer, and that works as a replacement of dryer sheets and you never have to buy dryer sheets, the wall balls work perfectly. And then number 2 thing is– the perfume. So there’s a chemically can test for called xylene, that’s the parent chemical on the toxin report. So many people wear perfume, especially like I go to the park and you’ve got these women in their work out clothes, and they run past you, and then 2 seconds later comes the breeze with them of their perfume. It’s like good Lord, let’s go to nature, to just pollute it with– with pot– so many different potential toxins from the laundry, to the perfume. So please, please please, nobody wants to smell that crap, and you’re making yourself toxic, I measure it everyday so from a clinician perspective, I’ve got proof– what these perfumes are doing to you and nobody else wants to smell that crap either.

Dr. Justin Marchegiani: Yeah, for me, the deodorant that I use actually has a really nice scent. Uhm– I use a brand called native COS– native COS and they have a coconut vanilla uhm— it’s actually a women’s uhm— deodorant but it’s smells great, I mean it doesn’t smell overly feminine at all, it smells very neutral.

Evan Brand: It’s real though.

Dr. Justin Marchegiani: Yeah, it’s real, so like for me, the deodorant that I use, I– I can smell it from the outside so it has the slight kind of uhm— you know, nice coconut vanilla smell, but it’s totally natural essential oil based, so– for me that’s where I get my scent from a native of couple brands. I– I put another ordering last night for a nice little uhm— rosewood, sandalwood blends. Sandalwoods are great essential oil for– for a guy. If you wanna have like a nice little– kind of slight masculine, kind of musc smell to you, sandalwoods’ great for a guy. My wife would use some lavender every now and then, and that’s a great– great kind of lil— a little bit more of a feminine undertone. So if you want a– a slight kind of smell to yourself, a good essential oil that’s non-toxic can be great.

Evan Brand: Yeah, yeah. I’m not against scents completely. But if you have to smell, if you just wanna walk around smellin’–[crosstalk]

Dr. Justin Marchegiani: Wow, and you know, sometimes, less is more, right?

Evan Brand: Absolutely, so yeah, look at those natural ones, the native, I do have some of the native too. They sent me some some stuff there, I want to respond to the podcast, and then– I– never heard anything back, so I may have to reach out, say “Hey, free deodorants for all listeners!”, that’d be cool.

Dr. Justin Marchegiani: Yeah I’m sensitive like I will react like my armpit will get super red, and their coconut is excellent. There’s citris herbal musk, I didn’t react a little bit too but I can use it for like 3 or 4 days in a row and then take a week off and I’m fine; it’s just like…

Evan Brand: Good you said that cause my wife had the same thing happen with the citris one and the lavender.

Dr. Justin Marchegiani: Yes.

Evan Brand: She can only do it three days and then her armpit goes super red and inflamed she has to do with unscented only.

Dr. Justin Marchegiani: Yup, unscented, try the coconut, vanilla too. That’s worked great for me. And they have uhm— they have a rosewood or sandalwood that just came out and they have one other– I think eucalyptus– mint one that’s out as well. So I ordered like 3 or 4 flavors last night, and the coconut vanilla is excellent.

Evan Brand: [laughs] Is that flavors? You could– you could it eat, you could–

Dr. Justin Marchegiani: Oh, you can– it– I mean, it’s clean, you know. And again for me it’s like, “You know, I’m– I’m busy, I’m working, I’m sweating– I wa— I also want protection as well. And let’s face this, a lot of these natural, you know, deodorants, they don’t really provide much protection at all and–

Evan Brand: The native– the native works man.

Dr. Justin Marchegiani: Very good, I mean, at the end of the day, I’m like, “Yeah that smells great!”.

Evan Brand: The listeners didn’t hear that but he sniffed at himself. That one– that one in the Primal Pit Paste was the other one for me that worked pretty good but is a little harder to put on so the native is the best in terms of like, I’ll rate that number 1 for now.

Dr. Justin Marchegiani: And like, the– the Primal Pit Paste is got a little bit more of a sticky coating to it, where like the native is like a very dry coating, so if you like, put your shirt on whatever, you don’t feel like it’s stuck up in your armpit there so that’s kind of a nice thing about that.

Evan Brand: Yup, we went longer than we were supposed to but we just– we started thinking of all these other tangential toxins that people need to be aware of so I hope it’s been helpful, uh– if you wanna reach out to Justin you can, his website is justinhealth— so, you could reach out and schedule a consult with him, and he’s also got another doc on staff, so if his availability is crazy you can get with him. And then for me, my website is, you can reach out there. And– either way, whether it’s us or whether it’s somebody else that knows what they’re talking about we just hope that you get the help that you’re looking for and that you can achieve the next level of health as soon as possible.

Dr. Justin Marchegiani: Absolutely. Let me just hit the last three things.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right on to another big one which is a– you know, it’s a– element in the soil and that can come up at– you know, for its– its– it’s actually in the rock, you know, in the foundation of where your house would be deep underground. And when you’re there it can come up to the house and that’s linked with potential lung cancer at levels I think greater than 4 ppm as what the CDC wants to blow. Uhm– we tested our house at one point, it was 8, so we have uh– we got a right on kit in there to help filter that out. We haven’t– down below .5 so radons and ___ [38:47] especially, you know in the midwest, in south that can be a potential problems so if you haven’t got it tested you can buy a radon meter on Amazon or you can pay someone I think for 75 bucks that come out and have your house tested, that’s important.

Evan Brand: Well said.

Dr. Justin Marchegiani: Of co– of course just like respiratory particles such as, you know, wood stew, fireplace, kerosene pipes, cigarettes, those kind of things, cigar smoke. And then we mentioned the volatile organic compounds. These are gonna come from paints, paint strippers, woods, aerosols, air fresheners, auto products, dry cleaning, clothing, household products, those are the big ones so. A good uhm— air filter will help with a majority those and of course a good water filter will help at the components we mentioned. And again, for me,, water are the ones that I personally use in my house.

Evan Brand: Yeah, you mentioned that a– the air freshener so I forgot about that. I’ll tell you, uh– one little thing I do, this is a secret, I’ve never revealed this, but now the secret’s’ out of the bag. If I go to a place- a public place and there’s a plug-in air freshener, I pull that thing out and throw it in the garbage before I leave. So if I go in the– if I go in the bathroom, and there’s a plug-in or you walk in and then– [sneezes], and you get sprayed with fake chemicals as soon as you walk in to go pee, I just pull the thing out the wall and throw it in the garbage.

Dr. Justin Marchegiani: 100%.

Evan Brand: That’s my little public uh– that’s my little public duty. I’m helping all of you guys have les fragrance in your bodies.

Dr. Justin Marchegiani: Well you were doin’ that uhm— survey last year where you tryin’ a– a petition where you’re tryin’ to get the uber drivers to pull the– the scented things out of the car, right?

Evan Brand: Yeah, I got over 2000 signatures on it and there was someone else kind of uh– I don’t know if it was food [crosstalk] benlycnh who shared it or something– somebody shared it and then they got thousands more signatures but I’ve still heard no updates on it but uh– luckily it’s very rare for me to have to take an uber or taxi but this problem happens every day where me– even they’ve asked preposted about how he talked in uber and the guy had like seven little Christmas tree fragrance–

Dr. Justin Marchegiani: Awful.

Evan Brand: They have like– he had a headache, he was dizzy, and etc. after he got out of his uber so, this is a real problem and I hope one day that we can educate people and just do natural fragrance or no fragrance at all.

Dr. Justin Marchegiani: Yeah, uh– the good– the essential oil, there’s gotta be some essential oil like, you know, the–

Evan Brand: The citrus one. They have a citrus– there’s a citrus like odor-absorber that would work perfect to people can put under the car seat–

Dr. Justin Marchegiani: Yes, yes.

Evan Brand: No one would know it’s there and it would take care of all the toxic–

Dr. Justin Marchegiani: It would stop a lot of the odor. That’s to– totally make sense Evan.

Evan Brand: Yup. But that’s all I gotta say so check out the links and then you can check out for consults or We love helping you guys. We really appreciate the good feedback, so feel free to write us a review on the podcast on iTunes because it does help us.

Dr. Justin Marchegiani: Great, and we’ll put the links below on some of the products that we like and use personally so you guys know it’s already betted. Give us a thumbs up, give us a share, give us a shout out, give us a comment down below; we appreciate you guys engaging; sharing is caring, thanks for everything. Evan, you have a phenomenal day, we’ll talk soon.

Evan Brand: Take care man, bye.

Dr. Justin Marchegiani: Bye.


Air Doctor Air Purifier

Autoimmune Diet and Bowel Disease | Podcast #166 with Angie Alt

Did you know that an autoimmune diet can affect bowel diseases? Today, we are happy to have Angie Alt, a successful author and the co-host of The Autoimmune Wellness Podcast , as he joins Dr. Justin Marchegiani in discussing this topic. Learn about the link between autoimmune diet and bowel disease, the Autoimmune Protocol Program, the common mistakes that people make when going on an autoimmune diet, and more. Watch and listen as they dig deep into the natural approach of treating bowel diseases here!


Angie AltAutoimmune diet and bowel diseases

In this episode, we cover:

03:40   Dietary Aspects of Autoimmune Protocol

05:30   Pitfalls

10:12   Autoimmune Diets to Improve Your Health

15:50   Curcumin and Autoimmune Protocols

22:15   Autoimmune Protocol for IBD





Dr. Justin Marchegiani: Alright. Let’s start it up. [long pause

Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here. We have a phenomenal guest, Angie Alt from Angie is an Autoimmune expert, specializes in autoimmune protocols, works with patients, kind of, in a group setting all across the country. We got some great updates today. We’re gonna talk a little bit more about the autoimmune diet, the pitfalls, how you can apply it to help improve your health, and also, we get some new research out on autoimmune diets for various bowel disease, which we’re excited to go over that, too. But in the meantime, Angie, how are you doing? Welcome to the show.

Angie Alt: I’m doing great. Thanks so much for having me, Dr. J.

Dr. Justin Marchegiani: Well, thanks for being here. So, first of, just tell the listeners a little bit more about yourself. How did you get into this nutritional field? And then, how did you make your way over to kind of an autoimmune protocol or template from a– you know, a diet approach. There’s so many ways. You can go Paleo, Autoimmune…

Angie Alt: Yeah.

Dr. Justin Marchegiani: …Vegan, _Rydes, Standard American.

Angie Alt: Yeah.

Dr. Justin Marchegiani: How did you make your way into that avenue?

Angie Alt: So, uhm– I got my start about six years ago. I had my third, uhm– and hopefully, final uh–

Dr. Justin Marchegiani: Yeah?

Angie Alt: …autoimmune diagnosis. So– [incomprehensible] and Celiac disease had been kind of haunting me for about eleven years at that point. Uhm– I had been all over the place trying to get help, and uhm– finally, we figured out what the problem was. And, i was told to go on a traditional gluten-free diet. Uhm– but that didn’t turn out to be enough to kind of get me in a better spot, because my– you know, my small intestine was so damaged and I was really malnourished by that point. So, uhm– I started hunting around, looking for better ways to restore my health,and uhm– I found the Paleo diet. I a– My first book actually was Robb Wolf’s “The Paleo Solution.”

Dr. Justin Marchegiani: Very cool.

Angie Alt: And there was like, one sentence in his book that said something about how people with autoimmune disease might need to take things a little bit further. And i thought, “Ohp– that’s me.” So, I started doing some more research and uhm– and that, at that time, Dr. Sarah Valentine at The Paleo Mom uhm– was starting to just, you know, do some research and some refining of this uhm– Autoimmune Protocol, AIP. And I said, “That’s me. I’ve got three autoimmune diseases. I’m gonna try this.” So, I jumped right in. And, you know, uh– three days later, a lot of the…

Dr. Justin Marchegiani: Uhmm–

Angie Alt: …mental and emotional health issues that I had been experiencing just seems to melt away. And, six weeks later, my gluten antibodies dropped by half, and six months later, it was like I had a new body. A year later, I changed everything about my life to focus on this and show other people how to do it.

Dr. Justin Marchegiani: Wow. So, how many autoimmune conditions do you have again?

Angie Alt: I have three.

Dr. Justin Marchegiani: Is that Lichen sclerosis and what’s the other two?

Angie Alt: Endometriosis and Celiac disease. Yup.

Dr. Justin Marchegiani: Wow! Unreal! And then, how much you were able to get a hundred percent resolution applying an autoimmune template to those conditions?

Angie Alt: Yeah. Pretty much. You know, Endometriosis is one of those diseases that sort of like, maybe or maybe not, uhm– the autoimmune list. You know, the research isn’t quite there to be sure that it’s autoimmune in nature.

Dr. Justin Marchegiani: Uhmn.

Angie Alt: Uuhm– But I kind of– I kind of handle it the same way that I do with my verified autoimmune diseases. And it’s been a little trickier to pin down. You know…

Dr. Justin Marchegiani: Hmm.

Angie Alt: …there’s little bits that I’m still dealing…

Dr. Justin Marchegiani: Right.

Angie Alt: …there, but in general– I mean, my health did 180-degree turn. [laughs] I’m in a totally different space when I was six years ago.

Dr. Justin Marchegiani: Awesome. And now, regarding having an autoimmune– you know, multiple autoimmune conditions, like you.mentioned, were there any other things that you looked at, outside of just having a foundational diet? Were you looking at blood sugar? Were you looking at adrenal issues or any infections, or any other things that could have been driving leaky gut outside of autoimmune foods?

Angie Alt: Yes. So, you know, what I did was uhm– I first just kind of worked on the dietary aspects of the autoimmune protocol. So, there’s an elimination period and a reintroduction period. And i just kind of focused on dialing that in at first, and then I added some lifestyle stuff. You know, I started to work on my sleep. I started to prioritize stress management, things like that. And then, uhm– you know, you come to this sort of Plateau area and I said, “Okay. there must be some underlyers that are preventing…

Dr. Justin Marchegiani: Right.

Angie Alt: …for their progress. So, I went and did some more testing, and uhm– I had SIBO, Small Intestinal Bacterial Overgrowth, uhm– which is not that uncommon for folks with autoimmune diseases, especially if you have uh– autoimmune that’s affecting your digestive tract. So, uhm– I went in and got treatment for that, and that helped me kind of gain some more ground and uhm– From there, I started to work on correcting some nutrient deficiencies that weren’t quite budging enough with diet alone, [crosstalk] you know.

Dr. Justin Marchegiani: Uhmn–

Angie Alt: So, things like uhm– improving my B12, improving my Vitamin D status, you know uhm– taking more Zinc– things like that– to kind of improve things and slowly but surely, uhm– I made my way forward. In terms of blood sugar and adrenal health, you know those two things are very interlocked. Uhm–

Dr. Justin Marchegiani: Totally.

Angie Alt: And, the autoimmune protocol diet alone, uhm– really helped me deal with that there. It was a very blood sugar balancing and I didn’t have to take too much of an aggressive approach outside of that.

Dr. Justin Marchegiani: That’s amazing.

Angie Alt: Yeah.

Dr. Justin Marchegiani: Now, I find that practitioners, they kind of have their various health challenges…

Angie Alt: Uhmn–

Dr. Justin Marchegiani: …to begin [crosstalk] with. And then they’re they’re able to figure out kind of the code to– or the right combination to crack the code, so to speak. They definitely go into being a– a– a practitioner, or a doctor or coach, in helping other people. They have a much different perspective, right? They tend to be more empathetic. They also kind of have navigated their way, you know, into the solution. So, they kind of have come across a lot of the pitfalls [crosstalk] that they have made it hard for you to be successful. Uhm– what do you think some of the pitfalls are? I tell you one that I see is a lot of people– let’s say, they eat this much food on their– on their, whatever that diet is. Let’s call it [crosstalk] the Standard American diet.

Angie Alt: Uhmn–

Dr. Justin Marchegiani: And then, they widdle away– let’s say, they find half of that food is maybe not compatible with an autoimmune template. And then, they don’t quite fill in the gap of the food that they’re missing now. So, they tend to go lower calorie, and [crosstalk] maybe enough fat,and they’re chronically hungry. That’s one pitfall I see.

Angie Alt: Yeah.

Dr. Justin Marchegiani: I’m just want to know your opinion on that and any other pitfalls that you see, too.

Angie Alt: Yeah. I– You have a really, really good point, Dr. J. That’s very common.

Dr. Justin Marchegiani: Yeah.

Angie Alt: Uhm– I think, you know, as you removed these foods during the elimination phase of autoimmune protocol, you know, you need to– you need to fill those blanks.

Dr. Justin Marchegiani: Yes.

Angie Alt: …just like you said. So, uhm– for instance, uhm– you know, one thing I see really often is, especially women, accidentally going too low-carb…

Dr. Justin Marchegiani: Uhmmn–

Angie Alt: …because they cut out all those grains. And the grains surely were drivers in some of their problems, but they need to fill that in with dense carbohydrate-rich vegetables. And they’re– they don’t realize that that’s what they need to be eating. So– And that could be really hard on the thyroid. Put a lot of drag on the thyroid can be tough for women in they’re uhm– you know, uh– menstrual cycle and everything. So, yeah. Y– You know– figuring out how to eat carbs without grains, that’s one pitfall that I see. Uhm– not filling in nutrient-dense foods…

Dr. Justin Marchegiani: Uhmn–

Angie Alt: …to replace those foods that you removed. So, bringing some bone broth on board, bringing fermented foods on board, bringing organ meats and– and seafood, uhm– and really pumping up your nutrient density. You know, you have to think about the autoimmune protocol as essentially fuelling your body to heal. And healing is a really intensive energy process. You need all those nutrients. Those are probably– those are probably the two biggies: forgetting to add while you’re eliminating and fr– and accidentally going too low-carb.

Dr. Justin Marchegiani: Got it. And I find some people, you know, because they have so much insulin-resistance happening, they– they do better going lower carbohydrate. But then there are people that are already at a relatively healthy weight, but then there’s a lot of inflammation and leaky gut and those are the ones, that I find, do get better. You know, adding some of those safer starches in there.

Angie Alt: Uhmmn, uhhm–

Dr. Justin Marchegiani: That’s something you noticed, too?

Angie Alt: Yeah, for sure. And, you know– I mean, one thing that I think some folks kind of forget to is like in co– in comparison to the Standard American Diet, AIP, the Autoimmune Protocol is already low-carb in comparison.

Dr. Justin Marchegiani: Totally.

Angie Alt: So, you don’t have to push it much further than that, unless– like you said, unless you have some specific conditions where you might need a push of a little bit further if you’ve got insulin resistance. You know, maybe for instance, woman with PCOS, they might want to try to go a little bit lower carb even so.

Dr. Justin Marchegiani: Nice.

Angie Alt: But, uhm–

Dr. Justin Marchegiani: Totally.

Angie Alt: There’s– there’s definitely a set of folks you need to be careful that they didn’t take that far. [sniffs]

Dr. Justin Marchegiani: Makes sense. So now, we’re adding in safer starches. Then we talk about safer starches because we’re trying to highlight, you know, carbohydrates that aren’t grain-based, so…

Angie Alt: Right.

Dr. Justin Marchegiani: …I’m gonna just throw out a couple of– You know, you can just tell me what some of your favorite are, and just let me know if they’re autoimmune-compatible. So, uhm– we have…

Angie Alt: Uhmn–

Dr. Justin Marchegiani: …sweet potatoes, which tend to be pretty good,…

Angie Alt: …Yeah.

Dr. Justin Marchegiani: Not white potatoes, right? White potatoes have the alpha-solanines. It can more on that autoimmune category, correct?

Angie Alt: Yup. Yup.

Dr. Justin Marchegiani: So, we have sweet potatoes. Uhm– we have cassava or yuca. Is that still okay in your book?

Angie Alt: Right. Ahuh. Yep.

Dr. Justin Marchegiani: The plantains, as well?

Angie Alt: Yup.

Dr. Justin Marchegiani: Squash, Jicama, Beets…

Angie Alt: Yup.

Dr. Justin Marchegiani: …sprouts, Rutabaga. Those are all kind of a net safe starch cat– category.

Angie Alt: Yup.

Dr. Justin Marchegiani: Any ones that I missed that you really like?

Angie Alt: Let see. I really like pumpkin. Uhm–

Dr. Justin Marchegiani: Hmmn– Yup.

Angie Alt: Pumpkin’s a little on the lower side in terms of the starches but it still makes it on to that list. Uhm– You know, there’s easy ones, too, like carrots, and…

Dr. Justin Marchegiani: Yup.

Angie Alt: …you know, uhm– turnips. Turnips kind of get a bad wrap ‘cause they’re really sulfur-rich, so they– they have like a strong flavor. But [crosstalk] they’re really good for you. [laughs]

Dr. Justin Marchegiani: Great. Any other carbohydrates you want to throw in there?

Angie Alt: None. I think– I think you named a lot of the ones that I’m regularly eating. You know, cassava is kind of different for us in North America, but it’s really, really common around the world and it’s a great substitute.

Dr. Justin Marchegiani: That’s great. And then, give me a run down with your opinion on fruits. So, we kind of have like our low– lower sugar fruits and our higher sugar. That kind of draw the line. Berries, you know– berries, blueberries, raspberries, strawberries, blackberries, lemon, lime, grapefruit, Granny Smith apples, kind of our lower. K ind of our moderate, like maybe our oranges, our regular apples…

Angie Alt: Uhmmn–

Dr. Justin Marchegiani: …maybe pear, maybe grapes. And then we kind of have like the tropical fruits above that. Mango, pineapple, papaya, those kind of things. Uhm– can you get a walk me through? How do you incorporate fruit into an autoimmune template?

Angie Alt: So, when you’re first starting on the autoimmune protocol, when you’re still on that elimination phase, you try to focus on eating lower sugar in general. [crosstalk] Even if that sugar comes from fruits, from fructose. Uhm– and the– you know, kind of advise uh– based on Dr. Valentine’s research was roughly 10 to 20 grams of fructose per day, which is around two to three servings [crosstalk] of fruit per day depending on the fruit you choose. So, like you said– like if you choose some of those higher glycemic fruits like, maybe some of the tropical fruits and above, then, you might eat a little bit less…

Dr. Justin Marchegiani: One serving.

Angie Alt: …uhm– ’cause– Yeah. One serving might be already 10 to 20 grams of fructose. But if you sti– stick with the berries, you can enjoy berries probably three times a day and still [crosstalk] not be in the 10 to 20 grams. So…

Dr. Justin Marchegiani: Loved it.

Angie Alt: Yeah.

Dr. Justin Marchegiani: Very cool. So, we have kind of like the carbohydrates we chatted about. We kind of made some recommendations there.

Angie Alt: Yeah.

Dr. Justin Marchegiani: The vegetables, it sounds like you’re pretty good with the veggies outside of maybe tomatoes, potatoes, [crosstalk] kind of eggplants…

Angie Alt: Yeah.

Dr. Justin Marchegiani: …potatoes, right? The nightshade category. So, veggies were pretty good, right?

Angie Alt: Yup. Yup.

Dr. Justin Marchegiani: Good. And then, meat. So, we have our– obviously, you know, fish, fowl, chicken, [crosstalk] beef. Trying to emphasize, kind of grass-fed organic. Is that true?

Angie Alt: Yeah. Definitely.

Dr. Justin Marchegiani: Yeah.

Angie Alt: You know, you– I don’t like to uh– you know– give anybody the idea that they have to kind of be in this perfectionist mindset…

Dr. Justin Marchegiani: Hmmn–

Angie Alt: …where they can only enjoy protein [crosstalk] if it has been grass-fed or pastured because, frankly, our system isn’t quite ready for the onslaught. Uhm– and we don’t have a lot of sources of grass-fed and pastured that we can easily get a lot of times. And, it’s more expensive and it takes time for people’s budgets to adjust to kind of focusing on food as the priority.

Dr. Justin Marchegiani: Right.

Angie Alt: So, you know, if you have  to get conventionally-grown meats uhm– you know– proteins that are, you know, beef or– or pork, or chicken that’s been conventionally growing. If you try to avoid the fat on those meats, you know, trim it up a little. Well, that helps  little bit with it. But, if you’re eating grass-fed and pastured. Enjoy the fat. It’s good for you.

Dr. Justin Marchegiani: Totally. So, if you have access to those higher quality meats, great. If you don’t, then…

Angie Alt: RIght.

Dr. Justin Marchegiani: That’s still an acceptable option. Now. in the autoimmune community– this question comes to me a lot. If, let’s say, the animals– let’s just say the– the cows are eating corn or grains to kind of fatten them up as their feed. Do any of those corn and grains get passed on to you if you eat those types of meats?

Angie Alt: Uhm– You know, according to the research that Dr. Valentine– you know– put forward, especially like in her book, “The Paleo Approach,” we don’t really have to worry about that with the proteins in that way. Uhm– We remove egg on the autoimmune protocol…

Dr. Justin Marchegiani: Uhmmn.

Angie Alt: …uhm– just because egg is a really common allergen that might be driving issues for a lot of folks, and it kind of has a way of sneaking across that gut lining pretty easily [crosstalk] due to its nature. But the other thing about egg is that the white can uh– take in…

Dr. Justin Marchegiani: Yeah, Avidin, right?

Angie Alt: …so– Yeah, yeah. It can take it soy from the feed that the chickens are eating.

Dr. Justin Marchegiani: Aaah–

Angie Alt: But when were talking about the beef uh– you know, the muscle meats from beef or pork, or something like that, we don’t have to worry too much about the grain or– you know, contamination. It’s not–

Dr. Justin Marchegiani: That’s good.

Angie Alt: It’s not the healthiest fruit. The animal’s not gonna be the healthiest for us, but it’s not really like a cross-contamination issue.

Dr. Justin Marchegiani: Awesome. I get that question all the time. I wasn’t quite sure how to answer. I always kind of said what you said, but I wasn’t a hundred percent sure on that. So, that really helps clarify that for me. That’s awesome.

Angie Alt: Yeah.

Dr. Justin Marchegiani: And then, give me the run-down with– so we talked about the eggs, right?

Angie Alt: Uhmmn–

Dr. Justin Marchegiani: So, we cut the eggs out. There’s potentially some irritating protein components in the whites.

Angie Alt: Uhmn–

Dr. Justin Marchegiani: So, let’s say if we’re– we cut the eggs out. Let’s say we’ve cut a lot of these things out for a while.

Angie Alt: Uhmn–

Dr. Justin Marchegiani: And we’re doing a reintroduction. Do you [crosstalk] typically– when I work with my patients, we reintroduce the yolks first…

Angie Alt: Uhmn–

Dr. Justin Marchegiani: …by themselves without anything else.

Angie Alt: Yep.

Dr. Justin Marchegiani: We keep them kind of lightly cooked. You kind of have that similar approach?

Angie Alt: Yeah. Yup. We start  with the e– with the egg yolk. You know, the egg yolk is very very nutrient-dense part…

Dr. Justin Marchegiani: Right.

Angie Alt: …of the egg. And it’s– you know, eggs have  a lot of great nutrient quality. So if you can get them back into your diet, it’s well worth it. So, we start with the yolk, and see how that goes. If the yolk goes well for you, then you know, maybe a couple of days later, you’ll start working on introducing the whole egg.

Dr. Justin Marchegiani: Great. So, typically, just to kind of list it off for everyone here at home. No grains, no dairy…

Angie Alt: Uhhmn–

Dr. Justin Marchegiani: …no nuts, no seeds, no nightshades– nightshades are tomatoes, potatoes, eggplants, peppers…

Angie Alt: Uhmmn–

Dr. Justin Marchegiani: …and no eggs.

Angie Alt: Uhmmn–

Dr. Justin Marchegiani: So, that’s kind of our list there.

Angie Alt: Yup.

Dr. Justin Marchegiani: We obviously then have kind of our spice section. So, anything it’s not [crosstalk] seed kind of spice-related, or pepper related, we’re also pulling those spices out too.

Angie Alt: Right. And, the seeds, you know, uhm– it’s uh– a m– a misconception that chocolate and coffee are beans. They are seeds. And so, they are also eliminated for a time. So, I know, want a coffee [inaudible]

Dr. Justin Marchegiani: Uuuuh– [laughs]

Angie Alt: Well, everybody’s bummed out but–

Dr. Justin Marchegiani: Totally.

Angie Alt: But yeah– And the legumes, also. So, like, you know– black beans chickpeas– things like that. Uhmn–

Dr. Justin Marchegiani: Got it. ‘Cause I was told– I think it was Dave Asprey said it one time, that coffee’s more on the family of fruit. Is that so– yo– you wouldn’t agree with that?

Angie Alt: I mean– you know, everything that I– you know, kind of follow in terms of the protocol’s, based on Sarah Valentine’s research…

Dr. Justin Marchegiani: Yes.

Angie Alt: …and that’s where that, you know, piece of information comes from. Coffee is not really eliminated because of caffeine on the protocol though.

Dr. Justin Marchegiani: Hmmn–

Angie Alt: You know, taking in a lot of caffeine isn’t probably best for your health, especially your adrenal health, but coffee isn’t really eliminated on that aspects. So, if you’re having trouble letting go of the coffee, you can kind of uhm– replace it with like caffeinated tea. It’s like a black tea or something, for a while while…

Dr. Justin Marchegiani: Got it.

Angie Alt: …while you start to kind of work on that.

Dr. Justin Marchegiani: Got it. So, the coffee and the chocolate, those are indeed the seed category?

Angie Alt: Right, right. Right.

Dr. Justin Marchegiani: Got it. Any other obscure spices we need to be aware of? What about curcumin? Can curcumin uhm– be used? Also, people talk about coconut. Is coconut a nut or can we still keep that in there? Like coconut milk smoothie or something.

Angie Alt: Uhmmn– So, curcumin– uh– it comes from turmeric, and turmerics defnitely in, as far as protocol’s concerned, it’s, you know, highly anti-inflammatory. And anti-inflamming is what everybody with autoimmune disease needs to do. So, yeah. You can definitely…

Dr. Justin Marchegiani: So, that’s okay?

Angie Alt: …incorporate it. Uhmn– uhm– And then, in terms of the coconut, coconut is not really a nut. Just like…

Dr. Justin Marchegiani: Yes. Peanuts.

Angie Alt: ..chocolate is not really a bean. Yes.

Dr. Justin Marchegiani: Just like peanuts, too. Peanuts are a legume, not a nut.

Angie Alt: Peanuts are a legume, not a nut. Yeah, exactly. So, it’s a little bit of a mis– misconception there, but– So, it’s really uhm– part of a family of– of uh– foods called drups that are kinds of related to grass.

Dr. Justin Marchegiani: Droops?

Angie Alt: Yes.

Dr. Justin Marchegiani: Say it again. Droops? Like D-R-O-O-P?

Angie Alt: D-R-U-P-S.

Dr. Justin Marchegiani: Oh!

Angie Alt: Uh– P-E-S. Drupes. So…

Dr. Justin Marchegiani: Knowledge bombs [crosstalk] today.

Angie Alt: It’s not really in that.

Dr. Justin Marchegiani: I love it.

Angie Alt: But [inaudible] about coconut is that it can be a [inaudible]. Some people are a little more sensitive to coconut than other [crosstalk] folks. So, you know the– you know, you might do fine with like coconut oil because it’s so refined and all those fibbers and everything are removed. But if you find that you’re having trouble with like, coconut meat, or coconut milk, it might be that it’s just a little too much for your system.

Dr. Justin Marchegiani: Totally. And also there’s some FODMAP potential uhm– irritation…

Angie Alt: Yep.

Dr. Justin Marchegiani: …with some of the coconut, too. You noticed the FODMAPs there?

Angie Alt: Uh– you know, I have not really struggled with that in terms of my own journey, with like SIBO…

Dr. Justin Marchegiani: Even with your SIBO, too?

Angie Alt: Yeah. Even with SIBO, I’m trying to eat low FODMAP, but that is definitely one thing I’ve noticed over the years working with the folks– is that the FODMAP foods, even in the presence of SIBO are kind of very individual.

Dr. Justin Marchegiani: Uhmn–

Angie Alt: Some folks tolerate more than others, and tolerate different kinds of FODMAPs more than others. The three biggies if you have SIBO– the three FODMAP foods that are probably gonna make almost everybody miserable are garlic, mushrooms and onions.

Dr. Justin Marchegiani: Mmmm– [nods] Totally agree. Yup. Hundred percent agree. And then just shifting back to the autoimmune spices,…

Angie Alt: Uhmmn?–

Dr. Justin Marchegiani: … are there any additional kind of obscure spices you want to say that you should nab? Is cinnamon okay?

Angie Alt: Yeah. Cinnamon’s totally fine. Uhm– you know, There’s things like uhm– Fennel seed, because it’s a seed…

Dr. Justin Marchegiani: Yep.

Angie Alt: …we don’t– we don’t do Fennel seed. Uhm– instead, you’d use like whole fennel. Uhm– we don’t do, uh– nutmeg but you can do mace. So, Mace is the outside of the nutmeg nut, and it’s uhm– kind of has that same flavor. It’s a little more mild than nutmeg, though. But you– so you can do that. I’m trying to think of anything else obscure out there. I’m sure…

Dr. Justin Marchegiani: Are teas okay?

Angie Alt: I’m sure s–

Dr. Justin Marchegiani: Are teas acceptable?

Angie Alt: Yeah.

Dr. Justin Marchegiani: Green tea, black tea?

Angie Alt: yeah. Tea is totally fine. Again, specially if you’re dealing with like uhm– adrenal health issues. You might want to take it easy on the caffeine, but tea is not a problem on the protocol.

Dr. Justin Marchegiani: How about mushrooms?.

Angie Alt: Mushrooms are fine. You know– If you’re– if you’re dealing with SIBO on top of autoimmune issues, you might want to take it easy on [crosstalk] mushrooms because they’re high FODMAP, but it’s not out on the– on the base protocol.

Dr. Justin Marchegiani: Wonderful. And is there anything else, any other foods that people mistake ass being autoimmune-friendly but aren’t?

Angie Alt: Uhm– [pause] Mistake as being autoimmune-friendly but actually aren’t. Uh– sometimes, we get a lot. I– I notice lately in the community, we get a lot of questions about Maca versus Matcha. So, Matcha…

Dr. Justin Marchegiani: Maca.

Angie Alt: …is green tea, and that’s fine. Maca is uh– an herb that can be a little bit immune-stimulating and definitely uh– can kind of jump the hormones. You know, and– and you might not want that in those early days of healing. You might want to keep the hormones kind of very quiet and even if you can. [laughs]

Dr. Justin Marchegiani: Got it. Got it. Perfect. Excellent. Loved that. Yeah. So, that’s a big question I get all the time, too. So, that’s great. Excellent. Any other autoimmune barriers that you want to mention that come up with the patients and people that you work with, that you’re constantly overcoming or repeating itself?

Angie Alt: I think probably just the biggest thing overall is that– you know, eating. Eating during the elimination phase of the autoimmune protocol is really different from how we eat in our Standard American Society, right? And I think it can be really, socially, a big barrier, and folks can feel really afraid of how their family and friends are gonna respond to them using this diet to heal. So, one thing we focus on a lot, for instance, in my group program is, “how to talk to others about why you’re doing it,” “how to explain in a succinct way what you’re doing,” and “how to just feel really empowered that you’re taking this really big ways for your health.”

Dr. Justin Marchegiani: Wonderful. And talk more about your group program. How does that work?

Angie Alt: So, I run a group program called SAD to AIP in SIX, as in Standard American Diet to The Autoimmune Protocol over six weeks. And we just do this gentle phase approach, where instead of just like cold turkey jumping in to the elimination phase of the AIP, which at– you know, we just went through that whole list of foods. It’s really intimidating to kind of do that cold turkey. And for a lot of folks, it’s not very sustainable to do a cold turkey. So, what we do instead is just gently eliminate one or two food groups per week, while we also add a nutrient-dense food, so that we don’t make that mistake of not adding in some uh– nutrient density. And also focus on one lifestyle habit per week to kind of tweak and perfect. Uhm– and then, by the end of the six weeks there in the full elimination phase, they’ve kind of got the lifestyle stuff on board, they’ve addressed the nutrient density in adding all those foods…

Dr. Justin Marchegiani: Yeah.

Angie Alt: …and then, they can start to carry that process forward and see if they can uhm– move that needle on their health and get to a point where they can start to reintroduce and individualize, kind of personalize, their diet.

Dr. Justin Marchegiani: That’s awesome. And, how do someone’s interested in this? How do they sign up with you?

Angie Alt: So, I ran the program four times a year. They can go to my website Sad, S-A-D, to, T-O, And uhm– right now, we’re not in enrollment. Right now, we’re in our first– first cycle of the year, the January cycle. The next enrollment starts March 1st for an April start date.

Dr. Justin Marchegiani: Awesome. And what’s that link one more time? We’ll put in the show and notes description, too.

Angie Alt: It’s

Dr. Justin Marchegiani: Love it. Very cool. So let’s dig in, too. You also told me earlier that there was a recent study done on the Autoimmune Protocol with Inflammatory Bowel Disease. I have the abstract up. Talk to me about this study. How did it– How did it happen? I know you teamed up with another medical doctor to make this study uh– some to life. Walk me through, kind of, the work it took to even make this happen [crosstalk] and then go on some of the results of the study, too.

Angie Alt: That’s so funny.

Dr. Justin Marchegiani: Oh, by the way– By the way, uhm– people that are watching this live, feel free and chime me with some questions. At the end, we’ll go through and answer some of your questions. Try to keep all the questions pertinent to the autoimmune protocol.

Angie Alt: Yeah.

Dr. Justin Marchegiani: Awesome.

Angie Alt: Uhm– So, ab– I guess it was in December of 2015, uhm– my blog partner Mickey Trescott, uh– you know, we blog together. Uh– we were contacted by Dr. Konijeti uhm– at Scripps University. Sclipps– Scripps Clinic in San Diego. She’s a gastroenterologist there. And she said, that she had had a patient who came in and asked her if he could try the autoimmune protocol but he was dealing with really severe ulcerative colitis. And she said, okay. She would give him a little bit of time to give us a try but she was really concerned that it was time to move on to more aggressive treatment. And– so he went for it and he came back a few months later, and she did some more imaging studies and he was in clinical remission.

Dr. Justin Marchegiani: Wow.

Angie Alt: And she was so shocked. Just so surprised about this enormous turnaround that she decided she wanted to study this diet and find out what was up and she asked him for information, like where did he find it, about this information. So, he pointed her to our website and she saw that I had a group program, uhm– you know, the SAD to AIP in SIX Program, introducing folks to the diet. So, she contacted us and said I want to do this study, and I love to use your group program to on board the study participants into the process. And, of course, I said, “Yes, please. Like I’ll do anything you want me to, Doctor. I would love to help you study this diet.”  It was the first ever study of AIP. So, we were really excited. Uhm– So we got started. She got uh– a grant put together, and then in 2016, we started the process. We took 15 patients through the process, uhm– slowly introducing them to the autoimmune protocol over six weeks. And then, we uh– walked through maintenance with them for five more weeks. And, by week 6, eleven of the fifteen were in clinical remission. So, that’s 73 percent. Uhm–

Dr. Justin Marchegiani: Wow.

Angie Alt: And they remained in remission during the whole process. And this was not uh– you know, like a wimpy bunch of folks with autoimmune disease, with inflammatory bowel diseases. They had either crohn’s or ulcerative colitis. Uhm– the average disease link for these folks was nineteen years. Uhm–

Dr. Justin Marchegiani: Whoah!

Angie Alt: A lot of them are on immuno– [crosstalk] you know, biologic drugs, trying to, you know, deal with autoimmune disease. They weren’t in remission despite the drugs. So, the diet really was the clincher, bringing them into remission. Uhm– and several of them were able to get off of their medications following the diet. So…

Dr. Justin Marchegiani: Amazing.

Angie Alt: …really excited.

Dr. Justin Marchegiani: We have the study at on screen. I’m not sure if everyone can see it or not. But I have it up on screen. It’s really interesting. So, fifteen patients with IBD. IBD is Inflammatory Bowel Disease…

Angie Alt: Uhhmn–

Dr. Justin Marchegiani: …typically, the big two are Crohn’s and ulcerative colitis, right?

Angie Alt: Fact. Uhuh.  

Dr. Justin Marchegiani: [inaudble] …like these fit in that category?

Angie Alt: Uhm– I’m not sure that there’s any other that are kind of as well-known as those two.

Dr. Justin Marchegiani: Right. That makes sense. So you have 15 of these patients. They have like kind of a subjective questionnaire, and they also had calprotectin levels, right, which is a…

Angie Alt: Yeah.

Dr. Justin Marchegiani: …of gut inflammation?

Angie Alt: Yeah. Exactly. So, Dr. Konijeti and her team uhm– They measured all the kind of medical markers, right?– all the clinical stuff. So, they did scopes with an endoscopy. They also did uhm– colonoscopy scopes. They uh– took blood work. They– you know, for instance, they measured calprotectin, which helps measure with their inflammation. And uhm– they uh– they look to those symbols so they could kind of see what happened to their microbiome over time. Uhm– they kind of did all that clinical stuff. And then we also administered kind of quality of life surveys that are uhm– designed specifically for folks with IBD. So, it helps, you know, kind of measure things like uhm– “how often are they having bowel movements and how is that changing over time,” “how is their disease affecting their daily life and the activities they can do” and “how is that changing over time,” etc. So uhm– all of that information, all that data was also uhm– kind of looked at at the end. And the changes were just incredible. You know, uhm– clinically and self-reported, they– they were in a totally different space by the time we were done.

Dr. Justin Marchegiani: That’s amazing. So, so we have this male score, which is a kind of a subjective indicator…

Angie Alt: Uhmn–

Dr. Justin Marchegiani: …in this Harvey-Bradshaw score.

Angie Alt: Uhmn–

Dr. Justin Marchegiani: So, we have these [crosstalk] kind of subjective surveys or questionnaires that were filled out…

Angie Alt: Uhmn–

Dr. Justin Marchegiani: …to just to kind of give a run-down– so here. I think it says on the uhm– abstract, it went from a 5.8 to a 1.0 and on a male, in a seven to a 3.4 on the Harvey. So, big reduction in the calprotectin when from 471 to 112. So, I run a GI Map test. So, typically, in a lot of my patients, which is a test looking at gut infections. It also has the calprotectin marker on there, and typically, less than 50 is considered negative. But 471’s like still like eight or nine times above normal, so 471 to 112 is still a good 75 to 80 percent reduction and inflammation in just six weeks. That’s phenomenal.

Angie Alt: Yeah. It’s really phenomenal. I mean uhm– you know, it was just awesome to get to, you know, hear them reporting for themselves how much it was changing their lives. You know, these are people who have been dealing with this disease for– you know, some of them, more than 20 years. Uhm– and to finally feel like– you know, their quality of life is back. That was– is really rewarding. It was like– it was very exciting to get to participate in that study.

Dr. Justin Marchegiani: Amazing, and it’s really interesting. C reactive protein did not change much. That’s fascinating, but it makes sense ‘cause calprotectin is definitely that. It’s more of an inflammatory marker, specific to the gut.

Angie Alt: Uhmn–

Dr. Justin Marchegiani: Any thoughts on the overall systemic inflammation via the CRP marker not changing?

Angie Alt: You knnow, I think for some of them, uhm– there probably were some little tweaks that needed to be made over the [crosstalk] more long term…

Dr. Justin Marchegiani: Right.

Angie Alt: …uhm– to– to work on the CRP. You know, maybe their sugar intake was uh– still a little high, even though we cut out all the processed uh– sugars. They probably needed to work on that just a little bit more. Uhm– for some of them, there might be genetic issues that are at play there that we didn’t have in the scope of the skudy– stu– Excuse me– Scope of the Study to work on.

Dr. Justin Marchegiani: Yes.

Angie Alt: Uhm– you know, maybe for instance, there are some MTFR that needs to be handled something like that. Uhm, so, some– some of that maybe there, I also think that maybe I– I know for sure, there was at least one study participant who was working out probably too hard. [laughs]

Dr. Justin Marchegiani: Yeah.

Angie Alt: Uhm– and so, he was probably contributing to some inflammation in that way that I kept trying to say, “Hey. Like– It’s– Working out is still a stressor for  the body. Slow down a little bit, so you’re body can heal and catch up. [laughs]

Dr. Justin Marchegiani: Totally. And it like– so how long did it take for this study to happen, start to finish? And, what was the cost of a study like this to make it happen?

Angie Alt: So, you know, I would have to go back and look at my invoice scene. I charged a little bit more than I normally do for my group program because I also brought in uhm– a registered dietitian, Amy Kubal, who helped me. ‘Cause you know…

Dr. Justin Marchegiani: Yeah. Amy.

Angie Alt: Amy’s got clinical experience, so Amy could help me uhm– some from that side of it. So we could [crosstalk] make specific changes in regards to disease and– and lab results and everything. Uhm– And then, uhm– I brought on another Health Coach, who has inflammatory bowel disease herself and got it to remission with the Autoimmune Protocol. So that– you know, she could really relate to them. It’s always great to have somebody who’s very empathetic. So, yeah. So, I pumped up my team a little bit, and we changed the program a little bit. We tailored it to be very specific to one diagnosis. Whereas, my program is usually, any autoimmune diagnosis. We made it specific to IBD. So– but even so, you can do this for so cheap. I mean, it– it– it really doesn’t– It’s nothing compared to the cost of medications.

Dr. Justin Marchegiani: Uhmn–

Angie Alt: You know…

Dr. Justin Marchegiani: Oh, totally.

Angie Alt: …you can really– Yeah. You can totally change people’s lives. And it was a total of eleven weeks. But they were in remission by week six. I mean…

Dr. Justin Marchegiani: That’s amazing. And I– I just kind of postulating. I imagine– you know, we’re not doing– you know, you guys weren’t doing Stool Testing, so there could have been infections going on there. There could still be low probiotic levels, or maybe even some malabsorption that maybe needed to be repleted with certain nutrients that maybe could have made accelerated results even more.

Angie Alt: Sure.

Dr. Justin Marchegiani: What do you think?

Angie Alt: Sure, of course. You know they weren’t doing stool samples but they weren’t doing– they weren’t doing Stool testing in that regard…

Dr. Justin Marchegiani: Uhmn–

Angie Alt: …like what you’re about, like a GI Map type of thing. And yeah. For sure, there could be some underlyers there that needed treatment, specially because they have IBD. You know, there could be uhm– issues with absorption and other things that need to be treated.

Dr. Justin Marchegiani: Phenomenal. Well, anything else you want to mention about the study before we head up a couple of listener questions?

Angie Alt: Uuhhm– I don’t think so. It was just– it was a really a great experience. It was an honor to get to participate in the first ever AIP study. It was small but it’s definitely proof of concept now. And I hope we get to do bigger ones. [laughs]

Dr. Justin Marchegiani: Phenomenal. Alright. Let’s hit these kind of rapid fire here.

Angie Alt: Okay.

Dr. Justin Marchegiani: First question: Can colitis or other IBD issues, Inflammatory Bowel Disease issues– Can they lead to other health issues?

Angie Alt: I mean, it’s not uncommon for people with one autoimmune disease if it’s not kind of aggressively treated and dealt with for them to develop more autoimmune diseases. So, for instance if you have ulcerative colitis, the possibility that you might develop, you know, rheumatoid arthritis or uhm– you know, psoriasis or something, is not really that far-fetched.

Dr. Justin Marchegiani: Great. And, what’s your opinion on other genotypes, like someone’s talking about HLA, right? Like of those HLA-DQ1 and 3 and 2 and 8, I think are more celiac ones. How does the genetics uhm– contribute or affect autoimmunity?

Angie Alt: You know, Dr. Terry Wahls said something that’s perfect all the time about this.

Dr. Justin Marchegiani: Uhmmn–

Angie Alt: She says the genes load the gun but environment pulls the trigger.

Dr. Justin Marchegiani: Phew! Yeah.

Angie Alt: Exactly. So, this is a really good way to think about this. So, if you have any of those uh– genotypes. You know, for instance, I have celiac disease, so i have HLA-8.

Dr. Justin Marchegiani: Uh!

Angie Alt: Uhm– you know, if you have those genotypes. Then you might be predisposed.

Dr. Justin Marchegiani: Uhmn–

Angie Alt: But if you can work on your diet and lifestyle, you may prevent that trigger from being tripped.

Dr. Justin Marchegiani: Totally. So, basically, we have control of the epigenetics that…

Angie Alt: Right.

Dr. Justin Marchegiani: …flip the genes off and on. So, if we managed– let’s say, the diet gene, the AIP gene, right, then that’s gonna affect those autoimmune genes from flipping on…

Angie Alt: Right.

Dr. Justin Marchegiani: …and activating the said [crosstalk]–

Angie Alt: Exactly.

Dr. Justin Marchegiani: Wonderful.

Angie Alt: Exactly.

Dr. Justin Marchegiani: Awesome. Patient writes here. Let’s see if we can connect it to the autoimmune approach here, but I have hypothyroid and a sluggish gallbladder. What do you suggest for diet and vitamins? Thoughts?

Angie Alt: Well, so first of all, with the hypothyroidism, I would, you know, really work with your doctors and do some antibody testing and try to clarify if that hypothyroidism is Hashimoto’s, which is the autoimmune version of hypothyroidism. A lot of times, folks are just told, “Oh, you’re hypothyroid.” But their doctors don’t do that extra layer of work to d– clarify if it’s an autoimmune disease. Uhm– If it is autoimmune in nature, yeah! I’d go for it and tr something like the autoimmune protocol. Oftentimes folks with uhm– Hashimoto’s need to have uh– some conventional and some natural approaches so, they might need some uhm– hormone replacement. Some thyroid hormone replacement.  

Dr. Justin Marchegiani: Uhmn–

Angie Alt: that’s okay. If you work on the diet and lifestyle, in conjunction with th– thyroid hormone, it’s gonna be so much better. You’re gonna need a lower dose and it’s just gonna work a lot faster. Uhm– as far as the gallbladder goes, you know, there’s things you can do, dietarily to help support gallbladder health, and hopefully turn that around before you lose your gallbladder. So, you can do things like uh– eat lots of beets, uhm– improve the quality of the fats that are in your diet, so focusing a lot on olive oil, and other good quality saturated fats, like you know, pastured lard or pastured tallow. Uhm– avoid all those damaged low quality fats that are out there. Like in fried restaurant foods. Uhm– if you already lost your gallbladder, you might want to consider supplementing with something called ox bile.

Dr. Justin Marchegiani: Phenomenal. Excellent. Other person writes in here, saying that uhm– when they have– they have diagnosed for celiac but hen they eat eggs, they have this really bad taste in their mouth and they get diarrhea three to four hours later. Not really a question. Just more of a comment. But any thoughts on kind of egg and digestion. I know that’s an autoimmune food, too. Any thoughts?

Angie Alt: Uhmn– Yeah. I mean, there might be uhm– I thi– I believe egg is one of the uhm– foods on Cyrex’s list of possible cross-reactors to gluten. So, there might be a cross -reactor situation happening there. It could also just be that because of the damage from Celiac disease, you know, she hasn’t– she has increased sensitivity.

Dr. Justin Marchegiani: Yeah.

Angie Alt: And maybe with a little bit of healing dietary approach, in times you could reintroduce egg just fine.

Dr. Justin Marchegiani: And so, for reintroducing foods we have an issue, how long do you recommend to try it again? Should it be something we put on our list, maybe once every month or two to kind of try back in?

Angie Alt: I think it depends on how bad a reaction is.

Dr. Justin Marchegiani: Yeah.

Angie Alt: So, let’s say, you try to reintroduce a food, and you have a really bad flare from it. Like, your– all of your autoimmune symptoms kind of flare up and you’re in a really bad space. You might want to give it at least 30 days to let everything calm back down and let your body…

Dr. Justin Marchegiani: Yeah.

Angie Alt: …kind of go back to the uninflamed nice, calm, immuned space it was when you started to reintroduce the food. Uhm– if it’s  a pretty mild reaction. I’d give it, you know, five days to seven days, and uhm– you know, really work on some healing. In the meantime, pump up that bone broth, stuff like that and then give it another shot.

Dr. Justin Marchegiani: Phenomenal. Excellent. I think we hit all of the major questions. I don’t see anything else there.

Angie Alt: Yehey!

Dr. Justin Marchegiani: Any other issues, or anything else you want to mention that’s yo– that we haven’t quite hit yet?

Angie Alt: Uhm– You know, for anybody in your audience whose a fellow practitioner uhm– of any kind, Mickey Trescott and Sarah Valentine and I started a program last year called AIP Certified Coach. It’s a training program for practitioners uhm– who want to coach the autoimmune protocol with their patients or clients. Uhm– We graduated our first class uh– in September and we have an enrollment coming up in March. And, we would love to have anybody join us. We had doctors and naturopaths and dietitians and fellow [inaudible] pharmacists. Uhm– It was really great, and people all over the world, so there was like lots of interesting discussion and cross-pollination with everybody, and we’d love to have uhm– any of those folks in your audience join us.

Dr. Justin Marchegiani: Was that

Angie Alt:

Dr. Justin Marchegiani: Okay. We’ll put that in the show notes below. Anything else?

Angie Alt: Nope. I think that’s it.

Dr. Justin Marchegiani: Alright. Let’s get your links one more time. What’s the– the coaching link program again?

Angie Alt: My coaching program is I blog and podcast with Mickey Trescott at…

Dr. Justin Marchegiani: Nice.

Angie Alt: … Yep. You can find all our books and everything there. Uhm– and then, the coaching program for practitioners who want to learn about the autoimmune protocol is

Dr. Justin Marchegiani: Awesome. Well, thank you so much Angie for all these great information.

Angie Alt: Yeah.

Dr. Justin Marchegiani: Look forward to having you back soon and it’s so exciting, like seeing these things that we know that work, and then translating it to a real study that’s…

Angie Alt: Yeah.

Dr. Justin Marchegiani: …peer-reviewed, and seeing the information. I’m just curious, like what’s the– what’s conventional medicine people, in these fields thinking about the results of these studies.

Angie Alt: Well…

Dr. Justin Marchegiani: Are they kind of blown away? Or…

Angie Alt: Yeah. I remember when we got the results, Dr. Konijeti– you know, it was really exciting to get her first phone call with the first results. And she was like, “Oh, my gosh!” And she was just really blown away. And, you know– I– I knew anecdotally that was this good, but uhm– getting to see those ,hard numbers was really exciting. I think I probably told the doctor like, “I told you so,” or something. [laughs]

Dr. Justin Marchegiani: Yeah. I mean. Look the page. Did you see the– subjective results, some of the objective stuff, but it’s not– we’re not doing these– you know, scientifically validated surveys and all these things, and really measuring it all, and having a statistical significance attached to it. SO, I’m really glad that you uhm– that you really crystallized this. I’m gonna do a video on my p– my channel where I review this– this study again. I’m gonna go to the full study and really…

Angie Alt: That’d be great.

Dr. Justin Marchegiani: So, I appreciate– you know, all the great work that you’re doing and thanks so much. Look forward to having you back on the show again soon.

Angie Alt: Yeah. Thanks for your work, too, Dr. J.

Dr. Justin Marchegiani: Thanks Angie. Take care.



Robb Wolf’s “The Paleo Solution”

The Paleo Mom’s Dr. Sarah Valentine’s, “The Paleo Approach” by Dr. Sarah Valentine

SAD to AIP in Six by Angie Alt, with Mickey Trescott

Dr. Terry Wahls

Dr. Gauree Gupta Konijeti, MD

Autoimmune Protocol with Inflammatory Bowel Disease

“Coffee is a fruit…” by Dave Asprey

Thyroid and Nutrient Deficiencies Q & A – Podcast #125

Dr. Justin Marchegiani and Evan Brand dive into an exciting discussion all about thyroid. Listen carefully as they engage in a dynamic conversation with the listeners and share some valuable information regarding their functional medicine approach on issues relating to thyroid; its connection to adrenal health, gut health, nutrition, and infections.

Learn about the hyper- and hypo- symptoms related to thyroid issues. Find out how other conditions like leaky gut and other infections are linked to thyroid health. Gain valuable information on different tests used to assess thyroid health and rule out other conditions contributing to thyroid issues. Increase your awareness about the different sources, like foods, supplements, and metals which all impacts thyroid function.

In this episode, we cover:

04:19   Thyroid and its connection to adrenals and leaky gut

12:50   Testing for Autoimmunity

16:42   Infections and Thyroid Health Connection

21:35   Cortisol Lab Test for Adrenal Issue

28:36   Thyroid Symptoms and Assessment

32:23   Iron

37:20   Gluten and its connection to leaky gut

54:23   Mercury

58:25   Iodine







Dr. Justin Marchegiani: YouTube as well. Any questions, feel free to type them in. Today’s podcast will be on thyroid. Evan, can you hear me okay?

Evan Brand: I sure can. You sound good.

Dr. Justin Marchegiani: Awesome, man. We are live. What’s going on, man?

Evan Brand: Oh, not too much. Like I told you, somebody in France has had a fun weekend with my business credit card. So uh – besides that, everything is good.

Dr. Justin Marchegiani: Very cool, man. Yeah. Well, at least you got a capital one card, so you’re pretty well protected, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s awesome. So we’re live on Facebook and YouTube. Again, better to be on YouTube, my opinion coz you get to see Evan and myself. If you’re watching me on Facebook right now, we’re a little compromised. We only got my feedback. You’re not gonna hear Evan’s side of it. So feel free and check out to be able to see Evan’s pretty face and be able to get some questions there. But we will answer questions on Facebook Live, too.

Evan Brand: Cool. So today we wanted to talk about thyroid. There is many lab test out there that you can get. Still, conventional doctors are not running the lab tests that are important, though, some of these antibody markers, some of the reverse T3 markers. Maybe you should briefly chat about that just since people maybe on Facebook. Talk people through why is this happening? Why are these conventional doctors not running these other important thyroid markers? Why is it just TSH and some of the other boring stuff?

Dr. Justin Marchegiani: Great question. And again, today we’re talking about thyroid and we talked about this topic a lot, done a lot of videos on it. I have a book coming out on this very shortly as well. So I’m just kinda do a brief overview. Feel free and check out Evan’s page not just and his podcast from more info as well as mine. We’ll give you more info here today. Hopefully we’ll be able to have a live interaction. But Evan’s question is for the Facebook live listeners. “Can we get podcast live on YouTube, too?” is the question about conventional thyroid issues versus functional thyroid issues. And this is a big difference, and most people they go and get help from their conventional physicians on matters of thyroid issues. They think that their conventional doctor is ruling them out for thyroid issues and they may, if it’s an extreme thyroid issue. You know, very, very high TSH, extreme thyroid swelling, uhm – maybe while hyper-symptoms if their grades are on the hyper side, or if they have a lot of thyroid destruction, or goiter things. They may get picked up by conventional testing, but many patients they aren’t getting picked up on conventional testing because they’re kinda in no man’s land. Conventional medicine looks at things like an on and off switch. You’re either healthy, right? The light’s on. Or you’re unhealthy, the light’s off. And we know in functional medicine world, that light switch is more of the dimmer switch, right? The light may be on halfway, right? You’re halfway healthy; or another way to look at it, you’re halfway to not being healthy. But it may not be all the way off. Maybe just flickering a little bit. And unless you’re all the way off, what’s gonna happen is they’re not gonna see anything wrong with your health issues regarding your thyroid. And they’re not gonna make any recommendations for interventions. And that’s the biggest problem. With thyroid issues, looking from the conventional to the functional medicine realm. And also, you have to look at the tools that they have right there. One tool – most part two, you’re gonna have some kinda surgical intervention or you gonna have some kind of uhm – pharmaceutical intervention. None of which typically fixes the root cause of what’s going on. Especially when we understand that thyroid issues are 90% autoimmune in nature. I’d say at least 50-90%. So we know if it’s autoimmune, and we don’t fix the underlying cause of why the autoimmunity is there, right? Then the underlying mechanism of the antibody is in the immune system attacking the thyroid tissue is still happening in the background.

Evan Brand: That’s terrible. I mean we’ve got thousands of people at this point who we work with, where they’re on thyroid drugs, and they still feel terrible. And I’ll go back and say, “Hey Doc, look, give up my Synthroid or other pharmaceutical, I still feel terrible.” And they’re just gonna up the drug more and more and more. So it’s like you’re jamming this gas pedal down, but you are not figuring out what’s the issue in the first place. And so for us, we’ll always gonna be looking at the gut; looking for infection; seeing what could be going on; why is there some type of attack going on. And then also looking at adrenals, too. And figure out what’s the adrenal thyroid connection. Maybe you could brief people on that a little bit? How someone with adrenal issues could have thyroid issues and vice versa.

Dr. Justin Marchegiani: Yeah. So Evan, your question was looking at adrenals thyroid issues, we also have a listener question as well, talking about thyroid and gluten sensitivity. I’ll try to intertwine with the two answers. But again, adrenals are really important because you have cortisol production coming from the adrenals, which is important for managing stress and inflammation. Also, generally energy via blood sugar. Also, cortisol – is they differ healthy thyroid conversion. So if we have two high cortisol, or if your stress response is too high, we’re kinda in a Stage I adrenal issue that can block thyroid conversion. So we have this T4 thyroid hormone that gets converted down to the T3. And T4 is relatively inactive compared to T3.  So we have to make this conversion. There’s a lot of things that are needed for that, whether it’s selenium, or zinc, or vitamin A, or other nutrients to help make that conversion. But cortisol, from a hormonal perspective, is also needed. So if we’re too low on our response, right? We have this HPA axis, this regulation, the brain, the agent P, the hypothalamus and pituitary are hypo functioning. They’re dysregulated like a broken thermostat in your house – doesn’t turn on the heat, or turn on the air conditioning. That same thing is needed to help make that conversion from T4 to T3. So we have depleted adrenals that can strongly, strongly be an inhibiting factor of thyroid conversion. And also, if we have too much stress, one of the mechanisms the body does to regulate the stress response, is to make more reverse T3, which is essentially like taking uhm – the clip by the – your gun and putting blanks in there. So they kinda – they fit into the – into the magazine. They fit into the cartridge, right? But they fire, but that then you don’t get the same metabolic effect. You don’t get the increase in energy; don’t get all of the hormonal benefits; you don’t have the warmness and the increased blood circulation; and you don’t have the degradation of cholesterol and other hormonal byproducts. So you can see that the adrenals are intimately connected. Now answering the person’s question here on gluten. Gluten is really important because that’s a big strong – That’s a big stimulator of leaky gut. So gluten exposure can drive leaky gut. What it does is it increases zonulin, which unzips the tight junctions in a lot of patients, even people that are necessarily having a response to gluten. It shows that there is still uh – intestinal permeability that’s happening. And the more food particles that get into the bloodstream, the more LPS is in the gut, the more that can unzip the gut, the more – allow more food particles in there, and create more immune stimulation. And it’s also inflammatory in the gut, too. And also can create this concept known as molecular mimicry, where the immune system sees the surface proteins, and it can mistakenly identified it is the thyroid, and it starts attacking the thyroid tissue, creating more inflammation. And that can cause these thyroid follicles. So still, that hormone is creating unbalanced levels.

Evan Brand: And this could all come from gluten exposure, you’re saying?

Dr. Justin Marchegiani: It can all come from gluten exposure. Gluten is one strongest stimulators of leaky gut, along with distress, along with LPS, which is a compound produced from bacterial overgrowth, right? So the worse stomach acid, the more stress we have, the more essentially we’re not breaking down our food, the more we’re gonna have bad bacterial overgrowth that’s gonna increase LPS, that’s gonna unzip those tight junctions even faster, which is gonna create more immune issues, more food allergy issues. Because think about it, right? The immune system shouldn’t be getting revved up to deal with food; shouldn’t be getting revved up to deal with the digestion. So the more that’s happening- well what that means is that your immune system is going in overdrive. One of the major reason why people are when they’re sick – think about it. Because their immune system sucks up so much energy. So the more you’re revving up your immune system by just consuming food, you’re gonna be constantly tired. And that’s just gonna drain your adrenals, and drain your thyroid, and increase that thyroid autoimmune attack.

Evan Brand: Yup. Well said. So I mean, we got the zonulin. What’s the link there between the zonulin and LPS? So are these connected at all? Or are these going up and down in relationship to each other?

Dr. Justin Marchegiani:  Yes. So the more zonulin you have, typically the more leaky gut you’re gonna have, right? So vitamin D is actually a zonulin inhibitor. So the more zonulin you have, the more leaky gut. So LPS will increase zonulin. Infections will increase zonulin. Gluten will increase zonulin. And that basically, if this is like Parker jacket, you’re wearing that’s kinda like unzipping those tight junctions and then basically food particles can get in there.LPS particles can get in there. When LPS flows to the brain and makes it way up to the brain, leaky gut, leaky brain that LPS can create inflammation in the brain which feels like brain fog, which feels like mood issues, which feels like depression, which feels like anxiety. And this is really hard for a lot of people. Getting back to Evan’s question on gluten and the brain, is people may have a gluten issue. Think that well gluten has to cause digestive problems diarrhea, bloating, gas, reflux constipation, diarrhea. But it may not – It may be causing depression, anxiety brain fog, poor memory, poor uh – just word recall. And you may have a gluten issue, but it may not be even because by – you know, you may not see it because it’s not those conventional symptoms. And again, that same thing is gonna create thyroid issues, too. Coz that same mechanism that opens up the lining of the blood-brain barrier and the brain, also affect the gut, which then creates that more autoimmune thyroid attack.

Evan Brand: Well said. And there’s a lot of people that justify eating gluten to us. Whether it’s like organic wheat, or they’re doing some type of like sprouted wheat, or something like that. But gluten is gluten, and even if you’re not celiac – now there is research that shows that celiacs are gonna have30 times higher zonulin levels than a non-celiac. So massive, massive leaky gut in the celiac person in comparison.

Dr. Justin Marchegiani: Right.

Evan Brand: But still, we could even talk about the study. It’s Scandinavian Journal of Gastroenterology. It showed that gliadin, which is a gluten protein can affect zonulin even in people without the gene for celiac.

Dr. Justin Marchegiani: Yes.

Evan Brand: And so basically they said, “All gliadin, regardless of what – whether you are celiac or not, it’s still going to activate zonulin, therefore leaky gut, therefore this LPS, these endotoxins are gonna get in there.”

Dr. Justin Marchegiani: Totally.

Evan Brand: Which is crazy. And – and I love that. I love that the science because then you and I aren’t the bad guys when we’re telling people to get rid of gluten. It’s like, “Look, here is the research.” Yeah, maybe you don’t get a – acne from gluten, but you still causing leaky gut, regardless. I love that we can actually prove that and it’s not just up for – it’s not just our opinion coz we’re the nutrition guys.
Dr. Justin Marchegiani: That’s the key thing that you mention there, Evan. The zonulin and the gluten can trigger the leaky gut and you may not necessarily have an autoimmunity, and the question is the more stressed you become, the more compromised you become, the more your toxic burden, your stress burden, the more  your – the physical, chemical, emotional stress buckets get full. That’s where your body’s ability to adapt to stress really becomes inhibited. And again, the biggest mechanism really is, leaky gut. Even if you’re not necessarily gluten sensitive, you may be getting a leaky gut, which is adding stress to that stress bucket, right? It’s decreasing stomach acid; it’s decreasing enzymes; it’s increasing the ability to have food allergens; it’s increasing transfer infections and SIBO.Because the more your immune system is weakening the gut, the more that force field, that IgA gets lower, and the more critters can come in. So, yeah, 100%. And again a lot of people – I’m not a big fan of gluten because its, one: it’s hard to break down, it’s heavily pesticide, it’s low in nutrient density. A lot of the anthropological data shows that it’s been consumed only about 10,000 years ago, and the people that are consuming it typically have lower bodies – body stature, smaller in uhm – skeletal structure and increased risk for osteoporosis. Again, hunter gatherers tend to be more forgers uhm – starchy tubers, berries. Those kind of things, and obviously, meat and bone marrow. You study how the brain evolved. Really, it was the hand axe that allowed us to carve into bones and access bone marrow, and then creates spears to kill animals, and access that nutrients to grow our brains massively. Omega-3 is fat from the fish. So all of those things were huge in evolving our brain. Now, getting back to thyroid-We got a couple questions over here from the listener’s here on YouTube. So I’m gonna list a couple of. Couple is “how do you test autoimmunity?”Number one: kinda tying it back thyroid. We would look at TPO, or Thyroid Peroxidase antibodies or anti thyroid globulin antibodies; we’ll look for immune attack on the thyroid tissue. Also, we can look at TSI, immunoglubin, which is a marker for Graves’ disease, which is also a thyroid condition; or TSH receptor antibodies for the hyper- TSH receptor antibodies for the hyper; TSI for the hyper; and then TPO and thyroglobulin antibodies for the hypo. Now again, you can have the hypo antibodies, though, and have hyper symptoms initially. So you can kinda be on both stages at one point. So just kinda keep that in mind.

Evan Brand: And then more time, just so people are clear to that. Seems a bit confusing.

Dr. Justin Marchegiani: A lot of people that start out with hyperthyroid – or sorry – hypothyroid antibodies, low thyroid function antibodies, the TPO and thyroglobulin bodies, even though those are markers for a hypo-, Hashimoto’s, they can progress into hyper- symptoms initially because your thyroid follicle have about four months of thyroid hormone stored in it. So what that means is, you can spill out that thyroid hormone many, many months before, even up to a year or so, before you actually get depleted and go low. And that’s where the TSH gets really high. TSH will go high as the thyroid gets depleted, but in the initial attacks, in the first year or so, you may feel more hyper- symptoms even though it is a hypo– Hashimoto thyroid mechanism that’s happening.

Evan Brand: Uh, got it.  Well said. Okay. So, people may self-diagnose themselves with hyperthyroidism, your saying that it could actually be a hypo-caused by Hashimoto situation that’s going on. They just don’t feel the full effects yet coz it’s a new – it’s a new attack. Is that correct?

Dr. Justin Marchegiani: Totally. So the symptoms they may have is irritability, anxiety, mood issues, difficulty sleeping, heart palpitations, uhm – they may have like tired but wired kinda feeling. Those are the big things that they’re gonna have. I would say, yeah, the anxiety is gonna be a big one. Difficulty sleeping is gonna be a big one. Where the hypo- symptoms star to come in, again you may still have anxiety; you may still depression. The big differences is you’re gonna start to see the hair thinning because thyroid hormones are needed for hair follicle growth. So the outer thirds of the eyebrows go; the hair starts to thin on top; cold hands and cold feet it starts to happen. You may start to see constipation issue, too. You may start to see your triglycerides and your cholesterol go up. Again, infections can cause constipation, too. Uh – increase insulin can also cause increase cholesterol and triglyceride, too. So there’s other things. But that’s a general indication, is the cold hands, cold feet, the fatigue, the hair loss, the constipation and the increase in lipids you’re gonna see. That’s why you wanna test full thyroid panel, which is gonna consist of TSH, brain hormone, T4,inactive thyroid hormone (free and total), T3, which is converted peripherally 20%, and 80% throughout the body (free and total) and obviously you T3 uptake. You can look at thyroid binding globulin, which can go up or down if you have PCOS or on birth control. And then also reverse T3 and all the antibodies I mentioned.

Evan Brand: Yes. So I’ve also16:19read about another one that I’ve not seen used very much called TRAB, thyroid stimulating hormone receptor antibody, but it says that the antibodies are only ordered when someone is hyper- . And a positive result for that usually means great. So I’m not seeing that one that often, though.

Dr. Justin Marchegiani: It’s just a different name for I think the TSH receptor antibodies. Like TPO also has a like a name called,microsomal antibodies. So again, typically it’s the same names. So TSH receptor antibodies that’s probably another name for that, just like the microsomal is the same name for TPO.

Evan Brand: Uhh. Okay, got it. Now should we talk about – Is this is the time we should talk about the link between infections and thyroid health? Because people that were looking at, we’re not just gonna look at thyroid, we’re gonna look at the gut, too. And the average between us is about 1 in 3 of having infections. You know, every third person is gonna show up with infection. Sometimes even – you know those weak. Sometimes it’s 9 out of every 10 people has a parasite or other infection.

Dr. Justin Marchegiani: Totally. So we have a few questions coming on the uhm – YouTube Live board here that we’ll kinda tie in. But yes, so the big infections that can affect thyroid and can increase that thyroid autoimmunity: H. Pylori, okay, Yersinia, Enterocolitica, blasto, E. histo. Those are gonna be the big ones that are really gonna affect the thyroid. Even Lyme has a specific amino acid pattern that can create autoimmunity to the thyroid. So for sure, those are the big ones. You know, there’s been study showing that when you eradicate H. Pylori – It’s Italian study out there, that thyroid antibodies significantly drop. I have a video on blasto, right? Blasto infections are resolved, antibodies drop. Same with Yersinia, infections drop. As you attack Lyme, antibodies drop. So that can be a big stimulator and drive more leaky gut, more zonulin, more immune stress, which then creates more stomach acid and enzyme environments, which creates more adrenal stress, more thyroid stressed, and more nutrient deficiencies which perpetuate everything. So you can see, if don’t get to the root cause in this, that’s fine. You can go see your conventional medical doctor to make sure your TSH isn’t elevated, right? But in the end, you’re still gonna be suffering. And that’s why I have so many patients then I know you do as well that have all these symptoms. And I’ve seen a doctor for over a decade and are just tired of it. Alright, you know, this can’t just be my thyroid and all that we done is on 50 mics or 100 mics of Synthroid and that’s it. We can’t do anything else. They know there’s something more and that’s why they are reaching for people like you and myself, Evan.

Evan Brand: Yeah. Well in toolbox, it’s just not there, right. I mean, it’s not their fault. They’re just doing all that they’ve got. That’s the only tool in the – in the shed. The surgery or wait till you have some type of disease, or some big nodule, or a goiter or something crazy. And now, okay, now we have to do surgery.

Dr. Justin Marchegiani: Yeah. And a lot of people are talking about, “Well, what if you don’t have antibodies coming back on your thyroid?” My personal take on that is, above 40% comeback false negative. So it’s negative, but it could be positive. So what does that mean? Well, typically I’ll run the antibodies on someone at least three or four times before I say that they probably don’t have – they probably don’t have an autoimmune issue – at least 3 or 4 times. Now, the gold standard is a biopsy. Still going with a needle aspiration, and they poke it into the thyroid, they’ll if the tissues have any lymphocyte infiltration. So there’s an immune response going into the thyroid. So you can also have – you know your conventional physician palpate it. They’ll typically reach around your neck. So here’s my Adam’s apple, so it’s down just maybe a centimeter, and then out 1 or 2 cm. So it’s right here. And then you can typically run your finger right across it, then you can touch and push from one side to the other, and just feel the surface. See if it’s smooth, and then you can swallow, and feel that structure. And you can feel like a little nodule or a little bump and that’s possible. A nodule can typically mean autoimmunity or can mean an iodine deficiency. You can go to your conventional physician for that. I talked about the needle aspir –aspiration, but I don’t recommend unless you have – must you really want to know a hundred percent. The next more conservative approach would be a thyroid ultrasound to see if there is any swelling at all. Yeah. And that will be – those will be – My first line of defense would be, “Alright, let’s do your antibodies.” Second line would be ultrasound. I typically wouldn’t recommend the needle biopsy unless you are more worried about the cancer side of it, right? If I’m more worried about cancer then we may do that, or we may do a thyroid scan. But again, those are more invasive. I really only want to see those if we’re trying to rule out cancer. Coz typically the ultrasound and the antibodies will be the best. And we know, uncontrolled Hashimoto’s can lead to cancer, right? It increases your risk of cancer. So everything we’re doing is actually decreasing someone’s thyroid from progressing to a mandibular, papillary, follicular cancer. That’s – that’s the goal. So regarding that piece, everything we’re doing is gonna work either way because we’re mitigating the gluten in the food; or reducing the infection load; or upping the nutrients to help lower antibodies and help the thyroid convert; or making all diet and lifestyle changes and getting rid of the infection, which are gonna help improve the thyroid conversion, activation, and  the upstream signaling downstream.

Evan Brand: Early on in the chat, someone asked, “How should one read the cortisol lab test for adrenal fatigue?” “What numbers indicate the issue?” That’s gonna depend on the lab. Justin and I really like Biohealth, especially because they’ve got a brand-new test that were using now, which is six-point cortisol test. So any practitioners that are using a four-point cortisol test on you-

Dr. Justin Marchegiani: Uh-hmm. Yup.

Evan Brand: They’re outdated. They need to get with the –the times. With the 2017, six point is the new one. And how can you read the numbers? Well, typically there’s gonna be like a high patient line, a low patient line and then you would wannabe right in between those sandwich. And it’s gonna depend. So other labs are gonna have different – you know, different markers, different reference ranges. So for us to read a reference ranges to you, will be really boring. Uh – but basically long story short, you wanna be perfectly sandwiched in between those two lines. And it’s very rare that we see somebody in that. Most of the time we’re gonna see a low cortisol picture. And this is a low-free cortisol.

Dr. Justin Marchegiani: Yeah. Exactly.

Evan Brand: They’re gonna be low pretty much all day. And this is for most people. And so, then we have to keep digging deeper.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand: We don’t just throw them a bunch of adrenal support and say, “goodluck” We gotta figure out what – why is this happening?  Is there a lot of emotional stresses, or chemical stresses, or thyroid issues, or parasites? And these are the other pieces of the puzzle.

Dr. Justin Marchegiani: Exactly. So you made some really good points there. So with the adrenal, the car test, the adrenal, the uhm – the cortisol-adrenal response, especially in the morning. Cortisol starts off low in that first initial bit of waking up, and really pops up in the first half-hour to one hour after waking. So Evan and I are looking more at those types of test to see how that cortisol awakening response is happening in the morning. Coz cortisol is so important for thyroid activation to prevent T3 pooling, which is T3 not getting into the cells, as well as to prevent reverse T3 up-regulation, right? Reverse T3 is the uh – the blanks. The blank bullets that fit into the magazine that prevent the real bullets from getting fired. The real thyroid hormone being the real bullets, upregulating your metabolism. So those are the things that we’re looking at. And I agree, cortisol, and low cortisol, and low thyroid can intimately feel the same, right? We have patients sometimes that will feel like, “hmm, do they have a thyroid issue or adrenal issue?” We’ll run both test and we’ll see their TSH is, let’s say: 1, 1.5; T3 is at 3, 3.2; and their conversion is okay. But we’ll see, “Oh, yeah” their cortisol awakening response is terrible. Their cortisol is low; their DHEA is depleted. If they’re female patient, their hormones are off, right? So we’ll see. We’ll be able to  differentiate the two. And if you’re just going based of a symptoms, and trying to self-treat yourself, it’s gonna be really hard. You start going in one direction over the other. You may not get better. And a lot of patients, they instantaneously wanna go get their thyroid supported and treated first. The problem with that is, you increase thyroid hormone levels, and you already have lower cortisol. You can actually lower your cortisol even more, right? Just go google uhm – Addison’s disease, which is cortisol failure, right? – Addison’s disease, contraindications – And one of the contraindications you’ll see on their thyroid hormone because thyroid hormone can actually lower cortisol more. Coz think about it, right? Thyroid increases metabolism. The more your metabolism is increased, the more you metabolize through your hormones as well. So if we lower our hormones, and you are already at super low cortisol to begin with, you can actually feel worse as well. A lot of people feel worse when they just go after their thyroid and it can really create more problems.

Evan Brand: Wow. Now that you say that, I’m picturing a woman last week who, she was on Levothyroxine for a very long time. Her cortisol levels were like the lowest I’ve ever seen. So I wonder if it’s that drug that’s contributed to her cortisol being even lower than it would have been without the drug. What do you think?

Dr. Justin Marchegiani: Yeah. Absolutely. Absolutely. You can see patients that they go on their thyroid support, and they start feeling worse. And it’s just – it’s really difficult because if they’re seeing a functional medicine practitioner, they may lose faith in that person, right? And – and just say, “Hey, I’m just gonna keep on doing what I’m doing. I’m just gonna go back on the Synthroid.” So you have that aspect there, right? And then uhm – also have the fact that you know, what’s primary? A lot of people have in – the adrenal issue is the more primary issue. And if we start treating that first, then we may get the patient feeling better, which then creates more compliance. The more compliance, the more – the more the patient’s gonna follow through on diet, on lifestyle, on addressing infections. And that gives us a better chance to leverage the patients to do the right thing to heal.

Evan Brand: Well said. And plus, if the adrenals get back online, then we know that that conversion from T4 to T3 active is gonna be better. So they may not even need to go to the “thyroid support” if all these other root causes were the biggest thing. I mean it’s a parasite and an adrenal problem. If you fix those two things, is it possible you can get away with never going into, “Hey this is your thyroid program now. We just have to fix the other pieces.”

Dr. Justin Marchegiani: Yeah. Absolutely. So uhm – looking at that piece, you’re hundred percent right. I see so many patients, we’ll measure their thyroid temperature like their basal temperature. And again, for basal temps: 97.8 to 98.2 °F is gonna be where you wanna be for your armpit axillary temperature; and then98.2 to 98.6 °F is oral temperature. And typically do that in the morning before you get out of bed. And also do it sometime in the afternoon before you have lunch, and kinda do a general average. And again, a lot of people will be relatively low, and they’ll start to see their temperatures start going up uhm – as we treat the adrenals. One of the big things we see with the adrenals is we see an erratic temperature. The temperature is kinda bouncing around. Anything greater than .3°F can be – can lead to be a sign of a potential adrenal issue via a temp.

Evan Brand: Let me ask this. Let me ask this with you. So you’re saying, .3 difference. So that would mean if you woke up one day and you tested your armpit temperature, let’s say you were 98° flat in your armpit before you got out of bed, then the next day, you’re at 98.3. To you, that’s gonna signify thyroid and adrenal issues. Is that right?

Dr. Justin Marchegiani: So we went from 98 to 98.3?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. So it’d be greater than .3 So if you’re 98-98.4 and we’re consistently seeing this back-and-forth oscillation, so we’re seeing 98, 98.4 or 97.9 and it’s constantly bouncing back and forth greater than .3 that could potentially mean an adrenal issue, right? And because it’s erratic, but at a good level of temperature 97.8 or higher. So we typically mean of an adrenal issue. If we see it low and erratic, let’s say, 97, 97.4, 96.9 to 97.5, then that would potentially be an adrenal and a thyroid issue. And again, temperatures aren’t perfect, right? Like when we assess thyroid, there’s three indicators we use. We use subjective, which in my opinion is the most important. How do you feel? Do you have a lot more hyper- or hypo- symptoms, right? Hyper- symptoms being anxiety, palpitations, mood issues, tired but wired.

Evan Brand: What about sweating? Increased sweating?

Dr. Justin Marchegiani: – sweating, irritability, difficult sleeping. Where the hypo- symptoms, again, you can still have the mood stuff; you can still have the anxiety and mood stuff; you can still have some tired and wired – some tired and wired

feeling but typically more tired, though. And then the big thing is the cold hands, the cold feet, the thinning hair, the thinning eyebrows, the constipation. Those are gonna be the big differences. And obviously what trumps any of it, is an increase in TSH or thyroid antibodies are gonna be the biggest distinguishing factor, if it’s TPO or TSH receptor antibodies.

Evan Brand: And I just wanna mention one thing, too. In a lot of cases, the people we’re working with are gonna have both hypo- and hyperthyroid symptoms which can be equally confusing.

Dr. Justin Marchegiani: Totally. Yup. Equally confusing. I mean we look at like the test that we give our patients to assess that uhm – right? The other big one’s losing weight. Losing weight uhm – even though you’re – or unintentionally gaining weight if you’re on the hypo- side or unintentionally losing weight if you’re hyper- side, right? That’s gonna be another, another big one. Elevated cholesterol – another, another big one. So those are a couple of the other ones that I mention there where the anxiety, the excessively sweating, uhm – again, hands shaking, difficulty sleeping, uhm – feeling more warm on the hyper- side. Those are gonna be the other big ones. And obviously having a family history. If your mom, or your aunt, or uncle, or your sibling has a thyroid issue, right? That’s gonna be a big – just, you know, big factor. One of the big questions I do in all my intakes is, are there celiac disease or any autoimmunity that runs in your family? Whether it’s thyroid, or Parkinson’s or MS, or ulcerative colitis, or Chron’s or anything autoimmune related, type I diabetes. And if there is, that really gets me to hone in there. But testing for autoimmunity, conventional medicine typically does it like ANA, or HLA-B27, or an RA Latex like – these are like the conventional, like broad markers for like scleroderma, or like – or celiac, right? Or see, rheumatoid arthritis, or lupus. They’re very non-specific a lot of times. And again uhm – and they typically are late stage markers. It takes a while for them to pop-up.  And again, a lot of people they may be asymptomatic and still have them. So it’s not a real motivating factor for a lot of people. Where some of the things we look at it with the thyroid antibodies, well even just a little bit above like the normal range. So like LabCorp, it’s 33 or 36 for the TPO. Where I think the thyro – the thyroglobulin antibody is anything greater than 1 is positive. So if we’re like at 1.5 or 2, you know – we will look at that and we’re gonna really push for autoimmune changes and autoimmune protocols. We see TPO going above 20, we’ll start to say, “Hey, you know, you wanna be careful with this.” And we’ll keep an eye on that. And then we have the – you know, people are on the thousands on the antibody levels. And we’ve made this change and I’ve seen 70, 80% drops. We take a patient from 2300 down to like 3 to 400, which is a massive drop.

Evan Brand: And so that’s diet, that’s lifestyle, removing infections, supporting adrenals. All those pieces, right?

Dr. Justin Marchegiani: Yeah. Absolutely. And I got a question here on FacebookLive. I’ll try to connect it in here. And again, I apologize for Facebook Live listeners here. If you’re watching us there, check out the YouTube so you can actually see Evan. I’m gonna try to reiterate the questions so that you can hear it. Uhm – but that will be the best way to get the full conversation. Regarding uhm – question on Facebook Live, he’s talking about iron. Now, iron is really important coz it’s a really important building block for thyroid hormone. And we also need triiron for thyroid activation from T4 and T3, and we need it for just generally carrying oxygen to ourselves, which is really important for cellular metabolism. So if we have low iron levels that could be an issue. Now I did a full video this for people to get back to the iron video to get like the specifics on that. But again, typically we’ll recommend, like in my line, we use an Iron Supreme. It’s a Ferrous Bisglycinate. And we’ll do about 25 milligrams of iron, anywhere between 2 to 4 times a day to help support that. But also, we’ll figure out the root cause. Coz a lot of females, it’s excessive menstruation or hemorrhage. It could be vegetarian and vegan diets, or it could be the x factor of malabsorption from gut inflammation, to low stomach acid and enzymes and not being able to ionize minerals to an infection that’s stealing your minerals.

Evan Brand: Yeah. I’m so glad you brought that up because here I am thinking about myself, and the whole time, I had two parasite infections.

Dr. Justin Marchegiani: Totally.

Evan Brand: I guarantee I have low stomach acid. I guarantee I had issues with iron absorption. And people, let’s say, even if you’re eating the best organic grass-fed beef, if you got an infection that is causing stress on the gut, therefore reducing stomach acid; therefore reducing the ability for you to cleave off those amino acids and iron from them – from the meat, you can still have trouble. And what about – what about ferritin, too? Because the iron storage protein, that’s what we’re gonna test. For many times, you’re gonna see, especially women have very, very low ferritin levels where – and you’ve got a woman with ferritin levels you know – in between say 20 and 40. You may be experiencing something like breathlessness, for example. You could definitely have hair loss falling out. Sometimes I’ll hear women say when their ferritin is about 20, let’s say their hair is falling out in clumps. So you wanna get ferritin, which is the iron storage protein. You gotta get that levels tested, too. And we like people to get up, you know, 60, 70, 80 with ferritin just to ensure that – that iron storage protein is actually working. Now – and this is something that I haven’t looked at very often, but I’m curious if you know Justin, if you’ve got low ferritin, are you always going to have low iron as well? Or is it possible that with low ferritin, your iron could still check out okay?

Dr. Justin Marchegiani: So with lower ferritin, iron serum can pop up, and it can pop up because – imagine like ferritin is like the gasoline that’s in the gas tank, right? And then think of like iron serum is like the iron is actually in the carbonator and then the piston’s ready to be – ready to be combusted, right? So one’s like – iron is like, what’s ready to go that’s in the actual engine and carbonator; and ferritin is like, what’s in the gas tank, right? So obviously the more important one is gonna be what’s in the gas tank coz that gives you the bigger picture, right? You don’t care, you know how much – how much engines – how much fuel’s in the carbonator. It will only take you maybe a couple of hundred meters, maybe a mile. I don’t know, I’m not a big car guy, so – But keep that in the back of your mind. Now the difference is your body has a little bit more of an interplay with other systems. So inflammation can increase iron serum. So that’s why we look at ferritin, but then we’ll also look at it with iron saturation, too. We see iron saturation low, below 25, when we see TIBC or UIBC on the higher side, that means your binding proteins are growing more and more fingers –  to have more iron. And if we see iron serum up, then we’ll be like, “hmm, maybe there’s some inflammation” We may wanna look at C-reactive protein, right? We may want to look at some of those inflammatory markers. Uhm – if we’re running a gut test, you may look at lactoferrin or calprotectin and see it – inflammation is occurring in the gut. So it really depends on what else is happening in the body. Does that make sense?

Evan Brand: Yeah. It does – it does. So, if you had to pick one or the other. Let’s say, somebody only gave you the option to run some of the specific iron markers or ferritin, what would you pick? For me, I think – I feel like I’ pick ferritin, if I could only pick one.

Dr. Justin Marchegiani: Yeah. I mean, ferritin for sure. But an iron panel is like 30 bucks. There’s no reason –there’s no reason why anyone should nickel-and-dime on that because you don’t wanna compromise $30 getting a complete picture. So I think we run it. We keep doing it for 30 bucks and that’s everything.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And that gives you the ferritin, the iron serum, and that gives you the UIBC, the TIBC, the iron stat. So then you have a real complete picture of what’s happening. And then you know, even just looking at someone’s CBC can be helpful coz you can look at red blood cells, hemoglobin, hematocrit and if that’s starting to go low, then we can look at MCH, MCB, MCHC, which is basically markers to see how big your red blood cells are, right? Smaller red blood cells typically mean iron issues; bigger red blood cells typically mean B12, folate and B6 issues.

Evan Brand: Wow. There’s another question. Actually there’s a comment up here by Tonya. She was talking about how she was able to eat gluten and dairy now after she had infections. And I guess she treated those, and now she’s able to eat gluten and dairy. I feel like that depends on the person. Me, personally even if I could get away with it, I still wouldn’t do it because you’re still gonna increase zonulin and leaky gut. Potentially set yourself up for future infections.

Dr. Justin Marchegiani:  Yeah. That’s the problem, right? Disaster doesn’t occur in –a day or a week, right? And we know that leaky gut can still happen even without the symptoms, right? We – there’s just been studies where they’ve given people pieces of gluten and they measured symptoms, they didn’t see necessarily an increase in symptoms or negative side-effects. But they saw this increase in zonulin and leaky gut because of it. Now we know that when that happens, you increase your risk of having other issues. So I know there are people right now, we get the same conversation. We’ll be talking to people that have been able to smoke cigarettes and not get lung cancer. Okay, great. Now, does that mean that you’re gonna go out and recommend smoking cigarettes to anyone? No. It’s still not gonna be beneficial. It’s still gonna be inflammatory. It still increases your risk. You don’t know who the people are that are gonna have the negative effects to begin with, right? It’s all like you have that looking glass that you can see in know. And also uh – you don’t know down the road when stress comes on and other things happen. Coz usually it’s not just one thing. It’s like, “great, now this person who’s talking – their stress bucket, they’re already filling it halfway.” So they’re going into with a half-full of stress bucket thinking that they’re okay, right? Alright. So, I got a half full of stress bucket. So now when other things come into their life, they’re gonna overflow faster.

Evan Brand: Agreed.

Dr. Justin Marchegiani: And then also – and also other people, that may overfill their stress bucket right away. And so that’s why you have to make sure that you know that some people may be the exception to the rule. They aren’t the rule. And this is where it’s –We have the advantage, Evan, because we see so many thousands of people that we can make correlations and can actually even see causation because we make changes and we see direct changes in the person’s physiology and their symptoms are getting better. So we can’t make – we can’t create all these protocols for the exception to the rule coz there are so many exceptions. There are people that smoke and don’t get cancer, alright? We know that. People that may consume gluten and may be okay, but the majority may have issues. Or they may set themselves up in increased stress bucket, right? Meaning increase their ability to handle less stress, so that when more stress comes on, boom, now they’re laid up.

Evan Brand: Exactly. Yeah. Tonya we had to put you on the chopping block there because for you commenting about saying gluten and dairy and you can get away with it now. You’re speaking for thousands of people that listen and do the same thing. And Justin and I will look at the symptoms of someone, and if there are still health complaints that haven’t been resolved, then let’s say we get the retest on GI-MAP stool test, and we look at antigliadin and antibodies, and I caught the lie detector test. I don’t know if you do, Justin. But it’s uh – when you get the antigliadin antibodies, it’s like, okay, one of three things happen. Either you’ve got gluten, you ate gluten, or you’ve got cross reactivity going on. And so, even if your symptoms are not supposedly there, your body is still fighting internally. There is still this internal battle going on, which is not what we want because then those antibodies can get confused and start attacking other tissues, which we don’t want.

Dr. Justin Marchegiani: Yeah. And it’s tough because there are people that we see eat a diet that is you know – highly processed with a lot of carbs. And their blood sugar is relatively okay. And that maybe because they’re naturally more insulin sensitive, or they exercise more. And we see some people that eat the same diet, and they’re diabetic. So what do you do? Like I can’t sit there, and say, “well this person who eats this way isn’t diabetic” that means that diets is fine. No, it’s not. You have to look at the greater picture. You also have to look at what – does that diet now, is it nutrient dense? Is it anti-inflammatory? Is it low in toxins? And no, it’s not. But again, don’t get me wrong. Like dairies are open-ended topic, right? Ghee may be perfectly great. Butter maybe perfectly great.  Raw milk may be perfectly great for some people. But then we go to the pasteurized dairy, we go into more of the yogurts, which could be great, but it may not be. So do – we have to kind of uhm – can have a criteria for all those different compounds, right? Because some dairy may be okay, some may not be okay. And sometimes bread, too. Some people may do okay with bread over in Europe. Or they’ll do fine with sourdough bread coz it’s fermented and has less gluten in it versus, let’s say, wheat bread here that’s conventional. So you got to look at it, too. Some of those things may be okay and may have to be more specifically talked about.

Evan Brand: Yup. She commented back. She says, we’re missing the point. If parasite is the cause, you can go back to the way you were, prior to eating – oh the way you were prior, like eating gluten. We as people, ate gluten for a millennia and now it is the cause of all ills. I’ll comment on it first, and then I’ll let you say something about it. In the modern world, we have a lot more toxins. We have a lot more things that we’re up against, and so gluten, where maybe only would have change someone’s health 2 or 3% 5000 years ago, now,  has the ability to modify someone, tell 50 or 75, or even80% in some cases. We’ll see 80% of symptoms get better without it. So for me, comparing millennia to the modern world, we’ve never had a world like today. So it’s just not really a valid argument.

Dr. Justin Marchegiani: Yeah. And the grains aren’t even like– If you look at the biblical grains, they talked about in the diet, and Dr. William Davies totally debunks this. If you look at the grains 2,000 years ago, reference in the bible, these are 12 chromosome uh – grain products versus the ones that they have right now, they’re hybridized and genetically modified, they’re up to 50 chromosomes. The gluten content is much higher and is also the extra stress of potential GMO nutrients, poor soils, as well as pesticide exposure. So it’s not quite the same way. Plus, people have to look at it from this perspective, if you drive around on your car, and you get a flat tire on your car, right? And you change the tire and you put the little – let’s forget that. Let’s just say you’re driving around on that flat tire for like a year, okay? So the flat tire is the cause of what’s happening here. But you drive around the flat tire for a year. That’s like ignoring the stressors of your health. It could be gluten. It could be parasite. But the longer you drive around on the flat tire, the more you front angles out of alignment; the more your suspension goes out of whack; the more your whole shock system in the car becomes stressed. And even if you decide, let’s say a year later, I’m gonna change that tire and put on a nice, fresh tire, which is like cutting out the gluten, managing stress, managing sleep, your car has been compromised where just changing the tire won’t fix it. You’re gonna have to go in for a full frontal alignment. You may have to get your tires rotated; you may need new shocks; your brake pads may have worn unevenly. There’s so many other issues that may happen with the car that where collateral damage from that flat tire being ignored. So just because you, let’s say, it was a parasite issue, and the parasites are now gone; or it’s a gluten issue, and the gluten’s now gone, doesn’t mean you now have nutritional deficiencies; doesn’t mean your enzymes and HCL are now effective; doesn’t mean your thyroid and your adrenals hormone system are now stressed; doesn’t mean your detoxification systems are now stressed, right? So this is what is happening. And other analogy is you’re in debt for 5 years. Great. You stop – you curtail your spending habits but you don’t get out of the hut – but you don’t get 100 grand out of debt by just changing your spending habits today. You need a bailout, or you need a lot more time just to start saving and get that money back up. Does that make sense, Evan?

Evan Brand: Yeah. Or the analogy of the spider web.

Dr. Justin Marchegiani: Yes.

Evan Brand: Where there’s other pit of the web that’s affected, too. So for example, we can use me as an example. You look at me when uh – first time I came to your house. You’re like, “Evan, man, you look like you get a parasite.” You just- you just saw it. And I was like, “okay” It’s been a year plus since I’ve eradicated those infections, but I still am using enzymes and HCL because I was in such hypochloridic state that I still need to use supplemental HCL and supplemental enzymes. And I don’t really have an end date in mind where I’m not going to use enzymes because if I’m busy, or If I feel like I’m just not chewing my food as much as I should, to me, I like that nutritional insurance policy in place.

Uhm – there’s another question too that Chris asked earlier. He said, “not to be the dead horse, but isn’t there another marker to show autoimmunity of failsafe?” I guess since he’s asking because a lot of times –

Dr. Justin Marchegiani: I already answered that one with the ANA and the conventional ones.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: And then the TPO. And also the gliadin antibodies be the stool testing we do. And then there’s uh – a test by Cyrex Lab that looks at leaky gut, which could give you a predisposing marker, where it looks at zonulin and occludin toxins which can open up the tight junctions. So that one will be another one when I look at.

Evan Brand: It’s pricey. Have you run that one often? The Cyrex, I mean, it’s like 600 bucks.

Dr. Justin Marchegiani: Yeah. I’m not a big fan of that because it doesn’t tell me any of the cause. So if people have infections and their diet is not good, and they have – we’re seeing a low stomach acid and low enzyme environments, it’s not worth it. We just kinda work on treating the cause and then a lot of times, the clinical picture changes. Peoples bloating in gas and all these symptoms improved, which we know that means their digestion is getting better, their absorbing more nutrients. That means there has to be a leaky gut mechanism happening. I’m a bigger fan of looking at causal test versus the effect test. The effect tests are only good if you’re trying to convince someone or that people are skeptical. But once – people that are coming to see us are very intelligent because they’ve already educated themselves. They listen a lot to podcast. They read lots of blogs. They watch a lot of videos. They already get it. They don’t need to be convinced. They just wanna be fixed. So it’s a different mindset with those people.

Evan Brand: Agreed. Well said. And we don’t have people that need to be convinced they have leaky gut. Most of the time, they’ve already self-diagnosed themselves. In many cases, you don’t need to spend – I’d say99.9% of the cases, you don’t need to spend the money on a blood test that’s gonna say you have leaky gut. We could just list off symptoms – boom boom boom. Yeah, you probably got leaky gut. Cyrex, for their food sensitivity test, that is – that is cool one, but even then I feel like it’s a unnecessary in most cases because if you and I are gonna put somebody on like a AIP approach, let’s say thyroid disease did show up, some Hashimoto’s. We’ll have to go AIP and maybe we could try to reintroduce things. But they’re gonna be able to be a better barometer of Austin than the test in most cases. Like, “Oh when I added dark chocolate back in” or “when I added dairy back in” and this is what happen. I feel like that’s more valuable than a blood test.

Dr. Justin Marchegiani: Totally.

Evan Brand: Totally.

Dr. Justin Marchegiani: We’ll do a full autoimmune elimination protocols and it’s gonna be very valuable for 90% of people. We’ll go an autoimmune diet, cutting out nuts, seeds, nightshade, eggs, obviously grains, legumes, dairy. And again, for people that are like the gluten fans that are on the message board here, they still aren’t nutrient dense food. If you look at the nutrients, if you look at the other compounds that aren’t gluten-related, right? Let’s look at the fact that some people are intolerant. They just can’t break it down because they’re missing the enzymes to do that. And that any time the food is not broken down, it can create stress in the body just like people that can’t break down lactose. They’re lactose intolerant and then they have diarrhea and bloating. So, some people just may be intolerant to breaking down the protein. Some people may be increasing inflammation because of the lectins and the phytic acid and then the oxalates that are just shutting mineral absorption. Other people may be having the autoimmune issue. So it’s still not a nutrient dense anti-inflammatory low toxin food. It’s not like there’s this missing nutrient that you can get out of gluten or out of these grains that you can’t get in some really awesome nutrient rich vegetables or healthy fruits with –or healthy starchy tubers. Does that make sense?

Evan Brand: Yeah. It does. Now – this is off-topic. But –

Dr. Justin Marchegiani: It’s not a missing link. That’s my thing. If people had to say that – we – could show me a nutrient density chart and say, “But Dr. J, you get these nutrients, or the zinc and this is amazing or this, B vitamins”. I’d say, “Okay, but there’s not that evidence that it’s there.

Evan Brand: Right.

Dr. Justin Marchegiani: Now a great – a great talk on this uhm – what’s his name, out of Harvard there – Matt Lalonde did a great talk at the Ancestral Health Symposium at 2012 on nutrient density. I highly recommend anyone watching that. But when you look at the nutrient density that you’re gonna get in meats, especially organ meats, it’s insane. It just destroys grains. And grains are the lowest out of all those foods.

Evan Brand:  Yeah. Now, we’re – we’re off-topic from the thyroid, but that’s fine because I love that’s it’s a dynamic conversation.

Dr. Justin Marchegiani: It connects in, right? Because-

Evan Brand: It does.

Dr. Justin Marchegiani: -nutrients help in thyroid conversion, they help with thyroid activation, they help with the adrenal, which helps the thyroid cells. Even though we’re off-topic, we’re gonna do our best to kind of meander our way back to the thyroid.

Evan Brand: Yeah. Now, what I was gonna say was a bit off- topic, which is – well all you’re saying is totally on topic but what I’m gonna say is it’s funny how even some of these professional healthcare companies are now designing supplements, which I’m not gonna even give them the credit of naming these products. But there are gluten supplements out there, where it’s like, “here, go eat gluten, but then here is this enzyme or here’s this XYZ supplement to where you can still try to eat gluten, but you just take these pills with them instead.” It’s like, that’s ridiculous. That’s like covering up the engine light in your car. The light’s still there, but here’s this magic tape that’s gonna hide it. I just don’t think supplements that enable you to eat gluten is a good idea.

Dr. Justin Marchegiani: Now, here’s the deal, right? If you have thyroid antibodies, if you know – if you have objective measures of autoimmune issues, or your heightenly celiac sensitive, another word is – almost like – almost like if you have gluten, like you’re laid up, like you’re just – you’re junk for days on it, I don’t ever recommend cheating with gluten. If you can manage, if you’re really healthy, and you don’t have severe thyroid or antibody markers popping up, then you could try going gluten-free you know, right? It maybe rice, or corn may be okay. If you do that, I typically recommend the enzymes, like the DPP-4 enzymes and we’ll take it with charcoal. But it’s a cheat, and we’re just trying to mitigate it. And we wouldn’t wanna ever do that as a staple to allow ourselves to eat gluten. Now, like myself, like maybe once year, like if I’m in Boston and I’m in the north end, I may have like a cannoli, but I found an alternative uh –modern bakery and get some gluten-free ones that are white flour-based. But if I go, I mean I’ll up the DPP-4 enzymes, increase the charcoal, and the vitamin C in the knack. And that will help me deal with it. Uhm – but again, that’s like – if you look at it, the 2000 meals I have a year, you know – maybe one or two have that in there, right? Not a lot. We’re talking .001% But people who are really, really sensitive or having gut over their health issues, initially you really wanna be puritanical. And then – I’ll kinda dovetail this with Johnny’s question here. Some of the testing that I will do to fine tune, if like patients are on the autoimmune, they kinda reintroduce things back in and they’re still having issues, and not quite sure what works, there will be some testing we’ll do like an MRT is a pretty good test. I’m liking the ELISA / ACT test as well coz it’s not just antibodies, it’s looking at various lymphocytes, too. And I do a combination of the ELISA and I’m – I’m kinda testing the MRT as well. And I’ll actually be doing some blind testing and sending some uh – different vials in with different people with actually my blood on with different names. I’m doing some blind testing on that. So hopefully I’ll do a video on that.

Evan Brand: You ought to try the, if you have it already, I believe it’s the Array 2. And there’s a couple of other Arrays form Cyrex, too. I’m a bigger fan of that than the MRT.

Dr. Justin Marchegiani: Well the problem with Cyrex, though, it’s only looking at Ig or IgA – that’s the issue. So with the ELISA, it’s also looking at T-cell lymphocyte response and you’re not gonna get that picked up on Cyrex. That’s the big issue. And if you’re not exposed to gluten, let’s say we’re doing this test, and “yeah, I haven’t eaten gluten in a month or a couple of months” Well, if the immune system isn’t responding to it coz it’s not being exposed to it, it won’t come up in the test.

Evan Brand: Uhhh.

Dr. Justin Marchegiani: And people will be like, “Oh, look, I’m fine.” But may not be the case. So you have to look at it in a complete spectrum.

Evan Brand: That makes sense. So the ELISA / ACT.

Dr. Justin Marchegiani: Uh- hmm.

Evan Brand: And that’s blood.

Dr. Justin Marchegiani: That’s blood. Exactly.

Evan Brand: Cool. That sounds great. Well, I feel like we should probably wrap this up. I know this has been a lot of information uhm – if people are interested in your book, then they need to sign up for your email list. I mean – you’re so passionate about thyroid health, it’s definitely infectious. And do we have a date on that? Of this thyroid book? What’s up with that?

Dr. Justin Marchegiani: It’s done, man. I’m shooting it up to the editor. So we can buff it out and – and you know, I read all – every thyroid book on the market, I pretty much read. And my biggest issue is, you can summarize every thyroid book in like 5 pages.

Evan Brand: I know.

Dr. Justin Marchegiani: So I want a book that’s shorter. It’s more condensed. I want every page to be neat. I want every page to be __I want every page to have like action items. People can walk away and really improve their health and then throughout – in a standstill, they can reach out to people like myself and you, to kinda like get to the next level. So that’s where I’m at right now – to fine tune and boil it down. I want to touch just one question. Dale mentioned it earlier, he talked about mercury. And mercury is an important aspect coz mercury can pinch it and affect the thyroid. There’s this study showing that lowering mercury can decrease thyroid antibodies. I have one patient that had thyroglobulin antibodies over 2000 and we saw the antibodies drop below 100. So we saw a 99% drop in antibodies by removing mercury. So we’ll test that. We’ll do challenge test via urine and we’ll use various provocation agents like DMPS, which is 2, 3 dimer propanoic acid, or we’ll do uh – 2, 3 dimer succinic acid, which is DMSA. Or we can even do EDT as well. But I typically do the DMPS challenge and we’ll be able to provoke that and see what’s coming out from the mercury. That can be a big, big uh – kind of underlying revealer of another aspect of what could be driving an autoimmunity, which is the mercury. And again, I know you’ve done the shade testing which looks at urine unprovoked, hair, and blood. Not a big fan of hair and because they don’t tell you an active or chronic uhm – a chronic level. Doesn’t give you a tissue burden. And also, there’s study showing that people that push more mercury out on the hair actually have better detox pathways, and they measure people who push less mercury on the hair, and they actually found that they had more provoked mercury in the urine even though they push less out in the hair, partly because their detox pathway is impaired.

Evan Brand: Wow. I’m gonna try yours coz it sounds like it sounds like I could be getting some numbers that are not what they actually are. I wonder what other heavy metals are impacting this, too? I wonder if cadmium, for example, or aluminum is also gonna impact thyroid. It seems like all heavy metals potentially could. Or do you think it’s specific to mercury. Mercury’s gonna be the biggest?

Dr. Justin Marchegiani: Well mercury is definitely gonna be the biggest coz it’s one of the second or third most toxic compounds in the world. It’s really bad. So that one. Obviously lead is gonna be really bad, too. Because lead and mercury interplay, right? If you look at the lethal dose of one – if you take uhm – the dose, you get hundred rats lined up, and you figure out, you keep on titrating the mercury dose up. So the first rat dies out of a hundred. So you titrate the mercury up, the first rat dies, right? That’s called the – the lethal dose of one, right? The 1, the 1% that kills – the dose of 1% of that kills. And you do that for mercury and lead, so you have the hundred rats, right? One dies of mercury, right? You increase the lead up here or one dies of lead. And you now combine the mercury and lead those together to all 100 rats, they all die. Did you get that?

Evan Brand: Yeah, I sure did.

Dr. Justin Marchegiani: So what they’re saying is even though it only kills one of here over a hundred and the lead over here kills one out of a hundred, but when you combine it together, and gives it all to 100, all of them die. Meaning that, these metals are synergistically connected and can have exponential effects when added. So if you see mercury and lead together, typically the compounds that we’re using, are gonna be specific to mercury and lead for sure. So you don’t have give a special one for mercury and a special one for lead, right? So you give it and it would globally affect mercury and lead and typically cadmium, as well. And we’d also wanna give extra binders. Crochet talks about this like MC but MCT like modified citrus pectin, MCP actually. Uh – we’d also give maybe charcoal or bentine clays. We’d also use things like chlorella, especially for mercury. And we’d also use things to support detoxification. So in my line, we use heavy metal clear and then we also use DMPS and we use a lot of sulfur amino acid support to run phase 2 detoxification, as well.

Evan Brand: And still eat your broccoli, folks.

Dr. Justin Marchegiani: Oh, yeah. Your cruciferous are gonna be really important for your DIM and Indole-3-Carbinol which all help run phase 2 detoxification.

Evan Brand: Awesome.

Dr. Justin Marchegiani:  Well, anything else here? Any other questions we wanted to run to? Uh – on the YouTube live here, anything else we can answer?

Evan Brand: I think that was everything.

Dr. Justin Marchegiani: I think we hit it all up pretty well. Oh, I didn’t touch upon this. Let me just hit it real quick. Iodine. Iodine is a really important nutrient for the Iodination process to make thyroid hormone, right? If you look at the T, the T typically stands for- some people say thyroid or tyrosine. And then the 4 number is the Iodine. So you have the Iodination process and then you have the 5 prime, the iodinase that comes in there and it grabs and pulls off an iodine, and activates it and makes it T3. Well, that enzyme that activates thyroid hormone is selenium dependent and comes from the liver. So healthy liver function is really important. But having adequate iron uhm – adequate iron level as well is important, but having adequate iodine is also important. RDA is about 150 to 200 µg a day to at least prevent goiter. Now some people may need more than that. Now you have people like Brown Steen and other doctors that are going super, super high, 2550 mg a day. I’m very, very cautious of doing any high-dose iodine. I have seen too many patients uhm – like literally just lose their hair. Like just like gaps, like handfuls come out and their thyroid has gotten worst. Number one, like if we give iodine and they have autoimmunity, it’s typically months later after we’ve stabilized the gluten, stabilized the adrenals, supporting thyroid, supporting nutrients, supporting the gut, get their diet in shape, get their digestion better and then we’ll start very low and we’ll gradually work them up. But we’ll be checking in, we’ll be monitoring it and we’ll be doing very low doses and then gradually tapering it up or also making sure there’s enough selenium there, enough B vitamins, enough minerals, enough vitamin C. So we’ll make sure there’s a lot of other cofactors coz when you give iodine, it can spit out hydrogen peroxide, which can increase D cell lymphocyte infiltration into the thyroid. So it can exacerbate autoimmunity. So if we do it, we’re doing it responsible. We’re doing a lower RDA doses as a starting point and then gradually working our way up from there.

Evan Brand: So what about working with foods at the same time? So I’ve heard some people, anti-kelp people out there. And I don’t know why there’s some anti-kelp people.

Dr. Justin Marchegiani: Well, I think you just gotta be careful with kelp just because just coz where it’s coming from, the whole Fukushima disaster two years back.

Evan Brand: Yeah.

Dr. Justin Marchegiani: -radiation. So just gotta be careful. There are some really good sources out there. You gotta make sure it’s not coming from one of those places and number two, there’s a whole list of foods that you can give. Typically, like in my multi- there’s gonna be at least the RDA there, which is great.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Egg yolks are gonna have some iodine as well. Uhm- obviously seaweeds have some good iodine sources. You just have to make sure that it’s not gonna be the Fukushima kind. I’ll get a list right here. I’ll read out a couple of foods that are really high in iodine in just one second.

Evan Brand: I’ve heard strawberries, too, which is interesting. And then I also wonder – it’s hard to get a composition sheet for a Himalayan pink salt. I wonder if you’re gonna get any iodine from pink salt or not?

Dr. Justin Marchegiani: Yeah. I mean there’s some maybe some trace amounts there. I know iodized salt; 1 gram will have about 77 µg. There are some research showing that increased iodize salt consumption did increase autoimmunity. And it could just be that these are the general public. They’re just taking it, they already have a poor diet, and they don’t have the selenium, and the B’s, and the minerals, and the vitamin C in the background. And maybe that’s why that happened. So it’s hard to say. So there are studies on that showing there could be an issue. But things like cod, right? Things like shrimp, uh – things like turkey. Even some navy beans, even some tuna, even some eggs are gonna have some good iodine. I mean one egg is gonna have 12 to 15 µg iodine. So if you do 4 eggs a day, that’s about 60. You got a good multi- that will be 150. Uhm – you have some fish, you got some other food, now you’re like at 3, 400µg. Now you may need to go higher, but you had to work with physician or functional medicine practitioner to be monitoring the antibodies and make sure you have all ducks in a row first, before you go there.

Evan Brand: Yeah. I mean there’s people that will just start covering themselves in iodine. And so that could be a bad idea, you’re saying, coz you could actually increase antibodies, right?

Dr. Justin Marchegiani: Totally can increase antibodies. Uhm- you gotta be careful with that.

Evan Brand: I’m not – for some reason iodine, one of those things and kind of the eggs will call the natural health community that is – it’s been portrayed as very benign. And I remember even in some of the – the classes I was taking down in Austin, I remember a girl in class, she like paints everyday, she was painting her arm with iodine. And she was like, “it’s the greatest nutrient ever.” I was like, “Oh, my Lord. This is out of control.”

Dr. Justin Marchegiani: Well painting on your skin for the most part, 80% of it evaporates.

Evan Brand: Uh-huh.

Dr. Justin Marchegiani: The only time I recommend painting it on your skin is if you have fibrocystic breast disease uh – you have a lot of cyst and painful breast tissue. Painting it on the breast tissue can be great coz you’re driving the iodine right into the localized spot, where there’s the cyst, which could help. But outside of that, I mean, if you have –if you need iodine systemically for your body and for your thyroid function, you wanna take it in – in your body. And typically do a liquid potassium iodide.

Evan Brand: So she wasn’t – She probably wasn’t making herself toxic then. She was just turning herself uh – brown.

Dr. Justin Marchegiani: Yeah. 80% of it – you know, the iodine pass test, like the faster it evaporates, meaning the more your body absorb it; the slower it evaporates the more iodine you have. It’s very crude measurement, right? The better test is gonna be like Hakala or I think doctor stated, there’s an iodine loading test. I think it’s 25 to 50 mg of iodine then you test uhm – your urine and see how much GPL. So the goal is, if you pee 90% or more, it means your iodine levels are saturated; if you pee less than 90%, right? You pee less than 90% that means your body grab more of that iodine. So it’s – you’re essentially low. That’s the theory on that. 90% and more, you’re okay; less than 90, you’re low.

Evan Brand: Uhh. That’s interesting.

Dr. Justin Marchegiani: But again, regarding iodine, you gotta do it responsible – responsibly. If you’re – think of iodine gasoline on the fire.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Gasoline is not bad when you put it in your car. But if your car is on fire, and you start putting gasoline in your car, you can create problems, obviously, right? That’s what’s kinda happening in your thyroid. You wanna look at everything holistically. And you want the body system approach that Evan and I use, the key three, looking at the hormones, ATF( adrenals, thyroid, female hormones); ATM (adrenals, thyroid, male hormones), gut and infections, putting nutrients, digestion, better food, allergies, and then looking at detox and nutrients, as well.

Evan Brand: Yup. Well said. Go to to schedule consultation with Justin. Check out the thyroid videos series. He’s got hormone videos series, too. You’ve got the supplement line there. And then, you could check out my stuff, too, or you could just google either of us. Justin, or Dr. Dr. Justin Marchegiani. Evan Brand. You’ll find us both. And stay tune because this is really fun. And I don’t know about you, but I’m loving this. I think maybe 3 to 5 times more than just doing an off-air podcast coz people are asking questions. And it’s like shaping and structuring this.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This little organic podcast ball.

Dr. Justin Marchegiani: Yeah. I love it. We love the questions. We like just having this little kinda dialogue back and forth and “ooh, someone responds over here, let’s see what they said” and we kinda see if we can interject it into the conversation. That’s great. Totally m__we’re on the fly.

Evan Brand: Love it.

Dr. Justin Marchegiani: Like impromptu, right? It’s like we’re on the stage, doing a little impromptu podcast.

Evan Brand: There’s no cuts; there’s no edits; there’s no –

Dr. Justin Marchegiani: Overall man, this is it.

Evan Brand: This is – this is the real deal. This isn’t – there’s not a makeup person coming in and touching you up here. I mean this is the real deal.

Dr. Justin Marchegiani: I know. If you guys are liking this, we’re gonna do it a lot more. We just need thumbs up; we need likes; we need shares; show us the love. Go like Evan’s channel. Share the podcast. And then we’re gonna do more of this, and get everyone’s questions answered, and just provide more value. Like how could we provide more value to our listeners and improve your health.

Evan Brand: Yeah. And I think I mentioned it already. But if you wanna schedule a consult with Justin, just go to the website, you could schedule the consults there.  And same thing for me, and we’ll chat with you all next week. And let’s do something next week, maybe – maybe on like clinical success stories we’re having in the practice.

Evan Brand: Well that means they’re coming in –

Dr. Justin Marchegiani: And just like, maybe go over our top 3 stories of the week. Coz we see – you know, so many patients. We can pick out 3 easily.

Evan Brand: Well, yeah. I thought of something, too. Uh- actually, a woman who was struggling with fertility is now pregnant. And I figured, getting her on and talking about her story with parasites and how her fertility was compromised due to the infections. Getting her on the air, maybe asking them– we have to make it fun for them, too. 

Dr. Justin Marchegiani: Yeah.

Evan Brand: For them to take time out of it, get them to share their story and just kinda talk them through what we did. I think that’s- that’s the most remarkable part of all this, is getting to hear the feedback, which a lot of people, they’re not getting to hear the stories. And this is what keeps us motivated and keeps us going.

Dr. Justin Marchegiani:  I love it, Evan. That sounds awesome, man. Well, let’s connect real soon, brother.

Evan Brand: Take care.

Dr. Justin Marchegiani: You take care. Bye now.

Evan Brand: Bye.


Natural solutions to combat stress – Podcast #122

Dr. Justin Marchegiani and Evan Brand talk all about stress, its effects on our health and variety of natural ways on how we can beat it. They discuss into detail the parts of the brain and hormones affected when we deal with stress and how these hormones are related to health issues like gut inflammation, ADHD, decreased libido, weight gain, depression and memory problems.Natural solutions to combat stress

Find out some of the sources of stress that we engage in consciously and unconsciously. Learn about the process and cycle of stress, develop awareness and apply some valuable tactics on how to combat stress in our life, which in turn improve our health.

In this episode, topics include:

1:46   Forest Bathing and its benefits

4:48   Cortisol levels and its effects on our body

9:19   Different sources of stress and  ways to deal with it

21:13   How the amygdala and hippocampi reacts to stress

26:09   Different approaches on how to beat stress







Dr. Justin Marchegiani: Hey there, it’s Dr. Dr. Justin Marchegiani here with Evan Brand. Really excited here, we got the video going today. So hopefully, we’ll have the face-to-face connection here for everyone at home. Evan Brand, how are you doing today, man?

Evan Brand: Pretty well. It’s sunny and cold but I’ll take it over cloudy and cold so I can’t complain.

Dr. Justin Marchegiani: Absolutely man, I love it. I know we talked about talking about stress. Speaking of stress, how you are you dealing with stress up there? I know you have winter and you got cold weather up there in Louisville. How is that going?

Evan Brand: I mean it’s not too bad to be honest. I love living here in Kentucky so much that I turned a blind eye. I think I put my rose colored glasses on despite the winter and it was like mid-20°F so cold. But I- actually, I put together a weight bench in the garage yesterday so I’m gonna be beginning some outdoor primal exercise. I joked with my wife I was like “Babe, there’s nowhere to put the weight bench. Let me put it down in our daughter’s room” and she was like, “ No” and she said, “our primal ancestors wouldn’t have needed to work out indoors” and I was like “Fine, I’ll put it outside”. So I’m gonna be getting some, some- I guess we’ll call it cold, cold exposure training and lifting weights at the same time.

Dr. Justin Marchegiani: I love it, I love it. That’s excellent. I can picture your wife using that excuse to send you to the store to run errands. Well normally, normally in the hunter gatherer society, the husband will be out for weeks trying to get food for his family. You should go to the store for at least the next hour or two for us.

Evan Brand: Exactly.

Dr. Justin Marchegiani: That’s smart. Very cool. Well yeah, here in Austin, it’s a great, great weather. It’s 56° on the colder side. I guess a little warmer up in the weekends but we talked about stress here pre-show. One of the big things I’ve been doing and I know you’ve done podcast of this in the past. I think you’re in bulletproof radio talking about this, is forest bathing.

Evan Brand: Yes, absolutely.

Dr. Justin Marchegiani: I found this awesome little nature trail behind my house there in Austin and I have taken my dog, Butter, and my wife and I now we go for a great walk down there and it is awesome. Really enjoying myself. We go for a couple of hours. I got my Fitbit on, I’m racking a couple of 10,000 steps days over there and then it’s great.

Evan Brand: I know, you feel so much better. For me, anytime that I’m stressed it’s usually due to a deficiency of nature. Obviously there are other causes at play which we can talk about some of those causes and effects-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -but you were designed as a human to be outdoors and if you separate yourself from the outdoor environment, you’re gonna have build up of stress. It’s just that simple.

Dr. Justin Marchegiani: Absolutely. And I know the research on forest bathing is pretty, it’s pretty- its quite compelling. Uhm the effects of lowering cortisol, lowering that stress hormone and the cortisol is this hormone that’s really interesting and today’s podcast is gonna be just on stress in general and natural things we can do. We’re gonna try to take a different nuance approach for it. But just getting outside and walking around not just on your street but if you can go on to a wooded trail, it’s actually great. The effects on lowering cortisol, if you just google forest bathing, a lot of really good effects with that. Can you go more into the detail? I know you’ve got more podcast on this topic.

Evan Brand: Yes, so basically a lot of the research is coming out of Japan who came up with the term “shinrin-yoku” and it makes perfect sense.

Dr. Justin Marchegiani: Totally.

Evan Brand: Of course we’re gonna have a reduction in stress compared to the control group in the research where they take salivary cortisol samples of people walking on the side walk walking on urban area. They actually see increase in stress hormone cortisol but adrenaline too and you see decreases in adrenaline not only DC reduction in cortisol but you also see increase in heart rate variability and the higher your HRV score is, the healthier your nervous system is. Meaning you’re more in parasympathetic, less in sympathetic. And for us in the modern world we’re constantly reacting to things that our ancient wiring system wants to put us in sympathetic like a bad email or a bad text message –

Dr. Justin Marchegiani: Yeah.

Evan Brand: – that can put us in fight or flight. We think our survival is at risk but it’s not.

Dr. Justin Marchegiani: Totally.

Evan Brand:  And forest bathing also there’s some cool research if you type in rumination in the forest, you can read that some of the bloodflow to the prefrontal cortex which is the newest part of the brain. The blood flow actually decreases and the more reptilian part of the brain in the back increases the blood flow back there meaning, you’re less likely to start overthinking and beating yourself up and being self-conscious and you know, people are hard on themselves. And I’ve been guilty being hard on myself too and a lot of times it’s just that front part of your brain is overactive and due to the modern world and technology, social media, I mean there’s a lot of bad influence that contribute.

Dr. Justin Marchegiani: And what’s that part of the brain that causes the rumination effect?

Evan Brand: Pre frontal cortex-

Dr. Justin Marchegiani: Okay. The prefrontal cortex, the neocortex, the high functioning part of the brain.

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Yup.

Dr. Justin Marchegiani: Excelllent. And also we know cortisol. Higher cortisol and lower cortisol are both detrimental, right? Higher cortisol is that tire but wire, you keep on going, you’re energized, but maybe you’re more anxious, maybe you have the heart palpitations, maybe you have excessive sweating and body odor. And these are the high cortisol. And again typically people that are higher cortisol, they least have the energy and the propulsion. It’s like the engine’s redlining but it still flying down the street versus, “hey, now the car’s going, it’s pot, pot and pot along”. But now your kinda in that low cortisol statement. Again, high cortisol, what it will do is rip up the gut lining, right. Coz it will rip up the IGA and it’ll tear up the gut lining. High cortisol also tear up muscle. So you start getting skinny fat. So maybe you look skinny but your muscles don’t really have much tone to it or contour. Or you start gaining weight because now you’re ripping up so much protein, you’re actually increasing blood sugar from the protein from the gluconeogenesis happening. So, now your blood sugars going up from the stress response as well. So you have- you can get insulin resistant, you can get sarcopenia, meaning the kind of the flabby muscle. And then you can also tear up the gut lining and tear up other tissues in the body, too. Hair, skin, nail, etc.

Evan Brand: I’m glad you brought up the IGA because I’ve been looking a lot. And I’m sure you have been too on the G.I. map at the bottom. Seeing how the link between people with adrenal issues their gonna have low IGA levels, but their also gonna have more infections, too.

Dr. Justin Marchegiani: 100%.

Evan Brand:  So not only are you tearing apart your tight junctions contributing to leaky gut, which can contribute to autoimmune disease. All stemmed from you being on social media too much, for example, you can also contribute to yeast overgrowth, bacterial overgrowth, SIBO infections because now your bulletproof vest, which is your IGA, your first line of defense, that’s now reduced. And I had a guy last week-

Dr. Justin Marchegiani: Yes.

Evan Brand: He’s in his mid-20s. His IGA level was, was one of the lowest I’ve seen. Like 2, maybe 200 and the scale is, you know, 500 to 2000 at least on the GI map that you and I use.

Dr. Justin Marchegiani: Yes.

Evan Brand: And yet, I’ll see a 75-year-old woman you would suspect would have lower IGA just to distress and aging. And her IGA could be perfect. It could be 700-800. So just because you’re young and overall you, you hit the gym, and you wear cool yoga pants, and all of that- that doesn’t mean you’re any healthier.

Dr. Justin Marchegiani: I totally get it, man. And here’s the thing, too, right- Is you can be making all these great changes to your diet to your lifestyle, and how you perceive stress- Let me just take a side out here, I’m gonna digress for a second. But Dr. Robert Sapolsky, the PhD stress researcher out of Standford, wrote a book I think in the mid-to-late 90s called, “Why zebras don’t get ulcers?” and his basic philosophy was that, a zebra, right- when chased by a lion, they have to run and they basically either live or they die. That’s pretty much it. And you’ll see a liberal, uh zebra that survives a tiger attack, or lion attack. I think it’s lion attack with a whole tank of flesh missing from its back and it’s out there- eating and drinking the water like nothing even happened. So this zebra that is basically close to death, is totally turning the stress response on and off like it’s a light switch. The problem with us is that our stress which keeps on flickering on and off all daylong is we cannot turn it off because that stress becomes a micro-stress. And it’s constantly being turned on we’re driving a conversation with our wife or partner, dealing with kids, poor sleep, you know, politics, this that, friendship drama, finance issues, that’s constantly flickering on and off. It’s like you have a- a light show going on in your house. That’s what kind of stress is happening. Even though you get this zebra, who basically almost died, totally relaxing and in drinking water and eating grass over there by the stream.

Evan Brand: Well, that’s the problem. We got too smart. Because if you look at- you and I- I know people heard the stories of car crash accidents where the adults may die in the crash but the children expect depending on what age they are the real young infant, you know, 2,3,4,5 years old. The kids will survive because they didn’t go into fight or flight. They had no anticipation. They didn’t tense up. They didn’t flex all the muscles and argh, before it- before the crash happens. And so they’re fine and the adults who anticipated it, they set off the fight or flight flexed all the neck muscles, got tight, tense. Boom, they broke their neck. They’re dead. So, I guess what we’re trying to convey in this podcast today is so many people are looking to the food and fitness gurus and they’re frustrated because they’re doing Paleo and it’s, “Oh, I’m doing AIP so well. I do paleo so well, but I’m still not getting results” and it’s like, “well, we could look at your circadian rhythm, I mean, are you using your iPad at night?” “Oh, I’m wearing blue blocking glasses” “Okay but your skin receptors still can pick up light, there’s light receptors on your skin”

Dr. Justin Marchegiani: Right.

Evan Brand: So you’re just bathing in an extremely bright bathroom plucking your eyebrows at 11 PM before you go to bed. This is the other factor.

Dr. Justin Marchegiani: I knew your eyebrows are looking good today.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ha ha

Evan Brand: Thanks.

Dr. Justin Marchegiani: I hundred percent agree with you, by the way. I think that’s a really important point, is that we’re just chronically under all the stress. My biggest thing is this, when dealing with patients is, try not to look at like- It’s so easy get stressed out over the diet and all the things that you have to do now. My goal is always a look at things from a perspective of, what can we exchange, what can we substitute or switch versus what do I have to remove and cut out, right. Because when you going to this cutout mode, “ I had to do this now”,  “Oh my gosh, I’m missing this”. The key is going to an exchange mode coz the exchange mode is kinda like a barter in your brain. It’s like, you want this result, that result is better mood, better energy, better libido, less brain fog. So for that, you’re gonna barter. What you gonna give up, what are you gonna exchange with, you know, uhm- let’s just call it your functional medicine doctor- us, right. What are you gonna exchange to Dr. J and Evan. What are you gonna do based on what they’re telling you to do, based on their experience and results to get to that goal that you want. So it’s kind of we’re having this barter. We’re  having an exchange of what, what habits can be put in your place, substitute in, for what your- what you were doing that’s not getting you the results you want. So, we can look at it as an exchange in a barter and negotiation versus like you have and give up all the stuff. I find patients have a much better mindset and they’re not getting stressed out by their mindset, making all these healthy changes.

Evan Brand: Agreed. The other thing too that’s really helpful if you’re stressing out about all the- minutiae. Coz that’s where the success really comes into me, is dialing in the minutiae. So getting the shower filter, getting the water filter, making sure that the butter is good. All of these minutiae things that tend to overwhelm people- you want to put those things on autopilot. So once that’s programmed on autopilot, for you it’s not a struggle to do AIP anymore. Maybe at first you’re like “Oh, I’m gonna miss this”, “I’m gonna miss that”.  But now it’s on autopilot, so it takes almost zero effort to maintain. And that’s the goal, is to get as much stuff and autopilot as you can that we don’t have to think about diet. You don’t have to think about exercise. And now all you’re focused on, is how my managing stress. So stressful situation comes at me, I know, okay- I’m to be more susceptible to go eat some sugar.  Because I’m stressed, I need a quick glucose to think better. That’s what your body’s gonna tell you to do coz that’s what you’re primed to do. Get a quick burst of glucose so you can think. And then the stress is gone.

Dr. Justin Marchegiani: Totally.

Evan Brand: But if you can catch yourself  and you’re on autopilot, then you could just- maybe you do EFT, may be due a round of EFT. I’m about to make a really bad decision.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m gonna tap this out.

Dr. Justin Marchegiani: All tapping points. Exactly. I think that’s great. I have my push up bar here. So between patients, I’ll be doing some push ups. Also, one of the best things I got- I haven’t told anyone, my patients probably hear it in the background- I’ve a walking treadmill now. So it’s lies underneath my desk and I stand about three quarters and half a day and I’m walking about 10 to 12 miles over 20 to 30,000 steps a day. Last week I walked 75 miles while seeing patients.

Evan Brand: Sheesh.

Dr. Justin Marchegiani: Isn’t that amazing?

Evan Brand: Are you wearing shoes? Or are you going barefoot?

Dr. Justin Marchegiani: I’m actually wearing sandals.

Evan Brand: Cool.

Dr. Justin Marchegiani: I wear sandals. I used to wear shoes, but they were just too loud.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they’re too loud when they hit and I went barefoot and after about 5000 steps I started getting blisters.

Evan Brand: I’m sure.

Dr. Justin Marchegiani:  I feel like this is kind of a good compromise but any of my patients that hear the uh-you know, little me walking in the background,I apologize but I’m giving you 100% of my attention. I can walk and chew gum at the same time. Uhm, but yeah, I’m really pumped because I’m getting 20,000 30,000 steps a day. And that’s actually helping to lower my cortisol.

Evan Brand: That is excellent.

Dr. Justin Marchegiani: It’s keeping the stressed down. And just to kind of reiterate one thing, is you talked about the habits. Like once you have your water filter dialed in, once you have like the sea salt by your water when you fill up, once you have like the stuff in your fridge to make meals, it’s all easy. Coz when I go to the- use the water, the filter’s already there. When I go to grab the cupboard on the fridge, the food’s already there. So I always say preparation is the biggest first step. Once you actually go through the inertia preparing and everything is there, it’s so easy to capitalize it, so easy to focus. It’s like, I’m a big Tom Brady fan, I know, haters are out there, but the Patriots are in Super Bowl this week. I’m really excited about that. And you know, you got to talk about the game time, right. When the game happens, so much of that game is one in the preparation leading up to that game, right. So, so much of the preparation in our health is one leading up to us making decisions every day. We can get ourselves prepared, if we can batch cook, if we can have the water and the minerals in the right place, we can have supplements in a really easy setup place, if we can have a good routine were our gym time is scheduled or we have a little set up at home to work out, like you do outside, that’s gonna let us be successful. But it’s gonna lower that stresses coz it’s gonna put these tasks in the random access memory the RAM versus havin’ a- havin’ a startin’up from the hard drive, so to speak.

Evan Brand: Right. Yeah, instead of having to retrieve and start fresh. I agree. I mean to retrieve and start fresh. I agree. You know I think what we’re saying in so many words is the lifestyle component to me is the most important aspect.

Dr. Justin Marchegiani: Huge.

Evan Brand: There’s so many sick people that have a great diet and they exercise 2,3,4,5 times a week. Maybe they’re doing hot yoga and Pilates and bar and all of these great things. And they eat at the hippest restaurants and they were the coolest leather boots. But at the end of the day, if you’re a stress case because you’re beating yourself up mentally, because there’s unmanaged emotional stress, or there’s a bad relationship that you’re not gonna cut out, I don’t care how organic your diet is. You’re not gonna be able to out supplement, you’re not gonna be  able to outkill it, you’re not gonna e able to out smoothie it. You’re toast unless you address the lifestyle. So you and I always talk about numbers, it’s tough to say because based on the context, our numbers might shift. But for this conversation, I could say 80% of the issue is lifestyle and 20% is combined diet and fitness. And lifestyle could include your circadian rhythm. So that can include getting bright light exposure-

Dr. Justin Marchegiani: Totally.

Evan Brand: – a bright environment. This could include grounding yourself, this could include swimming, this can include walking with your dog and your wife like you’re doing, this can include you drumming, listening to music, dancing.

Dr. Justin Marchegiani: Yup.

Evan Brand: I told you, I went to my grandparents house and played cards- huge stress relief. I mean that it’s so fun.

Dr. Justin Marchegiani: Yeah, absolutely.

Evan Brand: I mean it’s so basic but yet, the exchange that you’re making in a small lifestyle investment can be far more than a simple diet tweak or beating yourself up because you had an extra piece of chocolate. I think honestly, the biggest battle that people face is themselves.

Dr. Justin Marchegiani: Yup, I agree. It’s self-

Evan Brand: It’s self-inflicted wounds whether it’s physical because they’re under moving or over moving, or emotional. They’re beating themselves up for no good reason. They’re guilty about something because everywhere you go, there’s an article about how bad this is for you or how bad this is for you. There is no deficiency of information that anybody listening to this show has. Its not the deficiency of information. It’s preventing people from getting what they want. To me, it’s dialing in what, what does it take for you to be happy, what roadblocks are in your way there preventing you-

Dr. Justin Marchegiani: Yeah.

Evan Brand:- from making the action steps you need to make.

Dr. Justin Marchegiani: I agree.

Evan Brand: If you got a constant battle going on with a spouse but yet, you’re trying to kick the sugar habit at the same time, I can’t tell you that you’re going to succeed by just trying to go cold turkey on sugar. You’re gonna have to take care the emotional stuff, too. It’s not one or the other, right. It’s not like you can- a perfect diet’s can gonna fix all these other aspects. I guess that’s what I’m saying. But I’m just been very long-winded about it.

Dr. Justin Marchegiani: No. You’re right on point. I always tell people about the patients that we kinda get into care. There’s four phases which most people go through during any difficult skill after trying to undertake or learn. And I, I call being healthy a skill. And also one thing to add on, too. It takes no more effort to get what you want than what it does to get what you don’t want. Meaning you develop habits in your life that are running in the background subconsciously, that are constantly making you sick and unhealthy. Now, we can create new programs and new habits that are running that are getting you to be healthy. So no more effort to get what you want than it does to get what you don’t want- same thing. So the four phases that people go through, typically in their health at this. They’re unconsciously incompetent. They don’t know what they don’t know. They think their grains are healthy. They think saturated fats- bad. They’re drinking their soda. They’re using aspartame and Splenda. They are clueless and in fact, they are thinking that what they’re doing is actually helpful to them even though it’s not. That’s the first step. Now, the second step is they’re consciously incompetent. Now they’re starting to know that they don’t know. Because now they’re starting to get sick, they’re starting to not feel well they’ve gone to the conventional doctor, they’ve said “Hey, you know we can’t help you” or they give him a whole bunch of diagnoses that involve some drugs that don’t fix the underlying issue. The drugs cause more problems, more symptoms. Maybe they keep on going back. Now they’re given antidepressant and a psychiatric referral and they’re like something’s wrong. They’re consciously- they’re like, “ I know something’s wrong, but I don’t know what it is”. Now that’s the point phase 2 with a reach out to someone like us, right. Now phase 3 is kinda where we intervene. This is the hard part going from phase 2 to phase 3 is the hardest. That’s where they are consciously competent. Dr. Jay and Evan have educated the patient. they know the kind of water. They know the minerals. They know the food. But it’s hard and it’s tough. And when they mess up, they beat themselves up. And they don’t quite know what the best exchanges are. They don’t- they haven’t made it a habit yet. They are not batch cooking. They’re not doing things. They are not prepping the house in a way that makes it easy for them to succeed. So they’re consciously competent but it’s taking all of the RAM in their database.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Me and you, Evan. We operate in unconscious competence. We don’t even have to think to do the habits that we wanna do. We just, “hey, I got my walking treadmill. I walk 10-12 miles a day. I got a gym. I got kettle bells on the corner. I pop out push-ups. You do this. You go out in your gym. You go for walk with your wife. You walk your dog. You’ve all these habits. You are getting vitamin D. You’re hydrating and you’re not even thinking about it. And there’s zero bandwidth being taken up. And that’s where we’re trying to transition our patients to. And I think any patient that’s listening, they have to understand the really big binds in that first one to two months while we get you from consciously competent to unconsciously competent, it’s autopilot.

Evan Brand: Yup. That was well said. That was excellent. I had a thought, too. And then I lost it. It was about how the lifestyle component is brought up. People say manage stress but they don’t know how to manage stress. So let me out one piece assigned to this.

Dr. Justin Marchegiani: Yes.

Evan Brand: Because rational brains are like-okay, you guys are getting into airy fairy land. What is this actually doing to me?

Evan Brand: So you have this –

Dr. Justin Marchegiani: Yes.

Evan Brand: – part of the brain called the amygdala.

Dr. Justin Marchegiani: Uh-hmm. Uh-hmm.

Evan Brand: And the amygdala is your- I call it your Rolodex, if you will. It kind of cycles through all of these thoughts, all of these things that come into the brain. And it determines whether it should trigger a fight or flight reaction, or is everything okay and we’re gonna press the green button instead. And with chronic stress- so if you are beating yourself up, You’re in this transition phase, you’re trying to remove bad habits, integrate new habits and your cell phone goes off. “Ding” that notification sound. Here you are trying to have a relaxing lunch, “Ding”, the cell phone goes off . Now you gotta go look at it. “Oh my God, it’s a text message from so-and-so”.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is the last thing you wanted to read. The amygdala, that part of the brain, is gonna go, “poof”, red button fight or flight. And the more that that red button gets hit, that becomes a hair- hair trigger. Just like a really sensitive firearm, that trigger is so sensitive you better be careful unless you’re ready to use it, don’t even get close. Because, “ding”, that notification goes off again, “poof”, red button gets hit. Fight or flight system goes, stomach acid becomes a luxury.

Dr. Justin Marchegiani: Yup.

Evan Brand: So there goes good digestion out the window. Blood flow’s now shunted away from the central part of the body and blood flow is basically going to design- be, be working to get you to run.

Dr. Justin Marchegiani: That’s it.

Evan Brand: And our goal is, you don’t want to press that red button. Leave that red button alone. Put a glass case over it. So it’s a lot more difficult to hit that red button. And this takes practice. You and I talk about this. There’s things that can still stress us out and still get to us but the goal is, with the combination of bringing in this functional medicine approach. So this is where the adapted genic herbs come in.

Dr. Justin Marchegiani: Yup.

Evan Brand: So like Rhodiola. You can look at a research study Rhodiola,  200 mg was used in about 1200 patients. And after just three days, it was- I believe it was above 90% of all of these patients experienced “a massive reduction in life stress”. So in this case, the adapted gene could be putting this glass case over this red button in the amygdala so no longer is as fight or flight system immediately, “ump” We’re not gonna hit the red button anymore. We’re building up the resilience so you can be a warrior. So next time that text message comes in, you can- maybe you shouldn’t have your phone by your table on the first place, but that’s fine. Let’s say you have it there, now you look at that bad text message and you can process it first. So instead of immediately, “ump”,  automatically hitting the red button. You can look at it, “okay not a big deal, I’ll take care of this . I’m gonna finish my meal first because I know Justin told me that if I skip meals, my blood sugars gonna crash coz I have adrenal stress right now. And if I skip a meal, have anxiety. And I’m trying to get off the Xanax that the doctor prescribed.

Dr. Justin Marchegiani: Yes.

Evan Brand:  Because I don’t want to be on it anymore and I want to get rid of this anxiety. So what I’m gonna do is I’m gonna put this phone aside. I’m not gonna hit the red button. I’m gonna put the phone aside, finished chewing my meal, take in my enzymes.

Dr. Justin Marchegiani: There you go.

Evan Brand: I’m gonna press the green button. Everything’s okay. There is not a situation I need to fight or flee from right now.

Dr. Justin Marchegiani: Yup.

Evan Brand: And let’s get back to life. And the more that you can hit the green button with the amygdala, and the less you can hit the red button, overall the better you’re gonna be. Because you are not designed to be in fight or flight 99% of the time like we are in the modern world.

Dr. Justin Marchegiani: 110%. I love it. So let’s just kinda recap. We talked about stress, how it affects our gut lining, how it affects and burns through neurotransmitters that’s why the more stress you are, you burn through dopamine you burn through serotonin and you start getting depressed. You start getting OCD, you start getting ADHD. So all these different things happen. It starts burning up the brain tissue and affects the area called the amygdala in the brain, which is right around the hypo, hypothalamic area. And that affects memory, the hippocampi, too.

Evan Brand: We didn’t even-

Dr. Justin Marchegiani: Yes.

Evan Brand: We didn’t even talk on the hippocampi. So you can- you can look at-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -with MRIs, the hippocampi you have one on each side. It gets marinated in cortisol and it begins to make these memory centers all look like Swiss cheese. So people as they get older, it’s happening younger and younger. But people joke about being forgetful that’s not funny. That’s a sign that something is going on. So, yeah. There’s tissue destruction, there’s the leaky gut aspect. Keep rollin’-

Dr. Justin Marchegiani: Yeah, a 100%. So you’re rippin’ up the hippocampus. With that affects memory and learning. So if you’ve any job like, let’s say me and you, Evan, we’re havin’ a problem solvin’, think all day long, you’re an attorney, you’re a doctor, you’re a nurse, you’re a teacher __, you-you’re a mom having to deal with your, kids you’re homeschooling you’re dealing with activities, you’re multitasking, people are calling. You need that higher brain function to perform at the higher end. Man, I’ve so many patients are reaching out to me, they’re like, I’m just- I’m a shadow of my former self.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right. They have that inner kind of feeling like that is not quite where they used to be. They’ve aged 20 years in the last year too, right. So we’re trying to develop all these tactics to help. So number one: the diet’s in place. Paleo template, autoimmune template, whatever works for you in that realm. Number two: gets some habits that you can do with your family that will help decrease stress. I like the forest bathing whether its just walking outside or doing a little nature hike. Love it. Number three:

Do push-ups or some air squats, or get a desk treadmill that you can walk at while you’re at work or in between whatever you’re doing. Just get a little bit of movement in. One of the biggest things that CEOs do is they exercise to not work with their body, but to help their brain coz they feel exercise helps with their brain and their ability to function and deal with work stress. So the exercise piece is not necessarily an aesthetic thing or physical thing, it’s actually more of a mental, emotional thing. Number four:  Make sure you have the lifestyle habits of clean water, a good sleep, good sleep habits, and hygienes. And your food- your fridge’s stock of really good food. And once you have all that piece left, then we can talk about supplements. Then we can have magnesium for stress. We can add Valerian or L Theanine. We can add our Adaptogens, our Rhodiola, our Ginseng, our Ashwaganda, our Lutarol, our Maca for female hormones, our chaste tree. We can add extra B vitamins, we can add even adrenal glandular and support. We wanted to find out that more based on adrenal test. And then next piece is we dig more into the functional medicine with the gut and the detox and other specific more nuanced nutritional deficiencies. Anything you want to add to that, Evan?

Evan Brand:  Well, I love how you’ve laid out 1,2,3,4,5 like that because the gut infections, although massively important, that’s so much later down the road. You put so many other foundations and placed first. A lot of people that come straight from what is called conventional and want to go straight to detox. Or, “hey, I took this detox tea” or “this detox Paleo  shake” or “I went straight into some gut protocol”. If all that other stuff is not addressed- Yes, it’s very important to remove Candida. This candida problem, definitely is impairing brain fog.

Dr. Justin Marchegiani: Huge.

Evan Brand: If you look back at- If you look back at my organic acid test from a few years ago, I had Candida problems and it perfectly explain why I was mixing up my words.

Dr. Justin Marchegiani: Totally.

Evan Brand: I was putting words in different order. When I had to address that to get the brain better; however, if I just slept better, I noticed 20,30, 40, 50% improvement in brain function there. So yes, it may be Candida, yes it may be the infection, yes it may be the mitochondrial function problems that we’re gonna have to fix, but also could be that you’re staying up until 2 AM and then you’re getting up at 6 or 7. And you say, “well I can just function better on 5 hours of sleep”. Well you probably just running on adrenaline which will give you that temporary heightened sense of cognitive function, but that’s because your body thinks that you’re running from a bear because why else would you be light sleeping tossing and turning all night. There must be a bear around. We’re gonna have to run from that in the morning. So you’re gonna get that burst, but in the long run, your brain function is going to be sacrificed and your memories can be sacrificed, your sex drive is a luxury. So why ovulate, women can lose their period.

Dr. Justin Marchegiani: Totally.

Evan Brand: Why have a sex drive for men if you’re running from a bear? That’s – Let’s do that tomorrow. We gotta-

Dr. Justin Marchegiani: Yeah.

Evan Brand: We gotta live.

Dr. Justin Marchegiani: Exactly. Yeah, 100%. And one of the things I’m gonna put it out there, so everyone can hold me accountable as well. But the biggest thing I find, too- for myself and a lot of people I talked to, is mobile devices, iPads, phones, Facebook stuff late at night.

Evan Brand: It’s not good.

Dr. Justin Marchegiani: Yeah, I mean, I think I like to go on Netflix or Amazon prime or Hulu and I like to wind down. Find a nice show that kinda entertain me, I can laugh, I can enjoy. But I’m finding, and my wife’s it too, is pullin’ out the iPad or the phone, checking this checking that, checking my email, checking a text, checking Facebook, all this thread. And it’s like, my brain just constantly go, go, go, go, go. The thing I’m trying to do now is, I’m putting my phone in airplane mode. I’m having a little moon on my iPhone so, no notifications come up and I’m putting my phone in my room, already plugged in and ready to go so I can go to sleep.

Evan Brand: You know many family members are mad at me because my phone is on airplane mode like 24-7. You’re like one of the only people that I text because I’m so  anti-phone.

Dr. Justin Marchegiani: I feel fortunate.

Evan Brand: Yeah, haha.

Dr. Justin Marchegiani: I’m taking you out of your Zen date now everytime I text you.

Evan Brand: No, you’re not. You’re fine, man. You’re fine. It’s always good to chat with you. But seriously, though. And apparently something happened to my voicemail, where now my voicemail doesn’t work. So you just get this voicemail has not been set up. I’m not even gonna fix it.

Dr. Justin Marchegiani: Oh, man.

Evan Brand:  I’m not even gonna fix it because that’s just one more thing, right. We’re always pulled away and I want to cut all the strings on things that are pulling me away. And checking voicemail is just one more thing. You how it goes, you get  2,3,4,6 voicemails piling up. I can’t do it.

Dr. Justin Marchegiani: I totally agree. And the big thing I’m challenging you and everyone else, else anyone else out there, have you cut off for your phone, right. Whether it’s 8 or 9 or 9:30. Have that cut off, it in airplane mode. Hit the moon or whatever that equivalent is on the android. What’s the equivalent on the android for zero notifications?

Evan Brand: I think it’s do not disturb mode, something like that.

Dr. Justin Marchegiani: Perfect. Do not disturb. Do not disturb mode, moon mode, sleep mode and then put your phone away. Put in your bedroom wherever that charging place it belongs for the rest of the night. And be present with your wife, or your partner, your child  or whatever that night on time is that you guys do special whatever that routine is. Be fully present with that. That’s the thing that I’m trying to do. Also, I’m gonna be on I think- I think a staycation next week. And I think I’m gonna uninstall Facebook for the week.

Evan Brand: Ooh, I’m proud of you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So one other thing that for me has been massive is completely getting rid of Wi-Fi in the house. I completely disabled it. And so now, I’m hardwired. And so for me to use my phone, you may think it’s funny, but I have an ethernet cord that plugs into a u, an ethernet to USBC, adapter.

Dr. Justin Marchegiani: Oh my God.

Evan Brand: And so-

Dr. Justin Marchegiani: Really?

Evan Brand: Yes. So listen- So this is how much work it takes me to get on my phone to use social media. I have to get- I have to disconnect the adapter for my computer, unplug the adapter, plug up the new adapter, ethernet to USBC, then run with the cable wherever I’m going to use the phone. Plug up to the phone in then use the internet access. So for me, putting that many barriers in place, my phone is completely hands-off. If  I’m not on calls, my phone does not exist to me. And that has been so massive for my productivity because you get in the social media loophole. You gotta check this, you gotta reply on this, you gotta upload new data to this, you gotta post an article here, you gotta put the podcast there. It’s too much. So now, actually a guy from the minimalist, I’m not sure that I chatted with him, was an email something, something with the conversation of the minimalist guy- it was Josh, he said that he completely got rid of Internet in his home. Now for us, we can’t do that. That’s not practical. But for him as a writer, he completely got rid of internet access from his home; therefore he was only able to write on like Word document applications and then when he would go to a coffee shop or something. Then he would have the ability to get online and do email and Facebook and blah, blah blah. So for as a writer, I think that totally valid. It wouldn’t work for us, but like I said, I’ve still for many- many, many reasons disabled the Wi-Fi completely. And it’s enabled me to- I have to be grounded in a set location before I’m gonna use the Internet as opposed to me just mindlessly walking around the house checking this, checking that on my phone.

Dr. Justin Marchegiani: Yeah, I agree. I think we’re hitting it two different ways. You know, I just try to put it in airplane mode and- and sleep mode. And then also the big thing is, you should’ve took this first, but either way, Christmas tree timer plugged into my router and modem. And the Christmas tree timer- that Wi-Fi and Wi-Fi is gone at 11 PM.

Evan Brand: I had that-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I had a power strip and a timer. I would- if we were not home, then I would I would use the timer. I would just let- because the fish tank was on the timer, too. But when we were home, I would just “poof” I would turn off the power strip. But for me, there’s a lot of cool, a lot of cool data coming out from Deborah Davis and some of these other-

Dr. Justin Marchegiani Oh, yeah. Yeah.

Evan Brand: EMF Wi-Fi experts that are showing like the different spectrums and babies. And in all of that- in showing that nature basically drops off around the 2000 MHz range. And that’s exactly where 2.4, 2.4 GHz

Dr. Justin Marchegiani: Gigahertz.

Evan Brand: – and router. That’s where they pick up. So basically, they have this natural, nonexistent field in the spectrums.

Dr. Justin Marchegiani: Yup.

Evan Brand: And that’s where Wi-Fi plugs in. So for me, I don’t want to touch that spectrum, especially with the baby around. I feel much better. To me, it’s- we don’t have to prove it’s dangerous. For me, we can’t prove that it’s safe.

Dr. Justin Marchegiani: Right.

Evan Brand: So for me, it’s not a huge deal to just do the hardwired Internet thing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And I chatted with Bing Greenfield, too. And apparently, he did that. He- in previous conversations he told me he was just turning Wi-Fi off at night. And last time I spoke with him,  he said, “nope, I’m doing completely hardwired. So I’m not the only one going- going so old-school. I don’t have dial-up.

Dr. Justin Marchegiani: Yeah, I think it’s good. I think it’s good but if you’re not ready to go that full length which I’m not because the TVs that I use, I have no cable- No cable TV. So my TV’s all Internet-based. And it’s- I don’t have router. I don’t have access to plug-in up there. So we keep it going just for the TVs at least. But if not, you can always put your router on a Christmas tree timer and just- There’s even one that will be like you can change the hours. So Saturday will go longer or Sunday longer, in case you’re up longer in the weekends. And you can adjust it. But I try to make it so that router is off for about eight hours a night. So that way, I can at least sleep without any Wi-Fi nearby.

Evan Brand: Agreed. Yeah, I think that’s- at the end of the day, the sleep time is most important. Some people goes as far as turning the breaker off in the room. I’ve not done that yet. Maybe when I get a new place-

Dr. Justin Marchegiani: Oh, that’s inconvenient.

Evan Brand: Yeah. You can put a kill switch on the wall but we’ll save that conversation for another day.

Dr. Justin Marchegiani: Oh that’s cool, I like that. Awesome. Part two coming up soon. Awesome, Evan. Hey man, great chat. I think we’re on video. This could be a really good one if we get this whole podcast issue fix, we get the video going, man.

Evan Brand: Go check out Justin’s YouTube channel. Type in justinhealth. You’ll see the videos. You’ve got what- twenty- 20,000+ subscribers there that are checking out your content.

Dr. Justin Marchegiani: Yeah. Over 25,000. Really fun, plus you get to see our ugly mugs here, too.

Evan Brand: Oh, yeah. Don’t say that.

Dr. Justin Marchegiani: Of course. All tongue-in-cheek, man. Alright, brother. Good chatting with you. You have an awesome day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.

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.