What are the Natural Anti-Inflammatory Agents for Pain Relief

In general, we have our COX pathways. Now, Arachidonic acid can feed those pathways. A lot of excess, junky, refined Omega-6 from animal products can definitely feed those pathways. That sets the table like gas in the kitchen where a little spark can take it off.

Click here to consult with a functional medicine doctor for recommendations on natural pain relievers.

Where to find anti-inflammatory agents:

  1. Natural herbs like ginger can help with COX-1.

  2. Fish oil is excellent for COX-2 at high doses. If you do high doses of fish oil, you can increase what’s called lipid peroxidation because fish oil is a polyunsaturated fatty acid. It’s more unstable. It’s got more double bonds in it. Omega-3 means three double bonds. The more double bonds that are they are, the more unstable the fatty acid is to heat things like that and the more, let’s say it can be oxidized. So, having extra vitamin C or extra vitamin D on board when you’re taking extra fish oil just to make sure you don’t have oxidation is great, and we already talked about things like systemic enzymes.

  3. There is also curcumin but liposomal curcumin is better due to the absorption or something with black pepper in it helps with absorption, too.

  4. Frankincense or Boswellia.

  5. White willow bark which is kind of how aspirin is naturally made though aspirin works more on COX-1. So, aspirin can be your other natural source and you can do white willow bark which is the natural form of aspirin.

  6. There are things like Tylenol but Tylenol works more on the central nervous system perception. So, it decreases the nervous systems’ perception of pain. Note: We have to be careful of Tylenol as it can actually chronically reduce glutathione. So, if you’re taking Tylenol longer-term, you definitely want to take it with NAC and/or some glutathione, just to be on the safe side.

  7. At the extreme example, we have opiates which block pain receptors in the brain, the opiate perception of the brain. It’s not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive.

  8. We can block some of these natural pain perceptions with CBD oil. So, CBD is another great way to reduce the perception of pain.

In general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation.

If you have osteoarthritis, rheumatoid arthritis, sports injury, or you’re just trying to heal maybe postoperation, these things may be something to implement and then obviously work in all the other root causes, too. You are not just what you eat. You are what you digest from what you eat.

So, if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair or falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place.

If you need to reach out to talk about your pain and inflammation issues, click this link to schedule a chat with me!

Natural Herbs and Foods to Help Fight Stress

When you’re stressed, what are the important things? Blood sugar stability is really important because most people get on a roller coaster when they get stressed, meaning they’re overly gravitating towards alcohol and towards refined sugar. Their blood sugar goes up and then it crashes down, and then it creates more nervous system stimulation via adrenaline, epinephrine, and cortisol being stimulated to bring the blood sugar back up.

Click here to consult with a functional medicine doctor for guidance on which foods to eat for stress relief.

So, I find just keeping it really simple and really easy with your meals. You may be more nauseous when you’re overly stressed because stress hormone does cause you to feel nauseous. So, this is where you may want to do a soup or a simple smoothie, something really easy where there’s not a lot of digestion but you’re still getting some proteins and fat in there, whether it’s some collagen and some coconut milk or just sipping on some bone broth. Something like that’s going to have some good fat and good protein, and it won’t be hard to digest. So, if you feel nauseous, just still know you should probably be eating but just try to make it something very easy on your tummy.

Then think what are some of the nutrients your nervous system is going to need when you’re more stressed. So, the low hanging fruit, B vitamins. B complex is going to be very essential. Magnesium is going to be excellent. GABA and L-theanine are good things that are going to help you relax and wind down. Valerian root or passionflower, which are all connected to GABA and that inhibitory neurotransmitter that helps you just relax a little bit. It kind of puts the clutching gear and disengages the gearbox, so you can downshift so to speak.

I always go to nutrients first and then I go to my favorite adaptogenic herbs second. So, Ashwagandha is one of my favorites. Rhodiola is excellent and there’s holy basil, which are my favorite very relaxing and tonifying herbs.

If you want to learn more about herbs for stress relief, click this link to schedule a chat with me!

Vitamin D Benefits You Should Know

Vitamin D has a couple of different benefits. Let’s go over some of the benefits. We’ve talked about the natural antibiotic that’s being produced by vitamin D, which is called cathelicidin, a kind of antibacterial enzyme. It is super helpful at being able to knock down bacteria. It also has antiviral mechanisms, as well as antimicrobial peptides and antiviral mechanisms.

Click here to consult with a functional medicine doctor to learn about proper Vitamin D supplementation.

Part of that is it stimulates and it can modulate the Th1 immune response in the Th1 immune system where you’re making a lot of your natural killer cells and your helper cells. Good helper cells can also help your antigen-presenting cell and it can help make antibodies more efficiently. So, you’re also going to have a better Th2 immune response. You’re going to make antibodies to whatever that infection is. Those tend to come a little bit later in the game, but good signaling to make your antibodies is super helpful as well.

There is a couple of other studies here that are talking about different things. We have a reduction in our MMP-9 concentrations. We have a reduction in bradykinin storms and reduction in our cytokine storm. So, basically we have a lot of inflammatory molecules that get produced such as bradykinin, cytokines, interleukins MMP-9. These are inflammatory types of chemical messengers. Vitamin D can help modulate that and prevent that from being overproduced. The more we overproduce those, the more our immune system responds. So, we can create more cytokine storm issues because our immune system will be on this positive feedback loop, responding and creating more issues with the cytokines. When there are less cytokines, there’s less chance of a cytokine storm, which is basically our immune system responding.

Imagine a fight between two people where one person yells out first and the other person yells back. Then they’re pushing, shoving, and hitting and the violence escalates. That’s what happens with the cytokine storm with your immune system and all the different cytokines and immune chemical signal. So, we can keep that modulated a bit which is very helpful. Vitamin D plays a really important role in that.


Get vitamin D supplementation from Thanksgiving to spring. At least, make that investment. If you want to come off the rest of the year, as long as you’re getting some sunlight, it’s fine. At least do that vitamin D supplementation to give you a good bump and the fat-soluble nutrients you’ll get over those four or five months will hang around months afterward because it takes a while for that vitamin D level to build up.

If you want to learn more about Vitamin D, click this link where you can schedule a chat with me!

Effective Ways to Increase Your Vitamin D Levels

Back in the 1980s, a guy named Edgar Hope-Simpson proposed that a seasonal stimulus was intimately associated with seasonal epidemic influenza. Long story short, winter comes and then all of the sudden viruses become more of a prevalent issue. There was this whole interventional study that showed vitamin D is reducing the incidence of respiratory infections in children. So, this was specifically talking about kids but there are countless of these for adults.

Click here to consult with a functional medicine doctor to find out how you can supplement with Vitamin D effectively.

What’s happening when the vitamin D levels are sufficient are a multitude of things but in particular, it’s helping to reduce Interleukin 6 (IL-6), which is one of those inflammatory cytokines that get people in trouble. So, if you can reduce your cytokines, that’s going to be beneficial. Also, another cool benefit is not only a sort of an antiviral but there’s some antimicrobial benefit. It can actually activate your immune cells to produce some antimicrobial like a natural antibiotic if you will by upping vitamin D concentration.

How do you take Vitamin D?

Is it just an ongoing thing? If you think you’re getting into trouble with illness, do you go high dose of it? It depends on what your levels are.

So, get a baseline first. I would say the lighter or more fair your skin is, probably the more efficient you are gonna be in converting vitamin D from the sun. The darker your skin is, the more melanin you have. You’ve got different spectrums and for example, a full-on African-American has the highest amount of melanin.

What is Melanin?

Melanin is like your natural UV block and it helps block your skin from the sun’s rays. So, due to evolution and where we evolved, there are people who live closer to the equator and there’s more UV light based on the angle of the sun hitting it. These people naturally evolve with more melanin in the skin. People that evolve further away from the equator get less direct UV light, so there’s less melanin in the skin because it’s all about making vitamin D.

So, the more efficient you are at making vitamin D, you probably will be able to get away with not supplementing as much or as frequently. The more melanin in your skin, the more you have to be on top of your vitamin D because unless you’re going to be outside 6 to 8 hours a day and you’re at a mid to low 30 latitude, you’re probably just not going to be able to ever make enough vitamin D. Therefore, you really have to be on top of everything in your testing.

Vitamin D Dosage, Testing, and Recommendation

For lighter skin, in general, a good rule of thumb is 1000 IUs per 25 pounds of body weight, especially in the fall and winter months. If you want to take a break in the summer, that’s fine. Just make sure you get a test here there to confirm it. The darker your skin is, you may even want to double that in the winter months. Then you may want to follow-up and retest in the early spring to see and to monitor where you’re at. If you’re someone who works outside, you have to make that adjustment. If you’re an office person and you’re inside all day, you also have to make that adjustment, too. So, in general, 1000 IUs per 25 pounds of body weight.

If you have darker skin, you may want to double that for the winter months, and then it’s always good to confirm some time in the winter and some time coming off the winter or early spring-summer to see where you’re at. We can always adjust accordingly and if there is any risk of autoimmunity or cancer, we probably want to be testing just a little bit more frequently. Once you know where you’re at, you can guess based on how well you’re doing.

If you want to learn about the most effective way to supplement with Vitamin D, click this link where you can schedule a chat with me!

Top 5 Warning Signs of Hormonal Imbalance

Let’s talk about hormones. I’m going to dive into a couple of clinical pearls that I see in my practice from working with hundreds of female patients and male patients which have a major effect on modulating and supporting hormonal balance.

Click here for a consultation with a functional medicine doctor if you want to learn more about hormonal imbalance.


These are my top 5 hormonal balancing strategies:


  1. One of the first things in regards to hormones that’s very important, and this may be common sense but I try to give a lot of knowledge guided by experience, is nutritional building blocks for your hormones. Healthy cholesterol from animal products are very essential. Fat soluble vitamins like A, D, K are very important. Lots of good protein are also very important. We have steroid-based hormones that are going to be more cholesterol-based and we have peptide-based hormones that will also be protein-based. So, a lot of these protein, fat-soluble vitamins, and cholesterol especially healthy animal cholesterol are very helpful for hormonal building blocks. If you have a vegan-vegetarian diet or if it’s very nutritionally poor or there’s a lot of processed food, that may set you up with a deficit out of the gates for just hormonal issues. Remember: Make sure the food is nutritionally dense, anti-inflammatory, and low in toxins. That’s vital.

  1. Now, if you’re having a lot of good nutrition in there, the next thing is we have to make sure we’re able to digest it and break it down. So, if we have a lot of chronic acid reflux, poor digestion, constipation, or bloating, we know we’re not quite breaking down our food and our nutritional building blocks. That could tell us that we may have hormonal issues because we’re not breaking that down. Therefore, those nutrients can’t get into our body or get in our bloodstream and be taken throughout the body to be used as building blocks. So, if we have a bottleneck in the nutritional side, that could be a big factor.

  1. Stress, whether it’s emotional or chemical stress. If we’re eating foods that are inflammatory or we’re nutritionally deficient and we have a lot of emotional stress, what tends to happen is our hormones kind of go on two sides. We have an anabolic side which are the growth hormones — testosterone, estrogen, and progesterone — that kind of help deal with growing. Then we have anti-inflammatory hormones which would be cortisol and are catabolic. I always put progesterone in that category because progesterone can be used to make more cortisol. So, we have our anti-inflammatory and then our anabolic. In some, they kind of cross over. Insulin, growth hormones, and testosterone are anabolic. The more inflamed we get, we could have high amounts of testosterone because of PCOS and because of inflammation. So, some of these hormones kind of interact and cross over. With men for instance, the more inflamed men get and the more stressed they get, that can actually cause an upregulation of aromatase and could increase their estrogen. So, see how these things kind of cross react. Your hormones are going to be either pro-building or anti-inflammatory to reduce stress. So, for chronically and stressed out state, cortisol is going to rip up your protein and kind of decrease your muscle mass. As a woman, you’ll see your progesterone level start to drop and that will start putting you into an estrogen-dominant state because if we normally got 20 to 25 times estrogen than progesterone, that ratio starts to drop. Even if you still have more progesterone than estrogen, that ratios is going to throw you off and that can create breast tenderness, cramping, mood issues, excessive bleeding/menorrhagia, infertility, a lot of mood issues, back pain, and fluid retention. All those are possible situations.

  1. Xenoestrogens from the environment and foreign estrogens. They can come from plastic components, pesticides, herbicides or rodenticides, mold toxins, and heavy metals. They are going to disrupt our hormones. The easiest thing is eat organic, avoid plastics, and avoid a lot of the chemicals in the water because a lot of times you can get pesticide runoff or hormone runoff in the water. So, clean water and clean food, and then make sure it’s organic avoid the plastics as well. That’s a big, big thing. Plastics are probably okay if they are in a refrigerator or in a cold environment but ideally if you’re heating stuff up or it’s going to get exposed to light, you want some kind of a Pyrex or a glass container. It’s much better and really important.

  1. Last but not the least would be just making sure our detoxification pathways are running well. So, if we have good hormonal balance but we can’t detoxify it, then a lot of times we can reabsorb it. So, if we don’t have good sulfur, good glutathione precursors, good B vitamins, good methylation, N-acetylation and glucuronidation, we may have a hard time eliminating. Hence, we are re-absorbing a lot of our hormones. So, being able to break down your proteins, break down your amino acid and your B vitamins is going to help with your body’s ability to eliminate a lot of these toxins.


Blood sugar, digestion, stress, xenoestrogens, and toxicity are really big. Those are the big 5 across the board. Try to apply at least one of these things.

If you’re struggling with hormonal issues and you want to dive in deeper, feel free to schedule a consult with myself.

Methods To Encourage Good Bowel Movement

You see women on Instagram. They’re all done up with their hair and makeup, and they’re marketing #ad #detox #tea. They have these ridiculous products that they’re remarketing and they’re not talking about poop. The best way to detox is getting poop out. I’m not going to buy detox tea. I’ll get a bit of dandelion or some milk thistle blended in and that’s part of it but unfortunately, detox is co-opted by the marketing industry. Most people don’t even focus on that. They’ll poop once a week but then they take a detox tea and they think they’re doing it correctly.

Click here for a consultation with a functional medicine doctor if you want to learn how to detox properly!

My whole take on detoxification out of the gates is very simple.

    1. Get enough good clean water in your system.
    2. Make sure you’re digesting your amino acids and all your nutrients well.
      Remember: Sulfur-based amino acids run the majority of your detoxification pathways, along with B vitamins. We need good B vitamins, good antioxidants, and good sulfur amino acids. For breaking down those nutrients well, there’s not a bottleneck with ACL levels or enzyme levels. We’re getting enough to clean water.
    3. Not overly stressing our sympathetic nervous system.
      Remember: The more we overly stress the adrenals, the sympathetic nervous system decreases that migrating motor complex which are the wavelike contractions that move stool through your intestinal tract, just like you roll up the toothpaste roll at night to get that toothpaste moving through to get your toothpaste out to brush your teeth. Your intestines are the same things.

    If you can do those top three things right, you’re on the right track. There may be extra things where we need extra sulfur or extra antioxidants or compounds or binders to help with mold or heavy metal. That’s true and that would be addressed down the road but a lot of detoxification happens hepatobiliary, liver, gallbladder, back into the intestines, and then out the intestinal tract. So, we need to have really good motility and really good absorption of nutrients, and a lot of good clean water to help fuel.

    Supplement Suggestion:

    Use one for liver support that has some gallbladder nutrients built into it. That can be really helpful because with sluggish bowels because a lot of times there’s also sluggish bile production. So, just helping thin the bile whether it’s using supplemental ox bile or methionine, taurine, B powder, whatever else we can do to increase bile flow. That’s going to be helping.

    Detox and Diet

    This is a low-hanging fruit that your average American is still really, really blowing it on which is just the fact that they’re not doing enough good meats, good fats, and good veggies. Your average American might wake up and do a piece of toast and maybe in 2020 or 2021, it’s an avocado toast but still that’s not the optimal thing for good poop.

    Inflammation in the diet can easily mess up the intestinal tract and can easily create inflammation in the gut. That could either move the body more to diarrhea or more to constipation. If we start moving more to constipation, that’s not good. Of course, these foods can stress out the intestinal tract and then when we start creating inflammation in the intestinal tract, then we already have indigestion meaning we don’t have adequate enzymes and acids. So, we’re burping a lot after our meals, food sits longer in our tummy, and a lot of gases are produced because the foods are not being broken down properly. That’s a problem.

    We’ve got to really make sure we’re masticating and chewing our food very, very, very well. We’ve got to make sure to increase the surface area for enzymes and acids to work. We also have to make sure not overly hydrating with our meals. So, hydrate 10 minutes or more before meal, and then if you’re consuming a little bit of liquid with a meal, just do it to help with swallowing pills. Don’t do it for hydration purposes. Because water has a pH of 7 and your intestinal tract has a pH of 1.5 to 2. So, if you start adding a whole bunch of pH 7 to up to a pH of 2, you’re going to move that pH more in the alkaline direction away from the acid direction. We need good acidity to help activate her enzymes in our acid levels. That’s very important.

    If you have any issues with detoxification, please reach out to a functional medicine doctor.


        1. Chew your food up well.
        2. Make sure you’re not overly hydrating with the food. Do all your hydration 2 minutes before.


The Top 5 Causes of Chronic Headaches

Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.

Click here for a consultation with a functional medicine doctor if you are experiencing chronic headaches!

So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.

1. Food Allergens

Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain.  Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.

2. Food Additives.

These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.

3. Blood Sugar Fluctuation.

We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings.  This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.

4. Gut Infections.

Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.

5. Hormonal Issue.

A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues.  That low level of oxygen may also cause some headache issues as well.  Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.

If you have any questions about headaches, please reach out to a functional medicine doctor to find a way to fix your issue.

Histamine Intolerance and Root Causes | Podcast #289

Hey, guys! We have a new podcast today with Dr. J and Evan Brand talking about histamine intolerance and possible root causes. We start with symptoms of histamine intolerance. While mostly linked to allergic reactions, they can be IBS, cramping, anxiety, dizziness/vertigo, fatigue, flushing, hives, brain fog, and more. Often, you’ll see these overlap as symptoms of hypothyroid, adrenal issues, or Hashimotos. So, what next?

Nutrients important to helping break down histamine are DOA enzymes, Vitamin C, Copper, and B6 (very important to neurotransmitters). We know that gut permeability and absorbing the nutrients you need can be difficult in itself when mixed with gut irritation, stress, and/or certain symptoms and this becomes a triple-edged sword. You need the nutrients to break down the histamine but your body can’t break them down because it’s stressed, overwhelmed, or not working as it should and you don’t want to eat certain foods you used to be able to consume because the histamine’s memory is messed up and you’re exhibiting more food allergies. It can be overwhelming, so then what?

Dr. Justin Marchegiani shares common foods that increase the histamine response, palliative solutions for relief, and the reality behind finding the root cause.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:00 Symptoms of histamine intolerance

10:57 How to metabolize histamine

12:59 Testing for histamine, histamine markers and root cause

19:03 Histamine medications

24:06 Hormonal link


Dr. Justin Marchegiani:  Hey, guys! It’s Dr. Justin Marchegiani here.  I hope you guys are having a fabulous week.  We are gonna be diving in to histamine intolerances and functional medicine solutions and what we do in our clinics.  Evan, welcome to the show, man.  How are we doing brother?

Evan Brand:  Hey, I’m glad to be here and glad to talk about this subject.  Something that I used to look at and I was confused by.  I would look at these histamine issues and I would say, “This just doesn’t make sense.”  Why does Jane Doe over here, why is she able to eat XYZ food and then you’ve got the other lady over here, and she can’t eat leftovers and she can’t eat mushrooms, and she can’t eat smoked meats, and she can’t eat ketchup, and she can’t do dried fruit without having problems?  And I was like, “Okay, what the heck is going on?”  Why, why, why.  I didn’t understand it and now that you and I have worked on this issue a thousand plus times, we start to find some connections.  And so, let’s first talk about some of the symptoms of histamine intolerance.  Many of these are similar to allergic reactions and allergic reactions can create histamine.  It could be anything from gut symptoms like IBS could be related to histamine, so abdominal cramping.  Anxiety could be part of it.  Dizziness, believe it or not, dizziness, vertigo could be part it.  Fatigue could be related.  Flushing, so when you rash out like on your skin or it could be your face from certain foods, like when you see people rashing out from alcohol, like red-faced from alcohol that could be histamine.  Alcohol is high in histamine and then it’s also gonna reduce DAO, right?  It’s gonna block the enzyme that helps metabolize histamine.  I believe that’s true.  Is that right that alcohol is high histamine?  I know it messes with DAO but is it high histamine as well?

Dr. Justin Marchegiani:  Um, alcohol—what alcohol does, it’s also a histamine blocker.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It also blocks the metabolism of histamine and it just depends because a lot of alcohol, there’s fermentation in the alcohol.  So of course, the fermentation will create histamine as well.  So it’s a combination of the two.  I’m pretty sure there’s gonna be histamine in it due to fermentation, right?  Like wine will be, you know, fermented or beer, and then of course, if there’s gluten in there, the inflammation could create more histamine and then you have the effects of blocking histamine as well.

Evan Brand:  Yeah that, it is a double whammy.  Yeah, here it is right here.  It talks about how like for example, red wine has up to 24 mg per liter of histamine while champagne has 670 mg of histamine per liter.  So of course, heart rate, flushing, those type of symptoms from drinking alcohol is no good.  But the problem is you’re depleting DAO.  DAO is what’s gonna help you—diamine oxidase.  It’s gonna help you to break down histamine that you ingest and so if you’re putting in histamine and reducing the ability to metabolize it.  You get in bad shape.  I got a few more symptoms and we can go on and on and one.  I mean, any list online you look at may have 50 different symptoms.  So blood pressure issues or blood pressure changes, itching—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So like the back of legs, you could just have itching.  I mean, for lack of a better word, it’s not necessarily a rash there but you could just be itching.  Nasal issues, sinus problems, nausea, and then swelling.  So like—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Tissue swelling.

Dr. Justin Marchegiani:  Yeah.  I mean you see a lot of it with Asians and alcohol.  For instance, Asians typically will get flushed when they drink alcohol because they’re missing genetically some enzymes to be able to handle it and they take a lot of Pepcid AC which is like an H2 blocker.  So a lot of times you’ll see that with alcohol and you’ll see it in certain ethnicities.  They’ll miss certain enzymes to be able to metabolize it.  I’d be curious how someone of that ethnicity would do with like extra DAO.  I wonder if the DAO would work over just a—over a histamine blocker so to speak.  Because we know the side effects in some of those medications, you know, can be drowsiness, brain fog, you know, not so good symptoms either and a lot of times you’re just trading one symptom for another.  Hope—

Evan Brand:   I bet it would—

Dr. Justin Marchegiani:  Side effects or less.

Evan Brand:  I bet it would work great.  I mean, I’ve done some experimentation with DAO.  If I have certain foods that will irritate me, like a big spice blend of you know, curry and cayenne and chili powder and cinnamon and those type of things.  Those can all irritate things, so I’ll take some DAO if I’m gonna do something with like a mixed spice blend and I feel fine with it.  I don’t really have any issue with dried fruit.  I know that’s an issue for some people but I’ll do like some freeze-dried blueberries just to see what happens and I feel fine.  So I think some of this stuff is there’s gonna be a spectrum of sensitivity with this.  Some people are gonna be extremely histamine-intolerant and then some people are gonna be totally fine.  So we’re trying to cater to all of those people.  If you’re somebody who—you can’t do fish, for example.  If it’s fresh-caught and freshly eaten or fresh-caught and flash-frozen for example.  That should be okay but if you’ve had, you know, fish that’s kinda sitting out at the market, open-air, you know that may be a bigger problem than if it were flash-frozen like on the ship,  I know there’s a couple of companies out there like Vital that they’ll freeze the fish as soon as they catch it.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And those are supposed to be well-tolerated.

Dr. Justin Marchegiani:  100%.  So you kinda went over like some of the symptoms, right?  The common ones, the flushing, the wheels or the urticaria, kinda hives on the skin, brain fog stuff, headache stuff.  It could just be allergy stuff like itching or sneezing or eye wateriness.  It could be fatigue.  It could be breathing issues.  It could be just swelling or inflammation or heart rate.  It’s just pounding, kind of the abnormal heart rate beating.  Now the problem is a lot of these symptoms can overlap with hypothyroid.  A lot of these symptoms can overlap with Hashimoto’s and adrenal issues.  This is the problem.  It’s this big overlap so that you get people that are like the histamine person or the adrenal person and you’re like, “But what’s the issue?  Is it an adrenal issue?  Is it a histamine issue?”  And this is where it gets really tough because you’re trying to seek out whose that person that can help me with this issue and the problem is everything overlaps.  So imagine like a venn diagram and then you have all these different issues, adrenal or thyroid, or histamine or gut, and then they all overlap in the middle and a lot of times that’s where people’s health issues, you know, really sit and you need a very good generalist to kinda parse these out because sometimes when we have these issues we don’t really focus on histamine, we focus on other things.  Like when you just magically reduce inflammation in the body through diet, lifestyle, supplement strategies, magically histamine can drop.  And we actually do need some histamine because histamine is a big stimulator of hydrochloric acid.  So it’s like, well, if you don’t have no histamine then we’re not gonna have good HCl stimulation and we know HCl is so important for digestion.  So it’s this, you know, it’s not like one of these things where we wanna just knock histamine down to nothing, right?  But we wanna modulate and prevent the, you know, the abnormal highs of it which tends to be driving a lot of the symptoms.

Evan Brand:  Yeah, that’s a great point and many people don’t hit that if you talk about the word histamine.  It’s sort of like a bad bacteria.  It’s just kill, kill, kill, kill, knock it down, knock it down, knock it down, knock it down but yeah, you’re right.  I mean, it’s a neurotransmitter and it does affect the immune system, too.  So it’s not something that you want zero off.  I know—I don’t know the exact mechanism but I know histamine has some role on energy like your sleep-wake cycle is somehow related to histamine.  Appetite, I know is involved with histamine.  So there’s a lot of things that people just, they skip out on and then they get on these H1, H2 blockers and then who knows what’s happening downstream?

Dr. Justin Marchegiani:  Yeah, I mean histamine is part of the stress or inflammation response.  I mean, it can cause clots.  It can cause cells to get more sticky.  It can cause your lungs to constrict a little bit more.  It can cause more swelling and fluid retention.  It can open up the blood vessels partly because imagine if you bang your elbow, right?  What happens?  Does it get more swollen or less swollen?  It gets more swollen.  Why?  Because of the inflammatory response.  It’s driving vasodilation, meaning it’s opening up the blood vessels.  Why?  Well, to help bring the immune cells there to help kind of bring the inflammation and recovery process under control.  So the problem is a lot of these mechanisms, they’re acute punctuated mechanisms.  They’re on then they’re off.  With chronic inflammation in the system through gut or other hormonal imbalances, it’s on and then it stays on and then now that it’s on, certain foods that may have been—may have not been a problem before, now perpetuate the problem.  Does that make sense?

Evan Brand:  Yes, it does.

Dr. Justin Marchegiani:  So it becomes this vicious cycle where like, yeah, you may be fine.  You should be able to have some kombucha and some bacon, but now because of the inflammation.  Now that bacon’s a trigger, now the kombucha is a trigger, now the citrus fruits are a trigger, now the good avocados are a trigger, and it’s like people are pulling their hair.  They’re like, “What is going on?  I don’t get it.  These are good foods.  What’s happening?”  And they have to look deeper at of course, you know, when we look at the symptoms, the first thing I do is I say, “Okay, let’s try cutting some of these histamines out of our diet food-wise, do we feel better?  Yes or no?”  That tells me something and if that helps, then we look at, okay, let’s work on better digesting our foods, number two.  Let’s work at gut infections because we know the microbiome, if out of balance, can really create these abnormal histamine responses and we know how the microbiome is so important with gut permeability and that increases autoimmune issues, hence, thyroid, hence adrenal, hence gut issues, irritable bowel disease, so everything can just really spiral out of control if the microbiome is not there, if the food is not there, and of course, if stress is there, we know what the sympathetic nervous system response does in regards to burning up our B vitamins and decreasing HCl and enzymes and decreasing dopamine and adrenaline over the time and then we also know that certain nutrients are gonna be vital for histamine—for making the enzymes to break down histamine, right?  We know certain enzymes, the DAO enzymes are really important and we know vitamin C.  We know copper.  We know B6.  B6 gets burnt down so much during stress, it’s very important for our neurotransmitters, and we also know that if we have low stomach acid levels and we’re stressed, we’ll be burning them up at a much higher level and we know that when our gut microbiome is out of balance, we have more bad stuff than good stuff.  We know that the bad microbes will be eating those nutrients versus making it and we know those bad microbes will be actually making more histamine byproducts as well.  So it’s this double-edged sword, when the gut’s out of balance, we eat the nutrients we need to break down histamine, the bad bacteria makes more of the histamine and then we don’t get a lot of those nutrients absorbed that help us make the enzymes to degrade histamine.  It’s a triple-edged sword.

Evan Brand:  Yeah and then think about, too, you need vitamin C to help reduce or sort of metabolize histamine for lack of a better word and a lot of people are gonna be pulling out citrus, even like lime-lemon.  Those are kinda demonized in the histamine world, if you are reacting to it.  So now, you don’t have enough vitamin C.  So I’ll try to supplement vitamin C personally and clinically and see if it helps and in many cases, it does.  So we’ll have people do quercetin which is in the vitamin C family to help stabilize mast cells that way we can prevent the release of histamine.  At least in theory, if we take a, you know, a shot of 500 mg of quercetin before—when I say a shot, I mean a powder, put in a shot glass with a shot of water and I’ll shoot it down like a 500 mg quercetin before a meal and then mix a little vitamin C with it and that tends to help reduce some of the reactions and then also the DAO before meals.  Let’s go in, just real quick list and then we’ll keep talking because you hit on something that I think people miss the boat on which is that and this is something you and I talked about before we hit record, which is that histamine intolerance or histamine issues are in effect.  What is the cause?

Dr. Justin Marchegiani:  Correct.

Evan Brand:  So if histamine issues—

Dr. Justin Marchegiani:  Correct.

Evan Brand:  Are in effect, what is the cause?  So let’s rant on that more in a minute but we hit the alcohol, fermented foods, cheeses, smoked foods, shellfish—many people that say they have a shellfish allergy, we suspect it’s a histamine issue—beans, nuts—my voice cracked, I said nuts, almonds, nuts.  I don’t know why but certain nuts get moldier than others, so for example like macadamias, for some reason, those and cashews tend to be more intolerable versus I find a lot of people do well with almonds.  Chocolate, vinegar, tomatoes, citrus.  So those are kinda like the histamine triggers but let’s go back to the gut because what you were saying is that the gut bacteria are gonna be doing several things.  They’re gonna messing up the gut barrier.  They’re gonna be producing histamine.  So regarding testing, if someone says, “Hey, how are you gonna test me for histamine?”  Let’s dive into that because the answer is we’re not directly gonna test you for histamine, correct?  We’re gonna be—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Looking deeper.

Dr. Justin Marchegiani:  Correct.  I mean, there’s the markers like the, you can do the tryptase marker.  It’s a tryptase enzyme marker that you can do.  When you break down histamine.  DAO is one of these enzymes that helps break it down and there’s also histamine N-methyltransferase (HNMT).  I think you can also test some of those enzymes.  But for me, I just—I make clinical changes with the diet and I also give specific supplements and I let those symptoms kinda dictate.  But we also understand that that’s not root cause and this is where it’s very important where a lot of functional medicine people.  I see it a lot with naturopaths where they’ll kinda come in there and they’ll use supplements to just treat symptoms and they’re not getting to the root cause.  So we always have—I always draw a line with patients.  What’s gonna be palliative changes to allow you to feel better in the meantime and then number two is what’s gonna be more root cause.  Because sometimes root cause stuff’s a little bit slow and that’s not good if you need relief now.  So we need to figure out a way to get relief now, like you mentioned some of the natural antihistamines—stinging nettle, quercetin, NAC, bromelain, kidney tissue that has the DAO enzyme, maybe B6, copper, zinc, good quality multi.  So we’ll do those things.  We’ll make the diet changes.  We’ll look deeper at the gut and the adrenals because we know steroids also are part of what’s given to address some of these issues, right?  From a symptomatic standpoint.  We know steroids, like the big medication we know are the H1 receptors and H2 receptors are the big ones, right?  We know the H1s like your Benadryl and your Claritin, these are the H1 histamine receptor blockers.  The Benadryl, the Claritin, right?  And then the H2 ones are gonna be like your Peptid AC, right?  H1 is gonna be more the histamines in the muscles, where H2 histamine is gonna be more in the intestines in the abdomen and that’s gonna be affect the heart.  So H1, H2, so keep that in mind.  Those are the big ones.  There’s actually H1 through H4, but the big meds are H1, H2 and we know that the medications can be helpful but they have a lot of side effects and we have to be very careful with that.  And we also know that the gut and all these nutrients play a huge role and when we look at the nutrients, we have to one, get a good quality multivitamin there that’s gonna have a lot of these nutrients that are gonna be bio-available so we can absorb it easily and number two, we have to get our digestion under control and number three, we have to look at other issues deeper.  That could be a mold issue or it could even be a Lyme or a co-infection issue.  I always table Lyme stuff unless there’s a strong history of tick bites, I always table it and deal with the gut first and the adrenals and hormones even before that and then personally after that I’ll—I typically will deal with mold—Evan and I may differ on this.  I’ll typically look at and test mold right away if there’s a strong history, water damage in the home, history of visible mold or if we’re on the fence, we do a plate test or a urinary mold test or hey, do you feel better when you leave your house for a week, right?  If those symptoms are there, we’ll look a little bit deeper and we’ll test.  I typically don’t go after and address mold right away because a lot of how the mold is removed is via the hepatobiliary system so that’s liver, gallbladder, gut, and the stools.  So if we don’t have great gut issues, a lot of times we can re-absorb stuff.  A lot of the binders that we may give to help pull out mold can actually cause constipation, so I always fix the gut, fix the gut motility, fix digestion before going after mold but we can at least test in the person, the patient.  Test it in the house and we can at least start making house changes right away.

Evan Brand:  Yeah, so I go after it straight away regarding testing but yeah, you’re right.  You gotta get people pooping before you go and do binders.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And a lot of times like some of the binders you and I are using have folic acid so constipation is really an issue and if you’re bumping up magnesium and vitamin C and that kinda stuff, generally it’s no big deal but how I approach it is that way you mentioned, plus what will make me go after it more beyond just history is just looking at the mold symptoms.  So in my intake form now, I’ve got like 25 different symptoms and if they check off more than a handful, we’re like, “Huh, this doesn’t look good.”  So we’ll look into it and a lot of times, I mean, it’s showing positive.  One thing I wanted to mention on the drug piece, you did a great job talking about like all the over-the-counter stuff that people get into on their own now.  So the Zantac and the Pepcid and the Benadryl and the Zyrtec and the Allegra that kinda stuff, those antihistamines may work in the short term but we’re gonna downregulate DAO and you get for lack of a better word, you get stuck on it because now you don’t have enough DAO so, therefore, histamine rises more than it did before.  And then one other thing, too, is that—and there’s a lot of people talking in forums about this on antidepressants and I don’t know exactly the mechanism.  Maybe it’s depleting DAO, maybe it’s increasing histamine.  I don’t have the mechanism and the study right in front me but if you just look at histamine intolerance Zoloft or histamine intolerance Cymbalta, Effexor, these really, really extremely in fact common prescribed and commonly dosed antidepressants—those cause histamine problems.  So how many people out there, in fact, there was a lady who had a big website dedicate to this which was histamine intolerance after discontinuing Zoloft, and so I don’t even know if the science is clear on it but a lot of people are talking about this.  So if you have been doing an antidepressant and now you’re reacting to more foods that may be something to look into.

Dr. Justin Marchegiani:  Yeah and also, so we talked about some of the big medications, right?  A lot of the Allegra, the Zyrtec, the Benadryl, a lot of the H2, 1 blockers, right?  Here’s the rub here and this is where it gets really, really, really, really confusing is that we talked about how histamine is actually needed to make hydrochloric acid.  So guess what happens with this histamine medications.  They also reduce acid levels and guess what happens when you reduce your acid levels.  Now your digestion goes down south.  What happens when your digestion goes down south?  Now you start to have more SIBO and bacterial overgrowth.  Guess what SIBO and bacterial overgrowth does.  It produces more histamine metabolism.  So it’s this unbelievable vicious cycle people get on and it’s—

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Very, very frustrating.  Not to mention that okay, there’s the other class of medications that help with histamine, guess what.  They’re corticosteroid-based.  You see it with Singulair, right?  Or a lot of these steroid-based medications, well, maybe our adrenals are so weak, we don’t have enough of our natural cortisol, corticosteroids, so we’re not—we have to fix the adrenals with it as well because the adrenals help make that that corticosteroid called cortisol which helps with our natural inflammation and if we can’t put the fire of inflammation in our body out every day that fire is gonna run rampant and create more inflammation and that inflammation is gonna drive more histamine issues and like we talked about before, all of those histamine medications, they deplete the DAO enzyme so then the histamine that’s made, it hangs out way, way longer so it’s not just about making histamine.  It’s about now you can’t break it down so now it stays at the party.  It’s like it’s the guy at the party that just lingers way too long.  It’s like you should be out of here, dude, right?  Closing time.  But that’s what’s happening with histamine in our body.

Evan Brand:  Oh, man.  Well, it’s not to say that we’re saying, “Hey, don’t do those drugs.”  But man, it would be a lot of better if before you get to the point where you get put on a daily Zyrtec or a daily Allegra or something like that or a Zantac or a Pepcid, it would be so much better if we could just stop those people and just say, “Hang on, hang in there.  I know you’re symptomatic.  I know you need relief.  Hang on.  Let’s try some of these herbal antihistamines.  Let’s give you some extra Vitamin C, maybe some extra DAO.  Let’s get you on maybe some leaky gut support.  Let’s get you on low histamine diet for now.  Let’s run a stool test.  Let’s run organic acids.  Figure out what’s going on.  Let’s test your environment.  Hang tight.”  And then if we could do that, it’s just such a deep rabbit hole.  It seems like every time you and I do a conversation on a different health aspect, there’s always a drug that’s involved in terms of being palliative but it seems like there’s always a double-edged sword to that.  No matter what the topic is.  Isn’t it funny how you and I always end up here?  It’s like crap.  The drug helped but now it actually put us in a bigger hole and now we gotta get them out of this hole because now they are downregulated of DAO even more than they were before.  It’s like, ugh!

Dr. Justin Marchegiani:  Exactly.  This is the problem, right?  And so, in general we gotta look at the adrenals, gotta look at the inflammation because if you’re taking steroids, we need to have our natural anti-inflammatories going.  We have to be very careful of the medication.  If we’re using the medication, fine, use it sparingly, but just know it’s gonna create more dependency in the long run.  Also, I’d say a big thing is environmental allergens.  Environmental allergens can dry histamine.  So imagine like we have this big stress bucket, right?  And I’ve given this analogy a lot over the years.  We put our stress balls in this bucket.  When that bucket fills up and overflows, this is where symptoms happen.  So, some people they come in genetically with a big bucket.  They can handle a lot.  They can deal with more stress and they have more adaptability.  Some come in with a small bucket and that bucket is already half full because they are exposed to mold, right?  Or heavy metals or they’re not eating organic.  So that now they’re bucket’s already at the very top and then you add in a little bit of gut dysbiosis or you add in some environmental allergens—BOOM! Histamine symptoms are going crazy now.  So we have to look at that.  So one of the first things is get the stressors out of that bucket and a lot of times so those stressors could be things unrelated to histamine, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that could be just eating organic, clean water.  The other component is environmental allergens can be a big deal.  If you’re out in Austin.  Cedar is big this time of the year.  You’re breathing in cedar and that hangs out in your sinuses all day and you don’t have a good air filter at home at night then you’re in this stressed-out state because that cedar’s up in your nose causing problems.  So my protocol with patients is we have a really good sinus irrigation system to flush thing’s out.  We clean it out with saline and Xly or Xylitol to knock out any biofilm.  We do it twice a day especially once we come in for the day, we are flushing our sinuses out so it’s clean for the day and we have really good air filtration so then when we are resting at night we are not in this fight or flight state because all the cedar is up in our frontal sinuses creating inflammation all night.  We flush it out once we come inside.  We flush it out when we start the day.  We may even do it midday if we’re really bad just to keep our immune system from overreacting and then we gotta have that clear air filtration at night so when we come home our immune system can relax.  Because if these environmental things are just keeping us in a fight or flight state, it’s gonna be hard to feel better.

Evan Brand:  Yeah, so you’re basically saying, “Let’s try to get some of the things in the bucket, the external histamine bucket down, that way potentially you could tolerate that food and then we’re working behind the scenes to work on the gut and reduce some of the bacteria making histamine there.”  Now here’s one thing we didn’t hit upon yet which is the hormonal link and so I have had many women say that they’re symptoms are worse right before their period starts and I’ve heard of many women who are postmenopausal who are now doing like estrogen replacement and other hormones and estrogen decreases the breakdown of histamine because it actually messes up with DAO, too.  Estrogen can lower DAO.  So if you think about all these women that were doing birth control pills or hormones or anything to mess up estrogen or you just think about the thousands of ways we’re exposed to the xenoestrogens in the environment like reheating our food in plastic and drinking from single-use water bottles that got exposed to sun and things like that.  The whole estrogen-histamine link is big and maybe that’s why we see so many more women than men, you know, I would say it’s a vast majority.  We see a lot more women deal with histamine problems than men.  I think it’s probably due to the hormonal changes and so like if we’re looking at that stool, you hit upon the gut bugs.  When we’re looking at the stool, we’re also gonna look at that glucuronidation pathway and if we see that that’s messed up, and if they’re taking hormones or if they just have estrogen dominance as a history, that’s gonna mess them up more.  So we have to address that as well.  So if you go to the gut guy and he hits on your gut and gives you some herbs there and you don’t get better, the hormonal piece and I guess that would factor in to your adrenals, too, because the adrenal test that we’re looking at, you know, that’s gonna look at hormones, too.  So we’d probably kill 2 birds with 1 stone there.

Dr. Justin Marchegiani:   Exactly and also I would say, so you’re—what you’re proposing as a mechanism is that estrogen helps break down histamine?

Evan Brand:  No, so estrogen depletes DAO.

Dr. Justin Marchegiani:  Okay, so when you’re estrogen’s too high, you’re depleting DAO.

Evan Brand:  That’s right.

Dr. Justin Marchegiani:  Okay, so if you’re estrogen-dominant, you’re gonna be depleting DAO.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  I would also say that when a woman goes through PMS, what’s happening in PMS, right? PMS is premenstrual syndrome, so right before menstruation that’s right at the heart of the luteal phase, if progesterone drops out early, that’s a lot of times what’s driving PMS.  That one, that enhances the estrogen dominance, right?  So high levels of estrogen deplete DAO, that supports and kind of, you know, backs up your mechanism there.  The other thing is progesterone is an anti-inflammatory.  Progesterone is a precursor to steroids like cortisol.  What do you get when you take Singulair?  You’re increasing cortisol.  If your progesterone is dropping out too soon?  What does that mean?  Less anti-inflammatory building block, right?  So all of this makes sense.  We’re trying to be the bridge to connect these hormonal issues to the deeper histamine but also connect the gut issues because it’s all connected, you know, in the interwebs of functional medicine.  So progesterone, estrogen dominance, all makes sense.  Progesterone anti-inflammatory.  Progesterone drops out too soon, that’s the PMS symptomatology there and that’s what driving the inability to regulate inflammation and then also estrogen dominance, right?  Estrogen higher in relation to the progesterone will deplete DAO which is the enzyme that cleans us histamine.  So all of this makes so much sense.

Evan Brand:  Yeah, and there’s a couple of papers on this, too, about the estrogen effects and allergy and asthma, and there are these papers kinda talking about women that are doing supplemental hormones and all of a sudden they’ve got new-onset asthma when they’ve never had it before and it started after they were doing hormones, and so that talks about how boosting up the hormones is affected the mast cells too much and then that’s creating more of an inflammatory chemical-release of histamine and probably other mediators, too.  So this is interesting and I think this is probably the answer.  I didn’t really know this but until I looked at it but it makes sense why we see so many more women than men suffering.  What you say clinically, I mean, women as a whole more in general but with this specific issue, would you say what you’ve seen is more women than men?

Dr. Justin Marchegiani:  Women’s hormones are much more of a symphony that happens throughout the month and it’s very easy for a symphony to turn into noise, right?  If the strings aren’t in there with the percussion instruments, you’re gonna get noise.  So when you start to have hormones a little bit out of balance, it’s gonna affect women in their ability to deal with stress and part of those stressors could be histamine.  So that’s really important and with stress in our environment, we are going to knock down progesterone and with a lot of the estrogens being in our environment, in plastics, pesticides, various chemicals, water, it just only drives more estrogen dominance, right?  It just drives more of these histamine issues.  So it totally makes sense but we have solutions and functional medicine is gonna be the best thing because we know just throwing birth control pills in there, guess what?  That depletes DAO further because that’s just heightening estrogen dominance, right?  And then just throwing in there antihistamines, well, guess what?  That creates more low stomach acid situations.  That’s gonna make digestion harder, breaking down proteins and fats harder, and that’s gonna perpetuate more SIBO, right?  Because if we don’t have good digestion, bacteria proliferate and an environment where there’s not good digestion.

Evan Brand:  Humans always have to complicate things, don’t they?  Will all the drugs, it’s like, “Darn it!”  I mean, without the drugs, I know drugs save lives, drugs save people, antidepressants prevent people from committing suicide and you know, heart drugs help stabilize the heart rhythm and blood pressure drugs help get the blood pressure down so they don’t have stroke.  I mean, I know drugs are needed, but man, every time we uncover some of these connections between the medications and these deeper issues, it’s just like ahhh.  I wish—

Dr. Justin Marchegiani:  I know.

Evan Brand:  We could save people from getting on them.  Yeah, if people just wanna look up, you just put in like estrogen DAO or you put in like sex hormone DAO, you’ll find some papers on this stuff.  It’s just—it’s pretty crazy how connected this stuff is and so.

Dr. Justin Marchegiani:  It is.

Evan Brand:  We’re trying to cover it all.  It’s tough to do what we’re doing in half an hour but we’re trying to make sure you address hormones, you address gut, you address adrenals, you address the sleep, you address the diet, you have to hit all of these pieces if you fully wanna beat this issue.

Dr. Justin Marchegiani:  Exactly.  Well, to get more info on this, guys, head on to evanbrand.com to reach out to Evan and schedule with him.  You can also head over to Dr. J, myself, at justinhealth.com.  We’re here to help you guys.  We’re available worldwide via Skype, Facetime, phone, video consultation.  We’re here to help.  Just make sure you guys take one piece of intel from this conversation today.  Apply it to your health and life.  We hope that you guys understand some of the deeper mechanisms and why some of the medications may help acutely but long term may set you up for more problems.  I hope you guys enjoyed it.  Sharing is caring.  Give us a share.  Put your comments down below.  If you’re suffering from histamine, let us know.  We’re curious about it.  We wanna engage in a deeper conversation and hope you guys enjoyed the podcast.  Evan, anything else?

Evan Brand:  No, that’s it.  Y’all take care.  Have a great day.

Dr. Justin Marchegiani:  Take care, guys.  Bye y’all.

Evan Brand:  Bye.



Audio Podcast:

How to Boost Nitric Oxide and Oxygenation in the Body – Can Help with Viruses | Podcast #280

We have another episode of Beyond Wellness Podcast. In this episode with Evan Brand, we discuss nitric oxide, how nitric oxide works and helps our system, as well as improve oxygenation in our bodies. As we all know, many viruses can attack our lungs, making it harder to breathe. And on the functional medicine side, how does Nitric Oxide work in preventing viruses? Read the whole transcription below to find out! Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:03     Hypoxia

8:48     Nitric Oxide

16:56   Kidney Disease, Kidney Stress

27:35   Functional Medicine is Important

33:54  Boost your Nitric Oxide Production

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: All right, and we are live. It’s Dr. J here in the house. Today we’re going to be chatting about nitric oxide and vasodilation and how we can improve oxygenation in our bodies. Evan Brand, how are we doing today, man? 

Evan Brand: I’m doing really well. Let’s talk about the context of this topic. There was a video that you and I watched over the weekend, about a doctor up in New York City ICU unit. And he reported it was like a six minute video. He reported what he was seeing in the ICU, and saying that what the official narrative of the corona virus is saying and what it’s causing, versus the reality in the ICU looks different. This guy’s name here is Dr. Cameron Kyle side L. And the title of his video was does Covid19 really caused ARDS which is acute respiratory distress syndrome. He talks about here that he believes that we’re treating the wrong disease. And this is all quoted here, and that we must change what we were doing if we want to save as many lives as possible. And he goes into this video about how, what he’s seeing that with the ventilators, there’s all this talk about ventilators, ventilators, ventilators, he sees that it’s actually causing more damage because the muscles of these patients he’s seeing are actually working perfectly fine. And he’s saying what he is seeing does not look like pneumonia at all. Because the the way that the muscle function is looking, it’s it’s not pneumonia, and he says that it’s something else creating this hypoxia and he says something along the lines of it appears that these patients were dropped off at the top of Mount Everest, and they had no ability or no time to adjust to the high altitude. So he says this is almost like a high altitude sickness, and therefore the treatment that we are now implementing across the country and across the globe in the ICU is not properly addressing that hypoxia.

Dr. Justin Marchegiani: Exactly, exactly. So hypoxia is basically lower oxygen levels in the blood. Now people at home can test that by getting a pulse oximeter. You know, once you start dropping below 90, I think a lot of these doctors are more like mid 80s to low 80s is more concerning. And I think you see even some of these people being in the 70s while in the hospital, so there’s some ways that we can kind of qualify and quantify it with a pulse ox, which is, which is really interesting to know. Now, the question is that ER Doctor, his video is quite interesting. We kind of walked away from it, where he kind of implied that the ventilator should be used, but they should be used kind of in a different manner. And that was really interesting because he didn’t really say how it should be used differently. So if any er doctors or people who are medical professionals that have experience using vents, I’m just curious right down below what kind of different setting options could be used. If this is not necessarily an acute respiratory distress. Issue, this is more of a hypoxia issue. How could that be used differently to help that situation? So I’ll pose that question for any of our medical allopathic listeners.

Evan Brand: Yeah, that would be awesome if we could get some answers because he didn’t provide the answers there. He just said, hey, what we’re doing, I think, is actually killing people. He didn’t say, flat out x equals y or X causes Y. But basically, long story short that the ventilators may be resulting in more deaths, because there’s too much pressure on the lungs because the person is breathing just the way they should plus the extra pressure of the vent is just too much and it’s damaging people. So-

Dr. Justin Marchegiani: I heard that a doctor an anesthesiologist chime in and say, What about a hemo lung, and hemo lung is interesting because basically it’s going in at the carotid artery level going down to the heart and hemo lung is used for like lung transplants and heart surgeries. Basically, it takes the blood out of the heart, brings it into this little device and it re oxygenates it and then brings it back into the heart. So then when it when it goes up to the to the left atrium down to the left ventricle, it’s already oxygenated. So that was interesting because then it takes away all of the the breathing and the pressure on the lung and it oxygenates the blood right at the heart level, which I thought was interesting. And maybe that technology, maybe it’s too invasive. Maybe there’s not enough of those devices. And we’re already short with the events. And maybe that’s just more of an impossible feat. So anyone that has experience with the hemo lung, I’m really curious to know if that could be a good option to decrease the hypoxia as well.

Evan Brand: Yep, yep. So all that backstory leads into today’s conversation, which is, well, what are things that we can do on our end, maybe if you would call it preventative? Now what I say that what we’re going to talk about today is something that you would want to implement if you were in an ICU unit and try to save your life by taking extra beet powder, for example. No, that’s not what I’m going to say at all. But I’m hoping that just by learning about some of these mechanisms in the body, you can become more educated and then you can have strategies that you implement on a daily basis to boost yourself up. Increase the cell to cell communication that happens the vasodilation that happens the proper regulation of inflammation that happens the neuro transmission that happens there’s a lot of stuff that is related to nitric oxide. So let’s give some people just a little bit of background on nitric oxide, kind of how it works. And then we’ll dive into you know what goes wrong. If you are even just aging, just aging alone reduces oxide, we found.

Dr. Justin Marchegiani: And because we’re kind of talking about some of the corona virus stuff, right. And there’s some first line therapy that that’s really promising, ie the, the hydroxychloroquine or the chloroquine, which is which is interesting. And as well as combining it with the azithromycin and the zinc. And if you notice, a lot of people out there aren’t talking about the zinc component in this whole thing. So I think that is important. Also, if you’re in the hospital, I’m not sure what kind of requests you could make to some of these conventional Doc’s about intravenous nutrients. So I’m in the hospital, because this is acute which again, 90% asymptomatic, so I personally say If you have a 90% chance of being asymptomatic, well just be healthy enough and boost your immune system enough now, so you’re in that asymptomatic camp. But if I’m in the hospital right now, I’m going to be asking for IV vitamin C, I’m going to be asking for IV glutathione. Because a lot of these antioxidants are actually shown to improve nitric oxide levels to improve the effects of nitric oxide in the body. And then also we could supplement on vitamin E. And, you know, various plant based bioflavonoids and polyphenols are all going to be great because they’re really high in nitric oxide, nitrogen, and they’re also really high in a lot of antioxidant compounds. Just kind of as a side note, hey, you know, what kind of requests can you make? The problem is conventional medicine is so one track, it’s hard to kind of come in there and do a different standard of care than the conveyor belt standard of care that’s at your fingertips.

Evan Brand: Right, yeah, my grandmother was in the hospital for a fib atrial fibrillation. I spoke with the cardiologist about using motherwort Which is an herb that’s great for the heart, and it has some papers on it being shown to help reduce the incidence of a fib or the severity of any heart issues. And he just completely literally rolled his eyes at me and said, No, Evan, we have our medications in place. And I’m like, yep, she was on these drugs. She’s still in a fib. You’re not fixing the issue with your drugs, you’re not fixing the root cause. And they just blew me off and fed her her lunch, which I told you was a peanut butter sandwich with high fructose corn syrup in the cardiac department.

Dr. Justin Marchegiani: Yeah, the problem with a fib which is like the hearts not being in sync with its electrical contractions, a lot of that has to do with like, inflammation and high levels of insulin and not having good adequate levels of electrolytes. But a lot of times, they’ll put you on blood thinners, or like a beta blocker, or things like that. And that a lot of times can decrease the minerals and actually make the underlying mechanism worse, and then you’re kind of more reliant on the drug forever. And that’s the problem with a lot of the drugs is they actually the root cause mechanism is really not addressed. And then now the drug is needed more because that underlying root cause is actually made worse.

Evan Brand: Yeah, it’s crazy. So that’s pretty much what’s happened. And it’s really sad to see because, you know, there’s good strategies out there that you can implement. But as you mentioned, it’s kind of a one track, one track that you get of treatment and beyond that, and that’s also what this doctrine that video talks about what the virus issue is that because of the dogma associated with medical doctors, and he is one, that they’re not really willing to go outside of the box. So it’s sort of just here’s the protocol we’re doing. you implement this, but he’s saying you put people on the ventilator. 75 plus percent of them are dying. So if you get to that point, it seems that it’s just not working. But you can’t really switch the protocol because that whoever is above making the decision said that’s the protocol. So, anyhow.

Dr. Justin Marchegiani: Exactly, exactly. So we’re going to be chatting about nitric oxide, which is basically nitrogen oxide and it’s double bond that kind of combines it and the 1998 Nobel Prize in Physiology Medicine was actually kind of looking at nitric oxides role in helping with cardiovascular disease. And so that’s very, very important because we’ve known for about 20 plus years this is a really powerful compound. And don’t confuse it with nitrous oxide. Nitrous oxide is N2o both are gases, right? nitric oxide is going to be the vevo dilator opens the blood vessels that’s n-o double bond. And 2-o is nitris. And that’s the laughing gas that though a lot of times they’ll you do when you’re getting your to pool they’re drilling a cavity at the dentist’s office so don’t, don’t confuse the two of those. And again, some big building blocks to make nitric oxide are going to be a lot of the plant based nitrogen compounds like Evan mentioned, beetroot powder is very powerful in helping to provide more nitrogen and building blocks. Also a lot of your green leafy vegetables so a lot of your carrots are a lot of your salaries and to be really powerful out of your lettuces. Spinach, arugula, a lot of your green vegetables, celery in the beet root. Those are amazing, amazing compounds to help provide those extra nitrogens to improve nitric oxide levels in the body.

Evan Brand: Yeah. And people may say, Well, why powder? Why does it have to be a powder it doesn’t, you could eat just straight beets if you want to. But for me, I’ve had much better benefit and it’s a little easier for me, I don’t have to go and cook anything if I could just open up some organic, non hybridize beet powder. I’ll throw that in with a scoop of my electrolyte formula and drink it down. And these, these vegetables that are high in nitrates are what allow you to naturally increase the levels. So it works in the erectile dysfunction department as well. Many people have heard of nitric oxide if they’ve ever had an ED issue and they try to go on some of these nitric oxide boosters for that issue and it can help. I don’t know if the mechanism of some of the conventional drugs like five I work on nitric oxide at all, but I do know that beet powder and other amino acids that you could use arginine citrulline, these kind of things, a lot of them are in bodybuilding type formulas that those can help increase blood flow quite a bit.

Dr. Justin Marchegiani: Yeah, I know Viagra was originally created in that was designed to help with angina with heart pain. And so yeah, it does. Things like Viagra are going to work on localized release of nitric oxide for sure. Yep, that’s definitely part of the mechanism. Now, the question is, there’s nutrients that run that, right, so the problem with the drug doesn’t provide any nutrient to have that pathway run better. So it’s kind of working by overriding underlying mechanisms, right? underlying mechanisms that are needed. So the problem over time is you tend to have to increase the dose. So whatever drug you’re using, because you weren’t fixing the mechanism, that’s why adding amino acids like citrulline and arginine are going to be helpful because Those are part of the building blocks to make some of these hormones or some of these, let’s just call them hormone like peptides to work in your body. And then also the building blocks in regards to nutrients. So a lot of these greens vegetables we talked about. And then the benefit of like a beetroot powder is just the concentration, you can just get a lot more of it in your body versus eating a couple of pounds of beats. You can kind of get it in a way that’s more therapeutic and easier to put in like a general generalized smoothie, if you will.

Evan Brand: Yep. And so why, why this conversation? Well, because not Justin and I did a whole podcast on some of the underlying causes, and some of the comorbidities associated with the virus and if people are ending up in really bad shape, or if it’s a fatal case, there’s a lot of these comorbidities him and I were talking about this before we hit record diabetes is massive, massive, massive, massive comorbidity put you at increased risk, also hypertension. And so guess what? Nitric oxide has a role and vasodilation therefore, if you have low nitrogen oxide production, which happens just as you age, just the aging process alone, you have reduced No, therefore, more likely to have hypertension. Hypertension is in the top five of the comorbidities of people that are in bad shape with this virus. So if you’ve got high blood pressure, you are at more increased risk. And we’ve got a study here 2014 Journal of Clinical hypertension, a single administration of an oral active, no supplement, decrease blood pressure, improve vascular compliance and restored endothelial function in patients with hypertension. So are we saying hey, this is going to get you off the hook? Not necessarily but to me, it sounds like a really, really good tool to have in the toolbox.

Dr. Justin Marchegiani: Very interesting. Yep. Very interesting. Also, we know that things like low thyroid production, low thyroid hormone, are associated with things like low nitric oxide or low decreased nitric oxide synthase, which is part of the enzyme that makes nitric oxide and Evan kind of alluded to it earlier there was an artist In the New England Journal of Medicine that came out within the last two weeks that looked at a lot of these coronavirus patients up in Seattle area, and they saw almost 60% of them had type two diabetes or some kind of pre diabetes. Now why does this matter is high levels of insulin are going to impact your immune cells from gobbling up bad bacteria or viruses, right? We know Corona virus is a virus. And so phagocytosis is the natural process that your lymphocytes or neutrophils and monocytes may engage in to gobble up these viruses. So high levels of blood sugars and increase insulin. That’s gonna make it hard to gobble these critters up, but we know people that consume or that have high levels of insulin, what are they consuming? They’re consuming a lot more processed sugar, high fructose corn syrup, all those things, people that are consuming excess fructose, right? high levels of fructose are going to decrease nitric oxide, endothelial synthase, that’s the enzyme that helps make nitric oxide and your blood vessels so how Having high amounts of carbohydrate and lots of processed refined sugar. One is going to impair your immune system, which is going to make coronavirus, a bigger deal, which then will create that hypoxia. But number two, it’s going to decrease the enzyme activation of nitric oxide in your body.

Evan Brand: Yeah, that’s crazy. And we were talking about the age factor. So if you’re older as well, right? Originally, we were looking at all this stuff from Italy, we were saying, Oh, well, this is a an issue affecting older people. It’s also been found to affect younger people. Everybody says, well, oh my god, oh my god. Now it’s the young people affected too. But think about how many young, diabetic overweight and obese people we have in America. I mean, we are the most obese country in the world. So I don’t think it’s fair to look at these headlines and say, Oh my God, this guy was 33 years old because we have the most obesity and diabetes. in that age group. Anywhere I know India, the diabetes rates are going crazy high there as well. But that’s not the point. The point is that when you look at the headline you see younger people are dying. That’s not actually apples to apples, a younger person who is on a paleo template is going to be, in theory much healthier and less prone to severe complications if they have good blood sugar. And you talked about the the amino acids a little bit so like arginine and citrulline. Those are things that you and I use supplementally what happens is the your kidneys, I didn’t know this is actually something I learned today. The kidneys are what turned the citrulline into arginine. And then the arginine is the precursor to nitric oxide. And so when you throw extra supplemental amino acids in there, you’re just helping this whole pathway run better.

Dr. Justin Marchegiani: And it’s really interesting, right? Because so you’re talking about the the citrulline gets converted by the kidneys to origin is that correct? That’s right. And we know that guess what, guess where 80% of all kidney disease comes from?

Evan Brand: Hmm, I don’t know. 

Dr. Justin Marchegiani: It comes from diabetes. 

Evan Brand: Yeah, I mean, Makes sense.

Dr. Justin Marchegiani: So high levels of blood sugar via excess fructose and crapple hydrates in our diet, that’s gonna put a lot of kidney stress. And I’m going to guarantee that with more stress on your kidneys, you’re going to have a harder time converting some of those amino acids like the citrulline to arginine and Argentines and help make that nitric oxide which is going to help open up your blood vessels. And so I wouldn’t be surprised the more kidney stress you have from excess carbohydrates, sugars slash fructose, and I’m not gonna I’ll go out in the limb because we already know the mechanisms there Evan, we know that issues like mold and heavy metals could also decrease nitric oxide and I wouldn’t be surprised if part of that mechanism is through stress on the kidneys. What do you think?

Evan Brand: Oh, it makes total sense. I mean, I had kidney pain. I know that was one of my symptoms. When I first got exposed to mold. I thought it was just like adrenal area but looking back it makes more sense that it was actually kidney so I did take some kidney support formulas astragalus and Agaricus, mushroom and some other things to help boost kidney function. Symptoms luckily went away. And also, one of the symptoms of mold exposure is increased urination, especially at night. So we talked a lot of people that talk about their they’re up in the middle of the night peeing all the time. That was a mold symptom. And I used to have it I was up four or five times a night peeing. And I no longer have that issue after detoxing and then supplementing with different nutrients for the kidney. So yeah, I think you’re, you’re definitely spot on.

Dr. Justin Marchegiani: 100%. And I’m looking at a couple of studies here. There is a connection between low levels of thyroid hormone and low levels of nitric oxide and this one study here, that’s a review on the topic. But they’re definitely talking about more, you know, more studies on humans are needed, but there’s definitely a connection with adding in thyroid hormone and helping to improve nitric oxide levels. So this is kind of like the chicken or the egg thing. So I look at a lot of nitric oxide, things are like more downstream, meaning it’s like more of an effect than a cause. So we’re talking about it here. Because it plays a really important role with oxygenation and the corona virus and some of the disease symptoms that may occur. But people that are listening to this that are functional medicine people, we may be inadvertently helping your nitric oxide levels just by moving to a paleo template. By helping you break down your protein, maybe you’re getting more citrulline than your diet. By looking at your thyroid, maybe you have an autoimmune thyroid issue, right, maybe your thyroid is getting destroyed because you’re eating a whole bunch of gluten and dairy and processed food, and that’s exacerbating your leaky gut and exacerbating your autoimmune issue which could then be affecting your nitric oxide levels. So a lot of times, we may be fixing your nitric oxide by helping your thyroid or by fixing your gut permeability through a gut infection or by assessing mold in your home or heavy metals in your mouth or your environment. So, you know, you don’t have to break out fancy supplements every time a lot of times we may be doing this just via diet and other what I call upstream Functional Medicine system assessment to get to the root cause of the system’s upstream because above below inside out, if we deal with the system’s up here, the symptoms downstream, may improve. And a lot of times that may be through regulating nitric oxide through other upstream things not connected.

Evan Brand: Yeah, it’s crazy. I mean, we always talk about how everything’s one big spiderweb and it’s all connected. But the more we dive into these things and pull things apart, it really is true. One paper here we had showed that roughly 80% of dietary nitrates come from eating vegetables. And so beets are at the top of the list of being rich and nitrates. You’ve got the leafy vegetables, as you mentioned, like you’ve got a rubella chard, spinach, you’ve got broccoli, you’ve got turnips, cucumbers, carrots, cauliflower, and then also you mentioned from the protein as well so, grass fed beef, wild caught fish, pastured eggs, potentially raw cheese’s if you can tolerate them. Pumpkin Spice seeds, sunflower seeds, even spirulina, these are all going to be high and arginine and that’s going to help you as well. So this is pretty cool. I mean, it’s watermelon was on the list too, which is interesting watermelons really high, apparently in citrulline. So Mm hmm.

Dr. Justin Marchegiani: Very good. I wouldn’t be surprised to if we find a connection with thyroid issues and a lot of the oxygenation thing with the coronavirus in this one meta analysis. I think this is powerful because we know nitric oxide and it’s a benefits on cardiovascular disease. Right? We could probably ask our friend Dr. Jack Wolfson. On that I know he recommends a lot of nutrients that help improve nitric oxide levels. But in this study right here, the literature discussed in this review together with our published data and preliminary results related to nitric oxide regulation and hypothyroidism suggests that nitric oxide levels could be a reliable marker for thyroid dysfunction as well. So we know nitric oxide can contribute to cardiovascular but they’re saying hey, nitric oxide can also be used to assess thyroid issues. hypothyroid now I’m gonna guess it’s the low thyroid is probably driving the nitric oxide. I think they have the roles reversed here. But they talk about that, um, that literally giving thyroid hormone giving lt four, which I think is I think they’re referring to that as level thyroxine and T4 actually has been used as a therapeutic molecule for improving cardiovascular related disease via thyroid dysfunction. So Furthermore, the newly discovered role of thyroid hormone and the effects of lt four on no production may have broad implications in cardiovascular disease. So meaning what meaning oxygenation and heart health is connected to healthy thyroid. So we know there’s a connection between thyroid and nitric oxide, and that’s going to help with oxygenation. So if you have oxygen issues, and or health issues there, we got to look upstream to make sure the thyroid is not a problem.

Evan Brand: And make sense why we have the most number so far if you’re looking at the statistics worldwide, I mean, we have a ton of people, right, we’re very large country, compared to some of these other smaller countries that are running numbers. So there’s a lot of factors but you look at the health of the US as a general rule, we’re not anywhere close to a quote native diet. I mean, you look at Japan’s numbers, Japan has barely been affected at all based on the stuff I’ve been seeing and these are people who you know, they’ve got some of the oldest living people on the planet in Japan, they’re eating their native diet. I mean, they do do a lot of rice so they probably are higher carbohydrate but just in general, they’re eating real food you know, they’re doing fish quite often. You go down the street anywhere in America, you’re going to find a McDonald’s which is going to be hydrogenated oils, massive inflammation, you’re going to find high fructose corn syrup and everything. You get the little cinnamon cookies with your kids Happy Meal, that’s pure straight sugar, high fructose corn syrup. So it makes sense, right? When people say oh, well, we could have done this better. We could have done that better. I mean, look at the look at the the the template that we started with look at America’s Health template as a whole. We were sick as well. As a general rule, you’ve got the little bubbles like you go to like a health conference. And you’ll see everybody’s keto. And the women look great. And like, wow, this is what Healthy People could look like. I’m always amazed, aren’t you? When you go to health conferences, and you look at people you’re like, these are good looking people. These are healthy looking humans. Wow, what a relief from seeing, you know, if you go to, let’s say, a theme park, you’re going to see the average American, you know, massively obese, eating ice cream versus you go to a health conference, you’re like, wow, these are what all humans would have looked like, a couple hundred years ago, or even my grandparents who were farmers, they’re my great grandparents who were farmers. They look like these people.

Dr. Justin Marchegiani: 100% I’ve actually noticed the opposite to some people that health conferences are really unhealthy because, well, part of it is they’re kind of on their health journey themselves, you know, true and a lot of times it’s all about your starting point. You know, if someone was really overweight, but now they’ve lost 50 pounds, but there’s they’re on the right track. A lot of times people are kind of moving into that field because they’re a wounded they’re walking the path of the wounded healer That’s very true. Alex gray says. So sometimes everyone’s on a different journey. Right. And so I see that too. But yeah, I’ve seen it both ways for sure. And, you know, one thing I wanted to highlight from you is, you talked about citrulline. And there is a couple of studies on low citrulline levels and low citrulline. And its effect on nitric oxide. We know that but one thing they talked about, is it how people are dying from this coronavirus is typically acute respiratory distress syndrome, right? That’s kind of how everything manifests at the end, and they’re talking about nitric oxide playing a big role in that. And they talked about that nitric oxide substrate citrulline would be associated with end organ damage. So essentially, lower levels of citrulline increased more acute respiratory distress issues and sepsis and organ damage. So it seems like loneliness really protective. With this end stage disease failure that you’re going to see with these issues.

Evan Brand: That is crazy. I wonder if you could get that I mean, that’s problem is, is that readily available that you could get it in IV? If you’re in an urgent situation? Or you depending on drinking it, you know what if you’re in such bad shape, you can’t drink an amino acid blend, you know what I mean? It’s just tough. Like, how do you implement some of these things?

Dr. Justin Marchegiani: Well, I mean, if you were IV or worst case, you’d get some type of access port to the to the stomach or the intestines where you could dump the the freeform amino acids. Yeah, in that way. I mean, that’d be the biggest thing. I would, I would think I’m not sure what your options are. And that kind of a crazy surgical session-

Evan Brand: That’s the problem too, because when you’re in that, as that doctor mentioned, in the video we talked about in the beginning is that it’s very difficult. And he actually wrote in the comments too, as well, that he’s actually kind of closing up his ICU unit, and he’s returning just to the emergency room, because he says he doesn’t have faith anymore in the standard protocol. And he didn’t say, flat out but I’m kind of reading in between the lines that he’s unable to go off of the protocol and try other things. So that’s the problem is, let’s just say citrulline and Argentina. Are game changers and beet powder and they could significantly boost up nitric oxide to really help reduce the severity of this issue. If you bring that up to your doctor, first of all, they may laugh at you. And then secondly, they may say, Well, we don’t have that you got beet powder in your pocket, sir. What do you want me to do? You know, they’ll probably give you some kind of smart aleck answer like that.

Dr. Justin Marchegiani: Yeah, exactly. 100%. And again, I just think conventional medicine isn’t really equipped to add some of these modalities and just because most of their modalities are going to be drug base.

Evan Brand: Well, they don’t have it on hand. They don’t have a pallet of beet powder in the back of the hospital.

Dr. Justin Marchegiani: Exactly, exactly. And I really like to see you know, conventional medicine kind of get more hip with functional medicine principles in the emergency setting, right? Because we know a lot of integrative medical Doc’s for chronic disease. They’re starting to get hip with functional medicine because they’re understanding that they’re just treating their patients long term with drugs. And it’s very expensive, right? If you treat a diabetic with just Metformin and insulin, In all these different things, it’s very expensive, over 20 years, it’s gonna cost millions of dollars. But we could actually work on getting to the root issue and fix it with diet and lifestyle and specific supplements. So I wish we could see more of that mindset with the acute palliative care. I think we may see even better improvements.

Evan Brand: Yeah, I mean, you and I have several medical doctor friends, some that work in cardiology, some that are emergency room and I bring these issues up all the time, I say, hey, look, if you’ve got somebody coming in, and they’ve got maybe some slight elevated blood pressure, and they’ve got major anxiety, what’s your typical protocol, and it’s going to be like a benzodiazepine like Xanax, it may be some type of medication to get the blood pressure down, and then they send them home with like a psychologist or a psychiatrist referral so that they could then go get on an antidepressant. But instead, if I were in charge, if I saw slightly elevated blood pressure, something I thought the nutrients could handle, and there was a panic attack associated with it too. I’d say okay, well, here’s your shot a passionflower motherboard. thenI Which I will call me down and simultaneously reduce blood pressure. And then hey, here’s some extra magnesium. Here’s some extra Foley. Here’s some Hawthorne Berry, and we’re good to go.

Dr. Justin Marchegiani: 100% I agree. I think those are all good things. People talk about 5G and being a driving factor. It’s hard to say. I think the jury’s still out on that. I think the first place you want to look for issues with 5g is you’re going to see it in professional athletes, right? professional athletes are going to be in major cities playing, they’re gonna be playing at the highest level, and they’ll be being you’ll be bathed in 5g just based on being in a in a local Metro City area, you’re going to see decrease in athletic performance injuries. So look at the athletes first thing that’ll be the first litmus test of a decrease in physiology and function.

Evan Brand: Yeah, and let me add this to that. t mobile and sprint and at&t and all these people part of their advertising as they speak about, hey, next time you come to such and such arena, we’ve equipped it with 5g so they’re actually putting those small cell units on Around the actual arena for some reason, so I’ve seen that as a, as a promotional thing that those arenas are some of the first places actually to get the new technology. And then of course, it rolls out into major city hubs and then neighborhoods and then eventually suburbs and on and on.

Dr. Justin Marchegiani: Yeah, I mean, there’s always been 4g for the longest time so there’s going to be some of this stuff. My whole thing is you’re probably not going to get away from most of it. So just get healthier. So the healthier you are, the better you’ll be able to deal with it. My big concern is going to be like if you’re got a 5g Tower right on top of your work office or a school that your kids and that’s kind of my bigger concern because a lot of these technologies they’re they’re exponentially more harmful The closer you are so the closer you are to it. more detrimental so when you’re when you’re right on top of it, that’s where I’m really concerned the most.

Evan Brand: Yeah, distance is your friend to I saw there was a couple of guys I don’t know if this was an official study or just some, some testing they did out in the field. It was some guys out of New Zealand, I believe. They found that even just raindrops for example, reduce the 5g signals by over half over 50% reduction in signals just based on the rain. And they may have actually been researchers that were helping implement the rollout of this. They weren’t necessarily anti 5g people, but they were just reporting, hey, look, when a rain shower comes, you’re going to lose your signal. And potentially with some of the satellite stuff that’s being done. What about cloud cover is in the clouds, because I’ve had family members that have had satellite TV or radio and they say, look on a really cloudy day your signal gets cut down. So I think there’s a lot of variables and factors in this in the rollout might not go as smooth as planned, which if you think that it’s going to affect you, that may be good if the rollout is failing, and these environmental issues like even the leaves, think about the seasonal changes when all the leaves Come on the trees. We know that was some I think it might have been the same guys who did the rain study. They showed that when you tried to blast that type of frequency because it’s a higher frequency. It can’t penetrate as deep so it couldn’t penetrate through a tree that had full leaves on versus a tree that had no leaves. It could go Of course right through it. So just line of sight is very important when it comes to actually getting exposed to the so if you’re kind of living in a Rolling Hill topography, unless you’re on top of the hill and the towers on top of the hill with you, you’re in much better shape. So yeah, I agree with you. It’s tough. I mean, I think it’d be really cool if we could just go and point the finger and say this is it. It’s this, but it’s too difficult. I think it’s going out on a limb right now.

Dr. Justin Marchegiani: Exactly. I don’t think I mean, let’s look at Italy. They’re one of the country’s hit the hardest. I think there’s a lot of other natural, you know, I call it overcomes razor, right? more probable reasons why Italy got hit really hard. Right. So number one old old population, right 70, 75 plus lots of comorbidities that that’s your biggest risk factor. Number two, they waited a very long time to close down their border and we know how the social distancing and the quarantine has been effective at decreasing the exposure, right. And then also, number three, they just have a lot of a lot of Chinese companies actually bought a lot of Italian brands, but a big name Italian, you know, clothing brands. And what they did is they basically ship all the Chinese people up there to work in that northern Italy town, producing those brands. And they did that to keep the Made in Italy tag on a lot of the products. So there’s a lot I think over 500,000 Chinese citizens that are legal citizens up and up in that Italy area. So I think there’s a lot of traffic going back and forth. That’s probably the bigger variable that I think hit Italy. That outside of a variable of 5g that’s probably more likely of all the different things that’s that’s happening there.

Evan Brand: That’s a trip. That’s very interesting. We got two more things we need to talk about before we wrap it up. One thing is exercise in generals, of course going to boost nitric oxide production. Yep, so like interval training you and I were kind of talking before we hit record about hit training. So high intensity interval training, maybe just a quick sprint followed by a walk or if you have a row machine a hard row or if you have a cycle machine, hard biking and then resting, those things are really really shown to to increase nitric oxide. Hey, go ahead. Yep, I was just gonna say Dr. Mercola had like a three minute nitric oxide video that he promoted where you were doing like a lot of arm exercises and just pretty intense stuff to boost it up. I think it’d be cool to try it and do a nitric oxide test strip on your tongue. That’s one way to measure before and after. Probably not the bet the best or most accurate but that’s pretty much what’s available. There’s not many good ways to test this right now to prove it. Besides feeling your hands if you got cold hands and feet, like I have and then you drink beet powder and then your hands warm up boom, there’s your answer you increase nitric oxide.

Dr. Justin Marchegiani: Absolutely. also things like infrared sauna and or red light therapy can kind of modulate and help improve a nitric oxide as well. We’ve already chatted about citrulline citrulline is an amino acid that’s a precursor that can be used to help improve nitric oxide and it can be used to bump arginine levels as well. And someone right wrote in on the message what about arginine and viruses. So yeah, there’s some data on arginine, feeding herpes and such. I’m not sure if that’s the case if you do citrulline because citrulline is a precursor. So your body may have some modulating mechanisms to prevent arginine from going too high to feed viruses. So I would if you’re going to lean on it and you have a herpes issue, then you may want to just lean more on citrulline and then just work on a lot of the other things and just keep in mind that the deeper stuff like the thyroid hormone, gut function, pre diabetes and metabolic syndrome issues with high levels of insulin from high levels of blood sugar, you mentioned some of the exercise full body functional movements are going to be powerful. And then also just keeping inflammation levels under control. You know, keeping the gluten in there, the refined kind of junky dairy and a lot of the refined sugar and processed foods are going to keep inflammation because inflammation antagonizes nitric oxide, right? inflammation is going to increase, you know, you’re going to have an increase in cytokines and interleukins and, and prostaglandins like prostaglandin, e two, and these things are going to cause more constriction, they’re going to cause the the vasculature to kind of pinch down tight, and then we’re going to have less oxygenation. So, in this time of coronavirus, being an issue, we really want to improve oxygenation. So these are strategies that we really want to make sure that we’re hearing to on the diet side lifestyle, side and supplement side.

Evan Brand: Yeah, I don’t want you to skip over it. That was an amazing paper that you found on the on the far infrared sauna therapy. So I’m just going to kind of quickly read off just a few more things that are in this paper here and then we’ll and then we’ll wrap it up. So there there is talk of improving into thelio function, peripheral blood circulation, increasing artery blood flow, alleviating fatigue and pain, reducing blood pressure, promoting capillary dilation. It also goes into heart disease. It goes into reducing cortisol and glucose. So they were saying here that far infrared therapy could help act as sort of an anti diabetes treatment, it really helps to reduce the blood glucose levels and cortisol overall, therefore improving the ability to respond to insulin, chronic chronic kidney disease. So let’s just say we talked about the kidneys a little bit today, talks about here too, that the function of the kidneys improves with sauna. So I mean, this is just amazing. I’m not going to say the sauna secure for everything, but wow, what a great tool.

Dr. Justin Marchegiani: Yeah, essentially sweating. I mean, saunas going to do it a little bit deeper, because the near infrared is going to penetrate deeper into the body. So you’re going to have a little bit more of that vaser dilating effects, but just getting good functional movements in getting some sweating, getting your body temperature up also is going to be helpful and then look deeper at the functional medicine principles, thyroid digestion, and, you know, look at potentially doing things like a lot of these vegetables and upping our In a lot of these things to help improve nitric oxide levels in the body.

Evan Brand: Absolutely. Well, let’s wrap it up if you want to reach out clinically, Dr. J and I are available. His website is JustinHealth.com. You can reach out worldwide we work, FaceTime, Skype, Zoom, phone, you know, we work virtually so we can send lab test to your door, you get those back to the lab, we review the results and then make a game plan to get you better. So that’s JustinHealth.com, my website for me Evan is EvanBrand.com. And please make sure you’re subscribed. We look at our subscribers and we’ve got a lot of you that are subscribed, but there’s a lot of people that just listen and are not subscribed. So what are you doing with your life, make sure you’re here because we’re trying to tie all the puzzle pieces together. We’ve covered the diabetes and blood sugar aspect of this thing. We’ve covered some of the immune support stuff, the cytokines stuff, and we were really trying to just build, build, build, stack it on, stack it on. So we’re going to continue to do that. So thanks for your support, and we’ll be in touch.

Dr. Justin Marchegiani: And just one last thing to kind of stack on there. I’ll reference other podcasts on the topic, but we already highlighted mold as being a potential deeper issue and then potentially heavy metals as well. And again, I wouldn’t recommend going after those right away. Unless you’re in an active moldy home that then we try to fix that. But you want to work with a good practitioner to prioritize these things. Because there can be a lot of, let’s say, rabbit holes that you can go down. And we always want to work on the order of operations, what’s going to give us the best results for the least time and effort?

Evan Brand: Yeah, exactly. You don’t want to get distracted and put all your money and effort into something that’s not the biggest piece of the puzzle. So that’s what we do. We try to analyze your case. Look at those puzzle pieces, arrange those in not only the correct order, but the order of importance of how big is it going to move the needle? So yeah, you’re you’re exactly right.

Dr. Justin Marchegiani: 100% anyone that has Corona or any other issues, put it down below want to know your comments. Any feedback that you guys have in regards to improving your nitric oxide levels are some of the strategies that we’ve already talked about and you’ve implemented want to hear your opinion and your thoughts down below. Really appreciate it. Hey Evan, it was great chatting with you, man. You have a great day.

Evan Brand: You too. Take care. 

Dr. Justin Marchegiani: Stay healthy. 

Evan Brand: All right, bye bye.

Dr. Justin Marchegiani: Bye.



Audio Podcast:


Vitamin C and Your Immune System

By Dr. Justin Marchegiani

Loading up on Vitamin C is a great first line of defense during cold and flu season. Many know instinctively to reach for vitamin C at the first signs of illness, and that’s for good reason. Vitamin C is truly a super vitamin, packed with immune boosting potential!

Vitamin C not only helps reduce symptoms and duration of respiratory tract infections–such as the common cold, bronchitis or sinusitis–it also decreases incidence of other conditions and complications like pneumonia and diarrhea.

Vitamin C plays a significant role in human health, both in reducing inflammation and preventing illness. Studies have even shown a correlation between being vitamin C deficient and having an increased risk and severity of the flu. 

What is Vitamin C?

Vitamin C is a water-soluble vitamin, also known as ascorbic acid, which acts as an antioxidant in the body. Vitamin C plays an important part in overall health, from maintaining healthy connective tissue, to protecting the heart and increasing nutrient absorption.

Benefits of Vitamin C

Vitamin C helps prevent getting sick, and if you do get sick, vitamin C can reduce the length and severity of your symptoms. Emerging research shows promising results with vitamin C being a treatment for viral infections such as the flu.

Vitamin C also helps reduce viral pneumonia-related hospital stays–in one study of a patient with virus-induced acute respiratory distress syndrome, vitamin C was administered through a high dose IV which was believed to be a key factor in the patient’s rapid recovery.

Is vitamin C right for you? Click here to consult with a functional medicine doctor!

Benefits of vitamin C include:

  • Better skin
  • Stronger immune system
  • Increased nutrient absorption
  • Reduced risk of chronic disease
  • Helps manage blood pressure
  • Reduces inflammation
  • Anti-oxidant effect fights free radicals
  • May lower risk of heart disease
  • Protects brain function (memory and thinking) as you age

How Can I get Vitamin C?

Vitamin C is found primarily in fruits and vegetables, which is why it is important to include a lot of fresh organic produce in your diet. A vitamin C deficiency leaves you more susceptible to falling ill, can cause you to become chronically fatigued, and can even lead to scurvy.

The human body does not make vitamin C–we depend on external sources to meet our dietary needs. In fact, the body doesn’t even store vitamin C, so it’s important to have a steady stream of vitamin C rich foods in your diet. Vitamin C can also help you better absorb the other nutrients in your food!

Vitamin C-rich foods include:

  • Bell peppers
  • Citrus: Oranges, grapefruit, lemons
  • Broccoli
  • Strawberries
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Tomato
  • Spinach
  • Green peas 

While vitamin C rich foods should b a part of your diet for many reasons, when you feel like you might be coming down with something, it’s time to start supplementing with more vitamin C than what you’ll get in food. You can use a high-quality vitamin C supplement, click here to see the vitamin C supplement I recommend to my patients. When you need an immune boost, take 2,000 mg 3-4x per day.

Other Ways to Boost Your Immune System

Vitamin C is an excellent immune booster, but it is best used in conjunction with other healthy lifestyle habits. 

Immune Protocol: When you feel the first signs of illness

  • Vitamin C supplement, take 2,000 mg 3-4x per day.
  • Avoid alcohol, gluten, and sugar: these impair the body’s ability to fight off infections. Studies show that every time you indulge in something sweet, the immune system is depressed for hours!
  • Get Enough Sleep: sleep is the body’s time to repair. It is essential to get enough sleep (even more than usual) when your body is fighting off an invader.
  • Getting Outside: Vitamin D from the sun can help the immune system work better. Great in conjunction with vitamin C!


Vitamin C is an essential nutrient and a powerful antioxidant which many regard as the king of vitamins. It can help improve your health, both inside and health. Remember to feed yourself nourishing foods, like organic fruits and veggies which are full of vitamin C, to keep your natural defenses strong. However when you’re feeling compromised, know that vitamin C is a great first line of defense!

Click here to consult with a functional medicine doctor and start feeling better today!







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.