Natural Solutions for Diarrhea | Podcast #239
Diarrhea is a common sickness that deals with disruptions in your gastrointestinal system. Diarrhea is characterized by frequent, watery stools, abdominal cramping, and bloating. In most cases, diarrhea can be treated at home and it will resolve itself in a few days. You might experience Diarrhea as a result of a viral or bacterial infection, sometimes, it’s because of food poisoning. If left untreated, it can cause pain and dehydration to a patient.
Learn more about the natural solutions for diarrhea, what to do when you have diarrhea, and look through what natural medicine can do with curing diarrhea. More info with Dr. Justin himself and Evan Brand.
Dr. Justin Marchegiani
In this episode, we cover:
00:20 Everything about Diarrhea
05:01 Common medications
09:29 Chronic Infections
20:25 Food and natural solutions
26:36 Essential Oils
Dr. Justin Marchegiani:
Hey guys it’s Dr. Justin Marchegiani here. Welcome back to the podcast. Evan, how are we doing today my man?
I am doing great. We’re here to talk about a glorious topic that somebody has to cover because if we don’t cover it, well then who the heck is going to get to the bottom of their gut issues.
Dr. Justin Marchegiani:
I know everything about diarrhea it’s there all the key things about diarrhea. What you can do? Why is it happening. Natural solutions. You really want to focus on getting to the root cause.
I had IBS for a long time, probably a decade.
Dr. Justin Marchegiani:
Oh by the way just to kind of chime in before we dive in on the diarrhea aspect is we’re really working on upgrading the audio quality today everyone. So you’re listening on YouTube. We’ll put a little podcast link as well so you can listen to the higher grade audio give us some feedback on it, let us know what you think and if you really enjoy it, please give us some extra shares.
This should be like the ultimate studio quality based on how we’re recording it now.
Dr. Justin Marchegiani:
Yeah. So we’ve changed kind of how our recording methods. If you guys like it, let us know. We appreciate it.
So I had IBS for prolly like a decade. IBS is really a terrible stupid term because it really just means that you don’t have a clue why you’re suffering from gut issues. So, we will mention constipation just because it’s often for people to alternate where one week or one day, they may have diarrhea, and then the next day, or the next week, they may have constipation. So a lot of people do alternate like that and there’s many different causes. So our goal today is to try to break down some of these big triggers, and then talk about some of the testing options to investigate this problem, and then talk about some of the solutions, like what are the palliative things, what are the little low hanging fruits that you can do, but then what are the root cause strategies you have to implement as well.
Dr. Justin Marchegiani:
Exactly. So one of the first things that’s happening with diarrhea is obviously motility is fast. Now the problem with that is, you’re going to you’re going to have malabsorption. It’s gonna be harder to break down protein absorb fat ionized minerals and absorb a lot of these key minerals for healthy metabolic function, thyroid function, mitochondrial function. So it’s really easy to have brain fog, fatigue, and to not feel like yourself. And especially to this inflammation of your body sucking out a lot of these minerals, pulling water into your small intestine and colon to kind of get whatever irritant is out. So then if these minerals are low, that can lead to more [inaudible] issues as well and minerals are important for healthy blood pressure. So if you’re getting dizzy, or standing up fast or having heart palpitations, or feeling anxious. These are all common side effects with diarrhea. Now we look at the long term effects of diarrhea or long term solutions or I should say solution slash causes, because they’re connected, are going to be chronic infections; parasites bacterial overgrowth H Pylori. We’re going to see a combination of low enzymes, low hydrochloric acid, levels and obviously inflammation in the gut. And the more inflamed the gut is the more things will be shuffled through the intestinal tract at a faster rate making it harder to absorb a lot of these nutrients. And when these nutrients aren’t absorbed, it creates this downward spiral because we need these nutrients for healthy metabolism, healthy adrenal, healthy thyroid right, selenium, magnesium zinc for healthy thyroid, magnesium for healthy mitochondria. Well now we start to have more and more nutrient deficiencies which continue to make these problems worse and worse and worse every single week. So it’s really this downward spiral and we have our chronic issues like I mentioned. And then we have acute issues, food issues, could be like food poisoning, like an E.Coli or salmonella, or [inaudible] chemical Baxter type of infection that causes an acute diarrhea, could be a gluten sensitivity issue as well. We’re gonna expose to a food allergen like dairy or gluten casein etc. and that’s creating inflammation that’s causing your intestinal tract to not be happy and to move things out faster. Also bacterial overgrowth typically with hydrogen gas, dominance regarding SIBO, the hydrogen gas can really affect motility and typically cause things to move along faster.
Yep. All great points. In my case I had H Pylori. So we know that was messing up all my acid production which is why I wasn’t digesting my food very well, once I got rid of the H pylori, then I retested the stool and that’s where I showed up with those parasites like crypto and giardia. And then once I got rid of those, finally I was able to get the diarrhea under control, and so I told the story to you many times on different podcasts we’ve done together where when I was in college I would have to figure out where the bathroom was, and that was just part of my lifestyle. I just thought OK, just find the bathroom and you’ll be fine. And many people they take the Pepto-Bismol or the Ammonium AD or whatever other type of prescription or over-the-counter anti diarrheal medication, and they just live with it. They keep it in their purse, they keep it in their backpack, and they just assume I just need this medication. And we always want to point out diarrhea is not a deficiency of anti diarrheal medication. There is something going on. So don’t just keep putting duct tape over the check engine light. You have to address why your check engine light is on in the first place.
Dr. Justin Marchegiani:
What are the most common antiviral medications. We have things like Pepto-Bismol, all right. These are gonna be anti diarrhea, Maalox would be another big one, those are the big kind of like over-the-counter types. Now one of the things that we’ll use in natural medicine which I think is great, is if we have some kind of toxin or irritant. The easiest way to help decrease that effect on the motility is bind it up. So we’ll use activated charcoal or bentonite clay taken with that food or questionable food were taken while motility is on the faster side and that can really help slow things up.
I’ve got my favorite one right here on my desk. Toxins Bind from Beyond Balance. You can only get it through practitioners but this is a game changer for me, one, the detox mode. Two, it’s very helpful to slow things down just a little bit. It’s not going to get you to a point where you’re constipated. You know some people can’t get constipated on binders if we are doing some type of detox protocol, but it’s very easy to mitigate that. Just throw in some extra magnesium and vitamin C and usually it’s no problem at all. It’s kind of like a gas pedal. You know some people they’re so into diarrhea territory they need full those binders multiple times a day to slow them down enough to have normal stools. But if you’re on the other side where you may tend towards one loose stool here or there, and then you get slowed down too much, then just throw in the extra vitamin C magnesium and you’ll be in the sweet spot.
Dr. Justin Marchegiani:
Exactly so the big thing is we’ll throw in the binders like we talked about. Also dehydration is big. So we may add an extra minerals whether it’s Redmon’s Real Salt you know a full teaspoon with water shoot it down, a lot of conventional people are gonna go in the direction of PD light, which is going to have a lot of junky dyes and high fructose corn syrup and not the highest quality minerals so we want more natural minerals support. So Redmond’s real salt is a great way of doing that. You can also sip apple cider vinegar is excellent. Get some really good mineral support you can sip sauerkraut juice is excellent. There’s also some really good electrolyte formulas that are kind of blended together don’t have all the extra dyes and flavors and sugar in there. So those are good options as well. And if we need some extra glucose or extra carbohydrate we’ll just throw in some coconut water. Coconut water is your natural electrolyte formula with glucose or with sugar in there because it got a little bit of coconut sugar, but it’s not going to be on the natural side and it won’t have all fructose corn syrup in there that’s kind of going to be extracted from corn, right. So you’ll get some extra potassium from the coconut water and then we can always throw in some extra Redman’s real salt or even some new salt which is potassium chloride based salt so we can get our potassium and we can up our magnesium, and our sodium, and our chloride, and our magnesium ,and our sulfates. These are great ways we can get our minerals up. Also extra Pellegrino or Topo Chico good quality mineral water. On top of that will be really helpful for rehydration and getting your electrolytes.
When my tummy is upset. I’ll go for ginger tea. I’ll do a double bag a ginger tea, or even mix one bag of chamomile with one bag of ginger and then just throw in like a half or a quarter teaspoon of raw honey. And that’s pretty good too. You know some argue there’s a lot of different minerals and trace nutrients and stuff in honey. I don’t really use honey as a source of nutrition though, I just use it to taste good.
Dr. Justin Marchegiani:
Yes I think that’s great. Now ginger is excellent as well. Typically ginger has some natural prokinetic effects to it. So it really helps with slow motility, but let’s not forget diarrhea tends to have an inflammatory component to it. So a lot of these natural prokinetics that help with slower motility. Well they also have anti inflammatory qualities to them. So if we can decrease inflammation in the intestinal tract, that can really help modulate motility. It’s too fast and kind of bring it back down.
Yeah. Now, speaking of inflammation, it is possible that your diarrhea situation is more than just an irritable bowel situation that could be triggered by parasites H Pylori, bacterial overgrowth Candida. It could be an inflammatory bowel disease or some type of autoimmune disease like Crohn’s or also Diff Colitis. So we don’t want to discount the fact that your situation could be more serious. So, we don’t want you to listen to this podcast and just go drink ginger tea and think everything’s gonna be OK. You really need to work with a practitioner who can help you get the proper testing done to make sure it’s not something more serious, especially if you’ve been suffering with chronic diarrhea.
Dr. Justin Marchegiani:
One hundred percent. So we have these chronic infections that need to be looked at. So you really want to hook up with a good functional medicine doctor that can help you look at what potential infections or gut stressors could be there. And then let’s not affect this is really important. Let’s not forget the emotional stress. So we know emotional stress is going to interplay with the adrenals, and the adrenals is are part of that stress handling sympathetic nervous system. So we have the bridge to the parasympathetic which is the relaxation. Calm down, that’s the break. That’s the brake on the car to kind of slow things down, and then we have the gas pedal which is go go go go go, and the bridge from the parasympathetic, the brake, to the gas pedal, go go go. The sympathetic are the adrenal. And so when we’re activating those adrenals and we’re heading that fight or flight response, one of the big things that’s going to happen is motility tends to go faster or it can go faster because digestion disrupted. So when we have poor digestion because the sympathetic nervous system’s up, we have less enzymes, we have less acid. We’re going to have less breakdown of these food. So I said that things can go faster. They can also go slower too. When we have poor digestion, things can go fast or they can go slow. So the same root cause may be in effect though. That’s the kind of hard thing is, you could have someone can have diarrhea. The other person could have constipation and it could be similar root causes regarding adrenal and stress and in digestive aspects. You really have to look at everything from a root cause lens, and we connect the hormone component to it as well. And then let’s not forget, thyroid, one of the main symptoms of low thyroid can be low motility. Because thyroid hormone has a natural migrating motor complex stimulating effect, meaning it helps stimulate those wave like contractions. That’s the migrating motor complex which helps move food through. Now, with diarrhea, thyroid typically may not be as much of an issue but definitely with constipation, it could be. So slow motility low thyroid increase adrenal stress, increased cortisol, increased sympathetic nervous system. We could very well have diarrhea partly because of that and who knows what kind of stressors in the gut are affecting it. Food could stress it out. Infections could stress it out. It’s a two lane highway of communication going from, you know, the adrenal to the gut. It’s not just a one way, it’s two way; stress in the gut can cause adrenal stress, stress in the adrenal it can cause gut stress and vice versa.
Yeah. Think about a time. Yeah it totally does. Think about a time where you’re really scared. You know you had to slam on your brakes in the car, or you had a big business meeting, and you’re worried, you’ve got to sit down with the boss, man. You get scared and people get that nervous tummy, makes perfect sense. I think people forget about how much stress could play a role in their gut symptoms.
Dr. Justin Marchegiani:
If you look at kiddos, right kiddos, they don’t even have the ability to manage their urine or bowels, it’s because at their age they don’t have the parasympathetic nervous system kind of built in yet, so they’re more sympathetic dominant. Cause sympathetic stress causes bowel or urinary release. And think about it, right, we all have had that story of someone who literally whether they wet their pants because they were so scared. Right. Why is that. Because the sympathetic nervous system can cause a release of the bladder or even the intestines. We see it more with the bladder because it’s more readily available. It’s easier to do. So we’ll see a lot with that level of stress can affect the bowels and affect the urinary tract.
Well I’ve read stories of different people in the military where they are in an active shooter situation or they’re in a hostage situation that people poop their pants. You know it happens. It’s not fun but it happens. So that just goes to show what the adrenal stress and the hormone peace can do to your gut. Now you mentioned medications, so we didn’t talk about drugs that people are taking that could be messing them up though. So what about like acid blocking medications? I would suspect that acid blockers are going to make the situation worse. And if you’re trying to control your reflux situation, but now you’re lowering your stomach acid, now you’ve got all this undigested food, you’re going to be much more likely to have diarrhea type issues if you’re on acid blockers.
Dr. Justin Marchegiani:
100 percent so acid blockers make everything worse. Let’s say it was an acid issue, and you’re coming down the acid levels in your intestines, well a lot of times that’s not an excess acid issue. Usually it’s the guts lining is worn down so thin it just can’t handle much acid at all. It’s kind of like you want a great massage because you’re back some pain but that back when you have a sunburn at the same time so that back massage causes pain even though it’s really not, it’s just you’re in hypersensitive mode, right. The same thing with your gut when you when that gut lining, when that gastric ecosystem that you just can’t handle much, so you may actually need more, but your tolerance is too low, and the number two, if you don’t have enough acid or esophageal sphincter which is basically the connection between the stomach and the esophagus can stay open and we don’t have enough acidity. So then the food sits it rots acid after the fact forms from the rotting of that food, then it can raise up through that open esophagus sphincter, and start burning that lower part of the esophagus.
Let’s talk about kids for a minute. We do see quite a lot of kids, you know infants, toddlers, you know, five six seven eight nine teenagers, that are dealing with gut issues of different types. So if we start at really really young kids, you know, like breastfeeding age and those kids have diarrhea, most of the time we’re going to blame that on mom, probably having gluten or dairy or some other food allergy. And the diet now, so my daughter Summer, and when she was about maybe one and a half, we got her first stool tests done and that’s where she actually showed up with H Pylori plus a virulence factor. And she had either one or two parasites. I want to say she had a blast though and inaudible] amoeba but I can’t remember without looking at her labs. And so she had multiple factors. You know mom’s diet was clean, so we knew it wasn’t that, but you know she had just act like her stomach hurt, you could just tell she was in pain. And so, we gave her some liquid antimicrobials and we got rid of it. We retested the stool the H Pylori was successfully gone, and then she had some bacterial overgrowth and Candida. So we did another round of antimicrobials and then finally her guts and in a good place now. So it’s hard with kids because sometimes if they’re too young, they can’t express to you what’s going on, but you know by the time they’re age three four or five, hopefully they can tell you, Hey, my tummy hurts and if the kids [inaudible] then you know, hopefully paleo template and they’re still having issues, then you can get testing done on kids. It’s easy, stool and urine can provide a lot of information.
Dr. Justin Marchegiani:
One hundred percent. My son Aiden had significant diarrhea a few weeks back, significant, I think it was a food issue. So one of the first things we did is we kind of gave them some extra anti inflammatory support, we have some ginger in a liquid form to kind of calm his tummy. We added some extra binders and activated charcoal to bind things up, and then I just kind of looking at him I could tell, though based on how everything came about. There was definitely a food poisoning episode to it. So I got him on some specific liquid anti-microbial herbs and within twenty four hours his bowels were solid.
Dr. Justin Marchegiani:
Two days of like pure liquid. And anyone that has infants that we’re diapers, is not fun to clean up. So I was able to get that stabilized within 24 hours, made a huge difference and he’s on a regimen right now, more than likely he got some kind of infection. So we have him on an antimicrobial regimen, that’s liquid, because it’s easier for kiddos to get the liquid down, and then we have months and probiotics as well. Now that’s one other thing, probiotics can have some really good anti inflammatory benefit. So with diarrhea, we may even add in probiotics while we’re doing the herbs, just because they can really help kind of calm the gut down which may provide some relief with the diarrhea. And that’s important because I need to make sure we’re absorbing those nutrients, so we can get diarrhea. Like you know, compressed or dialed in. Then that’s going to help nutrition absorb a lot better. And then we used all the antimicrobials as well, that made a huge huge difference. But one other thing I want to highlight, because you were talking about acid blockers in the spiral of negative consequences that can happen with that, well same with antibiotics, because antibiotics are commonly prescribed for diarrhea as well. What if it’s not a bacterial issue? What if it’s a parasite? What if it’s a yeast overgrowth? What if it’s a gluten sensitivity reaction? Well guess what? Now you just knocked out a whole bunch of beneficial bacteria, maybe you create more inflammation. We know antibiotics can create mitochondrial stress. So it’s not good taking unless you know it’s an a help. Right? So then you could create a whole bunch more issues with the guts. Now we have this rebound overgrowth occurring and now we may have more issues that intensify over time because of that antibiotic. So we really got to be careful if we’re going to just throw medications at things kind of willy nilly.
Well said. Well, take someone who has chronic fatigue. You mentioned the mitochondrial damage. We know that’s associated with antibiotic use. So you’ve got someone that’s tired maybe because they’ve just been pooping so much, they’re exhausted from all the mineral depletion, we talked about the adrenal stress. You take that chronically fatigued person, you throw antibiotics in the system, they’re going to become more tired. So now they’re not even motivated enough to get up and cook the healthy nutritious foods they need to heal their gut. So I love that you brought that up because my next thing I was going to say was, well let’s go down the rabbit hole and change that. Let’s turn the tables a little bit. Let’s take my daughter. Let’s take your son and let’s put him through the conventional medical rabbit hole. What would have happened. We would have taken your son to the pediatrician or my daughter to the pediatrician and they would have said, Oh they’ve got diarrhea. Well, probably a bacterial issue. Let’s give them a round of antibiotics. There’s going to be a huge rebounding of Candida possibly skin issues that would happen.
Dr. Justin Marchegiani:
What if there was a parasite?
Exactly. It wouldn’t it worked.
Dr. Justin Marchegiani:
Yeah. What if my son got exposed to some gluten. No. Well no. It’s not going to fix that.
And most of the time when people come to us they’ve already been through that route. You know I’ve had many people that have been to their pediatricians with their children’s health issues and they’ve been disappointed at the level of care they’ve received. So they come to somebody like you or I. And we say look we really don’t want to use antibiotics in this case, number one because we have the clinical data. We’ve run the genetics full testing, we’ve run the urinary organic acids, we can tell you with confidence on the piece of paper, look, we’ve got this parasite, this bacteria, and we’ve got Candida overgrowth. So, yes you could use antibiotics for those bacteria but our success rate is so high using herbs. Why throw in the big guns if we can use things like olive leaf and Berberine and clove and other herbs that will still do the same antimicrobial benefit without killing mitochondria without killing good guys. There’s just a better way to do it and that is the way to do it.
Dr. Justin Marchegiani:
Exactly. We also may make changes with foods, we may cut out from fermentable carbohydrates, if there’s bacterial stop being fed by it. We may lean more on a gaps or a kind of a soup or stew or kind of bone broth type of template where foods are more in a liquid form to make everything easier to digest. And also we’re going to add an extra anti inflammatory [inaudible], aloe, slippery elm of course, Evan mentioned ginger already. These are excellent things to help kind of reduce inflammation maybe even turmeric or curcumin. Conventional medicine typically won’t touch that because, what are their anti inflammatory medications? Well they’re Prednisone, maybe [inaudible] right. These non-state real anti inflammatory is which actually can rip up the gut lining more and create more problems. So a lot of times these medications won’t be recommended because they may create more issues on the intestinal side. You know the major side effect of [inaudible] is alterations that kill 20000 thousand people a year, according to a New England Journal of Medicine. So they tend to not to to reach for many of these anti inflammatory is because they tend to cause more problems than not. But in natural medicine world, we have a lot more anti inflammatory that are natural and they aren’t going to have those side effects and can be added into your diet and really have beneficial effects.
Yeah. It’s crazy how quickly you could get down the rabbit hole and not end up any healthier than when you went into a hospital or immediate care center. You know, when we talk about antibiotics, we’re assuming that if you did have a bacterial infection, we’re assuming that that is a non antibiotic resistant strain. But what if you’ve got C. Difficile for example, which kills so many people you know diarrhea could be C. Diff. C. Diff is something that we see as an infection. Yep. And C. Diff has become very very resistant to antibiotics to where these gastroenterologists are recommending stronger and stronger drugs sometimes, even resorting to I.V. antibiotics to kill the Clostridium. I’ve never had an issue getting rid of Clostridium using herbs. I’ve seen it countless times I know you have to. It disappears with the antimicrobials that are natural because see, herbs are not a single mechanism, right, you can’t just say well there’s this one alkaloid or this one polyphenol it doesn’t work like that in nature. There’s so many things that we don’t even fully understand what’s in there. We just know hey Berberine has all this other stuff that comes with it and the package deal gets rid of C. Diff where antibiotics just may not.
Dr. Justin Marchegiani:
Exactly. That’s why we’ll add in specific Sacramice or bifida or lactobacillus species to really calm things down. My big kind of warning for everyone listening is if you have an excess of blood in the stool, it’s not stabilized or the electrolytes in the minerals dropped so low lower, so fast that we’re dizzy, light headed we may need to go to an E.R. to get an I.V. and they kind of get things stabilized while you get things on track. Same with the blood and the stool. So just keep an eye. Things are really intense. And symptoms are ratcheting up fast and you can’t get fluid in, you can’t get electrolytes in, you can’t get things stabilized. Conventional medicine may need to be used to at least get things stable, and that’s going to be on the extreme side. We’d like to at least draw a line for people listening so they aren’t incredibly dogmatic and only go the natural route for the majority of people that would probably be fine. But if you’re in that camp where you can’t stabilize, an I.V. with electrolytes will be helpful. If excessive blood in the stool, then we may have to look at getting that at least stabilized in the meantime while we come back to this we should never ignore it. We should always come back. We may need some level of stabilization first.
Yeah well said that happened to my grandmother she had started. I think it was privately to a medication she had started, this was a couple of years ago where she ended up vomiting and having diarrhea. So she was losing liquids out of both ends.
Dr. Justin Marchegiani:
She couldn’t keep any water down. Her blood pressure was starting to get messed up. She’s already dealing with atrial fibrillation. So she had some heart issues going on as well. I just told her, look, this is a situation where you just got to go. So she went to the E.R. they gave her fluids. Unfortunately, they put her on antibiotics. So then she ended up having more issues with the antibiotics but as soon as I got her back home I was able to pump her full of 50 to 100 billion couple times a day of probiotics and then within about three days, one overnight, but within about three days, we got her bowels normalized again. So she was in a situation where you know especially at her age, she could have gotten really big trouble if she didn’t go to the hospital.
Dr. Justin Marchegiani:
Same thing happened with my son. We were just able to get enough activated charcoal to slow the motility up and all of his drinks had extra electrolytes, extra minerals, extra nutrients, in the drinks. And then we just kept everything really cooked and really easy and on the lower FOB map side as well, and that kind of helped stabilize things, and then getting some of antimicrobials and really help too.
Yeah I mean if you have vomiting going on with diarrhea at the same time, one things that our pediatrician did say that was helpful early on in my daughter’s life was, I think she was around six months old. She got, we think it was like a rotavirus or some other type of virus maybe a no real virus. You know vomiting and diarrhea, so coming out of both ends and in the pediatrician we spoke with she’s supposedly more functional. However she still recommends a lot of antibiotics and things we don’t agree with. But, she said, give it two to four hours after vomiting before you try to throw anything and even breastmilk, even water, just let the gut rest. And I thought you know what. That’s actually a pretty good idea because sometimes, if it’s diarrhea and vomiting you get in a rush to throw stuff back in. But if the gut is so irritated sometimes you may just need to just fast for a couple hours and don’t do anything yet. Obviously, there’s a podcast, we’re not consulting with you also you see how there’s so many huge variations of this, and there’s such a spectrum of what may need to be done.
Dr. Justin Marchegiani:
Yeah. How I would handle that is I would just come in there I’d let it rest for a bit. I’d add in some bone broth, some ginger tea, everything very liquid, bone broths, maybe some collagen and amino acids keep it very simple, very gentle, start working in a little bit of probiotics in there as well, start working in a little bit of binders and just kind of get your bowels stabilized, and if we can’t, big deal we just go get an I.V. on board well that buys us a little bit more time. We don’t have to worry about any electrolyte or hyponatremia issues from losing too much fluids.
Essential oils or something we should mention, some people get crazy with essential oils, like they’ll say that all essential oils are for everything, or essential oils cure this and cure that. You know I’m not going to go there, all I’m going to say is that essential oils can be helpful. There are some clinical double blind randomized placebo controlled studies of patients with irritable bowel syndrome and by using peppermint oil.
Dr. Justin Marchegiani:
They have significant improvements in quality of life-
Dr. Justin Marchegiani:
So coconut oil, avocado oil, put a little bit of carrier oil, just put a couple of drops of peppermint oil, rub it onto your tummy, that can be a game changer. Now I’ve seen people like putting like, lemon essential oil and stuff in their water. I just I don’t personally ingest essential oils, I just use them topically.
Dr. Justin Marchegiani:
Yeah. That can be helpful though. The dilimening in those citrus oils or essential oils can definitely help with the diarrhea. So there is the component limiting in the citrus or orange or lime or lemon that does have some natural antiviral qualities, but again, when it’s more subtle that works, some of the herbs that we’re doing, the amount that we’re giving, acutely is so high. And if you were to take that, let’s just say an essential oil liquid form, you’d be shooting down like half the bottle a day and some of these oils can be very abrasive. That’s where it’s nice to have it in a capsule form or a liquid form that’s designed to allow it to get down smoothly without all the taste problems.
Yeah that’s where I get concerned. It’s like, OK, grapefruit seed essential oil, maybe that’s a good thing but lowered. I don’t want that going down my esophagus really.
Dr. Justin Marchegiani:
Yeah. So it me essential oils can be great when it’s gentle stuff, can be really great for kiddos too, when they can’t swallow just being able to get a couple of drops in them. It can be very soothing on their tummy but when it gets more acute, that’s what we’ve got to pull out the big guns.
Yeah. So fever, that was another situation we forgot to mention, and we talked about the bleeding. We talked about the vomiting situation that can make things more tricky complicated. And then also fever but fever may be the body’s natural response too. So like this immediate idea to suppress a fever may not be wise either. I think it’s just a case by case basis. That’s why a conversation like this gets kind of hard.
Dr. Justin Marchegiani:
Yeah in general my perspective on fevers, if it’s below a hundred and five degrees, we don’t worry about it. Fevers for the most part are always going to be fine as long as there’s not head trauma, if there’s head trauma in the hypothalamus maybe has an inability to regulate temperature then we get a little bit concerned. So head trauma from a car accident, or a fall, and then a fever ensuing afterwards may have to be a little more careful of that. But if there’s no head trauma involved, then we have a fever, then we’re just going to work on supporting the immune system because that’s the body raising the temperature to kill off Mesophilic bacteria. Medium temperature bacteria that will die around 100 hundred and one hundred and two. So it may go up a little bit, that’s below 1 0 5 you’re more than likely fine, conventional medicine we’ll typically recommend Tylenol way sooner which in my opinion is going to decrease glutathione. Actually not my opinion. That’s according to research. It will decrease with glutathione levels, and it will decrease your body’s ability to kill that bacteria. So my opinion is hundred and five or below you’re probably fine as long as there’s no head trauma. Either way please see your conventional MD regarding that. Just to be honest.
Yeah. Well said CBD oil just give a brief mention to it. You know I think people overstate the benefits of CBD oil just like they do with essential oils, like you can, oh my left pinky hurt, oh! CBD oil. You know so people get a little carried away with it however I used it for my daughter, I use it for myself, CBD oil does have benefits, now is it going to be as helpful as an aloe extract, the raw ginger extract, or berberines or Pau de Arco or olive. Probably not, really. I mean I think it’s great and it can modify things, but I just don’t think it’s necessarily root cause as much as some of the other things we talked about.
Dr. Justin Marchegiani:
I a hundred percent. So that was an excellent podcast. He really went in deep on the clinical side. I hope everyone is valuing this information. If you do, give us the thumbs up, give us a share, and let us know your comments below, what you liked about this article, and what future topics you would like us to chat about. And if you want to dive in deeper, if you feel like this article resonates with you or a friend or family member, head over to EvanBrand.com to schedule a consult with Evan, or JustInHealth.com to schedule a consult with myself. We’ll put links down below. We work with patients virtually all over the world and we’d love to help you out if you’re ready for that next up.
Sounds good. Well great conversation I hope this helps people and we’ll be back next week.
Dr. Justin Marchegiani:
Excellent. Hey man it was great chatting with you. We’ll talk soon.
You too. Take care.
Dr. Justin Marchegiani:
Take care. Bye.
Addressing Reoccurring H. Pylori Infection | Podcast #238
H. Pylori is a bacterial infection. This kind of infection is something that we always see in our patients with gut issues or poor digestion, or mood and energy issues. H. Pylori is anywhere between 20 to 50 percent of the population that could have this infection.
Know more about more symptoms that could lead to H. Pylori infections, advanced tests and medications, added symptoms, and a lot more.
Dr. Justin Marchegiani
In this episode, we cover:
00:57 What is H. Pylori Infections
02:49 Antibiotic Resistance
03:19 H. Pylori Medications, Tests
08:13 H. Pylori Symptoms
14:31 Other H. Pylori complications
Dr. Justin Marchegiani: Hey there it’s Dr. We are live. Evan, how are we doing today?
Evan Brand: Hey man I’m doing good. Happy Monday to you.
Dr. Justin Marchegiani: Very good. Happy Monday to you as well. Well we talked about today we’re going to be chatting about H pylori and H pylori infections. The topic that we see weekly in our office of patients coming in with gut issues or poor digestion and even patients that don’t even have gut or digestive issues that have just strictly mood and energy issues. H pylori is anywhere between 20 to 50 percent of the population could have this infection and I see it a lot in my clinic.
Evan Brand: Yeah I would rate this is one of the top five roadblocks to achieving optimal health. You know you and I will zoom in and focus on maybe smaller more nuanced topics. But to me this is like one of the biggest roadblocks there is, mainly because of the mechanism that H pylori is doing on the body which is reducing your ability to produce stomach acid.
Dr. Justin Marchegiani: 100 percent. So H pylori is a bacterial infection. H stands for helico so it’s like a helix shape and they can kind of like burrow and turn and twist into that gut lining it can create inflammation and there are virulence factors that we look at the big ones are gonna be [inaudible]. These are cytotoxic proteins that are being produced by H pylori by the bacterial infection and they can create more inflammation. It’s a good sign that the H pylori stronger. It’s a big player to be creating a lot more problems. I do see patients still have issues that don’t have these various factors but if we see them it’s a good idea that we want to clear them out by knocking out the infection. And it’s.. for me it just kind of like puts the infection at a higher level in priority in the treatment protocol.
Evan Brand: Worst case scenario with H pylori and those virulence factors you can develop gastric ulcers, you can develop gastric cancer, you can have major damage to your esophagus, so this stuff can get pretty nasty. And we’ve seen cases like that where someone comes to us where they’ve already had an ulcer diagnosis by doing like a barium x ray where you drink a terrible chalky drink they do an x ray on you and they can visualize the ulcers and then the gastro doc in that case generally they’re just gonna put you on acid blocking medication. So I think maybe we should spend just a minute here talking about conventional treatment for this stuff. It’s not very pretty. Triple or quadruple therapy is often used which is three or four antibiotics used at the same time. Now we know that that doesn’t work. Number one, because the CDC admitted that antibiotic resistance is happening. But number two, you and I measure antibiotic resistance on our stool testing and we find a lot of positives which would indicate, hey if you take this antibiotic, you throw it down the hatch you try to treat the H. Pylori with it. It won’t work.
Dr. Justin Marchegiani: Yeah I see that a lot as well. I also see a lot of the antibiotic resistance even clear after herbal treatments. Do you see that at all?
Evan Brand: I do too and I’ve always been interested in that. And people asked me and I don’t ever have a good answer to why
Dr. Justin Marchegiani: Yeah I’ll have to call the lab about that and figure out why that is. But I think —
Evan Brand: I think I know the answer yes. So if we clear the H. Pylori, maybe they can’t test the resistance of the antibiotic towards it because the actual bacteria that showed positive flow.
Dr. Justin Marchegiani: And that very well could be maybe you need enough of that bacteria there to actually test the resistance against other antibiotics. Now that it’s low enough we don’t have enough of that sample, it’s possible. I think that’s a possible theory. But we see H pylori frequently. Now we’ve been testing the DNA. And that’s a good way to test the PCR, the polymerase chain reaction testing is the newer DNA technology to assess the infection. It’s about two to three thousand times more sensitive than the previous gold standard which was the antigen testing. So antigen means it’s the foreign. It’s a piece of the H Pylori. They use a specific stain and they visualize it under a microscope. That was kind of the old type of testing.
Evan Brand: Or remember about five years ago, you and I were just starting to get into the DNA PCR testing but we were still using the old antigen testing where it took three days of stool samples. Remember that?
Dr. Justin Marchegiani: Yeah I remember that.
Evan Brand: So we it would test negative and then we’d have the DNA and we’d see positive and then we’d look at symptoms and we’d say Wow. So now, I mean you tell me if you if you’re doing it differently but I believe you and I both have ditched doing the antigen based testing pretty much completely because we used to run both because we were not sure which one was more accurate. Now we know the DNA is much better.
Dr. Justin Marchegiani: Yes, exactly, so the DNA is great. I will still every now and then if someone is, I think to have an H pylori infection but they’re not coming back up every now and then I will order a blood test where we’ll look at IGG IGA IGM to get a window into acute infections or chronic infections. Right. IGA IGM is more acute, IGG is more chronic. It’s possible that you had exposure to H Pylori. It’s cleared and the IGG still positive. You don’t ever want to treat based off of the IGG blood test for the H Pylori anyway. And then there are breath test, so breath test essentially work by testing and elevation in CO2. So essentially you have and they think they also may assess urea as well. So you have ammonia or you have protein in your tummy and that protein breaks down into urea. And when you have the ureae that’s elevated from H Pylori that urea is can cause that you re to break down into ammonia and CO2. And so you’re getting a lot of that CO2 that’s coming back positive as an indirect indication that H Pylori is active in the gut. So it’s that increase in CO2 that’s giving you that indirect measurement that H Pylori is there.
Evan Brand: Yeah. So one of the questions that we get from people is well, hey I tested positive on this stool test now you gave me this horrible protocol to address this infection. Can we just do a breath test because it’s cheaper or my doctor is going to run the breath test for me. Can’t we just do that to prove that we got rid of it.
Dr. Justin Marchegiani: Right. So typically you always want to compare apples to apples so if we ran let’s say a genetic stool test and we came back with H Pylori we’d always want to compare apples to apples. We want to compare it to the other tests to assess the, to assess the veracity. So you came back with the G.I. map positive. We want to retest on the G.I. map.
Evan Brand: Now you could throw in the breath on top of it if you want to but I wouldn’t try to replace breath or blood. You know I wouldn’t try to use those to replace a stool panel. We still find the stool is most accurate and also too, you know when you’re looking at somebody who’s got it’s very rare to see H. Pylori by itself. Why don’t we discuss that? I mean, if we look at right now it’s on page two of the stool test. That’s where we see all these H Pylori markers we’ll look at the beneficial bacteria which are often low. But that’s not all. I mean usually there’s a handful of other things like Candida overgrowth that happens as kind of a, I would consider maybe a secondary issue that happened due to the primary H Pylori infection.
Dr. Justin Marchegiani: Oh totally, 100 percent. So just kind of looking at the breath test they are assessing urea but the big thing that does come up is carbon dioxide does come as a byproduct. So just to be clear they are looking at a lot of the urea and that’s a lot of the protein breakdown because H pylori does have that enzyme urea. So just kind of giving you an update of kind of what that breath test is looking at. So we have we have our genetic stool test that we like and they can also assess and look at the virulence factors, and they can also look at the antibiotic resistance. The big antibiotics are typically going to be a combination of triple or quadruple therapy usually it’s in to be Clarithromycin, Amoxicillin Prilosec or PPI and or Bismuth. And sometimes they’ll throw in Tetracycline or Doxycycline to pull those other antibiotics out. So that’s kind of the general triple slash quadruple therapy. And then on the IRB as we may use other things like or goldenseal or CLO or mastic gum or higher dose of oil oregano or even probiotic species can be very helpful at knocking down H Pylori. So there’s a lot of things that we may use to help knock down that H Pylori.
Evan Brand: I want to talk more about like confections that come with this. Yeah. So bacterial overgrowth you know we’ll talk about gut inflammation permeation of the gut barrier. But first why don’t we talk about symptoms because people may be hearing H Pylori all this talk and the like. OK well how the heck do you know besides testing that you have it. You mentioned some people may not show any symptoms at all but they still have a very high level of it. But most people that come to us they’re symptomatic right. They’re not just reaching out just for fun. They’re reaching out because they’re symptomatic. So I would see I would say weight loss or weight gain. In my case, I lost a bunch of weight with H Pylori where I just wasn’t digesting my proteins very well and so I lost muscle mass. I would say bloating, heartburn, gas burping, bad breath is pretty common your breath gets bad because your food’s rotting in petrifying in the gut, your nails my nails develop vertical ridges like my nails became more weak and at ridges because of my malabsorption. What else would you say symptom wise?
Dr. Justin Marchegiani: Can you talk a little closer to the mic?
Evan Brand: Yes. So your audio right there. Your audio did the same thing it sounded like you were really far away but you weren’t I think then something.
Dr. Justin Marchegiani: Okay. All right guys we’ll just keep it really close. Perfect. All right. So in general yes. So the low hanging fruit with H Pylori is gonna be getting enough stomach acid. acid, super super important when it comes to H Pylori. Now it’s a double edged sword with H pylori because with H pylori your gut lining could be a lot thinner. It could be a lot more inflamed due.. due to its inflammation. So hydrochloric acid is like it’s like trying to get a massage for your back pain or an adjustment for your back pain when you have a sunburn like you may need it. It may be the right thing but it may be too much for the amount of inflammation that’s present in your body. So we it’s really important that you work with a clinician to have this kind of dialed in. So we may come in with very low dose on hydrochloric acid or maybe even not maybe just use some gentle bitters or enzymes to support the digestive process and then assess how much inflammation, make sure there’s no bleeding, make sure we add in things to kind of cool off the gap before we do anything on the acidic side. And everyone’s a little bit different. So it just depends I’m always airing on the side of talking to the general public in doing things that aren’t going to set you up for more pain or more inflammation and then work with a clinician that can help individualize things as you start to stabilize.
Evan Brand: Nausea is another symptom I forgot to mention. What about you? Do you have any other symptoms I mentioned the gas bloating burping–
Dr. Justin Marchegiani: Your gas, your bloating, your constipation, your diarrhea, anytime enzymes or acids are affected motility can be affected. And then of course you have, there’s a couple of studies out there saying, hey look at these symptoms of H Pylori. They have nothing to do with digestive symptoms. These are mood issues, depression, anxiety, cognitive issues so you can have a lot of issues that aren’t H pylori driven, and they can be mood in emotional and cognitive stuff and this is hard because people are kind of like indoctrinated to think, oh I have to have acid burning, I have to have stomach pain, I have to have an ulcer for H pylori to be a problem, and you may not have no symptoms at all connected to digestion.
Evan Brand: Yeah absolutely. I had depression, I had anxiety, I had panic episodes. I mean I was a wreck when I had H Pylori. So I can agree and attest to the fact that yes there probably are some cognitive, psycho, emotional stuff involved and you know, your, your counselor is not going to tell you to go get a stool test for your depression.
Dr. Justin Marchegiani: Exactly yes. And that’s an important part. And why does this happen? What’s the mechanism? The mechanism is pretty simple. I think if we don’t have enough hydrochloric acid if we don’t have enough digestive support, we have to break down these amino acids, right? So think of like a necklace you’re wearing. Think of that as protein, right. If we go to break each pearl off of that necklace. Those are amino acids, and essentially digestive was we have to break those little pearls up so we can utilize, assimilate, and absorb them. And then of course in our body they get converted into a lot of our neuro chemicals, serotonin is going to be tryptophan, or five HDP, tyrosine will get converted to dopamine and adrenaline and norepinephrine and then you’re going to have some of these amino acids convert to GABA which will help you relax and wind down. So we have to essentially take this necklace and break each individual off so we can digest it absorbing assimilate.
Evan Brand: Yep. Well said. All right, so let’s go back to the point I mentioned earlier. So the Coinfections like what else happens with H Pylori, we often see Candida overgrowth happening. We often see bacterial overgrowth happening, so at that point maybe more GI symptoms will come on board, and it may not be the H Pylori directly. It may be know pseudomonas or streptococcus or Klebsiella. Some of these other bad guys. And then we know too that all this undigested food has collateral damage on the gut barrier, right? So we’re going to see the secretory IGA go low and then we know someone has a leaky gut situation. Now what about Do you test Zonulin? I don’t because I just haven’t found it worth the extra expense for people. But some people this beg and plead that they want on when tested.
Dr. Justin Marchegiani: Yeah there is some data on it. I mean most of the data is kind of circular it comes from Alessio Fasano over at Harvard but there’s some good data that that’s good. That’s the number one protein forgot permeability so if I see a lot of auto immune people I will definitely run it just to assess how permeable the gut is. So Zonulin, this protein when it’s elevated it means the tight junctions are kind of getting unzipped in your gut and the epithelial lining, and then the more permeable your gut is, the more bacteria and infectious debris and or foods that aren’t broken down fully can get into your bloodstream, and create an immune response and create more inflammation, because your immune system not used to seeing all these foods not broken down in the bloodstream. So that creates a lot of immune stress. So it’s nice to have that. I’ll look at it more patients that are have a lot of autoimmune stuff going on just to assess if treatment brings it down. But again it’s not causation for me that’s more correlation. How does this improve as we do these things over here to get rid of inflammation or digest foods or get rid of other infections, so it’s kind of a corollary marker for me.
Evan Brand: Makes sense. I mean I just generally look at the low secretory IGA. I’d say based on that hey you know probably a leaky gut situation.
Dr. Justin Marchegiani: Yeah, 100 percent. So looking at the H Pylori right today’s podcast is on H Pylori. It’s going to be affecting the digestion of protein. It’s going to affect the lowering of that PH in the got that nice low PH does three things, it, one it makes it harder for bacteria to grow think of nice low PH as like bleach on a dirty picnic table. It kind of cleans things up and sterilize those things bacteria hates acidic environments to grow and likes actual the alkaline environments. Number two, it gets enzymes activated. So those nice active enzymes are PH sensitive so we drop down that nice PH. These enzymes perhaps energy and turns the peps in. We get these nice protein like enzymes going and then all that food that’s all kind of mushed up. That’s called kyme. All right that gets emptied into the small intestine and that nice low PH triggers a whole bunch of Bicarbonate from the pancreas, a whole bunch of enzymes, proteolytic enzymes, light ballistic enzymes that means protein and fat digesting enzymes. And it’s also gonna trigger that gallbladder to bruise a whole bunch of bile which will help you digest fat as well. So three things, right, it’s creating an environment that’s harder for bad critters to grow, it’s activating enzymes, right? And it’s activating a lot of our proteolytic portions and as well as getting the pancreas and the gallbladder involved so really important.
Evan Brand: Yeah, the whole domino effect has to happen with enough HCL which you can’t make if you have that infection, and we find 80 plus percent of partners share H Pylori too, so this is why sometimes we have to get the husband or the wife or even the kids involved too, because if someone gets better and then two to three months later, symptoms come back or issues return then we know it’s probably just a case of reinfection.
Dr. Justin Marchegiani: 100 percent. So if H Pylori is one of these predators that you know typically a lot of parasites the more fecal oral so we usually have to be a higher level of intimacy for that infection to pass back and forth outside of the fact maybe someone did wash their hands and they cook a meal for the family. That could happen every now and then. But the bigger thing with H Pylori that can be spread with saliva. So just you know a kiss between a mom and her son easily spread that, or sharing silverware or sharing a drink in a household– pretty common among family members so that could easily be spread. So, definitely if we see a husband or wife come in, I definitely want at least those two treated. And then we may look at what’s going on with the kids that have any issues that are kind of abnormal on the radar. Meanwhile a little bit deeper right.
Evan Brand: Yeah. Well said well I don’t think there’s anything else we need to cover on this subject. I’m sure we could, we could pick and add more things to the picture. I would you say if you don’t have gut symptoms that doesn’t mean that you’re clear.
Dr. Justin Marchegiani: Correct. I think it’s good to look at that. And then if you have cognitive issues or let’s say you have mood issues and you’re on an SSRI, maybe a medication that may not be getting to the root cause, it’s stabilizing. Right. But let’s get to the root cause. And then, once we address that then you can go back to your prescribing doctor and look at tapering off that correctly but we always want to get to the root cause.
Evan Brand: Absolutely.
Dr. Justin Marchegiani: Now don’t find one thing here I’m just kind of highlight it is gluten is a big deal. I find the more inflamed we keep the gut it’s harder for H Pylori to be eradicated. So, in other words, if people don’t change their diets even with really good herbs it can be harder to knock out the infection. So the more we can keep inflammation down, the better the patient responds to a lot of these natural herbal treatments that.. you notice that too?
Evan Brand: Yeah. Well most of the people that come to us they’ve already changed their diet. So it’s rare that we have to have that, hey you need to be off gluten and dairy conversation. But yeah it does act as a roadblock, especially when we see teenagers that are going out and eating pizza and stuff like that. I don’t get as much success as quickly with them.
Dr. Justin Marchegiani: I agree I think it has to do with getting the inflammation in the gut and the digestive tract drops, but also I think it has a major effect on the immune system. I think if your immune system is continuing to be pounded with the entire course, eventually that performance would drop.
Evan Brand: Good call. I didn’t think of the mechanism. What do you mean system that makes perfect sense. With the dairy piece especially, I could think of kids that are saying oh my skin is still bad you know cause skin issues can result from H Pylori too. Right. Because that rotting food will create some acne. OK. Well what are you eating and they say well I go out and eat pizza twice a week. Well there you go.
Dr. Justin Marchegiani: Exactly. Find the big thing in a lot of the skin issues are what happens because poor digestion is going to be a skin issue. That’s why you see, lots of people talking about improving. You know when they start adding apple cider vinegar into their diet because you’re asking. To see the gas and that’s helping to break down proteins and therefore you see improvement. Yes. That’s another mechanism. Why skin improves with better gut out, better acid and digestion, less putrefaction to the patient and the skin is always going to be used as a means to detoxify. So if you have stress and we can’t get it out giving you to deliver, the skins into the next organ system that’s going to be leaned upon to help with the thoughts of the patient.
Evan Brand: Yeah if I start to break out of my face, I start to think, OK what’s going on. Am I not doing something right. Is my gut? Is it my diet? Is it my liver? Like what’s going on.
Dr. Justin Marchegiani: Exactly. Good point. All right. So just kind of recapping the if someone’s struggling with issues that digestive side or even mood side and muscle look at that. That’s the H pylori infection connection. Make sure you click down below. Reach out to Evan at EvanBrand.com or Dr. Justin Marchegiani. Myself at JustInHealth.com. Links down below. We also have transcriptions available if you guys want to look at or read transcriptions there’s a great option for you. Make sure you click and subscribe as well so you get new great content that is coming out of your way. Right. Anything else you want to say here?
Evan Brand: No that’s it. I would just say get yourself tested. You never know until you test.
Dr. Justin Marchegiani: I totally agree. You’re not testing, if you’re not testing, your guessing. Right. We want you to assess and getting that correct data so we can make the right.
Evan Brand: My daughter showed up with H Pylori. She had loose stool, and so we tested her around age 2 and she had H Pylori. So we gave her some liquid herbs. We retested her H Pylori, now gone. So I mean this doesn’t discriminate no matter how old or young. I mean, you could be two years old with this infection and that could lead into potentially issues with growth and development and all that. If you’re just not digesting, her gut inflammation was high with that as well. So I’m glad that we were able to catch it early and take care of it.
Dr. Justin Marchegiani: Awesome. Pretty cool. Well great podcast today. We’ll be back next week. You guys have a phenomenal day. Thanks guys.
Evan Brand: Take care. Bye
Dr. Justin Marchegiani: Bye.
Natural Solutions for Food Poisoning | Podcast #231
Food poisoning, also referred to as foodborne illness, is illness caused by consuming contaminated food. Infectious organisms — as well as bacteria, viruses, and parasites — or their toxins are the foremost common causes of food poisoning.
In our new episode with Evan Brand, Dr. Justin shared his recent food poisoning experience. He detailed what he did, what medicines he took, and how he overcame with it. He also shared some tips on what medicines to bring when traveling.
Enjoy! Don’t forget to like and subscribe!
Dr. Justin Marchegiani
In this episode, we cover:
00:15 Dr. J Food Poisoning Experience
02:36 Food Poisoning Treatment and Remedies
08:23 Gut Issues for Kids
16:26 Enzymes Available
25:14 Candida Diagnosis
Dr. Justin Marchegiani: Hey guys it’s Dr. Justin Marchegiani here. Welcome back to the podcast. Evan, how we are doing today man?
Evan Brand: I’m doing great, good morning to you. We’re ready to talk about food poisoning. You got food poisoning. What was it, a week ago now that we are talking?
Dr. Justin Marchegiani: Yeah, so I was in Boston for a wedding last weekend and I got sick. I was in the north and I did pretty good. I did like a ribeye steak with this broccoli and I was okay, but something didn’t feel right with that kinda mixture. I did go afterwards, and I do this once a year. I did have a cannoli with gluten and dairy in it. So, I did get that. That’s like my one thing cause it’s just like so great. But the previous two years as well, so I’m like, is it really dairy and gluten thing? So there’re just two different light levers here. Alright, you got like food poisoning where it’s like bacteria kinda thing like an e.coli kinda thing. It could be food poisoning AKA an infection like a parasite or bigger bug, or number three, it could be inflammation from the food. Both kinda similar. First thing I did was, I was alright, enzymes, charcoal, ginger, you know, anti-inflammatory southing support that kinda calm things down. And the big thing was I was so noxious. The ginger really helped but it couldn’t keep it down all the way, so that was number one. I’m like, alright. And then I was doing a lot of L glutamine so I’m like, I don’t think this an inflammation thing. It’s lasting a little bit too long. I started to hit a little bit of oil of oregano, didn’t move in a ton, so I was doing my GI clear five oil of oregano, wasn’t moving a ton then I started hitting, when I got back home, my GI clear four and I knocked it right away. So there was some kind of I think a bigger bug in there so I don’t think inflammation that I caught but within a day, within two doses of my GI 4 which has the Berberine the Goldenseal the Burdock the Black Walnut, my nausea went right away. So I’m still on it now I’m gonna take actually one of it as we speak.
Evan Brand: So, were you throwing up or you were just noxious?
Dr. Justin Marchegiani: I didn’t have any diarrhea or any you know throwing up. It was just like just incredible amount of nausea like whoa!
Evan Brand: Like a scale of 1 to 10, 10 is the worst nausea ever, where were you?
Dr. Justin Marchegiani: It was probably like an 8
Evan Brand: Oh, that’s pretty bad…
Dr. Justin Marchegiani: Like I didn’t wanna move like I thought very uncomfortable moving at all.
Evan Brand: and you were flying back home…
Dr. Justin Marchegiani: Oh yeah, I mean what really helped those, those GT Dave’s kombucha, the ginger really really helped. I mean I was doing that…
Evan Brand: You were saying
Dr. Justin Marchegiani: Yeah, I was doing the Kettle & Fire bone broth which is very soothing as well. So I was just doing bone broth, kettle & fire, to the ginger kombucha, and I was hitting probiotics, hitting activated charcoal, and then I was nailing the oil of oregano the last day. The oil of oregano didn’t touch it as much, but the GI Clear 4 really knocked it up. Typically I tell my patients and you travel, go with the GI Clear 4 and 5 when you travel, just to ensure that you don’t have any food poisoning issues or you get an infection. So my generalized stack if you’re traveling is one dose of probiotics, in my line like a probiotic 4, the lactobacillus kinda Hindus lactobacillus bifidobacteria species, I GI Clear 5 which is a higher dose oil of oregano, and then my GI Clear 4 which is a broader spectrum, bigger parasite kinda killer, and then activated charcoal.
Evan Brand: Yep.
Dr. Justin Marchegiani: Like my big four and then like a little bit of enzymes and HCL too so actually five. That’s my stack for traveling.
Evan Brand: You must have probably picked something up then because that sounds more than just… I mean maybe it was food poisoning. But if it took you to throw in berberine and a lot of these anti-microbial herbs, it sound like to me, I mean I’ll just make up something out of thin air, maybe picked up Clostridia, or some other bacterial pathogen that took you over.
Dr. Justin Marchegiani: Yeah, I mean the oil of oregano didn’t move it as much, but when I got the GI Clear 4, it was like holy smokes. It went away in about 3 hours.
Evan Brand: I was gonna say it was a coincidence that it just got out of your immune system and your immune system mounted the attack or you think it was the herbs that really knocked it out?
Dr. Justin Marchegiani: It was the herbs. I mean I was doing my GI Clear 5 the day before. I did 12 capsules, so I was hitting it hard. Don’t get me wrong, I think it’s still important to do that.
Evan Brand: Yeah.
Dr. Justin Marchegiani: I will just do it centergisticly. I did really good success with the 5 at other types of food poisoning, so it does work very legitimate. I had a parasite in Mexico years back, and that was very helpful but the 4 really did it, so my stack for traveling is GI Clear 4 and 5. But the 4 is like the most important, 5 is kinda secondary, and then the probiotics too are super helpful and I recommend enzyme. You’re eating any questionable foods. Activated charcoal and enzymes and HCL is great. Just to ensure your digesting and breaking everything down.
Evan Brand: I was speaking of enzymes. I was talking to my wife yesterday about how when I went over to your house, you cooked a nice steak for me, and you had your little caddy on your table full of like three different brands of enzymes on your dinner table, I loved that.
Dr. Justin Marchegiani: Yeah. Yep.
Evan Brand: Your wife and your mother-in-law, all of us we had just a whole handful of enzymes we were able to take right there. See I’ve got them in the pantry or in the cabinet in the kitchen, but then you sit down in the table and you forget so you gotta run into the kitchen and grab your enzymes. So I think I’m gonna adopt your roll thereon having enzymes right on the table so you don’t forget ‘em.
Dr. Justin Marchegiani: Yeah. I put them right with the salt and pepper like keep it really simple, really easy, I mean I think the low hanging fruit and functional medicine world is be able to digest your food well. If we spending a lot of money on good quality organic food we wanna make sure we can digest it and break it down especially when you’re eating when you’re stress, because that fight-or-flight nervous system response really keeps the enzymes and hydrochloric acid levels lower so maybe you’re not making as much, so I think that’s really important.
Evan Brand: Yeah, I’m back on enzymes so, we could talk about this for a minute, you know. A lot of people have the… they’ve got a question of well if I’m taking enzymes, am I making my body lazy? And the answer’s no. it’s not like melatonin where if you take melatonin you can down-regulate your production. With enzymes, you’re really just adding to the fire. You’re not replacing it and that becomes more important as you get older too. But for us, you know we’ve got a baby now and so she’s 4-weeks-old, maybe she’s five weeks, I don’t know. Time’s already flying. But if we’ve got the baby, I’m tryna hold her, mom’s tryna hold her or keep her happy while we’re eating dinner. we’re not optimally digesting, we’re not in parasympathetic tryna keep two kids happy at mealtime. So we’re back on enzymes now just the insurance policy.
Dr. Justin Marchegiani: Yep. And I think it’s great when you’re eating when you’re stress. If you’re doing great and your diet’s really good and you’re feeling stable with everything and you can actually sit down and relax fine. Then I think it’s totally cool that you don’t necessarily need it, as long as digestion overall is good. But if you’re definitely more on the stress side, and you’re eating a meal a little bit faster then I think it’s good to always have them as an insurance policy. I just keep them right there so if I fill the need to have it, I’m right ready to go.
Evan Brand: One thing you didn’t mention, which I think we should mention for you know…
Dr. Justin Marchegiani: Yeah
Evan Brand: Just general… yeah… getting hit with something like that would aloe. You know, there’s a couple different aloe extracts that we used. I’ve got one, do you have your own aloe as well?
Dr. Justin Marchegiani: In my GI restore, I have a 4ml that has aloe TJ and glutamine, so I do like that for gut soothing and gut healing support. And then one thing when I was traveling, I went to whole foods and I bought some aloe juice. So I did get some aloe juice, I would sip in on that. I do find it very soothing and it was very palliative, wasn’t fixing the underlying issue does mean you shouldn’t put it in there. Cause even if you have infection there’s gonna be some level inflammation present so it’s gonna help calm it down.
Evan Brand: True, true. I see so many kids with gut issues. I feel like it’s probably more common than even the adults that I see. I don’t know if it’s just that you know the kids are finding the answers from the pediatrician, so they end up reaching out to us or what but when I’m looking at stool test lately, I’m finding kids’ gut are so much inflamed. I mean I’m seeing 7 or 8 hundred 9 hundred on the calprotectin. It’s like, my Lord.
Dr. Justin Marchegiani: And that’s a very high level I mean that basically in like irritable vowel disease kinda category. You know that you’d see the crones and also the fled, that’s really high. And I think a lot of it is you see have more crap food out there for kids today. I mean my God, it’s very rare to see kids eating whole foods. It’s very rare to see kids even just drink water like my son, he drinks sparkling mineral water, he drinks water and he drinks unsweetened crane juice like with kale, broccoli, spinach, like no added fruit, no added sugar at all outside on what on those green vegetables. And then he has meet sole for breakfast, still have half of an avocado today, a piece and half of bacon, and then maybe a couple of blackberries and some coconut unsweetened vanilla yogurt. Like that’s it, that’s his breakfast and for lunch, it’s tough with kiddos so I try to always recommend with parents, whole cuts tend to work really well on kids just choose a higher quality one. Like at the Applegate or the Wellshire Farm works at least at step two, so you at least getting a pretty good quality, or if we do the hotdogs, we get the Wholefood step 4 so they’re at least grass-fed and organic in pastrofed hotdog so at least the meat quality is high so those are good.
Evan Brand: Another uncured as well so…
Dr. Justin Marchegiani: Yep
Evan Brand: You’re not having bunch of night trades or other sodium into rebates added, you don’t want those.
Dr. Justin Marchegiani: Yeah. That’s overblown kinda thing, especially it’s coming from celery powder. But either way,the more important thing is the food quality is there. And if we can’t get the vegetables in, we at least do the green juice. He’ll pound 8 to 10 ounces of high-quality green vegetable juice a day. That’s helpful.
Evan Brand: I gotta tell you about something. I just found today and we ate it this morning, it was absolutely so delicious so my wife wanted to do waffles for a long time so we were looking at all these different grain-free waffle recipes, but we went to Wholefoods and there’s this brand called Swapples. Do you know Swapples?
Dr. Justin Marchegiani: No, I don’t know Swapple.
Evan Brand: Oh my God, alright so I’ll send you the link here. But they’re grain-free like this is an autoimmune approved. I got the cinnamon one, I’ll send you the link here. This thing was so good, I thought this can’t be real how good this is. So it’s yucca, let’s see let me tell you the ingredients here. Yucca, coconut oil, organic coconut palm sugar, 2 grams of sugar, I think per waffle, cinnamon, sea salt, vanilla extract.
Dr. Justin Marchegiani: Swapples, okay I’ll put some links in the description below. That’s awesome. Are they premade already?
Evan Brand: Yeah, it’s premade. You just throw it in the oven for like 10 minutes at 375 and its ready.
Dr. Justin Marchegiani: That is awesome dude. That’s really cool, Swapples. Okay cool.
Evan Brand: I think you told me when you were in Austin that you say you goy yucca, yucca pancakes that you got?
Dr. Justin Marchegiani: Well I picnicked, yeah anyone that knows picnic is awesome for their autoimmune gluten-free, grain-free type of foods they have great yucca-based waffle and pancakes. So I would do like blueberry pancake.
Evan Brand: That’s delicious. So they have other ones too that people can use like as a bread replacement. Still gonna be you know, carbohydrates. If you trying to stay in ketosis or something, this is not gonna work for you. But they got like a tomato basil one which is the yucca, however you say it, coconut oil, tomato, sea salt, spice, and garlic. So if you’re like one of those people who just can’t leave without bread, and it’s like pulling teeth for you, for us to get you to an autoimmune template, you may be able to do something like this instead and get you off of the grains, I mean.
Dr. Justin Marchegiani: Yeah, I like that.
Evan Brand: I love the stuff like this exist.
Dr. Justin Marchegiani: That’s awesome. Yeah, have a recipe in my website basically it pretty simple it’s a half cup of coconut milk, 2 and half cup of coconut flour, to four eggs. That’s it. And it’s blended up and then we use a waffle maker and we just put it in there, it’s done. So that’s another good option too if you wanna make it, coconut flour, coconut milk, and eggs. But this is not a great option, it’s always nice to have them pre-made so if you’re in a rush you just can heat them up fast and be done with it.
Evan Brand: Yep, absolutely.
Dr. Justin Marchegiani: That’s great.
Evan Brand: I wanna share that cause like people are always like looking for things cause they wanna get off their diet, you know they’re like “oh I feel deprived, or I miss this food. I miss that food” I mean I’m still trying to get my grandfather off chocolate milk, you know. So, it’s like we got a long way to go. People would think our families listen to us on everything but at least my family doesn’t.
Dr. Justin Marchegiani: Yeah, it’s tough. For sure the key this is to have substitution mindset like what’s the substitute, what’s the switch, what can we incorporate in there that will provide similar mouthfeel, will you feel good about it, you enjoy, the taste’s good, but you’re not getting the crap. So, I love options like these. Especially the carbohydrates and the sugar in a pretty good spot. So, I like it. That makes a lot of sense man.
Evan Brand: What about the serials and all that? Have you found any alternatives? Cause so many people “why do I do I can’t have serial anymore?”. Like what do you push people towards in the morning?
Dr. Justin Marchegiani: There’re some decent lite paleo granola that’s out there that’s more nut and seed based. So that pretty good. And then you can use like a coconut milk kinda thing for it. If you’re on autoimmune templet, that wouldn’t be as good because its nut and seed based.
Evan Brand: Right.
Dr. Justin Marchegiani: That’s a good option as well in the morning. Option number 2 is just a really simple collagen-based smoothie, you know, some good collagen powder, unsweetened coconut milk, and then some frozen berries. Or just you know, a butter collagen-based coffee, butter collagen-based tea. Or kinda like my go-to is pretty simple, pretty easy. Yesterday we went out to eat in a restaurant near us that we, I was able to get like an egg florentine, so it was like an eggs benedict with over bacon and vegetable, and tomatoes. So it was like a really nice kinda lower carb, good fats, good protein, tasted really good, felt good. I don’t get a chance to do much eggs benedict so when I go out, I’m all over that.
Evan Brand: Nice, we had a question here from James. Happy Monday to you James. He says that, when we talk about gut health, what organs are we referring to besides the stomach?
Dr. Justin Marchegiani: So when we look at the intestinal tract, right, we have a mouth, that connects to our esophagus, connect to our stomach, our stomach then connects to our small intestine, three parts of the small intestine duodenum, jejunum, and ileum, then down here at the… at this side, bottom right-hand side. The ileum and the cecum meet up. This is where the colon starts, the colons up here, ascending, transverse, descending, sigmoid and then anus rectum. So, that’s kinda your generalized intestinal track. Everything from mouth to esophagus to stomach to small intestine to large intestine to rectum, anus and out in the toilet, that’s it.
Evan Brand: Yeah, and then organs. So other organs we’re referring to, gallbladder is a part of digestive process, pancreas.
Dr. Justin Marchegiani: Gallbladder and liver, its gonna be hanging out right here that dumps into the small intestine to be the duano hepatic ampulla. That’s a big one, splints more of a red blood cell kinda graveyard. Not much with the splints
Evan Brand: Pancreas.
Dr. Justin Marchegiani: Pancreas will help more excrete whites with the enzymes, it will help with the blood sugar component from the insulin and glucagon.
Evan Brand: Depending on how crazy your mealtime is. If you’re one of those people, you know how many people I see driving on the highway eating, stop doing that people. Eating sandwiches while they’re on the highway like trying to merge on. Lady’s got like a wrapper with a burger on her hand.
Dr. Justin Marchegiani: The worst time to be eating, I mean definitely fight-or-flight nervous system response. I hope they’re at least doing some hydrochloric acid and enzymes but they’re eating a sandwich. Probably not there yet.
Evan Brand: no, they are not there yet.
Dr. Justin Marchegiani: Exactly
Evan Brand: Here’s a question from Carol, she said, love the idea of keeping the enzymes on the table. What company are you purchasing your enzymes from? We have costume manufacturing, so we work with several professional health care companies for practitioners, and they make special blend and products for us. So, you could check out Justine’s site, Just In health, Ge’s got several different enzymes on there, I do on my site EvanBrand.com as well.
Dr. Justin Marchegiani: Correct, yeah mine’s enzyme synergy, HCL supreme, and then digest energy is kinda my lower dose enzyme hcl, blend I like those. Evan has… Evan, what’s the name of yours?
Evan Brand: Mine’s pure digest. That’s my go to. That’s the one that got DPP 4 in there for an accidental gluten exposure. 200mg butane per capsule. Here’s a question from Matt, ill be taking a trip to Greece sometime next year, definitely will take charcoal and enzymes, I’m mostly worried with water, all I drink is reverse osmosis. Do I just resort to bottled water?
Yeah, I mean I don’t see an issue with bottled water. Or if you want something that… if your just like super anti-plastic, you could do the Berkey sport, the little blue bottle, I think I may be made of silicone but it’s got the berky filter in there and you just out in your tap water and you can suck it up through the straw and as you’re sucking to the straw, it pulls the water through the filter, now it’s incredible and its relatively cheap too.
Dr. Justin Marchegiani: Yeah those were good. I don’t have problem with drinking out of a plastic bottle it its you know, special occasion kind of thing. Like in general, like I was up in a bout this weekend and I rough like a whole bunch of chiccos with me. So, I was able to do that, but sometimes it’s just not convenient because I don’t want the glass breaking, you know. O I don’t want the glass clanging around my ca from there. So sometimes I use that can, I use another type of water sparkling brand or you know. I’m typically doing fiji for a higher silica, or I’ll do the evy on for the high mineral content. I’ll do that. The key thing is, just make sure you keep it out of the sun. if it’s plastic, you know. If I’m outside drinking it, I have a backpack and it goes right in the backpack afterward. I don’t wanna have it the sun’s rays. My biggest concern with water is they just put it on the pallet, leave it outside, let it sit in the sun. so typically, you know, you want it pulled inside right away because the UV Rays from the sun will cause the plastic to deleach some of those estrogen compounds in the water.
Evan Brand: Yeah, I trust like Wholefoods the way they handle their stuff cuz if they get a truck full of fiji water, they’re gonna unload the truck directly from the truck un the darkness and in to the store and then the case of the water may even be inside of a cardboard box there where you are not getting the sunlight to hit it.
Dr. Justin Marchegiani: Yeah. Wholefoods, in those stores they have… you can just see right. They have a smooth tracking containment inside the store. You’re pretty darn safe cause it’s going from inside to outside or inside the store pretty smoothly. So that’s at least a good option for it. So, I like that.
Evan Brand: Yep. We had a question here from Judith, she says she has an H. Pylori. She can’t get better and she’s got pain constantly. She’s using Matula tea, everything makes her tremor. I don’t know if she’s talking tremor like T-R-E-M-O-R, but she spelled it tremor like a tremor for your hair, and anxiousness. So, yeah I mean if you got H. pillory, obviously there’s some random supplement that Justine and I both have that could help that. But really, you wanna be working with somebody with this cause if you’re in pain constantly and you’re anxious, there could be some other things you need to do. We don’t necessarily want to give you H. pylori herb or you may need adrenal support and other things.
Dr. Justin Marchegiani: There could be other infections going on there. A lot of people who are going after gut infections, they don’t have the ability to regulate blood sugar and energy, and they tend to feel more anxious like this. This is a common symptom that I see when people just go after the gut and don’t fix the other things first.
Evan Brand: Yeah.
Dr. Justin Marchegiani: So, this is a common side effect. This is why we really wanna have a comprehensive program lined up and not just spot treat people with a gut bug. Sometimes you can do that when people are in really really really really good health and their infections are more acute. You can totally do that. But in more something chronic, in a more other fatigue,harder issues are in play, you really have to line things up and a really systematic approach to get the best results.
Evan Brand: Yep. Yeah. Well said. So, Oliver asks; Do you guys tolerate raw milk kefir? I don’t do any. I probably tolerate it; I just don’t do it.
Dr. Justin Marchegiani: I don’t do well. I had a patient get me a gown of like really awesome super high-quality grass-fed pastored milk and I’d still have a lot of diarrhea from it. So, I’m just like, it’s not worth it for me. The only dairy that I can do well is yea and butter and then if I do kefir, its gonna be coconut based, I’ll do coconut based kefir.
Evan Brand: Yeah, it’s just not worth it for me to try so, I just don’t.
Dr. Justin Marchegiani: Exactly. Suzanne writes; What can I do to fight hunger cravings. I do not eat after 5 pm but I wake up crazy hungry. I drink a lot of lemon water with some Himalayan salt.
So, yeah. You probably need to be eating a little bit later. If you’re going to bed around 10-11, that’s you know, 5-6 hours before going to bed without food. So, there could be some blood sugar instability happening. So, if you’re walking up at night, you may wanna have a nice, little, simple snack, protein and fat by your nightstand and try eating within 2 hours before bed. Again, if we’re having blood sugar issues and those sugar issues are waking you up, that’s the next logical step.
Evan Brand: Yeah, may need some adrenal support, you may need some chromium, you could throw some cinnamon on a baked sweet potato with butter. Have that for dinner that may stabilize the blood sugar a little bit too. I really really love using chromium and other minerals to help so, there’re herbs that you can use too. There are some like glucose, modulating glucose control herbs that we use, but once again, that’s something that you don’t wanna guess and check on. You gotta get to the root cause.
Dr. Justin Marchegiani: And then Carol writes in; Are your products that you mentioned safe for 2 years old and up?
It depends, most 2-year-old can’t swallow pills that are in our product so we have special tincture that are liquid based and they tend to be easier to dose. So, we can dose them. We like the tinctures for the younger people.
Evan Brand: there are couple chewable products we used for kids too that kinda depending on what it is.
Dr. Justin Marchegiani: You’re talking chewable for actually like clearing herbs?
Evan Brand: Uhh no. I’m talking for digestion.
Dr. Justin Marchegiani: For enzymes stuff.
Evan Brand: Yeah, chewable enzymes.
Dr. Justin Marchegiani: Yep.
Evan Brand: Chewable aloes, things like that.
Dr. Justin Marchegiani: Yep. There’s some DGL and aloe up there I’ve seen and then there are some enzymes that chewable that are good.
Evan Brand: I know. For killing, no. I don’t know of anything that can kill that’s chewable.
Dr. Justin Marchegiani: Exactly. There are pump based that I like and then dropper ones that are dropped based. Then you can kinda dial that dosage up. So those are the ones we typically like and we can dose it up better. Just more individualized.
Evan Brand: Judith had a question. She said; can I call on the phone, please?
You know that what that makes me think off? That makes me think we should have like a call in podcast where people can call in and talk and tell their questions on you know, like on the air so to speak, like a radio. That would be fun.
Dr. Justin Marchegiani: Yeah.
Evan Brand: I don’t know how we do it. Im,sure there’s a way.
Dr. Justin Marchegiani: Yeah. I’m open to that. For sure I think I need some kind of a call board and plug it into my computer. Something we can look at. Anyone has information on it, let us know. We’ll put it in a queue.
Evan Brand: That would be fun.
Dr. Justin Marchegiani: Couple more questions, George writes in. hey,George hope you’re doing well. I typically do ashwagandha to dry herbs versus the tincture. Ashwagandha and tincture taste absolutely horrid especially if you take wrong ashwagandha. One of the worst tasting herbs next to Tribulus.
Evan Brand: I do ashwagandha and tincture actually with the sooth formula, the adrenal sooth formula I do and I mean…
Dr. Justin Marchegiani: Blend?
Evan Brand: Yeah it is a blend. I mean it does have; well it has motherwort in it which is equally.
Dr. Justin Marchegiani: There’s liquorish too?
Evan Brand: Uhh. No there’re no liquorish. Its ashwagandha, rishi, motherwort, ziziphus, albizzia. It’ pretty horrid. I have a lot of clients who like “I just can’t do it”.
Dr. Justin Marchegiani: Okay. Yeah yeah yeah yeah yeah. But there’s a blend. But if you do ashwagandha 2 to 1, meaning 2 times the amount of herbs to the alcohol’s in there, most people do like awanda 2 or awanda 5. So, its literally 5 to 10 times less potent. It’s not even close. But when you really do 2 to 1, it’s like holy god! It’s crazy.
Evan Brand: Oh man. Judith, how can you contact us. So, Justine, you can reach Justine at his site, Justinhealth.com. there’s a scheduling button if you need to schedule a call or there’s also contact information if you just wanna email.
Let’s see what else here. Me, my site, Evanbrand.com, same thing.
Dr. Justin Marchegiani: Yep.
Evan Brand: Do you wanna answer this one here from Christian?
Dr. Justin Marchegiani: Yup. 9 months ago, I was diagnosed with candida, came up 40 on my oats test, feeling a lot better and got rid of it, lost too much weight, how can I gain back the weight and not look sick? So, first thing first. Not to be a wise guy, but you have to make sure you’re eating enough. That’s number 1. You have to make sure you’re getting enough calories. Sometime when people do a lot of killing, that killing can actually decrease the appetite. So you have to actually run your food chronometer. Justinhealth.com/cronometer, make sure you’re getting enough calories, number 1. Number 2, if you’re more of an ectomorph or its hard for you to gain weight, you also have to look at your macronutrient ratio. Ratio a protein fat carbs and increases the percentage of your carbs. So, if you’re 30 of 40 percent go to 50 of 60 percent. And still, ry to make sure you’re doing grain free based carbs. Don’t get extra grains in there just to get more carbs. Do more squash, sweet potato, plantains, you know those kinds of things instead.
Evan Brand: You know what I’m gonna say based on his comment, right. I’m gonna say there’s probably more than just candida, you know.
Dr. Justin Marchegiani: Yeah, and if you’re feeling better and you’ve gotten retest, that’s great. But you would also wanna get a high-quality gut test on because the oat will not look out the parasites. It won’t get the parasite. It will look out bacteria and fungal metabolize and that’s it.
Evan Brand: it’s extremely rare. I mean whoever they say 9 months ago they were diagnosed with candida. Whoever diagnosed you with that, I mean I can legally diagnose anyway, but I would be very very suspicious that you had just candida. It’s very rare to see. I guarantee there’s probably maybe some parasite, bacterial overgrowth, h. pillory. Something else going one cause I feel like candida’s usually kinda late to the party whereas the bacteria and the low HCL from the h. pillory and the parasite, those kinda disrupt the gut and then I feel like candida moves in. I guess it could happen. Chicken or egg, who cares. But I feel like candida is a secondary issue to a primary parasite.
Dr. Justin Marchegiani: Exactly and typically the timing of how we treat. We typically do the h. pillory first, parasite, bacteria, 2nd or 3rd and then candida last. That’s kinda the general way in which we treat, Robert. Hope that helps.
Evan Brand: Yeah, Robert’s question for those listening, he had a question on what should you go after first. Candida or sibo? I mean honestly, a lot of the herbs used tho have multiple properties that we may use blends of herbs that are anti-microbial and anti-fungal so you kinda killing 2 birds in 1 stone. But I guess it depends on the serenity of one issue we may use more inti fungal as a posting, anti-microbial if its parasites who may have parasitic herbs that could kill fungus. So, its really just case by case basis.
Dr. Justin Marchegiani: Totally. And I thank Guererro about this zoom meeting thing. I’ll keep that in mind, I think it’s good. Matt writes in; Would there ever be any benefit to not save carbs for the evening? So, meaning to do your carbs in the morning. So, that’s like kinda common sense where lot of people load up carbs in the morning. Again some of the data suggest in the carb backloading community that better at night. There’s also some data that some people tend to sleep better with a little it of carbs in their system at night. Also tends to help with fat burning and such. So, I typically always, let’s just say lean on the carb backloading mindset but always tested out. I mean there’s data out there but then you gotta use your clinical experience. So test it out to see how you do and see how you feel.
Evan Brand: Yeah, I got a question from Jac. Should one take probiotics daily?
I mean that’s like such an open-ended question. I mean we could spend an hour on that subject. We probably have spent hours on it. I’m kinda on and on face right now with probiotics. I’m doing some special probiotics blends to help lower regulate histamine. And then I’m also doing some Saccharomyces boulardii. So, I’m doing those daily for probably months, but now with my daughter, cycle her on and off probiotics, throwing some Saccharomyces. It kinda just depends on what you’re doing.
Dr. Justin Marchegiani: Correct, correct. Now in general about people taking herbs between meals, couple things to say about that is, I use to say like do your herbs hundred percent before food, which I think is great. You typically take at least five minutes before food. the problem is you get a lot of patients that are like they forget, and they just won’t do it. Then they’ll forget half a time so then half a time they’ll never taking the herbs. So, my perspective is ideally five, five minutes or more is fine especially you’re not getting nauseous, but if you forget, still have it. Like still have it, always do it. Eating your food and forgetting is not an excuse to not take it. I always try to draw that line with patients and if the patients are more sensitive, we’ll typically do it with food anyway just so it mixes in and it’s a little bit less potent as well.
Evan Brand: Yeah, the question Justin was answering was should you take herbs between meals or with meals. I would say amino acids. That wasn’t the question but just to overeducate people. Amino acids, we’ll like to have those on empty stomach cause they can peak. But hers, I like herbs with meal and a lot of gut killing protocols we do the herbs are suggested with meals.
Dr. Justin Marchegiani: Yes, exactly.
Evan Brand: I think that was different question unless you saw more then we can kinda circle back to the food poisoning thing and then talk about testing real quick and wrap it up.
Dr. Justin Marchegiani: I appreciate Judith’s comment as well. I got a question here from Facebook from Dawn. Dawn hope you’re doing well. What type of protein powder do you recommend for smoothies? So, Dawn, for like autoimmune kinda template, we typically lean more on just plain collagen or just plain P protein. So those are the big ones that will do if we’re just kinda on more autoimmune side, and then typically gotta low sugar berries, ripe berries, blueberries, raspberries, they can be frozen, and then some unsweetened coconut milk tends to be a pretty good shake option. And then in my line,I do the true collagen to the true P and then I have one called the true keto collagen, which is a really good collagen-based smoothie that sweetened with vanilla and cinnamon and that is still autoimmune approved. It got some MCT oil, I added some taurine in there and a couple more amino acids and coconut colostrum. So, that one’s a really good one and it mixes awesome with unsweetened coconut milk.
Evan Brand: Nice, I mean I’ve not had… many people have issues with hemp. Hemp protein. A good organic hemp protein could be okay. Some people don’t like, feel like they digested as well as the P, but I feel okay with hemp.
Dr. Justin Marchegiani: Yeah, I mean if someone’s on autoimmune, I would say no. but if they’ve been able to kinda reintroduce nuts and seeds, and they’re doing good then I think it’s fine. I don’t have a problem with that.
Evan Brand: Okay. So, circling back if you’re ready. Circle back to the conversation, we started about the food poisoning and going put to restaurants and traveling and all that. We talked about kind of preparation kit of having your binders like your charcoal, your soothing gut nutrients, like maybe your aloe, and your glutamine. You mentioned using some of your GI Clear 4 and 5 products with like berberine and anti-microbial herbs like oregano oil and then I would just say doing a once a year testing on your gut system, My daughter just turned 3 over the weekend, and we’ve already done 5 stool tests on her. She’s not even 3 years old yet. But that’s cause she has a lot of issues on het stool. So, she had h. pylori, then we got rid of it. Then had 2 parasites, then we got rid of those. Then she had a bunch of bacterial overgrowth, then we addressed that. Then she had candida, now we’re working on that. So, man it’s been a, it’s been a ringer what she’d gone thru. So, for her, we’re doing more often than once a year for testing, but I would look getting an organic acid urine test we’re on. And we’re often running that through a mycotox screen now where we can look at mold toxins for people, because diarrhea and abdominal pain can be caused by mold, by mycotoxins. So, we’re running that now cause sometimes we find people don’t have gut infections, but they have mold that’s why their body is creating diarrhea cause they’re trying to flush out toxins. So, doing the urine once a year would be a good idea and then doing the stool test, we like to use GI Map stool test. We often use that one. And that’s a DNA-based one where we can look at all the different infections people have. We can look at your inflammation to determine well, is it the infection, is it the inflammation, is it both. How’s your pancreatic enzymes function look. Are you eating and reacting to gluten? How’s that look. How’s your fat digestion look. We can get all those pieces of data. Just really at the end of the day a lot of people have these great questions here. But a lot of questions are… they’re too general, and really you need a clinical data. You need to see the answer… the question, do I need probiotics daily. Well, I don’t know. Why don’t we look at your bacteria flora, and if you’re low across the board, the answer would be yes.
Dr. Justin Marchegiani: One hundred percent. So in general for everyone who’s traveling and has a food poisoning issue or wants to be careful, it could be a food poisoning where food poisoning could mean like there’s just mold in the food, there could be some E. coli in there. Then you upgrade to like infections like h pylori and actual parasites, there could be a little bit longer lasting that aren’t gonna go away at night and then you obviously have food allergens and the inflammation from food allergens. Whether its glute, whether it’s the junkie vegetable oils, MSG, those kinda thing. So, typically the charcoal, the enzymes, the HCL are great for binding up the bad foods and maybe the infections. If you have the issues and they’re acute, you wanna hit the GI Clear 4, GI Clear 5, oil of oregano, Goldenseal, higher dose or berberine. Those things are gonna be great. Higher dose probiotics lactobacillus bifidobacter, enzyme, HCL, activated charcoal with the food at that point. We do not worry about taking charcoal before meals when we are eating questionable foods or when we are sick. We try to bind things up. And prevent excessive diarrhea and such.
Evan Brand: Yeah there was a question earlier about like a shilajit and fulvic acids. I used a product that has charcoal and fulvic acid in it and shilajit as well. And its from Beyond Balance that’s a practitioner company. You need a practitioner to order that. But it’s a product that we use called tox-e bind. And it’s a binder. Very very helpful. So I’m using that personally and have a really good experience with it.
Dr. Justin Marchegiani: Exactly, I love that. Very good. Well,today was a great chat, man. Excellent. If you guys enjoying the podcast, make sure you head over to Evanbrand.com. Evan’s got some great information there. Really good stuff. Justinhealth.com as well to reach out to me. And of course, you can schedule consult with Evan and myself if you want to dive in deeper. And if you’re enjoying these guys, smash the like button, hit the share, hit that bell so you get notifications. We appreciate connecting with you all and we will be back next week. You guys have a phenomenal day, talk soon.
Evan Brand: Take care.
Dr. Justin Marchegiani: Take care, Evan. Bye.
Evan Brand: Bye.
Gut Health and Anxiety | Podcast #227
The good bacteria in our gut are the ones responsible for the chemicals in our brain. Inflammation or anything that can affect your gut especially when it comes to digesting nutrients can cause a big impact on your brain chemicals. But how does really your gut affect or cause anxiety? Find out more!
Today’s episode talks about giving importance to the gut health which is the one responsible for the digestion of our food and vitamins that are needed by our body. One deficiency in the vitamins needed by our body can already affect our brain chemicals, thus creating mood issues and cause anxiety. Listen as Dr. J discusses the topic together with Evan Brand which gives his own personal experience to highlight the importance of gut health. Continue to find out that anxiety is more than just anxiety. Stay tuned.
Dr. Justin Marchegiani
In this episode, we cover:
00:35 Effect of Various Medications, Digestion and Brain Chemicals
08:12 Lab Testing
11:05 Bad Bacterias
12:22 Home and Environment
19:44 Seeing the Whole Picture
16:55 Adrenal Testing
24:48 Thyroid Issues
26:24 Blood Sugar Level Optimization
Evan Brand: Yeah man, me too. So I’ll just start with my personal, and I don’t know if you experience much anxiety. I don’t think you’ve ever really said “Hey, I’ve had anxiety” but I definitely did, when I had gut infections. When I had ___[0:35], when I had parasites, when I had bacterial overgrowth, when I had candida overgrowth and when I had kind of a quadruple ___[0:43] that I really think stemmed from me during a round of antibiotics after I got my wisdom teeth and my 12-year molar extracted, you know I had a round of antibiotics after both of those procedures. I think that’s what led to the candida and then probably started to tore away, uh, tear away my gut barrier and then I ended up getting leaky gut situation. You go swimming Barton springs a few times, you swallow some creek water, you get some parasites down in your gut and then all of a sudden everything falls apart and you’re anxious for no reason. So that was at least my, my story, my unusual experience with anxiety ‘cause I’m not an anxious person by nature, but that made me anxious when I had those gut bugs.
Dr. Justin Marchegiani: Totally makes sense. I mean gut health is so important because all of your nutrients get absorbed through your gut. So, just a kind of review of physiology because we wanna connect the physiology and the biochemistry to why you feel the way you feel. That way you’re not just taking doctor’s orders, you’re understanding how these things are working. So, so we have our stomach, where we chew up our food, we swallow, it goes down our esophagus into our stomach. Digestion starts when the mouth gets chewing so just chewing up our good proteins is gonna be huge. That starts the digestion process and increases the surface area for hydrochloric acid, and enzymes in the stomach. So we increase hydrochloric acid in the stomach that lowers the pH it makes it more acidic, like ‘cause pH is lower. And that activates certain ___[02:07] enzymes in our stomach like ___[02:08] which starts that protein digestion process, that nicely enters, that enters into our small intestine, which then triggers ___[02:16] so we start breaking down the fat, fats are important because vitamin A, D, E, and K have instrumental effects on our physiology. Fats ___[02:25] vitamins especially, uhm, you know vitamin d for example, for instance has some effects at helping with mood as well. And we also know vitamin K, and vitamin A are really important for, uh, thyroid function and we know thyroid can have a major implication on mood as well, so low vitamin A, low thyroid. But in general all of these proteins and amino acids and even these minerals, these tranquilizing minerals, like magnesium, help our body relax. They chill out our heart, they chill out our mood. ___[02:55] amino acids get broken down in our stomach. They get ionized in our stomach and get reabsorbed again our small intestine. So we know that digestive processes are so important for these nutrients getting to where they need be is important so we can feel good.
Evan Brand: Talking to your microphone go close like this.
Dr. Justin Marchegiani: Yeah.
Evan Brand: I’m not sure if that’s – I think you might be using your built in microphone.
Dr. Justin Marchegiani: Oh lemme double check that.
Evan Brand: ‘Cause I sounds a little echoey. Go on, uh, go on your little gear box on Hangouts there, see if you see
Dr. Justin Marchegiani: Oh yep, you’re right. How about now?
Evan Brand: Much – a million times better.
Dr. Justin Marchegiani: Okay, I apologize for that everyone. So we got a better mic up and ready to go, ex-
Evan Brand: We, we still heard you but, now we’ve got that show, that studio quality gone.
Dr. Justin Marchegiani: Love it.
Evan Brand: So here’s the deal. Everything you said makes a perfect sense, assuming, you’re actually digesting and assimilating all these nutrients and breaking everything down like you said. And so where the domino goes bad, I mean for a lot of people, it’s just being prescribed in acid blocking medication. So you may think, well, how in the world does anxiety tie in to me being ___[02:55] or some acid blocker. Uhm, the way Justin described it, it was perfect. You take all these amino acids from your dietary protein, assuming you’re eating those. You know for eating a bagel, and, you know, cream cheese for breakfast, that’s not gonna cut it, you know. We’re eating a good, you know, we’re eating a good quality meat, a bacon, a sausage, you know handful of pecans, uh, half of avocado, you know, some blueberries, that’s a hell of a breakfast. If you’re eating that, you’re gonna beginning some amino acids that can be broken down and therefore turned into, for one, create muscle tissue-
Dr. Justin Marchegiani: ___[02:55]
Evan Brand: Uh, create neurotransmitters. But, if you’re on an acid blocker because you had heartburn and you in one visit with your doctor and they say “Okay you need to be on an acid blocker” you could start that whole domino effect against your health just from something that simple and then you end up with anxiety so then you get referred to your psychiatric doctor and they put you on Xanax and, and, and it’s not a Xanax deficiency, it was the acid blocker messed up our digestion, your digestion issues created the inability for you to absorb your amino acids and make brain chemicals. Now you’re anxious and depressed, so then you get put on anti-depressants. So before you know it in three seconds you’re on an anti-depressants, an anti-anxiety, and on acid blocker. And then maybe you can’t sleep good because just as mentioned you’re breaking down these relaxing things like you’re getting magnesium from your diet. So if you don’t have enough of that, or let’s say you don’t have enough B6 to convert serotonin to melatonin, now you’re not sleeping well so then you get on the fourth med which is a sleep drug. I mean this is how what happens, this is why an average person is on multiple pharmaceuticals.
Dr. Justin Marchegiani: Yeah, and I don’t even think you talked about uh, cholesterol medications on there as well, right?
Evan Brand: No I didn’t.
Dr. Justin Marchegiani: Because cholesterol is gonna be the building block for all your hormones so then you have, maybe your cholesterol’s starting to creep up because of inflammation or you’re doing too much carbohydrate which stimulates insulin, insulin jacks up your cholesterol inflammation will also do it too, so for eating inflammatory foods that could do it. And then now your cholesterol’s high, you’re prescribed to ___[05:58] and then the ___[05:59] gonna decrease your, uhm, ___[06:01] production so now your ___[06:02] lower. Your building blocks for your hormones are lower and we know ___[06:05] have other conitive mood side effects as well so that’s gonna create more issues. And then from there after that you’re on a libido medication like a viagra, uhm, or something like or xalexa to help with ED and that’s create more side effects and more issues and then God forbid you got some mood issues. You go, if you’re a female now, you got top your conventional doctor, their typically gonna recommend birth control pill or even ___[06:33] on top of that, then you’re just screwed. Because stacking one medication on top of another medication and then all these medication have various side effects that you treat with other medications. And then these medications also create nutritional deficiency. So birth control pills will lower Magnesium, Zinc and certain B vitamins which are really important in ethylating ___[06:55] your neuro transmitters so it’s just really important especially Magnesium for calming and relaxing your heart. For helping, let’s say, be the shifter between your sympathetic and parasympathetic nervous system. Meaning, parasympathetic, relaxation. Sympathetic, stress, go, go, go. We need the ability to downshift from sympathetic of stress and go, to the parasympathetic, relaxation and chill out.
Evan Brand: Well let’s add one more drug to the mix, that are hundred, that are hundred million Americans are on which is blood pressure medication.
Dr. Justin Marchegiani: -Right.
Evan Brand: And Valsartan and all these commonly prescribed blood pressure medications are all getting recalled now due to containing carcinogenic chemical, you know. There’s like, this type in Valsartan cancer, you can look the research yourself, and these people get put on blood pressure medication because they can’t regulate their blood pressure because as you mentioned, you lose that parasympathetic-sympathetic balance, you’re depleted in Magnesium because you’re not digesting, because you got gut infections or you’re on acid blocker. So now you’re acid blocker, antianxiety, antidepressant, you’re on like you said, Xalexa, and now you’re on blood pressure, and then you’re on ___[08:01] at all the same time. None of that is gonna, you know, none of that is gonna contribute to a long healthy life.
Dr. Justin Marchegiani: No, none of it will, man. So really important, we’re trying to get to the root underlying cause here. So, let’s shift gears on the lab testing. There are some lab testing we go to see what’s going on. Number one, just looking at your digestion. Just doing a comprehensive gut test, look at inflammation in your gut. Inflammation in our br- inflammation in our gut will create an inflammation in our brain. That activates the cell called microglial cell, which are essentially immune cells in our brain. When they are activated, they will create a, you know, brain fog. So you know, you know obviously that the more foggy you are, the more anxious you could feel as well. So inflammation in the gut could create inflammation in the brain. So we gotta look at gut functions. We wanna look at a comprehensive gut test, that’s gonna assess inflammation in the gut, like ___[08:50]. Wanna look at your IGA, your immune levels, because your immune system is over active, that could be a sucking up a lot of resources, right. So, for instance, the more your immune system is overactive, that’s like the equivalent of you, let’s just say, leaving the water on in one of the guest bedrooms in your house that you never go to. Water builds huge, and you don’t know why, because you’re not using a lot of water but there’s water being used in the background, it’s kinda like that. You have all these immune resources that are being used in the background, cause your immune system is chronically firing off, so your immune function. Next is looking at various candida overgrowth, yeast overgrowth, which have a huge effect because they produce various acid ___[09:32] and toxic byproducts. And they also create chemicals that makes you crave a whole bunch of sugary stuff. So it becomes harder to stay on a good diet to your template. Next would be SIBO or various bacterial overgrowth. Whether it’s ___[09:44 – 09:48]. These are all bacterial overgrowth that are despotic meaning bad, so we have more of the bad stuff and less of the beneficial probiotics like lactobacillus ___[09:55] and then we have various parasitic infections. ___[10:00 – 10:06] various parasitic infections. And ___[10:08] h pylori which is some kind of bacterial infection too, or worms.
Evan Brand: I’ve seen a lot of crypto the last few weeks, it’s very interesting because during the winter I didn’t see much crypto so I don’t know if that’s because people, for their self maybe are like, Texas, Florida, California clients maybe they’re getting back in Creekson rivers or streams or lakes for the season or what. But I haven’t seen much crypto and then over the last three weeks I’ve seen, I don’t know, probably fifteen to twenty people, including children, even as young as age 2 or 3 years old,
Dr. Justin Marchegiani: (Crosstalk.) Wow.
Evan Brand: Those cryptosprodium, I tell you for personal experience it causes a lot of stomach pain, nausea, it can cause appetite swing, or sometimes you sit down at the dinner table you just can’t eat, you’re just not hungry and obviously, anxiety belong with that because now, if you’re getting robbed of your nutrition because of crypto, you’re not gonna be absorbing your amino acids, and then you can’t make your ___[11:01] for example. Now, you’re tired, you’re wired, you’re stressed, and you just don’t know why. So, um, you did a great job on talking about stool test, you mentioned the candida, we, you find candida on the stool test when you and I look at that. However, we often find it more accurately on the organic acids panel because we’re gonna measure the gases that candida produces rather than the actual candida itself. So in the stool, we’re trying to find the DNA of candida which is a little harder to do, so we often see a lot of false negatives on stool testing. So this is why, we just can’t quickly compare or contrast your conventional gastroenterologist that you get referred to. They’re not gonna be running these type of tests, maybe on ten or twenty years, that could be the whole standard, for right now they’re not running these tests. So even if they did they called it “stool test”, their stool test could not be probably as intensive as the technology we are using because we are kinda on the bleeding edge here. So that being said, the organic acids’ profile, we’’l look at the gacids. And when we look at the gacids, you can also look at the other fungus too, so we can even look at the things in their environment like mold, because on page 1, of the ___[12:05] there’s different markers that hide in candida but there’s also different markers that we’ve found that indicate ___[12:11] of mold. So you could have mold in your sinus cavity as so close to your brain it can go to the blood brain barrier and that will cause anxiety too. So now we’re talking about, fixing someone’s sinus infection as well as fixing their gut infection, and fixing their home environment. Their home environment because potentially as we’ve seen people like in Florida had one client who shits too much candida in their house. We did this little petri dishes for her house, she shits so much candida in her house, so much anxiety and we fixed her gut and three months later she’s got a white tongue again. The candida comes back and so we give her herbs again, her gut gets better, and then candida comes back. Say we need to test your house, so we test her house, the candida in her house is off the chart. So now what we did is we did the fogger, we fogged her house with the essential oils and the candida in the house is gone. So now she’s staying free and clear of the candida overgrowth. So, this is why you gotta take a step than even the functional medicine people saying “fix the gut, fix the gut, fix the gut” now you gotta fix the home, microbio home as well as well as your internal microbio home. You can’t just cherry pick.
Dr. Justin Marchegiani: Yeah, and for every person this may not be the root issue but it’s important. Yeah especially if we can do history and you feel bad or coming out of the house or we can even just start with a decent play testing. And even from the ___[13:26] micro toxin collection after that and if we can see, we can put a check in each one of those boxes ___[13:34] confidence that what we have to start dealing with the home environment right?
Evan Brand: Yeah, exactly yes. The home, you know, like, like you said it’s not everyone. Like, I’m kinda over paranoid about the issue now so I’m checking some of the houses. But I’m only finding maybe 20% of the people were testing their home or showing up with the problem. There’s a lot of people coming out, their home is perfectly fine and I just say you know what for a hundred fifty bucks US it’s worth the peace of mind. Work the plates, check your numbers, and worst case scenario I’m wrong and your home is not contributing to your anxiety or other health problems.
Dr. Justin Marchegiani: I hundred percent agree, and also uhm, one of the things that you brought to my attention is very interesting is that you may have no history of water damage or no apparent water damage in your house at all but you may just have a high amount of moisture in your house because of the climate you live in, and one of the things that you did was you invested in a good quality dehumidifier attached to your ___[14:29] to pull the humidity out of the air. Which then makes harder for mold to grow because mold needs that humidity over fifty percent in the house for it to grow so you were able to decrease the humidity because there’s certain times where you may not have an air-conditioner on. Uhm because you know it’s, it’s sixty or seventy degrees out or fifty degrees out but the humidity still high even though the temperature’s low and that’s one of the benefits that you have of having a cool house to humidifier attached to your ___[14:56] to suck out that moisture which prevents the fuel source for this mold to grow.
Evan Brand: Right, and in the spring you’d love to have the windows open right so actually we did this over the weekend, we opened up all the windows. There was one day we have like seventy, seventy-two degrees out so it’s perfect. We opened all the windows up but then I go downstairs and I heard the dehumidifier’s running just in overtime and I go look at the percentage and their up to fifty two percent. So people they opened up their window and mold grows on fifty or above. When you’re like oh, the weather’s beautiful, let’s leave the window’s open for a week straight, you know, or let’s leave the windows open all night or let’s leave the windows open every day all day. That’s allowing all that moist air from outside, assuming that’s the climate’s moist, to come inside, and that’s increasing the humidity in the home. I love the idea, you know, open the windows, ten to fifteen minutes a day, let fresh air come in, wash out from all the ___[15:46], wash out from all the VOCs in your home, but, you don’t wanna do it all the time. A friend of mine, a mutual friend of our’s, Daniel Vitalessi, who lives up in Maine, it’s so moist up there. Uh, I can’t, I don’t remember the full details but I remember him saying about having a mold problem on his previous houses, and it might consider at the podcast, he left his windows open all the time. ‘Cause he like to live in the woods, and he love the sounds of nature and all that so he had his windows open all the time. But I mean all that moisture was just forming on his window sills and so you gotta, you gotta think about the building materials that we’re using. Like our ancestors they were outside all the time, you know, but they had like a buffalo hide, they had bison hide, you know, they didn’t have dry wall, and uh, you know, treated wood and all those sort of stuff. They didn’t have the same building materials that we used today. So, try to compare, “Oh my grandma she lived in the summer and she have air conditioning and her windows are open all the time,” yeah, but her house wasn’t probably made with modern dry wall. So those materials could withstand moisture, our modern day materials are more moisture sensitive.
Dr. Justin Marchegiani: Exactly. Yup, hundred-
Evan Brand: It’s a bit of a tangible. Let’s go back to the testing. So, we didn’t talk about adrenal testing for anxiety, I mean that was one of my problems too is, uh, I would feel pretty good during the day but then at night I would feel anxious before I would go to bed, and I have that night time spike of cortisol that we often see.
Dr. Justin Marchegiani: Yeah, so what we do is we look at the cortisol rhythm throughout the day and then the cortisol rhythm gives you a window to how your cortisol, how the outer part of your adrenal glands are doing. So we look at this high to low to lower to lowest type of taper. These tapers are important because it’s set by our HPA access. So we start to see these regulations lower by the morning or higher at night or it’s kind of bouncing around like we call the pinball effect. It’s pinballing that could create mood issues number one. Number two, we also look at the inner part of the adrenal glands called the medulla which make a lot of adrenaline. Adrenaline or no adrenaline, same thing as epinephrine and norepinephrine, medicine uses a lot of words to say the same thing. So, we’d also wanna look at that, ‘cause if we’re really stimulating a lot of adrenaline or no adrenaline that’s helpful to know so we’d wanna run a good cortisol rhythm test to look at free and total cortisol which is great. We’d also wanna look at some of the uh, amino acid metabolizer or some of these neurotransmitters. Like, we’d look at vanilmandelate to get a window at adrenaline metabolism. We’d look at homovanillate to get a window to dopamine metabolism. And also you’d wanna get a window into B6 because B6, especially at folate and B12 are really important for methylation. And a lot of these brain chemicals like epinephrine and adrenaline, ___[18:28] they need to get methylated. So we, we need these carbon hydrogens to bind it to methylated, to activate it and that requires sulphur amino acids so if we’re excessively stressed or really methylating our brain chemicals ‘sause we’re making a lot of adrenaline, we’re gonna be burying under a lot of sulphur amino acids as well. And we need sulphur amino acids also to detoxify, we may not have a lot of extra sulphur left over to run ___[18:58] we may not have enough of these sulphur compounds to run these other accessory pathways which are really important for what? Detoxifying us from mold, heavy metals, various organic chlorine, pesticides, or stressors in the environment so that’s why it’s really important to look at these other accessory nutrients that are involved in the stress handling response.
Evan Brand: Yeah, let’s take what you said. Let’s dig further. So now you’re deficient in sulphur, you’re not detoxifying properly. You do get exposed to pesticides, go out to a restaurant with your family on a weekend and have a good dinner knowingly eating pesticide and that’s gonna kill off good bacteria in your gut. Those good bacteria are supposed to make your brain chemicals so now we go back all the way to anxiety again. So it is this kinda self-repeating cycle. So this why you can’t just focus on one aspect of your body. You can’t just put all your eggs on the gut basket, all your eggs on the adrenal basket. This is why Justin and I don’t really say, you know, you know, word expert at adrenals, word expert at gut, or word expert at this or that, because if you go in with the microscope and you’re just looking with this one problem, like you could see the thyroid, and see that there’s a problem with the thyroid, that could cause anxiety too, right? Like if you have Hashimoto’s you’ve got antibodies that attack the thyroid and you get a little bit of hormone into the bloodstream that could cause anxiety for sure.
Dr. Justin Marchegiani: (Cross-talking.) Yeah.
Evan Brand: I mean we didn’t talk about that extensively. However, if we just focus on thyroid, okay we’ll gonna give you ___[20:24] or something else to calm the thyroid, did we fix the problem why the thyroid is auto immune in the first place. We fixed the immune system attacking the thyroid by looking at adrenals, and gut and chemicals, all that. Or we just give someone herb to calm the thyroid and that was all we did.
Dr. Justin Marchegiani: (Cross-talking.) Right.
Evan Brand: Because if we did just that, then we fail.
Dr. Justin Marchegiani: Correct, and I’m seeing this more and more with various functional medicine doctors that are out there. What I’m seeing there are people, just the thyroid functional person, just the gut functional person. There’s nothing wrong with that marketing stampone, and like I’m gonna market to those people but I’m gonna look at everything once they’re in there, I get that. That’s kinda where my focus is. You wanna reach out the people so they ___[21:06] with you but you’re still looking at the whole thing. I’m seeing people, I’m seeing people only focusing on just the thyroid. Or only focused on just the gut. And then I’m looking at their labs, I’m seeing these people coming to me as patients and I’m like, oh its’-it’s really too bad because had an anemia and anemia was missed because this person was only focused on the thyroid or hey, this person had an adrenal issue or other issues going on and they were only focused on the gut, they didn’t fix those other things. Does that make sense?
Evan Brand: (Cross-talking.) It does.
Dr. Justin Marchegiani: So just be careful. A lot of people out there are focused on, you know they’re focused on, they’re reaching to functional medicine practitioners that are marketing one thing and another for their anxiety but they may be missing in the treatment a whole body system that’s so important. So, when people are out there looking for functional medicine doctors, you know, if you find someone that you like that’s great, just make sure when you interview them, when you talk to them make sure they’re gonna be looking at all the underlying systems, not just focused on one system like the gut or one system like just the adrenals. Make sure you’re looking at the whole thing.
Evan Brand: Yeah, I think over the next five to ten years this is gonna be a bigger problem just because of the Internet. The Internet allows us do what we do, and we are very grateful for the opportunity. But that also allows other people to go pick up some high profile credential and then market a specific flavour of functional medicine. Like, I’m gonna be the hormone girl, and I had a woman last week and she went to this hormone functional medicine specialist and the lady’s loosing hair, in clumps and clumps and clumps every time she takes a shower, and we look at her blood work, and she’s never been – she goes to this hormone lady, I don’t know how, a hormone functional medicine never tested her, never tested her blood, didn’t look at her ferritin, ferritin level was a six. The lady can hardly catch her breath, she’s got major anxiety, she’s losing tons of hair. Like, look at your ferritin, like, if you don’t fix that, you’re not gonna get your hair back no matter what this lady tells you about your bio identical hormone plant. So, it’s just that, it’s – I think it just comes with the territory of this because as you say people are trying to market, but you gotta make sure that they’re turning over all the rocks.
Dr. Justin Marchegiani: (Cross-talking.) Yes.
Evan Brand: ‘Cause last thing you wanted to do is go spink like two to three thousand dollars and then now you gotta start all over because you didn’t address the other stuff.
Dr. Justin Marchegiani: You want the complete picture. Let’s connect this with some other things. Obviously we have female hormone issues like progesterone, low oestrogen or oestrogen dominance if you’re a cycling female. Obviously we have the menopausal kinda side where the hormones could just be low across the board, and we’re starting to have a lot of menopausal symptoms, from low progesterone, low oestrogen, because now our follicles, our ovarian follicles are used up. And then we have obviously on the cycling side, where we’re having a lot of PMS, a lot oestrogen dominance and we have lower progesterone, and that could be another component because progesterone is a GABA Chloride channel opener. So it opens those GABA Chloride channel in the brain, and allows us to relax. A lot of people could have a lower progesterone, oestrogen dominance, or just lower hormones across the board if you’re on the menopausal side. And the crazy thing is, we can also have similar symptoms if our thyroid is also low. This is why it’s so important to why you cannot just, just create a market and for one thing but it’s really important that you look at the whole component to make sure, other patients were hey, thyroid was the missing key to their anxiety, some it was low progesterone, some it was a combination of the two. And unless you’re treating and looking at it, and also treating it, then you know, you’ll know from you know, from experience what levers is moving what.
Evan Brand: Yeah, and I briefly hit on the Hashimoto’s, I think we should talk about it for a second because this is such a common issue. We’re seeing women with all sorts of different levels of thyroid antibodies. From the tens to the hundreds to the thousands. When the immune system is going after the thyroid, the first thought is, well, we’ve gotta calm down the immune system, we’d better try to stop this attack on the thyroid, but really, it’s fine at the first thought, but really what we’re seeing is we have to be addressing the other causes, if you give someone like a thyroid multivitamin, like it’s got your Selenium, and your Chronium, and and ___[25:18] and all those stuff. That’s good on a theory but you could stay on a thyroid multivitamin for five years and still never get to the root cause.
Dr. Justin Marchegiani: Absolutely. All the thing that I would think is at the low hanging fruit perspective ___[25:30]. So of course gluten sensitivity can create GAD antiobodies and GAD is glutamate, uh, glutamate decarboxylase enzyme which is the enzyme that helps make, uh, uh, helps make GABA in the brain and GABA is that nice inhibitory relaxation chemical, so GABA’s important, gluten’s a strong component in that ___[25:50] response. But also gluten can drive, uhm, Hashimoto’s and that you will see increase in thyroid peroxidase and thyroglobulin antibodies. And these antibodies are gonna stimulate attack on the thyroid, attack the thyroid, and you may spill out hormone and as that hormone spills out to rev up the metabolism create swings of anxiety there as well.
Evan Brand: Have you ever experienced that, I mean you talked about your story with Hashimoto’s. have you ever had a day or a week or a time in your life where maybe a stress or, you know, uh, when you first had your son you’ve had like high in stress did you ever feel like “Oh my God” like “My Hashimoto’s is kicking in” did you feel that or-
Dr. Justin Marchegiani: I definitely had episodes where I felt like blood sugar fluctuations and that cortisol adrenaline blood sugar swing ___[26:39] issues in the past and I feel that potentially previous gluten exposures have potentially revved up the thyroid and had created some of those symptoms as well. Yeah I have in the past for sure. I tried to medicate that as soona s possible-
Evan Brand: Yeah, but it’s not fun the blood sugar piece you implied you hit them. Let’s, let’s – I know we hit that kind on Anxiety Part One, but with the blood sugar, you know in terms of testing, right? We talked about hormones; we talked about gut, organic acids, etcetera… Blood sugar testing, how simple and easy is that? If you’re feeling anxious, I mean I had a time where I had impending doom. I thought my god, the world’s gonna end, something bad is about to happen. I don’t know what it is, I checked my blood sugar, it was a fifty nine.
Dr. Justin Marchegiani: (Cross talking.) Yeah, yeah.
Evan Brand: I mean, whoa.
Dr. Justin Marchegiani: I know, I know. That’s gonna be an issue because low blood sugar will drive a lot of cortisol adrenaline to pick it up. Now again if you’re fully ___[27:30] adapted that’s better because you have a lot more ketones there but I still think, uhm, even when you’re blood sugar’s that low could definitely create some issues for sure.
Evan Brand: Yeah, so if you have anxiety, I mean, don’t automatically think oh it’s Hashimoto’s, it may might not be. It could be something simple like low blood sugar or high blood pressure. You know when I was having some blood pressure swings, I noticed when the pressure was high, a side effect of that increased blood pressure, was anxiety. So do you take anti-anxiety herbs or do you think blood pressure herbs? For me, it was a combination of both. I took, like, inhibitory things to support GABA, you know ___[28:09] etcetera and I also did some hawthorn berry and some folate and some other things to help blood pressure. I kinda worked on both. That’s why really, people, you know, email us and say “Oh doctor J can you just give me a protocol for my Hashimoto’s?” It’s like, do you see how bad of a question that is? It’s like we have no idea what the heck is going on. Or can you just give me “Doctor J give me a parasite protocol” We have no idea what’s going on. Like, give me an anxiety protocol. You can’t do that because what’s the mechanism? What is the mechanism behind it? So, you know, in the long run you’re gonna spend so much more money knowing the whole foods or in Amazon buying this anxiety supplement bust, you know, stress busting supplement. Like, might help, probably won’t hurt, but, get the testing done. Get the data, get the rocks turned over. I can’t tell you how much time I wasted just taking this random herb for energy, random herb for sleep. And I had no idea what I was up against.
Dr. Justin Marchegiani: Hundred percent. Well, excellent thoughts here today. I think we laid some, some good references for various mechanisms. How we can go down this path and of course how the gut is intimately connected. And I talked about the auto immune mechanism a minute ago, just kinda gonna dovetail on that because today’s podcast is on gut health and anxiety. A lot of that mechanism happens and works because of gut prebio ability. So with leaky gut and gut prebio ability have that mechanism where we have that undigested, whether it’s yeast or bacteria or foods include in our casein compounds get into that bloodstream through the gut lining right. We have our tight junctions, they open up especially with exposure to gluten and casein and potentially other endo toxins and fungus metabolites. They’re gonna open up these things get into our bloodstream and then our immune system is now exposed to it or these things now exposed to our immune system and can really heighten that auto immune system response now. And then that’s part of what’s going on here. So auto immunity is a big issue especially if someone’s anxiety is connected to a thyroid issue, there’s a good chance that thyroid issue is auto immunity nature, and then acts the part of it.
Evan Brand: Yeah. How simple of a thought. Like your, your dinner at the pasta restaurant could be driving your anxiety in your auto immune condition. Well it’s very well possible.
Dr. Justin Marchegiani: Well, excellent. Today’s a phenomenal podcast. To everyone listening if you wanna dive deeper with Evan head over evanbrand.com you can schedule a consult with Evan. If you wanna dive deeper with myself justinhealth.com click the arrow we can schedule a consult and dive in deeper. Yeah some of the labs we talked about today we’ll put links down beneath the podcast. You can access some of these labs, uhm, some of the gut tests are really important. Some of the adrenal tests, some of the neurotransmitter metabolite tests we’ll make sure we have links down below as well. Evan, any other questions, comments or concerns?
Evan Brand: I would just say don’t give up if you do need some type of anti-anxiety medication or something prescribed temporarily while you’re working on the root cause. I’m not judging you for that, neither is Doctor J. The point is we want you to get to the root of this and we see so many people that they wanna get off their pharmaceutical medications and they don’t know how. This is your road map to do so keep your head up, keep focusing on “What else have I not done yet? What other rock do I need to turn over My blood test, and my doctor said I’m fine.” Well there blood test probably sucked, get a better blood test, figure out what the heck is going on.
Dr. Justin Marchegiani: Exactly. You guys liked the show here put some comments down below. I love to hear what you think, like to get suggestions on future episodes. Give us a thumbs up or might share as well. Really appreciate it. Evan, today was great man, we’ll be in touch and we’ll talk this week. Take care everyone here. Bye bye.
Evan Brand: Bye bye.
Clostridium Difficile and Leaky Gut – Podcast #174
In this video, let’s join Dr. Justin Marchegiani and Evan Brand as they talk about the link between Clostridium
Watch this video as the two functional medicine experts share their thoughts on how this disease can affect your health and what you can do about it.
Dr. Justin Marchegiani
In this episode, we cover:
01:50 Biggest Risk Factor of CDI: Accumulative Antibiotic Exposure
05:32 Mood Issues Equals Gut Issues
07:47 The 6R Protocol
15:23 Fecal Transplant is an Experimental and a Palliative Therapy
21:10 Top Symptoms of Clostridium
Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here with Evan Brand. Evan, how are we doing today, man? Happy Monday.
Evan Brand: Happy Monday to you, the best day of the week. Uh– We’ve got a short limited time but we wanted to dive in and chat about gut infections and how this can affect mental health. We test everyone’s gut. We run a stool test on everyone, organic acids testing on everyone, or nearly everyone as much as possible, because there’s a lot of different markers that conventional doctors are never going to test. Therefore, you’re never gonna know what’s going on unless you can get these specific functional medicine testing run. And, one thing that we see a lot of is Clostridia. And- So, you and I
Dr. Justin Marchegiani: In one of the biggest things that
Evan Brand: That’s crazy. Well, let’s chat about the brain a bit. So, there’s a lot of complicated uh– neurochemistry involved and we’ll keep it as simple as possible. If you just Google for yourself, Clostridia brain chemistry or Clostridia HPHPA, this is something that you can find– this picture. And what happens is normally, your neurotransmitters, like Tyrosine, are supposed to get converted into Dopa then into Dopamine. But what happens is, when we pull up your stool test and your organic acids, if we see that you’ve got elevated HPHPA– That’s organic acid that will show high on an OAT Test, a urine test. If you have this bacterial infection, what happens is, your Tyrosine doesn’t get converted into the Dopamine like it’s supposed to because there’s an enzyme. And Justin, maybe you can clear this up
Dr. Justin Marchegiani: Well, yeah. I mean, if you look at the–
Evan Brand: Yep. So, if you’ve got mood issues, a lot of times, you’re gonna have gut issues at the same time. When I had parasites, I had H.pylori, I had bacterial overgrowth. I didn’t have C. diff., luckily, but I had other species. My moods were– were not good. And even though, I’d done the Paleo diet for a long time, 80 percent of symptoms were better, but I didn’t get that final 20 percent symptom improvement until I fixed the gut. And Clostridia’s just
Dr. Justin Marchegiani: Well, again, the GI Map Testing that we use, we also look at C. diff., the toxin A and the toxin B. These are various toxins produced by these critters, and if you have both of them, A and B, the– You know, that’s gonna be– means you have uh– a more virulent infection. You need to get treatment A.S.A.P. for that. But you may just have one toxin over the other, A versus B, or B versus A. So, that can give us a pretty good window what’s happening. And, you know, we have the Clostridium
Evan Brand: Yep. Yep. Well said. Let’s chat about protection a little bit. I mean, let’s say that you have to go visit a friend or a family member in a nursing home or a hospital, what could you do to maybe prevent yourself from picking this up? Because this Clostridia can be airborne
Dr. Justin Marchegiani: Well, number one,
Evan Brand: Oh, gross.
Dr. Justin Marchegiani: …of course, keeping the toilet seat close–
Evan Brand: You know what’s crazy?
Dr. Justin Marchegiani: …I–
Evan Brand: The most of the public bathrooms, they don’t have lids on their toilet seats. So you just think of all these hundreds of people going in a public bathroom. There’s usually not a toilet seat. They flush it. That stuff’s going everywhere. Have you seen those studies where they’ve used like– I don’t know if it was a thermal imaging camera or like a UV Camera or a blacklight, and they can see like
Dr. Justin Marchegiani: [sigh] I’ve not seen that. I think it’s got to be getting better
Evan Brand: Yeah.
Dr. Justin Marchegiani: So, there is that benefit, right? As soon as someone gets off the seat, it flushes within a few seconds.
Evan Brand: True.
Dr. Justin Marchegiani: That– That’s better than someone just letting it sit there for a long period of time. Of course, you know, physical contamination is gonna be the big one. So, just touching stuff and not washing your hands– I think it’s good to have one of
Evan Brand: Yeah.
Dr. Justin Marchegiani: essential oil kind of rub you can get to spray or the gel. So I think it’s good like, once you’re out, like just kind of do that. You know, use a little bit of that gel or that spray as well. Just because, now you’re out. You haven’t touch anything, and that gives you a good chance of knocking that stuff down. So, I’ve no problem with that. That’s gonna help significantly.
Evan Brand: Yeah.
Dr. Justin Marchegiani: …wants that component dialed in.
Evan Brand: Yeah. Good advice. ‘Cause if you’ve got it on your hands and maybe you scratch your nose or you touch your face or something, and then you’ve
Dr. Justin Marchegiani: Exactly. And of course, just having a stronger immune system, right? A lot of these things happen when
Evan Brand: Yeah. Well said. So, if you’re on an acid blocker, this conversation should perk your ears up a little bit. Pay attention ‘cause you’re at a higher risk for these infections. We see it every single week between us both. We’ve seen thousands and thousands of gut bugs. So, uh– acid blockers or uh– also birth control pills, too. We know that can affect the gut microbiome a bit. And also,
Dr. Justin Marchegiani: One hundred percent, and just stay out of hospitals. Really, just stay out of, you know, conventional hospitals. I mean, if you have
Evan Brand: Yeah. I mean, my wife
Dr. Justin Marchegiani: Oh, totally. And, if someone’s in the hospital ‘cause of some, you know, severe reasons, right? Of course, you want to go, right?
Evan Brand: Yeah.
Dr. Justin Marchegiani: But if it’s like a severe life and death kind of thing, you know, try to utilize Face– FaceTime or Skype in your smartphone. That’s a good way of connecting ‘cause that– The biggest thing is being in hospitals and getting an antibiotic exposure. And guess what– yes, to the people that get the most antibiotic exposure are who? Right? They’re in hospitals.
Evan Brand: Oh, yeah. Yeah, rational.
Dr. Justin Marchegiani: These are people that are sick and they’re coming
Evan Brand: I know, IV is, too. [crosstalk] IV antibiotics. I mean, that’s just. I can’t believe how often that’s dispensed and distributed. It’s kind of scary.
Dr. Justin Marchegiani: A hundred percent. So, in general, like, we look at this from a functional medicine perspective. We can kind of like, zoom in on one type of thing here, which is C. diff., but when we were looking at things, we’re looking at the whole picture. So, C. diff. may be a part of your clinical picture if you have diarrhea or digestive issues or have leaky gut. So, maybe saying is C. diff an issue? It may be. But it may also be a combination of C. diff., H. pylori, and Blastocystis
Evan Brand: Great.
Dr. Justin Marchegiani: So, they’re just gonna keep that, you know, in the back of your head. A lot of these issues aren’t binary.
Evan Brand: Yep.
Dr. Justin Marchegiani: And, there’s toxicity and inflammation in the gut, your colon and your intestine’s soaked up a lot of water. Why? It’s doing it to dilute the– the infectious debris so it can flush it out. It’s diluting it and then flushing it out. But, what also is diluted and flushed out is also gonna be all of these micronutrients that are in your intestines that may not have enough time to assimilate, as– absorb and be utilized yet.
Evan Brand: Yep. well said. And then, we’ll give a mention here to fecal transplant. I mean, this is still kind of an ex– uh–
Dr. Justin Marchegiani: Yeah. Uhmhm–
Evan Brand: Because I’m seeing people that are getting fecal transplants, and there is cool literature that after one, if not two, maybe three of the most fecal transplants, where you’re taking stool from a donor
Dr. Justin Marchegiani: Yeah. And again, when you do a fecal implant, you know, it– it’s gonna have effects that aren’t gonna be, potentially forever. Because z– when you put bacteria in your gut, it tends to be more transient and pass through.
Evan Brand: Okay.
Dr. Justin Marchegiani: You know, that kind of a microbiome that you have in the beginning is kind of what you have. You can influence it and
Evan Brand: Yeah.
Dr. Justin Marchegiani: So, if I’m seeing
Evan Brand: So– [crosstalk] yeah.
Dr. Justin Marchegiani: It’s not quite fixing the root cause better than antibiotics, in my opinion. So, we’ll have to just keep an eye in, and see how these things are– are looking in the literature. It’s the same thing with a lot of these docs that are using the helminth or worm therapy. Right? Uhm– They’re using and stuff to kind of modulate the immune system. I see a lot of that as being palliative, right? If not, we’d see people in third world countries that have lots of parasitic infections and worms, you know, have super robust health, right? Obviously, there are also malnourished and have
Evan Brand: Agree.
Dr. Justin Marchegiani: I just that– For me, I just have a hard time wrapping my head around it. I think it can push the immune system in one way or the other. And
Evan Brand: Advil.
Dr. Justin Marchegiani: Magnesium, curcumin, right? Well,
Dr. Justin Marchegiani:
Evan Brand: Yep.
Dr. Justin Marchegiani: So, I look at like palliative and then what’s the
Evan Brand: Yep. Well said. Well said. Uh– I think we could probably make this conversation longer, but since we’re out of time today, I think that was efficient. You’ve got to get the diet dialed-in. When we’re talking to you guys, we’re always assuming you’re following something like a Paleo template, organic pasture-raised meats, organic veggies, high-quality berries, maybe some nuts and seeds, if you’re not on an AIP diet and you can tolerate those, you’re getting to bed on time, you’re getting out with the Sun, you’re getting exercise, adequate hydration, no sodas, no– you know– fake fructose in the diet, you’re not skipping meals, you’re getting your adrenals checked out, you’re thyroid, and then you’re jumping into this conversation. So, that’s all the prerequisites required to– to have on-board before you really start diving
Dr. Justin Marchegiani: Absolutely. And just
Evan Brand: I think that’s it. Get yourself tested.
Dr. Justin Marchegiani: Absolutely. And then, anyone that’s asking questions here, try to keep it on topic. If you’re going off the deep and talking about things that we’re not chatting about, save that for my daily FAQs,
Evan Brand: Take care. Bye.
Dr. Justin Marchegiani: Have a great Monday. Bye.