Hack Your Alcohol Consumption and Avoid Hangovers | Podcast #300

Whether it’s a few glasses of wine with friends, beer over sports, or a fun night out, there’s ways you can enjoy drinking yet mitigate the health consequences and skip the hangover. What are some of the consequences of drinking too much alcohol? Gut damage, issues with blood sugar levels and gut permeability, candida overgrowth, adrenal stress, and more. The big stressors of a hangover is the acetaldehyde made from the alcohol and getting the body to process it into acetic acid. The enzyme responsible for this conversion is glutathione-based, so glutathione can help clear alcohol out of your system faster, think: N-acetylcysteine (NaC), liposomal glutathione, vitamin C, milk thistle. Since these help the catalase enzyme to clear the alcohol out of your body faster, it’ll also be better for your liver. These are the kind of tips and tricks Dr. J is dishing out (and more!) today and we’re pretty sure you’ll be using them to help avoid future hangovers. Drink responsibly and be safe!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:46      What is alcohol?

6:03      Alcohol Metabolism

15:18    Alcohol Poisoning

21:33    Blue Zones, Good and Bad choices for Alcohol

35:06   Alcohol Cravings

41:03    Different Types of Alcohol

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Today we’re going to be talking about how to hack your alcohol consumption. Again, people are out there, they’re gonna want to have a little bit of alcohol now and then maybe at the end of the week, maybe to kind of signify like, Hey, you know, the weeks over whatever it is, you’re relaxing, it’s summer, it’s fall, how can we do it in a way that’s one not gonna damage your body. But two, we can also hack the hangover, so we can do it responsibly and mitigate some of the health consequences. All right, Evan, what’s going on man? How are we doing? 

Evan Brand: All doing really well excited to dive into this thing with you read a quick article from USA today that said that since all the shutdown stuff happened, that alcohol sales, does that contribute to consumption as well? I’m sure it does. It didn’t say alcohol. Yeah. So said alcohol sales are up 27%. And this was since June. So that’s a big bump in alcohol sales and people are stressed out and I mean, you and I are working with clients. Everyday, all day people that have been laid off or furloughed or lost jobs or kids can’t go back to school or whatever else is going on with them. And so what are people going to do when they’re stressed? Well, hopefully they go meditate and go to the park, but they’re probably going to have extra alcohol too. And so we don’t want people to make themselves sick. We don’t want hangovers. We don’t want gut damage. We don’t want increased issues with blood sugar. We don’t want increased issues with gut permeability. We don’t want candida overgrowth, we don’t want all those things to happen. We don’t want adrenal stress and sleep issues that then affect energy and motivation and, and productivity. So, you know, alcohol can affect all of the body systems because of the impact on potentially blood sugar and adrenals and gut and all of it and so I think there is a way to do it smartly, which is what we’re going to dive into today. 

Dr. Justin Marchegiani: 100%. So, everyone talks about alcohol being a toxin, right? Well, alcohol essentially, is ethyl alcohol, and your liver has to metabolize that and break it down. So the metabolism goes like this. Alcohol, ethyl alcohol, methyl alcohol, that’s like a toxin, right? ethyl alcohol is the alcohol that we consume. That gets converted into acid aldehyde. And this enzyme here, right, this whole enzyme, it goes alcohol to acid aldehyde. And this is what alcohol dehydrogenase two right here, from alcohol to acid, aldehyde. And an acid aldehyde gets converted to a C to gas, which is basically apple cider vinegar. Okay, now acid aldehyde is the same compound that fungus or Candida actually produces. And that’s why Candida can actually make you feel a little bit drunk. Really, the big stressor. The big hangover stressor, is this acid aldehyde. Usually the body’s pretty efficient at taking alcohol and clearing it to acid out behind. It’s the acid aldehyde process that really has to go from acid aldehyde to Apple, the acetyl acetic acid right here, and we talked about this earlier. I think it was Asian descent right. Asian descent has a very, they they’re really efficient at taking alcohol and going to acid aldehyde. But they have a hard time of going acid aldehyde acetic acid. So this acid aldehyde increases, increases. And this acid aldehyde has a, let’s say histamine like effect. So high amounts of acid aldehyde can really increase that flushing kind of feeling. And so, a lot of people use the medication called Pepcid AC, which is that which is an h2 blocker. h2 blockers are an anti histamine. And what that does is anti histamines take the alcohol to acid out the high conversion they slow it down. So Asians they’re so fast at it, they increase their acid aldehyde like this acid aldehyde goes up. And so what they’re doing is they’re taking a h2 blocker to slow down the alcohol to acid aldehyde conversion again, it may help with the facial flushing and the histamine but not good on the liver because it’s creating more more that more of the alcohol is summer is basically surrounded That liver so your liver has to deal with the alcohol longer. It’s like you’re clogging up the coffee filter and it’s taking way longer to filter that out. Yep, you’re saying acid aldehyde. I think how you pronounce I think how you pronounce it is a sido. Allah cetyl alcohol. Yeah, I’ve always pronounced that as an aldehyde. I think someone where I learned about 10 years ago, they said it that way. I’ve heard it both ways. But yeah, a cetyl alcohol acetal aldehyde. So that’s going to be how it’s spelled. 

Evan Brand: Yeah, it’s a big word. And you mentioned the issue with fungal overgrowth. And we’ve seen that a lot with people. Now when we’re talking about brain fog you and I’ve done so many podcasts on cognitive function issues, brain fog, anxiety, depression, those kinds of things. So if you’re somebody who has a Candida problem, maybe we should briefly go into this. This is you if you have a Candida problem. You’re probably not a good candidate for it. Now, could you get away with a little bit here and there, maybe so but if I have clients where we see that they’ve got major brands, Fogg, they have cognitive problems, they have memory problems, they go into a room and they forget why they’re in there, they lose their keys all the time, that kind of thing. And they show up with Candida on their labs, I’m going to tell them, hey, best case scenario, the question always comes up. And what about alcohol? I say, based on what’s going on, probably wise to stay away from it for a month or two while we get your gutter under control. And then let’s add it back in later, and you know, at a small amount and see how you do so I think there are some cases where you know, you and I work with quite a lot of people that are that are quite sick, and they don’t feel very well. So in those cases, we may try to say, hey, you can hack it like we’re going to talk about today. Or maybe just stay away, let’s let’s get your gut in better shape, let’s get your liver in better shape, especially if there’s a big mold problem. I’m gonna say, Man, your liver already needs help and, or if we test their chemical profile, we see they got a ton of pesticide herbicide. It’s like, ah, I really don’t want to add any more toxins to the bucket. So I personally try to stray people away from it, but at a certain point, you know that people want to live their life and have fun and that’s one of the ways people live. in society have fun. So then we go into the hex. 

Dr. Justin Marchegiani: Exactly. So just kind of talking about the alcohol metabolism one more time, right? We have ethanol, that’s our alcohol that goes to a seal out acetaldehyde acid aldehyde. Right? This the enzyme that’s responsible for that conversion, guess what it is? It’s catalysts. And catalyst is a glutathione dependent enzyme. So having good glue ion function helps you go alcohol ethanol, to acetyl aldehyde. That’s glue to fire independent as catalysts and then acetyl aldehyde to acetic acid or acetate, right? That’s going to be your apple cider vinegar. This is alcohol dehydrogenase to ALDH2. Okay, and so this is the enzyme A lot of people have a hard time with the Asians, they have a hard time clearing that and so the acid aldehyde goes up really high. So big things I want to highlight here, we’ll talk about it in the strategy standpoint. glutathione is good because glutathione clears the alcohol out of your system fast. So things like n acetylcysteine liposomal glutathione s acetyl glutathione, vitamin C, milk thistle, things that help increase catalyze clear the alcohol out of your body faster, that’s less stress on the liver. But then now we have this acetal aldehyde thing that has to happen next. And so typically, I’m going to I’m going to guarantee that a ldh is going to be supported and boosted via glutathione. And a lot of those nutrients some way shape or form. So I’ll try to pull that up here as well on the enzyme standpoint. Any comments on that? 

Evan Brand: Yeah, I think milk thistle is something that’s pretty cool too. I don’t have any papers that are just specifically milk those by itself. But we know milk thistle is very, very beneficial for protecting the liver. So I think if you were to take which you and I have several of our own, like a liver complex or maybe you’ve got Got some and AC milk thistle which the active ingredient is silymarin. And that helps to act as an antioxidant and an anti inflammatory in right paddock cells. And here we go, I’ve actually got something right here that the milk thistle is going to help metabolize toxic compounds lowering the damage to the liver cells in the process. So there’s a guy here Dr. Weston child who was talking about silymarin. And he said, although it’s helpful, he said it’s not a cure all. And it doesn’t reduce all the damage from drinking in excess. However, it can help heal the process once the person has stopped drinking. Bla bla bla bla bla, so a parent Apparently, the in German, Germans in Germany, apparently they’re recommending milk thistle to treat liver toxicity. So yeah, so long story short, I mean, any of the stuff we’re typically doing clinically to help the liver is is going to be beneficial and protective. Now here’s one funny thing. So the wine industry You know, it’s all about resveratrol, right? It’s like resveratrol, resveratrol wine. But, you know, according to just looking at some of these labels and the actual amount of milligrams of resveratrol, you’re getting in red wine, you would literally have to drink like 100 bottles to get the amount of resveratrol that you would get in a single pill supplement.

Dr. Justin Marchegiani: I know. Yeah. So a little bit. Yeah, it’s a little off there. I mean, there’s a lot of Blue Zones. These are very healthy parts of the world that live a very long time into the hundreds, you know, over 100, and they do consume some alcohol. So I don’t think alcohol should be looked at like it’s this unbelievable toxin on the body. I mean, I think there may be a mild stress to it, right? But exercise is a stress, right? So I think there’s have been a little bit of stress on the body does help with adaptation. The key is, is allowing your body to receive that stress and allow you to be able to adapt to it as efficiently as possible. Instead of it being the stressor you put in your bucket that causes your bucket to overflow. Now it’s going to be the stressor. helps make your body a little bit stronger. By just getting back here briefly, I found one article here talking about acetyl aldehyde. And it talks about the fact that cysteine and glycine again, which are the two major backbones to making gluten, what’s clewd a file and it’s a tri peptide, right? tri meaning three, glutamine, glycine. cysteine are the three amino acids in glutathione. So it talks about Long live sulfur containing bio molecules, including cysteine and glycine that incorporate acetyl aldehyde might affect cysteine, including ion homeostasis and also plays a protective role in reducing circulating acetyl aldehyde levels. Okay, this is one article called binding of acetyl aldehyde to a glutathione metabolite, so glutathione does bind up acetyl aldehyde. So we talked about an acetyl cysteine. We talked about glycine and bone broth, we are now glutamine. We also talked about things like Milk Thistle are silymarin, which are actually a glutathione recycler, so is cortisol that helps maintain the recycling of glutathione. And then of course, taking lipids, omo glutathione, itself. And then also things like charcoal, I think also have a positive effect at binding up a pseudo aldehyde as well. So look at acetyl aldehyde and charcoal, you can take binders that help you right here, a study of acetyl aldehyde absorption on activated carbons, right, which essentially activated carbons is going to be what you see with activated charcoal. We’ll talk about that in a second. 

Evan Brand: I saw that one. So here’s what you’re saying. You’re basically saying you should make a Grass Fed Whey Protein Shake that’s going to be loaded with cysteine and all that make you a grass fed protein smoothie with a shot of vodka added to it. You’re going to have a good time. 

Dr. Justin Marchegiani: Yeah, I mean, it depends on how you want to do it. Right. I think that’s there’s there’s definitely a couple of options right? So when I look at alcohol consumption, right, the first part is choosing healthier versions of alcohol. We’ll talk about that in a second. The second is how do you detoxify? So there’s a couple of mitigating effects. Alcohol is a diuretic. Some of the effects that you have on alcohol is the fact that you are decreasing ADH antidiuretic hormone from the post here pituitary. Okay. So, I hate when they do double negatives. Remember double negatives equal a positive. All right, so anti diuretic so diuretic means it’s your diuretic means it makes you pee. So it’s the anti. It’s the anti pee hormone, if you will. So essentially, it’s the anti p anti anti p hormone. So in other words, it makes you pee. It allows what’s in your body from a hydration standpoint to be released out. So that means you’re going to lose a lot of water. You’re going to lose a lot of minerals. So part of the mitigating effect of hangovers is Yeah, you have the seat. Allow the high but you’re also going to be low in minerals and low in hydration. So if you’re going to be drinking more having a Pellegrino or having a nice mineral water at your table or at your home and having a glass of mineral water in between each drink is going to be huge from a hydration standpoint and a mineral standpoint, that’s number one. Number two, you may do a binder during the drink to kind of help mitigate and bind up some of the the acid aldehyde to help bind that up. And then number two, you can add in some things that are can be protecting the liver whether it’s clear to thiam you can do NAC you can do some vitamin C, you can do some you can do some milk thistle. Those are all good options. Now I keep it very simple. I’ll do n acetylcysteine, vitamin C and activated charcoal. And then when I come home, I’ll typically do some liposomal lumify and once I get home, all right and then I’ll also really make sure the minerals are good. I’ll typically sip on something like a tub of cheese Go in between the keep my minerals up. That’s a kind of a really good way to look at it. So alcohol is a diuretic. 

Evan Brand: They need to sponsor you Topo Chico, you know, many times you flashed that Topo Chico bottle over the hundreds of episodes we’ve done they need to send you a free case or two or three.

Dr. Justin Marchegiani: Exactly, exactly. No, I totally I totally agree, man. I got to reach out to him for sure. 

Evan Brand: I found I found one paper wanted to tell you this real quick. So maybe this is a study that maybe it’s been done on humans, and I just didn’t find it in PubMed, but when I found quickly was the effect of activated charcoal on ethanol blood levels in dogs. And apparently, they gave the dogs different amounts of ethanol and then they measured their blood after a dosing of charcoal. And it of course, duh. It just said that blood ethanol concentrations were significantly inhibited by activated charcoal during the first hour after administration and then blood ethanol levels are significantly lower throughout the study in the activated charcoal group. So this is what they do supposedly, this is what they do in poisoning emergencies in the hospital. Like if you go into the hospital with alcohol poisoning, supposedly they pump your stomach full of charcoal. Is that still standard practice? I’m not sure if you- 

Dr. Justin Marchegiani: I can tell you personally not that I was ever affected but my college roommate freshman year, yeah, I had alcohol poisoning. I had to take him to the hospital. And we went to the ER. And I watched the whole process happening. They gave me a huge glass of activated charcoal. He was just drunk off his gorge. And he was just they had him sit him up at an angle and he was just out of it. And they were just kind of feeding him. The activated charcoal right down his mouth. 

Unknown Speaker: I witnessed it myself. And then they also had them hooked up to an IV which is good, right? Because then you get the minerals in. Right and then you get the activated charcoal. Now is that worth $1,000 ER bill don’t know, I mean, you’re probably getting a $1 if of activated charcoal and then maybe a $5 IV, right? It’s quite the markup on there. So in other words, folks, if you’re listening, get your $20 bottle of activated charcoal, bring five or six capsules with you take them throughout the night, and then just get your little mineral water, right little Topo Chico sponsor right there. And then sip that throughout the night. And then this is your IV, okay, and then you get your activated charcoal, that’s going to kind of be your little binder. And I have one study right here, I’ll just kind of read the conclusion. And again, it’s amazing how researchers just do not know how to write in a way that connects with the average person. Let me read it and then I’ll translate talks about it talks about right here. This is due to the contribution of hydrogen bonding to the dispersive interaction of hydrocarbon moiety with the act of carbon pore walls after oxidation for the carbons with unaltered decreased surface area The esoteric heat of the acid aldehyde absorption is decreased. Alright, right here. This is it basically activated charcoals, which are these hydrocarbons, bind up acid aldehyde and decrease its absorption. So there’s less acid aldehyde or acetyl aldehyde in your body to be absorbed, because it’s being bound up by the activated charcoal. 

Evan Brand: Let me point out what you’re saying. Because there’s people that are, you know, 17 minutes into this and they’re going yeah, but I don’t drink alcohol. Alcohol is stupid. It’s poison. I haven’t touched alcohol in years. I’m 20 years sober. Hey, he just said acetyl aldehyde. So if you have dealt with gut issues, and you’ve got a Candida overgrowth, that’s why we use binders for people. We’re not giving someone a binder and saying, oh, by the way, this is going to help with your Friday night drink. No, we’re using binders clinically, because it helps with the toxins that Candida and bacteria and parasites and all these gut infections that we talked about. That’s very beneficial for that, but it just so happens to be helpful with the alcohol piece too. So for those people like oh, Alcohol is the devil, which I joke around and say that many times. If I see my dad drinking, I’ll say, you know, I’ll call the devil right? And he’ll laugh. But anyway, for those people that don’t drink Look, the charcoal is still beneficial. Now, here’s one like side tangent, but I think it’s important to mention because it’s a sad reality is that up, women suppose you know, majority are going to go out to if they go out. I mean, whenever everything’s back to normal, they go out to a bar, and date raping still happens. I had a friend from high school who I saw at the gym years ago, and she apparently got dosed with gh B, you know, she was drinking water, and ended up getting date raped, and here she is not even drinking alcohol. I guess someone slipped ghp into her water and you know, next thing she knows that’s what happened. And so, the good news is there’s a study from European Journal of pharmacology, what’s it say here Pharmaceutical Sciences. Long story short, activated charcoal has clinically relevant ghp binding capacity. There you go. So if you have kids that are 2125 30, whatever they’re in college, you’re worried about them. Just make sure no matter what that if they go to a party or they go to a bar or whatever, that they take the charcoal because it’s going to help with the alcohol. But hey, if somebody tries to potentially date rape them, Look, now you’ve got that absorption as well.

Dr. Justin Marchegiani: Yeah, and I imagine that you’d also see glutathione as being a big one because fluidify on helps run those cytochrome p 450. oxidase pathway. Yeah, and right here ghp is naturally occurring compound and glutathione peroxidase, which is one of the major enzymes made by Luna found does help deactivate that. So yeah, these are all really good things. I mean, the goal of this podcast isn’t to tell people to drink it’s just the fact that hey, we know people are going to drink and there are people out there that still may drink and be very healthy, healthy minded. I like to consume a little bit of alcohol a couple glasses a week a lot of my patients do you know they want to have a social life not that you have to be drink alcohol to be social but they enjoy making that a part of their life and how can they do it in a way where they enjoy the the spirits and the the the levity that they get from their alcohol drinks, but at the same time, still maintain good health, cognitive benefit, good decisions, you know, and really still having a good social life without having the hangover and or having any negative health consequences. And so these are good strategies to do it. And we’ll talk about alcohol in a minute. But just to kind of reiterate, we had talked about the enzyme conversion glutathione is very important. We talked about the acid aldehyde is where a lot of the negative consequences happen. glutathione and activated charcoal can help with that as well. We talked about some of the liver tonifying herbs, such as milk thistle or silymarin. Things like dandelion or artichoke, things that support liver and gallbladder function can be helpful too. We talked about some of the nutrients like vitamin C and selenium, selenium is a glutathione precursor as well. And then we talked about the three amino acids and acetylcysteine is a core one and glutamine glycine, are really good amino acids. And Evan mentioned whey protein, which is really high in those amino acids as well can be really good supports to help with that alcohol, to acetyl aldehyde, acetyl aldehyde to acidic acid or apple cider vinegar, that’s the conversion process. And we’re just trying to help one either bind up some of that nonsense or help your body converted optimally. So you don’t deal with the deleterious consequences. 

Evan Brand: Let’s talk about the, you know, kind of the good, not so good, bad choices for alcohol. But first, I want to comment back on the Blue Zone thing you mentioned, because that’s interesting. You’re talking about the Blue Zones and how so many cultures around the world where you’re seeing a massive amount of centenarians, people that are living to 100 years or greater. These people, a lot of them do consume alcohol. I remember that story of that guy down in Austin. He passed away a few years ago, but it was that that African American guy, he lived like 113 or something, and he was like, he was like a world war two veteran, he was super famous. There’s a street named after him in Austin now, but this guy, don’t quote me, but I’m pretty sure this guy was drinking whiskey and smoking cigars every day. Wow. But here’s the funny thing about him and all these Blue Zones. Alcohol is just the lubricant for the social life. All these people in these Blue Zones, these are people who they have multiple generations of family living with them. They’re gardening, they’re there, they’re getting exercise, they’re getting sunshine, they’re barefoot in the dirt all day, they’re possibly eating food that’s not sprayed with chemicals. And they have much, much more of a social life than like your typical nine to five or so I think that when you look at those things, it’s hard to say, hey, the alcohol helped them live to 100 because they were relaxed. Part of its that too. Maybe they got a little bit relaxed, so they weren’t as stressed. And maybe they took let life less serious. Maybe they laughed a little more. But then also those people were super social with all their friends and family and data. So maybe that’s contributed to the longevity because we’ve seen all those papers on like social isolation being compared to smoking cigarettes and how toxic being isolated is so it’s kind of like the alcohol is there at the party, but the main benefit was the party in the people at the party.

Dr. Justin Marchegiani: 100% and I just kind of want to highlight here, because there are many people that are listening to this and they’re saying, you know, they may have a history of alcohol abuse or being an alcoholic. Of course, this isn’t for you. But one of the things I want to highlight of why alcohol can be a problem and some people, some people that really have chronic alcohol abuse, the B six vitamin is incredibly affected by alcohol. And B six is really important for synthesis of neurotransmitters in the brain, serotonin, dopamine, it’s very, very important and B six is important for methylation for detoxification for full A and B 12 absorption. So basics really One article right here it’s called vitamin B six metabolism in chronic alcohol abuse to talk about individuals with chronic alcohol abuse frequently exhibit lower plasma levels of pyridoxal five phosphate, that’s B six, because the liver is the primary source of this coenzyme in plasma. Basically, it talks about that liver. toxicity of ethanol can impair hepatic peroxyl five phosphate metabolism. Now this is a rat study, but they’ve seen the same thing in humans. And basics. He talked about ethanol is diminished in the in the rate of release of pyridoxal phosphate phosphate perfused by the livers. The effects of ethanol in vitro were abolished by four methyl piracetol, an inhibitor of alcohol dehydrogenase, so they found that the alcohol dehydrogenase drug actually increased B six, so something to do with that alcohol metabolism really do ranges that be sick. So what does that mean? What’s the Reader’s Digest version means maybe getting a little bit of extra benefit. Complex on board there couldn’t hurt either way so if you have a history of alcohol in your family maybe you don’t but you want to provide extra support for yourself taking a B complex while you consume alcohol could still be a good thing for you. People that are more at a preventative side not saying if you have it still avoided if you have alcohol issues, but if you want to be extra preventative be complex could be something that you may want to add in on top of that. 

Evan Brand: Cool. Yeah, I’m like a one shot a year guy historically, I remember I took like maybe two shots on my bachelor party for my for my wedding and then I we were out playing pool with my dad and my friends, my best man and all that and I just got to the point where I just felt stupid. I was like, God, even after this small amount of alcohol, I couldn’t comprehend simple things. And obviously, my brain likes to run. And so I was like, No, this is slowing me down too much. And so that’s that’s what kind of got me away from it. But But I may try it and see you know, I think there there are some Good, maybe stress reduction benefits. I’d like to see something on alcohol and cortisol. I wonder if there’s anything on that like seeing if salivary cortisol drops, like, let’s say you’re super stressed. I mean, think about like the TV show where you see the guy get pulled over by the cops. First thing he does is whips out a cigarette and starts smoking to take the edge off. I wonder if you took like salivary cortisol, you know, took a shot of vodka, took salivary cortisol. 30 minutes later, you think you’d see it drop? 

Dr. Justin Marchegiani: I think you’re gonna see, you’re gonna see a modulation of serotonin and dopamine, I know nicotine does stimulate dopamine. So you’re gonna see some kind of acute input, some type of acute synthesis of those compounds. Now it’s all about the dosage right? chronicity of it, you’ll actually deplete it more, right? It’s kind of like doing a stimulant, you’re going to get a little bit more dopamine. But if you do it chronically, well, now you’re going to deplete that dopamine and you’re going to need more stimulant to get the same result. But just to kind of highlight that last article. I wanted to read the last sentence that said, the data supports the previous findings that acetal aldehyde is the responsible agent for which acts by accelerating the degradation of intercellular b six. So what does that mean? The more acid aldehyde The more we decrease our B six. So the more we can help metabolize acid aldehyde or cetyl aldehyde with charcoal and glutathione and binders, then we’re going to degrade less B six and then if you really want to support and on top of that, you can do extra B six on top of that extra B vitamins and you’ll be good. Now I consume maybe if I go out I consume alcohol maybe only on a Friday or Saturday. That’s it. I do not do any alcohol during the week. It’s just kind of my personal thing. I like to have that at the end of the week, my hard week done, and I’ll typically do one to two glasses of high quality like a clean dry champagne. I like that I like the bubbles in it. For me bubbles are like my best friend to Chico lots of bubbles. There’s been some studies that the bubble and the carbonation and alcohol actually increases the ability eruption of alcohol into your bloodstream. So what does that mean? bubbles mean you have you need less alcohol to get that alcohol in your bloodstream. So I like that they’ve it’s actually studies on that. Imagine the college study where you sit down and you get one group that’s taking shots of vodka. The other group take shots of vodka with carbonated water and they test your blood alcohol content, yet they’ve done studies like that. I’ve seen them. And so you need less alcohol with the bubbles, which is kind of cool. And then you can do a lot of the strategies that we talked about afterwards. So that’s kind of my strategy. Maybe I’ll drink three. It was my kids birthday this weekend. So I had maybe three glasses of you know, I like a nice, nice champagne. Or I’ll do my Dr. J’s Moscow Mule, which is another great recipe. So we’ll do a high quality Tito’s vodka from Austin and get the potato vodka. It’s filtered as well really clean. I’ll do some Tito’s vodka and I’ll mix that in a nice ginger kombucha and I’ll do a half a wine squeezed and that’s a wonderful drink because you get B vitamins in the kombucha. You get a lot of antioxidants in the kombucha and then you have the the line which provides some extra vitamin C, which does can particularly the thigh own. So it kind of gives you a lot of nutrients that actually help with any acid aldehyde metabolism, which is cool.

Evan Brand: That’s very cool. Okay, so I want to talk real quick about neurotransmitters and bits and you kind of got into it and then we’ll go into maybe the good worse bad kind of choices. So I sent you a in the chat there, I put you a link to this big long paper about neurotransmitters and alcohol. And so we know this but it’s always good to see it in in paper form that both metabolites of serotonin which is they probably were measuring five aiaa, just like we see on the organic acids test, I’m guessing but it talks about here how in humans the levels of serotonin metabolites in the urine and the blood increase after a single drinking session indicating increased serotonin release in the nervous system. And so, you know, if you and I both love, Julia Ross, I’ll speak for you and talk talk about You love her because I love her. I’ve had her on the podcast several times. She’s done amazing work on amino acids. And you know, when she talks about serotonin being low, the deficiency symptoms of serotonin, this these are the things that drive people to drink in some cases. So these are like negativity, depression, worry, anxiety, low self esteem, and then you notice how those people who were kind of anxious and kind of closed in and introverted. Guess what, what happens when they drink, they become extroverted, they’re talking louder, they’re more bubbly, they’re, they’re more happy, they’re more, they’re less anxious, they’re less worried, and that’s because you get that quick boost of serotonin. Now, here’s the problem. And I haven’t read into the paper to confirm this. But I’ve read other papers on this and everybody knows this. If you’ve been in society, what happens at the end of the night when the guy goes home with the wrong girl or the girl goes home with the wrong guy at the end of the night? That’s because you have this temporary boost initially of serotonin and then guess what happens the serotonin crashes and when you have not Not enough serotonin, your decision making goes down, your prefrontal cortex just shuts down and you make bad decisions and you do things that you shouldn’t do. So you have this initial spike, because of the five htt receptors being hit by the alcohol, and then boom, rapidly declines after that. 

Dr. Justin Marchegiani: Yeah, I think also alcohol just naturally decreases frontal cortex activation anyway. And so frontal cortex is the part of the brain right here, the neocortex that makes us human beings, it basically allows you it’s impulse control. So I don’t know you get in a fight with someone you’re like, oh, man, I really want to whack that person. But then your frontal cortex is like, Oh, no, don’t do that. That’s not good, right? You’ll go to jail. So your frontal cortex kind of like, Can like take a decision, that may be a bad one that you’re thinking impulsively, and it can shut that down. It also can, it can predict outcome of actions. And so when your frontal cortex is closed down, now you don’t have impulse control. So you just start saying whatever comes to your brain, and then you also don’t think about the consequences of your actions hence bad decisions. Yep. And then also in this paper it goes into how serotonin and not only just serotonin but GABA, you know alcohol is going to have an effect on gab as well. So, you know, people are familiar with GABA, it’s kind of the brakes of the brain, I call it and so when people are doing benzodiazepines, like Valium, and Xanax and those kind of things that’s working on the GABA receptors to calm anxiety. You and I prefer to use things like naturally fermented pharma gabbeh. We like to use things like elfy to help boost GABA, but you know, from a toxin perspective, the Gabba Gabba nergic pathway that’s also affected by alcohol too. So that would probably contribute to the relaxation a bit. Yeah, it’s interesting how the date rape drug which is gamma hydroxybutyrate ghp is actually a GABA metabolite. But it’s amazing that that can have the mind altering effects of memory loss. So obviously it must be a dose dependent type of thing. 

Evan Brand: It is Yeah, I was actually Looking at the GH B page, like a data page on it, it was talking about how at a low dose you get like a little bit of euphoria. But then when you go moderate high dose, yeah, you’re unconscious, you got no memory, it’s bad stuff.

Dr. Justin Marchegiani: Yeah, it’s funny when my wife and I go out to eat, I have my little stomach case. And I have enzymes and HCl on one side, and then I have activated charcoal, NAC or vitamin C on the other. And so when we go out, it’s funny, I just pull it out. And I kind of just set up my little supplements as a as I’m going like trying to always hack things, right. And then I’ll do glutathione later at home, because number one, it tastes really bad. anyone that knows liposomal glutathione. I don’t want it to affect the taste of my meal. But then I do those amino acids while there and so that’s just kind of how I hack it. And I’m guessing too. One thing you could do on top of that is people that are trying to whip their serotonin or dopamine levels up, you can just use amino acids as well, to bump up your brain chemicals, right, so we’ll do tyrosine or l dopa. When appearing is to really help improve dopamine or adrenaline levels. And dopamine is a precursor to adrenaline. So part of the way we support healthy dopamine levels is we fix the underlying stressors that are causing your dopamine to go to adrenaline. And then of course, five HTP with B six and B six is very important because it helps with the conversion of your neurotransmitters. And we talked about the article showing a cetyl aldehyde decreases B six levels. So you can see the interplay here, so you can you know, if you’re smart, right, and you have issues to begin with, just avoid alcohol. But if you don’t, and you want to engage in it and have a couple of drinks per week, and you want to do it safe and effectively and hack it so you feel great doing it don’t have a deleterious effects, B six is one, okay. And then we can even do the amino acids five HTP and tyrosine with B six right, I talked about that. And then we have your binder, we have your glutathione precursor and then we have your minerals or your hydration which could just be a nice bottle of Pellegrino dropped off at the table with some limes and you can get some vitamin C in the lime juice and then you’re set. 

Evan Brand: Let me mention this. The people that have alcohol cravings, so you’re like hey, workweeks done great week let’s chill out a little bit that’s not you craving it that’s you just going to it because you’re enjoying it now the people that have to go to it the people like oh my god, I got to have a drink. Those people need more functional medicine help. So you know, Julia Ross talks about this a lot people that are having cravings for alcohol. You know, these are people that may need something like glutamine to help with the the brain to help the brain feel stable and calm. The people that are low in serotonin, they may crave alcohol as well. So like you said, that’s where the five HTP comes in. If someone’s burned out their catecholamines, they may have alcohol cravings, and some people it manifests as dark chocolate cravings, and some people it manifests as sweet cravings and some people it’s alcohol or it’s cannabis craving so you can have different vices tied into the same neurotransmitter. Same thing with Gabba. If you’re real low in GABA, you’re going to be someone who it’s hard for you to relax your real tightly wound. And you may crave sweets or starches, but you also may crave alcohol. So when you get the alcohol, oh my god, you loosen your shoulders a little bit, that’s a sign that you need help and the GABA department and then reach out to somebody like Dr. J. And let’s help you boost your natural levels and some of its genetics. Some people are just genetically going to be lower, they’re more anxious, maybe family history, childhood, whatever. And some people it’s the stress of toxicity and gut bugs or whatever else. It’s affected neurotransmitters like you and I see when people have gut infections, we’ll look at their serotonin and serotonin is often low. And my theory is that, hey, you’ve got a lot of gut bugs, you’re probably not able to manufacture enough serotonin in the gut, and therefore that’s why you’re anxious and depressed. And that’s why you have to have your alcohol to be happy or to do whatever you have to do but if you fix the gut, we retest the organic acid, boom, serotonin. goes back up to normal, which is really cool to see on paper.

Dr. Justin Marchegiani: Totally. Yep, totally. And again, alcohol isn’t there is some genetics to it. You’ll see it in a lot of people of Irish descent. Supposedly there’s some issues with with B vitamin or thymine deficiency, which is B one. And alcohol consumption actually further depletes that. So you see it in the Irish population. You also saw in the Native American population, a lot of alcoholism there. So thigh means a big role. That’s kind of why I was saying that. A good B complex would be one and B six can be very helpful as a preventative for people that may not be alcoholics but may have it in their family as a good preventative. Number two, if you are an alcoholic, you really want to look at supporting the adrenals you want to really look at supporting blood sugar, blood sugar is really important. You want to look at treating Candida because of the acid aldehyde in your gut from Candida can still mimic that. You want to look at supporting B vitamins and digestion and absorption. And one of the best things you can do when when you go out to eat is have Some protein and fat with your meal, it’s very helpful. One of the things I’ll do when I consume alcohol is I love oysters. And oysters are very high in zinc. And I’m pretty sure oysters are also very high in B vitamins too, I have to look at that real quick. Yet oysters are very high in B 12. And they’re also very high. And they do have some smaller amounts of timing nice and in full eight. And so that’s really good. So really, if you can go out and actually consume really nutrient dense foods, foie gras, liver, high quality grass fed steaks, you know, good seafood consumption, you’re going to have a lot of extra B vitamins there that will help fill in the gap nutritionally as well. 

Evan Brand: Yep. So let’s get into the good, worse, bad choice if you want to now. So you mentioned vodka already, which is good, because you mentioned it’s going to be distilled. It’s going to be ultra purified. So if you’re looking for just the pure stuff, it’s going to be that and then a golf a would probably be up at the top of the top of the list. Do you mean Yeah, tequila made from a GAVI. So- 

Dr. Justin Marchegiani: One thing to add though the volca I’m a big fan of titos I’m pretty sure it’s potato bass and I think it’s also a filter like seven or eight times and isn’t it also isn’t also go to a charcoal filter.

Evan Brand: Supposedly that’s what we read. I haven’t confirmed it but yeah.

Dr. Justin Marchegiani: Yeah, so very clean. So if you want to consume that, and then I’ll do the Vodka with a high quality kombucha to really help improve the self improve the B vitamin nutrient levels too.

Evan Brand: Yep, so so tequila are coming from a GABE that’s gonna be generally really, really clean and then you get into the brown stuff. So you’re going to get into the whiskies. And then of course, you got bourbon which bourbon just means that it was made in Kentucky where I live Nice, huh? Same thing, whiskey and bourbon, same thing like Bourbons made in Kentucky and that’s what that’s what allows it to be called bourbon. So, but that’s but that’s made from grains. And generally grains are going to be genetically modified. They’re going to be sprayed with a lot of chemicals. So if you get a quote, really high grade High School Last whiskey bourbon, guess what, it’s not going to be certified organic and it’s not going to be, you know, GMO glyphosate free. So I would argue that the tequila and vodka choices would probably be far better. Now there’s also one. It’s like a Hawaiian company that makes an organic vodka. I’m gonna see if I can pull it up. It had like a blue bottle. It was like a, it’s called ocean. It’s organic vodka. And it was by a company called ocean. So and they make it from organic sugarcane. So that’s kind of cool. I like that it comes from an 80 acre farm and distillery in Maui and they use solar panels to power the distillery and blah, blah, blah. So it’s organic sugar cane, blended with deep ocean mineral water. So that’s kind of cool. So I think if you could get organic, and that would be smart. Now people that have allergies with corn. There’s another brand called frankly, who makes organic vodka but it’s made from organic corn. So when cause any issues if you had a corn allergy, I don’t know, maybe go for the sugar cane stuff instead.

Dr. Justin Marchegiani: Usually it’s filtered enough, it’s gonna have lot of its proteins. Proteins are a lot bigger so usually those are gonna get filtered out. Vodka’s gonna be the cleanest, there are antioxidants and some of those compounds. So you mentioned Gin, which is made of Juniper Berries which are very powerful antioxidants. Also things like Whiskey for instance, which is made from grains but typically the distillation process filtered it out, and it has different antioxidants in there, so it’s allagic acid which is a powerful antioxidant. And there are some decent compounds in there so your hard alcohols are gonna be good. Vodka’s my favorite because it mixes really well and you can get a high quality one that’s really clean. And we have like a nice dry apple cider, it’s really good, just try to get the one without sugar added. There’s a good brand in whole foods in Austin called Anthem, it’s a pretty good one. Another one is Magner which is pretty good too. Then of course you have your dry wines right so you have like a champagne which is basically a bubbly wine where the grapes come from one province in France right, but then you have like versions of prosecco which is a champagne version in Italy you have cava which is a champagne version in Spain and so I’ll tend to lean to some of the sparkling wines or really clean dry apple cider or really clean like my Dr. J’s Moscow Mule which i have a blog post on how to make and that’s the vodka, the ginger kombucha, half a lime squeeze and that’s phenomenal stuff.  And then of course you have the regular white wine, drier version you have the redder wines, which could have some other types of gluten in there because of the uh the granules of flour that may line some of the bottles, the like the big bins the big like barrels of of actual wine there could be some cross contamination there, and then you have like your flavored liqueurs, and then you have your beer, your lager, and then of course your not so good mix drink with lots of high sugar that’s kind of the spectrum.

Evan Brand: Yeah you notice like we barely even give any credit to the existence of those garbage ones like your Smirnoff  blue dye colored sugary corn syrup cane sugar mixture with alcohol, I mean the stuff like if you go out to like an american restaurant you get a margarita i mean it’s going to be a disgusting combination of artificial colors and dyes and sugar. It’s probably more sugar than there is alcohol in most of those things.

Dr. Justin Marchegiani: Yeah I mean I can tell you, market demand though a lot more higher quality healthier alcohol drinks. I’m seeing a lot of sparkling water with a little bit of vodka, and some even just sweetened with a little bit of stevia, I think it’s like the white claw one and there’s another one out there, so there’s a couple of decent ones that are out there that are made from mass consumption. They kind of are dialed in with a little bit of vodka, a little sparkling, maybe even a tiny bit of Stevia and so not as bad. 

Evan Brand: Cool. I’ve heard of the white claw. I haven’t looked it up yet. I’m going to try to see what are the ingredients here. I’ve got an ingredient label here- black cherry-

Dr. Justin Marchegiani: There’s another one it’s like fawn and something vaughn and forget. 

Evan Brand: So apparently, it’s carbonated water alcohol which I’m not sure what kind of alcohol it is. It just says it’s a gluten-free alcohol base natural flavor cane sugar citric acid. So yeah I mean I guess I would argue that’s not terrible. 

Dr. Justin Marchegiani: You have to look at some some are low it’s another one bon and vive are one that i’ve seen before that just on the shelf that like pretty low sugar, like for me, i would probably just make my own with kombucha, because i feel like i can i can add more nutrients to it, and have that natural sweetness there.  But so just kind of giving you guys an idea of kind of how we think about it, Evan doesn’t drink at all i drink a tiny bit on the weekend, not during the week, so just kind of how we approach it. One, how do we choose the healthiest version possible. Two, how do we mitigate the side effects with some of the supplements that we recommend during. 

Evan Brand: I’m not opposed to it. I know I would go for it if it’s something clean i would probably go for it. I was just staying away because after my mold exposure you know i developed some histamine issues and when you look into alcohol and dao the enzyme that breaks down histamine the idea is that alcohol down regulates the dao enzyme and then it increases histamine because of that whole acetyl-aldehyde path that we talked about earlier. So people with histamine issues, uh people with gut issues those are probably people that should proceed with caution, but you know, once I feel like i’m on steady ground with the histamine thing i’ll probably try some. Let’s see what happens, maybe i’ll — but here’s here’s the funny thing. I’ve always been so social uh such an extrovert, so outgoing, that anytime i were at a party if i were driving friends around or whatever, i was always more social than the people there and like people would think i was buzzed or think i was drunk because of how social i was and so people have to drink to get on my level of sociability which has always been pretty funny. 

Dr. Justin Marchegiani: No, I get that. That makes sense. So just kind of recapping for everyone right, choose the highest quality alcohol you possibly can based on that scale that we gave. Vodka, tequila, to whiskey, to gin, to your dryer kind of bubbly champagne, to your dryer red and white wines, to your beers lagers and kind of sugary drinks at the end. So choose kind of the best on that spectrum. Metabolism of alcohol right, ethyl alcohol, acid alcohol, two acetaldehyde acetaldehyde to acetic acid right so catalase enzyme here in that first step glutathione helps with that, and then from the uh acetaldehyde to acetic acid- that’s the alcohol dehydrogenase II, activated charcoal and different sulfur amino acids help decrease that as well. So use those. Be very mindful of alcohol, especially hard alcohol can actually decrease your blood sugar. So what happens is your liver does help with blood sugar stability, gluconeogenesis, when you lean up a whole bunch of ethyl alcohol against it, guess what happens? Your liver stops helping with blood sugar and so you when you take in alcohol. You can actually lower your blood sugar because there’s no sugar when you take in vodka for instance. So you’re actually decreasing your blood sugar, now what happens? When this happens it can create cravings, so when you go to a bar or restaurant they want to give you alcohol first a lot of times that’s going to decrease your blood sugar, because what your body can’t help maintain blood sugar stability. So the harder it is you have a lower blood sugar level. What does that do? More cravings, more appetite, more eating sugary and crappy carbohydrates and that can create a blood sugar roller coaster. So have good proteins good fats first before you eat so you can have better blood sugar control, and then use a lot of the supplementation that we talked about activated charcoal, vitamin c, milk thistle, nac, glutathione, and then make sure you hydrate in between to maintain your mineral levels.  

Evan Brand: Yeah. The restaurants know that if they can get you drinking you’re more likely to order that brownie with vanilla ice cream on top. 

Dr. Justin Marchegiani: Bingo. 100%. So I always want to put myself in a position where my cravings are not driving the bus, so to speak. I’m able to make decisions based on what I want versus what my cravings want. 

Evan Brand: Yeah, exactly. Well, let’s wrap this thing up. If you want to reach out, you can check out Dr Justin at JustinHealth.com. He does consults worldwide- phone, facetime, skype, whatever we have to do to connect. That’s what you do. We send lab tests to your door, we help you with a wide range of health issues, you can view more on that website and if you want to reach out to me, Evan Brand that’s the website- EvanBrand.com. Same thing available worldwide. We’re blessed, we love being able to help people, we love being able to help hack things where people can still feel like a normal human. You know sometimes when you’re in this functional medicine health world, you feel like things are restricted. You’ve got these dietary restrictions, and now you can’t do this and now you can’t go eat the birthday cake and da da da da da so the good news is you can hack things like we’ve talked about today and you can still feel like a quote normal human. I really don’t want to feel like a normal human because most normal humans are super unhealthy and sick and overweight and whatever. So I’d rather feel the way we feel.

Dr. Justin Marchegiani: 100% agreed. I can’t believe this is one of our longest podcasts in a while, but I guess there’s a lot to talk about when it comes to uh alcohol consumption and how to do it the right way. So hopefully um the listeners enjoy the extra in depth and the biochemistry and some of the mechanism stuff and uh just you know walk away and apply a couple of components here to make your alcohol consumption healthier. If you feel the need to engage so far.

Evan Brand: Yep or share the content so sharing is caring. Please do and I would love if you’d write a review for us on iTunes because wherever you’re listening on your podcast app you should just be able to click write a review. So do it, I know we’re like we’re real people we’re not just like the annoying pop-up where the app’s like please rate me and you’re like maybe later or you’re like no thanks, don’t do that to us. Actually give it to us, we need it, we appreciate it. 

Dr. Justin Marchegiani: We appreciate it. We wanted to get uh in front of more people so they can take control of their health and that makes the world a better place so we appreciate that. Evan excellent chat today really appreciate it. We will be back next week you guys, have a phenomenal week. Take care y’all. Bye now.




Audio Podcast:


Blood Sugar and Gut Issues – Podcast #183

Listen to today’s podcast as Evan Brand, along with Dr. Justin shares his personal experiences and expert views about the different symptoms and mechanisms of gut and blood sugar issues. Discover how blood sugar levels and health levers, such as gut inflammation, stress, nutrition, eating frequency, weight gain, Insulin sensitivity, etc.

Stay tuned as this duo explains techniques that may apply to you for you to utilize.

Dr. Justin Marchegiani

In this episode, we cover:

01:00   What are Blood Sugar and Gut Issues

06:00   When to Get Concerned with Blood Sugar

15:00   Basic Adrenal Support to Help Stabilize Blood Sugar Levels

18:30   Mwave Mobile Phone App

19:30   Walking Meditation and Massage


Dr. Justin Marchegiani: Hey, guys. It’s Dr. J here in the house with Evan Brand. Evan, fabulous little Monday here in Austin, Texas. How are you doing?

Evan Brand: Happy Monday. I’m jealous. I was looking at the US Current Temperature Map. You’re in like the 70’s, and it’s like freaking snowing here again. We just had like 80 degrees on Friday, and now it’s 35 and snowing today.

Dr. Justin Marchegiani: Totally. Yeah. I mean, we had a great weekend here. I have my— my brother and family in town here. And we were on Lake Austin on Friday and Saturday so, we got some great exercising. And, it’s great Monday, man. Looking forward to dropping some good knowledge bombs today..

Evan Brand: Yeah, me too. I did some squats this morning and I can feel it. My legs feel like jello. So, if I fall down during this, that’s why.

Dr. Justin Marchegiani: Totally. Makes sense. Pulled it. So, in general, man, I know we chatted about blood sugar and some fasting stuff. We wanted to talk today about blood sugar, and we kind of want to connect it to a lot of the gut issues that we see with our patients.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ready to dive in?

Evan Brand: Yeah. Let’s do it. Uh— I’ll first share my story, then we’ll get into maybe the mechanism. Uh— When I had H. pylori and Bacterial Overgrowth and Candida problems, my blood sugar was not good. If I went longer than two or maybe two and a half hours, I would start to get a little bit of Anxiety, kind of shaky, kind of stressed, maybe a little bit irritable, kind of…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …moody.

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: That’s not normal. And it wasn’t until I fixed my gut that my blood sugar stabilized. And now, I could basically skip breakfast if I wanted to. I don’t. But if I did skip breakfast, I could pretty much work all day, from like 7:00 AM until 2:00 PM, with no food and feel perfectly stable. And that is unusual for me, ‘cause I had the blood sugar issue for so many years— probably because I had infections for so many years.

Dr. Justin Marchegiani: Yeah. As your adrenals get stronger, they can definitely stabilize blood sugar better. Right? ‘Cause, as your blood sugar drops, your body produces Adrenaline and Cortisol to raise this. So, the more stable your Adrenals are— They have that little bit of extra strength to bring that blood sugar back up. Of course, the more Keto adaptive you are, you’re not gonna have high and low peaks of— of blood sugar, meaning, the faster your blood sugar goes up, the faster your pancreas produces Insulin, the faster your blood sugar drops, the faster your Adrenals produce Adrenaline and Cortisol to bring it back up. So, there’s this like— There’s this like event flow. So, the— the smoother your blood sugar goes up, the smoother it falls, the less your pancreas, and your adrenals are called upon to buffer that out. So, the more Keto adaptive, the more you’re burning fat for fuel, the more metabolic logs that we’re putting on the fire. Think of logs as like Proteins and fats. That’s kind of our metabolic log. And then we have our spectrum of Carbohydrates, non-starchy vegetables, low sugar fruits, higher sugar fruits, higher starchy foods, grains, refined sugar, alcohol, right? There’s a spectrum, lower to higher. And of course, think of Carbohydrates as kindling. We have like, twigs over here, to the more ref— refined Carbohydrates in the middle, which are more like paper. And then, to the end, which we consider Gasoline. So, you know, if we just started a fire with paper and gasoline, that fire goes up and out. You know, if you start a fire with some logs, Protein and fats, and then you get a little bit of kindling in there, then you’re pretty good match to keep that fire burning long and strong.

Evan Brand: Yep. Love that analogy. I was doing pretty good on the fat content. I think it was just the gut was disturbing the blood sugar and adrenals so much that even a perfect diet couldn’t have fixed it. This is what we see too with our clients. I just had a woman before I got on a call with you, who— she has H. pylori. We looked at her Stool Test. She’s got a couple parasites, many species of bacteria overgrowth. Her Candida’s off the charts. Like I  told you before we got on here, she’s literally eating eight times a day. And, I said, “Is that like a snack?” She goes, “No. I’m eating like Steak and veggies, or chicken and veggies, like eight times a day.” she’s eating almost a full meal. I said, “Would an average person think that was a snack Science, or would they think it was meal?” And they would say, they think it’s a meal. So, I told her first of all, “My Lord! That’s a lot of food.” You’re probably not detoxing well if you’re just focused on digestion all day. And, with all the infections, if she goes longer than an hour or two, she’s having Anxiety and Panic attacks. So, I did give her some supplemental, like uh— the PharmaGABA, so that she can kind…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …of chew on those, and gave her some basic Adrenal Support. But, I told her, “My suspicion is that once we resolve the infection, she should be able to go longer without eating.

Dr. Justin Marchegiani: Yeah. I would say, with a lot of people that have blood sugar issues like that, there’s a combination of a couple of things. Number one, there’s typically, a lot of gut inflammation, and inflammation then creates a response of Cortisol. Think of Cortisol as your natural water to put out the fire. Inflammation is the fire — that makes sense. And then, Cortisol’s the— the water to put out the fire. So, if you’re constantly having a fire going, that Cortisol’s constantly being pushed to put out the fire. But Cortisol’s also is gonna have an effect on your blood sugar too. That’s why when you get stressed and you do a Blood Sugar Test— got my little blood sugar meter over here in the corner of my desk. But, if you tested your blood sugar, you would see yo— it on the higher side when you get stressed.

Evan Brand: How much can it fluctuate? Like if, let’s say, during the day, what would you say you’re kind of resting glucose would be maybe like now? Would you say it being like the 70’s or 80’s?

Dr. Justin Marchegiani: I mean, I would say between 80 and 100, but it would depend, you know, when my meal was. But, if I ate like an hour ago, my goal would be to be under 120, closer to 100. I mean, my goal is typically, you know, 140 an hou— after an hour, 120 after two hours,and then back below 100 after three. The more Insulin sensitive you are, you may be able to get that below uhm— 100 within two hours. But, it depends too, ‘cause if you’re doing a lot of stuff and you’re active, it may be okay to have a little bit higher blood sugar because you’re— you’re utilizing that fuel. It’s not like sitting in your bloodstream and being dumped into your muscle to go to Glycogen, or dumped into your liver to— to run De Novo Genesis and make fat out of it. It’s— It’s there as a fuel source and your body’s tapping into it. The concern is that when your blood sugar is— you’re not doing much. You’re not in much physical perceived stress, and that blood sugar is chronically high because in the body has to then go into storage allocation versus burning allocation.  

Evan Brand: Okay. So, when do you get concerned about a blood sugar level?

Dr. Justin Marchegiani: Well— I mean, I would say that, if someone is testing their fasting blood sugar and it’s chronically above 100, not just in the morning. Now, the morning’s important because the morning is when your blood— when your Cortisol goes the highest, right? Your Cortisol rhythm is like this. It— It starts here waking. It pops up in the first 30 minutes, and then goes down during the day. So, i— Some people may have higher blood sugar in the morning ‘cause of that Cortisol spike. And, that’s okay. That’s normal. The question is, how does it look during the day as that Cortisol drops? So, those are the big questions that I always have. So all the patients do a functional Glucose tolerance where they test their fasting. One, two, and three-hour blood sugar, you know, at different intervals during the day, so we can get a window of how that blood sugar fluctuates. So, inflammation’s gonna have a major effect on your blood sugar. Emotional stress will have a major effect on your blood sugar. And a big vector for inflammation is gonna be gut issues.

Evan Brand: Yup.

Dr. Justin Marchegiani: Gut issues.

Evan Brand: And I will—

Dr. Justin Marchegiani: And—

Evan Brand: I forgot to mention too. You’re right. Her— Her Calprotectin, her intestine inflammation marker, it was pretty darn high. It was at— I believe it was at 96, and anything above 50 is flagged high on the test that you and I use.

Dr. Justin Marchegiani: That’s big. Yeah.

Evan Brand: She— She was pretty inflamed and uh— the emotional stress piece was a factor, too. She had just recently gone through a divorce. She’s got three kids that she’s trying to keep up with so uh— that’s a big deal. And, uh— I think the case studies like this are important to share because the data can only take you so far. But when you hear a story like that, it’s like, “Oh my God. This makes sense. And this lady, she’s been burning the candle at both ends, going through divorce for how many y— years— you know, it’s been a year in the making— with three kids in the middle of it. That’s stress.

Dr. Justin Marchegiani: Totally. So, the other big thing is if the gut’s chronically inflamed, that’s creating stress. But, if the gut’s also inflamed, there may be a bottleneck in how she— this patient’s able to digest and get these nutrients into our bloodstream and have a stabilizing effect. So, the big thing I would say with this patient is, we have to make sure— you know, especially at the inflammations that high. She’s really having a hard time. I would make her do a lot of these foods in a crock-pot kind of soup type of manner, where nothing’s raw, everything’s either blended or, you know, pre-digested with the cooking process to make it very easy for the gut to absorb. I would probably be also adding a lot of supplemental free-form Amino acids, Amino acids that are already broken down, so she can just absorb these right into our bloodstream because 50% of the energy by the Protein that you eat goes into the digestive process. So, it’s like, you know, imagine I gave you a dollar. FOr every dollar I give you for you to be able to use it, you really only get 50 cents back.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, that’s kind of what happens with how your body utilizes Protein. So, if we gave you free-form Amino acid, it’s already broken down. So, if I give you a dollar, then you actually have a dollar to spend, but the big thing is, you don’t go through the— the stress of having to process it. So, adding in free-form Amino acids can be helpful in, of curse, getting the Hydrochloric acid and the enzymes dialed in. Now, some people, we try to increase the Calories, which in— you know— We talk about Calories, we’re talking about Calories from whole foods so that means nutrients. Right? We just used the term calorie ‘cause it’s easier to cut, right? We were kind of in this. A lot of the technology that’s out there, right? Whether it’s Chronometer, or MyFitnessPal, or “Lose It!” — There are lot of these things that are calorie-driven. We like Chronometer because it gives us the ability to count the micronutrients, the vitamins, the minerals, etc. So, we can make sure that nutrient density is up. We try to increase the amount they eat so they can last four or five hours. That’s ideal. Some patients, we may not be able to get enough food in there so the can last that long. They may say, “I am blo— so bloated. I’m so stocked,” but then they only can last two to three hours. That’s the issue.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If they can only last two to three hours, but they eat to the point where they feel so satiated and they can’t do anymore, that’s where I recommend more frequent eating at the two to three-hour level. I like to get closer to five ‘cause I want my patients to have a little bit of Ketosis happening, whether tapping in to more of the fat. ‘Cause every time you eat, for the most part, it’s gonna be make— your body’s gonna be paying a little bit of Insulin. So, if we can keep the Insulin down a bit, that helps with a lot of Insulin resistance. And, a lot of people can get Insulin resistant, primarily from the excess Carbohydrates. But, Cortisol can also push that because Cortisol can mobilize extra sugar in your bloodstream that can create that same kind of Insulin resistant mechanism that the excess Carbs will do as well.

Evan Brand: eah. When people hear that, they’re like “Okay. Well, how does that apply to me?” And the answer is, “Well, if you have weight issues, you could be eating a good diet. But if you have a Cortisol problem, you could have weight issues even though you’re eating like a Paleo template. You’re eating real food, meats and veggies. We see it everyday. Where people may have 20/30/40 pounds excess weight, if you fix that Cortisol issue, all the sudden, people just start dropping weight. And I always say it’s a side effect of getting healthy, which is the best part.

Dr. Justin Marchegiani: Exactly. And, you know, just to kind of toot our own horns a bit here, the reason why I think our show is so important is ‘cause we’re talking about real life patient experience. A lot of people talk about theoretical philosophical functional medicine and nutritional concepts. We’re bringing you the live stuff. So, anyone listening, if this applies to you, try to use it. Try to utilize it for yourself. See if it fits. And if you need more customization or sport— or support, make sure you reach out to Evan or I by clicking any of in— information below in the description section.

Evan Brand: Yeah. So, I want to comment on something else you said too, which was about the people who get so bloated after a meal. And  those people, you don’t want to depend on just the Stool Test. You may have to get that Organic Acids, and if you already had Organic Acids but it’s several months old, you may need to get retested ‘cause you could just have a massive Yeast problem. And if you’re throwing Kombucha or something into the gut, and all the sudden you’re bloated and you’re like, “Hey, I don’t have parasites.” Okay, cool, but it may be something else. That was my issue, man. I would get super bloated, and it was ‘cause I had a Candida overgrowth.

Dr. Justin Marchegiani: Yeah. What happens is the digestive system is so stressed that you can’t even get enough nutrition in your gut. So, that food stabilizes you for two to three hours ‘cause you feel so bloated or so nauseous or so just digestively incapacitative. And that’s where you really have to focus on the gut and you have to make the meal smaller, and you really have to utilize tools, like a Crock-pot or an Instant pot or more Bone Broth or more Liquified Nutrition to make it easier on your Digestive System. And, other strategie are just chewing your food up well enough. Uhm— making sure you’re not eating when you’re stressed. Of course, utilizing digestive enzymes and Hydrochloric acid to break that food down. The chewing process increases the surface area and allows the Hydrochloric acid and the enzymes to work better. So, if you’re only chewing your food like 15 or 20 times, try to double the amount of chews. You know, typically, one chew per tooth— 32 teeth. That’s a pretty good rule of thumb— that will help your Digestive system to work better, give more surface area for the enzymes and the Hydrochloric acid to work.

Evan Brand: I’ll tell you, nobody’s doing that. People are like, “Oh my God! Thirty-two chews. I’m doing three and then I swallow, you know, especially if somebody goes to like Chipotle or somewhere where the food is just so soft and mushy. You just shove that mush down and you don’t even chew it. So, yeah. That’s a— That’s a big problem.

Dr. Justin Marchegiani: I mean, like today. I had some really good Collagen peptides, like 20 grams with some grass-fed butter and uh— some MCT Oil. And then after, I’m having, right here, a nice organic Korean drink.

Evan Brand: That’s  good one.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I like that one.

Dr. Justin Marchegiani: It’s a good one and it’s cold-press.

Evan Brand: How much sugar is in that one?

Dr. Justin Marchegiani: Not much at all. I mean, it’s got 9 grams, but that’s the— the lowest you can have with a vegetable drink. I mean, listen…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …to the ingredients, right? Cucumber, Kale, Broccoli and Basil. There’s not anything that’s higher sugar, and there’s not anything that’s fruit-based, right? [crosstalk] You can have…

Evan Brand: Some of those are like 40 grams. Some of those Suja’s, they get crazy with the apple juice.

Dr. Justin Marchegiani: The Suja, yeah. I mean, you can get really screwy because they’ll have like, “Oh! It’s a vegetable juice,” but then it has a carrot in there. Remember, a cup of carrots— cup of carrot juice has more sugar than a Coca-cola.

Evan Brand: That’s hard to believe.

Dr. Justin Marchegiani: I know.

Evan Brand: I know you told me that, but it’s like, “What?!” That’s crazy.

Dr. Justin Marchegiani: And again, There are some good nutrients in there but sugar is sugar, and your liver still has to do what it has to do. And, if it’s Insulin resistance, all these JNK lye enzymes that are really inflammatory get upregulated in the liver to process it all. So, you’re much better off getting the phytonutrients for something like this. And, this is really easy on my gut, right? So—

Evan Brand: Yeah.

Dr. Justin Marchegiani: I had amino acids, some fat. Uhm— I had some MCT Oil, and I have this. So, it’s a really easy kind of digestive breakfast— ton of phytonutrients, seven servings of veggies. Easy peasy, right?

Evan Brand: Yep. I have an idea where I’d like to take the conversation…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …unless you’d like to go somewhere else, and it would be to talk about some of the foundational supplements you could use while you’re working through some of this. So, we won’t get too much into like the gut protocol stuff because that is so different, depending on whether it’s just parasites, whether it’s parasites plus Yeast, whether it’s bacteria plus parasites plus Yeast plus fungus plus [incomprehensible].

Dr. Justin Marchegiani: Totally. Totally.

Evan Brand: That gets crazy. So, maybe we can just chat about kind of our favorites in terms of basic Adrenal support and things that could also help stabilize blood sugar to get somebody through this.

Dr. Justin Marchegiani: Well, I think the first thing is— Let— Let’s start with food, right?

Evan Brand: Okay.

Dr. Justin Marchegiani: Let’s make the nutrition that we’re eating easy to process and easy to digest. So, you can do like a smoothie option with good fats and Proteins blended up. You can do a Crock-pot kind of meal. You can do maybe the butter, MCT, Collagen coffee, and then, you can get some of your micronutrients through a green drink to make it easier on your digestive system. Of course, maximizing Hydrochloric acid, enzymes, and your bile salts, especially if your stools are floating. You can definitely utilize a lot of the free-form amino acids. And then, if your gut’s on fire— you know— we have a lot of uhm— formulas that are gut soothing like my GI Restore. A lot of the healing, soothing nutrients to help that gut line heal. So, those are a couple of really good options to start. Again, we always start with the foundation. You want to build this awesome fancy hotel, you got to start with the floor one. Most people want to go to like. Wha— What’s that floor ten? What’s this cool little thing there? Start low. Start at the bottom, and then, build up to the top.

Evan Brand: Yeah. Make sure you’re addressing your emotional stress too. It’s like all the magic pills we give you for your gut can’t counteract you going through the middle of a divorce. So like, sometimes, you just have to make sure that you’re getting a counselling session. And you know, we kind of are counsellors in a way, but at a certain point we can’t go too deep. We’ll give you recommendations like your emotional freedom technique to tap [crosstalk] on what you love. Uh— That stuff is good too. So, you want to try to make sure you empty the stress bucket. You do your lifestyle stuff, too, like your Epsom Salt baths. Schedule a massage. Maybe you take a Friday off so you can have a three-day weekend. Go out like Justin, and go play out in the water like that…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …stuff is all good, too, and that stuff is just priceless. And then, my recommendation, which I like to mention, would be Schizandra berry. I’ve been feeling really good. So, what I’ve been doing? I’ve been taking my Vitamin C tonic powder, which is a teaspoon a day, 2,500 milligrams Vitamin C, and I mix it with the Soothe tincture, which is the one with Ashwagandha, the Reishi, the Motherwort, the Sisyphus, the Albizia— the one I tell you about…

Dr. Justin Marchegiani: Sisyphus, like—

Evan Brand: ..which I love. I’m growing some, man. So, I just got some. They’re called Jujubes.

Dr. Justin Marchegiani: Oh, yeah.

Evan Brand: It’s actually called Chinese dates, but that’s where they get Sisyphus from. So, it’s the seed that comes in the middle of the Chinese date. That’s where they extract for the [crosstalk] Sisyphus.

Dr. Justin Marchegiani: Jujube. Uh— There was someone talking about this recently. I had a patient…

Evan Brand: Really?

Dr. Justin Marchegiani: ..talking about the Jujube. There’s someone in the podcast realm that’s— that’s— that’s really up on it now.

Evan Brand: Uh— Okay. So, the Jujube seed…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …that’s where you get it, and I’ve got two trees out in the yard that I just…

Dr. Justin Marchegiani: Oh! I know who it was. It was Jimmy Moore and Dr. Will Cole. They were talking about this recently.

Evan Brand: They were telling about Jujube?

Dr. Justin Marchegiani: Yeah, Jujube. Yeah.

Evan Brand: Oh, really? I like the term Sisyphus better— sounds cooler.

Dr. Justin Marchegiani: Sisyphus sounds awesome, man.

Evan Brand: And that’s technically what they’re using. They’re not using Jujube. They’re using the Sisyphus seed, but uh— Sisyphus is the Latin for it.

Dr. Justin Marchegiani: Okay.

Evan Brand: Anyhow— So—

Dr. Justin Marchegiani: But just to just— I want to dovetail…

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: …what you’re saying. So, simple things you can do, right, EFT stuff. Right? Really simple, like three minutes. Just go through— Just think about whatever the problem is. Just— Just go through and tap all the points.

Evan Brand: Do you do affirmations or you just think about the problem?

Dr. Justin Marchegiani: U—

Evan Brand: ‘Cause I like the affirmations.

Dr. Justin Marchegiani: Both. Both. I— I think it depends, right? Like if you’re in a really negative place, it’s hard to go positive and ignore what’s the emotion that’s happening. So, I try to calm the negative down. And then once that’s down below, like a three out of ten, right— ten out of ten’s the worst; one’s nothing; three— The— Then I can go into that positive place. But I try to get— get it down first, and then— and then I’ll do a— affirmation. Number two, is you can do the uh— the Mwave, the new one for the— for the mobile phone…

Evan Brand: Yeah. How does—

Dr. Justin Marchegiani: …out on the year.

Evan Brand: …it work?

Dr. Justin Marchegiani: It basically, you just synchronize your breathing, and you focus on your heart and gratitude while you synchronize the breathing. And then you go into a place of coherence, where the heart and brain are more in sync, so to speak. And that’s…

Evan Brand: I feel helpful.

Dr. Justin Marchegiani: …good.

Evan Brand: I’ve got— I don’t have the mobile one. I’ve got the little…

Dr. Justin Marchegiani: Yeah I have both.

Evan Brand: …pocket one. It’s got way too much blue light though. It’s a blast you in the face. I need a little filter or over something.

Dr. Justin Marchegiani: I think the mobile one’s better, personally.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And uhm— it’s easier to bring with you. You just have this and your phone’s all ready. ‘Cause I don’t bring it with me and it’ll always be dead, and I’m like, “Aw, shoot!”

Evan Brand: Right.

Dr. Justin Marchegiani: So, one more thing to charge.

Evan Brand: [laughs]

Dr. Justin Marchegiani: So, as long as my phone’s good, then that’s good. So, I like that. You know, you can do three to five minutes twice a day. You can just download the Calm Meditation App, and you can do a five-minute, even a three-minute meditation, twice a day is helpful.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just a couple little things like just something that’s not gonna take a big chunk out of your day up that you can justify doing. So, figure out which strategy is best for you and just try one. Even if you do it once for three to five minutes a day, it’s a good starting point to put you in parasympathetics. And the other one is just a good walking meditation. Like, if you do a walking meditation, three to five minutes on appreciation and gratitude, and then three to five minutes on visualizing kind of what it is you want to create or manifest. ‘Cause, you know, appreciation, you go backwards and you— and you thank and you appreciate, and then the visualization is kind of moving forward. So, I think that’s a really good way to do it. And then, you know, like, I get this one from Tony Robbins. It’s a— It’s a— It’s a breathing in. [breathes in multiple times] and then fo— and then four out. And then, what he does is when he breathes, he taps on the acupuncture points on the fingers. So, it’s like in-tap, in-tap, in-tap, in-tap, and then out, back.

Evan Brand: Oh, as your breathing you’re saying?

Dr. Justin Marchegiani: …two, three, four. So, it’s [breathes in and out multiple times in sets of four] So, you’re tapping on these acupuncture points, which are basically EFT points, and you’re doing that while you’re breathing. So, you’re kind of having an EFT session on your fingers, while you’re breathing and walking and then you do a— a kind of a— a gratitude?

Evan Brand: How many reps is he doing? Does he say, specifically, or just whatever?

Dr. Justin Marchegiani:  It’s just basically used about a time thing. So, he does a five…

Evan Brand: Oh.

Dr. Justin Marchegiani: …to fifteen minutes. So, technically, it’s like gratitude for five, visualization for five, and then affirmations for five.

Evan Brand: And that’s all while walking?

Dr. Justin Marchegiani: Corre— Oh, wait. Yeah. You can do a bite. Uh— I like the movement. He does some kind of a movement with it.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: Yeah. So, it’s five visual and five appreciation, five visualization, five affirmation. And you can cut it down to three, three, and three. If you need to do it in ten minutes. And in the affirmations, they’re just affirming what it is you want to create and manifest. Like, everyday and every way, I’m getting healthier and healthier. Everyday [crosstalk] and every way, I’m getting happier and happier. Whatever that is, you’re just affirming it. These are some really good tools and it changes your physiology. And you’ll see, if you— you testing your heart rate variability, you will see it. And then, another simple thing, ready? This is something everyone can do, no matter what. If you’re a programmer, if you’re a teacher, wherever you’re at, just focus on nose breathing. [nose breathing] No breathing from the mouth at all. The Parasympathetic Olfactory nerves tie into the vagus nerve, which is the part of the Parasympathetics, and that really helps relax you So, [breathes deeply] deep nasal breathing— You can do it when you’re having a conversation, when it’s your turn to— to listen. You can do it when you’re watching TV. You can it when you’re typing something up or doing some research. Whatever you’re doing, just like good deep nasal breathing.

Evan Brand: I was doing that just now. I feel so much more relaxed. I think it was because I focused on it. I feel good, like I just calmed down like a notch or two.

Dr. Justin Marchegiani: So, like my thing is what’s the low-hanging fruits. So, if anyone’s like, “Oh my God! I’m so busy. I don’t have time for anything.” Great. You’ve time to breathe, right?

Evan Brand: [laughs]

Dr. Justin Marchegiani: Obviously. So, breathe through your freaking nose, [laughs] right?

Evan Brand: [laugh]

Dr. Justin Marchegiani: Breathe through your nose. Number two, if you have three minutes— three to five minutes, I would just say, if you have a lot of emotional stress or baggage that’s bugging you where you just feel bugged down of whatever that stress is, I think EFT is great. ‘Cause it’s really hard doing a meditation when you got a whole bunch of crap coming through. So, I rather just like lower the emotional stress of whatever that— that, you know, trauma is coming in— whatever that is. Get that down. ‘Cause once your brain’s a little bit quieter, then you can engage in meditation. ‘Cause I find meditation— It’s hard to enjoy it if your brain’s going crazy…

Evan Brand: Agree.

Dr. Justin Marchegiani: …thinking about stuff. So, I much rather get quieter brain by doing some tapping, and then once it’s tapped— Once you kind of tapped out, so to speak, you can go and do a meditation or visualization.

Evan Brand: I would recommend scheduling something, too, whether it’s paying somebody to do an at-home massage or going to get a massage, or—

Dr. Justin Marchegiani: Massage is a game-changer.

Evan Brand: I’m a huge fan of float tanks too because…

Dr. Justin Marchegiani: Yup.

Evan Brand: …there’s something you just can’t get by meditating or taking an Epsom Salt bath, like a physical touch from another human. I mean, we’re in a touch-deficient society due to technology, and I thought that was interesting too. I had Jason Prall in my podcast. He just did this whole Human Longevity Project…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …him travelling the world. And he said, “Man, Americans are so weird when it comes to touch.” Hey. He was like ove in Greece and Italy and Spain,and all sorts of other places. Costa Rica; he goes. Man, everybody hugs and kisses like it’s nothing. He said they were at a restaurant. It was like an Italian restaurant, and all these complete strangers were interlocking their arms together and dancing and singing, and just having so much fun. It’s like, you would never lock arms with a random stranger and dance with him in America, that would be frowned upon and made fun of. So, I think our touch-deficient culture requires more things like a massage, which you got to pay for.

Dr. Justin Marchegiani:  I do think a massage is phenomenal. I just went and took m— my family out for massages. Yesterday was phenomenal. I get massages one time a week. I get a full— full-body kind of foot massage, as well as a Myofascial Release in the upper body, and I think it’s essential.

Evan Brand: Have you visited other places? Have you seen what I’m talking about, this whole cultural issue where people are freaked out to touch a— a stranger or— or hug people and kiss people?

Dr. Justin Marchegiani: Yeah. I definitely that’s— you know— that’s a part of, I think, our culture. I think it depends too. I think different ethnicity is like, you know, an Italian culture I kind of brought up. I was brought up and everyone’s kind of hugging and this and that, and that was kind of part of it. So, I think it just depends, you know, within whatever culture you’re within. Uhm— That can definitely shift, for sure. And I think it’s good to have that. I think it’s great to have it, but if it’s something you don’t feel comfortable with— I mean, obviously, you should feel comfortable with that in your family. I think that great. But maybe a stranger or…

Evan Brand: Right.

Dr. Justin Marchegiani: …maybe someone…

Evan Brand: [laughs]

Dr. Justin Marchegiani: …you’re not really close with, you know, you can use massage as a great way. Especially like a foot massage ‘cause the Somatosensory cortex has lots of receptor sites in the feet. And that really gets the Parasympathetic stimulated, which really gets you into that Rest and Digest mode. So, a good foot massage is amazing on the nervous system. My brother, I took him out, him and his wife, for a massage yesterday, and he got a foot massage and he’s like, “Oh my God! I feel invigorated after that massage.” I’m like, “Yeah. It’s really getting that Parasympathetic branch of the Nervous System dialed in.

Evan Brand: Ain’t that crazy? It wasn’t even a full-body. You can just so the feet. Uh— I don’t know if you’re little baby— Is he— Is he starting to tee— Is he getting teeth in?

Dr. Justin Marchegiani: Yeah. he’s doing great. We were using a homeopathic called Camilia.

Evan Brand: Yeah. [crosstalk] We were using that one too.

Dr. Justin Marchegiani: That one’s phenomenal. Amazing.

Evan Brand: Here’s some— Well, here’s something crazy, So, uh— summer, my daughter, she— She doesn’t have the molars coming in yet, but…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …her— her fourth canine is starting to come in, and we’ve been using the homeopathics and it’s worked somewhat. And then, I came across this literature that was talking about like acupressure points on feet. And supposedly, the tips of the toes, or the places where the canines or the molars can be kind of desynthesized And so, basically, she was really fussy, and II started just massaging her toes, especially the tips of her toes, and she calmed down.

Dr. Justin Marchegiani: Mm—

Evan Brand: I was blown away. So, I mean, maybe it’s random Placebo or maybe there’s something to that. But, I tell you, man, it worked in like 30 seconds of me rubbing her feet.

Dr. Justin Marchegiani: Oh, I think that’s great. I always get my son like a tummy massage. You know, if you’re looking at his— looking at his tummy.

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s a clockwise massage so I start here at the, like for instance, this is gonna be like the descending colon and this would be like the ascending colon going up. And it’s just uh— here, and obviously, there’s like a nice like moisturizer on his tummy and it’s just like this. And I use that thumb to kind of pull everything right down the Sigmoid colon. So it’s at this…

Evan Brand: That’s cool.

Dr. Justin Marchegiani: …and then right down. So, I just use my thumbs, and that helps. That really helps with bowel regularity. ‘Cause their Nervous Systems aren’t quite as dialed in, hence why they aren’t wearing diapers, right? So, that kind of just helps give the— the bowel just a nice gentle assist.

Evan Brand: Yep. That’s cool. So, maybe that advise will help you when he starts getting those uh— canine teeth and it’s brutal—

Dr. Justin Marchegiani: [incomprehensible] to the toes. That’s good. And, u— any of the toes are just like the big toe.

Evan Brand: The big toe worked the best. Yeah.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And she got kind of ticklish with the other ones but the big toe worked the best.

Dr. Justin Marchegiani: [incomprehensible] right at the tip?

Evan Brand: Right at the tip of it, yeah.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I just kind of rubbed it like I had like s— a piece of sand between my fingers. Just kind of rubbed it like this. And I swear— I’m not joking, she went from maybe like a seven out of ten on like the crazy “I’m Crying This Hurt” scale to maybe like three or four.

Dr. Justin Marchegiani: Cool.

Evan Brand: Like, she was still little fussy, and you could tell ‘cause the gums are really swollen, but she was not complaining as much. So— So, there you go people. Go get a foot massage. Go do a float tank. Now, let me mention my shake or my little tonic rather.

Dr. Justin Marchegiani: Yeah. Go ahead.

Evan Brand: So, it’s— it’s the VItamin C powder. It’s about 2,500 milligrams, and then I do two shots of the Soothe, which is the Ashwagandha, Reishi, Motherwort, Sisyphus, Albizia. And then, I do uh— two squirts of herb forms uh— Schizandra. So, we don’t have our Schizandra so that’s one case where I don’t use your brand or my brand. They do have a professional line for practitioners that we use, and I— I do two squirts of that Schizandra. And that addition to the Soothe, I didn’t think it would make a difference but it did. I feel really stable, really solid, blood sugar-wise. If I had a late lunch, I had no issues.

Dr. Justin Marchegiani: That’s awesome, man. Really cool. Very good.

Evan Brand: So, I hope that helps people. So, you mentioned your GI Restore product. So, it’d like kind of your leaky gut support.

Dr. Justin Marchegiani: Yeah.

Evan Brand: [incomprehensible] probiotics. I’ve got some probiotics. We carry several strains. Those could help modulate the inflammation a bit. Maybe just buy it and try it, but maybe work with a practitioner too. ‘Cause we have seen some cases where if you have a bacterial overgrowth or something, the probiotics can kind of— Uh— I don’t know if I’d say “stoked the fire” but for lack of a— for lack of a better term, I’ve had some cases where I don’t do probiotics to the post-infection plan and it works a bit better.

Dr. Justin Marchegiani: Yeah. I mean, I see probiotics being good on step five where you repopulating, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: With that three in the inflammation phase, probiotics can be very anti-inflammatory. It depends how much gut issues or how FODMAP sensitive, how much SIBO is there. Sometimes, probiotics can cause more gas and bloating. So, definitely got to work with the practitioner on that to make sure its individualized.

Evan Brand: Right. And— And you could try and maybe throw stuff at it but I don’t want you guys to build up a supplement graveyard because you’re trying to listen to random things and— and piece it together like— Justin uses a great analogy of like going up Mt. Everest. It’s better to go up Mt. Everest with uh— a Sherpa who’s done it a thousand times— same thing with Justin and same thing with me— rather than just free— you know, freeballing it because [crosstalk] you’re gonna spend—

Dr. Justin Marchegiani: Nice.

Evan Brand: You’re gonna spend more money. You just do.

Dr. Justin Marchegiani: Totally.

Evan Brand: You spend more money in the long run. Like, how many clients do you talk with every week who say, “Justin, I worked with so-and-so practitioner, and they have me on 50 supplements, and none of them worked because they didn’t base it on labs like we do. They just freaking guessed.”

Dr. Justin Marchegiani: Yeah. And also, when you make recommendations for supplements, you want to make sure it’s connected to a system as well.

Evan Brand: Yeah.

Dr. Justin Marchegiani: You want to make sure that yo— you’re supporting an underlying system, not just the symptom. ‘Cause if you’re playing the symptom game with supplements, it’s really easy to kind of whack them all. But if you’re tracing it up to the s— to the underlying systems and you’re also made underlying changes to the stressors— physical, chemical and emotional. You’re gonna be in a much better place; more holistic too, right?

Evan Brand: Yeah. Well, I would like to add another comment to that too, which is— which is, we see that a lot with Naturopathic Medicine and Naturopathic…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …practitioners versus functional medicine. I think there is the distinction there because a lot of Naturopaths, they may say, “Okay. we’re not gonna use Aspirin for the inflammation. We’re not gonna use Turmeric, and that’s it.” [crosstalk] But they don’t get…

Dr. Justin Marchegiani: Or White Willow Bark.

Evan Brand: Oh, yeah. Or White Willow but they don’t get to the root cause of, “Okay. Well, why is the inflammation there in the first place?” Let’s run Labs to figure out the source. So, here you are taking high-dose fish OIl, You’re taking Turmeric. You’re doing White Willow Bark or whatever and you feel better but you didn’t address the root cause. So, you get off the Turmeric and the Fish oil, you still feel like crap. Your joints hurt. You’re fatigued. Your sleeps sucks And you don’t know why. It’s ‘cause you had infections but you never went that deeper level. So, I always told people, “Get to the root cause of the root cause.” Meaning, “Okay. If there’s inflammation, if there’s blood sugar issues, if there’s sleep issues, why?” Okay.

Dr. Justin Marchegiani: Hundred percent. That makes sense.

Evan Brand: And then— And then ask why again, and if you keep asking why? You should have initially get to the answers.

Dr. Justin Marchegiani: I like it. Makes a lot of sense to me. Let’s hit a couple other blood sugar questions. When people talk about being more Insulin sensitive, that means you need less Insulin to fit into the receptor site to pull that Glucose into the cell to utilize it for fuel or store as fat— one of the two, right? Glucose is either gonna be stored or burned. So, the more metabolically active you are, the more of an ectomorph you are, the more Insulin sensitive , the bigger— the more muscles you have, the more you’ll burn it. The more Insulin-resistant, meaning the more Insulin you need to make that receptor site happy to pull that Glucose in, typically the less active you are, the more fat cells you have so, the more your body will store that and not burn it. Not good because fat cells produce a significant amount of Interleukin, which are inflammatory compounds. So by the more fat you have, you’re actually making yourself more inflamed.

Evan Brand: Well, I think you need to slow down and say that one more time ‘cause that’s gonna blow people’s mind.

Dr. Justin Marchegiani: So, [exhales] reg— regarding Insulin. We want to be Insulin sensitive. Insulin sensitive means— Insulin receptor site, Insulin goes in. That allows the door to open so Glucose can go into the cell Once it’s in the cell, it’s either gonna be stored or burned. ‘Kay? So, the more Insulin sensitive you are, you’re tending to burn that Glucose for fuel because there’s less of it there, number one. And you’re gonna be more Keto adaptive, so you gonna be more— be burning more fat for fuel over Glucose, you have less Glucose coming into the cell. So, it’s either gonna be stored in the muscle for exercise or movement, it’s gonna be a small amount will be used by the brain, 20 grams a day, and the rest could be stored as Glycogen in the liver. So, as long as we don’t have— we don’t— we don’t go above what our— what our body can store, then it’s all gonna be is Glycogen or gonna be burnt up in  moment for fuel during an exercise or a movement pattern. Okay? The more Insulin resistant we are, those storage sites are gonna be full. It’s gonna be like you trying to use a sponge to sob upi a mess on the table, but the sponge was never wrung out. So, the more active you are and the more Insulin sensitive you are, it’s like wringing out that sponge. Now that sponge is more absorbent. ‘Cause we know that if you don’t have that sponge wrung out, you’re just pushing around the Glucose. And you’re essentially pushing it into the fat cells, metabolically, in this analogy. So, the more Insulin sensitive, the more we burn fat for fuel, the more any Glucose that comes in. We have storage sites to put it in— liver Glycogen, muscle Glycogen, or using it for fuel. The more Insulin resistant, the more it gets burnt or stored as fat versus allocate it for— for burning.

Evan Brand: Got it.

Dr. Justin Marchegiani: You are primarily a sugar-burner when you are uhm— when you are Insulin resistant because the more Insulin that’s in your blood, the enzymes shift to more storing enzymes than burning enzymes. So, instead of having Lipolytic enzymes being produced— Lipo meaning fat; lytic meaning breaking down or to cut. So, the more Lipolytic means you’re breaking down fat when Insulin is low. The more Lipogenic enzymes are produced when there’s lots of Insulin— Lipo meaning fat; genic meaning store or forming. So, Lipogenic enzymes go high when Insulin’s high. The more Insulin sensitive you are, the more Lipolytic enzymes are produced, the more you’re burning fat for fuel. Does that makes sense?

Evan Brand: It does, and I was gonna take it a step further and say, “This is why people who were Insulin uh— sensitive could probably get away with some fruit versus people who are Insulin resistant. The may have more issues with fruit, and that maybe why we temporarily pull it out if the goal is weight loss. The can’t deal with it. You made a good analogy. It’s like that sponge is full so if you throw in— you know, a bunch of apples or oranges or mangoes or whatever, that Glucose— there’s no room. So, it’s just gonna go straight into the fat, and— and create more body fat and gain weight.

Dr. Justin Marchegiani: Yeah. And the more Lipogenic, the more Lipogenic enzymes are produced, a lot of times that can make you tired, right? Some people, the more Carbohydrate is produced, there’s a propensity to burn that for fuel. So, of course you move it and you burn it. Some people, the more Carbohydrate that’s produced, they actually get more tired, so there’s actually less propensity to burn it, which means it gets stored as fat. So, listen to your body if you start increasing the carbs and you’re not getting energy out of it and you’re not feeling a propensity to move, be careful. Or you just make sure you have good exercise regiment in there. And of course, muscle mass— the more muscle mass you have, it’s like upgrading your sponge size, right? So, that’s the benefit of ecuhm— resistance training. It’s number one, you build a bigger sponge, and number two, you upregulate these little Glut4 receptors, which are like little fingers on top of the— the cell that pull into that Glucose. So, it more efficiently pulls it out of the bloodstream.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s like Glut4 like Tim Ferriss and his book, “The Four-Hour Workweek.” He talks about doing like little air squats or like little mini push-ups before he has a Carbohydrate-rich meal because he’s trying to upregulate the Glut4 receptor sites doing some resistance movement before he consumes the Carbohydrates.

Evan Brand: Yeah. I don’t do anything like that. I just would do Leg day and then have sweet potatoes and it felt so good together. Oh my God! Having a sweet potato after Leg day was like the best. We have a comment here too. The person put, “The longer I’ve been on Keto, uh— if I’m getting uh—” maybe they’re saying Intermittent Fasting. I think that’s what they’re saying— Keto IF. “I’m getting more Insulin sensitive. I’ve noticed I’m getting more resilient to being knocked out of Ketosis. That’s good.

Dr. Justin Marchegiani: Yeah. I mean, I think the— the more Ketogenic you become— because it’s like you starting a fire. With logs in the fire, it’s gonna burn longer. Anyone that’s has to use kindling, here they are feeding that fire all day long. And that fire going up and down also means energy. It also means mood. It also means focus. It also means cog— cognitive. That’s why so many people are getting massive neurological benefits and cognitive benefits becoming fat burners. And a lot of people talk about being Ketogenic. The problem is, what the hell does that mean, number one. And a lot of people confuse it with Ketoacidosis, which is bad thing. So, there’s a lot of dogma with what— what does Keto mean? But just, in your brain, think fat burning.

Evan Brand: Right.

Dr. Justin Marchegiani: Who doesn’t want to be burning fat for fuel, right?

Evan Brand: Agreed. Agreed. Well, let’s wrap this thing up. We had uh— We had one question here from Tim, “Could eating chicken breast without skin while keeping Carbs under 20 grams keep someone out of Ketosis?” It depends on your Protein, right? Justin, ‘cause if you go too high-protein, can’t that kick you out of Ketosis or am I wrong?

Dr. Justin Marchegiani: Yeah. I mean, you can go into Gluconeogenesis and make Glucose out of Protein. The thing is, though, I think a lot of people in the Keto community miss this. Are you gonna make more Glucose from chicken breast or are you gonna get more Glucose from eating like refined sugar?

Evan Brand: So, don’t worry about it basically?

Dr. Justin Marchegiani: No. I think you got to be careful of it. It just depends. Like, you’re gonna need more Protein if you’re more active. So, if you’re lifting more weights, for instance, you may need more Protein. I just think go to a more full-fat source versus a boneless skinless chicken breast. Do a skin on at least, or at least move to a thigh.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Get some full fat in there. But again, I think in Keto, if you’re lifting more and you’re doing more resistance training, you’ll be able to get by with more protein and not have it affect you.

Evan Brand: Agreed. Agreed.

Dr. Justin Marchegiani: But the more sedentary you are, definitely got to lean more in the fat, higher fat percentages and, of course, full-fat meats.

Evan Brand: Yup. Well said. I had some chicken thighs last night. It was delicious. I put the real salt. They have a seasoned salt. Have you had that one?

Dr. Justin Marchegiani: I got it. I got it.

Evan Brand: Aw, man. That’s yummy. That plus Coconut aminos— Summer, she loved it too, man. She ate so much of it. She ate almost as much as us. It’s like, “You’re not even two years old. How do you eat this much?” I can’t believe it. She ate like two full thighs. It was unbelievable.

Dr. Justin Marchegiani: Love it, dude.

Evan Brand: Well, let’s wrap this up. I think— I think I said everything I need to say and want to say on this topic.

Dr. Justin Marchegiani: What a great podcast, man. Hey! We’ll chat real soon. That and you have a phenomenal day. Everyone, if you’re subscribing, give us a thumbs up. Hit the bell and give us a share. Sharing is caring. We appreciate it.

Evan Brand: Mentioned our links so uh— if you guys want to reach out, schedule a consult with Justin. You can do so at his site, justinhealth.com, and if you would like to reach out to me, same thing, evanbrand.com. And, we look forward to helping you all out. Take care.

Dr. Justin Marchegiani: Take care, Evan.


Jimmy Moore and Dr. Will Cole’s Jujube-related Podcast

“Human Longevity Project” by Jason Prall

“The Four-Hour Workweek” by Tim Ferris



Looking Deeper at Your Blood Tests – Podcast # 168

Dr. Justin Marchegiani welcomes Dave Korsunsky, founder and Chief Executive Officer of headsuphealth.com, which is a website about tracking health data. Join them as they discuss about blood sugar levels, ketone levels, blood test and other health-related data that can be integrated with smart devices and the website as a means of analyzing your health.

Know about preprandial and postprandial blood sugar readings and glucose functional ranges. Also, find out more about the Carb Tolerance Test and learn how it can provide value and insight to how your body responds to sugar from different food sources.

Dr. Justin Marchegiani

In this episode, we talk about: 

05:08   Functional Glucose Tolerance

13:45   Body Composition and Postprandial response

18:16   Quick walk through on Headsuphealth

31:51   Heart Rate Variability

35:54   Stress and its associated markers


Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio! My good friend Dave Korsunsky is in the house. Dave Korsunsky, how we doing today?

Dave Korsunsky: Fantastic, Doc. It’s been far too long since we’ve connected, so happy to be back.

Dr. Justin Marchegiani: Excellent. Love it. So happy we’re connected here, too. Let’s talk about I mean you run the website headsuphealth.com— Heads Up House, phenomenal site where you can track your data. Again, you’re putting lots of new features in there where people can—can plug-in or integrate some of their smart devices, Fitbit, some other ketone or blood sugar reader scales, blood pressure cuffs integrate with lab companies. Lab Corps, coming out soon, you mention Qwest. So great way if you’re kind of like a bio hacker or a health hacker and you want to put everything in one place. Awesome place to look at there. So we have uhm—we have a new feature, where we talked about the new features that are coming up. So we’ll have an affiliate link here below, so if you’re listening to this information and it resonates with you or you want to try plugging it in, we’ll have an affiliate link down below that you can click to get access to some of this information to get your account moving. And again, start integrating some of the features that we’re gonna chat about today.

Dave Korsunsky: Great.

Dr. Justin Marchegiani: Okay. So off the bat, let’s dig in. So, one of the more important things that it’s coming here is we have some newer ketone readers in the market. Uh—one of those readers is called the “Keto Mojo” Cool thing about it is Keto strips are cheaper, which is great. It’s gonna measure ketones along with blood sugar and and it’s also gonna measure hemoglobin and hematocrit. Love it. I’m waiting for just that extra feature of insulin then we got like just freaking lab in the little reader right front of us. Wouldn’t that be amazing?

Dave Korsunsky: Every time I see Dorian the founder, I beat him up to say, “Hey, Dorian, can we get an insulin strip?” Because as you know, that’s— that would be a game changing piece of information that currently there’s no way to do that in a consumer test. But if you can start testing things like postprandial insulin just at home after different meals, it’d be awesome but nonetheless, they’ve put a great product out there and it’s really made ketone testing affordable and accessible to people who perhaps couldn’t have access to this before. So that’s a great one. We’re gonna to talk more about it as we go here.

Dr. Justin Marchegiani: And the reason why insulin is so important is because you have a lot of people that are insulin resistant with their blood sugar looks decent, let’s say 90 or 95 right? But it’s only decent because insulin is compensating and going so, so high. So insulin is shoveling out that blood sugar into the cell, so then the blood sugar looks lower because the insulin is basically the shovel. You got a lot more shovels shoveling that out. So it’s different coz if your blood sugar is here with high insulin, then you’re developing insulin resistance, right? Coz you have more shovels—cons—you know, compensating for that. If we decrease—and your blood sugar’s good, that means you are insulin sensitive.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And we need low insulin to increase ketones, right? Ketones and insular on the scale. So people are like, “Hey, I’m like trying to lower carb or my blood sugar’s low but my ketones are low.” Well, that’s the missing variable is the insulin could be high. So to keep that in mind, we have this little seesaw fat with insulin and ketones. Anything you wanna say about that?

Dave Korsunsky: Yeah. We wrote a blog post exactly on that topic. And we talked about why fasting insulin is one of the most important test your doctor probably isn’t running because you’ll—you’ll get a typical fasting glucose test with no indication of whether or not insulin is artificially inflated, keeping that number down. That’s why it’s important to test both at the same time. So, yeah, I would agree. I think it’s incredibly important. I’d love to see the day we can start testing that at home. But right now, the only way to get an insulin test, whether it’s fasting or postprandial or whatever, is at the lab. And we’re gonna talk about that a little later in this metabolic panel that you have cooked up here.

Dr. Justin Marchegiani: Yeah. Absolutely! And we’re gonna do a screen sharing just a few minutes. The key—we’re gonna kinda just dial a couple of key components here. So let’s say you kinda already transitioned from a Paleo template approach or maybe you’re doing a Keto Paleo where you’re focusing on nutrient dense, anti-inflammatory, anti-toxin foods, right? But you’re keeping the grains, the dairy, the legumes out and such and you’re doing higher-quality fat, but you’re trying a very lower carb version 20 or 30 net grams. Big thing that we can work on integrating today is some of the heads up features looking at that fasting one hour, two hour and three hour glucose tolerance where we called it a functional glucose tolerance. Meaning, we’re not going to drink that 75 gram of glucose artificial sugar crap at the doctor’s office. We’re choosing a real meal not a fake exaggerated meal, but a real meal that we can see how our blood sugar fluctuates over that three-hour period. And you’ve integrated that in there. And why don’t we go to the screen shot on your side and you can kinda just walk us through how that looks. And just for everyone below here, if you listen to this on podcast, the YouTube channel click the affiliate code below we’re gonna have so you can get access to this information.

Dave Korsunsky: Yeah. I remember when you and I first started working together, doc. And I was your patient and you educated me on what the functional glucose tolerance test actually was versus the oral glucose tolerance. And the functional glucose tolerance being something you could do at home after any meal. And for those who were unclear, the oral glucose tolerance is the formal test we go to the doctor, drink the sugar and you hang around and get the— the postprandial blood glucose test done. Not really that practical in reality. But the functional glucose reference you can test with anything. So I’ve got my screen shared, can you see it here, Doc?

Dr. Justin Marchegiani: I can see it. You’re up.

Dave Korsunsky: Yes. So, this is something we ended up calling initially we called it the functional glucose tolerance test, but it was just a little too wordy to fit in. So it’s really just a carb tolerance test and actually Rob Wolf talks about this in his book as well, where based on some research out of Israel, there was a study done following 800 different people and they found that you could give two people the exact same carbohydrate source whether it’s sweet potato or bread or lentils and they would have very different postprandial glucose responses. So the key take away was that it’s different for everybody. And back to the functional glucose tolerance, where you’re actually having people test their favorite breakfast, test their favorite restaurant meals or meals they’re eating at home. So here’s how this works and you can see on my screen here I’ve got the future called the Carb Tolerance test and you can just click the plus button here. You can test anything you want. So let’s say you test your—your favorite breakfast of Denny’s bacon and eggs. And all you do is just put a name in here, but this could be anything. It could be a muffin, it could be 50 g of Sweet potato, it could be anything that you’re curious about. You say I eat this food regularly, I want to understand how my body— my body’s postprandial glucose responses are going to be. So I’ve called this anything I want. And what I do is I test my blood sugar before I eat that food. So let’s say that my—my pre-prandial for example was 85, and if this was a fasting reading, I could also take it as such. And then what you do is you just test one hour, two hour and three hours after the meal and update this intro info accordingly. You can also record any subjective symptoms and this could help you identify—even though you may have a nice, healthy postprandial glucose response, there’s also the ability to record subjective symptoms. “Did I have an energy crash?” “Did I get brain fog?” Did I feel hungry 30 minutes later?” or “Did I have digestive issues?” And you can save that and then share it with a practitioner like yourself. So I’m gonna answer my pre-prandial glucose reading here and then hit save. And you’ll see this will create a new entry here. And then all I have to do is just update the one hour and a two hour and a three hour after I go. And just to give you an example of what that looks like when it’s completed is here’s what I did at In-N-Out Burger because when I’m traveling, often you don’t have access to all of the healthy, low-carb food to do a home. So I go to In-N-Out, I’ll get two lettuce wrap burgers with—they call it the protein style. And I wanted to see, does—does just a protein burger with no bun have an effect on my glucose?

Dr. Justin Marchegiani: Uhm.

Dave Korsunsky: And here with the results: 90- 106 at one hour; 89 at two hour; and then back to about 95 at the three hour mark. So, maybe I’ll kick it back—back to you, Doc. And you can share more about what you’re looking for in the postprandial glucose curve as you have your patients test different meals and different foods.

Dr. Justin Marchegiani: Absolutely. So, in general, you know, we have this kind of fasting ideally below hundred and 95. Again, we got to be careful in the morning because in the morning and that from when you wake up to 30 minutes later, your cortisol is increasing nearly 50 to 60% in that 30-minute period. And because of that healthy cortisol response, you can actually increase blood sugar and that big spike that’s like, you know, you’re making them over three quarters of your cortisol just in that zero- 30 minutes. So that spike can increase blood sugar and you may think, “Hey, you know, this is partly because of my diet.” And it may or may not be. So just kinda keep it like a little, you know, asterisk next to that and really look at your lunch and dinner ones, especially if you’re seeing an anomaly in the morning. So we like that zero below hundred and 95. We like hour number one, below 140 for extra credit. For extra credit, we like it below 120.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Below 120 and then at two hours, below 120 or close to a hundred and below— at three, definitely, below 100. So, kinda keep that as your— as your kind of your baseline. Remember we went out to eat out like a few months back. We went to a steak restaurant. I think I tested mine one hour after a meal and my blood sugar was 70 or 75, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So you can eat really well and you can choose foods that keep your blood sugar from spiking. And the whole benefit that is when your blood sugar’s not spiking like that, you’re not over secreting insulin; when you’re not over secreting insulin, you’re not gonna develop insulin resistance and all of the effects of that may have with ovarian cyst or cancer cells or inflammation and our blood pressure. So all those things kinda benefit. So, just kinda highlighting on your side, we can plug those in and we can map them and we can put the notes in there regarding what meals. Then you can say, “Hey, protein style In-n-Out.” “The steakhouse where I did” or “The cheat day where I ate this dessert or this crappy food.” Right? And then you can kinda map it out. And that can provide a lot of value and insight of how your body responds and also there’s the immunological qualities that Rob Wolf has talked about where it may not be a carbohydrate thing. It may be a cortisol response to a food allergen that’s getting your immune system wound up that could— that cortisol can increase the blood sugar as a—as a side side effect.

Dave Korsunsky: Yeah. And we—we’ve had several users on Heads Up Health test different foods that they thought were metabolically safe for their body and the results were absolutely shocking for someone will test certain foods that they’ve been eating. And I’ll share some results with me anecdotally and I’ll say, “Wow, I thought this food was safe.” And then they tested and it’s—the blood sugar still skyrocketing at the three-hour mark. It hasn’t started to come down at all. It’s a runaway train. And—and people actually had no idea. So this can be incredibly helpful just to make sure that there’s nothing really sabotaging your efforts. And unfortunately, you do need to test these foods yourself. You can’t just rely on things like the uhm— the guidance from the Diabetes Association or from the uh—glycemic load tables. There’s so much individual variance that this is why postprandial blood sugar testing— even if you’re not diagnosed as having a metabolic disease, even just for your own personal health, it is helpful to test different foods and—and just make sure that you are having a healthy postprandial response. So, that’s the new feature we’ve built into Heads Up Health. You can test anything you want and just make sure it’s metabolically safe. All of these readings will be stored. And actually, you can probably add more here, Doc. But after you’ve been on a clean Paleo eating template for several months, you may actually be able to tolerate foods that you couldn’t tolerate before as your body composition improves, your gut microbiome improved. So, maybe, you can comment on how something that might not be metabolically safe now could potentially be reintroduced at some future point after you’ve made some progress on your health journey.

Dr. Justin Marchegiani: Absolutely. So, of course, if you’re not breaking that food down, not digesting it well, that can create a stressor. It could just be a food allergen kinda like gluten. That could be a stress or dairy or casein, right? People on the Keto community, Keto Paleo community, they are notorious for maybe doing excess casein because you know, “Hey, you can do dairy or cheese or all these things.”
Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you got to be careful with the case in uh—from a Ketogenic perspective because that could be__. And uhm—of course, if you have an infection or SIBO or parasite or H. pylori something that’s driving gastrointestinal permeability or the word “leaky gut” That can get your immune system wound up, too. And of course, if you have you know, low levels of probiotics in your gut that can create issues. Coz probiotics help with the immune function to help reduce B vitamins and vitamin K. And of course, you know, good bacteria eats poop and poops nutrition, right? Bad bacteria eats nutrition and poops poop. Essentially, good bacteria provides more nourishment; bad bacteria provides more toxins and stress in your gut.

Dave Korsunsky: Yup. Exactly. So and—and what about body composition as well? Have you seen for example as you increase your lean muscle mass, for example, that may— does that also have an impact on postprandial response? Because we—we talked to a lot of guys who are bodybuilders and they can go out and need a huge quantity of food and—and postprandial responses are very low. So, I know you mentioned gut microbiome, but what about body composition muscle mass in response to uhm— postprandial glucose?

Dr. Justin Marchegiani: So, number one, if you have more muscle mass, you’re gonna have more glut 4 receptors to soak in that glucose. So, think about it as your kid makes a mess on the table, you go with a tiny little sponge to clean it up. That’s like tiny bit of muscle is a tiny of sponge.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Whereas like a huge—like one of those big sponges you used to kinda wash your car you have more muscles equivalent to a big sponge like that. Lots of glut 4 receptors. You can soak about that glucose just like you can go to your table with your kids mess and you can soak it all up and you didn’t even— didn’t even bat an eye, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So muscle does that. Also, muscle, if you have more muscle, that means you automatically have less fat, right? So fats and exocrine gland within itself so it will produce estrogen as well.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And what pretty much drives the fat is gonna be insulin. So excess insulin drives more fat; more fat drives more estrogen. So it’s kinda like this vicious cycle. More estrogen can make you more insulin resistant, especially if you’re a guy and then more insulin increases aromatase, which will take your testosterone and bring it downstream to estrogen. So you become more of a female hormonally and with women, it’s actually the opposite. They get more insulin – more insulin will drive the 17,20 lyase enzyme, which then increases androgens and then they get ovarian cyst and then they get more, you know, hair growth, acne. So it’s this vicious cycle our mother nature kinda swaps the roles there.

Dave Korsunsky: Yeah. I talked to a lot of people who are doing everything right in terms of the macronutrient profiles. They are eating low-carb, they’ve got things dialed in there, but— but little to no exercise. And yes, you will— you will lose that to a certain extent body composition will improve, but there’s—it’s also critically important to be building muscle mass, lifting heavy things and sweating. Those are two of the most important ingredients in my own regimen. Making sure I’m building up lots of muscle mass in in the quads, in the back, in the large muscle groups. And I think that’s something that at least in my experience, people I don’t think appreciate as much as they start down this path. They think that diet alone is going to handle it, but lifting heavy even if you’re just starting out starting to learn some of the functional movements that are— that build a lot of core body strength and really hit the big muscle groups. I think that’s perhaps the next level to get to once you have a solid foundation with the diet. Would you agree?

Dr. Justin Marchegiani: Hundred percent. And also, say make sure you get your 10+ thousand steps. Yesterday I got a 14,000 steps. That’s helpful because that— the steps really allow you to start basically cleaning out some of that extra—there’s little bit of extra carbohydrate in there. You can clean some of it out coz you’re constantly moving and the extra steps really help. And of course if your— you know, “ I don’t have a ton of time, so I’ll just jump in and do a couple cattle bells swings to failure, some push-ups to failure.” And that could help because the—the push-ups, right? You know, I have a push a bar so I can go really deeply, so I get a full range of motion push-up all the way down all the way up. I can get the upper body going. I’ll do my TRX Rose to get the posterior side nice and some kettle bell swings as well. And if you have a lot of time, throw a Tabata in there coz that high-intensity gets the growth hormone. And growth hormone is really gonna be stimulating a lot of that—that muscle tissue.

Dave Korsunsky: Yeah. I definitely have a home gym envy, Doc. I’ve been over to your place and I’ve seen your set up. It’s pretty nice, so I definitely would love to have something similar someday in the home.

Dr. Justin Marchegiani: And if you’re on a budget, really simple, TRX that hangs over door.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: You have the adjustable kettle bells on Amazon and get a push-up bar. Push-up bar is optional but I just like it coz you can get really deep coz I would go so deep I bang my head against you know, the floor. So I can go really deep full range of motion and not have to you know make out the floor, so to speak. So that’s a great option for you.

Dave Korsunsky: Those are great. I’d love to maybe see if we can find some of the recommended products on Amazon— the adjustable kettle bells, the TRX stuff and just actually may be included that here in the notes so people know which ones you’ve tested and they can just go out and get that and try it. So I think that would be uhm—yeah, that’d be cool.

Dr. Justin Marchegiani: We’ll get that in the show notes, for sure. Also, let’s just give—we kinda show some of the functional glucose tolerance stuff but you know—you just give us a cursory. Just just give us a quick walk through through Heads Up so someone that they’re gonna click on the link below, they’re gonna get to the site, but then what do they do? How does it work? Give us that like little round up there.

Dave Korsunsky: Yeah this is—this is my—my personal data. So let me just refresh the screen here because uh— some of the information didn’t actually come in on the last load. And as you share screen that’s what I wanted. So the first thing we’ll ask you as a new user is, “Which devices and apps you’re using to measure your health?” And so at least everyone who signs up has at least one of these devices. A withing scale an eye health wireless blood pressure monitor or glucometer, a fit bit, uh— my fitness pal for tracking the macros, Apple Health. These are gonna be able to pull in things like heart rate and blood sugars, sleep, macronutrient profiles. So all of that will flow in so you can connect as many of these sources as you want and then you’ll see were also starting to build some of the more specialized sources as well. The ones I showed first were more of the commercial grade stuff, but you can also see we’re starting to integrate devices like the Oura ring and the level breath acetone analyzer and things like Elite HRV and the other HRV monitors are coming in. So uh—we’re also working on the decks com, CGM device so we want to make it easy for people to build their own custom dashboard because everyone’s tracking different metrics. So this is all completely customizable. So that’s step one. And then you’re allowed to build your own custom dashboard. So I’ve got the carb tolerance test data here, but if that’s not something I’m working on, I can just actually hide it. And you can see my top three metrics are glucose, ketones and the glucose ketone index, which is just a ratio of these two numbers. A lot of our cancer patients and people with serious metabolic dysfunction are tracking the—the index of the two numbers. And then you can see I’ve got my weight and body fat readings those can come from a withing scale. They can be entered manually. This year is my heart rate variability, which actually comes in from the Oura ring and so that’s on here as well. Same as sleep. So that ring gives me a good sleep and HRV reports. So this is all completely customizable, breath ketones, resting heart rate. And then really what people try and figure out is how is this affecting my clinical markers? Are my lifestyle changes lowering my inflammation or not? And the only way to see that is to put the clinical markers in the same system as the light markers. And typically, the doctor has this clinical data. So it’s very difficult to compare lifestyle changes to clinical markers and that’s what we wanted to solve here and make it available for everybody. So I could just jump down and look at things like my inflammation markers and say, “Okay, is CRP coming down as I go on a clean Paleo template?” And we can actually link directly to your medical facility and pull this data out. So all you do is click the connect data button and let’s say that you’re sending patients to Quest Diagnostics. They would be able to just link their quest account to Heads Up and all of that information would flow in or if they’re using a more traditional health system and billing their insurance, you can connect Stanford, you can connect UCLA, you can connect the Cleveland clinic. There’s over 10,000 medical facilities in here and what we’ll do is we’ll take all of that data, clean it up and organize it from oldest to newest so people can actually have the full picture of their health and what we’re seeing is patients can look back into their history five 10-15 years into the past. Maybe even decades before they’ve even started working with their current doctor and see these patterns emerging years before the disease was diagnosed. And the reason you—you can’t do that today is because every time you change doctors, your health record get fragmented but when we put it all together for people, then you can start to see, “Wow, actually that trend was visible 10 years before I even got the diagnosis.”

Dr. Justin Marchegiani: Right.

Dave Korsunsky: But nobody noticed because I moved and my records got fragmented and my doctor can only see back three years, but I can see back 15 years. And that’s where this has the potential to I think really help people uhm— have actually more power and more information on their health. So, there’s a whole bunch of other stuff that goes into the system, Doc, but it’s really meant for patients and then most importantly all I have to do here is go to care team access.

Dr. Justin Marchegiani: Uh-hmm.

Dave Korsunsky: Give you access and you can come in and review all this data whenever you want. And then if I don’t want you have access anymore, I would just disable that access.

Dr. Justin Marchegiani: And if you’re listening to this on iTunes or a kind of an audio version, we’ll put a link down below for the YouTube video version as well. So if you’re trying to figure out like kinda find us, we’ll put the link but Justin health.com/YouTube Y-O-U-T-U-B-E and subscribe there. That way, you can see the videos well and then you can also listen to the audio.

Dave Korsunsky: Yeah. So I just killed the screen share, but that’s a quick walk-through. I wanted to show people the functional glucose tolerance test because it just allows everybody to test their favorite foods, make sure that they are metabolically safe even things you thought might be safe, may not be. So it’s easy to just test and be hundred percent sure and obviously, you can integrate all the other information. So, that’s a little bit about one of the most recent features we just finished up.

Dr. Justin Marchegiani: Love it.

Dave Korsunsky: And actually we uh— we have a debt of gratitude to Dr. J on that one because he was the one who told me about the functional glucose tolerance test. So we took your vision, Doc, and implemented it into our software program.

Dr. Justin Marchegiani: Love it. That’s phenomenal, man. Very cool. I’m also gonna be doing a live right now—a blood sugar test to myself kinda see where I’m at and put it out live on air.

Dave Korsunsky: Well, I can’t get you go solo there, Doc. I’m gonna have my Keto mojo here.

Dr. Justin Marchegiani: 87.

Dave Korsunsky: 87—that’s respectable.

Dr. Justin Marchegiani: And just so you know, that’s an hour and a half to two hours after having three eggs cooked in ghee with sea salt and then some butter coffee with MCT.

Dave Korsunsky: Alright. Let’s see what I got here. So uh—you mention the mojo here it is—uh 99 ketone strip. I’m not gonna do the ketone test right now. I’m just gonna do a is to glucose strip. This is about I don’t know, half an hour after I had breakfast which is really just a chicken breast today. I’m traveling so I don’t have access to all my food and uh—clocked in at 82. Respectable 82. That’s where I wanna be, so, yeah, I’m dialed in.

Dr. Justin Marchegiani: That’s good. Yup. I mean, my ketones are probably around .6 mmol typically is where they are out of, what, like an 80, 80+ percent fat breakfast. I typically get my protein in the morning from collagen. I did some good quality pasteur-fed eggs, but that’s important. And let’s just kinda hit a couple of the other blood sugar markers that we can do. So, I like the functional glucose tolerance. One: because it’s specific to the meals.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Where if you do kind of a blood test, so you go to Labcorp, it may be helpful, but it’s kinda like a fixed thing—

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: And it’s not something that someone can do all the time. So we can do fasting insulin, which is really nice. And if you’re more insulin resistant, that’s great because your blood sugar may look okay, but it’s nice to see the insulin coming down. And that’s even better coz that tells us that we’re reversing insulin resistance. We can do fructosamine. So, fasting insulin, ideally, below five—the sweet spot.

Dave Korsunsky: So let me—let me jump in on fasting insulin.

Dr. Justin Marchegiani: Yeah, sure.

Dave Korsunsky: A lot of people, probably their doctor might not run it for them because there’s not a diagnostic code. My doctor wouldn’t run it for me and it’s extremely important. As you said, to see glucose and insulin to make sure that one is not overcompensating for the other. And so that’s— sometimes to test that, a patient will have to order on their own and whether they get it from you or whether they go or it themselves online, maybe you can just comment on that. My doctor won’t run that specific test for me and—and how could somebody do that themselves if their doctor won’t run it?

Dave Korsunsky: Yes. So, of course, you want to reach out to a functional medicine Doc like myself. There are others out there because in the realm of functional medicine, we’re not actually treat disease, we’re supporting underlying systems that may not be working optimally. We’re fixing diet and lifestyle and we’re trying to bio hack and kinda maximize optimal performance. So it’s a different mindset and if you’re in the insurance model, things tend to be all disease-based, CD 10 code, CPT attached to it and uhm—it’s just you know, if you’re trying to utilize your insurance for this type of healthcare, it’s typically not gonna work.

Dave Korsunsky: Yup. And so what I did just for myself and my family is we just— we just went on to one of the websites where you can order your own tests. There’s a bunch out there and just ordered our own fasting glucose, our own fasting insulin 70 bucks and just got it done and make sure all numbers were in range. So, at least in the United States, this is not available internationally. But within the United States, we do have direct to consumer lab testing. If you’re concerned and you want to know the numbers and your doc won’t run it, do it yourself and track it in Heads up Health.

Dr. Justin Marchegiani: One hundred percent. And again, a lot of people, they maybe listening concerned about you know, cholesterol, eating this much fat and this much good quality protein, again, I just got approved for the highest life insurance policy you can get from uh—you know, grade wise health and my lipids came back 180-185 for total cholesterol HDL is in the mid-60s Trigs were in the 50-60 range. So again, you know, nearly perfect on everything is wide at the highest rating that you can get for life insurance. But just to show you, you know, you’re concerned about thinking about eating these foods and it jacking up your cholesterol, typically not. The biggest thing that will jack it up will be insulin. Insulin will up regulate the enzyme that makes more cholesterol the uh—Hemo Methyl Glutarate COA Reductase enzyme.

Dave Korsunsky: Yup. So, yeah, we–-and that’s great. And you were just actually also, we were talking about a panel we’re gonna put together which is going to be a fasting glucose fasting insulin A1C and fructosamine. So uh— some people may not be familiar with fructosamine and A1C so maybe comment on those and then we’ll will put the panel together on the website people can just go do it themselves, Quest or Lab Corp and we’ll put the functional ranges in the show notes because the conventional ranges are misleading sometimes. So what do you think about those numbers in general?

Dr. Justin Marchegiani: Yes. So fructosamine, typically is a 10-14 day window. So in the lower, 200 is gonna be great.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: A1C in the lower fives—

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Lower 5’s is gonna be great. Of course, glucose, it depends upon the timing. But fasting you know, below hundred, below 95 is great, you know, we got shot it in the 80’s which is excellent. Insulin below five below six is really good from a fasting insulin closer to two or three is—is—is great, too, as well. And again, if we go really low in the insulin, we have a lot of fatigue issues. We do need insulin to help convert thyroid hormones. So we could be driving insulin too low, which could be creating some other metabolic issues. So keep that in the back of your head if you’re Keto, Paleo and you’re still having some symptoms you may need to actually raise the insulin a bit especially if your body comps are already pretty good. So keep that in the back of head. That could be a little something we have to tweak down the road.

Dave Korsunsky: And that is actually something you help me with last time I was in Austin where I had extremely low carb for a really long time. Potentially, it was even keeping insulin too low and I was seeing some elevated cortisol responses and just having some uh— post exercise uhm— insomnia type issues. And I was able to just dial it back a little bit and over time, quickly correct those. So that was one of the things I learned just from my own personal experience was to cycle out every once in a while and—and dial back up the—the carbs maybe from below 25 to 50 or something around there. I know you’d target 100, you’ve mentioned before. So, I think variance is good, basically. And uhm—I I know I personally may have stayed low carb too long I didn’t need to be I was actually— my body composition was good, but that’s a good point. It’s actually being too low can also have some downstream effects on the insulin side as well. Correct?

Dr. Justin Marchegiani: Hundred percent. And again, for me, I always default to go in low coz it’s easier to start low.

Dave Korsunsky: Absolutely.

Dr. Justin Marchegiani: Kind of stabilized and then move up.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: Coz if you’re kinda in the middle, then which way that you gotta go. There’s more variables that you have to move through; but if you start lower, then you start to move one direction.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you know, then you’re okay. Then if you hit a point, you know, you got, you got—so to speak, some uh—you have a direction that you just got to go the opposite to get back to where in case you just start having a negative reaction.

Dave Korsunsky: Yup, cool. Okay, perfect.

Dr. Justin Marchegiani: So we talked about those couple of markers there. That’s perfect. We hit those things. Also, let’s chat about the HRV a bit. So I see HRV, your heart rate variability, which is the unevenness between the hearts uh—you know, the heartbeat in each second. It’s not a consistent beat, there’s some level of unevenness, which basically is a parasympathetic response. So the more the parasympathetic nervous system is activated, that’s a great sign of being able to heal anabolic hormones, being able to recover, build, back up, recycle neurotransmitters, build muscle. That’s really good. So we have some devices that we can utilize I mean you can do the Amway device by HeartMath. Uhm—I like the just the Fit bit, making sure sleep looks pretty good. Uhm you can check in with the Oura ring. So let’s dial in with some of the things that you use to help improve heart rate variability.

Dave Korsunsky: Yeah. That sounds good, Doc. Give me one second here. Can you hear me, okay?

Dr. Justin Marchegiani: Yeah. You sound great.

Dave Korsunsky: Alright. So, starting to see a lot of individuals who are starting to look at heart rate variability. I think there’s still a lot of people who aren’t quite sure what is. They’re starting to hear that term, HRV. You might not know exactly what it is. I’ve only recently started introducing it into my regimen. Initially I started by very simple—just purchasing a heart rate monitor— a polar heart rate monitor that you can get on Amazon for 30 bucks and it’s a chest strap. So in the morning you would—you’d put it on and you would fire up an HRV app. And in my case, I was starting with the lead HRV. There’s a number of them out there you can pick one that you like and it will just ask you to sit—sit still for two or three minutes in the morning and it will start doing what’s called a readiness score and it will start measuring that variability. The—the time between each heartbeat and looking at the variance and then it will be able to give you a—a measurement of your level of recovery. How well recovered your body is on a given day and it just can help you inform how hard you should push yourself on your training. So some of the popular apps out there that I’ve come across are lead HRV, bio force and the one I’m using now is actually the Oura ring, which is here and this one actually will measure a number of different metrics. It will measure HRV, body temperature, sleep cycle analysis and give you a readiness score based on all that information. But for those who are not familiar with it, HRV is an excellent measurement to start assessing your level of personal stress, sympathetic versus parasympathetic, your level of recovery from physical training on a given day. And it can be a very helpful metric to understand just—just the level of stress in the body that can have implications for inflammation, can have implications for your blood sugar levels. So for those who aren’t familiar with it, starting to look into doing some basic HRV measurement I think is increasingly becoming a very popular metric that we’re seeing requests for from our users.

Dr. Justin Marchegiani: Love it. Excellent.

Dave Korsunsky: Are you testing? Have you tested HRV? Have you use any products there? do you have your patients measured at all?

Dr. Justin Marchegiani: I don’t do a lot of testing with it. I just—I haven’t found something that I’ve been streamlined with because there’s many things out there. So like the bigger things for me are like functional glucose testing. I like the Fit bit. If people aren’t gonna be going to the gym, making sure they’re getting enough steps.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: There’s a cool one that’s out there I’m liking. Coz I see a lot of people poor posture. It goes on your spine.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And then there is an app and that it tells you how straight your spine is.

Dave Korsunsky: Yeah.
Dr. Justin Marchegiani: So you put it on for optimal posture and then if you start moving, there’s a screen alert and it shows you where your posture is. So it’s instantaneous biofeedback for your posture.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: That’s—

Dave Korsunsky: Yeah. It’s called—I forgot the name of it. It’s Lumo Back or something like that.

Dr. Justin Marchegiani: Yes. I’m liking that to a certain degree coz if people sit all day, I think it provides a lot of awareness that, “Hey, your posture is pretty bad maybe get a stand desk.” I stand 5-6 hours a day and have a walking treadmill that I slide into my desk and I walk about you know 5 to 10 miles a day while I’m seeing patients. That’s I think helpful. So I don’t go crazy on that, but I think it’s something that I will look more into. I— I wish that Fitbit would integrate and have a heart rate variability aspect, too. I think some of the more expensive ones do, but I like the Flex for the Fitbit. It’s just a little more durable.

Dave Korsunsky: So this is something that I think would be uh— helpful—helpful to a lot of users on our system who are managing autoimmune disorders. They are managing metabolic diseases. They are managing cancer, for example. And if HRV is a proxy measurement for stress and perhaps underlying cortisol and elevated sympathetic nervous system response, maybe it’s not specifically to HRV, but can you share how things like stress can affect autoimmune, specifically, gut disorders and other autoimmune diseases and how measuring and lowering stress can improve symptoms and associated markers.

Dr. Justin Marchegiani: So, of course, we have stresses –is in a couple different areas, right? We have like when people think of stress, it’s typically emotional stress, right? It’s work, families, relationship, finance. Like that’s one element to you know, emotional stress.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Also things are like blood sugar. Having your blood sugar swing up and down because you’re eating too much carbohydrate or you’re skipping meals and you’re not getting enough nutrition and B vitamins and minerals at the meals coz you’re burning that stuff up, the more stressed you are, right?
Dave Korsunsky: Got it.

Dr. Justin Marchegiani: Think of you driving a car. You gas it on the highway. You’re going faster, you’re making fast turns. Well, you go through gasoline at higher rate.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Well, the same thing happens with people when they are skipping meals, right? And they’re under a lot of stress. They don’t have the gasoline and the take. The difference is our body just starts shifting in the catabolic physiology where it starts breaking down other tissue. The difference in a car is once you’re on empty, right? That Seinfeld episode, how low can you go? Well, eventually, you just—the car just stops. The difference is if the car was equal to our physiology, we’ll start metabolizing the bumper or we’ll start metabolizing the internal uh—gas, you know, the internal oil and fluids and such, right? The car is not quite like us. Once it’s on, once it’s out of fuel, it stops.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: We don’t stop. We break down other tissues and hormones and neurotransmitters and that creates disease because we’re breaking down, we’re getting chronically inflamed. So cortisol is gonna break down of course more neurotransmitters. It’s gonna create— it’s gonna a breakdown gut tissue, which is gonna create more leaky gut and create more immune stress. The more immune stress there is, the immune system sucks up a lot of resources, a lot of energy and of course, when the gut is impaired, when the gut is inflamed, we’re not gonna be able to absorb a lot of those nutrients. So, let’s say you start shifting your diet back to up to a Paleo template or an autoimmune template and you’re not getting better, that’s probably why. Is your sympathetic nervous system is so turned on we have to work on that. We need to support the gut integrity. And there’s probably some infections that have come because your immune system has been shut off. So basically, you left your door in uh— unlocked and now you get five homeless people sleeping your house when you get home, right? That’s the equivalent of you know these parasites. You got to come clean them up, right. You gotta go do all the stuff you need to do in the functional medicine program to get them all dial back in.

Dave Korsunsky: Yes. So my take away from that is heart rate variability is actually a way that people construct to quantify stress because—

Dr. Justin Marchegiani: Another way to monitor it, right? Like heart rate variability is not “tell me what to do” but it tells me that what I’m doing is actually working.

Dave Korsunsky: That’s exactly right. So if someone is suspecting that they’re doing everything right and they’ve got an autoimmune condition, they’ve got some other condition going on, they know that they have some stress in their life that’s probably exacerbating things. Starting to get some HRV measurement can actually give you some hard data because otherwise stress is just as nebulous thing. “Yeah I’m stressed out. It may be affecting my markers, my symptoms. I don’t really know how to quantify it.” And I think that’s where learning HRV can become extremely helpful especially getting that morning HRV readiness score, where it just says, “you got a great sleep” “your HRV numbers look good” “you can push yourself today” or you can say “Your HRV numbers are terrible. Take today focus on rest and recovery.” And it actually gives you a number of quantifiable, accurate number that can be used to start to calibrate lifestyle, actually understand how stressed your—your system is. And then make adjustments and have some data to work with instead of this nebulous “I’m stressed” term. The HRV can give you real numbers to work with. And there’s some great tools out there. The Oura ring is one. The elite HRV readiness score is another. Not difficult to measure and that can help you start to move the needle in terms of stress response. So, I guess that’s my take away from why I recommend HRV, why I test it personally.

Dr. Justin Marchegiani: And what’s your favorite device again?

Dave Korsunsky: Well, right now I’m using the Oura ring. It’s a pricey device that’s the thing, but it incorporates a lot of different things into the uhm— stress response score. It includes a lot of data from your previous night’s sleep. Deep, light, REM, uh— bedtime, wake time, resting heart rate. Things of that nature. So that’s the device I’m using. I also have a Polar heart rate chest strap which I bought on Amazon. I think it was $29 and the elite HRV app is free. So that’s another one. And I know that there’s other HRV apps out there. Pick one you like. Maybe test a couple. Start getting some basic HRV measurements and then it can be just another helpful data point to help you try to assess and measure and improve metrics associated with stress, elevated sympathetic nervous system, poor sleep quality could also contribute to poor HRV numbers. So those are the products I currently am familiar with.

Dr. Justin Marchegiani: Love it. Excellent. Well, I have to get them to sponsor the show here, Oura Ring, phenomenal. Alright, Dave, hey, phenomenal show. We’re gonna put links here kinda link to get access all this material here for you guys.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Get people over there. We’ll put some of the material and things we talked about in the show notes section underneath. So if you’re listening to iTunes or YouTube, we’ll be able to give you access some of those information there and some of those tools. Anything else you want to share that you think is really important before we wrap it up.

Dave Korsunsky: No. I think it’s always good to—to be on here and just –my whole thing is data-driven health and using having access to your numbers and learning how to figure out what works for you and it’s also great to speak with you and get the clinical perspective on how to interpret these numbers as well. So it was just great to be back. We’ve always got a lot of stuff we can talk about. We could probably go on forever but I think we recovered some good information here so uh— it was it was fun as always, Doc. I’ll be seeing you at Paleo f(x) Not to— not too far from now. Always a fun time so I’m sure we’ll have an opportunity to have some fun and uh yeah, otherwise, it’s just great to be on the show.

Dr. Justin Marchegiani: Love it. Great to be here, too. And also you’re listening to this, sharing is caring. Give us a share. Give us the thumbs up. We appreciate it. Spread the word. Uh again, it really fires me up when I see more people getting healthier so make sure you give that a share. Dave, thanks a lot. Great having you here today.

Dave Korsunsky: Okay, great.



Adjustable Kettlebells

TRX suspension trainer

Push up bar

Keto Mojo

Lumo Back App


Oura Ring

Elite HRV readiness

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