How To Enhance and Support Fertility with Functional Medicine | Podcast #332

There are two main methods for getting pregnant and if you’ve struggled with conceiving then you’ve likely looked into and/or pursued traditional medicine. This doesn’t necessarily make you healthier, but your doctors will try to change your hormones to encourage pregnancy. On the functional side, Dr. J would focus on enhancing health, enhancing physiology, regulating hormones, etc. Even then, sometimes measures like IVF are still necessary for the end. But before we get to that, we want to look at all the natural ways we can encourage your body to prepare for baby-making in both men and women.

Dr. Justin Marchegiani

In this episode, we cover:

0:24        Two Approaches in Fertility

7:29        Root Causes

17:20      Right Diet

30:40      Prenatal Supplements

34:54      Adrenals

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house. Evan, how are we doing today man?

Evan Brand: I’m doing better. I had COVID Believe it or not. And that was like a five day journey. I think I’m over the hump. So if I sound a little weird, that’s why, but family’s healthy. And I’m a survivor. Now I’m going to be in the, quote, recovered category.

Dr. Justin Marchegiani: Love it. That’s good. Excellent. Well, today we chatted kind of pregame that we wanted to talk about fertility, talk about natural ways to enhance fertility. We see lots of patients that as a side effect of getting healthier through natural medicine, functional medicine, good nutrition, diet and lifestyle. They get pregnant, even if fertility wasn’t a goal, and we have some patients that come in with a goal of fertility and the nice thing is, fertility is a byproduct of getting healthy. So I mean, there’s kind of two approaches to it. There’s the conventional medicine side where they’re not really making you healthier, they may just be changing some of the hormones in your body. So you can get pregnant, right? IE via IVF therapy, those kind of things, right. And then there’s kind of natural ways that we are utilizing the enhancing of healthy and enhancing physiology to get pregnant. And sometimes IVF may be necessary. If you’ve done everything you can do on the health side, and you’re still not getting pregnant, that may be an option, right? But we want to do everything we can do on the natural medicine side, because if you do that, you know, 80 to 90% of people I think are going to get the results they want, which is getting pregnant. So I’m excited to dive into this topic with you today.

Evan Brand: Yeah, I would say that it’s pretty rare to need IVF based on some of the people that you and I’ve seen clinically, I’ve had several men and women and it’s good as a couple right. So that’s the important thing to mention. It’s important for the couple to get healthy the a lot of the blame is placed on the woman but in many cases, you know, male sperm motility or sperm concentration is a big issue. So the men kind of, you know, I don’t know why, but in general, the men get ignored in this conversation, but it’s really important for them to get optimized as well. And we’ve had couples where they looked at the cost of IVF, you know, typically 10, upwards of $15,000, depending on where 20,000 Really? Yeah, okay, so 15 to 20. And people come to us first and say, Well, you know, we didn’t want to go to IVF yet, because of the cost cost was kind of their main motivator, and maybe they, you know, hopefully had some sort of a natural minded bias. And so they said, well, let’s see what we can do first. And then 100 out of 100 times, so far, we’ve been able to avoid IVF for those people. And we’ve had, you know, between you and I alone, we’ve had four healthy children on our own. And then, you know, countless women that have had healthy pregnancies with our support

Dr. Justin Marchegiani: 100% it’s all about getting to the root cause, right? And yeah, there is that whole idea of the pottenger cats experiment where pottenger was in a medical doctor, I think, in the 50s, and he had different cats and he would feed some raw food, some processed food and and then there was, I think, within three generations of eating processed food. The cat group that ate the processed food lost the ability to reproduce. So there is this idea that we’re on like the third generation or so of this pottenger cat experiment. And there is some people that are just at that and end level where they may have reduced fertility just because they’re living out the pottenger cat experiment in real life. It’s possible some of that is the case. So we want to do our best to really emphasize a whole food nutrient dense anti inflammatory diet. We know that pregnancy involves healthy hormones. And as a starting off point, we don’t want to eat foods or toxins or hormones in our animal products that could throw off our fertility. So the first step in any fertility program, nutrient dense anti inflammatory, low toxin, that’s going to mean an organic whole food diet. that’s going to mean cutting out hormones and antibiotics and pesticides, and GMOs. A lot of these pesticides are xeno estrogens, they mimic hormones as well because they affect the insects from reproducing. That’s how they kill them. Right. And so it can also have an effect a cumulative effect on women and men on the sperm count women on the fertility side. So diet is going to be one of the first things and the second thing is going to be blood sugar stability. I think this low fat low cholesterol era, skipping meals fad dieting has prompted lots of insulin resistance, lots of reactive hypoglycemia, meaning too much sugar, too much carbs, blood sugar goes up and then spikes down, which then creates this insulin surge and high levels of insulin is really what’s behind the leading cause of infertility in women which is pcls. That’s polycystic ovarian syndrome. And that the mechanism there is high levels of insulin, insulin resistance insulin surges, thus increase androgens, and then the androgens also can throw off prolactin and then that can dis regulate a woman’s cycle. So you can see There’s a lot of different hormonal rhythms that can that can go off together and create many issues. So the major mechanism is in the beetus, insulin resistance, followed by increased level of androgens, free testosterone, testosterone, and then also prolactin issues to boost. Those are kind of the big initial sequelae that we see. And of course, usually if they’re eating a lot of crap or hydrating junky foods, people that are missing that level of awareness, tend to also be consuming the pesticides, maybe going to low fat, low cholesterol, maybe not getting high quality animal products and getting all the hormones in there too. So that’s like kind of my first two things out of the gates.

Evan Brand: Yep, well said and just want to quickly go over the conventional treatments for infertility, especially resulting from pcls. That’s what we did on our gut health podcast, kind of the conventional versus functional gut health. People loved it. I got a lot of good feedback on that. So thanks for the feedback. But it’s not pretty you mentioned it’s not root cause and it’s not so you’ve got this clomiphene which is the American College of obstetrician gynecologist recommendation that’s their primary medical medication for pcls patients with infertility, it indirectly causes eggs to mature and be released. Then you’ve got Metformin, which we just talked about the insulin resistance problems. So Metformin would come in and help. They talk about it helping just in terms of population, but that would probably be just due to helping to lower insulin. That’s what it is.

Dr. Justin Marchegiani: Yeah, Metformin, it liquefies. That’s a big one.

Evan Brand: And then you’ve got the letrozole. This is a drug that slows estrogen production causes the body to make more follicle stimulating hormone FSH, which is what you need for ovulation. And what else here they’ve got just other hormones in shot form, which are going to cause ovulation and then the craziest one, let me just read this one here and then we’ll we’ll move on into the functional you’ve got ovarian drilling. And so the surgeon makes a small cut in your abdomen inserts a long thin tool. And they use a needle with an electric current to puncture and destroy a small part of the ovary. This surgery leads to lower androgen levels, which may improve ovulation. So Wow. And if you do all those and you don’t get pregnant, then you could go to the IVF, which is where the sperm in the egg are put in a dish outside the body fertilization, fertilization happens, and then they put the fertilized egg into the uterus, and then boom, there you go.

Dr. Justin Marchegiani: Exactly. Now, I kind of want to tie back to the root cause I want everyone thinking about fertility from a root cause perspective, because when you think about it from a root cause then you can say, hey, are we getting to the root cause doing this procedure or doing this thing? So first off, like I already mentioned, pcls is a big one. Now with infertility, there’s usually going to be some level of insulin resistance or blood sugar dysglycemia meaning your blood sugar is up and down. And your body has to make a lot of hormones to regulate that flow blood sugar So when your blood sugar goes really high, right, because of excess carbohydrates in balanced meals, not enough protein and fat, you’re going to surge a whole bunch of insulin to bring the blood sugar back down. Now, women that tend to be more on the heavier side, usually that blood sugar eventually start staying higher, because that’s that’s what diabetes is right chronically high levels of blood sugar, but usually before that, there’s some level of reactive hypoglycemia where blood sugar goes up and then crashes down because the body over secretes insulin. And when the cells are still sensitive to insulin, that blood sugar will drop down really, really fast. And then your body has to make a lot of adrenaline and cortisol to bring it back up. Okay. So if we tie in prolactin, prolactin is going to go high when there’s high levels of estrogen. So when we start having more estrogen dominance, Okay, first mechanism, how does estrogen dominance happen? Well, it’s going to happen one through exposure of estrogens and the environment to with gonna happen through metabolism of progesterone. So progesterone is a really important progestational Pro fertility hormone very important. When we get stressed we’ll actually convert progesterone downstream into cortisol. So when we get chronically stressed, we’re going to decrease progesterone. And then number three high levels of estrogen, estrogen dominance, that is going to start driving prolactin issues. And when we start burning up dopamine, right, dopamine is a very important neurotransmitter. Dopamine gets used to make adrenaline so when we start making a lot of adrenaline, a lot of stress neurotransmitter, dopamine gets used, and dope means a tonic inhibitor or prolactin. So imagine you have prolactin and you have dopamine level is like the foot on the brake, right. And as you start depleting your dopamine and you start getting more stress, you’re taking your foot off the brake and what happens to prolactin, it goes up and prolactin starts to go up one of the side effects Next is loss of ovulation. Right You can go, [inaudible]. So you have a couple of mechanisms, right? You have this prolactin mechanism from dopamine, you have estrogen dominance, which can affect prolactin as well. You have this infertility through pcls. And insulin resistance and elevation and androgens, right. And then also all of the food components, all of the hormones and the toxins and the pesticides also contribute to that.

Evan Brand: Yeah, those are, I would say the biggest and most important things affecting your average american. There’s a couple other small subgroups, I want to mention what I’ve seen with infertility, one being people that are overtraining with exercise, you mentioned also the period. So I had a woman who she was, she was in the small percentage, but we have to talk about the small percentage because you know, people who are healthy and want to be healthy, listen to our podcast, and so there’s people that may be overachievers will call them and so we had a lady that was doing CrossFit like four or five times a week 45 minute sessions, and just beating the pavement. Now, typically when someone’s doing that we don’t really need to run a hormone profile. But just because I knew that it would increase her compliance. If I told her to stop exercising, she may not listen to me. So we use the testing to prove on paper what we already knew intuitively, which is that she was causing her cycle to be disrupted due to the chronic stress of the overtraining. So when we ran the hormone profile, and we showed her what her cortisol look like, it was basically flatlined, except for the time of the day when she did the exercise, she had a mild spike, which is why she felt better. You know, she said, Oh, my day is not complete until I exercise that’s because her cortisol was so low, and when she whipped the tired horse, all of a sudden she got this temporary boost of cortisol and adrenaline. She felt normal and that was it. But the prescription for her to get pregnant was simply just go down in the exercise. I just told her do three days a week Max, but do yoga, restorative, do biking, do hiking, do gentle things that are fun for you, and fun. For your family, and that’s all she did. I mean, her diet was already dialed in. We did look at her gut. We didn’t see any infections there. You know, we knew that there was no insulin problem, the carbs were not an issue. And she got pregnant just by simply reducing the training. And then another small group of people are people, women, specifically that were just going to low carb. So I had several women that were on a ketogenic diet. And some would argue well, our ancestors they could have been ketogenic, right, they were out in the prairies eating the bison, and they may not have had access to potatoes and whatever else but I do believe that some carbs are beneficial and necessary for fertility and for healthy pregnancy. So I had some women that were on keto for a long time, all we did is just add in some starch, organic white rice, we did some potatoes every once in a while and boom, they got pregnant and we didn’t change anything else. This is of course after we do the whole functional medicine workup, which you and I will talk about in a minute. That was after we did all that then we tweak the diet and then boom, she got pregnant.

Dr. Justin Marchegiani: Yeah, and I would say because information ability is primarily driven through PC OS and PC OS, the major mechanism behind it is going to be insulin resistance. I think a default template should be a lower carb paleo ketogenic template. But just because that’s our default doesn’t mean we’re not clinicians and adjusting things for the patient. So of course, with this girl, she may have done really well with that. And then she may have tapped out her benefits with it. And she may have already been at a really good place with her insulin. Because if you get insulin too low, and you’re already are relatively healthy body comp, that could also be a problem too. So this is why we have to individualize it for patients. So we’re talking about pcls and insulin resistance. And for most people, that kind of a dietary strategy is going to be a really important starting point. But for some people, you may hit the wall, and you have to adjust like you haven’t talked about others, you may have to hang out there a lot longer. So it’s kind of keep that in the back of your mind because we’re kind of having two conflicting recommendations. And that’s because everyone’s at Individual, and we have a starting point for most and then we adjust according to the patient’s needs after.

Evan Brand: Yeah, and that’s just an extreme case, but I at least wanted to mention it right? Because you always have the people that say, well, I’ve already done paleo and I still you know, had issues of course, there could be other underlying causes, you know, infections or whatever else we’ll get into, but in her case, this lady who was literally just doing like meat, and maybe a salad, you know, she literally had almost like virtually no carbs at all. So, so that’s just an extreme manifestation. But if you’re doing your, like you said, just kind of standard paleo template, you’re probably going to do maybe it’s plantains or some berries or you’re probably eventually over the day would accumulate enough starch or carbs to to fuel the fertility, but in her case, no, she was too low.

Dr. Justin Marchegiani: And again, if you’re insulin resistant, the starch or carbs may be keeping you infertile, right? Yeah, we can always do testing. We can always run fasting insulin and we can see where your fasting insulins are at. If there’s pcus. We may also want to look at prolactin, we may also want to look at free and total to stop Throw a see where that’s fitting to make sure it’s not, you know, in the top half top top 25% of the reference range. That’s pretty good to look at. So what’s the underlying mechanism? So if this person’s over exercising, it’s probably one over exercising, it can create estrogen dominance, right? So it can decrease progesterone. It can also decrease your dopamine and adrenaline which can be that driver that increases prolactin, right. And it can also just deplete hormones in general, I see a lot of women that are low estrogen, low progesterone, and they still may be a little bit in estrogen dominance because the ratio is still skewed, but their hormones are just low across the board. I see that a lot as well. So you have to this is why it’s super important to to test right because if you’re not testing you’re guessing. So with fertility cases, we may run a month long test to see where you’re at from day one when you bleed, all the way to oscillation all the way to the end of the month looking through the luteal phase to see how high that progesterone gets. We may just come in there and run a snapshot on the luteal phase two If patients have some infertility issues, but it’s not a primary thing, then we may just come in there with the luteal thing. If they’re really struggling on the fertility side, then we may do that full month. So I’ll typically do one or the other. And of course, looking at the adrenals are so important. Why? Because the adrenals interplay with dopamine and adrenaline and cortisol and estrogen dominance, ie via progesterone going to cortisol, we have to look at the adrenals because they play a major role as a backup generator with the female hormones.

Evan Brand: Yeah, absolutely. I mean, adaptogenic herbs are part of my life. They’re part of your life, you know, on a daily basis for us clinically And personally, and it’s a game changer. I would say it’s one of the biggest, one of my most favorite and biggest tools that I will use with a woman who is struggling with infertility, especially because there’s so much emotional stress. And there’s trauma associated with this, especially if a woman’s had a miscarriage or if a woman you know, has worked on this for months and months and years and been to several doctors in practice. And she feels like she’s at the end of the rope and she’s aging and she’s kind of running out of her her fertile window anyway. I mean, there’s so much stress associated with the emotional component of this as well and maybe family pressure when you’re going to have kids and that whole thing so, to me, that’s where adaptogenic herbs come in and not only help with the hormonal side, but the mental emotional stress as well.

Dr. Justin Marchegiani: Exactly. So in general, like with women and men, similar things with the diet, right men, there’s less of a hormonal fluctuation that’s going to be throwing fertility off. So keeping the pesticides, the hormones, the artificial hormones, these you know, estrogens, the growth hormones, really emphasizing good proteins, good fats, high quality cholesterol from animal products, lots of good antioxidants from leafy greens, keeping insulin in check. That’s a good first step. Of course, we can add in resistance training, we can add in mitochondrial nutrients like carnitine and co q 10, and arginine and zinc and selenium. Again, it was certain male patients will come in. We’ll run a nutrient profile and see what nutrients Their low end as well and of course, we’re going to be fixing the gut fix to the adrenals. And using a lot of those first line things, it’s also herbs we can use as well. ashwagandha is a big one tyrosine and dopa means a big one right? You see macoun as well as a big one. Why? Because dopamine helps with fertility. You mentioned earlier tongkat Ali really helps with that upstream signaling from the banana tropic releasing hormone, which then helps with FSH and LH. Lh is really important for spermatogenesis and making healthy sperm. So these are really good first line steps for enhancing male fertility. Anything else you want to add about that?

Evan Brand: Yeah, we weren’t. We didn’t press the record button yet. When we when you were now we’re talking about that. So let me just give just a quick little story on Tongkat Ali. There’s a Latin name for it as well. It’s something that’s beneficial for for men. We give it a lot to athletes, it does help with testosterone levels. And there are a couple of really, really cool papers on it. Where it’s increasing supermoto Genesis by influencing that HP ga axis the hypothalamus pituitary go Natl access. And long story short, not only did it increase the sperm count, but it increased the sperm motility. So you’ve got better swimmers. So when we talk about men, you know, having an important role in this fertility, you know, piece, that’s also a game changer. And then tribulus is another, you know, tribulus is once again kind of used in the bodybuilding community quite a bit to help with muscle mass and androgen increasing effects and all that, but it does help with the testosterone in the DHT DHT levels, which are all sex hormones that are important. And then also, what about the What about the influence of the gut? Do you want to talk about that now because I’m just thinking out loud with you here. We should probably talk about the mechanism of beta glucuronicdase issues with men and women where they would be re circulating estrogen and having issues with estrogen due to the beta glucuronicdase. enzyme being hired. Due to like a bacterial overgrowth problem, for example.

Dr. Justin Marchegiani: Yeah, so in functional medicine, right, we may look at things a little bit closer when it comes to fertility, but we’re still going to be doing the same things with the gut because if we don’t go to the six R’s of healthy gut function, we don’t go to the six R’s, removing the bad foods, replacing enzymes and acids repairing the gut lining in the in the hormones, removing the infection, repopulating rynok elating, good bacteria retesting. The gut is where everything happens 80% of the immune systems there, that’s where all the nutrients are absorbed and digested and assimilated and utilized. So if we just were to skip that and go to a hormone protocol, or a typical augmentation program with progesterone, we may miss a lot of those nutrients getting assimilated, broken down and absorbed and utilized. So we have to always assume the gut could be a major interplay. And again, most people, they’re not connecting the gut with their hormones. They just never right. But like you mentioned beta glucuronidation plays a role in hormone detox and We could be increasing estrogen dominance to the bad bacteria causing us to reabsorb estrogens. Right. We could also just have bad liver and gallbladder function because we’re not digesting fat, partly because of low stomach acid partly because of an H. pylori infection or grd infection. And that can make us hard to break down and assimilate cholesterol and essential fatty acids, which are important building blocks for fertility, right. So these things always kind of connect whether they’re one two or three degrees away from the root.

Evan Brand: Now if you’re a little brain fog, and you’re listening to Justin talk, you’re like, Oh my God, he’s talking fast. What is he saying? Giardia? What the heck pet parents Oh my god. So yes, literally, gut infections can literally make you infertile. We had several women who were infertile, and we ran their stool panel, they showed up with parasites, whether it was Giardia or krypto. As you mentioned, H. pylori being a big influence on stomach acids. So now, if we think about we always talk about good diet for mom, which is going to be a good diet to feed and grow a baby. But what if she does have these infections, and she is doing a paleo template and she’s doing her Grass Fed Whey or whatever to get her amino acid profile complete. And now all of a sudden she’s got these gut infections. So literally, just by running a gut panel and walking someone through using herbs to eradicate these infections, boom, I’ve had I lost count many women who, during a parasite protocol, they’ll email the office, I’m pregnant. What do I do? I’m like, holy crap. Yeah, by the way, this protocol by eliminating parasites, it actually increases fertility. Boom, there you go. Congratulations. And so it’s, it’s pretty nuts.

Dr. Justin Marchegiani: In general, anything else you want to say about that? So we talked about gut being really important. So HCl, enzymes, those kind of things are really important. We talked about the six hour if you’ve done podcast on that topic, so just make sure if you’re thinking about fertility, make sure we don’t ignore that right. has to be on the women has to know On the men, usually male men are easier to deal with because they don’t have a very unique symphony of a cycle. They kind of have a foghorn of hormones. And usually that’s going to be depleted by stress and poor nutrition and gut stuff. So it’s a little bit easier on the hormone side. But with women, it’s a little bit more complicated because of the cycle. So we talked about IVF. We talked about medication like clomiphene citrate or Clomid, which is a stimulates gnrh, which then stimulates FSH and LH and follicle stimulating hormone luteinizing hormone from the pituitary, which then stimulates egg maturation and oscillation. So there’s that right. But that’s kind of like a stimulator. Like Think of it as you got a tired horse. Do you really want the horse to perform by whipping it harder? Right? Is that the mindset? So for some people, that’s like an easy, you know, quick, simple, okay, I’m pregnant now. And most people who are aren’t as natural minded, that’s usually the first line of therapy that they’re going to do on the fertility side right. Then usually after that, they may go I UI which is the inter uterus insemination and then they may go into IVF or they shut down the whole HPA access using Lupron, they come in there with certain like follistim and different hormones at certain times so they can grow the eggs, harvest them, put them back in, get the whole hormone cascade going with all the injections, and then while you’re pregnant and then maintain the pregnancy with progesterone, that’s kind of what happens on the IVF side. But that may not be necessary for a lot of women. We already talked about the major mechanisms. Now, what are some deal breakers that may hold you back from getting pregnant even with doing all this? So there are certain things you have to look out for fibroids are a big one. If you have some big fibroids that are just hanging out, they could be there could be enough there where it’s disrupting blood flow, because the fibroids are a blood flow hog, and that could be preventing the egg from implanting into the uterus lining. Also, the fibroid can create a little bit of inflammation now everything we’re talking about is designed to To help prevent those fibroids from growing, the question is How long have they been growing they’re they’ve been hanging out for like years and years and years and decades. Some of the natural things just make take may take too long. And so you have to be very, very aware of that. Or it may be so big where it has so much momentum, it may need to be removed surgically. So you have to be mindful of things like fibroids. Also, endometriosis is a big one. That’s endometrial tissue, can it which is basically the endometrial lining tissue starts growing in areas it shouldn’t be, it could grow on the ovaries, it could grow on the bladder. Sometimes endometriosis, endometriosis can cause inflammation in that area. And then a lot of times with a simple procedure where you come and take a laser and kind of laser it off can be very helpful. conventional medicine won’t fix the root cause of why the fibroids there or why the endometriosis is there, but sometimes it’s gotten so bad where that may be necessary. There’s also something called a chocolate cyst, which is basically an Dimitrios in the ovary and that can Definitely be a problem as well. So that may need to be drained. So that you have to look at some of these things, some of these tissues that have grown for a long period of time, they may need a conventional intervention. Now, as long as you’re relatively young, and you have some time, try the natural stuff first and see if your body can handle it. If not, that may be the next thing to look at. And then of course, we already talked about pcls, which is polycystic ovarian syndrome. And that’s where there’s system the ovaries from all the things I mentioned, elevations and insulin and androgens, and I seen those reabsorb time and time again. So I’ve seen the body be able to handle that. I don’t see most patients that will have to go in and get those things drain per se, I find the body can handle that. The other things may need to be addressed at some point over time, but I always say wait and see work with a good functional medicine Doc, have a good ob gyn or a reproductive ob gyn kind of in your back pocket. So you’re monitoring things as you move forward. And if you have to go a surgical route, don’t throw away the functional medicine doctor keep both of them working together.

Evan Brand: Yep. Yeah, good point. And you know, it’s possible that you could find like a holistic or more natural minded ob as well, that would be good to have on hand that way they would help support you with some of the dietary stuff. But yeah, with endometriosis, you know, there’s a hormone component to that as well. So we already talked about diet and things like that, but of course, in the beta glucuronidation, so like calcium D glucose rate, for example, you know, that’s something that we may use to help with getting out these excess xeno estrogens. And that could be a game changer too. And of course, in the diet, you’re getting some like, you know, calcium D glucose, right? You’ll get some of that naturally in the diet. So whether you’re doing like broccoli, or blueberries or whatever, I mean, different. You know, cruciferous veggies, you’re going to get some beneficial stuff like that. Anyway, that will help. Regarding the hormones. It sounds crazy that broccoli could help pregnancy but yeah, but it definitely could. And then also, I mean, there’s no there’s various exercises to that can be helpful. Exercise in general is helpful. So I mean, if you have a sedentary woman, and you get her moving, but not to the CrossFit, five, you know, five times a week level, you know, that could be a game changer.

Dr. Justin Marchegiani: Exactly. So you got to look at everything holistically, like, I’ll tell you my personal story. We have two Healthy Kids, two healthy boys. And my wife and I had a hard time getting pregnant in that first year. And we found she just had a really, really, really, really, really big fibroid, very big-

Evan Brand: Was that ultrasound or how gel, figure that out?

Dr. Justin Marchegiani: Transvaginal ultrasound, and my wife before she met me, she was on birth control pills for over a decade. So I think there was that she wasn’t he she was eating a lot of conventional foods in the beginning before she met me before we tweaked her diet. So I think there was a lot of hormonal growth that was going on for decades that caused some of that growth. And you can’t just pull it away and expect it to just reabsorb all of a sudden, right? You can’t take 10 years and just expect it to go away. And so we actually tried reducing it. Now there are things you can do, they can work there. You can do things like egcg epigallocatechin is in the green Green tea you can do things like resveratrol and lipids or curcumin, and you could do systemic enzymes like Sarah peptidase and lembrar kinase, which are helped to metabolize some of that tissue and can work. The question is, can it work fast enough? And so we went the surgical road that the fibroids removed and literally within two months of it being gone pregnant, no problems. And so sometimes that can be an issue. So you have to look at, okay, what’s the root? Cause? You know, do we have some limitations of matter, right? Were those tissues just been hanging out too long? Just the body needs a little bit of a head start getting that tissue removed. And if you got time, you know, do the natural things and just watch and wait, right watch and wait. So if you’re a female listening, and you’re not in a relationship, or you’re not looking to get pregnant anytime soon, but you want to at some point, I just recommend getting good, good workup with your ob gyn to make sure there are no endometriosis or fibroids, endometriosis. This is hard. Typically the only way to figure that out is laparoscopically, little incision for the scoping. So it’s kind of tough to know that one. But you know, usually a lot of the telltale symptoms like the painful periods, like those kind of things, if you’re having those symptoms work with a good functional medicine doc to help it, but keep an eye out on bigger issues, like fibroids and those things so you can act on it early.

Evan Brand: Yeah. Thanks for sharing the story. And now you got two little boys and they’re keeping you busy. So everything worked out.

Dr. Justin Marchegiani: You got it? Absolutely. So keep that in the back of your mind. Anything else you want to add? On the supplements? I know you were kind of riffing on a couple of adaptogens earlier. Anything else you want to add? You mentioned while you listen tongkat Ali?

Evan Brand: Yeah, so that could be for the men. I would just say during during the you and I’ve talked about this idea before we kind of call pregnancy more like a four trimester thing which women like cringe at like, Oh my God isn’t pregnancy long enough, but not just meaning that there’s a kind of a pre, a preNatal phase that happens before you even get there. Right now kind of a pre, you know, fertility supporting area. So we’ll bring in multis and omegas. And like you said, maybe systemic enzymes will bring in trace minerals, micronutrients, maybe Grass Fed Whey protein, maybe some Oregon supplements. I mean, there’s a lot of things that we can do right away to kind of prep the body before you even get pregnant. It’s not I disagree with this idea of you got, you’ve got a pot of positive pregnancy test start the prenatal, it’s like, No, you could be six weeks in already, like you should have been on the prenatal six months before you got pregnant in my opinion.

Dr. Justin Marchegiani: Yeah, and most prenatals I mean, prenatal is a more of a marketing thing, like in some of the prenatals that we recommend, what makes it a prenatal Well, there may just be a little bit more calcium, there may be some extra full weight in there. And of course, everything’s active, full light, no folic acid, everything’s mthfr. Of course, everything’s methylated. There may be some extra iron in there, right? So there may be a couple little nutrients that are a little bit extra. But if you look at a really good high quality multi versus a prenatal they’re going to be about 90 95% At the same Yeah, if you’re getting a high quality couple little tweaks here and there, of course, you may want to add in some extra essential fatty acids cod liver oil, those kind of things I think are are very, very helpful.

Evan Brand: I get so mad I get so mad when you go like if you go to like Whole Foods or I mean even even places like that where you’ll go and you’ll see these little cute gummies in like a clear container. And it’s like six gummies a day and the first ingredients like fructose or fructose tapioca syrup. And it’s like, okay, here you are taking the woman who, you know may not know exactly what’s going on may not understand the root causes, and he or she has eaten these little gummies every day as a prenatal it’s like no, it’s like candy.

Dr. Justin Marchegiani: Totally 100% agree. One other thing if you have to go a surgical intervention I recommend personally, if you’re a fertility age and you want to get pregnant that you see someone that has a specialty in reproduction as well as being a gynecologist. I find that certain gynecologist have a A perspective on what’s happening surgically with the goal of removing the tissue, while others have a perspective of that while maintaining fertility. So I find someone that’s a ob ob gyn as well as a reproductive specialist, they looking at the procedure with a lens of keeping fertility intact. So I always recommend if you have to go the surgical route, try to find an OB GYN that also has that reproductive specialty as well. Yep. Good advice. Yeah, I think that’s important. I’ve just seen, I’ve heard too many stories from ob gyns, who don’t have the repro specialty, and they’re just and again, some of these are older stories. They’re too easy. They’re too They jump the gun on just doing a complete hysterectomy or doing a partial hysterectomy just removing the uterus or just removing too much tissue and and that scaffolding of that uterus can collapse and other issues can happen. So I always like to make sure you have someone with an eye Keeping fertility intact.

Evan Brand: Yep. No, I mean that if that’s their job to just remove uterus and ovaries all day Yeah, they may not care about the fertility aspect at all.

Dr. Justin Marchegiani: Yeah, it’s really, really important. And then yeah, and that’s, that’s incredibly important and of course, the most non invasive to invasive is is the best way to go. Anything else having you want to add on the topic? I mean, Today’s been really great. I think we really hit a lot of things from the nutrition aspect to some of the herbs and nutrients just to dovetail that progesterone is a big one we may be adding in progesterone we may be adding in things like chase tree and damiana and different herbs that help modulate maka that modulate estrogen receptor sites and or modulate progesterone and even support progesterone and of course, we’re also supporting the adrenal so all of those key tenants there need to be fully looked at and supported that you want to add anything else that Evan?

Evan Brand: I don’t think so. There’s a Yeah, there’s a good handful of like female supporting herbs, things that we would typically use anyway. To help with like PMS, for example, things that are going to help regulate hormone levels, those things alone can contribute to fertility. So yeah, it’s sometimes where a woman comes to us with a different problem with hormones, they may say, Oh, I eventually want to get pregnant. But right now I need to focus on this major PMS. I’m out of work every week, you know, I’m laying in bed in pain, and we just help regulate hormones using some of those herbs you mentioned there and then fix the gut and then boom, hey, we got pregnant sooner than anticipated. Cool. Let’s go ahead and kind of transition now let’s, you know, let’s get you into this, you know, maternal support phase now and it’s really fun I tell you, there’s there’s nothing better than you know, whether it’s getting a picture in my inbox of a new baby or just a mom telling her birth story. It’s It’s fun, and it’s a very, very rewarding thing. And, and, and I always, I don’t know I like to pop my collar a little bit more after I hear a good story like that, especially when a woman was dealing with the conventional medical world and she was so frustrated. And so hopeless, and then she was able to actually do it naturally. It’s like, Yes, I told you so I told you you could do it because the conventional doctors are obese will be like, nope, you can’t do it. You’re not going to get fertile. You’re too old. Your hormones are too messed up. It’s not gonna happen. And then boom, a baby comes. It’s always just like I told you, so.

Dr. Justin Marchegiani: I like it. Well, after you talked about popping the collar, I’m gonna I’m gonna join you on that one. There we go. Excellent. Very good. So yeah, I love those stories. I think that’s excellent. We always want to focus on the root cause so just anyone listening we want to make sure our goal is that you’re looking at your fertility from a root cause perspective. If you have to bring a functional medicine doctor in great if you have to bring a conventional fertility MD and great just always make sure you’re looking at the root cause. If you have to go you know more invasive on the IVF or surgery side, that’s fine. Just make sure you exhaust all of the foundational options first, nutritionally and functional medicine wise. And then also make sure your husband’s a part of what’s going on. So Make sure he’s getting tested, his nutrients are assessed. He’s doing all the right things on the fertility side, we can also get a sperm count on him as well make sure sperm numbers are good, you know, at least 50 million, make sure shape and morphology and all that good stuff is dialed in as well to assess that being okay. And of course if, if it’s not, then we have to work on all the nutrients and work on removing a lot of the toxins that we already talked about.

Evan Brand: Yep. So get off the mountain dew. Oh God, we had a friend that was an old friend who was having issue with fellow body and her and her husband both just pounded the Mountain Dew. I’m like, who even drinks Mountain Dew anymore? I mean, it’s like, it’s like 80 grams of sugar per bottle. I was like, oh, get off the mountain dew. So of course, you know, typically people would think everybody around you and I like we’re just the circle of health, our family, our friends and everybody would just listen to us and reach out to us for help. But that’s typically not how it we’re not how it is. So of course they don’t ask me anything. What do they do? They go do IVF they spent, I think it was 15 or $20,000. They did like a fundraiser raise money. It’s like how about just like, let us give you the workup, it’s going to be a fraction of the cost. And you’re going to have, you know, minimal to no risk. I mean, like with other procedures, you know, you could have risk of twins and triplets. I mean, they’re not, you know, death necessarily risk, but there are risk associated with some of these other things. So, it’s just sad. It’s sad that people just don’t know. And, you know, you always say, oh, let’s talk about the root cause of this. It’s like, why is that so revolutionary? That should be the first way people think but it’s not.

Dr. Justin Marchegiani: 100% you’re never a prophet in your own town. And also, if women have to go the IVF road, the goal remember the end goal is not just to get pregnant, right? What’s the angle? Let’s huddle up and focus on what’s the end goal the end goal was to have a healthy baby, right that’s that’s the angle and pregnancies one step in that journey. So don’t confuse the first step as success number one, and then number two, If you’re going to engage in more conventional approaches that don’t address the root cause, I strongly urge you to make sure you’re addressing the root cause. So the angle should be having a healthy baby at the end. So just keep that in mind, make sure you are really focused on what the root cause and goals are.

Evan Brand: Let me say one last thing, and then I want to get your take on this real quick. And I love the way you said that, you know, the pregnancy is not just the end all Gold’s it’s the healthy baby and all that. So, you know, what about if a woman does get pregnant, and in an unnatural method, like IVF, for example, but she still has an insulin problem. I’ve seen cases where you could argue with something else, but I would argue that the elevated insulin and the sugar and the carbs and all the crap in the diet could potentially make the baby get too big. And then the doctors are saying, Hey, you know, now you’ve got a nine pounder, we’re gonna have to do a mandatory c section, for example. You know, there’s other complications there.

Dr. Justin Marchegiani: Yeah, I mean, just having that high amount of insulin, gestational diabetes. kind of thing going on, which a lot of times the Hopis don’t even acknowledge, really being a diet thing. I mean, I remember going in and my wife was getting testing on the blood sugar, and we were monitoring her blood sugar at home. And the nurse practitioner said, you know, hey, you know, the gestational diabetes is a genetic thing. And I’m like, I literally pulled up a study of like, literally says more grains, and trans fatty acids can actually increase it. And it was like a, it was just, it was like a paradigm thing. It’s like, even though like, if people are conventionally trained, and have to pass all these, you know, mainstream boards for their licensing, they’re not really up to date with the conventional literature in the conventional literature isn’t really injected in the first line therapies for what these doctors and nurses need to know. So it’s kind of sad. So we just want to bring that information everyone on the forefront now so they’re aware of it, and also test the blood sugar and if you’re at high risk for a miscarriage, then you’d want to keep an eye on your progesterone levels. As soon as you get pregnant. One of the easiest first things is using progesterone, an inter-vaginal progesterone probably 200 milligrams or so a day throughout that first trimester can be a godsend for a lot of women. So if you’re at high risk for miscarriage, make sure you keep an eye on testing those progesterone levels, you know, 15 to 20 or so in that first week, couple weeks of getting pregnant and to be important, so keep an eye on that with your ob. So you’re monitoring if you’re high risk.

Evan Brand: Yup. Well said. Well I’m sure I could break off a few of the things but let’s wrap it up and keep on reaching out clinically. We’d love to help you. Justin is available around the world at JustinHealth.com. Me, EvanBrand.com and we’ll be back soon to talk more.

Dr. Justin Marchegiani: Phenomenal chatting with you all. Have a good day.

Evan Brand: Take Care.

Dr. Justin Marchegiani: Bye.

References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/how-to-enhance-and-support-fertility-with-functional-medicine-podcast-332

Recommended products:

Cycle Balance

Meno Balance

DUTCH Sex Hormones Metabolites

DUTCH Complete Hormone Test

Paleo Alcohol: How to Consume Alcohol Safely!

By Dr. Justin Marchegiani

Is alcohol Paleo? Obviously not! My definition of Paleo is eating foods that are nutrient dense, anti-inflammatory, and low in toxins (independent of macronutrients).  The better question to ask is, is how we can experience a nice buzz while avoiding the dreaded hangover and blood-sugar swings.

My experience with alcohol is that it tends to be the gateway drug to junk food. Most of us have found ourselves, after a few drinks, prone to reaching for some extra sweets or even gluten-rich food, like pizza. Well, if you consume alcohol correctly, your cravings for sweets will be much more manageable.

With the holidays coming up, we will find ourselves at more parties and gatherings where alcohol is served. This goes without saying: you don’t have to consume alcohol to have fun, but many people will be put in social situations where a drink or two may be par for the course.

It also goes without saying, if you are an alcoholic, please abstain from alcohol completely.

So There’s the 80/20 Rule

If you are in relatively good health and on point in your diet and lifestyle 80% of the time, you have about 20% wiggle room to (responsibly!) cheat and indulge. I am a fan of this rule, but I still like to choose the best cheats possible. When it comes to cheating, there is a spectrum: indulge in cheats that may have a little added sugar (ideally not from high fructose corn syrup), healthy proteins, or healthy fats and cheats that contain nutrients (not empty calories) and are non-GMO. This will avoid throwing your blood sugar on a roller coaster ride.

Healthier Treats vs. Unhealthier Treats

• Unsweetened (stevia) organic coconut ice cream is better than Ben & Jerry’s ice cream that’s loaded with casein and sugar.
• A 90% organic dark-chocolate bar is far better than a Snickers bar.
• A sweet potato with butter and cinnamon is better than a pizza.

As you can see, it’s possible to indulge and not have to take on the deleterious side effects.

If you have an autoimmune condition or have issues with blood-sugar balance, adrenal fatigue, your gut, or thyroid imbalances, you may want to think about what percentage you cheat, and to what degree you cheat. With most of the previous conditions mentioned, blood-sugar stabilization tends to be an issue. One of the biggest stressors on the hormonal system is blood-sugar stability, so if your blood-sugar stability system is already stressed, adding refined sugar in the form of alcohol may be the straw that breaks the camel’s back and prevents you from healing.

I have an autoimmune condition, so I very rarely let gluten touch my lips, but I will sometimes let myself indulge with a gluten-free pizza. Most of my cheats typically include the following:

1. Sweet potato with grass-fed butter and cinnamon
2. A green apple with almond butter
3. High-quality dark chocolate, 80% or greater
4. Hail Merry tart

Is the 80/20 Rule Right for You?

80/20 Rule: You feel good most of time, but you take relatively good care of yourself.

90/10 Rule: You are tired more often, experiences PMS, digestive issues, low libido, brain fog, hypothyroidism, and memory issues.

100% Rule: You currently have an autoimmune condition, poor energy, poor mood, frequent diarrhea, digestive disturbances, or are overweight.

Need more help properly detoxing alcohol? Click here.

Most Alcohol Contains a Few Compounds I Consider Toxic:

1. Mycotoxins (fungus)
2. Excessive sugar, especially when consuming multiple drinks
3. Empty calories, containing 0 nutrients
4. May contain gluten, especially if you consume beer

How to Mitigate the Damage of Alcohol and Utilize Paleo Alcohol Versions?

1. Stabilize your blood sugar before you drink: I always consume protein and fat before I consume alcohol. Protein is primarily digested in the stomach, the same place alcohol is absorbed. Taking in some protein can slow down the absorption of alcohol (in a time-released fashion) into the bloodstream. This provides a magic carpet alcohol ride instead of the roller coaster version where alcohol sneaks up on you fast.
2. Choose healthy versions of alcohol, and add extra components to the drink that aid in detoxification, prevent dehydration, and mitigate toxins in the body. I typically choose a clean vodka (potato based) or tequila.
3. Consume Kombucha tea, which is high in various B vitamins, antioxidants, and probiotics. Coconut water is also high in various electrolytes, such as potassium. Combining these two together helps prevent dehydration and actually provides some nutritional value to the alcoholic beverage.
4. Use the juice of half a lime. Lime juice is highly alkalizing and also helps with insulin sensitivity. Remember, alcohol is sugar, so it’s important we do everything possible to decrease our insulin spikes. Insulin spikes will lead to hypoglycemia, and hypoglycemia will add more stress to the adrenal glands and also cause additional sweet cravings.
5. Adding in sparkling mineral water provides extra minerals and also adds carbonation to the alcohol, which helps with alcohol absorption. The better you absorb alcohol, the fewer alcoholic drinks you need to consume. This is a win-win deal!

My Favorite Paleo Alcohol Drinks:

Nor-Cal Margarita (Thanks Robb Wolf)

What you need:

1. 1–2 shots of tequila
2. 1/2 a lime squeezed
3. Carbonated water (I use sparkling mineral water)
4. Liquid stevia if you need extra sweetness
5. On the rocks

Dr J’s Moscow Mule

What you need:

1. Ginger kombucha 5–8 ounces
2. 1/2 a lime squeezed
3. 1–2 ounces of coconut water
4. Liquid stevia if you need extra sweetness
5. On the rocks

The Take-Home Message!

Following a Paleo diet is not about being perfect. Yet many people that go Paleo notice remarkable improvements in how they look, feel, and perform. When some people cheat or move away from that style of eating, the side effects are bearable, and many are able to return back to their Paleo diet with no issues. Some people are more sensitive, and cheating with inflammatory foods and beverages may set them back for days—it’s essentially their kryptonite!

There’s always a risk-reward analysis that has to be done, and it’s always good to do a mental check to see if the few hours of fun and indulgence are worth the few days of pain. Again, it’s different for everyone, and it depends on where you are on your health journey. My suggestion is to figure out where you lie in that spectrum, and if you are more sensitive, try some of the suggestions that I made above.

If you don’t listen to your body’s whispers, you will have to endure its cries!

Click here to learn more about alcohol and your health

The Truth About Blood Sugar Imbalances – Podcast #55

Dr. Justin Marchegiani and Evan Brand talk about blood sugar and imbalances that lead to hypoglycemia and diabetes. They discuss about the glycation process to better understand how sugar affects our body. Find out how to tell if you’re insulin-resistant and what a blood sugar meter is by listening to this interesting podcast.

This interview also gives us pointers on nutrients to take that will help with blood sugar stability.  Discover the benefits of Kombucha, cinnamon and eating every 4-5 hours with enough healthy fats and proteins. Dr. Justin also talks about his Meal Matrix and how to apply blood sugar stability techniques in this podcast. Get to know what supplements to take which can further aid in stabilizing your blood sugar.

Podcast: Play in New Window|Download

Dr. Justin Marchegiani:  Hey there, it’s Dr. J!  Evan, how we doing today, man?

Evan Brand:  I am doing great.  What about you?  I never ask you how you’re doing.  How are you?

Dr. Justin Marchegiani:  I’m doing great.  We’re actually stepping it up for all of the listeners today.  I just got a–awesome new microphone based on your suggestion.  So we’re just trying to get the quality better.  We got a better Wi-Fi connection at the office, 200 megabytes per second.  It’s like, man, I’m cooking with fire here.

Evan Brand:  Yeah, totally.  Cooking–cooking your brain, too, if you ask some people.

Dr. Justin Marchegiani:  But if I’m cooking, it’s gonna be a high quality saturated fat with a high smoke point, right?

Evan Brand:  Totally.

Dr. Justin Marchegiani:  I’m not gonna use any of these canola oil or olive oil crap.

Evan Brand:  Definitely not.

Dr. Justin Marchegiani:  Awesome.  Olive oil’s good but it’s better for salad dressing, folks.  I’m not–I’m not dissing olive oil.

Evan Brand:  Yeah, just cold use only.

Dr. Justin Marchegiani:  Cold use only.  Yeah, absolutely.  Well, on that note, we were kinda chatting pre-show that we wanted to chat about blood sugar.  Blood sugar is a super important issue and we kinda have like the blood sugar functional imbalances which is what a lot of people deal with, and then we have the extremes where we have hypoglycemia where people, you know, they get dizzy.  They get lightheaded.  They may even pass out or have a, you know, what’s called syncope in the medical world, or the other extreme which is diabetes, where our blood sugar goes super high and it’s creating all of this glycation and free radical damage and all of the deleterious effects that come with diabetes.

Evan Brand:  Yup.  Yeah, blood sugar issues, they’re not only for people that have diabetes or that have pre-diabetes, I mean, for people listening, if you consider yourself even extremely healthy or you’re an athlete or you’re somebody that uses your brain, you’re high–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Functioning business executive, blood sugar is just as if not more important to you as well.

Dr. Justin Marchegiani:  Absolutely, again it’s like blood sugar goes too high, it creates a stress response because of the fact that it starts coding all of our proteins in our blood vessels with sugar.  This is called glycation and this glycation is kinda the same thing that happens if you go to the restaurant and get crème brulee.  You pull out the blowtorch and you just kinda crisp that top layer of the crème brulee and it turns brown.  That’s kinda what’s happening in your arteries when you have this whole glycation process going.  So when next time you’re, you know, eating a whole bunch of sugar, picture yourself pulling out a blowtorch.  And again, this isn’t like a one-time thing.  This is more of a chronic thing, right?  If we’re healthy, our insulin receptors are gonna be sensitive and we’re gonna be able to pull that blood sugar into our cell but the more those cells become numb, right?  The more you go and play ding dong ditch to the neighbor, they’re just not gonna open up the door after you ring like the fifth time, right?

Evan Brand:  Totally.  Great analogy as always!  Yeah, insulin resistance is huge and how–how do I know if I’m insulin-resistant?  Well, I tell people, if you go look in the mirror and you’re overweight, you’re likely insulin-resistant.  So that’s probably my best way of identifying, obviously you could do lab testing and stuff like that, but what about you Dr. J?  Would you say that’s a–a safe bet there?

Dr. Justin Marchegiani:  Yeah, I would actually say off the bat, your blood sugar meter is right around your tummy.  So for men you want it below 40 inches.  For women, you want it below 35 inches around your tummy.  Also, get a blood sugar meter.  I’m gonna do a live test, so as we’re recording I’m actually gonna pull up my blood sugar and I will share it with all the listeners.

Evan Brand:  Okay, so–so while you’re doing that, we’ll do the caveat that it obviously depends on what you ate, if you did eat breakfast, if you’re fasted, things like that, but typically I like to see people around I’d say 70 starting to get low but I’d say somewhere close between the 70 and 80 range for blood sugar.  Obviously if you’re above a hundred, then you start getting into the pre-diabetic state and things like that.

Dr. Justin Marchegiani:  Yeah, I just pricked myself if you guys heard me scream in the background, that’s what it was.  Alright, yeah, so I agree.  I think somewhere between 75–I would even go up to 90.  I mean, if you’re doing a fasting blood sugar, a healthy stress response can cause your blood sugar to accumulate.  Alright, I’m getting a reading right on it now.  Evan, seeing me, 3 seconds.  Alright, so right now, my blood sugar’s actually a little bit high.  It’s 110.  Now I–

Evan Brand:  What did you eat for breakfast?

Dr. Justin Marchegiani:  I just had 4 eggs for breakfast.  Now so typically you want to be–I ate about 4 hours ago–it could possibly be why my blood sugar is this high right now, I just had 4 eggs and some bulletproof coffee, so I had absolutely zero carbs.  It could be one, I did have some potato chips last night that I typically don’t have.  Or number two, it’s time for me to eat and my adrenals are kinda ramping up some adrenaline.  I mean, I ate around 8 o’clock this morning, so it’s been about almost 5 hours.  So 110 typically is a little high for me, blood sugar-wise.  The problem with a blood sugar meter like this, you don’t really know if it’s dietary-induced or if it’s because your adrenals are ramped up.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Like if you got a little bit of stress, you’re doing some things, that cortisol can push your blood sugar up a little bit and it may not be a bad thing if your body is utilizing it for energy, right?  So you gotta look at it from the perspective of one, you know, what are you eating?  Two, you know, do a functional glucose tolerance, meaning eat your meals, see how it goes, one, two and three hours after a meal, and then leave one of these on your desk and just do it periodically throughout the day.  The biggest problem is you don’t get a window into insulin because you may be pumping out a whole bunch of insulin to drop that blood sugar back down.  Insulin’s job is to pull the sugar into the cell.  Now, if someone’s at 110 like myself but is pumping out twice the amount of insulin that I am, that’s a problem.  So people can overcompensate by having more insulin to pull that blood sugar in.  So the biggest issues with these, they don’t look at insulin and they don’t look at cortisol levels.  If we get a blood sugar meter that looks at insulin and cortisol, man, that is like–that is amazing.  I would just get one of these for every one of my patients.

Evan Brand:  Totally.  Yeah, so you talked about being high for a couple of reasons, also you’re standing up right now, you’re moving around, you’re–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Excited about talking, so I mean, you are kinda rising to the occasion, that may be somewhat of a natural response that you just measured.

Dr. Justin Marchegiani:  Yeah, I mean, I’m at a standing desk here.  I just, you know, we’re–we’re talking, we’re jazzing, I’m moving as we talk.  When we get this podcast on video, people will see how–how annoying I look bouncing back and forth.  So yeah, you can get some of that sugar up there.  I wish you had a meter so we could do yours; we could have a comparison.

Evan Brand:  I know, I need to buy one.  Isn’t there–isn’t there a recommend–a website that you recommended where they basically just hand out free glucometers–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Like it’s nothing.

Dr. Justin Marchegiani:  Yeah, they totally–this one, I’m gonna pull it up right now in my Gmail.  Gimme one second, I’ll do it live for everyone so they get access to it.

Evan Brand:  Cool.

Dr. Justin Marchegiani:  Yeah, the website is choosefreestyle.com.  So www dot choosefreestyle dot com.  Go to beyondwellnessradio.com or notjustpaleo to get the transcriptions of that so you can see the–the link on that.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  So we have our at-home test like I mentioned.  I talked about some of the limitations that happen in that but the blood sugar rollercoaster that most of our patients, Evan, I think we would both agree are on, it’s this if you’re not at the diabetes state, which is just your blood sugar’s high across the board the whole time, then we’re in this reactive hypoglycemic state where we eat a meal that may be a little bit high in sugar, our pancreas freaks out, shoots out a whole bunch of insulin which brings that blood sugar back down but it brings it back down a little bit too low, maybe in the low 70s, maybe in the 60s, and we get a stress response.  Now our body then comes and brings a whole bunch of cortisol and adrenalin to the table to bring that blood sugar back up.  Now again, the problem with that is you may not see it reflected on the glucose tolerance test if you test too late because again, the adrenals and the cortisol and the adrenalin will raise that blood sugar back up and you may not see it being raised up by the–by the adrenals but a lot of times you can feel it.  You may feel a little bit jittery.  You may feel a little bit lightheaded, a little bit flighty, a little bit hard to focus, kind of a tired but wired feeling.  So you know how that feels.  Everyone can think of a time where they had sugar as a kid, they were bouncing off the walls, then they crashed.

Evan Brand:  Yeah, totally.  And I drink Mountain Dew so I know very well what that Mountain Dew crash did to me.  I mean, I even have a video.  I think was like 3.  It’s so sad.  My–my brain wasn’t even developed.  My skull was probably still soft and here I am drinking Mountain Dew, but–and then I was filmed crashed out with my blanket and my milk probably afterwards.

Dr. Justin Marchegiani:  Wait, did you say that you currently drink Mountain Dew?

Evan Brand:  No, I do not currently.

Dr. Justin Marchegiani:  Oh.

Evan Brand:  I did when I was maybe, I think I was like 3 when I had my first dose of it and I was on video camera.  I think my dad filmed me at the cabin drinking Mountain Dew and it was hilarious and awful.

Dr. Justin Marchegiani:  I almost thought I was gonna have to give you 5 Paleo demerits for that one, Evan.

Evan Brand:  No, I actually did drink a “soda” today.  I have the Live Kombucha Soda.  Thank you Live for the revived root beer.  It is delicious.  9 grams of sugar but this is the best Kombucha that I’ve–that I’ve had.

Dr. Justin Marchegiani:  Oh, that great.  Actually because we’re talking about blood sugar.  We talked about the up and down.  We talked about the blood sugar rollercoaster.  One thing that’s getting super trendy are Kombuchas.  They’re becoming like the new soda and a lot of the Kombuchas have a fair amount of sugar in them.  Now the one that you just mentioned is actually in the middle.  It’s not–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It’s not good but it’s not bad.  I–I’ll name names, screw it.  Buddha’s Brew, Kosmic.  There’s a couple down here in Austin.  They got as much sugar as Coke and I’m gonna do a video on this real soon.  My fave is GT Dave’s.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I like the ginger–the Gingerade.  It’s got 2 grams of sugar, so much–

Evan Brand:  Per serving?

Dr. Justin Marchegiani:  Per serving.

Evan Brand:  I think it’s per serving, yeah–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So it’s 4–4 grams per bottle which is what?  16 ounces?

Dr. Justin Marchegiani:  Yeah, I think it’s a little less.  I think less than 16 ounces per bottle, right?  I think it’s like 12 ounces per bottle, so it’s 1-1/2, I think it’s 3 grams.  I was putting hairs there but yeah, it’s around 3-4 grams of sugar per bottle, right?

Evan Brand:  So about a teaspoon?

Dr. Justin Marchegiani:  Not bad.

Evan Brand:  Not bad–

Dr. Justin Marchegiani:  Not bad.

Evan Brand:  Compared to 20 plus of grams of sugar like some of the others.

Dr. Justin Marchegiani:  Yeah, plus you can justify it, 3-4 grams isn’t bad because you’re getting ginger which is an anti-inflammatory herb.  It’s a prokinetic.  It helps with, you know, gastric releasing.  It’s–it helps with the lymphatic system.  It’s also a natural, you know, stimulator of hydrochloric acid.  It’s a bitter.  It’s also–it’s also got B vitamins in the drink.  It’s also got probiotics and lactobacillus–no, more I think, more saccharomyces boulardii which is great for fungus and yeast.  So a lot of good benefits by drinking a conventional Kombucha that’s like, you know, your–the GT Dave’s brand is my fave.  Either Trilogy or ginger–Gingerade.

Evan Brand:  Yeah, as long as you’re not drinking like 5 a day.  I’ve had a couple people drinking like 5 a day and it’s a true addiction, and then you can run into some issues there with yeast.  I don’t have any studies or anything to prove it, but I’ve just seen people that are drinking way too much have problems.

Dr. Justin Marchegiani:  Yeah, I agree.  Like yesterday I went on my boat and typically I’ll avoid drinking alcohol and I’ll justify it to myself by buying like 2 or 3 Kombuchas.  So I get that good, you know, that good feel, that good, you know, elixir feeling that you get when you drink those Kombuchas, but I can at least justify it by not having the alcohol.  It’s kinda my–my exchange if you will.

Evan Brand:  Right, right.  Yeah, so let’s talk about controlling the blood sugar a little bit.  I’m sure you were gonna end up there by I have this–I have this particular nutrient on my mind that I just wanted to talk about, and that nutrient is cinnamon.  And I really love cinnamon.  I add it to my smoothies.  I’ll do some organic–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Blueberries, almond milk, some grass-fed whey, I’ll throw some cinnamon in there and I do that just because it tastes amazing for one and two, cinnamon acts in a way as a–as an insulin substitute so to speak.  There’s a –a compound in there and it’s way too hard to pronounce, but it’s MHCP is what it is.  And it basically gives the same biological activity as insulin itself so it basically increases the uptake of glucose by the cell but it can stimulate glycogen synthesis as well so I mean, it’s kind of a multifactorial little nutrient that you can really do good things with and my wife, she’ll actually add a little bit of cinnamon on top of her–she has a little reusable K-cup for Keurig which I’m not the biggest fan of the Keurigs because of plastic and whatever, who knows?

Dr. Justin Marchegiani:  Yup.

Evan Brand:  But anyway, she’ll add some cinnamon on top of her coffee there and brew it.  If–if you–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Try to stir in the cinnamon to the cup of coffee, it doesn’t really work but if she actually adds it on top of the grounds and then brews it, it–it just smells amazing.  I don’t really drink much coffee, but it smells amazing and I know that it helps her blood sugar because she comes home and she didn’t have to snack between breakfast/coffee and lunch.  So that’s how I know that her blood sugar is better than it used to be.  She used to have to have like a little protein bar or something in her pocket at all times in case she needed a snack, some kinda hypoglycemia sign there, but now she’s able to just kinda leave the house with just a bottle of water and–and be fine.

Dr. Justin Marchegiani:  That’s great.  Yeah, that’s really good.  Like with my blood sugar stability, I do insulin.  I use a Granny Smith apple at night as my dessert, typically on most nights.  I’ll cut it up.  I’ll sprinkle it over with cinnamon and maybe have a little bit of almond butter with it.  Again Granny Smith’s got about half the amount of sugar as normal apples and then you add the cinnamon to it, that’s a pretty good place to go.  Again the big tips I try to follow myself and I just did a video on this recently, I think you had an anecdote last week where you mentioned you had a real stressful day.  You had a light–a light lunch and then you were feeling a little bit of palpitations and anxiety and we were thinking that it probably blood sugar induced.  You wanna–

Evan Brand:  Oh–

Dr. Justin Marchegiani:  Talk about that?

Evan Brand:  Totally, yeah.  We were on the phone for something.  I think we were talking about the microphone but I said, “Man.”  I said, “I don’t know what’s going on.”  I said, “I guess my blood sugar got to me again,” because you and I were doing the podcast, and here it was maybe 3–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  3 or 4 in the afternoon, and I either had a very light lunch or I just didn’t have a lunch.  Maybe I had–maybe I had to see someone and then I had to a podcast and then something, I don’t know.  Anyway, I was not a good 3 square meal a day eater and my blood sugar got low and I was feeling pretty awful at first, you know, kind of the fatigue, the–maybe the irritability, moodiness, things like that and then when it gets to the more extreme level, at least for me, the more extreme low, that’s when I start even having the anxiety, that cortisol-adrenalin feel, the fight or flight mode where I just wanna–I don’t know if I should run down the street or  hide under a blanket.  You know that sort of anxiety feeling.  So as soon as I went and actually ate something–I don’t know if I just ate some Kerrygold butter by the spoonful or what I did, but once I got that blood sugar under control, I had an immediate relief.  So that’s how I know that I’m still dealing with a little bit of hypoglycemia stuff myself.

Dr. Justin Marchegiani:  Yeah, you know, it’s like one of biggest things you can do to take stress off your adrenals is stabilize your blood sugar.  So if you’re under a lot of stress–I’m a big fan of eating every 4 or 5 hours, I don’t necessarily like every 2 or 3, I feel like you’re just pumping out too much insulin and you’re not letting your body utilize ketones for fuel, so I do like the every 4-5 hours.  I think a lot of people in the ketogenic, in the low carb world, because they’re spitting out so much ketones–ketones are natural appetite suppressants as well, so it’s for them just to skip meals, but the problem is ketones aren’t nutrients.  Like ketones aren’t like B vitamins or vitamin C or fat-soluble like, you know, DHEA, E–EPA stuff.  They aren’t nutrients per se.  They are a fuel source just like sugar’s a fuel source, right?  But they aren’t nutrients and we need nutrients.  Our body and our mitochondria and our cells run off of nutrients so eating 4-5 hours delivers the nutrients you need and if you’re under stress, your body’s going to need nutrients and if you’re under stress, your body will spit out sugar via gluconeogenesis and surprise, surprise, but gluconeogenesis is cortisol-dependent.  So that means you gotta mobilize all the sugar or glucose via cortisol, via your adrenal glands.  And that can be a problem if your adrenal glands are already a little bit stressed or if you’re burning the candle at both ends.

Evan Brand:  Oh, totally, yeah.  And that I’d say 80% plus of the people that we see are doing that exact thing, maybe not on purpose but by the time they get in to see us, they’re already so burnt out and now they wanna–that now they wanna get help and it takes time to fix this stuff, you know, it–it didn’t–your blood sugar didn’t just go haywire overnight.  It may have but this–this state–this stuff takes time so it takes time to fix it, too.  But yeah, getting in, you know, the good–I mean, even eggs, that’s awesome.  The Kombucha we’ve mentioned.  We mentioned the cinnamon.  You mentioned the eating frequency every 4-5 hours.  Maybe we should talk just a little bit about more of the food side of things.  I mean, people yet–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  People, they know every 4-5 hours, but I think people forget the importance of getting enough healthy fats and proteins.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Because that is what you need.  You’re not going to stabilize your blood sugar by eating some type of carb or quick, like rice crispy snack.

Dr. Justin Marchegiani:  Yeah.  One of the things that I’ve created that helps is called the Meal Matrix.  And the Meal Matrix is just a simple list of macronutrients.  It’s got your proteins in one column, your carbs in another column, and your fats in the third column, and it’s got herbs and spices in the second column.  But your proteins are your proteins.  And again I like people eating full fat proteins, meaning not boneless skinless chicken breast but you know, if you’re doing chicken breast, you know, do it with the skin on or do the chicken thigh which is even better with the skin on, which is what I’m having for dinner tonight by the way.  And then you have your carbohydrate column, which I break carbohydrates up into 3 categories.  Non-starchy–non-starchy are more of your vegetable-based carbs, high in nutrition, low in sugar.  Your starchy, but safe starchy, meaning no grains, so potatoes, sweet potatoes, yucca, plantains, squash, alright those are our starchy ones.  And then our low sugar fruits or low glycemic fruits.  These are our berries, our lemon, our lime, our grapefruit, our passion fruit.  These fruits are–they dissolve to sugar in our bloodstream slower than let’s say our tropical variety like pineapple and watermelon and–and mango, as good as they are, they could be just like candy.  So–

Evan Brand:  Oh yeah, especially the dried ones.

Dr. Justin Marchegiani:  Oh, my gosh, yeah.  And then the third list is the fats.  So typically we’re either eating a fat that’s combined with a protein or we’re cooking with the fat or we’re putting fat on our veggies like coconut oil or grass-fed butter or avocado oil, or good quality nuts if you’re not autoimmune or you’re not too sensitive.  Things like that and I typically recommend starting between 3-6 ounces of protein per meal and a good recommendation is anywhere between a palm–palm-size to a fist to a full hand.  So again, bigger people, bigger hands, right?  So palm’s about 3 ounces, fist is about 4 and a full hand is about 6.  So I like people using body parts because you’re typically up there and you can like eat, always use that hand as a good frame of reference so when you’re serving yourself some food, and the more stressed you are, the more protein you need because protein gets utilized for neurotransmitters.  It gets utilized for detoxification and if we put it in there, it acts like a log on the fire, on that blood sugar fire.  So again, logs typically last about 4 hours, 5 hours on the fire, so think about it like your metabolic fire–you wanna throw that log on there so you have about 5 hours in between having to put more logs on there.  Logs being protein and fat and then the carbohydrates are like the kindling, right?  We need just a little bit of spark there to get things moving and that could be some non-starchy vegetables, broccoli, asparagus, kale, spinach, etc. and depending on how insulin-sensitive you are, maybe some low sugar fruit, maybe a little bit of starch, again I’m a big fan of backloading my carbs, doing a more at night and then almost doing no carbs outside of the non-starchy variety during the day.  So that’s a good general way in which I teach my patients how to apply blood sugar stability techniques.

Evan Brand:  Good stuff.  Yeah, I’ve also experimented with doing the carbs like some organic white rice.  I’ll try that with dinner and then I’ll try it with breakfast.  It doesn’t work with breakfast as much, man.  I–I crashed.  It’s a completely different feel than if I have the rice with dinner and say some steak and then I’ll throw some aminos on there of some sort.  I sleep way better that way but the morning time, it’s just not a good time so I–I stay, I wouldn’t say ketogenic but maybe, very, very low carb for–for morning, for breakfast time, mostly just pure fat and protein.

Dr. Justin Marchegiani:  Yeah, I think our body is just more naturally insulin-resistant in the morning.  I think a lot of this has to do with the cortisol levels.  So if you look at a–a diurnal cortisol rhythm, our cortisol is much higher in the morning and drops throughout the day, and because cortisol, it’s a glucocorticosteroid–first part of that word is gluco, it helps with blood sugar stability and energy, so if we have a high amount of cortisol, then we’re already gonna be pumping glucose naturally as I just showed you on my blood sugar meter.  So it makes if we already have that natural stimulation, don’t add more fuel to that metabolic fire so to speak.

Evan Brand:  Yeah, we don’t need to add it too high because then that may create a larger hill for you to come back down, you’re saying.

Dr. Justin Marchegiani:  Exactly.  That’s kind of the deal.  So the diet and lifestyle part is super important.  I like doing about 3 meals every 4-5 hours, maybe 1 snack in between there if we have a longer break.  Like let’s say, some patients they are having their lunch around noon or one, then maybe their family gets home and out of school like around 7, so there’s a 7-hour window there.  So they may need a nice need for a good clean protein shake or a mini-meal.  I hate the word snack, because snacks are typically imbalanced, right?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Like I’m gonna go snack on some blueberries.  You mean, you’re gonna just throw some carbohydrate in your body?  That’s gonna probably mess up your blood sugar if you’re just throwing that without anything else in it.

Evan Brand:  Yeah, it–it’s kinda sad.  I don’t know how carbohydrates in general or carbohydrates are snacks.  Snacks have become carbohydrate.  Like–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  When somebody says they want a snack, I think of like pretzels and potato chips and ice cream and cookies.  I don’t think of–I mean, I should think of avocados and coconut oil and spoon feeding butter, but the culture of–of the snack mentality has been so perpetuated by the big food marketing industry–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  That no one even knows what the hell a good snack is.

Dr. Justin Marchegiani:  Yeah, exactly.  And again, carbohydrates are the cheapest foods out there so it makes sense why this is crap that’s, you know, shoved down our–our mouths or, you know, to our faces on TV, right?  So what are some healthy snacks?  Well, one, a good clean protein shake.  I like a good clean whey protein, pea protein or beef protein, you know, without any additives, you know, some good coconut milk in there, maybe you throw a few berries in; maybe a few berries that’s okay because we’re getting some protein and fat which kinda stabilize it out, that could be good.  It could be like an EPIC bar.  EPIC bars are great.  Some good clean grass-fed beef jerky, that’s a really good thing.  Scoop of coconut oil and maybe a couple of bites of an avocado or maybe a bite or two of your lunch’s leftover, that’s always good.

Evan Brand:  I know for you, dealing with autoimmunity yourself, you may stay away from corn at all.  I’m not sure.  Do you do corn at all?

Dr. Justin Marchegiani:  I try to always stay away from that.  I did have some last week at a restaurant but it was confirmed to be 100% gluten-free.  It was even in its own bag and, so there was no cross-contamination or anything.  So if I can confirm its–its quality, I will indulge from time to time–

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Like once or twice a month.

Evan Brand:  Because what I was gonna say is my little guilty pleasure snack, Target of all places, yes, Target the store, they have the best organic blue corn chips.  I feel like I may have even have told you this before, but they do them the traditional way, with the trace of lime and the sea salt then it’s the organic blue corn which has more nutrients than your white or yellow corn and anyway, Hannah, she’ll come home–my wife she’ll come home and she’ll get a fat avocado and she’ll open it up and throw in some–some spices in there and we’ll just eat that as a snack.  I mean, we’ll split an avocado; there’s nothing better.

Dr. Justin Marchegiani:  Evan, that is 3 Paleo demerits.  No, I’m kidding.  That’s good.  That’s good.  I mean, I do the Boulder chips that are organic.

Evan Brand:  Yeah, Boulder’s good.  Yeah.

Dr. Justin Marchegiani:  That are non-GMO certified and that are cooked in the avocado oil.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And I’ll do that with–we’ll have like some grass-fed beef in a bowl and then we’ll have some avocado that’s like crushed up in a guacamole essentially with a little bit of lime and stuff, and we’ll just scoop the–the meat on there and scoop the guacamole on there and it’s like amazing.  Little bit of carbs, but you get some good quality protein and fat, too.

Evan Brand:  That sounds good.  I actually just got my grandparents to convert from either Lay’s or Ruffles or whatever garbage it was to the Boulder chips and they actually have the avocado oil, you know, there’s a sea salt black pepper one, that’s probably one you get.  That’s the best one to me.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  And then there’s the–there’s an olive oil one now but I’m guessing they cook it in olive oil–

Dr. Justin Marchegiani:  That’s why.

Evan Brand:  They probably ruined it, so–

Dr. Justin Marchegiani:  Yeah, I would not touch it.  Last night I got so–my wife and I got so gassy, we had the–some chips at Whole Food and they were like organic, like non-GMO.  They were cooked in coconut oil, so I’m like, “I’m gonna try this.”  Looked at the back and it has just a little bit of fructose in it and it also had a little bit of rice dextrin.  So like kinda like rice starch.  I’m like, “Why the hell do they put this crap in here?”  I’m like, “I’ll give it try.”  And there was no sugar.  No added sugar on the ingredients, so I’m like, “At the very end, you know, it’s not a big deal.”  I tried it and I could really taste the sweetness on the chips.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And they were salt and vinegar.  I’m like, “Well, I don’t want sweet when it comes to salt and vinegar.  I want that salty flavor.”  So I said, “Never again.”  So stay away from those chips.  Salt and vinegar.

Evan Brand:  Oh, why would they–why would they add fructose?  That makes no sense.

Dr. Justin Marchegiani:  Dude, I know, man!  I like–I went against my Paleo intuition and said, “I’ll give it a try.  It’s a good company.  It’s GMO, it’s organic-free, I can’t find a better alternative.”  But yeah, you gotta go with that gut instinct sometimes.

Evan Brand:  Oh, gosh!  I know, I can’t think of a particular nutrient or food but I’ve done several times where I go to get something.  I’m like, “Oh, I probably shouldn’t.”  And I just take a couple of bites anyway and it’s like it wasn’t even worth it, like the Reptilian brain overwhelmed my–my prefrontal cortex.

Dr. Justin Marchegiani:  Yeah, I think some of my blood sugar that we just tested here a few minutes ago is potentially part of the repercussions of that.

Evan Brand:  Oh, so that was yesterday.

Dr. Justin Marchegiani:  It could be.  It’s possible.  I’ll do my blood sugar again tomorrow and if it’s better around this time of day, you know, same kind of breakfast, then I’m gonna know that it was–it was the dinner before.  It–

Evan Brand:  Yup, yup.  Well, did you have anything else on this–on this food journey of blood sugar?  I think we covered a lot of it, but I know there’s other pieces to the puzzle that we haven’t even covered and I don’t know if we have time to.

Dr. Justin Marchegiani:  I think let’s just touch upon some of the supplements.  Some of the things that I use with my patients for blood sugar stability is we’ll give some additional support with alpha lipoic acid.  We’ll use chromium.  I’ll use herbs like jemima and bitter melon, and what a lot of these nutrients are doing is they’re helping with the blood sugar receptor site.  It’s helping with insulin receptor sensitivity.  It’s helping with blood sugar sensitivity.  What that means is, is that when our body takes in blood sugar, that blood sugar comes into our bloodstream, the more insulin numb we are, the more insulin we have to make, and that’s a stress around the body.  So if we have these nutrients there, what it does is that it allows us to make less insulin and to pull that blood sugar into our cell and utilize it for energy better and more efficiently without this big bolus of insulin.  Remember the insulin is inflammatory.  You just go into PubMed, type in hyperinsulinemia or hyperinsulin, that means high insulin in medical speak, and disease you want and you will find a correlation between hyperinsulin and cancer and autoimmune conditions and diabetes of course, any type of disease you will find that connection.  So those nutrients help with the receptor site sensitivity and allow your body to need to make less insulin and help your body deal with the blood sugar better.  But if you’re using those supplements and you’re not making a diet change, it’s just a Band-Aid and it’s not gonna work long term.

Evan Brand:  Right and yeah and I mean chromium is found in foods but some of the foods that chromium is–is found in, a lot of people aren’t eating, like calves liver, you have oysters, you have liver, you have onions.  So a lot of people may be avoiding these.  I typically don’t eat onions just in general anyway.  I kinda stay away from peppers and onions and things like that so I’m probably lacking on the chromium.  I personally don’t eat mini oysters because of the sea–you know, it’s always the balance of the ocean toxicity versus chromium, you know, it’s just–

Dr. Justin Marchegiani:  Yeah, exactly.

Evan Brand:  It’s–it’s always a toss-up for me.  I–I’m so on the fence about the seafood issue, but anyway, so that’s why I use sometimes an Aqueous, a liquid chromium, and I enjoy it and I do notice a difference.  So I’m trying to think of what else I use, man.  Honestly, the chromium in the–in the cinnamon are only my two direct ways of supporting blood sugar.

Dr. Justin Marchegiani:  Yeah, when I see patients with adrenal fatigue, we’ll add a blood sugar support.  They’ll take one per meal, because it just gives me that insurance policy that they’re getting those nutrients in each meal.  Because like you said, it’s already hard enough to get them to eat these newer foods that are less inflammatory and better and then now we go extra level and now it’s like, well, it’s gotta have chromium in it and vanadium and all these nutrients.  It just adds another layer.  We forgot magnesium, too.  Another layer of compliance.  So if we can just take a pill that has those extra nutrients along with that, that’s gonna be a great–a great step in the right direction.

Evan Brand:  Yeah and I guess–I guess glutamine would be kind of my other recommendation that almost give–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Every person I see just because I recommend it as sort of like a emergency reserve, like if you’re gonna go eat a cookie, how about just take a capsule of glutamine and open that bad boy up and pour it into the mouth instead.  And it actually tastes decent.  It’s one of the–the decently tasting amino acids compared to some of them.

Dr. Justin Marchegiani:  I agree.  The best is inositol.

Evan Brand:  I haven’t had that.  What’s it taste like?

Dr. Justin Marchegiani:  It tastes like sugar.  It’s actually it’s more of a derived pseudo B vitamin but it actually helps with blood sugar stability.  So if you want a little bit of sugar feel, well, go chew on some inositol.  It’s a good way to help your blood sugar but also give you a little bit of a taste.  Just be careful, it’s like Xylitol where it’ll give the runs if you do too much.

Evan Brand:  Really?  Okay, now explain this to me if you’re familiar with the myo-inositol.  I’ve seen that and I don’t know.  Is that like a better bio available form or what?

Dr. Justin Marchegiani:  Yeah, there’s like a chiro-inositol and a myo-inositol.  There’s some research that it actually is very beneficial with PCOS or polycystic ovarian syndrome, which is a condition where females will grow excessive cysts on their ovaries and again, there’s a massive connection with PCOS and insulin, which insulin then gets connected to blood sugar.  So this inositol is really helping with PCOS indirectly by helping with blood sugar.  And just go Google like I said, insulin and PCOS, and that’s why the main line therapy is Glucophage or Metformin to treat it.

Evan Brand:  Really?

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  So what are they trying to do there?  They’re trying to get that insulin back down to fix that PCOS?

Dr. Justin Marchegiani:  Yup, because the insulin is what’s driving the cyst to grow.  It’s like the–the insulin is like the–the food for cyst, it’s so to speak.  And then the insulin then causes the females estrogen downstream to testosterone and that that’s why you start to see with that whole sequelae of, you know, extra hair along the jawline, thickening of hair, thickening of follicles, things like that.  You’ll just see changes in women.  It’s like this cruel joke when we have high levels of insulin in the body, women become more like men and men become more like women with, you know, the–the gynocomastia and the breast tissue and all that stuff.  So it’s this–this shift in sexuality if you will.

Evan Brand:  That’s incredible.

Dr. Justin Marchegiani:  By our–by our hormones with just hyperinsulinism.

Evan Brand:  Wow.  So this is probably a topic for a entire episode but–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I had always seen stuff about like how estrogen being a cause for or maybe a cause or a symptom or something that’s correlated with PCOS, or was it kind of those two together?  Is it high insulin and high estrogen like estrogen dominant state that’s causing that PCOS or is that just kind of a side effect and the insulin’s really the biggest culprit there?

Dr. Justin Marchegiani:  Well, again, there’s gonna be a combination of the two.  A lot of times when we have estrogen dominance, we may not have high levels of estrogen so to speak but we may have high levels of estrogen in relationship to progesterone.  So because progesterone can go downstream to cortisol and cortisol connects with us because it’s stabilizing blood sugar.  So the more you’re taking your meals and eating a whole bunch of sugar, the more you’re taking your progesterone downstream and it’s gonna convert down to cortisol and if you’re on the second half of your cycle that luteal phase, that’s the phase where you’re more prone for PMS, right?  Day 15-27 of your cycle, so if the first day of your period is day 1, day 15-27 is where your luteal phase is and if you’re eating too much sugar right there, you are setting the stage up for some nasty PMS, because that cortisol is draining all of your healthy progesterone.

Evan Brand:  Interesting.  So someone could be really messing themselves up from kind of a multilevel thing here if they have excess stress in the form of emotional stress for example, but also the nutritional stress where maybe they’re skipping meals and when they are eating meals, they’re having too much carbohydrate, therefore, driving up the insulin likely suffering from blood sugar crashes which is then elevating cortisol which is then you’re saying it’s taking away from the progesterone because the progesterone is not able to do its job because it’s needing to go downstream to create cortisol and, therefore, estrogen just has no–no gatekeeper, no regulator I guess.  Is that the way to put it?

Dr. Justin Marchegiani:  Yeah, it’s just the ratio is starting to go–gets skewed.  And again, there are estrogen issues because we are just flooded with xenoestrogens in our environment, right?  With our plastics and you know, you mentioned the whole–the coffee thing that your–your wife does there.  That’s got an extra plastic in it.  You mentioned all the pesticides are estrogen-based.  You know, the receipts that you get at Whole Foods, right?  There’s a coding of BPA in there, on the inks, so you gotta fold those up and don’t touch your fingers to it.  So lots of different things in our environment are giving us these extra estrogens, so you gotta be careful of that.

Evan Brand:  Right.  So that progesterone, that’s typically always–you’re not gonna have enough in the modern world a lot of times compared to the amount of estrogen that’s out there.  We’re just in an estrogen–estrogen-filled world.

Dr. Justin Marchegiani:  Yeah, we just gotta have our detoxification pathways working well, eat organic food, go exercise and sweat.  The solution to pollution is dilution according to Robert Rackowski.  Again, drinking water is gonna help your body get some of those hormones out.  And again, your detox pathways run with amino acids, don’t forget that.  We need aminos to run those detox pathways and all of these toxins, they screw up the blood sugar receptors.  They make us more insulin resistant.

Evan Brand:  And remind people where they get aminos.

Dr. Justin Marchegiani: Well, aminos, I mean, your best sources are gonna be animal-based proteins because they’re gonna be higher in a sulfur amino acid profile, and if we’re gonna do a powder-based, your next best is gonna be a good quality whey protein that’s grass-fed or a good quality beef protein that’s grass-fed.

Evan Brand:  Yup, and you’re also helping with detox there.  You can increase your glutathione level, your master antioxidant with some–with some grass-fed whey.  So if that’s not in your supplement cabinet, I’d get some in there.

Dr. Justin Marchegiani:  Absolutely.  Anything else you wanna add, Evan?

Evan Brand:  No, that’s it.  This has been a great overview and it’s fun.  Fun as always.

Dr. Justin Marchegiani:  Yeah, I’m really looking forward to our last podcast together.  I mean, we’re just ripping off, you know, thousands by the day, and I just really want the listeners to just get as much out of it, so if they have questions for us, let us know.  And if you’re enjoying the show, give us feedback.  We love feedback.  It’s what gets us out of bed in the morning and motivates us to do these shows.

Evan Brand:  Yes, sir.

Dr. Justin Marchegiani:  Evan, thanks a lot, man!

Evan Brand:  Thanks, see ya!

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.

Susan McCauley on Addiction and The Stress Connection – Podcast #46

The effects of stress can cause major damage to your psychological and physical make-up.  When people are unable to deal with these stressors, they may resort to using alcohol, drugs or any other form of addiction to manage their stress levels.  While these can provide temporary relief, it is ultimately self-destructive.  Read the rest of this entry »