Gut Health and Anxiety | Podcast #227

The good bacteria in our gut are the ones responsible for the chemicals in our brain. Inflammation or anything that can affect your gut especially when it comes to digesting nutrients can cause a big impact on your brain chemicals. But how does really your gut affect or cause anxiety? Find out more!

Today’s episode talks about giving importance to the gut health which is the one responsible for the digestion of our food and vitamins that are needed by our body. One deficiency in the vitamins needed by our body can already affect our brain chemicals, thus creating mood issues and cause anxiety. Listen as Dr. J discusses the topic together with Evan Brand which gives his own personal experience to highlight the importance of gut health. Continue to find out that anxiety is more than just anxiety. Stay tuned.

Dr. Justin Marchegiani 

In this episode, we cover:

00:35    Effect of Various Medications, Digestion and Brain Chemicals

08:12    Lab Testing

11:05    Bad Bacterias

12:22    Home and Environment

19:44    Seeing the Whole Picture

16:55    Adrenal Testing

24:48     Thyroid Issues

26:24    Blood Sugar Level Optimization

Evan Brand: Yeah man, me too. So I’ll just start with my personal, and I don’t know if you experience much anxiety. I don’t think you’ve ever really said “Hey, I’ve had anxiety” but I definitely did, when I had gut infections. When I had ___[0:35], when I had parasites, when I had bacterial overgrowth, when I had candida overgrowth and when I had kind of a quadruple ___[0:43] that I really think stemmed from me during a round of antibiotics after I got my wisdom teeth and my 12-year molar extracted, you know I had a round of antibiotics after both of those procedures. I think that’s what led to the candida and then probably started to tore away, uh, tear away my gut barrier and then I ended up getting leaky gut situation. You go swimming Barton springs a few times, you swallow some creek water, you get some parasites down in your gut and then all of a sudden everything falls apart and you’re anxious for no reason. So that was at least my, my story, my unusual experience with anxiety ‘cause I’m not an anxious person by nature, but that made me anxious when I had those gut bugs.

Dr. Justin Marchegiani: Totally makes sense. I mean gut health is so important because all of your nutrients get absorbed through your gut. So, just a kind of review of physiology because we wanna connect the physiology and the biochemistry to why you feel the way you feel. That way you’re not just taking doctor’s orders, you’re understanding how these things are working. So, so we have our stomach, where we chew up our food, we swallow, it goes down our esophagus into our stomach. Digestion starts when the mouth gets chewing so just chewing up our good proteins is gonna be huge. That starts the digestion process and increases the surface area for hydrochloric acid, and enzymes in the stomach. So we increase hydrochloric acid in the stomach that lowers the pH it makes it more acidic, like ‘cause pH is lower. And that activates certain ___[02:07] enzymes in our stomach like ___[02:08] which starts that protein digestion process, that nicely enters, that enters into our small intestine, which then triggers ___[02:16] so we start breaking down the fat, fats are important because vitamin A, D, E, and K have instrumental effects on our physiology. Fats ___[02:25] vitamins especially, uhm, you know vitamin d for example, for instance has some effects at helping with mood as well. And we also know vitamin K, and vitamin A are really important for, uh, thyroid function and we know thyroid can have a major implication on mood as well, so low vitamin A, low thyroid. But in general all of these proteins and amino acids and even these minerals, these tranquilizing minerals, like magnesium, help our body relax. They chill out our heart, they chill out our mood. ___[02:55] amino acids get broken down in our stomach. They get ionized in our stomach and get reabsorbed again our small intestine. So we know that digestive processes are so important for these nutrients getting to where they need be is important so we can feel good.

Evan Brand: Talking to your microphone go close like this.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m not sure if that’s – I think you might be using your built in microphone.

Dr. Justin Marchegiani: Oh lemme double check that.

Evan Brand: ‘Cause I sounds a little echoey. Go on, uh, go on your little gear box on Hangouts there, see if you see

Dr. Justin Marchegiani: Oh yep, you’re right. How about now?

Evan Brand: Much – a million times better.

Dr. Justin Marchegiani: Okay, I apologize for that everyone. So we got a better mic up and ready to go, ex-

Evan Brand: We, we still heard you but, now we’ve got that show, that studio quality gone.

Dr. Justin Marchegiani: Love it.

Evan Brand: So here’s the deal. Everything you said makes a perfect sense, assuming, you’re actually digesting and assimilating all these nutrients and breaking everything down like you said. And so where the domino goes bad, I mean for a lot of people, it’s just being prescribed in acid blocking medication. So you may think, well, how in the world does anxiety tie in to me being ___[02:55] or some acid blocker. Uhm, the way Justin described it, it was perfect. You take all these amino acids from your dietary protein, assuming you’re eating those. You know for eating a bagel, and, you know, cream cheese for breakfast, that’s not gonna cut it, you know. We’re eating a good, you know, we’re eating a good quality meat, a bacon, a sausage, you know handful of pecans, uh, half of avocado, you know, some blueberries, that’s a hell of a breakfast. If you’re eating that, you’re gonna beginning some amino acids that can be broken down and therefore turned into, for one, create muscle tissue-

Dr. Justin Marchegiani: ___[02:55]

Evan Brand: Uh, create neurotransmitters. But, if you’re on an acid blocker because you had heartburn and you in one visit with your doctor and they say “Okay you need to be on an acid blocker” you could start that whole domino effect against your health just from something that simple and then you end up with anxiety so then you get referred to your psychiatric doctor and they put you on Xanax and, and, and it’s not a Xanax deficiency, it was the acid blocker messed up our digestion, your digestion issues created the inability for you to absorb your amino acids and make brain chemicals. Now you’re anxious and depressed, so then you get put on anti-depressants. So before you know it in three seconds you’re on an anti-depressants, an anti-anxiety, and on acid blocker. And then maybe you can’t sleep good because just as mentioned you’re breaking down these relaxing things like you’re getting magnesium from your diet. So if you don’t have enough of that, or let’s say you don’t have enough B6 to convert serotonin to melatonin, now you’re not sleeping well so then you get on the fourth med which is a sleep drug. I mean this is how what happens, this is why an average person is on multiple pharmaceuticals.

Dr. Justin Marchegiani: Yeah, and I don’t even think you talked about uh, cholesterol medications on there as well, right?

Evan Brand: No I didn’t.

Dr. Justin Marchegiani: Because cholesterol is gonna be the building block for all your hormones so then you have, maybe your cholesterol’s starting to creep up because of inflammation or you’re doing too much carbohydrate which stimulates insulin, insulin jacks up your cholesterol inflammation will also do it too, so for eating inflammatory foods that could do it. And then now your cholesterol’s high, you’re prescribed to ___[05:58] and then the ___[05:59] gonna decrease your, uhm, ___[06:01]  production so now your  ___[06:02] lower. Your building blocks for your hormones are lower and we know ___[06:05] have other conitive mood side effects as well so that’s gonna create more issues. And then from there after that you’re on a libido medication like a viagra, uhm, or something like or xalexa to help with ED and that’s create more side effects and more issues and then God forbid you got some mood issues. You go, if you’re a female now, you got top your conventional doctor, their typically gonna recommend birth control pill or even ___[06:33] on top of that, then you’re just screwed. Because stacking one medication on top of another medication and then all these medication have various side effects that you treat with other medications. And then these medications also create nutritional deficiency. So birth control pills will lower Magnesium, Zinc and certain B vitamins which are really important in ethylating ___[06:55] your neuro transmitters so it’s just really important especially Magnesium for calming and relaxing your heart. For helping, let’s say, be the shifter between your sympathetic and parasympathetic nervous system. Meaning, parasympathetic, relaxation. Sympathetic, stress, go, go, go. We need the ability to downshift from sympathetic of stress and go, to the parasympathetic, relaxation and chill out.

Evan Brand: Well let’s add one more drug to the mix, that are hundred, that are hundred million Americans are on which is blood pressure medication. 

Dr. Justin Marchegiani: -Right.

Evan Brand: And Valsartan and all these commonly prescribed blood pressure medications are all getting recalled now due to containing carcinogenic chemical, you know. There’s like, this type in Valsartan cancer, you can look the research yourself, and these people get put on blood pressure medication because they can’t regulate their blood pressure because as you mentioned, you lose that parasympathetic-sympathetic balance, you’re depleted in Magnesium because you’re not digesting, because you got gut infections or you’re on acid blocker. So now you’re  acid blocker, antianxiety, antidepressant, you’re on like you said, Xalexa, and now you’re on blood pressure, and then you’re on  ___[08:01] at all the same time. None of that is gonna, you know, none of that is gonna contribute to a long healthy life.

Dr. Justin Marchegiani: No, none of it will, man. So really important, we’re trying to get to the root underlying cause here. So, let’s shift gears on the lab testing. There are some lab testing we go to see what’s going on. Number one, just looking at your digestion. Just doing a comprehensive gut test, look at inflammation in your gut. Inflammation in our br- inflammation in our gut will create an inflammation in our brain. That activates the cell called microglial cell, which are essentially immune cells in our brain. When they are activated, they will create a, you know, brain fog. So you know, you know obviously that the more foggy you are, the more anxious you could feel as well. So inflammation in the gut could create inflammation in the brain. So we gotta look at gut functions. We wanna look at a comprehensive gut test, that’s gonna assess inflammation in the gut, like ___[08:50]. Wanna look at your IGA, your immune levels, because your immune system is over active, that could be a sucking up a lot of resources, right. So, for instance, the more your immune system is overactive, that’s like the equivalent of you, let’s just say, leaving the water on in one of the guest bedrooms in your house that you never go to. Water builds huge, and you don’t know why, because you’re not using a lot of water but there’s water being used in the background, it’s kinda like that. You have all these immune resources that are being used in the background, cause your immune system is chronically firing off, so your immune function. Next is looking at various candida overgrowth, yeast overgrowth, which have a huge effect because they produce various acid ___[09:32] and toxic byproducts. And they also create chemicals that makes you crave a whole bunch of sugary stuff. So it becomes harder to stay on a good diet to your template. Next would be SIBO or various bacterial overgrowth. Whether it’s ___[09:44 – 09:48]. These are all bacterial overgrowth that are despotic meaning bad, so we have more of the bad stuff and less of the beneficial probiotics like lactobacillus ___[09:55] and then we have various parasitic infections. ___[10:00 – 10:06] various parasitic infections. And ___[10:08] h pylori which is some kind of bacterial infection too, or worms.     

Evan Brand: I’ve seen a lot of crypto the last few weeks, it’s very interesting because during the winter I didn’t see much crypto so I don’t know if that’s because people, for their self maybe are like, Texas, Florida, California clients maybe they’re getting back in Creekson rivers or streams or lakes for the season or what. But I haven’t seen much crypto and then over the last three weeks I’ve seen, I don’t know, probably fifteen to twenty people, including children, even as young as age 2 or 3 years old,

Dr. Justin Marchegiani: (Crosstalk.) Wow.

Evan Brand: Those cryptosprodium, I tell you for personal experience it causes a lot of stomach pain, nausea, it can cause appetite swing, or sometimes you sit down at the dinner table you just can’t eat, you’re just not hungry and obviously, anxiety belong with that because now, if you’re getting robbed of your nutrition because of crypto, you’re not gonna be absorbing your amino acids, and then you can’t make your ___[11:01] for example. Now, you’re tired, you’re wired, you’re stressed, and you just don’t know why. So, um, you did a great job on talking about stool test, you mentioned the candida, we, you find candida on the stool test when you and I look at that. However, we often find it more accurately on the organic acids panel because we’re gonna measure the gases that candida produces rather than the actual candida itself. So in the stool, we’re trying to find the DNA of candida which is a little harder to do, so we often see a lot of false negatives on stool testing. So this is why, we just can’t quickly compare or contrast your conventional gastroenterologist that you get referred to. They’re not gonna be running these type of tests, maybe on ten or twenty years, that could be the whole standard, for right now they’re not running these tests. So even if they did they called it “stool test”, their stool test could not be probably as intensive as the technology we are using because we are kinda on the bleeding edge here. So that being said, the organic acids’ profile, we’’l look at the gacids. And when we look at the gacids, you can also look at the other fungus too, so we can even look at the things in their environment like mold, because on page 1, of the ___[12:05]  there’s different markers that hide in candida but there’s also different markers that we’ve found that indicate ___[12:11] of mold. So you could have mold in your sinus cavity as so close to your brain it can go to the blood brain barrier and that will cause anxiety too. So now we’re talking about, fixing someone’s sinus infection as well as fixing their gut infection, and fixing their home environment. Their home environment because potentially as we’ve seen people like in Florida had one client who shits too much candida in their house. We did this little petri dishes for her house, she shits so much candida in her house, so much anxiety and we fixed her gut and three months later she’s got a white tongue again. The candida comes back and so we give her herbs again, her gut gets better, and then candida comes back. Say we need to test your house, so we test her house, the candida in her house is off the chart. So now what we did is we did the fogger, we fogged her house with the essential oils and the candida in the house is gone. So now she’s staying free and clear of the candida overgrowth. So, this is why you gotta take a step than even the functional medicine people saying “fix the gut, fix the gut, fix the gut” now you gotta fix the home, microbio home as well as well as your internal microbio home. You can’t just cherry pick.

Dr. Justin Marchegiani: Yeah, and for every person this may not be the root issue but it’s important. Yeah especially if we can do history and you feel bad or coming out of the house or we can even just start with a decent play testing. And even from the ___[13:26] micro toxin collection after that and if we can see, we can put a check in each one of those boxes ___[13:34] confidence that what we have to start dealing with the home environment right?

Evan Brand: Yeah, exactly yes. The home, you know, like, like you said it’s not everyone. Like, I’m kinda over paranoid about the issue now so I’m checking some of the houses. But I’m only finding maybe 20% of the people were testing their home or showing up with the problem. There’s a lot of people coming out, their home is perfectly fine and I just say you know what for a hundred fifty bucks US it’s worth the peace of mind. Work the plates, check your numbers, and worst case scenario I’m wrong and your home is not contributing to your anxiety or other health problems.

Dr. Justin Marchegiani: I hundred percent agree, and also uhm, one of the things that you brought to my attention is very interesting is that you may have no history of water damage or no apparent water damage in your house at all but you may just have a high amount of moisture in your house because of the climate you live in, and one of the things that you did was you invested in a good quality dehumidifier attached to your ___[14:29] to pull the humidity out of the air. Which then makes harder for mold to grow because mold needs that humidity over fifty percent in the house for it to grow so you were able to decrease the humidity because there’s certain times where you may not have an air-conditioner on. Uhm because you know it’s, it’s sixty or seventy degrees out or fifty degrees out but the humidity still high even though the temperature’s low and that’s one of the benefits that you have of having a cool house to humidifier attached to your ___[14:56] to suck out that moisture which prevents the fuel source for this mold to grow.

Evan Brand: Right, and in the spring you’d love to have the windows open right so actually we did this over the weekend, we opened up all the windows. There was one day we have like seventy, seventy-two degrees out so it’s perfect. We opened all the windows up but then I go downstairs and I heard the dehumidifier’s running just in overtime and I go look at the percentage and their up to fifty two percent. So people they opened up their window and mold grows on fifty or above. When you’re like oh, the weather’s beautiful, let’s leave the window’s open for a week straight, you know, or let’s leave the windows open all night or let’s leave the windows open every day all day. That’s allowing all that moist air from outside, assuming that’s the climate’s moist, to come inside, and that’s increasing the humidity in the home. I love the idea, you know, open the windows, ten to fifteen minutes a day, let fresh air come in, wash out from all the ___[15:46], wash out from all the VOCs in your home, but, you don’t wanna do it all the time. A friend of mine, a mutual friend of our’s, Daniel Vitalessi, who lives up in Maine, it’s so moist up there. Uh, I can’t, I don’t remember the full details but I remember him saying about having a mold problem on his previous houses, and it might consider at the podcast, he left his windows open all the time. ‘Cause he like to live in the woods, and he love the sounds of nature and all that so he had his windows open all the time. But I mean all that moisture was just forming on his window sills and so you gotta, you gotta think about the building materials that we’re using. Like our ancestors they were outside all the time, you know, but they had like a buffalo hide, they had bison hide, you know, they didn’t have dry wall, and uh, you know, treated wood and all those sort of stuff. They didn’t have the same building materials that we used today. So, try to compare, “Oh my grandma she lived in the summer and she have air conditioning and her windows are open all the time,” yeah, but her house wasn’t probably made with modern dry wall. So those materials could withstand moisture, our modern day materials are more moisture sensitive.

Dr. Justin Marchegiani: Exactly. Yup, hundred-

Evan Brand: It’s a bit of a tangible. Let’s go back to the testing. So, we didn’t talk about adrenal testing for anxiety, I mean that was one of my problems too is, uh, I would feel pretty good during the day but then at night I would feel anxious before I would go to bed, and I have that night time spike of cortisol that we often see.

Dr. Justin Marchegiani: Yeah, so what we do is we look at the cortisol rhythm throughout the day and then the cortisol rhythm gives you a window to how your cortisol, how the outer part of your adrenal glands are doing. So we look at this high to low to lower to lowest type of taper. These tapers are important because it’s set by our HPA access. So we start to see these regulations lower by the morning or higher at night or it’s kind of bouncing around like we call the pinball effect. It’s pinballing that could create mood issues number one. Number two, we also look at the inner part of the adrenal glands called the medulla which make a lot of adrenaline. Adrenaline or no adrenaline, same thing as epinephrine and norepinephrine, medicine uses a lot of words to say the same thing. So, we’d also wanna look at that, ‘cause if we’re really stimulating a lot of adrenaline or no adrenaline that’s helpful to know so we’d wanna run a good cortisol rhythm test to look at free and total cortisol which is great. We’d also wanna look at some of the uh, amino acid metabolizer or some of these neurotransmitters. Like, we’d look at vanilmandelate  to get a window at adrenaline metabolism. We’d look at homovanillate to get a window to dopamine metabolism. And also you’d wanna get a window into B6 because B6, especially at folate and B12 are really important for methylation. And a lot of these brain chemicals like epinephrine and adrenaline, ___[18:28] they need to get methylated. So we, we need these carbon hydrogens to bind it to methylated, to activate it and that requires sulphur amino acids so if we’re excessively stressed or really methylating our brain chemicals ‘sause we’re making a lot of adrenaline, we’re gonna be burying under a lot of sulphur amino acids as well. And we need sulphur amino acids also to detoxify, we may not have a lot of extra sulphur left over to run ___[18:58] we may not have enough of these sulphur compounds to run these other accessory pathways which are really important for what? Detoxifying us from mold, heavy metals, various organic chlorine, pesticides, or stressors in the environment so that’s why it’s really important to look at these other accessory nutrients that are involved in the stress handling response. 

Evan Brand: Yeah, let’s take what you said. Let’s dig further. So now you’re deficient in sulphur, you’re not detoxifying properly. You do get exposed to pesticides, go out to a restaurant with your family on a weekend and have a good dinner knowingly eating pesticide and that’s gonna kill off good bacteria in your gut. Those good bacteria are supposed to make your brain chemicals so now we go back all the way to anxiety again. So it is this kinda self-repeating cycle. So this why you can’t just focus on one aspect of your body. You can’t just put all your eggs on the gut basket, all your eggs on the adrenal basket. This is why Justin and I don’t really say, you know, you know, word expert at adrenals, word expert at gut, or word expert at this or that, because if you go in with the microscope and you’re just looking with this one problem, like you could see the thyroid, and see that there’s a problem with the thyroid, that could cause anxiety too, right? Like if you have Hashimoto’s you’ve got antibodies that attack the thyroid and you get a little bit of hormone into the bloodstream that could cause anxiety for sure.

Dr. Justin Marchegiani: (Cross-talking.) Yeah.

Evan Brand: I mean we didn’t talk about that extensively. However, if we just focus on thyroid, okay we’ll gonna give you ___[20:24] or something else to calm the thyroid, did we fix the problem why the thyroid is auto immune in the first place. We fixed the immune system attacking the thyroid by looking at adrenals, and gut and chemicals, all that. Or we just give someone herb to calm the thyroid and that was all we did.

Dr. Justin Marchegiani: (Cross-talking.) Right.

Evan Brand: Because if we did just that, then we fail.

Dr. Justin Marchegiani: Correct, and I’m seeing this more and more with various functional medicine doctors that are out there. What I’m seeing there are people, just the thyroid functional person, just the gut functional person. There’s nothing wrong with that marketing stampone, and like I’m gonna market to those people but I’m gonna look at everything once they’re in there, I get that. That’s kinda where my focus is. You wanna reach out the people so they ___[21:06] with you but you’re still looking at the whole thing. I’m seeing people, I’m seeing people only focusing on just the thyroid. Or only focused on just the gut. And then I’m looking at their labs, I’m seeing these people coming to me as patients and I’m like, oh its’-it’s really too bad because had an anemia and anemia was missed because this person was only focused on the thyroid or hey, this person had an adrenal issue or other issues going on and they were only focused on the gut, they didn’t fix those other things. Does that make sense?

Evan Brand: (Cross-talking.) It does.

Dr. Justin Marchegiani: So just be careful. A lot of people out there are focused on, you know they’re focused on, they’re reaching to functional medicine practitioners that are marketing one thing and another for their anxiety but they may be missing in the treatment a whole body system that’s so important. So, when people are out there looking for functional medicine doctors, you know, if you find someone that you like that’s great, just make sure when you interview them, when you talk to them make sure they’re gonna be looking at all the underlying systems, not just focused on one system like the gut or one system like just the adrenals. Make sure you’re looking at the whole thing.

Evan Brand: Yeah, I think over the next five to ten years this is gonna be a bigger problem just because of the Internet. The Internet allows us do what we do, and we are very grateful for the opportunity. But that also allows other people to go pick up some high profile credential and then market a specific flavour of functional medicine. Like, I’m gonna be the hormone girl, and I had a woman last week and she went to this hormone functional medicine specialist and the lady’s loosing hair, in clumps and clumps and clumps every time she takes a shower, and we look at her blood work, and she’s never been – she goes to this hormone lady, I don’t know how, a hormone functional medicine never tested her, never tested her blood, didn’t look at her ferritin, ferritin level was a six. The lady can hardly catch her breath, she’s got major anxiety, she’s losing tons of hair. Like, look at your ferritin, like, if you don’t fix that, you’re not gonna get your hair back no matter what this lady tells you about your bio identical hormone plant. So, it’s just that, it’s – I think it just comes with the territory of this because as you say people are trying to market, but you gotta make sure that they’re turning over all the rocks.

Dr. Justin Marchegiani: (Cross-talking.) Yes.

Evan Brand:  ‘Cause last thing you wanted to do is go spink like two to three thousand dollars and then now you gotta start all over because you didn’t address the other stuff.

Dr. Justin Marchegiani: You want the complete picture. Let’s connect this with some other things. Obviously we have female hormone issues like progesterone, low oestrogen or oestrogen dominance if you’re a cycling female. Obviously we have the menopausal kinda side where the hormones could just be low across the board, and we’re starting to have a lot of menopausal symptoms, from low progesterone, low oestrogen, because now our follicles, our ovarian follicles are used up. And then we have obviously on the cycling side, where we’re having a lot of PMS, a lot oestrogen dominance and we have lower progesterone, and that could be another component because progesterone is a GABA Chloride channel opener. So it opens those GABA Chloride channel in the brain, and allows us to relax. A lot of people could have a lower progesterone, oestrogen dominance, or just lower hormones across the board if you’re on the menopausal side. And the crazy thing is, we can also have similar symptoms if our thyroid is also low. This is why it’s so important to why you cannot just, just create a market and for one thing but it’s really important that you look at the whole component to make sure, other patients were hey, thyroid was the missing key to their anxiety, some it was low progesterone, some it was a combination of the two. And unless you’re treating and looking at it, and also treating it, then you know, you’ll know from you know, from experience what levers is moving what.

Evan Brand: Yeah, and I briefly hit on the Hashimoto’s, I think we should talk about it for a second because this is such a common issue. We’re seeing women with all sorts of different levels of thyroid antibodies. From the tens to the hundreds to the thousands. When the immune system is going after the thyroid, the first thought is, well, we’ve gotta calm down the immune system, we’d better try to stop this attack on the thyroid, but really, it’s fine at the first thought, but really what we’re seeing is we have to be addressing the other causes, if you give someone like a thyroid multivitamin, like it’s got your Selenium, and your Chronium, and  and ___[25:18] and all those stuff. That’s good on a theory but you could stay on a thyroid multivitamin for five years and still never get to the root cause.

Dr. Justin Marchegiani: Absolutely. All the thing that I would think is at the low hanging fruit perspective ___[25:30]. So of course gluten sensitivity can create GAD antiobodies and GAD is glutamate, uh, glutamate decarboxylase enzyme which is the enzyme that helps make, uh, uh, helps make GABA in the brain and GABA is that nice inhibitory relaxation chemical, so GABA’s important, gluten’s a strong component in that ___[25:50] response. But also gluten can drive, uhm, Hashimoto’s and that you will see increase in thyroid peroxidase and thyroglobulin antibodies. And these antibodies are gonna stimulate attack on the thyroid, attack the thyroid, and you may spill out hormone and as that hormone spills out to rev up the metabolism create swings of anxiety there as well.  

Evan Brand: Have you ever experienced that, I mean you talked about your story with Hashimoto’s. have you ever had a day or a week or a time in your life where maybe a stress or, you know, uh, when you first had your son you’ve had like high in stress  did you ever feel like “Oh my God” like “My Hashimoto’s is kicking in”  did you feel that or-

Dr. Justin Marchegiani: I definitely had episodes where I felt like blood sugar fluctuations and that cortisol adrenaline blood sugar swing ___[26:39] issues in the past and I feel that potentially previous gluten exposures have potentially revved up the thyroid and had created some of those symptoms as well. Yeah I have in the past for sure. I tried to medicate that as soona s possible-

Evan Brand: Yeah, but it’s not fun the blood sugar piece you implied you hit them. Let’s, let’s – I know we hit that kind on Anxiety Part One, but with the blood sugar, you know in terms of testing, right? We talked about hormones; we talked about gut, organic acids, etcetera… Blood sugar testing, how simple and easy is that? If you’re feeling anxious, I mean I had a time where I had impending doom. I thought my god, the world’s gonna end, something bad is about to happen. I don’t know what it is, I checked my blood sugar, it was a fifty nine.

Dr. Justin Marchegiani: (Cross talking.) Yeah, yeah.

Evan Brand: I mean, whoa.

Dr. Justin Marchegiani: I know, I know. That’s gonna be an issue because low blood sugar will drive a lot of cortisol adrenaline to pick it up. Now again if you’re fully ___[27:30] adapted that’s better because you have a lot more ketones there but I still think, uhm, even when you’re blood sugar’s that low could definitely create some issues for sure.

Evan Brand: Yeah, so if you have anxiety, I mean, don’t automatically think oh it’s Hashimoto’s, it may might not be. It could be something simple like low blood sugar or high blood pressure. You know when I was having some blood pressure swings, I noticed when the pressure was high, a side effect of that increased blood pressure, was anxiety. So do you take anti-anxiety herbs or do you think blood pressure herbs? For me, it was a combination of both. I took, like, inhibitory things to support GABA, you know ___[28:09] etcetera and I also did some hawthorn berry and  some folate and some other things to help blood pressure. I kinda worked on both. That’s why really, people, you know, email us and say “Oh doctor J can you just give me a protocol for my Hashimoto’s?” It’s like, do you see how bad of a question that is? It’s like we have no idea what the heck is going on. Or can you just give me “Doctor J give me a parasite protocol” We have no idea what’s going on. Like, give me an anxiety protocol. You can’t do that because what’s the mechanism? What is the mechanism behind it? So, you know, in the long run you’re gonna spend so much more money knowing the whole foods or in Amazon buying this anxiety supplement bust, you know, stress busting supplement. Like, might help, probably won’t hurt, but, get the testing done. Get the data, get the rocks turned over. I can’t tell you how much time I wasted just taking this random herb for energy, random herb for sleep. And I had no idea what I was up against.

Dr. Justin Marchegiani: Hundred percent. Well, excellent thoughts here today. I think we laid some, some good references for various mechanisms. How we can go down this path and of course how the gut is intimately connected. And I talked about the auto immune mechanism a minute ago, just kinda gonna dovetail on that because today’s podcast is on gut health and anxiety. A lot of that mechanism happens and works because of gut prebio ability. So with leaky gut and gut prebio ability have that mechanism where we have that undigested, whether it’s yeast or bacteria or foods include in our casein compounds get into that bloodstream through the gut lining right. We have our tight junctions, they open up especially with exposure to gluten and casein and potentially other endo toxins and fungus metabolites. They’re gonna open up these things get into our bloodstream and then our immune system is now exposed to it or these things now exposed to our immune system and can really heighten that auto immune system response now. And then that’s part of what’s going on here. So auto immunity is a big issue especially if someone’s anxiety is connected to a thyroid issue, there’s a good chance that thyroid issue is auto immunity nature, and then acts the part of it.

Evan Brand: Yeah. How simple of a thought. Like your, your dinner at the pasta restaurant could be driving your anxiety in your auto immune condition. Well it’s very well possible.

Dr. Justin Marchegiani: Well, excellent. Today’s a phenomenal podcast. To everyone listening if you wanna dive deeper with Evan head over evanbrand.com you can schedule a consult with Evan. If you wanna dive deeper with myself justinhealth.com click the arrow we can schedule a consult and dive in deeper. Yeah some of the labs we talked about today we’ll put links down beneath the podcast. You can access some of these labs, uhm, some of the gut tests are really important. Some of the adrenal tests, some of the neurotransmitter metabolite tests we’ll make sure we have links down below as well. Evan, any other questions, comments or concerns?

Evan Brand: I would just say don’t give up if you do need some type of anti-anxiety medication or something prescribed temporarily while you’re working on the root cause. I’m not judging you for that, neither is Doctor J. The point is we want you to get to the root of this and we see so many people that they wanna get off their pharmaceutical medications and they don’t know how. This is your road map to do so keep your head up, keep focusing on “What else have I not done yet? What other rock do I need to turn over My blood test, and my doctor said I’m fine.” Well there blood test probably sucked, get a better blood test, figure out what the heck is going on.  

Dr. Justin Marchegiani: Exactly. You guys liked the show here put some comments down below. I love to hear what you think, like to get suggestions on future episodes. Give us a thumbs up or might share as well. Really appreciate it. Evan, today was great man, we’ll be in touch and we’ll talk this week. Take care everyone here. Bye bye.

Evan Brand: Bye bye. 

References:

https://www.evanbrand.com/

https://justinhealth.com/

Dr. Kelly Brogan – A Mind of Your Own – Podcast #165

In today’s video, Dr. Kelly Brogan, an accomplished doctor and author of the New York Times bestselling book “A Mind of Your Own”, joins Dr. Justin Marchegiani as they both discuss the link between gut issues and mental health. Get some useful tips on how to keep your mind clear and active without gut issues hindering it. Get your own mind back with the help of functional medicine. Let’s watch and listen!

Discover some natural ways to be more productive and learn about the different ways to address brain and gut inflammation. Also, stay tuned for some more information about Dr. Kelly’s bestselling book, “A Mind of Your Own” and viral articles.

In this episode, we cover:

02:41   Depression: Illness of Modern Civilization,

Not a Chemical Imbalance 

04:53   Animal Model of Depression

08:20   Multiple Different Lifestyle Pillars

12:00   Meditation and Productivity

16:42   Supplemental Ways to Address Brain Inflammation

Dr. Justin Marchegiani: Hey there. It’s Dr. Justin Marchegiani. Today’s podcast, we have a great guest.  Dr. Kelly Brogan in the house. Kelly is wicked smart. I’ll bring up my Boston ex. You went to MIT Undergrad in Cornell from Medical School. So, it’s a privilege to have her here. She has a New York Times bestselling book, “A Mind of Your Own.” Did I say it correctly?

Dr. Kelly Brogan: That’s right? [crosstalk] You got it.

Dr. Justin Marchegiani: A Mind of Your Own, really looking at natural solutions to get your brain back on track and move back on track. And one of the things about Dr. Kelly that I love so much is she looks at how mood is connected with the gut. Because most people, they just want to throw a medication to fix the brain. They fix the symptoms but not actually get to the root cause, which can be in the gut. So, Dr. Kelly, welcome to the show.

Dr. Kelly Brogan: Thank you. Total pleasure to be here.

Dr. Justin Marchegiani: Excellent. Well, tell us a little bit more about your self, ‘cause you went down this conventional medical rabbit hole, right? MIT, Cornell– You’re diving in deep– you do your residency, uhm– and you’re kind of learning all these conventional treatments for Mood disorders, etc. How did you come out of that alive? And how did you get your training to get to the real root cause and the functional medicine side here.

Dr. Kelly Brogan: Yeah. So, you know, I come from a very conventional mindset, and I was raised by uhm– an immigrant mom. And anyone who has immigrant parents knows that, basically, you follow the rules; you become a doctor, a lawyer and you’re supposed to be making a lot of money.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: And that was essentially, you know– My effort uhm– was to become a doctor. I thought, you know– I figured out through my work on a suicide hotline, actually, at MIT, that we’ve cracked the code of human behaviour. We know that these are genetic illnesses that are reflected as chemical imbalances that require pills for lifelong management. Cool! You know, I’m gonna participate in that model. And so, it really wasn’t into my own, sort of uhm– health journey, which is what you’ll all hear from any turncoat doctor. We had a personal experience where we bumped up against the ceiling of what conventional medicine has to offer. And we learned a broader version of the truth. And uh– you know, I’ve always been a Science Nut. I’m very comfortable on pubmed.com, and I went and researched for myself, you know– the truth about everything I learned in medical school and residency and fellowship. Uh– and what I learned was pretty jaw-dropping. I was ready to hear it though because I had already had my own uh– experience of putting an autoimmune disorder into remission through nutrition. And so, you know– what I learned is that depression, for example– Let’s just talk about depression because it’s a– It’s a emblematic of these more systemic issues in our medical system. But, uhm– it’s not a thing. It’s not a disease in a way we were told it was. And, you know, what I– what I learned through my review of the medical literature is that in six decades, you know– we’ve been trying to validate this idea that depression is a chemical imbalance. The science just isn’t there. I was shocked because I can’t tell you how many hundreds of patients I’ve sat with and I said, “You know, you have a chemical imbalance. It has something to do with Serotonin or Dopamine or Epinephrine, and you know– you need to manage it. And the sooner you accept that, you know– the easier your life is gonna be.” So patronizing. You know, I’ve said that to countless patients. And when I looked to the Science, it just wasn’t there. But, what is there, interestingly, is a science that frames depression as uhm– an illness of modern civilization, right? So, it’s a response on the part of the body, mind and spirit, uh– you know, to the kinds of stressors, exposures, triggers, toxicants that we are encountering today, that we just haven’t evolved to accommodate. And perhaps, we never will. Perhaps we’re not even meant to, right? Because…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …of– of wrong living today, and– and the way that the natural world will ultimately ask us to get back in line. And– and one of the ways that– that asking happens, that– that invitation’s delivered is through symptoms. So, uh– you know, I found  that there are actually a lot of reversible causes of what we are calling depression.

Dr. Justin Marchegiani: Interesting. Very good. And I see a lot of patients, clinically, right? ‘Cause I’m working with patients making diet changes or cutting out gluten, grains, refined sugar, a lot of the inflammatory foods, or cutting out a lot of the bacteria in the gut that has this compound called LPS or lipopolysaccharide. And, you’ve talked about that kind of getting into the bloodstream and making its way to the brain, and creating mood issues there. Can you elaborate more on that?

Dr. Kelly Brogan: Yeah. So, you know, I think it’s fairly intuitive for most people– you know, that the gut and the brain are connected, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: You felt nervous about giving a speech and maybe you lost your appetite or you have diarrhea, or something like that. And that makes intuitive sense. But, the other direction– you know, the gut to brain direction, is really something we’re just beginning to develop scientific comfort with. Although it’s been actually several decades since it’s emerged in the literature. When it comes to depression, it’s interesting because the animal model of depression– There is such a thing. In the animal model of depression, the way that they induce it is to inject– Systemically, right?– in these rodents, LPS, as you mentioned. So this– this compound in a grand– grand negative bacterial balls. And the deal is that it’s not meant to be sort of circulating around. So, once it’s breached that gut-brain uh– Sorry– that gut barrier..

Dr. Justin Marchegiani: Yes.

Dr. Kelly Brogan: …then it can alert the immune system to the need of greater inflammatory response at the gut level. It’s all by design. Everything that the body does makes sense if only we have the mindset and framework to, you know, receive that uh– information. So, you know, through this lens, uhm– the inflammatory response that ultimately results in the symptoms of depression, which are what? Sleep disturbance, social avoidance, changes in appetite, for example, changes in  motivation, fixation on very specific thoughts, uhm– you know, the– the– the driver of that perhaps could be reduced to a gut insult. So, where do gut insults come from? Most of the time, through what we put in our mouth…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …right? So that means that we are empowered to make changes to our brain behavior and cognition through diet, you know. And of course, now we have science that shows that within seventy-two hours of changing your diet, you change that ecology in your gut, your microbiome. Uh– and so, I totally agree, you know, that there are certain foods that really moved the needle quickly. They also happen to be foods that are very addictive in nature, right? You know, things like, wheat, dairy, sugar, alcohol. I actually stored coffee in that mix. I know that’s little controversial.

Dr. Justin Marchegiani: Hm– Mmhmn.

Dr. Kelly Brogan: Uh– but, you know, so– so, not only are you seeing what you look like without these addictive foods, but you’re also engaging in a pretty deep exercise of changing your gut ecology. And, you know, we could talk about the role perhaps of certain kind of starches in, you know, feeding gut bacteria, ‘cause that’s, you know, part of my approaches to restrict those for the first month.

Dr. Justin Marchegiani: Got it. Interesting. And what’s your experience treating patients ‘cause, clinically, I treat– well, fifty patients a week in my virtual clinic here in Austin. And I’m running Stool test–  sometimes, even multiple Stool tests on different patients, and I’m saying, you know, obviously, “Your SIBO type of overgrowth.” “You’re Methane and you’re Hydrogen overgrowth”. And then, I’m seeing infections like, Blasto, Giardia, and Cryptosporidium, E. histo and H. pylori. What are you seeing in your patients? Are you kind of seeing a similar imbalance of those creatures.

Dr. Kelly Brogan: It’s interesting because I– you know, when I departed conventional medicine, my first deep dive was into functional medicine.

Dr. Justin Marchegiani: Mmhmn.

Dr. Kelly Brogan: Uhm– and that’s, you know, uh– I was certified through ADIHM, and I was very interested ‘cause this is how my mind works…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in quantifying every aspect of my patients’ existence, right? So, I wanted blood and saliva. I wanted hormone testing. I wanted Urine analysis and I wanted Stool analysis. And I did that for several years– yeah, almost a decade, into this work. Uhm– until I came upon uhm– a deep desire to bring this opportunity to more and more people. Perhaps you couldn’t necessarily afford all that testing, or for whom it was just overwhelming, right? And so, somehow, I arrived at the point today, where my approach is actually quite simplified. Such that, I actually come to believe that if you recruit the synergy of multiple different lifestyle pillars. And they’re pretty basic, right? Pretty familiar, too, obviously. So, detoxification…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …looking at daily contemplative practice. Of course, I’m– have my specific opinion on what I believe is one of the more powerful types. I’m Kundalini Yoga uhm– Instructor.

Dr. Justin Marchegiani: Nice.

Dr. Kelly Brogan: And, also the role of a strict commitment to a therapeutic diet for the space of the month. So, in working with these pillars, even without testing at all– So, in my online program, we don’t do any labs. The outcomes that I have gotten actually more rapid and more robust than when I was mired in the weeds of testing. But when I was, I actually found that there are some common uh– reversible drivers of diagnosis of anxiety, of depression, even OCD, panic attacks, ADHD, Chronic Fatigue– In my practice, the one of the most common ones was blood sugar imbalance, so…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …big one, right? Uhm– so you could test for that. You can diagnose reactive hypoglycemia, or you know you can just do a dietary intervention for ten days and see if that was part of the deal for you, right? So, another big one is wheat and dairy indigenousity. So again, you can test for that or you can just take it out and see how you do. Another big, big, big– big one, probably upwards of 80 percent of my patients have a diagnosis of Hashimoto’s, often…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …perhaps driven by mimicry like you’re talking about e– Epstein-Barr, uhm– for example, uh– you know, infection. Uhm– Hashimoto’s, Graves, Postpartum Thyroiditis are big– what I call, psychiatric pretenders, right? If you do not know that you have this going on, you could land your self on Zoloft and Lithium, or more. And that’s why this kinds of testing– unless you’re really committed and you just know, you’re not gonna go the medication route– you know, this kind of testing can really– potentially even, you know, save your life. I’ll be that dramatic about it. Uhm– and, you know, and then, of course, I’d become very passionate about the untold side effects of other common medications, right? So, as drivers of psychiatric illness, so things like birth control pills and acid blockers, statins, antibiotics. Uhm– so, you know, sometimes it– it– it needs to be looked at through the eyes of an expert like yourself. Uhm– but sometimes it’s really simple. You know, and– and engaging in this kind of uhm– you know, pillar approach can– can be really all you need.

Dr. Justin Marchegiani: Very cool. Just curious. Can you give us like uh– a day in the life of Dr. Kelly. What does your diet look like, Breakfast, lunch, dinner?

Dr. Kelly Brogan: Yeah. So that’s the interesting uhm– part about this kind of like holistic medicine, if you want to call it that, is the power of your potential to influence and heal patients, I believe, is in direct proportion to your ability to walk the walk, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So, you know, you transmit something to the people you are looking to help, simply because you’re living that life. So, I– you know, I walk the walk completely, you know. I asked many of my patients to do coffee enemas, for example, which I learned from my mentor, Nick Gonzalez. And you know, if II didn’t do them, how would I ever convince someone else that it’s effective? And this is why meditation is a tough one for me because I follow the literature on meditation for many years and I never did it. I was too busy. Meditation was for other people. And everytime I sat down to do it, I hated it. I hated the experience of just being with myself and being with my crazy mind, right? So, until i broke through that barrier and actually committed to a daily practice– Now I have a pretty strong 45-minute daily practice…

Dr. Justin Marchegiani: It’s great.

Dr. Kelly Brogan: …predawn. But, you know, until I did that, I didn’t– I don’t think I convinced a single patient to meditate. You know, we both sort of thought it was a good idea. They weren’t doing it. I wasn’t doing it. So, you know, the real game changer for me, personally, ‘cause I heal my Hashimoto’s mostly just through dietary change uhm– in almost eight years ago now. Uhm– and my life really changed. I’ve really rewired my nervous system and my productivity performance and aligned it with my flow, changed dramatically when I started meditating every single day. And, specifically, when I started meditating before sunrise, uhm– everything changed. You know, I used to be up until 2 in the morning, working. I’m a total workaholic.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I wake up everyday dying into this work. I love this work. I– I would do it for free, forever. You know, this is what I’m here to do. But, I would work ‘til two in the morning regularly. And you know, in New York, that’s– it’s the culture here.

Dr. Justin Marchegiani: Totally. [crosstalk] Hustle and bustle.

Dr. Kelly Brogan: Totally. Exactly. Totally sanctioned. So, you know, I uhm– When I started meditating at 5:30 in the morning everyday, which I started after in the setting of grief uhm– you know, after my mentor died. It’s the hardest thing I’ve ever dealt with…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in my life.

Dr. Justin Marchegiani: Roger that.

Dr. Kelly Brogan: I was desperate.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. I was totally desperate, and I did it. The nest day, I woke up and I have never missed a day since. Uhm– but, if you’re waking at 5:30, you can’t go to bed at 2:00 AM, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Or you’re gonna be in trouble [inaudible]

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So now, I go to bed at nine. Do you know how revolutionary that is for a New Yorker…

Dr. Justin Marchegiani: It’s amazing.

Dr. Kelly Brogan: ….to go at bed at 9:00 PM? And–  and you would think, “Oh, I’m missing– you know, what is that?– five hours of productivity.”

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Like, how do I even keep my business afloat. Uhm– but my performance– and again, sort of alignment with– just things unfolding, everything happens exactly, you know, the moment I need to. I don’t need to drive this ship. You know, that’s one of the sort of secret pearls in self-care that you wouldn’t otherwise believe unless you’ve had the experience. So, i’m a big believer in foregrounding self-care as being really my only responsibility. All I have to do every single day is make sure that I have committed, again, to taking care of my self. And the rest is gonna. Is gonna be exactly how it needs to be.

Dr. Justin Marchegiani: Very cool. So, I think I missed it. What was breakfast again, typically, for you?

Dr. Kelly Brogan: So, I have this uhm– smoothie often. It’s so funny because sometimes I’ll write a blog that I, you know, spend weeks and weeks and weeks researching. It’s like, you know, ten, 15, 20, 30…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …represent it. And like four people will read it, right?  

Dr. Justin Marchegiani: Mhmmn.

Dr. Kelly Brogan: And then, one day, I just decided to write uh– the ingredients of the smoothie that I put uh– together. Okay, it’s like egg yolks, coconut oil, uh– plus/minus coconut oil. Uhm– nut butter, frozen organic cherries. It’s collagen powder, uhm– coconut water.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Just, yeah. Basic– basic stuff, but it’s not a green smoothie, right? Uhm– it’s not a ton of Kale and Spinach or anything like that. And it was– It’s like, to this day, the most viral thing I’ve ever written. [laughs] It’s just breakfast, [crosstalk] right?

Dr. Justin Marchegiani: Love it.

Dr. Kelly Brogan: Because if you struggle with blood sugar stuff, like I did, uhm– like many of the people I work with do, It’s like, within the day resolution. Like within one day, you can turn that around. You’ll feel what it is to put, you know– It’s two tablespoons of ghee. Put that much fat into your body for breakfast is an unusual thing uhm– for most people, and it tastes delicious and you actually feel full for some times, double-triple the amount you would have otherwise. So, that’s why I’m actually big– I’m glad you asked– big believer in just beginning with changing your breakfast. Like if you are not ready for the rest of it, just start with there. And see…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …how different you can feel.

Dr. Justin Marchegiani: I love it.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: ‘Cause stabilizing that blood sugar is so important. ‘Cause when your blood sugar goes on highs and lows, you get the Hyperinsulinism, which is gonna create all kinds of problems in your hormones. If you’re a woman, it will turn you into a man, uh– by getting the PCOS stuff going, and if you’re a man, it will turn you into a woman by upregulating aromatase. So, you have that side of the fence. And the blood sugar swings. When they go low, you’re gonna get a lot of Cortisol and Adrenaline, which can create mood issues and create that anxiety and that may be the reason why you’re on the Xanax. [crosstalk] So the other moods stabilizes, right?

Dr. Kelly Brogan: Exactly. [crosstalk] You said it so I don’t have to. That’s exactly it. It’s powerful. I mean, I have patients who’d have six panic attacks a day. They’ve had three medications heading to Electroconvulsive Therapy. And all that was going on was Dysglycemia.

Dr. Justin Marchegiani: Huge. [crosstalk] Huge. Now we have these cells in our brain, also called the glial cells, and a great portion of the cells in our brain are actually immune cells, which is interesting. And once these cells get activated from stress or inflammation– it’s like  positive feedback loop. It just gets more and more and more. Uhm– what do you do to help decrease brain inflammation? I think you’ll talk about the gut, but is there anything you do supplementally to help decrease that brain inflammation?

Dr. Kelly Brogan: Yeah. So that’s where I am a big believer in this multi-pronged approach, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: Because, if we’re– if we’re looking at an anti-inflammatory diet, the typical template of a diet I recommend is not gonna be any major surprise uhm– to anyone– but, the Vegans probably, because it’s uh– you know, a classical sort of ancestral diet. You know…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: It was animal food. You know, the nuts and seeds– all vegetables…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I restrict resistant starch for the first month. Uhm–

Dr. Justin Marchegiani: like a Paleo template, basically.

Dr. Kelly Brogan: It’s a Paleo template, basically. Includes, uhm– some starchy vegetables, but not uh– white potatoes. So, just to restricting…

Dr. Justin Marchegiani: Nitrates.

Dr. Kelly Brogan: …they always– Nitrates are included, so tomatoes are fine. Eggplants are fine. You know, mushrooms are…

Dr. Justin Marchegiani: Just the potatoes, okay.

Dr. Kelly Brogan: Just the white potatoes. And uhm– and you know, otherwise, my patients do always reintroduce things like white rice, gluten-free grains, uh– legumes. So, it’s not a long-term Paleo diet. It’s just restricted for that first month. Uhm– so that we can understand what resistant starch does to your microbiome, basically, because when you reintroduce potatoes– Do you have gas and bloating? You know, Are you super tired after you eat white rice? We just want to know that, right, for these potent starches. Otherwise it’s not that uhm– dramatic, but it is– just have this anti-inflammatory effect, ecologically rebouncing at the gut level. And then the meditation components, I just think, as one of the meditations I often recommend is called Kirtan Kriya Carer or _____[18:13]. It’s been studied in  randomized trials, actually, for changes in brain level profusion. Uhm– and the subjective outcomes in terms of resolution of cognitive impairment and Dementia patients, who we have nothing to offer, you know, on a pharmaceutical level. So, literally, all they did was 11 minutes of this meditation every single day.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: So, i’m a big believer in the potential of this ancient  technologies to send that signal of safety at the brain level. And then, of course, you know, when you’re engaging in detoxification– even if it’s as simple as taking the pesticides out of your diet.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Uh– You know, we’re fundamentally changing the way the immune system is being triggered. And as you said, you know, we have evidence that from a gut level, and also from a psychosocial stress level, we could mobilize the immune system in the– in the systemic circulation. That then tracks back to the brain. And like you said, kicks off that alarm. You know, when i was in med school, we don’t even know that the brain had an immune system. We thought that it was a privilege region.

Dr. Justin Marchegiani: It’s crazy.

Dr. Kelly Brogan: We didn’t know that what’s inside of the brain. You know, we’re just discovering basic anatomy, still, at this point. So, it’s important to work with the tools that do the least harm.

Dr. Justin Marchegiani: Very good. Now, I’ve seen you write this, and I may be off in a little bit. I’ll just throw it out there and you can correct me.

Dr. Kelly Brogan: [nods]

Dr. Justin Marchegiani: You know, you’ve talked about the brain-gut connection with mood. Now, being a functional medicine physician, I’m addressing everything: diet, lifestyle, blood sugar, [crosstalk] all the body system, hormone, detox. So, we’re never ever putting in on one magic pill.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: But as we fix things, I do see certain amino acid nutrients with certain nutrients, like B6, and certain B vitamins. I have seen that significantly helped a lot of people on the mood side, not every time. So, I know the SSRIs and some of these medications, we think they work by just blocking reuptake of some of these chemicals but that may not be the case. So, what’s your take on the amino acids? I do see benefits, but I know, you–you’ve talked differently about that.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: Things like 5-HTP, tyrosine, ___[20:09], L-dopa; those kind of things.

Dr. Kelly Brogan: Exactly.

Dr. Justin Marchegiani: Yeah [inaudible].

Dr. Kelly Brogan: Yeah. You know, listen. I am a passionate supporter of natural medicine. You know, and there are many, many, many, many different approaches. Uh– I mean I had patients who’d come– not patients. I know of people who come up of psychiatric medications using flower remedies. So…

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: …you know, i know that there is not one path here. And that’s the beautiful thing. Uh– but, in my approach, I use no supplements at all for the first month.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: Uhm– when– I don’t begin medications taper, for the first month either. So, in a context of medication taper, then I actually do use amino acids. Uhm–

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: I use things uh– you know, the ones you’ve mentioned in particular as a compliment to the purported mechanism of the given medication, and I aIways use a general mix of amino acids. And I find them to facilitate the process. Uhm– I don’t use any supplements as a replacement for medication because it’s not the contraces we’re going for, right? We’re going for uhm— you know, trusting the body, trusting it’s uhm– responses, curiosity about what the body is meaning to tell you. And then also working through a lot of uhm– sort of indoctrinated fear around emotions like, you know, deep sadness, rage, grief– You know, this kind of pain that we are uhm– not, in any way, making space for. You know, to– to investigate with any degree of curiosity because, you know– one of the greatest uh– most meaningful lessons I’ve learned is that on the other side of that process of personal encounter with your deepest, darkest uhm– experience of your mind and body, is a kind of expansive, you know, exposure to these exalted emotions: gratitude, joy…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …even bliss. You know, that becomes available to you when you have the courage to sort of walk through that dark night. So that is a big part of my uh– approach.

Dr. Justin Marchegiani: So, some free-form amino acids which is great. What do you do with adaptogenic herbs? I mean, I use Ashwagandha a lot. I find that really help modulate Cortisol, which can thus help along with anxiety and even sleep. What’s your take on adaptogens, and what are your top three favorites?

Dr. Kelly Brogan: Uhm– I would say, I have a top one favorite. [laughs]

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: Because I’m a big Rhodiola fan.

Dr. Justin Marchegiani: Uhh– love it.

Dr. Kelly Brogan: And had been for many years. And it’s one of my first introductions to the power of herbal– you know, herbal approaches and herbal medicine, personally. And, You know, I find that it’s a really powerful compliment, not only to support in cognition at the time when many of my patients have been injured by medications on the cognitive front, uhh– but also that inevitable, you know, exposure to stress. I think it’s a really magical plant to dance with. So, I’m a  big fan of it.

Dr. Justin Marchegiani: What about nutrients? And I say, BC– uh– B6, or P5P, Pyridoxal-5-Phospate, really essential for helping these neurotransmitters activate. What’s your take on the most important nutrients for you that you see makes the biggest bank for your back and also a B6, too.

Dr. Kelly Brogan: Mm– I– I would– In my experience, the most profound single nutrient– because, you know, most of us do offer that as uh– you know, sort of a compliment…

Dr. Justin Marchegiani: Uhmn–

Dr. Kelly Brogan: Uhm– in– in the entire birth.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: But the one that I had the most miraculous outcomes with is actually B12.

Dr. Justin Marchegiani: Yes. Huge.

Dr. Kelly Brogan: And, you know, through my work with Nick Gonzalez, I’ve had a better ability to contextualize why– that is, in the patients that I work with. They are what he would call parasympathetic dominance, and so they respond especially well to animal-based nutrients, particularly white B12. You know there are cases in the literature of one woman, in particular, who was diagnosed as uhm– having psychotic depression. She was given Electrocompulsive Therapy…

Dr. Justin Marchegiani:  Totally.

Dr. Kelly Brogan: …and uh– multiple medications, and all that she was going on was a B12 deficiency. So, I actually used– have my patients inject themselves uhm– with something like a Hydroxyvaline in a pretty generous dose. Sometimes like 5mg, sometimes several times a week uh– initially, which is obviously considered to be rather aggressive. But uh– it seems to be, you know, quite effective in a short period of time, particularly for uh– you know, cognitive and energy-related impairments.

Dr. Justin Marchegiani: You know, Dr. Brownstein’s also a big form of the hydroxyl form. Why do you like the hydroxyls so much– let’s say, over the methyl or the adenosyl?

Dr. Kelly Brogan: Uhm– I had– I started with a Methocarbamol form.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan:  I just had a couple patients who uh– felt overly activated by it. You know, like whose are wired by it. And– and again, I’m using large doses, so it could have just been that. Uhm– so I– the hydroxyl form is just a– a way to thread the needle, you know, for those patients who might be susceptible to the– the methyl as [inaudible].

Dr. Justin Marchegiani: And then, do you have any opinion on GABA as well? You know, some people say the molecule’s too big to cross the blood-brain barrier. Others are coming out with liposomal forms. What’s your take on GABA?

Dr. Kelly Brogan: Yeah. I have gone very comfortable using a form called PharmaGABA. [crosstalk] It’s a–

Dr. Justin Marchegiani: PharmaGABA, yeah.

Dr. Kelly Brogan: Yeah. Fermented…

Dr. Justin Marchegiani: The science got it.

Dr. Kelly Brogan: …form

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. And, you know, it’s uh– when it works, it works. And who knows if that’s, you know, Placebo. Otherwise, I don’t really care, because if it’s as benign as it is, I’ll apply that Placebo Effect all day long. But I, It’s a fan favorite– you know, of my patients, uh– particularly during the process of moving through a medication taper. It’s a very important uhm– tool.  

Dr. Justin Marchegiani: And then, when you’re dealing with people that are on these medications, whether they’re Benzos or SSRIs, or even Lithium and such. How are you dealing, like– Does every– Can everyone have the ability to get of those medications at some point, and who are the patients you don’t want to like take them off. Where it’s really you got to be super, super slow.

Dr. Kelly Brogan: Mm– Well, it’s my passionate belief that every single person should be offered the opportunity to come up with psychiatric medications.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I’ll even go farther to say all medications, period. What the most critical ingredient is uhm– is the mindset, right?

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: So, believe that it’s possible. It’s the readiness to commit uh– to lifestyle, medicine and to self-care. Uhm– which, of course confers the type of empowerment that’s very necessary to move you out of the dependent and helpless position that you are put in as a psychiatric patient. Uhm– but I had taken patients off of– you know I have videos of my website to prove this, so to speak. I’m publishing cases in the purity of literature. Uh– taking patients of up to medications they’ve been on for 25 years. Uhm– I have patients with histories of Schizophrenia, psychotic mania, suicidal depression. And over and over and over again, they’re shedding their diagnosis and they’re completely and totally off medication. I have yet to fail. Uhm– and I don’t expect to. But, I always screen my patients. I have a very skew population, because of these two criteria– the mindset and the belief.

Dr. Justin Marchegiani: Totally. And then, we’ll put a disclaimer. We don’t want anyone getting after uhm– psychiatric medication on their own. We want them to go back to the Prescribing Physician. But on average– just in general, are you typically tapering off about one to two-month timeframe? Is that generally, where you’re at?

Dr. Kelly Brogan: Oh, wow. No. It can be years.

Dr. Justin Marchegiani: So, years or so?

Dr. Kelly Brogan: I’m glad you asked, because…

Dr. Justin Marchegiani: Good.

Dr. Kelly Brogan: I think I forget sometimes that that’s not uhm– you know, uh– an assumption. So, I don’t touch uh– medication until my patients, in my online program– until they have gone through this month-long commitment.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Meditation, detox and diet. Literally, I won’t touch it. It’s a total requirement. Because I used to do it before I require that, and it was kind of a nice idea. We’ll start looking at your diet now. It’s non-negotiable. Okay? So, that happens first, and then the taper is around 10 to 20 percent of the total dose per month is a typical pace. So, it depends on…

Dr. Justin Marchegiani: Got it.

Dr. Kelly Brogan: …what you’re taking. It’s one medication at a time. The process can take years. And, you know what? If you want it to last, and you want it to be a permanently chaptered for you, you have a right with that. You know, because it’s an investment in this being, not just a revolving door where you’re back on meds in a couple of months. Uh– but I– I absolutely do not recommend that anyone consider coming off medications, particularly until they have uh– initiated this kind of self-care and physical healing regiment. And you know, in my program, I have an entire module dedicated to tapering, because it’s not a science, unfortunately. Uhm– and there are very few practitioners who know how to do it. And that’s why patients actually become more educated. Then their provided about how to do it. Uhm– it’s a bit of the wild west at this point.

Dr. Justin Marchegiani: And, is that course over at kellybroganmd.com?

Dr. Kelly Brogan: Yes! We– It’s called, Vital Mind Reset.

Dr. Justin Marchegiani: Vital Mind Reset. We’ll put all the links below. We’ll put the links to the Amazon Book as well, “A Mind of Your Own.” So, everyone that’s listening and finding value. Go support Dr. Kelly by getting that book. That’s great. Now, one last thing here before I let you go, Dr. Kelly. Uh– when I use certain amino acid with patients, even some of the free-forms, I’ll start to notice the patient is starting to have some of the– the side effects, as if the drug’s too much. Do you see that at all? And then, do you start to gradually taper if those higher side effects from the amino acids are making the drug work better? Do you notice that at all?

Dr. Kelly Brogan: That uhm– is possible. I don’t often encounter that for whatever reason, uh– but  that’s absolutely possible. And in fact there’s a proprietary formula called uhm– EMPowerplus by TrueHope. It may [inaudible]

Dr. Justin Marchegiani: Yes. TrueHope, yeah.

Dr. Kelly Brogan: Yeah. And, you know, they counsel about that– you know, that it’s very possible that in the setting of uh– nutrient repletion, that medication could become actually almost quasi-toxic uh– so that you would need to begin to ramp down on the dose of medication at that point. So, it’s– it’s highly possible and that’s an incredible reminder. You know, that nutrients are– are very powerful uhm– tools to be used with strategy.

Dr. Justin Marchegiani: Awesome, Dr. kelly. I think you’re changing the world. I appreciate you coming on the show. Last question for you, “If you’re on a desert island and you can only bring one nutrient, one supplement, one herb– whatever it is, what would that be for you?

Dr. Kelly Brogan: Oh, turmeric, of course. [laughs]

Dr. Justin Marchegiani: Turmeric. Okay. Got it. [crosstalk] Crucumin?

Dr. Kelly Brogan: Yeah, Crucumin.

Dr. Justin Marchegiani: Can [inaudible] can the anti-inflammatory on?

Dr. Kelly Brogan: It’s everything. You know, it’s like a miracle. It’s a miracle herb, and you know the research on it, of course had– had my skeptical mind convinced. You know, with the catalog research on Crucumin, which is one isolate of this…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …very complex herb, is astounding. You know, head to head against medications like Cox-2 Inhibitors, antidepressants. It’s extraordinary. So, I think of it as a, you know, the– the power performer, for sure.

Dr. Justin Marchegiani: I love it. Now, is there anything else you want to let the listeners to know? Any new books, products, online things coming out for you that people should be aware of?

Dr. Kelly Brogan: No. Just you know that we’re here to support your journey. If any of these is resident, it is one hundred percent possible for you. I see it every single day. And so, just to make sure that I plant that seed of potential. And oh, you know, we’re here to support. We have tons of free information on this site, and of course, greater uhm– complex products if needed.

Dr. Justin Marchegiani: And let’s hear those links one more time. kellybroganmd.com– the second one was?

Dr. Kelly Brogan: That’s it. You know…

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: …all the information’s there. So let’s just keep it simple.

Dr. Justin Marchegiani: And then the book– if you guys love it, go get that book on Amazon. Dr. Kelly, we really appreciate you coming on the show.

Dr. Kelly Brogan: Thank you so much.

Dr. Justin Marchegiani: Awesome. Take care.

References:

www.kellybroganmd.com  

“Vital Mind Reset Program,” by Dr. Kelly Brogan

New York Times bestselling book, “A Mind of Your Own” by Dr. Kelly Brogan

https://www.amazon.com/Mind-Your-Own-Depression-Reclaim/dp/0062405578

“Increase your Brain Health by Changing Your Breakfast: The KB Smoothie” by Dr. Kelly Brogan

https://www.truehope.com/effectiveness/ingredients EMPowerplus by TrueHope

Brain Chemistry, Mood and Amino Acids – Podcast #57

Brain chemistry is the sum of all the chemical messaging that takes place in the brain, which allows it to carry out its daily functions, such as generating movement, speaking, thinking, listening, regulating the systems of the body, and countless others.

Dr. Justin Marchegiani and Evan Brand begin this podcast by sharing patient stories that deal with blood sugar issues and eliminating sugar cravings as well as patients
with autoimmune conditions being treated with dietary work and adrenal work. You can reach out to either of them so they can help you put together an action plan on the next steps to do to improve your health. Discover the differences between conventional medicine and functional medicine and how patients’ symptoms are being addressed and what treatments are being given. 

They also get into in-depth discussion about brain chemicals and neurotransmitters. Dr. Justin effectively demonstrates the process of the action potential and the neuro conductivity that take place. Find out how long a person should use amino acids therapeutically in order not to create any deficiencies as Dr. Justin explains it thoroughly in this interview and he tells us what other nutrients you need to be taking while on this type of treatment.

In this episode, topics include:

Podcast: Play in New Window|Download

Dr. Justin Marchegiani:  Hey, it’s Dr. J.  Evan, what’s going on, man?

Evan Brand:  Hey, not much.  I just finished up some matcha, some organic matcha and schizandra, so I’m feeling pretty turned on in terms of my brain function today.

Dr. Justin Marchegiani:  Turned on.  I like it, man.  That sounds good.  That sounds really good.  Yeah, I’m having–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  A pretty spectacular morning.  It’s Friday.  It’s–it’s hot.  It’s sunny in Austin, so I mean I can’t really complain.  Actually flying out in a few hours to go up to San Francisco here for the–for the weekend, so I’m pretty excited about that.

Evan Brand:  That sounds good.  What are you doing up there?

Dr. Justin Marchegiani:  You know what?  We’re just doing a little bit of R&R, gonna travel a little bit.  I lived in San Francisco for 5 years so heading back to the old hood.

Evan Brand:  Wow, so it will feel like going home then?

Dr. Justin Marchegiani:  Getting’ away from some of this Texas heat.  Yeah, I know.

Evan Brand:  True.  I’m sure it’s hot.  That’s one thing I’m glad to be back in Kentucky, man.  We’re not burning up like–like I was there.  I was waiting for the snow to come and it never came.

Dr. Justin Marchegiani:  Yeah, well, I hang out in the lake a lot in the summer and that kinda cools off.

Evan Brand:  That’s true.  That’s true.

Dr. Justin Marchegiani:  Go down at the Barton–Barton Creek Springs downtown there, it’s really nice.

Evan Brand:  Yes, it is.

Dr. Justin Marchegiani:  Awesome, buddy.  Awesome.  So anything new with you?  Any patient stories this week?

Evan Brand:  Yeah, actually I just posted a testimonial on my YouTube page or my website if people wanted to see it.  It was a patient that I saw inside of the chiropractor’s office.  One of my very, very few in-person patients that I see these days because I’m like you, a lot of people are not in the local area that need help.  So anyway, she basically eliminated her sugar cravings–I guess I would say I eliminated or maybe she just felt the effects, within 2-3 days of her supplement protocol.  So when I did the initial symptom gathering process on her, I saw that she had some blood sugar issues going on which surprise, most people do and–

Dr. Justin Marchegiani:  Right, exactly.

Evan Brand:  So I recommended some supplements that were gonna some blood sugar.  Some Aqueous Chromium and a couple different other biotics products that have some good, you know, blood sugar support nutrients in there and her testimonial was verbatim to this.  “I usually have trouble going through the candy aisle, but I went into the grocery and I felt like going straight to the vegetable section.”  I was like, “Wow!”

Dr. Justin Marchegiani:  Oh, wow!

Evan Brand:  That’s pretty cool!  So–

Dr. Justin Marchegiani:  That is awesome.

Evan Brand:  She said her stress is already better.  She had a lot going on with her husband.  He’s got some pretty bad health issues and so that stress bucket is full, but she’s already feeling a little bit calmer which has then in turn reducing her amount of emotional and stress eating that she identified with on the questionnaire.  She was one of those people that she feels stressed out, she’ll go and eat like a candy bar and now she is able to–

Dr. Justin Marchegiani:  Right.

Evan Brand:  To work through those times.

Dr. Justin Marchegiani:  Well, that’s awesome, man.

Evan Brand:  What about you?

Dr. Justin Marchegiani:  That’s a great story.  Well, I had a patient.  I’ve actually had a couple of patients in the last week where they had some severe autoimmune conditions.  This one patient I saw has an autoimmune condition called hidradenitis suppurativa.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So this is a–a really interesting autoimmune condition that like attacks the skin and creates these major boils or welts, almost to the point where they have to be, you know, surgically removed because they become so massive.  This patient had some surgery scheduled to actually get some of these hidradenitis suppurativas removed and we talked and we just did a little bit of dietary work and a little bit of adrenal work off the bat and within 1 month when she got ready to see the general surgeon to have the lesions looked at, they were gone.  And the surgeon was like, “What did you do?”  This–that happened?  The surgeon was flabbergasted and this it really comes down to a lot of the chronic conditions that medicine is seeing are autoimmune and medicine is not addressing the underlying issues of autoimmunity which is stress, which is a leaky gut, which is a lot of food-induced stuff, and there’s a lot of infections and underlying issues on top of that, and now with this patient, we didn’t even have a chance to dive deep enough into the real deeper functional medicine issues but just an autoimmune diet made a massive difference.  And this is just so cool because, you know, conventional medicine doesn’t really have a solution for this but in the functional medicine world where we live, there’s so many things we can do.

Evan Brand:  That’s awesome.  That’s a great story.  Yeah, I’ve actually had a podcast on that topic.  I can’t remember the name of the book now but there’s an author that wrote a book about that and she struggled a ton with it and it’s crazy because it’s a very underrecognized condition.  Some people at first think they have eczema and–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  These other kind of generic skin issues and then they really have an autoimmune skin issue which sounds terrifying.

Dr. Justin Marchegiani:  Oh yeah, and the cool thing about our podcast, I’m really loving our dynamic.  We’re getting a lot of great feedback on your show, on my show, and I think the podcast that we’re producing is just different than most because we’re having a lot of clinical feedback and we’re really helping people walk away with a lot of action items.  I don’t want people just to walk away feeling like they just got some brain candy and it’s like, you know, they got some stuff for jeopardy, right?  I want them to feel like they got some brain candy but they also got like an action item that they can walk away with and make their life better, performance-wise, whether it’s a biohacking thing or a clinical pearl.  Just something they can walk away with.  They can be like, “Yeah, I’m gonna–I’m gonna be better after listening to this podcast, healthier in some way.”

Evan Brand:  Right.  Yeah, I mean, I’m coming up on 150 episodes of my podcast and I’ve really felt for a while that I’m helping people but in a certain way some of these episodes that I’ve put up and I’ve even not up an episode since with some people because I feel like it was blabber and too much about them and not enough about action and things like that, and so I’m really trying to shift the show.  So hopefully, people are enjoying that on my end as well, and I’ve gotten some feedback that that verifies it and the downloads are, you know, higher than ever.  So apparently, something’s working.

Dr. Justin Marchegiani:  Yeah, and anyone listening to this and feeling like, you know what, maybe they’re at a crossroads at their health where they’re not quite sure what to do, reach out to Evan or reach out to me, and we can kind of put together an action plan on what the next step so we can move forward on to get to the underlying cause of your health issues versus just covering up symptoms which is really the only option in the conventional medical model.

Evan Brand:  Yeah, or ignoring them or saying they don’t exist like Lyme disease for example.  That’s a whole another podcast topic, but very timely.

Dr. Justin Marchegiani:  Yeah, or just numbing you out and give you an antidepressant or again, being a functional medicine doctor is stressful, too, because you get to hear all the horror stories.  I can’t tell you how many patients that come see me each week, have seen their medical provi–you know, medical provider, their GP or whatever, and they’ve been told it’s all in their head.  I just–I can’t-

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I mean, 4 or 5 times a week it makes me wanna pull my hair out because I see people suffering and we see it, they’ve come back on tests where they have functional issues and their conventional doctors are just like, “Yeah, it’s all in your head.”  And then they look at them like they’re making it up and I’m like, “Oh, my God.”  There’s a physiological and biochemical explanation, and just because it doesn’t fit into the mold of, you know, cutting it out or drugging it, it doesn’t mean it’s all in their head.

Evan Brand:  Totally.  Yeah, I’ve seen that, too.  It’s always crazy to look at the symptoms and then you look at the prescriptions they’ve taking, and it’s like, “Why?  Why Lexapro?  Why Valium?”

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Wh–why do you need this stuff?  And I know there’s a time and place for that model for some people and maybe there’s extreme scenarios but oftentimes there’s a much better alternative that happens to come from a plant or some type of botanical extract or something, so there are options out there.  I guess that’s–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Kinda what you’re getting at.

Dr. Justin Marchegiani:  And it may be in their head from the perspective of their gut’s inflamed and inflammation in the gut creates inflammation in the brain, and there may be some brain inflammation meaning it is in their head.  But not from the perspective that the MD is meaning that they’re making it up, right?  There may be an underlying etiology and biochemical issue that is partly affecting the brain but they’re not making it up though.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Cool.  Well, let’s dig in.  We chatted a little bit about amino acids and brain chemistry and mood.  I wanted to dive in deep to that because conventional medicine for the most part it’s anti-depressants, it’s anti-psychotics, it’s benzodiazepines like Xanax and such.  It’s Wellbutrin, right?  SSNRIs, things that modulate norepinephrine or dopamine or the reuptake of serotonin or increased GABA receptor site sensitivity, all these drugs they do nothing but change the location of a lot of these brain chemicals, which I might add all come from protein.  So this is powerful, right?  In the conventional medical kind of field, we have drugs that change the location of these brain compounds or these neurochemical compounds, and in functional medicine world, from just the supplement standpoint, when we give specific amino acids to alter brain chemistry we’re trying to change the amount of these brain chemicals by altering building blocks versus conventional medicine’s just changing the location, and this is a fascinating kind of comparison.  You wanna break it down a little more?

Evan Brand:  Oh, yeah.  Neurotransmitters are basically brain chemicals.  That’s the easy way to remember them and scientists–I haven’t identified per–personally any but I know they’re out there.  Scientists have identified over a hundred and they actually have no clue how many neurotransmitters there are in total.  But typically when we’re talking about helping people with health symptoms, we’re focusing on just a key group of neurotransmitters such as the GABA, the serotonin, you have the dopamine.  You have your adrenalin and then you have your noradrenalin or your epinephrine and norepinephrine, wherever you are in the world, whatever you call it.  And these basically to me, they run the show.  Hormones are equally if not more important, but to me, neurotransmitters are huge and I’ve–I mean, I just wrote an entire book.  It’s not out with the publisher yet, but I just wrote an entire book on neurotransmitters, basically talking about the way that different herbs and supplements interact with this brain chemistry and how you can tweak it towards your benefit, whether somebody listening that just wants some cognitive enhancements, some, you know, brain power, some focus ability or if you’re somebody who can’t go out of your house or go to the grocery store without having a panic attack.  There’s a wide spectrum of people that are struggling, that can get help once they first measure with lab testing and then accurately treat or align or balance those underlying brain chemical deficiencies or imbalances.

Dr. Justin Marchegiani:  Absolutely.  So the first thing we have to look at is that all of our brain chemicals for the most part are made from protein and protein is like the pearl necklace and the individual pearls are like the amino acids.  So amino acids, especially L-tyrosine which gets converted into dopamine, L-trytophan and 5-HTP which gets converted into serotonin, so these are like our master neurochemicals and they all come from protein.  So first step is making sure the diet is protein-rich, good quality, natural organic sources of protein.  That’s number one.  Number two, are we digesting these proteins, right?  Do we have enough hydrochloric acid and enzyme secretions to be able to break it down.  And then number three, if we aren’t able to break it down, what are the underlying infections, dysbiosis, SIBO, parasites, H. pylori, etc. that are creating this malabsorption?  So we kinda look at the front-end how’s the supply chain coming in?  Are we putting enough good amino acids and proteins in our mouth?  Are we breaking them brown?  Is there an infection in the gut that’s affecting that breakdown?  Once we know that front-end chain’s okay, the next is well, where are our protein levels at in our brain?  Where our amino acid level’s at in our brain and we can use symptom surveys that look at dopamine or serotonin symptoms and we can also look at organic acid tests which I think are really cool that can give us a indirect indicator of the metabolites of dopamine which is like vanillin mandelate or homovanillin mandelate or we can look at serotonin in which a good metabolite is 5-hydroxy and doloacetate.  So we can look at these from a empirical perspective, symptoms, but also from a lab perspective.

Evan Brand:  I like to do both.  For me–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  It’s really fun to look at the symptoms and see how accurate some of those symptom questionnaires can be.  I really enjoy Julia Ross’ symptom–symptom questionnaire I guess we’ll call it.  It’s amazing.  I’ll sometimes laugh at some of the symptoms I’m going through and I’ll tell Hannah, my wife, instead of saying like, “I’m feeling blue or low, I’ll just say, ‘Oh, God, I’m low on serotonin today.’”

Dr. Justin Marchegiani:  Yeah, exactly.  And again, conventional medicine, right?  Let’s kinda break it down here, alluded to it briefly.  So I’m gonna do a little demo here, you being able to see me on video, it’ll make more sense to you, I’m gonna try to describe what I’m doing.  So I’m putting my–my two knuckles together like this.  So you can see here, I have one fist on the left side connecting with the other fist on the right side, and I’m gonna leave a little gap between the fists.  So my left arm here, this is my presynaptic neuron, the little gap between my left fist and my right fist is my synapse or the synaptic cleft, and then my right fist here is my post synaptic neuron.  So again, the action potential and the neuro conductivity is happening from this left arm over this little synaptic cleft into the right arm which is my post synaptic neuron.  So I know, big talk, we’ll try to put some demos or pictures in the transcription, so head over to beyondwellnessradio.com for that.  So you’re gonna see all of the serotonin and dopamine precursors are all up here in–in this presynaptic neuron, it gets released out into this synaptic cleft and that serotonin and dopamine hangs out and it kinda helps bridge that gap from that action potential from that presynaptic neuron to that post synaptic neuron.  Now most drugs, they prevent the reuptake, so the whole idea here is these neurochemicals sit in this synaptic cleft and they get pulled back up into that presynaptic neuron and get recycled.  And what these drugs do is they prevent the reuptake of these neurochemicals so they accumulate and they sit longer in between that synapse where they could have a–a physiological effect.  Now the only problem with that is it works but in the short run it works, but in the long run it doesn’t work because all these meds are doing, they’re just changing the location of where these compounds live.  So instead of being up in that presynaptic neuron, they’re now in that synaptic cleft.  Now the problem is, these neurochemicals get recycled and broken down faster the more they’re in that synaptic cleft.  So the more, the longer you’re on these medications, you actually create more deficiencies with these brain compounds because they’re being recycled faster and that’s why anyone that’s on one of these medications, they’re gonna have the experience of having their dosage–their medication either changed to a stronger one or having an increase in the dosage.  So the whole idea of being able to come off, unless that underlying cause is fixed, typically those symptoms gets worse when you come off these meds.  So that’s why the amino acids are so different because we’re coming in and actually changing the supply, not just the location.

Evan Brand:  Incredible.  Yeah and that explains why–you know, I’ve had some people that have had prescriptions for benzo–I’ll always just call them benzos for short.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  But the Xanax or–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Valium, you know, that are mostly acting on the GABA receptors, if I’m not mistaken, since those are GABA antagonists, that would be downregulating your actual production of GABA so when they try to come off, they have less GABA than they had before they even started the Xanax and now their panic attacks and their anxiety is tripled or quadrupled what it was before they even started the medicine.

Dr. Justin Marchegiani:  Absolutely, plus the underlying physiological, the underlying biochemical reasons of why they were having anxiety to begin with is just totally ignored, whether it’s excessive stimulation by the adrenals because they’re making too much catecholamines or adrenalin or because they’re gut’s on fire and they’re burning through their neurochemicals, those underlying reasons are ignored.  So the problem only gets worse and worse overtime and then they are reliant upon this constant stream of medications just to control the symptoms so they can function.

Evan Brand:  Yeah, if I go back to the lady that I was discussing at the beginning of the podcast, you know, she was having a lot of blood sugar issues, to me, you know, there’s a piece of the adrenals that are going–that are going haywire because the piece of the blood sugar is going haywire, she’s in her mid-50s right now so she has been dealing with this stuff for a long time, and she has gone to the mainstream doctor before and said, “Hey, I’m completely overwhelmed with my husband.  I’m trying to take care of him.  I’m very sick, etc., etc.,” and the only thing they had to offer her was a) either an anti-depressant or b) an anti-anxiety medicine to handle the stress.  And she said flat out and–and they can see it on the video, she said, “I don’t want the drugs,” and she wouldn’t have gotten better because the blood sugar is the issue or her stress bucket is too full and she doesn’t have enough stress bucket, so that’s kinda where I’m trying to help fix her as opposed to leading her astray.  I mean, it’s just–it’s really scary to be honest with you, how quickly some of this stuff could get derailed.  I’ve talked to you about my blood sugar stuff being–being low in the middle of the day and you’re like, “Dude, Evan, go eat, man,”  Like, “What are you doing?”  Because if I–say, I went to the doctor for some reason and said, “Hey, I’m feeling low and fatigued and maybe a little bit anxious in the middle of the day.”  They’re not gonna ask, “Are you skipping meals and you’re blood sugar is low?”  They’re gonna say, “Well, hey, let’s get you on something.”

Dr. Justin Marchegiani:  Exactly.  Exactly.  And that’s the difference between conventional medicine and functional medicine.  So the first pillar is gonna be blood sugar, right?  Because blood sugar is gonna create your–or is gonna stimulate your adrenals to make more adrenalin or more cortisol to help bring that blood sugar back up and stabilize it which can cause the jitters.  Anyone, you know, gets that feeling where they get those–the little–little Spidey senses going or they get that little tingling, that little butterflies because of stress, well, one of the biggest hormonal stressors is blood sugar imbalances.  That’s number one.  Number two, most people have chronic stress that has now affected their gut and they have malabsorption, they have infections, they have inflammation in their gut and inflammation in the gut creates inflammation in the brain.  Alright?  Now it’s important, right?  A lot of like–like people talk about serotonin in your gut, well, serotonin in your gut–serotonin can’t cross the blood brain barrier, it can’t, same with dopamine.  But the precursors, the substrates to serotonin and dopamine can, meaning the 5-HTP can cross that blood brain barrier.  The L-tyrosine can cross the blood brain.  So these are important things because when we have malabsorption and gut issues and stress, we can therapeutically use these amino acids at specific doses together.  We don’t wanna use them single at least not longer than 2 or 3 months and we can therapeutically boost up brain chemicals.  And it’s important you never wanna take these without B6 as well because B6 is an important carrier, it’s gonna escort that helps these things cross the blood brain barrier and convert into their end-stage neurochemicals.

Evan Brand:  It’d be good to go a little bit deeper on that.  You said don’t take for 2-3 months and I’ve had people that have been on 5-HTP for 2-3 years and they’re wrecked.  And I want you to explain why, because like, “Huh?  Why–why not?”

Dr. Justin Marchegiani:  Well%2