Staying Fit with Adrenal Dysfunction and Chronic Fatigue – Is it Possible? | Podcast #308

If you have adrenal dysfunction and chronic fatigue, exercise is probably the last thing you feel like doing. Your adrenal glands are responsible for keeping the well-being of your body in balance through hormones. These glands also produce the hormone cortisol, which is released during your fight-or-flight response. As you can imagine, cortisol is beneficial when you need to be alert and escape danger.  For more on exercise with adrenal dysfunction and chronic fatigue, listen to the entire podcast!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:38        Exercise Movements, Use of Bands, Etc

9:06       Rowers

15:37      Hacks to Increase Exercise Performance

18:53      Post Recovery Stuff

29:39      Why Exercise is Important

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Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand, Evan, how are we doing my friend? 

Evan Brand: Doing really good, excited to dive into this topic, I’ve suffered tremendously with exercise intolerance for a while, and luckily have pulled myself out of it. And I can empathize with people that want to exercise, but they literally physically can’t. Or if they do, they crash out, which is what was happening to me. So let me just share a story just for a minute, and then we’ll dive in some to the details of it. But there are different things that can make people exercise intolerant. For me, I think it was a combination of factors like everything, but I was to the point where, if I did try to push myself, it would take an extremely long time to recover, you know, two, three, sometimes four days, I would still be recovering from the the workout and I thought, Okay, well, as you and I talked about, we got to adjust the levers, I got to lower the intensity, I got to lower the duration and the frequency. So I did, but it wasn’t enough, I still felt like no matter if it’s a 10 minute or 30 minute, I was still drained. So for me, I think it was detox, I think it was getting my mitochondria working better, definitely getting adrenals working better. I think neurotransmitters played a role too, because, you know, you could have low motivation and low drive if dopamine is effective. So we’ll go into that. But that’s, that was my story. 

Dr. Justin Marchegiani: Very important. I think anyone that’s health conscious, right, like you’re moving a couple of levers when you’re health conscious, right, you’re really working on drinking clean water, you’re working on improving your food quality, maybe adjusting your macros, maybe you’re taking some supplements. And of course, the The other thing you will be putting a lot of focus on will be movement, right. And I just call exercise movement. So like the first met, the three levers that we can move we already kind of highlighted is frequency, how many times per week we’re exercising intensity, could be how intense the movement is a compound movement that uses multiple joints, like a front squat, or a single leg deadlift with a row kind of component, or something like a bicep curl, that’s like, you know, just your elbow joint, that kind of a single joint movement, that’s more bodybuilding based, and, and less kind of metabolism based, right full body bass. So we have frequency intensity, the type of movements and that also can include the rest time between sets, too, right. So you can also increase, you can do more intense stuff, and then just have more rest time to kind of be back to baseline in between. And the last is duration, how long your workout is, that’s helpful, too. So some data by Charles poliquin, who talked about cortisol really starts to increase, you know, 45 to 50 minutes in. And again, that’s gonna be for someone that’s more on the healthy side. So I always tell people, like keep your workout, if you’re more stressed, keep it under 20 minutes, that’s a pretty good rule of thumb, you know, and just try to do more circuit movements, where you do movements back to back to back, that can be helpful. But then we kind of have to gauge and how your body is adapting to the exercise. It’s all about adaptation. And so exercise is a stress, and we want our body to be able to adapt to that stress, so we grow stronger. Now, if that stress is too much, where our body is not able to adapt to it, meaning we’re getting weaker, we’re getting more tired, that defeats the purpose of exercise, we want our body to positively adapt to that stress. If it can’t, then we have to move those three levers frequency, intensity, duration, and we may even have to switch out of certain movements, we may have to switch into more yoga or more walking or more, you know, Tai Chi types of movements in the beginning and just kind of go from there. So there’s a couple different levers. And so there’s three questions I always ask my patients, my patients that are listening, they know this, do you feel better after the workout than when you started, you want to always feel like your exercise is energizing you. That’s a good place to know that you’re adapting to your exercise you’re able to adapt to it. Number two is you can emotionally repeat the exercise afterwards. Once your heart rates kind of brought back down to the baseline after you stopped your movement. Can you emotionally do it again? Are you like, wow, I’m done. Right? And then number three is going to be last question is how do you feel later on that day, if it’s a morning workout, or that next morning, if it’s an afternoon or nighttime workout? Do you feel overly tired hit by a bus overly sore? Now if you’re adding in a front squat or a deadlift for the first time, you may feel a little sore. But in general, how do you feel? Do you feel overly tired overly sore hit by a bus? If so we want to adjust some of those movements for sure.

Evan Brand: Yep, good, good points. For me. I don’t have to count or measure or anything like that or time to workouts. I just get to a certain point with lifting weights. I primarily lift weights. I mean, I do like to go on bike rides, I’ll take the kids that’s pretty hard work with the legs. I do like my roll machine. So I’ll do that. But I don’t really measure count or anything I get to the point in the workout where my pump goes into more of like you can just feel that you’re becoming catabolic, you feel like your muscle tissue is now being used as an energy supply. Now, people that are new to it or if they haven’t been exercising for a long time. They may not be that in tune with their body. But for me, it starts out with the heavy lifts, I’m getting the pump, I feel good, I feel the blood flow. And then it gets to the point where I feel like I don’t want to say I’m hurting myself. But the dumbbell that used to feel pretty good and challenging now just feels like a frickin rock. And I’m like, oh, okay, I think that means I’m done now, and then I end the workout. If I go past that point, then it’s too much. 

Dr. Justin Marchegiani: Yeah, exactly. So that that’s a really good place, you can also incorporate bands, what’s nice about bands is the loading is the highest at your concentric phase, right? Imagine I’m doing a dumbbell curl, right? At the highest point, the The band has the most force in it, right the most intensity or force. And then as I lower right, this is the East centric face. I’m Ilan gating my muscle, so in a bicep curl, I’m moving the bar down to the dumbbell downward, the load is actually decreasing as I’m lowering it. So you have a decrease in force on that essentra curve, where like, if a dumbbell or barbell was there, it’s the same the whole way, like, so the benefit of the decrease in load is most of your muscle, shredding, or depletion happens in the E centric. So what does that mean? That means you can focus on really light, really nice, slow lowering phases that those two things, it burns more muscle, right. And then number two, most injuries happen, because people are bouncing the weight, or in that lowering phase, they kind of have a jerky move where they kind of relaxed the weight, and they catch it at the bottom of that movement. And like what sofa benchpress, that’s on your chest or military press that’s on your shoulder. Or if it’s a bicep curl, it’s at the bottom right, and you’re kind of bouncing that way, or a deadlift that’s at the bottom right where you bounce. So when you do a nice lowering phase, you prevent that bounce from happening. And that’s where almost always all the injuries happen. So if you do a nice lowering a nice slow lowering phase, maybe a three to four second, he centric think he centric he long gait. So have a nice, slowly centric, you’re not going to hurt yourself as much. And then number two, you’re still burning a bit of a bit of muscle. And number three, if you’re still really sore excessively, one, you can switch to more bands, and the bands will give you that decreased load. As you as you kind of move, which is nice, it really helps the muscles give it a little more recovery, but still gives you that increased load at the top, so you have more concentric load, right? So when your muscles the shortest, right that benchpress at the top position, the loads the highest, and it’s going to be even more than a weight would be right. And then it drops off on the lowering. So it’s a little bit safer. And you’re not going to overly kill your muscles in that lowering II centric phase. 

Evan Brand: Yeah, that’s safer, too, if you don’t have a spotter, right? If you’re trying to do all this stuff at home, I mean, I’ve been guilty before of wearing myself out getting past a point of fatigue, where I’m like, Oh, I could really use a spotter right now. But I don’t have one. So the bands would be safer in that aspect too. 

Dr. Justin Marchegiani: Yeah, bands are safer and are of course, just using like a dumbbell is going to be helpful too. Because dumbbell obviously there’s no bar across there. So you’re not gonna expect to fixate yourself, your lower too much. And then you’re going to get a lot of fatigue on the lowering. And that’s what helps. But the bands do help for sure. And it gives you that really good ability to generate a lot of force. And also it’s safer. So I do like that as a good option. 

Evan Brand: Yeah, and someone’s listening and they’re gonna say, well, bands where the heck do I get them? What strength? Do I get them? They usually come in variety packs, don’t they? Like there’s going to be like a black one, a green one. And they’re going to be different like intensities, right? 

Dr. Justin Marchegiani: Yeah, I mean, I like the X3 bar for some of the some of the the bigger bodybuilding movements because the band’s really thick and it can generate hundreds and hundreds of pounds of force. So I like the x3 bar for that. So like for deadlift, that bar that that strap or that a cable is going to create a band. I’m sorry, that band will generate hundreds of pounds of force. Same thing on the bench, same thing on a tricep extension. And so it’s very helpful. So I do like that. 

Evan Brand: Cool. Any updates on your rower? 

Dr. Justin Marchegiani: Oh, yeah, it’s coming. I got the concept D rower. So I try to do a little bit more of the rolling for my aerobic stuff just because I like things that bring me into extension so much cardio is like your inflection, whether you’re on elliptical or riding a bike or whatever. I like kind of bringing more extension into my body so… easy! Sorry. That’s my dog. That’s my dog. We’re live here. 

Evan Brand: I love it. I love the rower. I mean, to me, it’s, it’s, I feel so good on it. And I never really thought about what you’re saying. But yeah, most exercises are you’re kind of like going into monkey mode, you’re not really pulling back and stretching. That is like one of the only things that and the seated row, like on an actual machine with weights. Those are probably two of the only things that really kind of pull you pull you out and stretch you out like that. 

Dr. Justin Marchegiani: Oh, totally. Oh, by the way, I have my my natural pesticide guy here, which is kind of cool. So he’s actually spraying essential oils around my perimeter. So he’s spraying cedar, some citronella, some orange peel some olive leaf, just to keep some of the bugs down. So and then we found a bee’s nest in the back on the ground. So we’re putting a little bit of boric acid in diatomaceous earth in there to kind of to knock that out. So we try to, you know, just a little education here, we’re trying to do some natural kind of insecticide solutions, because a lot of those toxins can be very harmful to kids and, and women and children, especially guys, too, because they’re very estrogenic. So we try to use natural solutions here. So you guys see that live in the flesh here. 

Evan Brand: Yep. And if you are exposed to all that crap, whether it’s from you spraying it or hiring somebody else to spray and you’re getting exposed to it, that’s going to affect mitochondria. And that’s going to affect energy. So when you get into this whole thing of chronic fatigue, adrenals exercise and tolerance, a lot of it has to do with toxicity, I will tell you 100% with confidence, when I’m doing binders, I’m stronger when I’m on detox support chlorella, whether it’s charcoal, Clay zeolites. I’m always stronger with some binders in my system. So for me, the toxins and for everyone really, the toxins are kryptonite. And that’s just a fact of the modern world. So wherever you can reduce those, reduce them, I mean, think about your kids, right? You go to a playground, my wife took my kids to a couple playgrounds over the summer, and the guy shows up with a huge tank of glyphosate on his back and just bombs the whole playground, because there were weeds growing up in the mulch and it goes up, well can’t go to that playground anymore. So it’s annoying that we have to be this observant, but it’s kind of what it takes in the modern world. I mean, unfortunately, in the 21st century, everywhere you look in turn, whether it’s the the air, or the water supply, or the ground, or the dirt or the soil you’re eating food out of there are chemicals that are disrupting your mitochondria, they’re disrupting cell membranes that are affecting your gut bacteria. And so I get annoyed with just the diet and exercise conversations that you see in the mainstream because they make it just like it’s that like, you’re not motivated enough. You just need to be strong pain is weakness, leaving the body push through, push through, it’s you literally from a biochemical, mechanical, mitochondrial perspective, neurotransmitter perspective, you can’t push through, you can’t so you know, you got poor Jane Doe, at the at the fitness class. And you know, she’s 50, or 100 pounds overweight, and she just thinks that she’s just fat and lazy. And that’s why that’s her problem. But it’s like, no, you’re toxic. Let me show you on paper. And I’m going to explain why your personal trainer doesn’t have a clue why you can’t tolerate the exercise and why you’re sore for a week. He just thinks you need to just quit being a sissy and drink another protein shake. No, that’s not the answer. So I love that we can intertwine the functional medicine piece into the exercise piece. Because the mainstream fitness community, it’s sad, it’s all this boot camp, you know, military CrossFit mentality. But when someone doesn’t perform like everyone else, those people get ostracized, and they don’t have a clue what’s underneath the hood. 

Dr. Justin Marchegiani: Yeah, I mean, everyone, you got to treat everyone like an individual. And everyone’s coming at this a little bit differently. So you want to meet people where they’re at exercise, you know, and a lot of these things is going to be a stressor, so you want to apply the appropriate amount of stress. So you give your body the chance to adapt, it’s never the the exercise, it’s the ability for your body to adapt, and you have to kind of meet your body where it is. So if you’re someone that’s obese, it may just be walking a couple thousand, maybe 1000 steps or just squeezing your muscles doing an eccentric movement, you know, that may be enough based on where you’re at. So you got to figure out where you’re at and try to go maybe 10%, above where you’re at, on a day in day out basis.

Evan Brand: Yeah, and I’m not trying to poopoo personal trainers, I used to do some personal training, I had some certifications in different movements, kettlebells and things and I helped a lot of people but so so you can tweak the exercises, meaning you can tone things down for those people. But there’s at a certain point, you at a certain point, a personal trainer has a limit to what they can do for you. Meaning if you literally have so much toxicity that’s affecting mitochondria, you literally can’t build up your your weight, you can’t go 10 minutes longer. You can’t, you know, do three more planes, you just can’t. So then that’s where you got to come in. And we look at the labs to try to figure out what’s under the hood with these people. Why can’t they Why are they such a poor recovery. So like, well measure lactic acid on organic acids testing. And we know that when you have bacterial overgrowth, for example, that it produces lactic acid certain species do. And so if this person is sore without even working out, they’re going to be really sore when they work out. So we’ll focus on the gut, we’ll get that the production of lactic acid down from the gut bugs, and then boom, now they can handle that lactic acid bucket is drained now they can handle the exercise and the production there. 

Dr. Justin Marchegiani: Oh, exactly. You know, I’ve taken personal training sessions as a personal trainer for a long time and I’ve been trained by people where I feel too sore for a couple days afterwards. And usually if you feel too sore, it’s you put too much intensity in it. The dose wasn’t dialed in for you because you’re Giving your body the chance to heal and recover because you get stronger on the rest time. And if you created so much damage for 234 days later, you’re really excessively so you did too much you’re creating scar tissue in the muscle. And that’s not good. So you really want to individualize this. And I, you know, I see patients from all different walks of life from chronic fatigue autoimmune patients that are bedridden to people that are professional athletes trying to perform at the highest level, and you want to meet the demand where that person is at because it’s all about getting their body to function just a little bit better every day, and everyone is at a different place on their journey. So I think the individualization is so important. 

Evan Brand: Do you want to get into some of the hacks at all like some of the things we do to kind of increase exercise performance? Because I’ve got several ideas at the top of my tongue here. 

Dr. Justin Marchegiani: Yeah, sure. I did a video on this last week where I talked about some of the ideas in regards to movement stuff like exercise stuffs, I think the easiest first thing for is really good lowering or good eccentric movements, I think are a great way to burn a whole bunch of muscle and, and allow you to use more weight and not get hurt. Because I mentioned earlier, it’s the lowering phase, the centric phase where people get hurt. And when you do a nice low, slow movement on the centric, you’re less likely to get hurt. And number two, you’re going to create more burning of that muscle, more depletion of that muscle. And as long as you don’t overdo it, it’s a good first step. 

Evan Brand: I was into bodybuilding in high school. So I was doing a lot of those pre workout drinks. And they were just so bad for you. I mean, it was all just hundreds and hundreds of milligrams of caffeine, artificial colors. I’m sure there were sucralose and aspartame and potentially other garbage in there. And it just wasn’t good. I tried to pick clean choices. But you know, at the time, there weren’t that many good clean products on the market. So now there are there are some professional companies that you and I use that have some pre trained type nutrients, things that have some creatine, some tyrosine, some acetyl, l carnitine, can be very helpful. A little bit of like green coffee bean extract for caffeine can be good. There’s actually a nutrient called peak ATP, it’s a company and they’ve make so much like literally just straight ATP, and you can actually take it in powder form so that for me really, really helps. And then I like all the nitric oxide stuff. So I’ll do like a teaspoon of beet powder. I’ll do before the sauna, but also do before exercise, the beet powder is awesome. And then I like a lot of the adaptogen. So rhodiola makes me feel really good. As a as an endurance support. We use it for athletes, as you mentioned. And Holy basil’s is good. B vitamins a course that’s always low hanging fruit, there’s some good really good forms of creatine that we use, those can be helpful. And I think that’s about it. Are there any other like pre train nutrients that you like or that you use? 

Dr. Justin Marchegiani: So you kind of hit a bunch of them. So off the bat, you know, creatine and branched chain amino acids are wonderful, and it gets great, a little bit of caffeine can be very helpful to kind of mobilize free fatty acids. So whether you’re doing like a cold brew, coffee in your smoothie with the amino acids can be great. I do my Mito synergy support because it’s got some extra carnitine, extra ribose, a little extra creatine in there, some HLA some B vitamins, just those low hanging fruits are wonderful before workout. But I’d say creatine, branched chain amino acids, maybe a little bit of caffeine, especially if it’s a morning or afternoon workout, don’t do that, if it’s a nighttime workout. That’s a good first step, I think, to really hit it out of the park. And then we talked about movement patterns, I like really focusing on the centric, I also like focusing on circuit. So doing two to three movements back to back to back can be very helpful, because you can get a lot of volume done meaning a lot of reps and sets in, you know, smaller amount of time. So that’s great, because you can have a 15 to 20 minute workout that may have may have taken you 30 or 45 minutes if you did it one exercise at a time. So it gives you the ability to to make it more practical, which is great. 

Evan Brand: Yeah, I think the next thing we should hit on is kind of the post recovery stuff. So what about the person who is getting into the exercise? Maybe they’re not tolerating it? Well, maybe their recovery time is a bit too long the wanting to shorten that I think the bcaas could be great before and or after. And then I’m a huge fan of like a Grass Fed Whey Protein Shake, but make a smoothie out of it. So there’s a couple grass fed ways that you and I use it are super good quality, and we’ll throw in like a scoop of coconut butter. If you can tolerate nuts, maybe a scoop of almond butter may be good. And then I’m a big fan of some of the Oregon meats too. Whether it’s actual Oregon meat or like some organ meat capsules, those can be really helpful for recovery and just making sure your body has the role nutrition it needs. And then good sleep. I mean, you can’t forget about good sleep. I mean, I see so many people who are moms that are trying to hit the gym or do whatever, five times a week, but they’re up too late. And they’re up too early. You know, they’re up at 430 in the morning to go hit the treadmill. It’s like ah, I’d prefer you sleep in until 630 or seven. Do that workout later and not miss your cortisol peak because the problem is if you’re up too early to exercise, you’re really missing that cortisol peak. It’s kind of like you took your iPhone off the charger when it was only at 50%. We’ve seen based on thousands of reviewing labs that the cortisol doesn’t really peak until around sunrise or so. And if you’re up at 430, the battery is not fully charged. So now that cortisol is going to just halfway peak, and then it’s going to crash much sooner, so you’re just not going to get the best bang for your buck, if you’re doing those super, super early workouts now isn’t better than nothing, probably. But I’m just giving you a couple details that we’ve, we’ve seen. 

Dr. Justin Marchegiani: Yeah, when your nervous system is a little bit more fragile. When you have more adrenal issues, doing a later workout in the day is probably not the best, because that’s going to get more of that sympathetic nervous system kind of stimulated. And it made the the more unhealthy or the more out of balance your adrenals are the harder it, it takes your adrenals to wind down and kind of downshift from that sympathetic adrenal stimulating workout. So there’s going to be some adrenal stimulation, of course, right, which isn’t bad thing. But the question is, Do you have enough time to adapt and come down from that workout before bed, and that’s where it may affect your ability to repair before bed. So that’s why doing a workout, let’s say before two o’clock is ideal, you know, and again, the healthier you are on, the more you can downshift, the better, right, I typically recommend try to give yourself at least two to three hours to come down. So if you want to be in bed by 11, you want that workout to be done by eight for sure. That way you have at least three hours to come down from it, and try to do it more in the morning because you have that natural cortisol peak. And if that cortisol peak is going while you’re stimulating cortisol, you’re just more in harmony with your natural rhythm of cortisol going up. And adrenal stimulation going up, it’s kind of like, hey, more light at night. And when when melatonin goes up, are they’re not going to work because cortisol is going down at night. And light goes up at night, which can stimulate cortisol. So you kind of have the inverse thing happening with lights. And with cortisol at night, it’s the same thing with exercise and cortisol. So you rather do it when you have more harmony going on. But I understand some people that may not be an option. And if that is just try to give yourself more time. And really try to make sure that it’s not throwing off your sleep rhythm. And if it is adjust the frequency, the intensity and the duration, so you can recover from it and not mess up your sleep.

Evan Brand: And this is tough to do a podcast on because there’s so many different people with different work schedules. And well, my, my kids are with me on these days. So I can’t work out in the morning on these days. And I take my kids to school on this day, you know, so obviously, what we’re saying these are generalities, I know you have to work it into your schedule. But yeah, if you could do like a morning workout, I think that’s smart. But not an early morning workout. I don’t think people should be setting an alarm to get up at 4am to go jump on the treadmill at 4:30am. I just don’t think that’s smart. But if you were up with the sun at seven, and you could do it, that would be good. 

Dr. Justin Marchegiani: Yeah, ideally, for sure. Now, if someone visits us their work schedule, and they can get to bed by between eight and nine o’clock, so they they’re still getting at least seven hours of sleep. Sure, that’s at least better than nothing. So you just got to make sure the sleep is is compensating for the time getting up early for sure. But I agree, you know, the more you’re in harmony with the sun, the more your body likes that. 

Evan Brand: Yeah, ashwagandha can be used in the evening, I remember I would do that if I had some late workouts that would kind of stimulate me. If I did like some ashwagandha at night, it would help help kind of calm it down you and I’ve talked about many times how it helps to regulate cortisol. So that’s what adaptogens do. If you’re too low, it kind of brings you back to balance if you’re too high and can bring you back to balance. So let’s say you did a eight o’clock workout tried to go to bed at 930 You’re still kind of ramped up maybe capsule or two, I like to use some liquid gel caps of ashwagandha tincture, and that really settles you down pretty quick. 

Dr. Justin Marchegiani: 100% agree. Yeah. 100%. Great. That makes a lot of sense. So I think we hit some of the exercise kind of options, right? We talked about amino acids and nutrients pre post during we talked about different styles of exercises. I would say one thing in there, if you don’t have a lot of time to BOD or some kind of an interval on the cardio cardio side, whether it’s like an elliptical or treadmill or or bike, we’re a bigger fan of the rowers because you’re getting more extension in your body and there’s tends to be less extension with cardios and we tend to be more inflection throughout the day right at a keyboard right typing, all that stuff brings our body more into flexion. So using more extensions stuff can be really helpful. So I like more extension movements like we already chatted about. And I like a rower for that and you can do a 32nd 20-20 or 32nd high intensity movement followed by a Tabata which may be a 10 second rest period all the way up to a peak eight which may be a 92nd rest period. And you can just adjust the rest period and the exercise period to kind of suit your body so anywhere between a 10 to 32nd. High Intensity full out, you know as fast as you can go followed by a 10 second to 92nd rest period. That’s very helpful for increasing your metabolism and putting on muscle too. 

Evan Brand: I tell you on that rower, what I’ll typically do is I’ll do 500 meter sets, you know so typically with like weightlifting in regards to building muscle people, you’re going to want to be looking for around three, maybe four sets of 10 to 15 Just depending on how you know what how you’re feeling what your goal is, but with the rower, I’ll do 500 meters as a set. And it’s give or take around two minutes to do that, man, I’ll tell you, you want a full body blood flow, that rower does it because you know your legs, you’re pushing to kind of slide yourself back, and then you’re pulling, and then hopefully, you’re, you’re fully pulling back, I think a lot of people stopped too soon. But if you’re pulling that bar all the way back to the chest, and then you go back in, and man, I feel great on it. So it’s-

Dr. Justin Marchegiani: Yeah, it’s using your hamstrings to kind of bring yourself back closer to the machine to so you’re getting a little bit of extension on the quads, a little bit of flexion on the hamstrings, and then you’re getting some bicep and some and some rhomboids and some upper back, which is really nice. So I agree, I think it’s really good movement pattern. 

Evan Brand: I put it on Max, I mean, you know, it’s, it’s kind of hard. Like if I was on a desert island, would it be the only piece of equipment No, I’d probably bring like a kettlebell maybe, or a dumbbell on the desert island. But it, rowers pretty dang close to the all in one solution, if you’re somebody who’s just looking to get your heart rate up, but also you could build some muscle, I put it on the max setting. So it is it’s the most resistance. And then if you pull on that thing really hard or really quick, you increase the resistance more. So yeah, I mean, you can get a pump, you can build some, some good back muscles and arms and deltoids using that and some traps. I mean, you’re gonna hit your traps a little bit on the road. So I’m a huge fan. 

Dr. Justin Marchegiani: Yeah, I like kettlebell swings as well. I mean, the only issue with the kettlebell swing is when you go into the East centric on the kettlebell swing, there is no low, slowly centric, it’s gonna be fast. So you’ve got to make sure you’re in a little bit better condition on the kettlebell. So you can go you know, have a really good explosive, ie sedgewick. And concentric because that eccentric when that kettlebell is coming down, you’re not you can’t lower that speed, it’s coming down at full speed, which is great, because you have to absorb it and use those hips to kind of soak in and grab that momentum, which is great. People that are beginners, they tend to use their back more and they can get hurt. So kettlebells I think there’s a really simple movement where you can kind of walk by it a couple times a day, and do you know some sets to failure on it, just make sure you know how to do it right. You have some good forum, find a trainer that can kind of walk you through the movement pattern, so you feel comfortable and confidence you don’t get hurt.

Evan Brand: Yeah, I was gonna say I probably in a kettlebell situation, I’d probably pay for a couple hours of training on it, because I definitely hurt my back. When I first started. I didn’t know what the heck I was doing. I just looked at some videos, I thought, Oh, yeah, this seems about right. Now, there’s some minor tweaks that can really affect how that load bearing hits your back. So for people, you know, that are not, you’re not an athlete, I would not go straight to a kettlebell. 

Dr. Justin Marchegiani: Correct. Yeah. 100%. And then I’d like a lot of body weight stuff. So I have like the push up bars I like just because I can get a really good deep push up most people, man, they do have push ups, right? They do have push ups. I like the bar. So I can just get really in deep, get a good full range of motion. And I keep my wrist kind of in a neutral format holding the bar versus like this, which I don’t I don’t think it’s the best thing. You know, it hurts the wrist. Yeah, it hurts. So you can kind of keep it nice and neutral. You can go nice and deep. And that can have a nice, good eccentric on there, which is wonderful. 

Evan Brand: Yeah, so you’re using the like, the handles, yeah, like here, we have each handle for the, for the push ups. Okay. 

Dr. Justin Marchegiani: Yeah, like that. And it goes really good. They have some that do a rotation thing, which is okay, too. I mean, you can hit the packs pretty good there too. But just to be able to go deep in there and be able to keep your wrist neutral, I think is wonderful. 

Evan Brand: I love pull ups. I mean, I tell you, I got extremely strong doing pull ups. But for people that are beginners pull ups, you might not even be able to do one and that’s okay, what you could even do is use like a little step stool, and just jump up there and just hold yourself up and the pull up position. That’s how I started out was just holding at the peak of the pull up. And then eventually I just let myself down slowly, and then pull up again. And then I was to the point where I could do three sets of 10 on pull up, I swear to you, man, that’s exhausting. 

Dr. Justin Marchegiani: If you go search online, like pull up assist, you can get bands, they kind of hook around and there’s like three or four bands. And then you can add a band for the for the intensity on the assist. And so what I’ll do is I’ll go in, I’ll do as many pull ups, which is you know, palms facing you or chin ups, palms facing away, right chin ups, more lat pull up more biceps, and I’ll do as many as I can the failure. And then I’ll go in and then put the bands on right after my knee and then I’ll go do it again to failure. So that’s a pretty good kind of a nice drop set where you go as much as you can bodyweight. And then you jump in with a little bit of help. And that can be super, super helpful. Just just people don’t people aren’t used to controlling their body weight like that. And it’s really functional to be able to move your body in a way where you are, you know, in control of your body from a weight standpoint, like you’re able to, to move and functionally manage your body in space and time without any extra stuff on there think it’s really functional. 

Evan Brand: Yeah, I mean, that’s the thing that people listening if you’re like, I just don’t like exercise. I hate exercise. I’m not into it. I’d rather go hiking Look, I hear you. But the benefits are not just in and out of the workout. The benefits apply to picking up your kids the benefits apply to playing with your grandchildren, the benefits apply to doing yard work. Bringing in heavy bags of groceries and you don’t want to make multiple trips, you can grab all the groceries in one trip. And so it’s just awesome to be able to to build muscle. If you’re climbing ladders, if you’re in construction, I mean just that, as you’re mentioning, it’s functional, this stuff applies. This is not just for vanity, this stuff really applies to everything if I weren’t in decent shape. my four year old, she’s heavy. When I go to pick up that kid, it’s awesome to be able to have the muscles to just make her a dumbbell. I just pick her up like a dumbbell. You know, it’s it’s fun. If I were in bad shape, you know, I maybe hurt my back, just bending over to pick her up. So this stuff is the stuff is great. And especially as you get into 60s and 70s. I mean, we know that with bone density being a big issue, we have so many clients with osteopenia, osteoporosis issues, yeah, we can give you supplements for that. But the best free thing you can do is to do weight bearing exercises to really preserve your bone health as you age. 

Dr. Justin Marchegiani: Yeah, I always look for movements that translate to me living my life better. So anytime you can move your body, you know, in a way where you’re managing the weight of your body, that translates to you managing the weight of your body when you’re, for instance, roughhousing with your kids in the pool or something like or like I’m throwing my kids up in the air, like one handed like, you know, one handed, like, Where did that get shot, put kind of thing. It’s like, I need really good shoulder stabilization and really good lat strength, and core stabilization to be able to make that happen. So it’s nice to do movements that can translate to you being able to play with your family or friends or do your sport or do your hobby. So that’s really important to think of like, what movements do I want to do in my workout that will translate to me living my life better. So always kind of think a little bit deeper. Most people just think like, hey, what movements to make myself look better naked. That’s cool. I have to run with that. But now we got to think a little bit deeper now.

Evan Brand: Yeah, I think if someone’s listening, and they’re like, well, I’m pretty much disabled. In terms of my physical performance. I’m just super weak. I would try a plank. I mean, a plank is a game changer, where you’re just getting on, you’re kind of resting on your elbows and forearms. And you’re just holding yourself even if you can only do a plank for 10 seconds. My Lord, I can’t tell you core strength, you hear about this term core strength, it really does apply, I just got back into doing some planks pretty regularly. And even just sitting in a chair, I sit better in a chair now having more core strength. Yeah, I think it’s great. You just don’t fold in, you know, if you have no core strength, you just like you said you fold in, you get into the turtle the turtle position on the computer, and it’s just not good. The next forward and get the core strength, you’re more just confident with the way you sit. 

Dr. Justin Marchegiani: Yeah, also just just get a stand desk that allows you to stand throughout the day, like I’m standing right now, I’m using core strength just being able to stand right, that’s super helpful. Or let’s say you sit a lot and you don’t have the money to invest in a state that’s well, let’s just try to invest maybe in a Swiss ball, a physio ball or Swiss ball that will allow you to sit but now you have to engage your core a little bit so you don’t fall right. That’s a good first step. And then you can move to a stand desk where you’re upright, and you can kind of move and like look at my body posture throughout the day, I’m pretty upright, I have to pull my backpack, pull my arms back. So I’m in a much better position to be more athletic. And to get my my cold body activated versus in this like sitting down position, which is totally unhealthy. 

Evan Brand: Yeah, I kind of bend my legs a little too, I’m standing down too. And so you know, I mean, my hamstrings are pretty flexed right now just standing here talking. So that’s pretty cool. 

Dr. Justin Marchegiani: And you can buy an anti fatigue mat, which is fine, you can do that too. I’m kind of moving a lot. When I’m standing I’m on a treadmill, so it’s not necessary. For me I like to move a little bit. So that’s helpful. And then it kind of have a slight bend my knees, take the stress off my my lower back so that I think those are really good first steps. And I also have some QB pedals when I sit down, I can also pedal a little bit. So it’s good to have a lot of unstructured exercise that you’re doing throughout the day where you’re getting some movement and it’s not yourself being in the gym doing this workout, you’re kind of adding some movement here adding some movement there. And it’s it’s nice to be able to get that 10,000 steps or so a day, just to make sure your body’s moving. You’re not overly sedentary. Because if you’re getting 2000 steps a day, but you’re in the gym for 30 minutes. Is that really healthy. I mean, you definitely want some steps, you definitely want some movements as well. 

Evan Brand: Yeah. Now, if you just want to opt out of the whole thing and just become a farmer, then that’s an option too. But if you’re like a farmer that’s just sitting on a tractor, you’re not getting much exercise, but think of our ancestors, right? I mean, they didn’t have to think about exercise the way we do. It just happened. It was a byproduct of surviving. And now it’s optional. So it’s funny, we have to have this conversation versus even just a couple hundred years ago, my grandparents, grandparents, you know, they’re out in the field. They didn’t even have mechanical equipment. They had horses and plows. Oh, my God, I bet you those people were getting 10,000 steps at least per day and sunshine and fresh air. They didn’t have to think about it. 

Dr. Justin Marchegiani: Yeah, I 100% agree, you know, but we got to adapt and we got to create artificial stress through our workouts to keep our muscles and our body strong. So I think that’s great. Is there anything else you want to add today and I think we hit all the really good stuff. Maybe people that are really having a hard time adapting and figuring out the next step they can they can reach out to us here below to reach out to for you worldwide. for Dr. J myself. And also we may have to dive in deeper and test your adrenals test your hormones, get your gut, maybe give you more nutritional support, hormone support adaptogenic stress support to get you all to the next level. And that’s going to be a thing for most people, depending on how good or bad they you know where they’re at, and how much they want to improve. That could be something that we consider to be an accelerator to get you to the next level. So that’s always an option for y’all as well. Anything else you want to add, Evan? 

Evan Brand: No, that’s it. You mentioned the links we’re happy to help people. We love this stuff. I mean, it’s, it’s such a great thing to be able to take a woman who’s exhausted trying to keep up with the kids, we get her mitochondria working better, we get her gut working better, she’s able to exercise and perform and then boom, it in turn makes her a better parent. She’s able to keep up with the kids now or the grandparents are able to run around with the grandkids. So you know, remember what this is all for. At the end of the day, it’s for you to be able to function through you know, on planet earth through your body in a better way without being injured. So it’s awesome. 

Dr. Justin Marchegiani: I love it Evan, excellent point today. It was a great podcast. Hope you guys enjoyed. Thumbs up really appreciate it. Comment down below. We really appreciate it. There’ll be a link below if you guys enjoyed it. Shoot us over a review. We’d love to hear your thoughts and feedback. Evan, you have an awesome day, man. You take care. 

Evan Brand: Take care now. Thanks bye bye.


Audio Podcast:

Mitochondrial Dysfunction & Other Causes of Chronic Fatigue- Mold & Candida Contribute | Podcast #287

Welcome to another episode of Beyond Wellness Podcast! For this episode, Dr. J and Evan Brand talk about chronic fatigue, which is a disorder characterized by extreme tiredness that doesn’t go away with rest. Because sometimes, chronic fatigue can also be associated with mold issues, Candida and etc. Check this podcast out. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:06     Mitochondria

8:26    Toxins that damage Mitochondria

14:40   Mold Issues

22:22   How Mold and Candida affect Mitochondria

31:05   Nutrients and Vitamins

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Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about chronic fatigue, mold issues and other different causes that could drive chronic fatigue. Evan, how are we doing today? 

Evan Brand: I’m doing really well. We’ve got just a couple of papers on this. And we don’t really more than that, because we have so much experience now ever since I had my issues. And you and I started digging into this. It’s like you and I jumped into the mold whirlwind over the past few years together. And it’s been really fun learning and educating people simultaneously. We’ve implemented stuff in our houses that have been game changers for us. We’ve implemented stuff clinically, that have been game changers for others, but I believe this is one of the biggest triggers of chronic fatigue is mycotoxins and I experienced it personally and so I can tell you my own issue, I was exhausted and I’m still recovering from that and your exercise intolerance goes down and a lot of that has to do with the mitochondrial damage to happen. So could you just give us maybe like mitochondria 101 What like, how do they help people? Why are they so important? What happens when they get damaged and all that? 

Dr. Justin Marchegiani: Yeah, so your mitochondria, they exist inside of yourself, okay? And it’s going to generate ATP. And part of you know, so you have glycolysis, right? That’s going to be outside the cell where you’re kind of taking glucose generating energy. And then you have the Krebs cycle where you’re spitting out different amounts of hydrogen and ATP. And those hydrogens then now go into so you have these things called reducing agents, called FADHNAD and they gather up hydrogens, okay? And then these hydrogens, right, they enter the electron transport chain, they generate more ATP. So you have glycolysis to the Krebs cycle, right, or citric acid cycle, same thing. And then we have from there into the electron transport chain. And this is where we start to enter the mitochondria. And we need things like carnitine to help shuttle fat into the mitochondria. We need B1 B2 to help with fatty acid oxidation in the mitochondria, it’s part of how the mitochondria burns fuel to run the Krebs cycle and to get the electron transport chain set up we need B vitamins, we need magnesium we need carnitine like I already mentioned before, we need creatine we can use things like ribose we can use things like co q 10. These are all really really important nutrients that fuel these different metabolic pathways obviously, intermediary nutrients like Fumarate and malate and succinate. And then different amino acids are involved with the electron transport chain and or the citric acid cycle, Krebs cycle the leading up to it. So all of these pathways, they roll and they really help generate energy and generate ATP, which is that energetic fuel source. 

Evan Brand: And there’s a really good picture of the citric acid cycle some of the stuff that that you and I’ve learned from some of our books and study so we may be able to put that up in the shownotes to where people just want to download it look at it, I think it’s kind of cool because you could look at it and you could just quickly learn all the different nutrients that fuel each part of the cycle. So then I don’t want to say you could spot treat but for lack of a better word, you could kind of spot treat and go, Oh, magnesium, boom, I might be missing that be six. Oh, I might be missing that.

Dr. Justin Marchegiani: 100% Yep. 100%. I’m gonna try to pull up a good picture for everyone to see here. So they can kind of wrap their head around it. A picture’s worth 1000 words. So if you guys can kind of understand the concept. I think that makes it a lot easier. I’ll pull that up here in a minute. Okay. All right, cool. Anything else you wanted to highlight on that before we dive in a little bit more? 

Evan Brand: Well, you mentioned a bunch of different nutrients. And so I think the most important part to pay attention to is that today we’re focusing kind of zoomed in. But you mentioned a lot of stuff that people could be deficient in for other reasons that we might not cover today. So parasite infections, bacterial overgrowth, any kind of dysbiosis. That’s not allowing the gut bacteria to produce some of these nutrients that may be involved. But that’s not the highlight of the show today. Today we’re focusing on other triggers and other causes. 

Dr. Justin Marchegiani: 110%. Exactly. Very good. So of course, the first thing is we have things that enter the mitochondria. And that major nutrient, that major compound that’s going to enter that mitochondria is going to be acetyl co a, and acetyl. co a is made from fats, carbs and proteins. So the first thing I always tell people is we have to make sure we can digest and break down our fats, carbs and proteins. And we have to make sure we have good proteins, good fats, primarily carbohydrates. You know, of course, if you’re more active, you know, you can always do more safe starches and make sure you’re not doing too many grains and an inflammatory refined sugar. But we need good fats, we need good proteins because that performs and creates a really good building block for that acetyl. co a, and we need that for really, really, really good mitochondrial production. 

Evan Brand: Yep. Let’s dive into this study. This is really cool. One of my favorites, this guy, Dr. Brewer-

Dr. Justin Marchegiani: If you don’t mind, I want to just hit one more thing. Just I want to set the table a little bit more for the listeners. Okay, let me just do this here real quick. All right. This is a really, really good picture. Can you see that on my screen yet?

Evan Brand: Yep, there it is. 

Dr. Justin Marchegiani: Okay, good. This gives you a pretty good idea. So the mitochondria is kind of the powerhouse of the cell. All right. And so when you look at energy, we first have the cytosol that’s outside of the cell. This is glucose. Glucose comes in glycolysis means breaking down glucose. glyco means glucose. And then license means breaking down. So we generate a little bit of energy here, ATP from glycolysis. Okay, then that then that little bit of energy then moves into the mitochondria. So this is the mitochondria here right now. So we have acetylcholine, acetylcholine then starts going into the Krebs cycle, that Krebs cycles in a turn twice and it’s typically forget exactly, I think it’s two to three NADH or going to be spit out for one fa, d h2. And this is going to turn around twice. And then these different electrons, these hydrogens that are collected from the Krebs cycle, the NADH and the FA, d h 22 to 3, NADH, one fA d h two going to enter the electron transport chain, and then more ATP is then created. So I want to say it’s like 36 to 39 ATP are created from glucose to Krebs cycle to electron transport chain, and I want to say it’s two or three for glucose. Like Allah says two or three for the Krebs cycle, maybe six for the Krebs cycle. And the electron transport chain is the majority where it happens. I want to say 33 or so I want to say it’s about 36 to 39 total ATP, per this whole thing and this is a mitochondria right here. So all most of this stuff happens in the mitochondria and then some of it happens outside in the cytosol. 

Evan Brand: Yeah, that’s what I was going to ask you. So if someone has major mitochondrial issues according to this picture, it looks like you would still be able to generate some, but it’s going to be a minimal amount of ATP created from glycolysis. Is that true? 

Dr. Justin Marchegiani: Correct and then glycolysis is going to be dirty fuel right? So you’re going to get a lot more oxidative stress because of the advanced glycation end products that occur when you start making a lot of sugar right? A lot of sugar you coat your proteins right this increases oxidation oxidation and and then require more electrons to stabilize because when you when you oxidize something, right, think of cutting open an avocado, and it browns right or think about cutting open an apple and it browns, you’re losing electrons. That’s what’s happening there. Now you can easily go take a nice lemon or lime and squeeze the vitamin C from that on there, and that will prevent it from oxidizing. So the difference in your body is going to require a lot more antioxidant reserves. If you start creating a lot of oxidative stress, so glucose always burns dirty, okay, and there’s a really good book by Kristofferson called ‘Tripping Over the Truth’. And it’s a book all about mitochondria in glucose and cancer. So there’s a lot of data on this stuff already. So it’s really important to know that’s why we want to be more fat burners, good proteins and you can get carbs, you know, according to your metabolic needs. If you’re more active and, and you’re healthy, healthier and more fit and more lean and more active, then you can definitely add in some good high quality safe starches, but you really want to dial that in according to your metabolic needs. It’s not a set kind of size for everyone. 

Evan Brand: Very cool. Thanks for the picture. That’s awesome to see. So where do the toxins come into the picture? Well, the toxins are going to damage the mitochondria. So as you showed here, you can make some energy outside of the mitochondria. So you can still quote get by, but you may be exhausted if that Krebs cycle isn’t working properly due to potentially some of those nutrient deficiencies you covered that could be fueling the Krebs cycle. Maybe you’ve got infections or malabsorption issues going on. But we know that mold toxin damages the mitochondria law as well and actually sent you another paper in the notes if you wanted to look at it. It’s called mycotoxin its impact on gut health and microbiota. And this is pretty cool, because the end of this paper discusses that if you have good intestinal flora, they say here, it’s now well established that a healthy gut microbiota is largely responsible for the overall health of the host findings revealed that gut microbiota is capable of eliminating mycotoxin from the host naturally, provided that the host is healthy with a balance of good gut bugs. So long story short, and there’s a cool picture on that paper to just I don’t know if you can pull it up, but it’s called frontiers, cellular infection, microbiology, it’s a really cool picture of the gut and it just shows on the right that you’ve got all these different infections, like helicobacter, you’ve got E. coli, you’ve got reduction of beneficial bacteria, and therefore, the mycotoxins are not going to get treated as they should. 

Dr. Justin Marchegiani: Oh, I see that right here. Yep. So on that you see a whole lot bunch of decrease in good beneficial bacteria. I can share it right real quick here with y’all. You can see a decrease in a lot of your beneficial floor right here, man, you don’t see an increase in a lot of the pathogenic floor right here. And then of course, you have lipid polysaccharides. These are going to be your endotoxin that are the outer coating of the bad Gram negative bacteria. And then of course, you have more than mycotoxins. And of course, that’s going to stress out the microbiome stress out the immune system is going to increase gut permeability. The more gut more your gut is permeable, aka leaky gut, the more immune stress you’re going to have, because now your immune system is interacting with compounds and toxins that normally wouldn’t Is that correct? 

Evan Brand: Yep, that makes perfect sense. And this makes sense of why probiotics can be beneficial right out of the gate. A lot of people discuss and you and I discussed binders and Bluetooth ion and fixing the environment and all of that, but I mean, this shows here that bumping up your good bacteria is going to be a critical component to so I personally implemented a 50 to 100 billion have some multi stream probiotics and I have felt better. Is that the magic here? No, I’m doing a lot of things, but it has been pretty beneficial.

Dr. Justin Marchegiani: 100% Yep, pull up that pull up that Brewer paper. Now I think that’s going to be the next thing we should talk about. So let’s go over that. 

Evan Brand: This is crazy. This is crazy. So if you scroll down, long story short, in clinic, Brewer and some of his associates in this in this paper, they were testing using urine testing, which is what Justin and I run in clinic as well. We do a urine mycotoxin screen. And right here on the first page. It’s crazy says right here that urine specimens showed that 93% of his chronic fatigue patients these are known chronic fatigue sufferers. 93% of those were positive for at least one mycotoxin

Dr. Justin Marchegiani: Correct. So if you look here, right, here’s 112 patients 93% had at least one mycotoxin, again you have different mycotoxins, you have the aflatoxin- This is common like peanut stuff okra toxin and then you have the tri coat the scenes which is common in the in the black mold the Stacie buttress black mold, okay, so these different toxins we can actually test and now it’s important. Some people may test these things and they don’t do a really good glute. If I don’t push people that have really poor to toxification they may not push these things out. So you really want to make sure a couple of days ahead of time you do a good Bluetooth ion push and and even that you may just want to even look at the home too and do a really good play test on your home. Again, we use immunologic labs, we’ll put some links down below if you guys want to procure those tests, but some people they may have a hard time pushing it out. So yeah, so number one is I always recommend do a glutathione push. If you feel achy or really bad or brain foggy or tired or fatigued that could be a good time. Also, if you have a lot of mold in the home, especially molds that have these mycotoxins The nice thing about the amino Linux. It’ll tell you if these mycotoxins are produced by the species of mold they find so they see Aspergillus, or different mold that can be produced during water damage, then usually there’s an oak, there’s usually going to be a mycotoxin attached to it. There are some molds that are natural, like in soil and just plant degradation outside. Those are different some more from pet dander and those kind of things. So you’re able to get a window into all those things, as well. 

Evan Brand: Yeah, and I just want to say one comment about the push. When I first did my original mycotoxin urine screen, I did do Bluetooth ion for maybe three days and I guess that wasn’t enough because my Michael phenolic acid, which is a mycotoxin that comes from Penicillium, which I was exposed to my level was a 12, which was in the red range, but it was just barely. And then when I retested six months later after trying really hard and doing sauna therapy, which is another way you could actually do provocation. If someone doesn’t have glue defi on, you could do a sauna session, then collect urine, that could also help but six months later, my levels went from a 12 to a 1700 my levels were off the chart, even though I’d been trying for six months to get it out, and I did feel better. Some may look at that. And I’ve had some clients, you know, call me and they’re like, I’m crying. I’m freaking out, my levels went up what’s going on, and we explain most of the time, that doesn’t mean new exposures happen. That just means you’re getting better at detoxification, and you’re pushing more out. And that’s what happened to me. So my levels were really, really low. Six months later, they were really, really high. And then another six, eight months later, they were low again, indicating that I did actually detox it and push it out.

Dr. Justin Marchegiani: Exactly. Now part of the reason why we were able to stick with it is because we knew that you had high levels of mold in your old home, correct? 

Evan Brand: Well, so it was a crawlspace exposure. Looking back at the plates. The house was minimally bad honestly, what I think happened based on talking to Scott force grant, he his theory on it is that my tick bites that I got sort of set the mold in motion because I had the most exposure when I was a kid hanging out in my grandmother’s house. Were her babies basement flooded many times. And I remember going down there and smelling musty basement. So I guarantee you, I’ve had mold toxin, you know, just because I’m genetically unable to detox it like a lot of people are, I probably had it since I was a very, very young child. But his theory was that the tick bites basically weaken the immune system enough to allow the mycotoxins to really take me down. Whereas before, I may have had some symptoms, but it wasn’t as it wasn’t as brutal. So it was the combination of tick bites, and then some more recent mold exposure, that kind of retriggered things. Yeah, and I think it was just the straw that broke the camel’s back. I think it was a combination because I didn’t really get exposed to that much upon looking back at my plates and comparing those to some of my clients. I’m like, you know what, this wasn’t that bad. I mean, we had a though, I remember them being more high. So everything in the house was in single digits. It was just the crawlspace that was in double digits. And then once we did the fog treatment, everything was back to normal but what really screwed me is when we modified the the hva system. And we were trying to circulate the air in the crawlspace. Better. So the ductwork was changed to make a complete loop system from the crawlspace, sucking that air pumping that air into the house, and then the house pumping back in. So it was a continuous loop. And that’s what really screwed me because that setup wasn’t there before. And that’s what really cranked the levels up. And that’s where, even after we did an initial treatment, the levels went way up. Because now we were bringing in bad air into the breathable air. And so once we reverse that correctly, so if I remember correctly, is you had this crawlspace right, there was mold in the crawlspace. That was really high. The rest of the house was okay, but there was a lot of whole mold in the crawlspace they fixed the ventilation part of the home before they treated the crawlspace. Is that correct? Yeah. So we Yeah, we treated the home silly. I mean, absolutely. I can’t believe that happened. I’m just like, How the heck did these guys screw that up? I know, I know. So So then we treated it again though. And then the reverse the duck system that we had put in we reversed all of that. And then treated it again. And then it was fine. So technically, I could have stayed because the plates were incredible after that, but I needed a bigger house. Anyway, we had another kid come in. So it was a good excuse for me to just say, hey, let’s just go ahead and leave. 

Dr. Justin Marchegiani: Right but that was a big trigger for you. And then I think even in the new home that was still a little bit more mold that came back on that home to right near the retreat that address. 

Evan Brand: Yeah, yeah, we treated this house as well. We had some high colonies near the kitchen, which is potentially from the kitchen empties out into a screen room. So if those screen doors were always open, bringing bringing in outside air outdoor molds over time can accumulate in the house and make mycotoxins so yeah, we’ve we’ve treated it and now we just do some of the maintenance solution and we do some of the candles and such and now we’ve got it under control. So and then-

Dr. Justin Marchegiani: Also in general, you have the dehumidifier put in so then the humidity is now a lot less in the home. So that helps so there’s less breeding ground for it. And then you also just have air filtration throughout the home. So even if things were to come in your filters would naturally grab it anyway. 

Evan Brand: Yeah, I would assume my house is probably one of the few in Kentucky that doesn’t have mold in it because even with our whole house dehumidifiers, I mean, it’s pouring rain as we speak right now the ground rarely dries out because we have so much rain here lately. And even with the whole house dehumidifiers running, we’re barely keeping the house at 50% 45 to 50% humidity if you didn’t have those Running Man, who knows outside right now is like 86% humidity. And you and I’ve discussed this many times on the podcast, but you know, if you have humidity levels above 50% continuously in your home, you don’t have to have a water event. You don’t have to have a dishwasher overflow or a toilet leaking. Just the high moisture from the humidity alone can create mold, and that’s what happens in many homes that you and I’ve tested. 

Dr. Justin Marchegiani: Yeah, it really happens in areas where the temperature is just a little bit low. So you don’t have the AC because the AC will act with a natural dehumidifier but it’s temperature driven where humidifier is humidity percent driven. So I had a little bit of so if you have a you know 65 or 70, and it’s not quite triggering the AC, that’s where you really get screwed, but it’s not cold enough, not hot enough to trigger an AC but it’s also very humid 6065 70 or it’s just a basement area where basements are really cool but humid, that’s where you really need it because then if you get a humid basement, that’s cool. Well guess what it’s going to that ventually those molds are going to go upstairs to the rest of the home even if the rest of the home is is you know nice in and low humidity because of the air conditioner. So having a dehumidifier is important. I had a little bit of water issues over the weekend I was changing my water filter. And there was like three vowels you have to turn off. I only turned off two out of the three so it leaked a bit. Nothing bad I you know, got three or four towels cleaned it up. But what I did is I went in crank that dehumidifier down to 40%. And within two, three hours, any residual water that was hanging out was all evaporated, gone. But if you had 60% humidity in that basement, that water would just sit there for days on end. Once that water sits for 48 hours. It’s gonna start raining mold toxins. 

Evan Brand: Yeah, I’m glad you got the dehumidifier too. That’s, that’s pretty much essential for where we live with higher humidity. So, back to the chronic fatigue thing. So let’s keep going back on this paper because this is what I had.

Dr. Justin Marchegiani: If you want you can go share your screen here, Evan, you can share your screen if you like. Evan, are you there? Can you hear me? I lost that and guy, so I’ll wait for him to kind of come back on here. I’ll just keep on riffing. While we are waiting for him. I’m just gonna give him a message here.

All right, awesome. So just chatting with Evan here on the on the side here. He’ll be back on the show in just a minute. Let me keep rolling with you guys. So in general, we have the mitochondria we have different mold toxins that can affect and poison the mitochondria. One of the things that we get with fungus or mold is we get things called oxalates. And oxalates can enter the mitochondria enter the Krebs cycle, and make it harder for that Krebs cycle to work and harder to generate energy. So of course, that’s going to be a big component to stressing out the mitochondria. So when we look at molds coming into the end environment, whether it’s mold from outdoors, whether it’s molds or fungal because it kind of have molds, right, and then you have different things like funguses in your gut like Candida, they kind of have a similar mechanism where they’re going to affect and poison the mitochondria. and different things like that can create oxalate and they can really make it harder for the mitochondria to generate ATP. 

I’m going to show a couple of articles here I got an article on mold and how it can affect or Candida and how it can affect the mitochondria. I’m gonna pull this up with you guys here right now so you guys can see it. So this is interesting right here, you guys can see my screen chronic intestinal candidiasis as a possible ecological factor in chronic fatigue syndrome. We talked about Candida syndrome, also known as Candida related complex, putatively caused by an overgrowth of Candida, so that’s an overgrowth, not the Candida is not ever going to be there. It should be there and maybe at very low levels, it’s the significant overgrowth. That’s the problem.

And essentially in response of large number of patient with chronic fatigue to an oral antifungal agent, there’s evidence that Candida infection of the mucous membranes depress our T cells and natural killer cells. Similar abnormalities of the immune function are found in chronic fatigue. So it’s altering our immune function. So our body’s ability to deal with an immune response and deal with infections and deal with stress is going to be impaired big time. This is this is really, really, really important to kind of highlight and then it says, um, and it’s important in preventing reactions like epstein barr cytomegalovirus, herpes virus, there are other viral infections that could play a role with chronic fatigue. Right? And again, with chronic fatigue, the question is what comes first? Is it the chicken or the egg? In other words, when you have a an infection, is it the infection is cause is the underlying cause or did you have a weakened immune system leading up to the infection that caused the problem to begin with. 

That’s really what the underlying issue is, did you get the infection first? Or did the infection come as a result of the weakened immune system, and I’m not sure if it matters too much, we always try to line up what the what the likely causes. But we know here things like Candida and gut issues can affect the T cell and the natural killer cell, this is going to be our th one branch of the immune system. So our th one or those kind of special forces, they get in there and really do a lot of killing ahead of time. And they kind of the first line defense of the immune response. That’s like kind of really, really, really important to highlight and then it talks about here. And so then when you have a compromised immune system, other parasites other viral issues may be an issue then mold may be more of a problem. So now when you get exposed to mold, you may have been able to whip through it no problem you adapted to a bun now it’s like dang I think really knocked on your butt. So then said yes. The immune dysfunction found in the sorter has been considered the primary underlying cause. So this imbalance of cytotoxic T cell and T helper cells and natural killer cells is the underlying cause. It proposed that the chronic intestinal combat is maybe an agent, which leads to the immune depression in many chronic fatigue patients, and therefore, it could be a causal factor in chronic fatigue. So a lot of times we have the guts stuff leads the way. Okay, the guts stuff leads the way and then everything else happens after that, that makes sense. All right, excellent. Excellent. Very good.

I’m going to just take a pause here for one second. We lost Evan here, so I’m gonna see if I can get him back on the show as we chat. All right, let’s keep on rolling. So we talked about some of the guts stuff now you can see some of these things here with Candida and mold. We can see the same thing with CBOE as well. All right, if we look at small intestinal bacterial overgrowth, SIBO and chronic fatigue, guess what we’re gonna see similar things and why? Why is it? Well, it’s because of the fact that the God is where 80% of the immune system lives this is important. So when you look at research, research suggests the high prevalence of SIBO among chronic fatigue patients, One study found 77% of chronic fatigue. patients had SIBO why because when you start to have gut issues, the immune system starts to get revved up, right. And when the immune system gets revved up, it gets weakened or you start to create an imbalance like that th one part of the immune system starts to become depleted. And when that th one becomes depleted, that’s going to make it harder for you to go after and deal with other stressors like SIBO like Candida like mold, right. This is why the gods plays a big role is because you have this tube.

That’s technically outside of your body yet when you swallow food, it’s technically outside of your body because when it goes into the bloodstream, that’s now inside, technically, it’s outside of the body, you’re have 80% of the immune cells in the golf, the gastric associated lymphoid tissue, that’s the part of the stomach. And then we have the mall. That’s the mucus associated lymphoid tissue that’s in the in the small intestine. And if you have stressors, whether it’s bugs or bad food that stresses out the immune system, the more chronically the immune system is stressed. It creates imbalances and makes it so other things that now encounter your body like mold or Candida or viruses like epstein barr mano, right? The kissing disease. Now that’s going to create more stress and really, really, really knock on your butt. So we always have to look at what the underlying root cause of everything is. So, so we don’t lose sight of that. So we always want to understand what’s the root cause? What are associated causes and just because it’s an associative cause, you still want to make sure you fix it. Because sometimesyou’re not really sure if there’s three or four different infection 234 different bugs, does it mean that hey, each one is 25% equal, maybe, sometimes one’s a bigger one. And we also have to make sure we set the table. So if there’s food or other issues that are driving the problem, to begin, we got to make sure we fix that. What if those things have created an autoimmune issue? And now you have Hashimoto is because of the mold or because of the bug issue. Right. And now, the thyroids been attacked for a decade. Well, now what do you got to do? You can’t just ignore the thyroid and be puritanical and say, well, the root cause is Candida. 

Therefore, if I only fix the root cause, then everything else should be fixed. No, you may still have to go in there and support the thyroid because the hormone levels have now dropped, or the adrenal levels now have dropped. So you, you, you know, it’s easy to be like, well, the root causes this, everything else goes downstream, yes, but you may have to come in there and support those other pathways so you can get better and feel better faster. If not, you may be suffering for a long time. Really, really, really important points. All right, I’m going to roll with questions guys and see where you’re at with everything. So in general, with foods, big things that are going to stress this out, if you’re eating lots of refined sugar, and you’re and you’re spitting out a lot of candy to the candy doesn’t make a whole bunch of lactic acid, and that can make it and though that can easily eat a lot of your B vitamins, so the more Candida and the more bugs we have, the more you’re going to be consuming and ripping up a lot of your B vitamins. So B vitamins are very important. When you have bad bacteria, it’s gonna make it a lot harder for you to consume a lot of those good healthy B vitamins because your bugs in your gut are going to be consuming it for you. That’s like super, super important bugs in your gut are going to be consuming it. Number two is the bacteria is and it produced toxins. And this is big because these toxins now put more stress on your guts. So put more stress on your detoxification pathway. 

So when you have a lot more gut toxins, like polysaccharide or endotoxin, or the different mycotoxins may be made by Candida, and now your detoxification pathways get stressed. And now the sulfur that your body needs to run detoxification pathway have to get up regulated, you’re going to need more B vitamins like b 12, and fold a and be sick. So you’re going to need more of those nutrients as well to run those detoxification pathways. And so that can also drive fatigue as well because if you’re really like your body only has so many so much resources, so if you’re really toxic, if you’re really toxic, your body’s gonna allocate a lot of the nutrients on the B vitamins side or the sulfur side that may plug into the mitochondria. ….. ossification have less resources over here. So just just very, very, very, very important to keep that in the back of your head. Okay, awesome. Okay, very, very good.

All right, excellent. So it’s very, very important to really keep an eye on all the resources here because the more stressed your detoxification pathways gets, they’re going to pull a lot of that sulfur, they’re going to pull a lot of the B vitamins, and those are all nutrients that would plug into that mitochondrial pathway to begin with. So really, really, really, really important. You need so for people forget you need sulfur to actually make a lot of your dopamine and adrenaline. So dopamine and adrenaline. You need good sulfur. All right. And so if you if you’re chronically stressed, you’re going to be making a lot of adrenalin and eventually you’re going to be depleted because you’re not going to have that good software to take dopamine to norepinephrine, epinephrine, so you deplete sulfur because when you have dope mean that’s your feel good neurotransmitter you feel good, helps you focus. It’s a good reward center neurotransmitter, and that will go downstream, the more stressed your app is epinephrine, norepinephrine, that’s basically adrenaline or catecholamines. And these things are going to get very, very depleted, the sulfur will, will get very, very depleted, the more you’re chronically stressed, and then you’ll have less sulfur. And then the less sulfur you have, you’re going to have less building blocks for glutathione for your methylation, for all your detoxification nutrients, so it really plugs in. You want to look at everything holistically, so it all makes sense. All right, wonderful. All right, guys. Hey, phenomenal chat with you. If you guys enjoy today’s podcast talking about Candida talking about mold and mycotoxins connecting it to the mitochondria connecting it to energy. These are all very, very important components and on how and why everything you know is vitally important, why it all connects. So in general, co q 10. Very important, you know, anywhere between 100 to 500 milligrams a day. B vitamins, you know, a good high quality B Complex especially if we see on an organic acid test more forming a glutamate or more methylmalonic acid that tells us B12. And it also tells us full later benign, we may see things like xanthi urinator, kind of urinate which tell us B6 is important because B6 helps with our brain it is needed for the synthesis of neurotransmitters, right serotonin and dopamine. So if we don’t have good neurotransmitters that’s gonna really really affect our body’s ability to sleep to deal with stress mood, our adrenals right B five is a really important one pens authentic acid, we need it for our adrenals and also plugged into our mitochondria. Krebs cycle amino acids like I’ll see on these mitochondrial tests, we’ll see low sulfur like we’ll see low sulfate or low power of glutamate, or we’ll see low Pokorny, which is a sign of lower amino acids and these amino acids plug in to the Krebs cycle. 

And you can see here I’ll try to pull it up on screen how the amino acids plug in, but there’s a bunch of amino acids and the Krebs cycle. I’ll try to pull it up here. Now, why is this important? Well, because if you have poor digestion, because of mold, because of Candida, guess what’s going to happen to your body’s ability to break down protein? It’s going to drop, it’s going to significantly drop. Okay, I’m going to pull this up here so you guys can see how amino acids plug in. They plug in significantly. Okay, I got it right up here for you guys. Alright, cool. Let me just show this to you guys so you can see it. So this is what the Krebs cycle looks like. Okay, so you have remember this is the glucose here is in the site is all that’s outside of the mitochondria. Okay. All right, and then this stuff here comes in glucose phospholipids animal pyruvate pyruvate to acetylcholine. Now this starts to enter into the mitochondria, so sudo Coase now in the mitochondria, so look at these building blocks a Piru a to acetal koi look what it is people listening here we have a video version two so you guys can see my screen alanine cysteine glycine serine three Nene trip the fan right I so loosing all these things are big these are all essential amino acids that plug in to pyruvate and the seal co a and these kind of provide the building blocks to ratchet through your Krebs cycle and this thing is going to turn around twice. So you have saturate the ISO citrate and then you have alpha ketoglutarate more glutamine more prolene more histidine more origin and get plugged in. Then you have [inaudible] when you have more isoleucine more veiling right these are branched chain amino acids. Now this is part of the reason why working out with branched chain amino acids helpful refining 3d and then it goes from succinylcholine to succinate or we have tyrosine and phenyl alanine, which helps dopamine and adrenaline and then Fumarate to melee, melee to oxaloacetate, which is aspirin gene and aspartate. And then it plugs right back into we’ll see the code so you can see how that works. All right, you can see how that works very, very important amino acids. So if we have very poor, if we have very, very poor digestion, we have low hydrochloric acid, we have low enzymes, that’s an a play a really, really big role in this whole thing. So getting your enzymes and your stomach acid up really having a clean diet, really breaking down your food, and then really working with a good practitioner to look at the mold toxins or the gut stress the Candida in the gut. Right, and it’s more of an overgrowth, maybe looking at SIBO maybe looking at H. pylori or other gut infections. Looking at the environmental mold, if there is mold, how do we fix it right? What’s the root cause of that mold? Is it a muted humidity issue? Do we just need an air filter? Do we have to do a bio balance protocol in the home to get the mold level down right? So we have to look at the whole picture so we get to the root cause I hope that makes sense. 

Any other questions? Feel free I’ll chime in and try to answer them here for y’all. I think we got most stuff here that’s on point kind of already dialed in. So if you guys want to reach out to Evan, is a console link you can feel free and schedule. Also head over to my site to schedule a consult with myself if you want to dive in deeper we’ll put links down below. If you guys enjoyed this content, share it with friends and family make sure you subscribe hit that like button hit the bell so you get notifications. It’s phenomenal chatting with y’all really appreciate it. Just do me a favor try to apply some of this information so that you can make yourself healthier. It’s really important when you’re healthier. You become a better parent, a better person a better employee, a better boss, and it just it really helps the whole world get better the healthier you get the whole world gets better. Alright guys, it was phenomenal chat and you guys have a great day. Take care. Bye


Audio Podcast:

The Many Faces of Stress | Part 1

The Many Faces of Stress | Part 1

By Dr. Justin Marchegiani

When I say we’re going to talk about stress today, you are probably thinking of emotional or mental stress. Struggling to pay the bills, difficulty in your relationship and the death of a loved one are all very real examples of emotional and mental types of stress. These stressors definitely take a toll on you, and it is my goal to make sure you are equipped with as many tools as possible to turn stress into speed bump rather than a roadblock.

However, there are other hidden stressors that we don’t talk much about, ones that we will be focusing on today: physiological stressors.


Stress can be simplified into three categories:

Triad of Health

You can see that stress is more than just mental/emotional, it can also be physical/structural (like a broken bone), and physiological- nutritional/biochemical (which we will be focusing on today).

Click here to find out how you can reduce stress.

Physiological Stress:  This type of stress commonly comes from 3 areas.

  1.  Food: Nutrient density, blood sugar stability, and food allergens.
  • Eating high quality nutrient dense foods is very helpful in providing the raw materials your body needs to recover from daily stress.  Our bodies are in a constant balance of building up and breaking down; as long as we build up faster than we break down, we can stay in a state of “healthy aging” rather than “accelerated aging.”

Remember: The human brain is roughly 60% fat!  I find many people today are fat-phobic and are worried about fat causing heart disease.  Because of this misinformation, many patients are deficient in important building blocks and are walking around with brains that aren’t functioning optimally.

  • If Parkinson’s, Alzheimer, Multiple Sclerosis, or any other neurological condition runs in your family it’s really important that you avoid common food allergens. Scientific literature and research studies repeatedly find gluten, grains, and other common food to affect and accelerate the breakdown of certain parts of your brain.  

Thankfully we now have tests that can actually predict up to a decade in advance if this is happening to you, which gives us the time to make the changes to help reverse these conditions from progressing.  Removing all grains is a good start, and if anyone interested in running these new state of the art lab tests, please contact the clinic.

  • When your blood sugar fluctuates up and down, we typically will see your energy or mood fluctuate in the same pattern.  Fueling your body with with protein and fat every 3-5 hours helps blunt these blood sugar and mood swings and lowers the amount of stress hormone our body produces.  Many patients I see live their lives on a blood sugar roller coaster and don’t know how to get off this dangerous ride.
  1.  Toxins:  Heavy metals, pesticides, xenoestrogens, molds, radiation etc.
  • Did you know that about 2 billion pounds of chemicals are dumped into our environment every year?  Most of these chemicals are hormone mimickers, commonly “xenoestrogens,” meaning they are very similar to the estrogen hormones in our body.

The environmental exposure to these xenoestrogens throws our body into a state of estrogen dominance, which makes it easy to develop weight gain, hormonal imbalances, and PMS to name just a few.

  • Heavy metals like mercury, which are common in silver filling that your typical dentist would use to fill a cavity, are known to have a negative effect on thyroid function and can cause low energy and weight gain.
  • Since we are constantly exposed to these widespread damaging compounds, it’s smart to do an integrative detox program to help get these chemicals out of our body. Check out the detoxification portion of this blog post to get started.
  1.  Infections:  Parasites, fungus, bacteria and viruses.
  • As our immune system becomes weakened due to the stressors above, parasites, fungus, bacteria, and viruses see an opportunity to infect you.  It’s usually during stressful times in our life that we are most susceptible. It’s important to note that about 50% of people that develop a parasitic infections don’t even experience gastrointestinal symptoms.
  • Travelers abroad have an increased risk of infection.  Having high quality digestive enzymes, drinking bottled water, and avoiding any local places that may look a little suspicious can also help.
  • It is a good prevention tactic to check about once per year to make sure you don’t have any of these critters lingering inside.  Any time you are experiencing excessive gas or bloating, even with a healthy diet and lifestyle, it is wise to get checked.

Great Ways to Improve Recovery and Decrease Stress:

Great Ways To Improve Recovery and Decrease Stress

  • Chamomile tea before bed.
  • 800mg of magnesium before bed.
  • Get your adrenal-cortisol rhythm checked (this looks at your stress hormones through the day and how they fluctuate).
  • Stool test for GI infections.
  • Keep “Bach Flower Essence” by your desk and anytime someone drives you crazy, take 4 sprays.
  • Chiropractic treatment and/or a massage can help decrease the body’s flight or fight response, and help it to relax and repair.
  • Heart Math Em-Wave2, more on this in posts to come.  I just bought one and I really enjoy it!

Stay tuned for the next post in this series on stress, which will focus on the “Physical/Structural” side of the stress triangle.

Click here for help eliminating physiological stressors.

Chronic Fatigue Solutions – Podcast #147

Dr. Justin Marchegiani and Evan Brand talk about some of the natural solutions to chronic fatigue in today’s podcast. They also discuss some of the stressors which contribute to this challenging condition.

People who have chronic fatigue condition tend to have issues with their mitochondria, thyroid or adrenal glands. Many times, these issues can be driven by hidden gut stressors, like infection or food allergens. Listen to the podcast below to learn more about chronic fatigue.

In this episode, we will cover:

Chronic Fatigue Solutions

16:16   Sleep Pattern and Chronic Fatigue Relationship

26:45   Gut Component of Chronic Fatigue

19:40   Metabolic Side of Energy and Chronic Fatigue.

35:00   Correlation Between Fluoridation and Hypothyroidism

48:20   How Infections Aggravate Chronic Fatigue







Dr. Justin Marchegiani: And we are live! Evan, how are we doing, man? It’s a nice little magical Monday here.

Evan Brand: Magical Monday.

Dr. Justin Marchegiani: [crosstalk] How are you doing, man?

Evan Brand: I feel good. I feel really good. The heat index has been like over a hundred here. I don’t know if you watched the weather at all but it’s like the hottest part of the country. We’re like hotter than Texas almost. It’s nuts.

Dr. Justin Marchegiani: Yeah, I mean, right now dude, I got the apple kind of weather screenshot. My wife put it on her Facebook, and it was like– for the next week, it’s a low of a hundred to a hundred and six during the day. So, pretty darn crazy. Very hot, so we’re inside. Actually, I’d been jumping on the water today in like two hours.

Evan Brand: Good.

Dr. Justin Marchegiani: Do a little boat training things. I’m excited about that. This weekend was good. Didn’t go on the boat this weekend, but I look forward to go on it this week.

Evan Brand: Cool. Yeah, people have a misconception about Texas being like a desert, but Austin is– there is humidity plus that hundred degrees. That’s a scorcher.

Dr. Justin Marchegiani: Yeah. That is– it’s hot for sure, but uh– again, most of the year it’s great. That’s my kind of Texas secret.

Evan Brand: That’s true.

Dr. Justin Marchegiani: I got a little workout this morning. Got up. Did some PK, you know, sprinting. Sprint some of my rower, some kettle bells, some push-ups, some rows, some good twist ball, crunches and such. I’m feeling good. I’m ready to go. How about yourself, man?

Evan Brand: Yeah. I rode the mountain bike actually this morning. I’m trying to make it a morning ritual. Typically, I’m doing some good morning sunlight exposure as much skin as I can, and kind of gazing in the direction of the sun. But then I thought, “Why not just add exercise on top of it.” So, I’ve been hitting the mountain bike. Probably doing just a mile or two, enough into intense but my brain worked so much better with morning exercise, morning light. So, on the topic that we’re chatting about today of Chronic Fatigue, that’s one of the best strategies, I believe, as some type of morning exercise. If you’re not too fatigued, and you’re able to do even just a walking routine, or stretching, or morning Yoga, plus sunlight, that’s like a one-two punch combo.

Dr. Justin Marchegiani: Yeah, I mean, I have a little home gym at my house so I get up and I’m trying to do a little bit of 15 minutes– 15 to 30 minutes of exercise as soon as I get up. Close to the 30 is ideal. My wife tries to just get up. She’s eight months pregnant right now, so she just tries to get up and walk the dog for 30 minutes or so before it gets really hot. But yeah, exercise is really important. If you look at a lot of these higher-level CEOs, right. They talk about exercises really being a benefit on the cognitive side, right? Helps decompress stress. Helps them just feel better, less anxious, make better decisions throughout the day. So, exercise provides some awesome components, especially on the cognitive side. It’s very cool.

Evan Brand: Yeah. the problem is when we’re talking about the chronic fatigue, so many people they’re so tired that they can’t exercise. So, it’s really tough to give them that– that first little bump of energy. So, maybe we’ll chat about that today, you know. How do you actually get started with exercise when you’ve been sedentary for so long? It could be a struggle but there are options.

Dr. Justin Marchegiani: Yeah, I mean, first things first, is find your exercise tolerance. For the most part, many people can walk at least, right? Are they gonna at least do some walking, gentle walking, or they can at least, you know, let’s say that’s too much, they can probably at least do some gentle, like, Tai Chi moves, right? So that’s – there’s always a way that you can move a little bit, right? Whether it’s walking or even uhm – on the Tai Chi side, or even Yoga side, right? So, there’s always some level of movement you can do. Ideally, pushing people to get on to the resistance training side’s gonna be ideal. And even the burst training side. If you’re older and you’re not used to that kind of compression in your joints, utilizing some kind of elliptical or rower or bike, or something stationary, where you’re not getting the impact. But you can at least go out to all out intensity and then relax– all out intensity and then relax, that’s important for the mitochondria and for the muscles. And also, doing some resistance training is gonna be helpful because– again, like, things like walking, they aren’t really gonna build much muscle. I mean, you’ll burn fat, it’s good to move, but you’re not gonna be putting on a lot of muscle on walking. So, you get that the muscle building effects, and you get the higher growth hormone effects with the resistance training and with the burst. So, that’s really important.

Evan Brand: Now, did you cancel your gym membership? Do you still go over there now that you got the home gym setup or do you just use the home as a compliment?

Dr. Justin Marchegiani: I mean, I do both. I mean, the gym membership for me is like 19 bucks a month so it’s just nice to still have that because I can get out of the house maybe once to twice a week just to have a different change of scenery. As you know, when you work from home, it’s like– ah you don’t really get out much, right?

Evan Brand: Right.

Dr. Justin Marchegiani: Like you’re stuck, so just an excuse to get out. But I still have the home gym, which is great. I got to start shooting some more videos from there on some of the exercise stuff. I think that’s important. That’s kind of fun too. So, look for that coming soon. And then, what else is on your mind? I mean, let’s dive in if you’re ready.

Evan Brand: Yeah, yeah, so uhm – and you can use your wife, as your videographer for your exercise videos. People would love them on the channel, man. I don’t think you’ve done any exercise videos yet, have you?

Dr. Justin Marchegiani: No. No, I haven’t, but just simple stuff, right? Simple– you know, I kind of like the Pulse Check mind set. Break it down into foundational movement patterns, right. Push-pull– you know, push, pull, bend, lunge, squat, twist, walk, sprint, right? Those were like your seven kinds of primal movements in it. Any exercise you can think of, for the most part, you can fit into that type of seven primal movement pattern, and then from there you can, you know, you can have it. You can do it with weights. You can do it with cables. You can do it with TRX. You can do it with Swiss balls and body weight. And you can implement and shift according to what you need. And also– you know, if you’re on a budget– I mean, TRX, swiss balls, and push-up bars, maybe a couple of dumbbells, I mean, you got like pretty much a full body facility for yourself.

Evan Brand: Yeah, for probably less than 200 bucks.

Dr. Justin Marchegiani: Yeah. A couple hundred bucks, man, and you got a great gym.

Evan Brand: So, let’s chat about chronic fatigue. I mean…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …what’s your ancestral take on this? I mean, do you believe a chronic fatigue would have existed in ancient times?

Dr. Justin Marchegiani: Well, I think, ancient time-wise – I mean, look at the stress, right? Stress was punctuated. It was very short term, right? It was a tiger chase, whether you live or you die, right? It wasn’t this chronic thing where you got a mortgage, you got all these different things you have to do to uhm– you know, to survive so to speak. You have to get your food. You have to have your water. You know, a shelter over yourself, you kill an animal, and then, for the most part, you’re resting, you’re relaxing all day. Well today, we have bills, mortgage, we have ki– and then look at today, right? Kids are kind of a liability today. I mean, look how much they cost to feed, schooling, college, where in those days, like, kids were a massive asset. Like, you want to have as many kids as possible, so they can go hunt with you or help out around the house. I mean, it depends how far back you want to go, right? You want to go farming days, right. My family were farmers like a hundred years ago. So, they have…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …you know, seven, eight, nine, ten kids. And then, we’re all working on the farm every day. So, they were a massive asset to the family. Today, kids are kind of a, you know, a liability, right?

Evan Brand: Yeah. I mean, you make a great point. My great grandparents – there’s old picture – the average was like 16 kids.

Dr. Justin Marchegiani: Oh, yeah. I mean, they were a massive asset. They help the family out. Today, they’re a stressor. Right? You know there’s no reason why you can’t make your kid an asset. You know, give him some chores to do around the house and be a team player, right? But it’s– but uhm – you know, it takes energy and parenting to do that. So, you got to. We got to look at what we can do now to decrease stress. Because after food needs are met, you know, from an anthropological perspective. Food, shelter, hydration, I mean, typically have much to worry about after that. We have a lot more we worry about in our life: traffic, uhm – everything, right? So, looking at where we’re at now, we know the adrenal glands play a vital role because they kind of are the interplay with our sympathetic nervous system, so we get that spider tingling sense, right? Stress levels go high. That’s our sympathetic nervous system in there for always in fight-or-flight, then that’s gonna really play a game on our adrenal glands. Could look at Robert Sapolsky’s book. He’s the stress physiologist out of Stanford. It’s ‘Why Zebras Don’t Get Ulcers”? And he just talks about how animals – I mean, it’s like, this Zebra could literally be running from a lion, right? The lion jumps on its back, like, takes on huge chunk out of its back up but the Zebra gets away so to speak. And then you see the Zebra an hour ago– an hour later, just grazing on some grass, like nothing happened, right? Could is this punctuated, even though half of its– you know, back side’s gone. It’s like, “Okay. No big deal.” Like, it’s this fight-or-flight response. It’s either off or on, where we kind of sit into this micro off-on, micro off-on all day long from work stress, from relationship stress, and then also food stress, right? I think food stress is probably one of the biggest stressors that keeps our fight-or-flight on. Just eating a lot of refined crap and sugar makes this blood sugar go up and down, up and down, up and down, which then puts a toll on the adrenals. And then also, when you’re stressed, you’re actually burning up more nutrition, right? You’re going through more B Vitamins, you’re going through more amino acids, you’re going through more minerals, Magnesium – those kinds of things. But then, when you’re stressed, what also happens is you tend to crave more sugary sweet foods. So, you see this kind of vicious cycle that happens? Stress issues, more Cortisol, more B vitamins, more Magnesium, but also more cravings for the bad stuff, right? Alcohol, refined sugar, but then, all those foods, they don’t contain all of the nutrients that you’re burning up at higher levels. So, you see that kind of – that little kind of vicious cycle you get into?

Evan Brand: Oh yeah.

Dr. Justin Marchegiani: More stress, more nutrient issues, but then you crave the food that actually contain none of what you need. And actually, to take those foods in, you actually create more deficiencies. When you run those things through your glycolysis and through your Krebs cycle, it actually takes nutrients to metabolize those things. That’s why alcoholics are so notorious for having B Vitamin deficiencies because of the fact, it takes B vitamins to process the sugar and alcohol. So you can actually create more deficiencies by eating things that have zero nutrition. But you create even more than that because you don’t get it in. But also, you have to process that sugar with other nutrition that’s not there, right?

Evan Brand: Yeah. Your gas tank’s already gone empty and you’re trying to push the gas pedal even more. You made a great point about this because many people when they talk about stress, they say, “I’m not stressed. I don’t feel stressed.” That’s like, when you don’t necessarily have to feel the stress, and you might not feel the stress. This could be, all your nervous system. This is your gut. This is your pancreas you’re talking about with the Insulin surges. This is the liver stress, where you’ve got clogged up detox pathways. You’re not actually replenishing your Vitamin C, which every time we look at an organics, I know I see nine out of every ten people…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …in the organics. Their Vitamin C is completely bottomed out. And, for me, I think it’s just the afterburners. You know, in the jet fighter. You can’t use the afterburners forever. You can turn them on, but it’s not designed for permanent use, and that’s kind of us in the modern world. And then also, the workload too. It has increased, which, you know, some people, maybe they can’t change that, but I believe  a lot of people – they’ll tell me that they’re going on a vacation but they’ll still bring the iPad or the tablet or the computer with them to continue working. And so, even when we’re paying for a vacation, we’re still not letting that nervous system ever fully kind of hit the reset button. So, you get back home, and you still feel just as stressed, if not more stressed, because you left your home environment and you just worked the whole time. And then, obviously, there’s the deeper issues that will get into today as well. So, I’m gonna start off, since you already hit on the diet…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …piece. Let’s just start off with talking about a Vegan diet as a cause of fatigue, or specifically chronic fatigue. We’ve hit on Vegan diet so much, and I believe maybe, maybe, maybe you could do it right if you just tried extremely hard. You could survive. Could you ever thrive? I don’t know. I don’t know in a completely Vegan. Maybe vegetarian. We’ve hit on this. I won’t beat the drum too hard, but ideally, if you’re getting your good animal proteins that are pasteurized, you’ve got your digestion actually working, you’re gonna get a lot more minerals, trace nutrients. You’re gonna get your eye Iron, which are gonna help to prevent Anemias, which is also on our list of causes of Chronic Fatigue. You know, a lot of times, Vegans are gonna show up on their blood work with different type of Anemias. And then, when you and I run blood work for thyroid, a lot of times we’ll see thyroid issues too. Like elevated reverse T3, which is like the blank bullet, for people listening, “You’ve got your revolver but you’ve got some blank bullets in there.” Because you run a Vegan diet, the body thinks it’s starving to death. So, it says, “Well, Evan, I don’t know when you’re gonna eat, so I might as well hold on to as much body fat as I can. This is why, so many Vegans, you’ll see they’re actually overweight. And it’s like, “Wow. You’re living on vegetables but you’re still overweight. What’s going on?” A lot of times, this whole cascade: the adrenals, the thyroid, the fat storage, the malabsorption issues, all the beans and digestive problems that they’re experiencing. This is like another vicious cycle that could be kind of similar to the standard American diet cycle, you mentioned.

Dr. Justin Marchegiani: Totally, and now, when you look at Vegans, right? The people that do best on Vegan or vegetarian diet, are the ones that are going to be the least Insulin-resistant. So, let me say in another way. People that are the most Insulin-sensitive, right, their Insulin levels, their Insulin secretions are in a good place, right?

Evan Brand: They do best.

Dr. Justin Marchegiani: And then, they do the best because, typically, Vegans vegetarians, they’re gonna be consuming Carbohydrates at 300-400 grams a day, minimum. Minimum just because that’s what it takes if you’re gonna get the protein in, and you’re combining proteins with the legumes and rice and other things like that. You’re gonna be getting a whole bunch of starch in, so your carbohydrates will be at anywhere between 60-70 percent per day on average, if you are a Vegan. Now, also, if you try to do it the – if you’re trying to keep the carbs down as a Vegan, then you typically, are gonna be relying on a lot more protein powders. You’ll be doing rice protein, hemp protein, pea protein, and you’ll probably be having to add in a lot of good fats too, like, you know, nuts, seeds, avocado, MCT Oil, Coconut Oil, Olive Oil. So, you’ll have to really up the fats. And if you can handle the nuts and seeds, they’ll also be really good, but the you’ll also have to get a lot of the protein powders up. And you’ll probably still need, as an insurance policy, a sublingual B12 to ensure that you’re not getting Anemic in any way. So, that’s kind of the big thing, and if you don’t do it that way, if you don’t do the protein powders, it’s really hard. You got to get about 300 grams of carbohydrate as a minimum, if you’re gonna do it that way. And if you have Insulin resistance, or if you have any digestive issues, you’re gonna have to do a lot of legumes, and there’s gonna be a lot of lectins in there and a lot of potential mineral and protein disruptors there. That’s why, you know, Beano is such a popular supplement to break down beans because a lot of those foods require a lot of enzymes to break it down. It can be harder on your digestive system. Again, some people can do it. the question is, how do we differentiate why can some people do it, and it’s– a lot of it has to do with Insulin resistance, right? The more Insulin-resistant you are, the better you’re gonna with meat because you can get a whole bunch of proteins and fats without the whole bunch of carbohydrates too. [crosstalk] And it’s very nutrient-dense. I mean, there’s a lot of B Vitamins in meat. If you look at the top B Vitamin foods, they’re gonna be meats. And we just talked about B Vitamins: how important they are for Chronic Fatigue. Fish, meats, pork, they’re gonna be really high in B Vitamins. Also, nuts and seeds will be right behind there too. So, that’s kind of a good take home.

Evan Brand: Let’s chat about Labs for a minute. I mean, I mentioned like, some of the thyroid markers.

Dr. Justin Marchegiani: Yeah.

Evan Brand: What are you seeing on paper for people with chronic fatigue? How would we break this down? I hit like reverse T3 about– What else is gonna show up?

Dr. Justin Marchegiani: Yeah, so when we look at chronic fatigue, there’s three things on the hormone mitochondria side we want to look at: we want to look at the adrenals, we want to look at thyroid, both of those together. Right? So, making sure there’s adequate T4 to T3 conversion on the thyroids item. Making sure you’re reverse T3 levels aren’t going too high. Number 1, looking at the adrenal side of the fence, so making sure Cortisol’s not too high or too low. And typically, you know, the more chronic the adrenal dysfunction is, the lower the DHEA sulfate will be as well. So making sure the adrenal components could– also the rhythm, right? Cortisol should be having a downward slope throughout the day. And a lot of people, they almost get kind of reversed as the adrenal dysfunction gets worse. And the problem with that is, it tends to significantly – it tends to significantly mess up sleep patterns, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Sleep can do…

Evan Brand: Let me.

Dr. Justin Marchegiani: …bad health.

Evan Brand: Let me restate that just so people understand what you’re saying. So, when you’re try to med a reverse pattern, what we’re gonna see on your saliva test, will be low, depressed morning levels, but then we’ll see an elevated level of Cortisol in the evening. [crosstalk] So, you’re exhausted in the morning, but you’re also wired and tired at night. So, you can’t sleep yet you don’t feel rested in the morning. We see that a lot, and we’ve done videos and podcast on a specific topic, but a lot of times, it’s due to some type of stress, like an argument at dinner, or someone’s doing bluelight at night. You know, even just a tiny amount of blue light from your phones, your tablets, etc., can crank up Cortisol. And you can fix it, with the lifestyle strategy and there’s herbs you can use to lower evening Cortisol, like Relora. We’ve chatted about that before.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And like the Magnolia bar, can some of that…

Dr. Justin Marchegiani: Yeah, and I’m just doing so. My supplementation right now is doing some adaptogenic herbs.

Evan Brand: Yeah, what did you take?

Dr. Justin Marchegiani: I’ve just taken my Adrenal Revive, which has Rhodiola-Ginseng-Ashwagandha combo. And then I would just take in some amino acid and some mitochondrial support. Just to make sure I am revved up in that maximum potential. And, this morning, I had three hard-boiled eggs. I had two pieces of bacon, and then I had some coffee with butter and MCT and 15 grams of Collagen peptides. That’s kind of my day so far. And little workout actions, I’m feeling good. So, just kind of reader in what you said, we have the adrenals, we have the thyroid, we have the mitochondria component, and the mitochondria is the B Vitamins. That’s the CoQ10. That may be extra Ribose. That may be extra Carnitine. That may be some of your Krebs cycle, intermediary compounds, like Fumerate and Malate and Succinate. So these are all really important things that can help the adrenals that I mentioned, the thyroid and the mitochondria. So, all three of those needs to be looked at. So, my analogy is for energy, the adrenals are what shifts the gears. So, if you’re from first gear to second gear, second to third, third to fourth, that’s like a standard kind of transmission, right? You shift the gears. You go up, you go fourth to fifth gear. Now you’re at highway speed, right? As you shift the gears up, that’s you generating energy so you can deal with and meet the stress, right? That’s a faster speed. You downshift so you can relax and calm down and control your nervous system. Those are like adaptogenic herbs. That’s like GABA. Here’s some GABA right now. I’m doing a little downshift action if you will. So that’s upshift and downshift. That’s the adrenals. That is your body being able to meet the demands of stress and be able to calm down from the demands of stress. That’s adrenals. Two is thyroid. That’s your resting engine tone, right? You put that car in neutral. Let’s say it’s around 700 rpm on a normal day. Maybe on a cold day, it’s 1200 to 1400, right, because the engine’s really cold. It’s got to generate more heat. So that resting engine tone, that’s the thyroid. I think of the mitochondria as the gasoline and the lubricant that’s in the car, right. It’s the engine. It’s the oil in the engine. It’s the gasoline in the tank. It’s the fluid in the car, whether it’s wiper fluid revrols. It’s the internal fluids that help that car to run. So, thyroid is resting engine tone, right? And we know what happens if the engine tones too low, the car stalls out too, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: So, if it goes too low, you stall out. That’s like hypothyroid, right? You’re stalling out because you’re getting tired. You’re getting fatigue. You’re getting cold. So, let me go back. Number one is gonna be your adrenals that’s being able to upregulate or downregulate stress. Number two is your thyroid. That’s your resting metabolism, your resting engine tone, right. Too high, you burn up. Too low, you stall out. Number three is the fluids and the internal fuel in the car, right? The gasoline, the oil, all the fluids to help that car run. So, that’s kind of my analogy on the metabolic side of energy and chronic fatigue. We ca go a little bit deeper in, next.

Evan Brand: Yeah, yeah. Well– well said. I love your analogies. I think there’s been a few recent podcasts where I’ve not heard your analogies. So I’m glad that you’re ripping those out. Let’s chat about now, we hit on Anemias. We hit on kind of the three-body system approach to this whole thing. Let’s talk about the other factor. We hit on blood sugar already. Let’s talk about heavy metals, Lyme disease, Epstein-Barr. You know, some of these underlying…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …that could be driving the adrenal-thyroid detox problem issues. Mitochondria [crosstalk] issues. A lot of times they go unaddressed. Now, there’s some people out there that their whole business model’s wrapped around, like, one piece of the puzzle, like, methylation, which is a factor, but it’s not…

Dr. Justin Marchegiani: [inaudible] …your Lyme.

Evan Brand: But it’s just a factor, right? I mean, when Justin and I are working with people, we’re never just saying, “Look. This is your one thing. There’s never one thing that broke you and there’s not one thing that’s gonna fix you. It’s always a combination of these factors. So, if you had a diagnosis of like Epstein-Barr, or Lyme, or mycoplasma or cytomegalovirus, or these other infections, or heavy metals. Somebody says, “Oh. You’re toxic with Mercury or Lead.” You know, yes, those issues have to be addressed, but they’re not gonna be 95 percent of the problem. They’re gonna be a piece. Now, what percent of the pie? We don’t know, right? Because it depends on like Justin said, your diet. What kind of diet are you following? What’s your stress load? How many hours are you working per week? How well are you sleeping? What’s your EMF exposure? What’s your exercise exposure? What’s your light environment? Are you actually getting bright sunlight in the morning, and you’re kindling down and you’re not using artificial light in the evening, right? All these factors will pile on top of Lyme, heavy metals, Epstein-Barr, mono, etc., and that can make you or break you.

Dr. Justin Marchegiani: Hundred percent. And of course, the diet to be there because inflammation – one of the major factors of inflammation’s gonna be through your food, right? So, making sure the foods dialed in. again, that’s anti-inflammatory nutrient-dense low toxin. Our approach is gonna be kind of a Paleo Template. That’s macronutrient gnostic, so getting the protein fat and carbs right and dialed-in for you, for your metabolism, and for what you can actually digest. Because some people had a hard time with the whole food component because it has – it involves digestion. And if that’s not good, we have to make some modifications there. And that dub tails into the next component, which is digestion, because if we have problems digesting food, that’s where all the nutrients come into our body. So, if we can’t break that down, that’s an issue. And not breaking down foods actually creates a stress in the body. So, if we can’t break down the foods, then the foods ferment, putrefy and rancidify in the gut, and create more stress and more bloating. And then, if we get really stressed and we have a hard time evacuating our bowels or moving our bowels, right, it may get more in the constipated side and then we start getting this auto-intoxication phenomenon where we start reabsorbing a lot of the toxins that are in our stool. Right? That’s not good either, right? We’re literally drowning ourselves in our own toxins. So, that component’s there. And then, we need the enzymes and Hydrochloric acid and we know that’s important and stress affects that, right, because the more stressed we are, the more the sympathetic nervous system decreases enzymes and decreases acids. Also, infections, right? All of these things interplay because the more stressed we are, the more digestion’s poor. Infections can come in, and infections amplify all of the things that we’re talking about. And infections then create more leaky gut action, right, where the tight junctions in the Epithelium lining open up and then more of those compounds in our gut get into our blood. And then our immune system interacts with them more, which then creates more immune stress. And your immune system is 70-80 percent in your gut, so the immune system always being active, it will really suck up a lot of your energy. That’s why when you get sick and you have like a flu or a cold, you’re really tired. You’re not tired because of the virus, you’re tired because of the immune system allocating resources to kill the virus. So, if your immune system is always upregulated, it will suck a lot of energy from you.

Evan Brand: How about gluten, as a simple immune stress?

Dr. Justin Marchegiani: Yep. That’s why cutting gluten out can really improve people’s energy because number one, it’s gonna create gut inflammation if you’re gluten-sensitive, which a lot of people are. Number two, you know, unless you’re eating the best kinds of grains, there’s still gonna be a lot of Round-up and glyphosate and chemicals and lectins and gut irritants in there, even if the gluten component’s not a problem. So, that may drive more leaky gut, which then creates this more immune reactivation, upregulation, which then starts to suck energy out just like when you get sick from a coal.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, that’s why cutting those things out, really decrease your immune cell activation.

Evan Brand: Well said. I want to circle back to couple things you mentioned about malabsorption digestive problems. People may want to know how do we quantify that? Well, you know, our philosophy’s “Always test. Don’t guess,” So, like when we’re looking at a stool test for someone, we can look at secretory IGA, which is kind of that first line of defense against infections. Oftentimes, we’re gonna see that real low. In terms of stools, obviously, you can look at your stool, if it’s floating, you know you’re not digesting your fats. So, if you’re trying to implement a Paleo or a Ketogenic diet, and your stools are floating, we know you’re not digesting. But we can also measure it with Steatocrit, a fecal fat marker…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …which is important because we can track this stuff. So, people say, “What’s the value of testing? Can I just, you know, take all these supplements and do the diet?” You can, but eventually you’re gonna spin your wheels because you’ve got to have the diagnostic data to figure out what’s going on. I had a woman last week, who her gluten antibodies were above 400 and she told me she hadn’t eaten gluten in four years. And we know that the gluten antibodies can be elevated for six months, but not for four years. And so, I told her, “Look. There’s got to be some exposure if you promise me the diet’s clean. One lady I found had a chopstick she was using everyday with wheat germ oil on her chopstick. And that was causing her antibodies to go up, but for this lady, you know, I’m thinking it’s something with her skin care products. She said she loves wearing makeup. So, I’m guessing she’s got some gluten in her makeup somewhere. And that’s a stressor too. So, like even if you’re listening, like, “You know what. Justin, Evan, I’ve heard you guys a million times about the diet. I’ve already got a gluten-free diet. If you don’t test for your anti-gliadin antibodies, you’ll never know because these people that come to us and say they’ve been on the gluten-free diet for years, but they’ve still got issues like fatigue, boom! Now, we’ve got the Lab to prove it and we can see why.

Dr. Justin Marchegiani: Hundred percent. Hundred percent. So, again, the gut component’s really important, and we know there are certain infections that– You now, we’re not gonna go into the treatment because we can do a podcast in each one.

Evan Brand: Yeah.

Dr. Justin Marchegiani: We know things like H. pylori, Blasto, coarse Lyme, which is Borrelia burgdorferi. We know the co-infections of Lyme, like Babisia, Bartonella, Alexia, right? These are different things. Mycoplasma. Mycoplasma’s a big one with chronic fatigue. I think your wife had that at one point…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …after a tick bite too. Figure’s back.

Evan Brand: We never even saw a tick. Who knows?

Dr. Justin Marchegiani: Yes.

Evan Brand: I’m guessing it was a tick, but yeah.

Dr. Justin Marchegiani: [inaudible]…IGA levels for mycoplasma. They’re of the charts, so…

Evan Brand: Yeah.

Dr. Justin Marchegiani: I remember we treated that and your joint pain went down and your energy came back.

Evan Brand: That was scary. That was a scary time, I’ll tell you. So, infections, you know, I’ve got hands-on experience. You know, seeing my wife struggle like that with the infection piece, and she was definitely fatigued. A lot of times– maybe we should mention this. I’m sorry to interrupt you, but a lot of times with chronic fatigued there’s something else going on too, like depression, anxiety, insomnia, sleep issues.

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’s not just chronic fatigue by itself. Fibromyalgia– so, usually it’s not an isolated issue, I found. Which means that more people should be listening. Because even if fatigue doesn’t apply, there could be other symptoms that are kind of complementary to this.

Dr. Justin Marchegiani: Yeah. Fibromyalgia is intimately connected with chronic fatigue. Why? Because, your systems to regulate inflammation are also connected to energy. So, when your ability to generate energy goes down, your ability to resist inflammation or put the fire of inflammation out also goes down. So then, you get very easily sore. You kind of have central allodynia kind of thing where you’re– you know, if I were to just touch someone who has no chronic fatigue or Fibro like, like this, it’s not a problem right? But then, their nervous system is proceeding that as like I’m punching them at full strength, right? So, it’s just hyper upregulation of the nervous system, and also the inability to regulate inflammation. So, the smallest things create a fire, if they will.

Evan Brand: So, it sounds like it’s everything. It’s not just a nervous system  like you mentioned, but you’re saying it will be the immune system at play here too.

Dr. Justin Marchegiani: Yeah, yeah. And then you have the Myalgic Encephalomyelitis, which is the European term for chronic fatigue, right? So, the Myalgic Encephalomyelitis is the other one. So, we talked about the infections, right? H. pylori, Lyme, all the Lyme, co-infections…

Evan Brand: Parasites.

Dr. Justin Marchegiani: …parasites, Yersinia. These are gonna be big. And again, the reason why they could be so big, is because of the immune activation, number one. Number two, because of the leaky gut, which then exacerbates the immune activation. Number three, the impaired digestion, right? The impaired digestion which means Hydrochloric acid and enzymes drop. And then number four, it’s gonna effect the gut bacterial balance in the gut, right? More bad bacteria than good.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Right? Just like when there’s sharks in the water, the sharks got all these little kinds of things sticking to its underbelly. They try to get a free ride, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: But when there’s parasites there, you get those kinds of things. They try to get a free ride as well, i.e. dysbiotic bacteria, and then, these things are gonna eat up more of your B Vitamins and more of your nutrients. And we know that more beneficial flora actually produces nutrition. So then, when you have that lack of beneficial flora, then you have lack of that input of really beneficial nutrients produced by them. And then also, beneficial probiotics produce more healthy acids that keep the environment in the gut uhm– let’s say, inhospitable for the bad guys.

Evan Brand: Yep. Yep. I’m glad you hit on the piece of them stealing your nutrients, and also the point about the dysbiotic flora is awesome. It’s like your powerplants. If you have a bad diet, but you’ve also got dysbiosis, I mean, I can’t think of a better combination if you wanted to create chronic fatigue and to wipe out all the good guys. So also, you know, maybe this is worth mentioning. Antibiotics too. I mean, we’ve seen people with chronic fatigue that it happened after a round of antibiotics to the point where some people are almost wheelchair-bound or bed-ridden due to massive rounds of antibiotics, especially someone, let’s say, they got a Lyme diagnosis. They start doing a bunch of antibiotics, then their chronic fatigue due to everything going on. They’ve just destroyed themselves.

Dr. Justin Marchegiani: Exactly. Hundred percent. And again, there are studies about bacterial cidal antibiotics induce mitochondrial dysfunction, right? And I’ll pull up a study here and we’ll go through at least the conclusion part. And we’ll put the references on below. But I have a study here on mitochondria and antibiotics, and I have a study here on the mitochondrial dysfunction in heavy metals. Because we know heavy metals are a really important component. We get exposed to them in our environment. It takes nutrients to detoxify from heavy metals. So, if we have poor nutritional issues because we’re not eating good foods or we’re not digesting those foods, then all those amino acids and healthy sulfur-based minerals aren’t gonna be utilized for phase I and phase II detoxification as well.

Evan Brand: Yep. Well said. I’ll also add in occupational exposure of heavy metals too. I was working last week with a female in her 70’s, a retired dentist, and I said, “What’s your exposure to mercury over your lifetime?” And she laughed and she said, “Oh, Evan, you know, back in the 50’s,” She said, “I was putting Mercury in my hands to show the kids all the things you can do with it.” So, who knows how toxic she is. We’ve not tested her, you know, quite yet. But, I mean, dentist? What else would be toxic occupations you would say? I would say anybody who’s working on a ramp, like at an airport, people that are outside breathing in jet fuel all the time. We’ve got…

Dr. Justin Marchegiani: Chemiist. Potentially, Chemist, those people. I would say, the big one I think is a lot of people that are doing a lot of lone care work.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Their spraying a lot of pesticides or chemicals or glyphosate, right? So, a lot of potential things and they’re getting exposed to, and a lot of times, they aren’t going to the proper precautions regarding exposure. They’re just uneducated about it.

Evan Brand: Right. And I think we hit on this. Maybe not on this episode but as we know, glyphosate damages mitochondria too. So, you just brought up a study about antibiotics. We know glyphosate does the same. So, if you’re not eating an organic diet, I mean, it’s gonna be tough to get you out of this whole. What about– Let’s see. I mean it’s not too common anymore, but people who work in like a toll booth all day, where there’s cars, or a drive-through. People who work in, you know, say Starbucks. You are working at the drive-through. You’ve got these cars pumping out exhaust fumes. They’re breathing in that stuff in all day. I think all the guys at UPS that worked out on the ramp. You know, the meal of the night when you’ve got these big planes, just putting out tons and tons of jet fumes.

Dr. Justin Marchegiani: That’s really tough. Yeah. And I know we see a lot– I know you run a lot of the GPL-TOX Screens and you see a lot of benzene and a lot of, basically, by-products from gasoline metabolism, right?

Evan Brand: Yeah. Yep. That and also, thanks from groundwater contamination too. So, people that are drinking from well water but they say, “Oh, I had it tested 20 years ago.” It’s like, well, fracking and a lot of other industries have destroyed a lot of our groundwater, so you got to make sure that you’re filtering your water too. If you don’t have a good clean water source, that could be another source of your fatigue.

Dr. Justin Marchegiani: Yeah, yeah. I kind of on the fence about fracking. I’ve seen some of the documentaries on them, but I also have some family and friends that live in areas where they have to have water, you know, uhm– basically, trucked in, right? Because the water that they have is so bad. But I’ve also heard from other people that these people, you know, had lots of problems with their water even before fracking. So, I’m kind of the fence about that, but anytime we’re putting toxins into the water supply and we don’t have the ability to filter it out, that’s always really a concern, for sure.

Evan Brand: Yeah, so I guess, maybe we’re kind of all over the place, but we’re really not because we’re building a complete picture of all these different sources. I mean, even Fluoride, for example, if you’re drinking Fluoridated tap water, we know that that’s gonna block some of the thyroid functions. So, if you’ve got Hypothyroidism or you’ve got autoimmune Hashimoto’s…

Dr. Justin Marchegiani: Totally.

Evan Brand: …I mean, that could be a source too. So, I use a fluoride filter to remove all that from my water. Because here in Louisville, even though the water’s great tasting, it’s naturally filtered through our limestone, all of our caves here, but still they add Fluoride at the very last step before they send it out to the taps. Which hopefully, there will be a day where that is not the case.

Dr. Justin Marchegiani: Yeah, then they study over in the UK, where they looked at certain towns or sections of areas that have Fluoridation and certain areas that don’t. And they saw an increase in Hypothyroidism in the areas where there was more Fluoridation. So, there’s a correlation with more Fluoride equaling more Hypothyroidism. And that makes sense because Fluoride’s a halide, therefore it can pinch-hit into that Iodine receptor, which is really important for that iodination process of making thyroid hormones. What makes sense why Fluoride could affect that iodination process, for sure.

Evan Brand: Yeah. there was a Chines study too. I’m sure you saw this one, about IQ being lower.

Dr. Justin Marchegiani: Yeah. It’s like seven of ten points. I mean, this is why I’ve invested in two filters in my house. I have a whole house filtered. That’s a carbon-based filter. And then I have one that is a reverse osmosis filter just for the countertop. So I have one that’s whole house, which filters about 50-75 percent of the Fluoride, and then another one that’s countertop. So, that way, the water, like I’m drinking now, is gonna be a hundred percent clean. Now, the one of the Fluorides we have, it actually adds back some of the good minerals, one of those filters. And they also have a trace mineral supplement that I leave right next to the water filter. So, that could take a couple of drops of some minerals where I have some really good sea salt I just sprinkle in. That way, I get the minerals back in too. I always tell people, like, I just– you know, people are like, “Oh. It’s gonna take away all your minerals.” I was like, “Yeah. But what I rather have less minerals and just add them back in or more toxins than I’m exposing myself to.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Because I can always just add some good minerals back in with the Trace Mineral Support that costs like five or ten bucks…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …versus gets exposed to toxins over my whole life, which [inaudible], right?

Evan Brand: Exactly. Yep, and – or using your good Redmond salt or your real salt, your Celtic salts, I mean, you can replace minerals. I agree much more easily than just saying…

Dr. Justin Marchegiani: [inaudible] toxins.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Totally.

Evan Brand: Glyphosate. I mean, parts per billion is bioactive so–

Dr. Justin Marchegiani: Yeah. So that’s why double filter, just to be on the safe side.

Evan Brand: I like that approach. So, when you move it won’t be too difficult. Those are pretty easy systems to install in, who knows

Dr. Justin Marchegiani: Yeah. I mean, typically, I think I had a plumber come in for 200 bucks. He installed both of them. [crosstalk] Pretty simple.

Evan Brand: Nice.

Dr. Justin Marchegiani: Yup, exactly. Now I have a couple studies here I want to kind of dive in. There’s one right here. It’s by the Journal Scientific Translational Medicine 2013. It’s called “Bacterial Cidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells.” Studies on mice, just so you know. It may not correlate a hundred percent but it just gives you some good kind of ideas of why were, you know, trying to only use antibiotics, for like, last case scenarios, but it says that– It’s in the abstract. We demonstrated these bacterial cidal antibiotics induce effects that lead to oxidative damage to DNA, to proteins, and to the cell membranes. Mice treated with bacterial cidal antibiotics exhibited elevated oxidative stress. Markers in the blood, oxidative tissue damage, and upregulated expression of key genes involved in antioxidant defense mechanism, which point to the potential physiological relevance of these antibiotic effects. Now, here’s the interesting thing. What they’re saying is more oxidative damage. What’s oxidation? Oxidation’s when you lose an electron, okay? What does that mean in real life? Cut an apple in half. Watch it start turning brown in front of you. That’s oxidation. Leave a nail out in the rain. It comes back rusty. That’s oxidation. So, what happens in your body, is you have oxidation at the tissue and cellular level. Now that causes more antioxidants, right, which give off an electron to help prevent that tissue from oxidizing or essentially going bad. So, it takes a lot of nutrients out of that reserve to prevent this oxidation from happening.

Evan Brand: Wow. And now– [crosstalk] I also [inaudible] something about the gene…

Dr. Justin Marchegiani: Hold that thought, one second. I want to just dog tail this with the last sentence because it’s – there’s a lot of stuff here. I don’t want to lose track. Give me one last second. [breathes] Now it says, “The deleterious effects of bactericidal antibiotics were alleviated in cell culture and of mice when they administered antioxidants of N-acetyl-L-cysteine, which prevented the preferential bacteriostatic antibiotic deleterious effects so by giving that extra antioxidants and sulfur amino acids. It actually neutralizes the negative effects that happen. Sorry about that. All yours.

Evan Brand: You’re good. Well, you mentioned the word genetic too. You said in that– in that abstract there that some genes were either turned on or turned off that helped to bring on any oxidants. So that’s crazy too. You’re actually affecting things at a genetic level with antibiotics.

Dr. Justin Marchegiani: Exactly. Any other comments on that though?

Evan Brand: Well…

Dr. Justin Marchegiani: About the nutrients kind of help into alleviate some of that.

Evan Brand: Once I wonder is that gonna turn on or reverse whatever happened to the gene as well. You think it will?

Dr. Justin Marchegiani: Well, I mean, if we’re talking about epigenetics, so I imagine, “Yeah it’s gonna have an epigenetic effect for sure.

Evan Brand: Cool.

Dr. Justin Marchegiani: Everything we do has a genetic effect. I mean, just sitting down and meditating for a few minutes will have an effect on your epigenome. The question is, do you do it enough? So, that switch kind of stays on or it’s just a temporary, you know, flicker if you will.

Evan Brand: Yup, exactly.

Dr. Justin Marchegiani: Now, one more study I want to get your take on as well. Now, this is talking about heavy metals, in particularly, Mercury. When we look at heavy metals, we’re kind of talking about Mercury, Lead, Arsenic, Cadmium and Aluminum. Those are the big ones for the most part. But in this study, they talk about– they talk about Mercury, and how it can accumulate in the Central Nervous System. It can impair physiological functions by disrupting your endocrine glands. What do you think he’s talking about there? Probably thyroid, probably adrenal, probably the HPATG-Axis. They talk about the most important mechanism by which Mercury causes toxicity appears to be Mitochondrial damage via the depletion of Glutathione, coupled with binding to thiol groups, which generate free radicals. Mercury has a high affinity to thiol, so that means you’re increasing free radicals. It’s also binding up a as an– high affinity to Selenium as well. They’re present in the amino acids. Cysteine– N-Acetylcysteine, again, we just talked about those in the last study too, so keep that in mind. Lipoic acids, proteins, enzymes, NAC, which are all precursors to Glutathione, which is among the most powerful intercellular antioxidants, right? Those have bind up and prevent the loss of electron. When you think antioxidant, think anti-electron loss, okay? Keep on going down the list here, “which among are the most powerful anti-cellular antioxidants available to redact against oxidative stress and DNA peroxidation, right? That’s the– basically, the outer– in the DNA, basically kind of uhm – coming bad if you will, right? When you have peroxidation, it’s like fats coming bad. You heat the fats up too much, you get all the peroxides, it goes bad. The consense of these methylthionines, Glutathione, Selenium and fish and high omega-3 fatty acids appear strongly related to the degree of which organic Mercury, and the protective detoxifying mechanism in human. The inclusion depletion of Glutathione, mitochondria increase lipid peroxidation and increase oxidative damage of proteins and DNA in the brain. So, let’s break that down. What did that say? It says Mercury – increased Mercury, is gonna cause more peroxidation, oxidation, right? That all just means damage. Think about that as damage. It’s gonna deplete a lot of those nutrients that help make Glutathione your master antioxidant, which include your sulfur meal acids, cysteine, glutamine, glycine, alpha lipoic acid. But it talks also about more of those nutrients, fish oil, glutathione, cysteine, Selenium, can also help, too, though. Again, you’d probably have to do it in a supplement form to get enough of a therapeutic level there.

Evan Brand: Cool. That’s awesome. I’ve got one study too to add to this pile?

Dr. Justin Marchegiani: Great.

Evan Brand: It was from American Journal Clinical Nutrition, and I’ve seen this actually on a piece of paper on Organic acid. So, I can confirm that this is accurate because I see it time and time again. Vitamin C elevates red blood cell glutathione levels and healthy adults. All it took, uhm– they had a course, placebo, and then they had 500-milligram dose, daily dose, of Vitamin C, and then they had 2000 milligram daily dose Vitamin C for four to five weeks. And that was enough to elevate glutathione levels by– let’s see. What the brains and the subjects. Some humans, they had eight percent more glutathione. Some had 84 percent more glutathione. Justin four to five weeks of supplementing with Vitamin C. And I’ve had people taking liposomal, like glutathione or reduced glutathione, they’re still depleted. Other organic acids, and then I’ll give them Vitamin C, and then the glutathione goes up better. SO, I almost don’t even push people into glutathione supplements because time and time again I see that their levels are still depleted. Like – Look, you could just supplement with Vitamin C and replenish it just as good, if not better. And it’s gonna be significantly cheaper in the long run too because Vitamin C is pennies on the dollar compared to glutathione.

Dr. Justin Marchegiani: How much Vitamin C are you getting?

Evan Brand: I usually do about 2500 milligrams, personally. [crosstalk] I do about a teaspoon a day.

Dr. Justin Marchegiani: …of three grams a day or so?

Evan Brand: Yeah. Give or take.

Dr. Justin Marchegiani: I typically only do glutathione for people that are having more chronic G– more chronic detoxification issues. And I think doing Vitamin C, which is always a good thing, because that’s always gonna help the adrenals too.

Evan Brand: Right. And it’s so cheap too. Like, liposomal glutathione. You could spend what, probably a hundred bucks a month if you wanted to on it.

Dr. Justin Marchegiani: Yeah, I mean. It’s probably a little bit cheaper than that. I know Kroshay and his liposomal – you know, you do maybe two to four– maybe four to 8 pumps a day, so probably six years. So, yeah, it’s definitely more pricy but it just depends, right, on what’s going on and how sick the person is. The average person probably will be better with Vitamin C, but again more toxicity to glutathione may be something to add with the Vitamin C.

Evan Brand: Good. Good, well said.

Dr. Justin Marchegiani: What are the things you want to add, Evan? I think we hit a lot of stuff. We put some research out. Then again, that study by me that I just talked about was the Review of Environmental Contaminants and Toxicology 2014…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …called Mercury Toxicity and Neuro Degenerative Effects. We’ll put the references to these studies in the reference section on our videos, so we’ll put it in there. You’ll see it there.

Evan Brand: Good. Yeah, I just sent you the study I was talking about too in case people want to read through. I think we hit a lot. We should probably wrap it up. I mean, we could…

Dr. Justin Marchegiani: Wrap it up.

Evan Brand: …we could go for hours on this subject, and so we’ve hit on chronic fatigue but not maybe in these much details. So, uh– wrapping up, three-body system approach. It’s gonna recover so much. Adrenals, thyroid, gut, detox functions, mitochondrial. Get all those systems evaluated if you’ve not worked with a functional medicine practitioner before, you can guess and check, sure. You can take random supplements we mentioned, but your results will be limited. Get the testing done. Even if you just get the testing done, and then you want to go on your own journey to figure out what it says afterwards, go for it. But to me, the data has changed my life. I know it changed your life. It changed thousands and thousands of our clients and patients’ lives. So, for me, I like testing. I like to see the piece of paper. I like to see the needle move. Somebody says they feel better. We looked back at organics, “Oh my God! Look. Their Krebs cycle’s actually working now.” That’s cool.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So…

Dr. Justin Marchegiani: Again, up to a hundred percent. Is there any quick questions you wanted to answer by the listeners or do you feel like we hit a lot of them just on our rhythm here?

Evan Brand: I can pull it up. You want to read a couple off. I didn’t have…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …the question list in front of me.

Dr. Justin Marchegiani: Yeah. So, couple things here. From Sam, do you recommend a water softener with a reverse osmosis under the sink or a whole house filtration for home? Again, I would do both if you can, just because of the convenience of having, you know, like– at night, before I go to bed, I’ll grab a quick glass of water upstairs even though it’s not from my reverse osmosis. Well, it’s still really, really good. But 80-90 percent of my water’s coming from my countertop units, so I don’t feel that bad. Plus, it’s nice having– not having to buy shower filters for all the showers in the house. And, if you have gas they can just kind of drink water out of their faucet upstairs. So, I like the whole house, and I like the countertop. And, you know, really, when you factor it, it ends up being like maybe 150 a year, 100 a year. And if you factor what you pay on bottles of water, I mean, you’re paying that in probably every three to four months. Easy.

Evan Brand: Yup. I would use the softener– [crosstalk] So I used to live in Las Vegas. The water there is super hard. Even with the shower filter, you could see Calcium build up. And a lot of people, you know, even my Mom, had kidney stones from the water out there. So, for her, a water softener’s a game changer. I don’t know. I don’t know if it’s all the west coast, if it’s just Nevada, Utah, other states, but man, the water’s hard out there.

Dr. Justin Marchegiani: Yeah. It would totally depend, I think, on where your area is. So, I would uhm– more than like they’re just talk to the company that you’re gonna go with, because they probably have experienced dealing with the whole country as a whole. So, don’t know what areas that you probably need the water softener. And if you know, your water is very hard, then I would invest with the water softener component. I don’t have one but, if I needed one there’s an attachment that you can put on that would soften the water as well.

Evan Brand: Perfect. Perfect.

Dr. Justin Marchegiani: Yeah. And then, regarding infections, they can cause chronic fatigue in themselves because they can create a lot of toxins that can clog up that mitochondria. So, SIBO and infections can add to chronic fatigue just from the toxins, like yeast and the acetaldehyde that comes off the yeast. That can slow down the mitochondria too and create fatigue, as well.

Evan Brand: Yeah. I was fatigued when I had two parasites. I was definitely fatigued, and now my energy’s much, much better.

Dr. Justin Marchegiani: Yeah. And there’s a lot of mechanisms, right? Because – Is it because it’s affecting digestion? Is it because it’s affecting the immune system, which is sucking up energy? Is it because of the biotoxins that are affecting the mitochondria? So, like a lot of times, like, we don’t know exactly, like how much is causing what? But we just know, generally, that this tends to cause it, and here are the kind of mechanisms outline that we know which you can plug in and interplay and have a negative effect. But we’re not gonna know exactly what percentage. But, again, in the end it doesn’t matter if you get better.

Evan Brand: Right. No, it doesn’t. Jack, he asks, “Is AA good source for Vitamin C?” I don’t know what he’s talking about? Do you Justin?

Dr. Justin Marchegiani: Uh – AA, uh- [blows air]

Evan Brand: Ascorbic acid? I’m guessing.

Dr. Justin Marchegiani: Yeah, that’s got to be what he’s talking about. I mean, again, if you do Ascorbic acid, I like to have some of the Bioflavonoids, the Rutin, the Hesperidin, those kinds of things with it. Now, I like the buffered form of ascorbic acid, as well. With like, the Ester kind of in there, and like, some of the Potassium, Vitamin C, salts in there. So, yeah. I think it’s good but get some of the bioflavonoids in there with it.

Evan Brand: Yeah. And I– If you want the optimal, if you’re listening to us, you want to be the top 1 percent of health, I like to mix Ascorbates, where you can do like the Magnesium and Calcium Ascorbates mixed with Ascorbic acid. So, you’ve got kind of like, a Tri-effect of Ascorbates. That tends to work better. Ascorbic acid is the cheapest though. So, if you’re on a budget looking to get Vitamin C, yeah, that may cut it.

Dr. Justin Marchegiani: Yeah. Yeah, I like good buffered Vitamin C as well, but yeah, I think it’s still really good. Just try to use a really good quality, a brand as well, GMO-free, all that’s great. And I think we kind of hit a lot of the other questions, I mean, a lot of people have all the questions that may be off topic. I don’t want to go too far off topic. But of course, you know, if we didn’t highlight enough diet, lifestyle, and sleep are gonna be foundational things. And if you’re not sleeping, we probably have to fix a lot of the hormone stuff. Like the Cortisol Rhythm component that will then help the sleep too.

Evan Brand: Yep, yep. You’re welcome, Jack. Thanks for asking question. If you guys have more questions, you can always email us. Contact Justin through his site, Contact me through my site, We always love questions and we love topic ideas too. So, if you guys have something that we haven’t covered that we need to, you know, we’re happy to – we’re happy to dive in. So, definitely, you could reach out to us at any time for questions and then for consults, too. Justin’s available. And you go to his site, Book a call. We both work with people around the world, so wherever you’re listening, it doesn’t matter. We can get lab test across the entire ocean, to Europe, Australia, New Zealand. It doesn’t matter. And then, the good old United States, we work with thousands of people here. So, reach out,, and make sure to hit the thumbs up button on this video if you’re watching on YouTube.

Dr. Justin Marchegiani: Yeah, if you’re live, get it right now, guys. Give us some love. We’ll come back and we’ll do more of these videos, so give me some hearts or some thumbs up and a couple of shares and likes. We appreciate it. It energizes us, and it makes us want to come back, more frequently and drop more knowledge bombs.

Evan Brand: Take care.

Dr. Justin Marchegiani: Awesome, Evan. Have it a go, man.

Evan Brand: You too.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.


Mercury Toxicity and Neuro Degenerative Effects by Justin Marchegiani on Review of Environmental Contaminants and Toxicology 2014

The other reasons why you may be tired – Podcast #91

Dr. Justin Marchegiani and Evan Brand are connecting the dots as to why some people who have normal adrenals come back still a little bit tired throughout the day. This podcast touches upon the mitochondria and the thyroid, which are the major driving factors of why someone may be fatigued and tired even though their adrenals look good.

stressListen to learn more about dealing with fatigue and inability to cope with stress. Get a better understanding of the thyroid hormones and how they affect the body. Discover facts about fluoride and the effects of drinking fluoridated water. Also find out the benefits of adding mitochondrial support in this interview.

In this episode, topics include:

04:24   Fatigue and inability to cope with stress

11:23   Adrenal, thyroid, and gut issues

14:41   Fluoride

25:32   Mitochondrial support

27:43   Summary









Dr. Justin Marchegiani:  Hey there, it’s Dr. J. Evan, what’s going on this great Tuesday?

Evan Brand:  Hey, good morning, man! I’m drinking some vitamin C and I’m feeling quite—quite yummy.

Dr. Justin Marchegiani:  Nice. Yeah, I got my butter and MCT coffee here, rocking it out, getting my ketones up so in a fat-burning mode today, feeling really good.

Evan Brand:  Great.

Dr. Justin Marchegiani:  How was your weekend?

Evan Brand:  It was great. My wife and I went to Cumberland Falls State Park. It’s the biggest waterfall in the south and I’m gonna be making like a little vlog on my YouTube channel of our adventure. We ended up coming home at like 4 a.m. on Sunday morning because the bed—we rented a little cabin—the mattress in this cabin was so freaking uncomfortable and because of her pregnant belly, she was unable to get in a comfortable position as it is, and it had the worse, like 19.000 springs in it. That–

Dr. Justin Marchegiani:  Oh, my gosh.

Evan Brand:  It—it killed our back. So we tossed and turned until 4 o’clock, and then I said, “Babe, we need to just get up and go home because it’s a 3-hour drive, but we’ll still get more sleep there than trying to lay and toss and turn here.” So—but it was still fun. It did not hinder our ability to enjoy the—the rest of the time we had there.

Dr. Justin Marchegiani:  That’s good. So you survived it. Very nice.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I’m getting back in the gym again, just more frequently and lifting heavy again, doing a lot more—a lot more compound lifts like front squats and you know, deep dead lifts. So I’m feeling really just a good total body soreness. It’s a really good healthy soreness. So I like that feeling. I’m looking forward to bring in that back more frequently, kinda combining that in with some of the high intensity interval training and then some of the—the heavy lifting as well.

Evan Brand:  That is a great feeling, yeah. I’m gonna be back into the gym today. I took probably a week or so off just to—I pushed it a little too hard and that belly button pain where I thought I had a hernia–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  But it ended up being an abdominal wall tear. I felt something—something give. So I was like, “Oh, I’m gonna take a week off and up the collagen.” So now I’m—revisit it.

Dr. Justin Marchegiani:  And I think, too, once you get your infections fully eradicated, what’s gonna happen is you’re not gonna have that viscerosomatic reflex—viscero meaning organ, somato meaning muscle. So when you have inflammation in the surroundings organs, they’re on the same 2-lane sensory nerve highway as the muscles around there. So I think what’s happened is the inflammation in those organs are refluxing to the sensory nerves that go to the surrounding muscles probably at L1 through maybe S2, regarding the spinal nerves, and they’re probably shutting off some of those muscles for support.

Evan Brand:  Ah, okay. So I should be increasing my ability to lift and not feel pain.

Dr. Justin Marchegiani:  Absolutely. Yup, that’s one of–

Evan Brand:  Good.

Dr. Justin Marchegiani:  The big ones. We can do a whole podcast on that piece alone.

Evan Brand:  Yeah, that’ll be fun.

Dr. Justin Marchegiani:  I see a big connection between these organs and inflammation in the organs and the muscles being affected, and we all know this intuitively, right? Anyone that knows about like heart attack symptoms, you know, it’s that left arm pain, left jaw pain kinda thing, right? We see it with appendicitis in that lower right hip quadrant, we see it with gallbladders in the shoulder, we see it with every woman who has had PMS for the most part, they can empathize with some lower back pain right in and around menstruation.

Evan Brand:  Definitely.

Dr. Justin Marchegiani:  So it makes sense, right?

Evan Brand:  Yeah, it does.

Dr. Justin Marchegiani:  Well, we talked before the show and we’re really trying to connect the dots for our patients listening and people that are having health issues, so it’s a practical show, and one of the things that we talked about the last few weeks, we’re seeing people that have normal adrenals but are coming back still a little bit tired throughout the day, and why is that? So we’re gonna help connect the dots with that and we’ve done some other shows on this where we talked about the mitochondria and the thyroid which are some of the—the major driving factors of why someone may be fatigued and tried even though their adrenals look good. So refer back to those shows for anyone that’s listening for more in-depth info, but we’re gonna kinda connect the dots here, just so it—we’re putting everything in once place, because this is a common symptom that we’ve been seeing recently.

Evan Brand:  Yup, definitely. Yeah, so we’ll start the story I suppose with a patient story of mine, maybe you have one as well, and fatigue and inability to cope with stress were some of the main symptoms that we were working on. So we started out with just the adrenal test. Now in a perfect world, you and I would have all of the testing done at the same time so we can get the full complete picture, but sometimes it just works out to where someone needs to proceed with just one test and we have to prioritize that. That’s what we did here is we ran the adrenal test and it showed up pretty normal. I would not consider it adrenal fatigue, maybe some dysfunction because his afternoon level was really low, but otherwise, he was in range throughout the rest of the day and his DHEA level was really good, and so it’s like, “Huh, well.” I know what’s going in terms of the adrenal picture? Why are you only low out of rhythm one part of the day? But your DHEA looks good but you can’t handle stress and you’re exhausted. So I don’t have the results yet, but what I was sort of playing out in my mind is there’s gotta be something going on with the gut because I asked him, kinda went through some of the symptoms that I—I see, and you and I have talked about for GI stuff. I said, “Huh, maybe there’s some type of infection going on that’s, you know, stealing your amino acids and impairing digestion.”

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Because he did talk about some heartburn. So I thought, “Oh, okay, good. We have at least one—one clue here.” And he’s got the vertical ridging on the nails like I’ve had.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  And so we’re running the stool test now. I don’t have the results but let’s just hash it out and say, “Maybe there is an infection or a parasite going on and that’s stealing his amino acids, and he’s unable to make energy from his food.”

Dr. Justin Marchegiani:  It’s very possible. People forget like when we see low amino acids on someone’s organic acid test. And you know, some of those organic acid markers for low amino acids could be—off the top of my head—could be a lactate. That’s a marker that goes low. We see low amino acids. It could be cis-aconitase, that’s another one, or it could be pyroglutamate. These are sulfur amino acid markers. So when we see these low markers, we automatically go back to malabsorption, right? It’s the gut stuff. We automatically go back to stress, because the more we are stressed, our body prioritizes lean tissue.  It—it says, alright, so here’s the mindset of the body, of the epigenome, it’s saying, “Alright, we wanna get rid of the most metabolically active tissue because it takes the most amount of nutrients and rest and hormonal output to—to keep it there.” So we wanna get rid of the most metabolically active tissue in times of stress. It’s kinda like you’re going—you’re going for a hike, you know, at Mt. Washington, right? And your pack’s really heavy. Well, what do you do? You go into your pack and you pull out all the stuff that may not be a necessity. Well, that’s kinda what your body does when it comes to stress and muscle and tissue like that tends to be one of these things that becomes less of a priority, the more stress you get. And also people just say, well, if I have low amino acids, why can’t I just eat more protein? That’s a really good idea. That’s one of the things we work on, as we’re making sure we have a palm to a first to a full hand of protein at each meal. That’s important, maybe even adding a protein shake in, but a lot of times it’s not enough because of the fact that 50% of the energy of the protein that we take in actually goes to breaking down the protein. Protein is very energy depleting regarding just the digestive processes and a lot of people already have broken digestion, so we’re working on the 5Rs and supporting the digestion with hydrochloric acid and enzymes by adding in free-form amino acids, adding in the collagen like you were talking about is a great way to help fill in those gaps.

Evan Brand:  Yeah. Yeah, that’s common that a lot of people, I mean even if they came from like vegetarian or vegan diet, they have trouble adding this stuff back in. Their body is like, “Whoa! We have no resources available to actually start breaking down these meat.” So that’s kind of a slow moving process, too, that I’ve been dealing with over the past week as just trying to work some amino acids in to people that have not eaten meat for a while, and it takes a lot of energy. I mean, that is like throwing the big log on the fire and it’s definitely a little bit troublesome for some people if they’ve done it for 5 or 10 or 15 years, which is just crazy.

Dr. Justin Marchegiani:  Yeah, and I personally believe this is the major reason why a lot of people go vegan and vegetarian because their guts really aren’t working and it’s just easier for them to process more vegetable-based things and they do the shake in the morning, very low amount of protein, maybe they add a tiny bit of MCT in there if they’re lucky, but most of them they aren’t doing it, and they’re avoiding it because their gut isn’t working to begin with. That tends to be the reason why.

Evan Brand:  You know what would be amazing if we could do and get him on board with allowing him—allowing us to run some testing on him would be Rich Roll. He’s got a top ranked podcast as well and he’s got a book about being a vegan and he promotes a vegan lifestyle. He’s got a huge, huge following with this ideology but he’s a skinny guy. So I guarantee if you and I reached out, and we said, “Hey, Rich! Let us run some GI testing on you, I wouldn’t be surprised at all if something showed up in terms of some adrenals issues, maybe some gut issues, maybe infections.” What do you think?

Dr. Justin Marchegiani:  Yeah, it’s very possible. Now a lot of vegans and vegetarians, they could still get away with it if they’re using a ton of pea protein or they’re using a ton of free-form amino acids. Or if they’re–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Using a ton of—it depends—if they’re allowed to do collagen or not. Sometimes in a powder form they can—they can kinda rationalize to themselves, hemp protein, even rice protein, so if they’re doing a lot of extra amino acid—let’s say they’re supplementing an extra 100g a day, well, that’s a huge step in the right direction. So it’s possible if they’re using supplements to get that, the difference is as a meat eater, as someone who is omnivore who eats both, we can get the extra amino acids from meat, without all the extra carbohydrates. When you’re vegetarian, if you’re—forget using supplementation, if you’re just relying off of whole food, it’s really hard to get the protein in there unless you’re doing soy, pure soy, which we know the detriments of that—we’ll have to do a whole podcast on that and the phytoestrogen effect—but for the most part, you’re gonna be getting a whole bunch of carbohydrates with a little bit of protein so the people that tend to do–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Good on vegetarian diets are the ectomorphs because they can handle a lot more carbohydrate and it doesn’t affect them, but the mesomorphs or even the endomorphs, right? So go back to our body typing podcast and videos for that info—they tend to be more insulin-resistant and those extra carbohydrates and even some of the—the lectins in the gut, the anti-nutrients and some of those beans and other proteins that vegetarians eat tend to create a lot of gut inflammation.

Evan Brand:  Yup, definitely. So I guess let’s zoom back in to this issue here of why someone may have like a good adrenal results or decent, you know, maybe it’s not stage 3 adrenal fatigue like most people are. What would you first clue into maybe beyond the gut that could be going on?

Dr. Justin Marchegiani:  Well, the first thing is we—we draw like the first layer I kinda draw a triangle, right? And in that triangle when there’s energy issues, we always look at the adrenals from the top. So kinda draw a triangle in your mind, put A on the top. That’s adrenals. Now, at the foundation let’s say we have adrenal symptoms but our adrenals look decent. So adrenal function is this nice cortisol rhythm, high to low cortisol rhythm, right? It’s where cortisol’s higher in the morning which give us energy and it slopes down throughout the day. So if we have adequate cortisol levels, you know, upper 20s to—to lower 30s and we have a good rhythm, well, then the next piece is we look at at the bottom 2 points, which are gonna be thyroid and the mitochondria. And we kinda already touched upon the amino acids because the amino acids are really important for the mitochondria. That’s a really important piece and when we see amino acid issues, we almost always see B vitamin issues because B vitamins tend to get depleted when there’s malabsorption in the gut. And then we also see other nutrients like CoQ10 and L-carnitine and a lot of the Kreb cycle intermediaries like succinate, fumarate and maleate. We’ll see those off on an organic acid test, and then if we go to the other side, that’s the T side, that’s the thyroid, we can see low thyroid function whether it’s primary hypothyroidism with elevations in TSH from the pituitary or whether it’s low T4, right? Your thyroid is not making enough active thyroid—or inactive thyroid hormone or it’s a conversion issue where we’re not converting T4 to T3, and that could happen from gut inflammation, autoimmunity. It could happen from liver issues and/or just low nutrients like selenium, zinc, and vitamin A and copper, etc.

Evan Brand:  Hey, I was gonna stop you there and ask what the conversion issues, you know, I know if you have some adrenal issues, maybe it’s not severe enough adrenal issues to have like a real diagnosis attached to it, but doesn’t that process cortisol and there some interaction there where you reduce the conversion of the T4 to the active T3?

Dr. Justin Marchegiani:  Exactly. So there’s a couple things, right? If cortisol is too high, that can actually increase TSH and that can block the thyroid conversion T4 to T3. If cortisol’s too low, we need some of it to actually get into the cells and to actually help activate T4 to T3 as well. So it’s kinda like the Goldilock’s effect. We—we don’t want so much where it’s—it’s a sign of a stress response, right? Because when cortisol’s high, too high, it’s typically because your Fight or Flight mechanism, right? Your HPA axis—hypothalamus, pituitary, brain, adrenals are active because your body’s sensing stress, so we have that sign and we have it on the low side where we’re now in a chronic stressed out state and now cortisol’s low. So it’s the Goldilock’s effect. We don’t want acute stress happening and we don’t want chronic stress happening, so just enough to help convert that T4 to T3 as essential.

Evan Brand:  Right, and one other thing I wanted to mention, too, is you mentioned things causing issues with the thyroid and the lack of selenium and things like that. What comes to mind for me, too, is you know, a lack of iodine potentially, maybe a lack of some of the amino acids like we talked about like tyrosine specifically and then what about like fluoride and bromide that people are getting if they’re still eating some processed foods or drinking fluoridated tap water for example. Is that a big factor? I mean, is that something—it’s something on my radar but I just don’t know how big of a needle mover it really is compared to some of these other ones.

Dr. Justin Marchegiani:  Yeah, I got a video lined up at my queue on my Trello board that I’m gonna do a video on fluoride for the thyroid because they’ve had an epidemiological study over in Europe come out last year where they looked at people who consumed fluoride water, based on the water systems, like they looked at various towns in England. And they found like the towns that had the—the more fluoride in the water had the higher incidence of hypothyroidism.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So more low thyroid function was present in people that were having higher amounts and more fluoride consumption in their water supply. So there’s definitely an effect there because fluoride is a—it’s a halide. I think it’s the 6–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Or 7 periodic table element. I’d have to—to look it up again. My—my biochemistry is a little but fleeting right now, but that—that group, that 7 periodic table, I think it is—is the halide family. Iodine sits there as well and basically, fluoride can get in there and kind of pinch hit and knock fluoride—I’m sorry, knock iodine out of its proper function and role of the iodenation process which is making thyroid hormone, right? When we see T, for T4, that stands for tyrosine. We see the 4 or the 3, that stands for the amount of iodine molecules that are there. So we know iodine is important building block for the production of thyroid hormone.

Evan Brand:  Yeah, the—I’ve been sounding the alarm on fluoride for a while, but I still feel like there’s not enough light on it, and so I guess I’ll do a video as well, and you know, the other piece of it that I looked at, which is maybe a little off-topic, but there’s a study out of China that was looking at children. Some that were exposed maybe different towns like you said, a fluoridated town versus non-fluoridated, and there was a difference of 7 IQ points. When the kids were fluoridated, 7 IQ points lower than a non-fluoridated town. So there is a huge impact on our intelligence as well and it’s no surprise that most of the United States is fluoridated except for 2 cities, I think it’s Portland and I wanna say it’s Houston, which sounds bizarre.

Dr. Justin Marchegiani:  I think—I’m pretty sure it’s Half Moon Bay as well. I know Half Moon Bay up in the Bay Area is an—is a one water supply that was not fluoridated. We had a—when I was in doctoral school, we, a whole class, a whole Public Health class based on us going through the literature on fluoride and it’s pretty crazy the stuff that fluoride is linked up to in the hard core science that people don’t wanna talk about.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I mean, like the study that you mentioned, I’ve read Mexico studies. These studies that happened in Mexico where it was like 10 to 15 IQ points. Like just scary stuff and in that—that halide group there is also chlorine, too, and bromine. And bromine, you’re gonna find that in a lot of your conventional bakery foods, a lot of your conventional grains, right? That’s why more reasons not to consume grains. And then your chlorine you’re gonna get that in your conventional water supply as well, so it’s like a double whammy. You don’t just get the fluoride, you get the chlorine as well which are—are problems. And then also people that—that studied fluoride, I’ll have to have like Dr. David Kennedy come on board here or Dr. _____, they’re some great experts on fluoride. But when you get fluoride, it’s not just like sodium fluoride. It’s fluorosalicylic acid which actually has a lot more dangerous compounds in it than just fluoride. So again, those molecules can come in and pinch-hit in the thyroid and really downregulate the thyroid function and the 1940s in Germany, they were using fluoride to treat hyperthyroidism and that was—it was literally a prescription medication that was given to people that had Grave’s or hyper symptoms and because it would go in there and—and pinch-hit and knock down that thyroid function, kinda like reverse T3, you’ve kind of alluded to it. Reverse T3 is when we’re in a stressed out state. Your body will convert T4 to reverse T3 which is like putting blanks, metabolic blank bullets in your metabolic guns so when you pull the trigger, yeah, you get the sound of a bullet, but there’s no bullet that actually comes out, right? You get the hormone going into the thyroid receptor but you don’t have that same kind of metabolic effect, which means you’re gonna have lower thyroid symptoms, the more metabolic reverse T3 or are T3 blanks that that are produced because of stress.

Evan Brand:  Yup, so yeah, and I think I may have mentioned it before but in the concentration camps, in the same time zone around, you know, 30s, 40s, sodium fluoride was used in the water, probably high, high, high doses for the concentration camp victims to keep them very docile.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  And very numb almost like operating like a sheep, so not to get conspiratorial here, but hmmm they’re—you know, a lot of our founding fathers said there should be a revolution in the United States every 10 years and it has been quite some time since we’ve had any type of major uprising, and our whole country generally is fluoridated and a lot of people are unhappy with what’s going on in the country, but we’re all fluoridated so it’s almost like we’re too numb to actually respond or actually get energetic enough to do anything about it, so that’s crazy.

Dr. Justin Marchegiani:  Well, it’s do—it’s doing something. We know it, just like, you know, let’s just stick to the facts here, right? We know it’s affecting the thyroid. We know it’s affecting—we know thyroid has a big effect on IQ, right? You look at many women that are—that have low thyroid hormone levels, they’re hypothyroidism through pregnancy, right? We know that that can create lower IQ in the baby, especially if the thyroid problems are caused by very low iodine levels. We know that can cause a form of retardation called cretinism, right? That’s a—that’s basically a totally preventable form of mental retardation because of very low iodine levels. We know it’s affecting the IQ as well just in people that have—were born healthy but are just consuming a lot of it. And if you look at the drug, Prozac. Just look at the organic chemistry of it. Just go to and pull up the organic chemistry of Prozac, you’re gonna see the major molecule of the drug is centered around is a fluoride molecule. So we know that there’s a lot of things that that drug can do, not a lot of good things per se. Now there may be some things like calcium fluoride that are more mineral-based in the water, that are more natural. We’re—we’re talking more of the sodium fluoride and the fluorosalicylic acids that are synthetic, man-made, typically as a result of the—the fertilizer/bomb-making industry. These are a lot of the by-product of those industries and a lot of this actually came about after World War 2 from all the excess bomb-making material that was basically from all the industry, right? A lot of our industry went to making weapons for World War 2, and then this—all these residual things were leftover afterwards, and this is what we’re getting exposed to today. And some great books on this is like Christopher Bryson has a great book on fluoride. See I think that’s Paul Connett. He’s an organic chemist over at St. Lawrence University. We have Dr. David Kennedy, DDS, phenomenal guy, great stuff on fluoride as well. So lots of good information out there and also lots of studies, too. Just Google Harvard Study and fluoride. You’ll see fluoride will actually increase your risk of osteosarcoma especially in boys. These are like a bone and muscle tumors. So we know there’s an increased risk for these compounds and they can affect your thyroid and they can create some of these energy issues that we’re talking about outside of just adrenals.

Evan Brand:  Yup, definitely. So long—long diversion but that still ties in to exactly what we were talking because we’re not gonna be able to see specifically, “Oh, are you getting fluoride exposure?” So we’re just gonna have to kind of ask and pry you for this question and so if you do have fatigue, if you do have hypothyroid symptoms, this is something to really look at and make sure that you are being more diligent about filtering your water. I know Justin you have a whole house system and your water tastes really good. I got to taste your water, and you know, I’m typically going to be doing some type of spring water which does have some natural fluoride but like you mentioned, it’s not the same.

Dr. Justin Marchegiani:  Not the same, yeah.

Evan Brand:  So, yeah, so really, you know, getting a good grip on your water. If that’s the only take away you get from this podcast today, then that’s—that’s fine because this is a factor that is still overlooked, and I can’t tell you the amount of people that I still see drinking tap water. One of my wife’s friends when we were down in Austin, I got on this whole subject with her and was talking about the science and all of that, and she goes, “Evan, I’m not scared.” And she goes over to the sink and pours a big glass of tap water and just starts drinking in, and I’m just like, “You’re not hurting my feeling by doing that, I’m just trying to help you,” you know? And so a lot of people are still—they think this is like a tin foil hat subject for some reason.

Dr. Justin Marchegiani:  I mean, this isn’t that controversial. Just go to the CDC’s website and just look at—just google fluoride and cavity. The CDC’s admitted that the children between 13—or 10 and 14 or 10 and 16, the major cause –the major cause of cavities in that age group is actually—it’s called a dental fluorosis, meaning excess fluoride in the drinking water. That’s like the major cause of cavities in these younger aged children.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  It’s like, my gosh, I mean I have con—I have conversations with dentists and they aren’t even aware of this stuff, but it’s like the CDC—it’s like it’s admitted that it’s out there. I mean you can just google these things, just type in CDC dental fluorosis, major cause of cavities, and you get a whole bunch of studies coming up and you get the CDC even saying it. So we know it’s out there. It’s real, just you know, things don’t get talked about because there are financial interest out there that, you know, benefit by having that there. So we just wanna empower people, be aware of it. Do your own research, right? That old, Reagan quote, “Trust but verify.” So do some Google work. Pull up some of these studies on Google Scholar or PubMed and do your homework on it, but forget fluoride, right? We know that there’s a lot of other crud and crap in the drinking water. Pharmaceutical drugs are getting in the water, because we don’t have means of filtering these things out, that people throw the—the drugs in there, down the toilet or you know, emptying them out or we have pesticide and chemical residue that goes into the drinking water supply as well. So everyone in their home should have a water filtration system. I have two. I have a whole house water filter, as well as a countertop filter that’s reverse osmosis based that filters out everything and then infuses some minerals back in as well.

Evan Brand:  Yup, that’s great.

Dr. Justin Marchegiani:  So any additional comments on the mitochondria part or the thyroid part, Evan?

Evan Brand:  It’s—it’s something to factor in for sure, you know, if you’re struggling with your program and it hasn’t been addressed. It’s something that you definitely wanna take in to consideration. The mitochondrial support, you know, we talked about the adaptogens a lot. That’s something that I like. I like some of the ribose and some of the PQQ and the other super mitochondrial boosters. It may not be necessary for you, you know, if you look and you get the organics run if you haven’t had it run, you know, by one of us, that’s something that you can have done. A lot of times we’ll see some mitochondrial issues on there and then we’ll know, “Okay, you do need some good mitochondrial support,” and then we bring it in and then the lights come back on and people feel amazing. So it’s always fun to really help people feel better. I think that’s the funnest part about my job is when you jump on the phone with somebody and we’re like checking in, you know, “How are you feeling?” And the energy has tripled. It’s like that is so priceless and it cost maybe $30 for a bottle of supplements that we just needed to prove that they needed and they feel better, so this—I’m just a huge proponent of what we do.

Dr. Justin Marchegiani:  Yeah, and then again, right? The reason why we need these things are either because one, we’re burning the candle at both ends and we’re burning through these nutrients faster, and/or we’ve had a poor diet in the past so we have to make up for that, and/or because we’ve had malabsorption because of infection. So you know, we’re—we’re changing the diet. We’re getting to the root cause. We’re fixing the underlying lifestyle and dietary stressors and then also making sure our body is detoxifying, right? Toxins rev up our need for antioxidants and B vitamins and all these minerals that you’re talking about, too. So toxicity from the water. Toxicity from the air, poor food, all of these things are gonna deplete you as well.

Evan Brand:  Yup, definitely.

Dr. Justin Marchegiani:  Well, any additional take homes here, Evan?

Evan Brand:  Not for today. I think probably have to break this up into more podcasts. I know you and I both gotta go to a call, but also there’s a lot of info just in here and we can kind of navigate the river and go down some more smaller diversion topics that we can break down further, but there’s always—there’s always next time.

Dr. Justin Marchegiani:  So I think that the bullet—the bullet point take homes from today’s call is get your adrenals tested, number one. Get on an adrenal program that includes diet and lifestyle and supplement changes. Number three, if you’re not getting the results you’re looking for—5 to 10% improvement each month, then we gotta look at the thyroid. We gotta look at the mitochondria, be it the organic acids, and then once we have that dialed in, then the next piece would be the gut afterwards. Is that a good take home, Evan?

Evan Brand:  That sounds great.

Dr. Justin Marchegiani:  Awesome, man. Well, best of luck with your patients today. You’re gonna knock them dead and we will talk really soon, my man.

Evan Brand:  Same to you. Well, hopefully, I’ll knock ‘em alive.

Dr. Justin Marchegiani:  Knock–yeah, I’m sorry. When I say knock ‘em dead in a good way. We’re—we’re getting to the underlying causes of why they’re feeling the way they’re feeling, but yeah, I get it, man. Cool.

Evan Brand:  Totally. Same to you, my man.

Dr. Justin Marchegiani:  Alright, you take care.

Evan Brand:  See ya.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.

Adrenal Fatigue Treatment and Symptoms | A Brain Problem

By Dr. Justin Marchegiani

Adrenal fatigue is one of those catch-all terms in the functional medicine and paleo community. Let’s dig a little deeper into adrenal fatigue and adrenal-fatigue treatment.

Adrenal-fatigue symptoms include the following:

  • Dizzy when standing up fast
  • Sweet cravings
  • Weight gain
  • Anxiety
  • Fatigue
  • Low thyroid symptoms (cold hands/feet, thinning hair, and low body temp)
  • Low immune function (gets sick easily)
  • Chronic pain/fibromyalgia-like symptoms
  • PMS/menopausal symptoms (your adrenals produce a significant portion of sex hormones)

When the term adrenal fatigue is used today, it is used inappropriately most of the time. Most people don’t have a gland that is fatigued like you may see in a long-term type II diabetic’s pancreas that now needs to rely on insulin to stabilize the blood sugar.

The adrenal gland’s lack of output is mainly occurring due to HPA-axis dysfunction; in other words, the brain is not communicating to the gland appropriately.

It’s like a thermostat that talks back and forth to the heater and the AC unit in someone’s house. As the temperature outside increases, the AC would kick on and vice versa; if the temperature would drop, the heat would turn on.

This intimate back-and-forth communication happens because the brain and adrenals cross-talk back and forth. This is how we as human beings adapt to stress. The better our brain can communicate back and forth, the more resilient we are.

hormonal stressors

Adrenal Fatigue Means Our Body Breaks Down Faster

Our adrenal produces a balance of various hormones:

Catabolic hormones:  Hormones that break us down, deal with inflammation, and liberate energy.

Anabolic hormones: Hormones that build us up and keep our body reproducing in a healthy fashion.

When our body deals with stress acutely, our cortisol and adrenaline increases to help mobilize energy and put out the fire of inflammation. Yet at the same time, our anabolic hormones (DHEA, progesterone, and estrogen) stay at healthy levels so we can adapt.

The more frequently our body has to deal with stressful situations like these throughout the years/decades, you will start to see the body breaking down faster because the catabolic hormones outnumber the anabolic hormones.

The Cortisol-DHEA Ratio

Our body shouldn’t be producing cortisol at a level of greater than 6 units of cortisol to 1 unit of DHEA. As our cortisol becomes >6, our body is shifting into a catabolic state (breaking down faster or accelerating the aging process).

adrenal ratio

Below is a lab test from one of my patients showing the elevated cortisol-to-DHEA ratio, signifying this accelerating aging process.

The lab markers are important indicators for the stress the body is under and can be a great marker to revisit to assess how patients’ improve various areas of stress in their life, regarding diet, lifestyle, infection removal, and detoxification.

Click here to get your adrenals checked!

Testing the Adrenal Glands

Assessing the glands that help control and regulate stress is very important to your health. Your body is designed to be healthy, and part of being healthy means adapting to stress. Your adrenals are instrumental at producing hormones throughout the day that are designed to do just that.


stress patterns

Cortisol is secreted in a pulsatile fashion, higher in the morning and then tapering off throughout the day. Cortisol is designed to help stabilize blood sugar and help deal with stress and inflammation.

The more dysfunctional our adrenals become, we start progressing into deeper stages of adrenal fatigue where our brain (the master controller) isn’t able to communicate with our adrenals properly. Thus, we develop HPA-axis dysfunction.

This is nothing more than communicational breakdown that can be fixed with proper diet, lifestyle, stress management, and a properly prescribed adrenal program (specific to your pattern of adrenal fatigue).

If cortisol is too high, this can affect thyroid conversion and disrupt TSH levels. The reason why TSH levels become effected is because if the body is stressed (a sign is excess cortisol), the body doesn’t want to raise its metabolic rate and break down faster. The next easiest step is to start lowering the metabolism or body temperature by dialing down thyroid function a few notches.


thyroid conversion


Most doctors may think the problem originates from the thyroid gland and put the patient on Synthroid. The problem could very well be attributed to the elevated cortisol production from the adrenal glands. This commonly happens in stage 1 adrenal fatigue and can be fixed with the right dietary changes, lifestyle, and supplementation.

The Good, the Bad, and the Ugly of Adrenal Fatigue!

As you can see in the various patterns of adrenal fatigue above, the worst of them is the extreme adrenal fatigue pattern. This pattern is flat throughout the day with cortisol being relatively low across the day, and even a slight raise in cortisol at night can throw off your sleep, too.

What makes this cortisol rhythm so devastating to most individuals is that it can cause low energy, prevent restful sleep, and decrease DHEA levels, which prevents them from healing and repairing optimally.

One study showed a flat cortisol rhythm was a major predictor of cardiovascular disease, even more than smoking!

When I discovered this study, it almost knocked my socks off. So essentially the closer your morning and nighttime cortisol are (a flatter slope in the cortisol rhythm), the greater your risk factor for the #1 killer, cardiovascular disease.

Early Detection of Adrenal and Brain Communication Problems

Getting a cortisol saliva test that can measure your cortisol throughout the day is essential to diagnosing exactly what stage of adrenal fatigue you have and if HPA-axis dysfunction is occurring.

There are some good telltale symptoms that help shed some light on how much adrenal dysfunction is present.

Count how many of the adrenal symptoms are present in your life.

Give yourself one point for each adrenal fatigue symptom you have:

  • Sweet cravings
  • Carries more fat in abdominal area
  • Dizzy when standing up from a laying position
  • Drinks more than 2 caffeinated beverages throughout the day
  • Blurry vision
  • Forgetful
  • Moody or agitate easily
  • Gets jittery, eating relieves jitteriness
  • Fatigue

If you have two or more symptoms, there is good chance your adrenals are under some stress and could use some support.

To get more customized information on how to address your fatigue, click here!

Adrenal Fatigue and the Thyroid Connection Part 2

Adrenal Fatigue and The Thyroid Connection Part2

By Dr. Justin Marchegiani

Adrenal fatigue and thyroid imbalances

In part 1 of this series, we talked about the adrenal and thyroid connection and how it can contribute to fatigue, weight gain, and mood issues. Adrenal fatigue and thyroid imbalances are some of the most common conditions I see my office.  If you have two or more of the symptoms listed below, there’s a good chance you have adrenal and thyroid issues!

Adrenal And Thyroid Problem Symptoms

    •  Fatigue
    •  Allergies
    •  Depression
    •  Joint pain
    •  Weakened immune system
    •  Constipation
    •  Low or high blood sugar
    •  Difficulty staying asleep
    •  Difficulty getting to sleep
    •  Thinning of the outer third of the eyebrow
    • Waist size greater than 35 inches for female or greater than 40 inches for male
    •  Low libido

How to Bring Your Cortisol Levels Back into Balance…

1. Don’t overexercise:

My recommendation for anyone who has adrenal fatigue is to seriously curtail his or her exercise. The most common type of exercise is long, slow cardio, and it is shown to increase cortisol production by the adrenal glands. Therefore, it’s important to engage in exercises that aren’t as cortisol dependent (6, 7).  The goal for any exercise should be to stimulate hormones that are going to change your body composition for the better.  One of cortisol’s main jobs is to liberate blood glucose. This is normally done through breaking down muscle into glucose. So if you continue to participate in long, slow aerobic exercise, over time you become fatter and flabbier. Not a good combination!

If you need help fixing your adrenal fatigue, click here!

Cortisol also has deleterious effects on your immune system, too, so if you find yourself getting sick frequently, you may want to think about changing the types of exercise you participate in (4,5,6).

Depending on how fatigued you are, walking and lighter exercise, like tai chi, may be all you can handle.

My overall exercise prescription has two criteria.

  • You must be able to complete the exercise feeling just as good as when you started the exercise.   Feeling fatigue a few hours later is also in the category of overexercise. Even if you’re sleeping well, it’s possible to feel extra fatigue that next morning if you’re working out too hard as well.
  • After completing the exercise, you must feel good enough to be able to do the exercise again. If you don’t, then you are actually causing more harm than good with your exercise.

If you are in total adrenal fatigue, keep exercise duration to 30 minutes or less by using either resistance training or some type of interval- or burst-training workout that allows for high intensity for 20 to 30 seconds followed by a minute to two minutes of relaxation and rest. These types of exercise promote growth hormone and are not stimulating cortisol production as much as the conventional long, slow aerobic exercise.

2. Keep your blood sugar stable:

I already mentioned above how important blood sugar stability is. I encounter many patients who think they’re doing everything right, but when I look at their food diary, I can tell their blood sugar is in trouble.

One of the most important jobs of your endocrine system is to stabilize blood sugar.

Therefore, when you’re skipping breakfast, not eating enough healthy fats and proteins, or going too long between meals, you’re putting a tremendous amount of stress on your body. It’s really hard for people to get this concept regarding blood-sugar stability, but it’s one of the most insidious stressors I see in people with hormonal related issues. In other words if you do not fix your blood-sugar stability, it will be almost impossible to bring your hormones back into balance.

3.  Sleep, rest, and repair:

Sleep debt can impair cortisol balance as well. Getting five hours of sleep a night can cause cortisol to go out of balance and also put your body in a state of insulin resistance. What this means is it’s very difficult for your body to bring glucose into the cell to burn it for fuel. Therefore, your blood sugar ebbs and flows more causing more stress on your adrenals to help stabilize that pleasure. Metabolic ward studies have been done on patients inflicting sleep debt and then running a glucose-tolerance test. The results tend to be a state of insulin resistance for the patients very similar to a diabetic. Therefore, stabilizing your blood sugar will help your cells to be more sensitive to insulin. The more sensitive to insulin you are, the less your body will store calories as fat. The more you’re relying on fat for energy, the less your cortisol systems will be stressed (2).

Sleep loss could thus affect the resiliency of the stress response and may accelerate the development of metabolic and cognitive consequences of glucocorticoid excess.

HPA Axis

Cortisol, Sleep, and the HPA Axis

It’s really important to know, over time your adrenal glands and thyroid gland don’t just become fatigued from the stress you are putting on them but there is literally a state of dysregulation involving the communication from your brain to your thyroid and adrenals.

This is known as HPA (hypothalmus pituitary adrenal) axis dysregulation or HPT (hypothalmus pituitary thyroid) axis dysregulation. In other words imagine a broken thermostat. As the temperature in the house goes up, the AC doesn’t kick on because the thermostat is broken. Just as the opposite is true when the temperature gets too low: the heat doesn’t kick on because the thermostat is broken. This analogy rings true regarding your adrenals and thyroid as well (1).

Stress Adrenal Fatigue

Reducing cortisol levels and stabilizing HPA axis dysfunction can be a very effective approach to addressing sleep disturbances while also reducing the long-term risks associated with elevated cortisol levels.

The most important thing you can do is get your adrenals assessed so customized supplements and nutritional- and herbal-medicine protocols can be created specific to your adrenal pattern. The overall goal in treatment is to help lower inflammation, give your adrenals time to rest, and help the adrenals in the brain communicate better. Making the diet lifestyle changes and following a comprehensive program will help ensure that  you feel better faster and don’t slip back into old patterns that got you there in the first place.

To help get your adrenal glands back on track, click here!


1. The Role of Cortisol in Sleep,Tori Hudson, ND, and Bradley Bush, ND. “The hypothalamic-pituitary-adrenal (HPA) axis interacts with sleep in multiple ways. This article reviews the effects of the HPA axis on sleep and the converse.”

2. Sleep. 1997 Sleep loss results in an elevation of cortisol levels the next evening, PMID:9415946

3. Manna, I., Jana, K., Samanta, P. Intensive Swimming Exercise-Induced Oxidative Stress and Reproductive Dysfunction in Male Wistar Rats: Protective Role of Alpha-Tocopherol Succinate. Canadian Journal of Applied Physiology. April 2004. 29(2), 172-185.

4. Cakir-Atabek, H., Demir, S., Pinarbassili, R., Bunduz, N. Effects of Different Resistance Training Intensity on Indices of Oxidative Stress. Journal of Strength and Conditioning Research. September 2010. 24(9), 2491-2498.

5. Walsh, N., Gleeson, M., et al. Position Statement. Part One: Immune Function and Exercise. Exercise Immunology Review.

6. Shojaei, E., Farajoy, A., et al. Effect of Moderate Aerobic Cycling on Some Systemic Inflammatory Markers in Healthy Active Collegiate Men. International Journal of General Medicine. January 2011. 24(2), 79-84.

7. Steroids. 2011 Evaluation of a method to measure long term cortisol levels. Manenschijn L, Koper JW, Lamberts SW, van Rossum EF.


The Many Faces of Stress | Part 1

Many Faces of Stress

By Dr. Justin Marchegiani

Stress comes in many sizes, shapes and forms.  Many people only equate stress in the category of mental or emotional.  Things like paying the bills, difficulty in a relationship or a death of a loved one etc.  Theses stressors are very damaging, but there other hidden stressors that may fly under the radar of most people.  Some stressors may be a little bit out of our control, but my goal is here is to make sure you are equipped with as many tools as possible so the stress that you can control becomes a speed bump and not a road block in your life.

Stress for the most can be put into 3 categories (like a triangle):

Triad of Health

This picture really sums up my working philosophy.  So as you can see outside of the “Mental/Emotional” stressors there are 2 other sides of the triangle that go commonly ignored.  Today’s blog will focus on just the physiological stressors, and simple things we can do to address them.

Click here to find out more about stress.

Physiological Stress:  This type of stress commonly comes from 3 areas.

1.  Food: Nutrient density, blood sugar stability and food allergens.

  • Eating high quality nutrient dense foods are very helpful in providing the raw materials to help your body recover from daily stress.  Our body’s are in a constant balance of building up and breaking down and as long as we build up faster than we break down then we can stay in a state of “Health Aging” instead of “Accelerated Aging.” Remember 70% of our brain outside of water content is fat.  I find many people today are fat phobic and are worried about fat causing heart disease.  Because of this scare many patients are deficient in important building blocks and are walking around with brains that aren’t functioning optimally.
  • If Parkinson’s, Alzheimer, MS or any other neurological condition runs in your family it’s really important that you avoid common food allergens that are repeatedly found in the Scientific literature to affect and accelerate the break down of certain parts of your brain.  Thankfully now we have tests that can actually predict up to a decade in advance if this is happening to you, which gives us the time to make the changes to help reverse these conditions from progressing.  Removing all grains is a good start, and if anyone interested in running these new state of the art lab tests please contact the clinic.
  • Every time your blood sugar fluctuates up and down or high to low usually we see people’s energy or mood fluctuate in the same pattern.  Fueling your body with with protein and fat every 3-5 hours helps blunt these blood sugar and mood swings and lowers the amount of stress hormone our body produces.  Many patients I see live there life on blood sugar roller coaster daily and don’t know how to get off this dangerous ride.

2.  Toxins:  Heavy metals, pesticides, xenoestrogens, molds, radiation etc.

  • Did you know we have about 2 billion pounds of chemicals are dumped into our environment every year?  Most of the chemicals are hormone mimickers, meaning they are very similar to estrogen like hormones in our body.  When our body is thrown into a state of estrogen dominance it is very common to see weight gain, hormonal imbalances, and PMS to name just a few.
  • Heavy metals like mercury which are common in silver filling that your typical dentist would use to fill a cavity.  These heavy metals are know to have a negative effect on thyroid function and can cause low energy and weight gain.
  • We are constantly exposed to these wide spread damaging compounds it’s smart to do an integrative detox program to help get these chemicals out of our body.

3.  Infections:  Parasites, fungus, bacteria and viruses.

  • As our immune system becomes weakened to many of the stressors above we tend to see these opportunistic infection gain a foothold into the body and can cause many problems.  Usually during stressful times in our life are the times we are most susceptible.  It’s important to note that about 50% of people that develop a parasitic infections don’t even experience gastro-intestinal symptoms.
  • Travelers abroad have an increased risk of infection of these infections.  Having high quality digestive enzymes, drinking bottled water and avoiding any local places that may look a little suspicious can also help.
  • It is good prevention to check once per year to make sure you don’t have any of these lingering critters.  Any time you are experiencing excessive gas or bloating even with a healthy diet and lifestyle it may be a good time to get checked.
Great Ways to Improve Recovery and Decrease Stress:
Ways to Improve Stress Recovery
  • Chamomile Tea before bed.
  • 800mg of Magnesium before bed.
  • Get your adrenal cortisol rhythm checked (this looks at your stress hormones through the day and how they fluctuate).
  • Stool Test for GI infections.
  • Keep “Bach Flower Essence” by your desk and anytime someone drives you crazy, take 4 sprays.
  • Chiropractic and or Massage can help decrease the body’s flight or fight reponse from the nervous system and help it to relax and repair.
  • Heart Math Em-Wave2, more on this in posts to come.  I just bought one and I really enjoy it!
Next blog will focus on the “Physical/Structural” side of the stress triangle.

Click here to find out more about eliminating physiological stressors.

The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.