Essential Blood Tests to Analyze Your Health | Podcast #305

Regular blood testing is one of the most important ways to keep track of your overall physical well-being. Getting tested at routine intervals can allow you to see how your body changes over time and empower you to make informed decisions about your health. Here’s Dr. J and Evan talking about the areas to check aside from the usual blood tests we know. 

A conventional medical doctor will typically recommend that you get routine blood work, but this is the bare minimum. There are several significant reasons you may want to get blood tests more often than that. Either you want to optimize your health or to reduce the risk of disease and health complications. 

What are some routine tests and others that you should ask or know? Aside from CBCs (Complete Blood Count), Dr. J and Dr. Even pointed out enzyme markers, cholesterol tests, blood sugar tests, liver markers, thyroid panel, and so on. It will help your doctors make a differential diagnosis and dive into the root cause of your present health status. To know more, check out this podcast.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

3:12       Conventional Side of Blood Works

12:14     Thyroid Panels

17:56     Blood Glucose

23:50     Adrenal Issues

29:33     Lipid Panels

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Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan brand. Today, we’re gonna be chatting about blood tests that we use to help assess our health and help us get better. So we’re gonna be chatting a little bit about kind of intro blood tests, what the best tests are kind of what our perspective on that is, Evan, how are we doing today, man? 

Evan Brand: Doing really well excited to dive into this topic, I went, got my blood work. And I got my wife’s blood work done on Friday. And I just want to give a brief little note on how you and I run blood work as clinicians because it’s very easy. And it’s so convenient, because we don’t have to go and beg a GP or an MD and say, Hey, please, please, doctor. I mean, you and I’ve heard countless stories. Yeah, I asked my doctor to run this, they wouldn’t run it, I asked my endocrinologist to run this, they wouldn’t run it. With us, the accounts that we have with our credentials, were able to order and create customized lab panels. So you and I both have created customized blood panels that with a click of a button, we can go boom, order it for anyone, whether it’s ourselves, or our clients or patients, and then we get an instant requisition form. We go straight into labcorp request, you check in, you sit down, they call your name, you hand them the paper, you get the blood draw, you go home, it is so amazing. Every time I get my bloodwork done, I’m like, wow. And I didn’t have to get anyone’s permission to do that. But my own. 

Dr. Justin Marchegiani: Isn’t that nice? Yeah, it totally is nice. Also, there’s the big insurance scam, right. So because we have accounts directly with the lab companies, we can order tests, and typically we get, you know, an 80 to 90%. You know, discount in price compared to what the insurance would bill. So like my typical thyroid panel, full thyroid panel that I charge my patients probably around $120. And the insurance would typically charge a patient for that well over $1,000. So then patients, most patients don’t get 100% coverage, right, especially if you’re not in network, and then the doctors can’t ever retest, but once every six months, so then you’re you’re stuck not being able to ever retest. But they think, Oh, I’m gonna get coverage for this. And then they get 90% coverage, and they end up paying more money. For the for the 90% coverage, even though they paid 100% cash, it had been cheaper. So that’s kind of the insurance scam. And then the problem with that is they can’t retest but once every six months, so they’re kind of stuck. So yeah, it’s really nice to be able to order what the patient needs and to be able to reorder and reassess. Based on a time that is good for us. Not good for the insurance companies. That’s kind of nice, right? 

Yeah. And you’re kind of we’re kind of circumnavigating that conventional system where you’re waiting two, three months, and then you get a bill in the mail and you’re like, oh, medical bill, What’s this about? And then it’s like, oh, you owe 700. with us. It’s all transparent. It’s up front, you pay, boom, boom, boom, you’re done. I’ve already paid for it. I know that I’m not spending another penny. And the turnaround time is insanely quick to like one or two days, typically on some of these panels are running. So let’s go into some of the details. Now, let’s quickly compare and contrast. I think you and I have a lot of fun. Like where we did our conventional functional medicine vers conventional medicine, gut workup. Let’s talk about the same with bloodwork. So if you go to your doctor, and you have them say, hey, Johnny, we’re going to run your blood. What is that going to look like?

So conventional medical doctor, they’re typically going to do a CBC, they’re going to do a metabolic panel, they’ll probably do a lipid panel that’s usually going to be at maybe a year analysis, that’s kind of it. So like on the CMP they’re kind of looking at liver enzymes. They will look at some electrolytes on the liver on the CMP as well. Those liver enzymes electrolytes, maybe some protein markers there, they’ll probably look at glomerular filtration kind of some baseline kidney function with creatine and and bond. The kit the liver markers are going to be a lt and as to the liver enzyme markers, the gallbladder is ggt but probably look at some bilirubin your electrolytes are going to be sodium chloride, potassium magnesium, all serum not not intercellular which is a difference Okay. And then on the red blood cells are going to look at red blood cells RBC some adequate hemoglobin that’s part of the CBC right complete blood count which is going to help be helpful for anemic patterns right low iron right, although also run indices which are MC VMC, HMCHC right me corpuscular volume me corpuscular hemoglobin me corpuscular hemoglobin concentration. When those markers go high, that tends to mean that we’re dealing with B vitamin issues like b 12, full eight issues, and we call that megaloblastic anemia. So we have two kinds of anemia. As we look at big cell anemia is right we tend to be more B vitamins stuff. And then small anemias. We tend to be more on the red blood cell hemoglobin hematocrit, low iron side, and then we have immune markers, whether it’s neutrophils, lymphocytes, eosinophils, monocytes, and basophils, which could be from bacterial issues, parasite issues, gut inflammation issues, viral issues. And then I would say on top of the CBC, that’s pretty much it and then your limits. So total cholesterol, triglycerides and then of course, your LD vldl pattern, and then there’s some add ons that we may talk about whether it’s c reactive protein for inflammation, fibrinogen, for inflammation, homocysteine for inflammation, methylation, vitamin D. and we can kind of go into each one of those in regards to what we think is important on the functional side. But you know, the whole lipid thing is, it’s kind of overplayed, right people think that lipids are a really important issue now once you start going over 200 or so on the total cholesterol, and that may not be. And we’ll talk about the ratios and the perspective that we add to when we look at it.

Evan Brand: Yeah, so the way you talk, it sounds pretty good. It’s like, oh, wow, that’s a lot of stuff. But truthfully, there are rarely issues that show up on just standard bloodwork. Now, if you have more of the functional training that you and I’ve had regarding blood chemistry, you can kind of, I guess you would just say pick through the CBC with a fine tooth comb, and you can really look and maybe find some functional issues, like for me, I know that I you know, for a very long time, my hematic crit, you know, I’ve always had the hematocrit be a little bit high, which, based on some of the training you and I’ve had, it would indicate that there’s probably a dehydration issue. And that’s tough. You know, it’s, it’s, it’s tough to stay hydrated. And so even if I mean, I’m sipping on water all day, but you know, I’ve heard there’s a big influence on anti diuretic hormone, and all of that when you’re exposed to mold toxin, that’s a conversation for another day. But anyway, unless you’re really looking with a with a fine tooth comb, conventional bloodwork doesn’t reveal much. And you may see a little bit of this a little bit of that, but it’s not, I’m not making too many protocol decisions based on a CBC I would say. 

Dr. Justin Marchegiani: So when I look at blood, it can give me a good area of where to where to look next, or where to dive in deeper, which is helpful. And then if we look at it, using the optimal reference range, or a functional reference range, we can definitely glean better information. So the problem with most conventional medical doctors, they’re looking at blood through a pathological range, they’re trying to pick up like major disease patterns or pathological patterns. And so how it works is you have to show you have all people kind of fit in what’s called the bell curve. And the typical range is going to be two standard deviations to the left and right, this is represents about 95% of the population fit into the so called normal. So you have two and a half on the high two and a half on the low that are on the high or low side, pathologically, right. And so the problem with that range is it as people get more unhealthy and sicker. And as those sick people tend to test more, what happens to the lab reference range over time, it gets wider. And so it becomes more encompassing, it’s like having a bad field goal kicker and you make the field goal every year wider and wider and wider and closer and closer to compensate for the lack of, you know, good kickers out there. So it’s kind of like that. And so what we do is we kind of narrow up that range a little bit, and that narrower range helps us pick things out before it becomes a problem. So let’s kind of go over a couple of things. So with women or people that are vegan vegetarians, women, because they bleed more when they’re when they’re at menstrual age, right, typically 50 or below 48 or below, they can be more anemic. So we may look at things like lower red blood cells, right, red blood cells, you know, below 4.2 or so we may look at hemoglobin below 12, we may look at him at a crit, you know, in the mid to low 30s as a sign that there could be some low iron issues brewing, we may also run an iron panel, it’s not typically run, but we may run things like ferritin, or iron binding capacity. Or we may look at things like iron saturation to get a window of low iron, for instance. And that’s commonly missed, because what most conventional Doc’s do is, their threshold for low iron is really low. And there’s a lot of women I see in vegetarians in general that could be on that lower side could be a little bit anemic, and then they’re not going to be able to carry oxygen throughout their body adequately, which makes a huge difference in energy and stress and and mitochondrial function and thyroid function because you need to be able to carry oxygen to have good energy. 

Evan Brand: Yeah, let’s go into some of the more let’s let’s, let’s break some of the stuff down. But before we break it down more, let’s hit on what are the things that that we’re going to run and so I’ve got my panel pulled up that I ran. And so I’ll kind of run through some of these things. But as you mentioned, ferritin that’s typically not going to get run I’ve rarely rarely seen fair to run by anyone. The iron saturation as you mentioned the iron binding capacity. That’s really wrong. That’s right to be ti BC. Often on your bloodwork, the vitamin D. I mean, my God, it’s so important, but yet vitamin D to this day is still not commonly run. Nope. And if they run it, they may run the wrong one. I’ve seen people where they don’t run the 25 o hydroxy. tryptophan, they’re going to run like the even the beat the D two. They’re going to run the What is it? Ergo? 

Dr. Justin Marchegiani: Yeah, the vitamin D too. Yep, Ergocalciferol.

Evan Brand: Yep, yeah. Ergocalciferol? Yeah. So you have a vitamin D, they may run the D two and you’re like crap I needed to d3.

Dr. Justin Marchegiani: Yeah, the [inaudible]. The animal base kind of the d3 is the more active form. The D two is the more plant synthetic form, typically made from lanolin. A lot of times, that’s the D two, that’s the ergocalciferol. Ah, so vitamin D is really important. And then the range on that is pathological as well. They want above 20. Why? Because they’re looking for rickets, right, the bone bending disease, right, because d3 helps absorb calcium and helps a calcium get into the bone. So we want 50 to 70 or maybe 70 to 100 if we’re autoimmune or cancer risk. So vitamin D is a big one, I would say also on the CBC, we may be looking at immune cells, if I see low white blood cells, you know, below four and a half. There could be some you know, deficiency issues if there’s high white blood cells, you know, greater than seven and a half there could be some immune stress. Now we look at the, the immune cells, how do we look at those never let monkeys eat bananas, that’s the mnemonic device and doctor at school we learned so neutrophils we want to see, you know, below 60 lymphocytes, we want to see mid reference range when we see high neutrophils or low neutrophils and elevated lymphocytes. That’s a common h pylori or bacterial infection pattern. If we see elevations in eosinophils, greater than four, we’re thinking potential parasites or chronic environmental allergies by sea monocytes, greater than 10. I’m thinking some kind of intestinal inflammation. So we there’s different, you know, patterns you may look at, when we look at some of these immune cells. That’s very important. But unless it’s very high, they’re typically not going to say much. And if it’s very low, they typically don’t say much either there. 

Evan Brand: Yep, so also more advanced thyroid markers. It’s very, very sad how many people go to even an endocrinologist and they may only end up with a free T for possibly a free t three, but even that’s not guaranteed. Maybe a total T for you may get Of course, TSH is going to be on there. But you and I are definitely going to be running like thyroid globulin, I mean obat antibodies, we’re going to be running t TPO, thyroid paradoxus antibodies, maybe TSI, sometimes if we think there could be something else going on next. And then you’ve got the uptake of T three, what else you got? You got reverse t three that we’re going to be looking at. That’s an awesome marker. And that’s never run. 

Dr. Justin Marchegiani: Yeah. So when it comes to a thyroid panel, you already mentioned it, most conventional endocrinologist and primary care are going to run TSH because that’s the major screening brain hormone, not a thyroid hormone majrooh. It’s not a thyroid hormone, but it’s a major brain hormone that talks to the thyroid and you’d be lucky to get a T for total after that. But we know downstream is a lot of conversion issues and even patients that have normal TSH, guess what, especially if they’re on Synthroid, which is a synthetic thyroid medication that’s just T for many of them can’t make that conversion. And that’s a problem too. And so you can have adequate T for good TSH and low t three. And you may have a lot of thyroid symptoms. So it’s really important that we look at things complete. And don’t even get me started on thyroid antibodies, because that’s almost never run and thyroid antibodies are the major mechanism why most people sideway glands aren’t functioning properly because their immune systems have beaten the crap out of their thyroid for a very long time. 

Evan Brand: And we’re talking what I mean, you’d say probably over half of cases of hypothyroid are probably autoimmune based on what I’ve seen, what would your guess be? 

Dr. Justin Marchegiani: Yeah, I would say that and some may not even come back on the lab test, but it’s very helpful to be able to look at those we run TPO antibodies and thyroid globulin antibodies. And so my full thyroid panel nevitt, some kind of a TSH, T for free and total t three free and total TPO antibody, federal globulin antibody, and we may run a reverse d3 or an uptake. Those are all okay markers to add to. So that’s kind of your complete thyroid panel. Let me just piggyback to the CVC. Is there anything else on the CDC? I think we hit it all there. We can go to the metabolic profile now if you want. 

Evan Brand: Yeah, well, you mentioned like earlier, like CBR active protein c reactive protein, I guess it kinda depends. I mean, sometimes that standard, but a lot of times that’s not an hscrp is, you know, going to be the same same section of the inflammation panel on your blood. So hopefully you get those two run together. 

Dr. Justin Marchegiani: Yeah, usually CRP and cardio CRP is basically the same thing CRP, they’re just, they’re breaking the number down typically below two, I think the cardio CRP, they typically don’t do it less than two or so. So when they you do a highly sensitive CRP, they’re just breaking it down into a smaller number. Let’s go we want to see that below one that’s great as a good marker of systemic inflammation. And fibrinogen is great. We have for highly inflamed, we may see a lot of clotting happen. And fibrinogen looks at clotting factors, which is helpful. So if we don’t have good fatty acids, good omega three omega six ratio or a lot of inflammation, a lot of trans fat, high blood sugar cells tend to agglutinate they get very sticky. And so it’s nice to see where that stickiness that stickiness level is. And homocysteine is also another measure of blood inflammation because it’s homocysteine is an inflammatory metabolite. That typically happens when there’s not enough B vitamins B six and four And B 12. In their active form, that can be a big inflammatory issue there too.

Evan Brand: Yeah, that was a problem for me. Actually, I did have elevated homocysteine couple years ago and started hitting some more Foley and it fixed it. So it was fun to see how the blood correlated to that. 

Dr. Justin Marchegiani: Yeah, you know, we’re going to try to get as much of that which we can do leafy greens and high quality, you know, essential fats and meats, right, but that’s good. And so metabolic profile, we may look at liver enzymes that could be helpful patients that have a lot of insulin resistance and inflammation, you may see an elevation in liver enzymes. What does that mean? That could be a non alcoholic, fatty liver, non alcoholic steatohepatitis, that’s Nash or non alcoholic fatty liver, meaning your liver has stressed not from alcohol, but from typically too much fructose and junky carbs. So the liver is a people think the liver is just a big filter for toxins. No, it also has a major effect at regulating blood sugar, and is also a storage site for sugar, especially fructose. So when you over consume fructose from high fructose corn syrup, or, you know, just too much carbohydrate, in general, the liver really gets stored up. And then when that liver fully gets saturated, overly saturated with fructose, for instance, you start having all these up regulations of inflammatory enzymes called the the junk enzymes, the J, the J and K one enzymes, and you see a lot of inflammation and a fatty liver there, and you see it an ultrasound. And so that’s a common marker seen those elevated liver enzymes, and it’s good to be able to look at that. 

Evan Brand: Yeah, I don’t know if you’ve tested bloodwork much with people like in the middle of a protocol. But I’ve had a couple interesting cases where, while using binders, we’ve seen liver enzymes go up. And it could have been also parasite protocols and things like that, that were kind of interwoven with detox protocols. But I’ve seen liver enzymes temporarily go up during that. So I don’t know if you pay much attention to that. But I’ve seen it and they always go down as soon as it protocols over so.

Dr. Justin Marchegiani: Even with some killing herbs, like worm woods, a common one that we may see a little bit of elevation and liver enzymes, people that are sensitive, some of the killing herbs, it could be a little bit of stress, is it just the herbs? Or is it the dead debris that is now mobilized from the killing of those microbes, it could be both. That’s where adding things like binders can be very helpful just to kind of put handcuffs on those critters and escorted out of the body versus kind of having it go back into general circulation. also adding an extra glutathione support can be helpful too. Just to really support and tone if I deliver those are very important too. 

Evan Brand: Yeah, well. And it’s common for you and I to use some sort of a liver gallbladder support too. So we may be throwing in like some extra taurine or Mathionine or beet powder artichoke. And there’s many, many things that I say milk thistle already NAC. So there’s a lot of stuff we can do. But yeah, I just figured I mentioned it. Because if someone’s listening and you happen to do blood work in the middle of a protocol, it’s possible that the levels may you may look at him and go, Oh, my God, my liver enzymes, but it will go back to normal relatively quick after killing protocols over. 

Dr. Justin Marchegiani: Exactly. Also, we may look at glucose, blood glucose is going to be on a metabolic profile as well. CMP panel, I don’t love it as much, because most people that are going to get a blood test and they’re getting pricked in the arm of the big needle, or they kind of stressed. Yeah, and so that the cortisol from that can really increase their blood glucose. So I like getting a really good blood sugar kit like this. And then you can measure your blood glucose during the day. So here’s my little kit here. And so I have I use the keto Mojo now because it measures ketones, so I’m a little meter, I have my little pricker here from my finger, and then I have the blood glucose and the ketones. So this one right here is the blood sugar. And this one here in the lighter blue, this is my ketones. So it’s kind of nice to have those. So I can test my blood sugar before I eat. And then I can do a one two hour three hour and play around with my blood sugar. The whole goal is the more you keep your blood sugar down after a meal and bring it back to baseline within two or three hours, the less insulin you’re making, the higher it goes up and the longer it takes to come back down, the more insulin you’re making. So it gives you kind of a good window how you’re responding to food. 

Evan Brand: Yeah, what I wanted to point out is that you’re doing more functional analysis of glucose versus if you just go into your doctor once every six months, you get a morning fasted glucose, that’s just not enough information.

Dr. Justin Marchegiani: It’s not because the whole goal while you’re just checking morning glucose is because you’re thinking your food, so out of whack, that your glucose is now elevated as a result. Now the problem is most people haven’t eaten in 12 hours. So for your glucose is still be out of whack. 12 hours later, the problem has to be pretty severe number one, and then number two, a lot of times it can be elevated not because of food, but because of stress hormones in the morning. And so the stress hormones, people say oh, I’m at 105. Yeah, but it just could be a good cortisol response in the morning called the dawn phenomenon that’s raising that glucose. That’s why you want to check it against your foods during the day. If you have a blood glucose issue. You’re going to see one and two hours later, it’s chronically elevated, and it’s taken a bit of time to come down. So that’s a better marker. Make sure you’re handling glucose okay.

Evan Brand: Yep. How about hemoglobin A1C, this is something that for diabetics, obviously, this is hopefully going to be regularly checked. But for your average person that maybe has some issues, A1C is probably not going to be on your standard blood panel. 

Dr. Justin Marchegiani: I don’t love A1C, I used to like it. I don’t love it as much, I find that when people’s blood cells live longer, because they’re more healthier, they have more time to accumulate blood glucose. So the A1C it’s a part of the hemoglobin and they’re looking at the coding, the coding of glucose on the outside of the hemoglobin, right? So imagine, like, you know, when you, you know, you go up into your car during allergy season, you can see like a big fixed swath of like pollen on the car, they’re kind of looking at the swath of glucose on the outer part of the human lobe. And now the problem is, the longer your red blood cells are hanging around, the more time they have to accumulate that blood sugar. So it can be helpful to look at something. But if you’re, if you’re a little bit on the higher side, or like, let’s say 5.5 or so, let’s say under six, but 5.5. And up, it may just because your red blood cells are a little bit more healthier. So like, for instance, with my anemic women who may have a ton of blood sugar, right, a lot of carbs, because maybe they’re vegetarian or vegan. Guess what? When you’re anemic, your red blood cells die faster. So all my anemic women have A1C super low, like in the forest. And so it’s not going to be a great marker when your red blood cells don’t live that long, and we see it with our anemic patients.

Evan Brand: That’s a good point. Good point.

Dr. Justin Marchegiani: If I see someone six or higher, yeah, it’s helpful, you know, but when you’re kind of in that subclinical zone, you’re going to typically have to go back to one, a meter like this, to really look at it. And then also look at your fasting insulin, which is a better marker, because that’s going to give you a better window, how much insulin you’re making frequently. 

Evan Brand: Yep, good point, that analogy is perfect. The pollen on the car. So good job there.

Dr. Justin Marchegiani: Right. And if you leave your car out there a lot longer, you’re gonna get a lot more pollen. It’s kind of like that, right? 

Evan Brand: I’m always under five though, no matter what with a one C, I’m always right. 4.9. Somewhere in there. 

Dr. Justin Marchegiani: Yeah, I’m pretty low, too. I’m always like, right in the low fives. 5’1 5’2. But I’ve seen a lot of patients in my career that have that have really good diets that have tested their blood sugar, have good insulin, and they’ll still have a little bit higher on the a one C and I’m just like, yeah, it’s just it’s missing some people. That’s all. It makes sense. The question is, what’s the mechanism? And that’s what it is. 

Evan Brand: Yep. Makes sense. You hit the you hit the dawn phenomenon. So you know, cortisol that may be run via blood, although we don’t really like blood cortisol too much. We really like more functional analysis of cortisol, like with urine or possibly saliva? 

Dr. Justin Marchegiani: Oh, yeah. And part of the reason why we don’t we don’t like it, is it because when you’re measuring a stress hormone, while creating a stress response, ie putting a needle in my arm, you may influence that a little bit, right? And so that’s kind of the reason why we don’t love that. And even if you’re like, Well, you know, do the adrenals make cortisol fast enough after the needle happens to show in the blood? Well, it’s not just that it’s the fact that you’re anticipating it happening. Therefore, you’re replaying that stress in your mind all the way up to the doctor’s office to go and then the elevator getting into the you’re already making that stress hormone while you’re anticipating what’s going to happen. 

Evan Brand: Yeah, you go in the friggin lab with the scientific fluorescent lights above your head. It’s all awkward the quiet they got some like drug commercials on in the waiting room, Justin, and they call your name come on back. Yeah. So and, you know, also Not to mention, too, that that’s just a snapshot, right? I mean, that doesn’t tell us anything about what’s happening at two or 3pm when you’re complaining of that midday crash. So I really am not too interested about what happened at 8am. I’m really want to know what what’s going on at 2pm when you’re saying you need that third cup of coffee. 

Dr. Justin Marchegiani: Exactly, yep. 100%. So it’s, it’s really important that you’re kind of on top of that. So I think we hit some good blood glucose stuff, we hit some liver enzymes we hit. I’m thinking here, we hit some of the electrolytes. electrolytes are good, too. So sodium and chloride are really good ones. Now when I see patients that have adrenal issues, you could easily have low sodium and high potassium, or you can just kind of have lower minerals all together. Now the serum is not going to be the best marker for testing minerals. So when you see your minerals out of balance, you know, it’s a big issue, but you could still have mineral issues. And the serum be okay, because it really matters what’s in the cell. Not necessarily what’s floating around in the blood. So think of interesting Imagine you’re in a pool, okay? The pool is serum. Okay, you’re in the little floaty. You’re in the little inner tube, right? So it’s you in the inner tube, right? You and the inner tube and the water in the inner tube that’s intercellular. The water outside of the inner tube is extracellular serum. So that’s kind of how you think of it. So when we test some of these nutrients, it’s better to get a sample of the water in the inner tube with you that’s intercellular versus the water outside of the inner tube. That’s serum.

Evan Brand: Yeah, and how do people get that? What is look like?

Dr. Justin Marchegiani: Well, you can like we can add like a red blood cell serum or a potassium serum on some of these panels, we may run like a spectracell, or a Nutri eval or an ion panel that looks at more intercellular nutrients, we may look at different tests that allow us to do that. But there’s not too many add ons for conventional testing like quest or labcorp. Outside of I seen a blood cell magnesium is good. You can do a potassium if you wanted. So there are a couple that you can do to get a window into that. 

Evan Brand: Yeah, I was gonna say I looked through all the options for the conventional labs, RBC magnesium, I think that was about it. I think that’s all I could find. 

Dr. Justin Marchegiani: So yeah, not too much. But it’s something you know, because magnesium is a big one, right? And with magnesium RBC, we want to see a greater than five on that one, red blood cell magnesium greater than five. So that’s helpful. And then, of course, we mentioned magnesium surround, we want that greater than two. And then your minerals, you want them somewhat mid reference range, once we start going under 100 or so I think like sodium, it’s like 104 is kind of mid range. If you’re under 104, it could be a problem, potassium, I forget the exact ranges in it, but I want them all about mid range. In regards to the reference range. 

Evan Brand: What do you feel about using conventional bloodwork to do like omega three omega six fatty acid panels, I know, there’s some Doc’s that are just so obsessed with all these ratios. But, you know, truthfully, if you’re doing the things that we’re discussing with our clients and patients for nutrition, you’re going to pretty much be optimized anyway. I don’t know what that would tell you. Besides, hey, maybe you need to do a little more this or that? 

Dr. Justin Marchegiani: Yeah, it’s a great question, I think, look at the person’s food. Like someone could have really good diet, but let’s say the meat and the eggs aren’t pasture fed. Well, that could easily be the reason why your omega six to three is off a little bit. Or it could be that you know, you’re just doing too much plant fats, and those plants or from coming from, you know, omega six bass plants soy or canola or safflower. So if you’re doing good fats, like coconut oil, and olive oil and avocado stuff, which are monosaccharides are Yeah, so those are, yeah, those are MonEl fatty acids versus like, vs. poly, which is like a fish oil, right. And then so the fish oils, you have omega threes, right, which are going to be like, the ones that are we talking about that are going to be more on the anti inflammatory side, right? These are the Polly’s. And then of course, the Omega sixes are going to be more on the vegetable side. These are going to be also Polly’s but they’re going to have six bonds, these are going to be your safflower canola, these are going to be your soybean oil, all of your plant based fats, most in the most of your plant bait fast, to extract the fats from them with the olive oil or maybe an avocado, you tend to have to damage the fats, they tend to be more damaged, they tend to be more on the Omega six side. And when you get when you eat plants by themselves, you’re not getting that concentration of fats. And so you tend to not have that high omega six to omega three, when you’re doing just vegetables by themselves. Okay. And so we can just look at how much fish you haven’t per week, how much pasture fed eggs you have in a week, how much steak or meat that is grass fed, you haven’t per week, and then you can kind of look at it relative to what’s high on the Omega sixes like the knots and the seas and the refined vegetable oils. And you can kind of get a pretty good assessment of where you’re at, which is like kind of for one or less. So four times omega six to one is pretty, it’s pretty. Okay. And you can always run that omega three to six tests on the blood too. Does that make sense? 

Evan Brand: It does. Yeah, I just find that it’s not a huge needle mover. So I don’t run it too often. I mean, I think it’s cool to check in you could call it kind of a lie detector test as somebody says they’re doing everything that’s dialed in, but then you find out that Oh, they’ve been coconut grass fed steak, but it’s been in this healthy heart oil blend that they found on the shelf and it was a safflower canola combo. You’re like, Oh crap, then we missed it. And you got to get off of that stuff. So yeah, I mean, I was just gonna say so it’s not really a standard thing. For me at least you know, I’m not running into often with people but- 

Dr. Justin Marchegiani: But it’s there it’s an option and then it’s something if someone wants to run we’ll run it and so we have the polyunsaturated which is the fish oil or on the omega three side, right. And then we also have things like flaxseed oil, but it has to get converted to the to the higher up fatty acid so you know, omega three fish, and then you get to get some mega three from cows that are grass fed as well. 

Evan Brand: What about particle size on a lipid panel? So we talked about that briefly. It’s just a good add on that most people don’t do and our friend jack Wolfson, he discusses particle size and I think it’s something that more people are asking questions to their doctor about but it’s still very uncommon to run. 

Dr. Justin Marchegiani: People that have a cardiovascular history. Just want to run it to begin with. I think it’s okay. I can almost always tell you what your particle sizes if you’re eating good health saturated fatty acids like coconut oil and grass fed butter. And you’re getting meats that are like good quality fish, good quality grass fed beef, egg yolks, you’re keeping a lot of your junky fats down a lot of the refined sugar down and a lot of the trans fats down, you’re going to have a large, you’re going to have a particle size A, which means large and buoyant and fluffy, right? Think of a like you want an ad on your test. And then you have the small dense atherosclerotic particle size B, think B for bad, and the B for bad, more trans fats, more inflammatory, processed vegetable oils, more refined sugar. And so with patients, I almost always can look at their diet. And guess what that will be to begin with. So if I do a dietary check and do a diet recall, what’s what’s the average day look like? And I look at that and I get a window, it’s pretty easy to predict that. And so we’ll run it for patients that have a cardiovascular history, and they just want to know, but for the most part, it’s not hard to predict it. 

Evan Brand: Yeah. And when you see it, are you just tweaking dial? Like, if you see a bunch of small dense particles, or are you coming in? Are you using any kind of like plant sterols or anything like that, to help with it are you just tweaking diet, and then it fixes itself? 

Dr. Justin Marchegiani: It depends how acute the patient is. But if it’s if it’s not acute, meaning the patient’s not dealing with a heart issue right away, then we’re going to just tweak the diet, and that’s going to take care of it, we’re going to add an extra omega three fatty acids from fish oil, we’re tweaking the diet, we’re getting the carbs down, we may be adding extra nutrients to manage blood sugar and manage inflammation. And then usually within a month or so you’re gonna see a big change. After we retest. Awesome, yeah, usually once you get about 100 good meals, then you’re going to see a big shift. A good average person is doing about 21 meals a week, right? So three a day times 721. So four to five weeks, once you get 100 meals in, if you can get them close to in a row. Your body has a huge shift in physiology. 

Evan Brand: It’s amazing how quick you can change stuff I knew. I mean, sometimes we get impatient because like what the detox piece like that takes longer. I mean, I’m here I am a couple years in detox and mycotoxins. I’ve still got some going on. So, you know, with that, it’s like, oh, man, you get impatient. But luckily, with the blood, it’s a quicker turnaround time sounds like. 

Dr. Justin Marchegiani: Oh, totally, man. It’s really important. So I think we hit some of the big markers today. I would say one other one for lipids. You know, I don’t really care if cholesterol is a little bit on the higher side, just I try to make sure the cholesterol to HDL ratio is ideally you know, four. So if the if your Triggs are sorry if your total cholesterol is 200, and your HDL is 60, or what’s that ratio to the math, put my calculator 200 divided by 60, that’s 3.3. That’s pretty darn good. Usually, when you’re under three and a half, that’s half the average risk factor. Okay? When you let’s say you’re at 242 40 divided by 60. On the HDL, now you’re at four. And so I like to look at the total cholesterol to HDL because HDL is what recycles cholesterol. Okay? So if you have good recycling lipoproteins, ie HDL, that’s a good sign. And then I’m also going to look at my trigger to HDL ratio, we want that under two. But if we can have a closer to one, that’s wonderful, what does that mean? Take your trig number, let’s say your trig numbers at 60. Let’s say your HDL is at 50. Well, what’s that? What’s that number? Well, we do 60 divided by 50. We’re at like, 1.2. That’s good. So we want to under two but closer to one’s ideal. That’s a really good marker. That’s my insulin resistance inflammation marker for my limits. So I’ll look at trade over HDL. That’s a really good marker. 

Evan Brand: Yeah, you know, I talked to jack one time about the, the blood and I said, When do you start getting freaked out regarding total cholesterol, because if you talk to a conventional cardiologist, they’re they’re brainwashed on that 200 number. And he says that he’s got people up in the 450s, that he’s not worried about 1%, like total cholesterol being 450. And it’s not an issue. So he just talks about, like he said, ratios, inflammation associated with it, you know, then you get into more trouble. But I mean, the total number, I mean, he acts like it’s just minimally important.

Dr. Justin Marchegiani: Yeah, on its own, I would be a little bit concerned once you start getting in the mid 300. Just because that’s that could be more hypercholesterolemia. And that’s not necessarily a diet thing, that’s more of a genetic thing where you’re making a lot more cholesterol. So I personally would get a little bit more concerned with that and I’d be monitoring that. But it’s hard to really jack up your cholesterol when you’re keeping inflammation down. Like I just did a blood test for my lipids last month, and my cholesterol my total cholesterol and you know what I eat man? I good fats, good proteins, good eggs, good fatty acids. And my total cholesterol was at 165.

Evan Brand: Whoa, yeah, I was like a 202.

Dr. Justin Marchegiani: Yeah, 165 my my trades were at 60. And my HDL is we’re at 50. So I had like a 1.1 1.2 ratio for trigger over HDL, which is great. And so most of the cholesterol, you’re gonna Ahead is gonna be made by your body. So when it starts getting too jacked up and your diets good, you know, we want to look at thyroid hormone, maybe that could be a big thing. And there could be a hypercholesterolemia genetic issue, and we can always run a genetic test for that to see what’s going on. And if that’s the case, what are natural things you can do to get your cholesterol down, you can do higher dose berberine to make sure your thyroids check, you can also do some potential plant sterols as well. But get that check. So my philosophy if it goes a little too high, I’m curious, I’m worried about the hypercholesterolemia piece. 

Evan Brand: Yeah, and I don’t mention that 400 number just to get people off the hook. I just thought it was interesting that that’s what he was saying. And he’s probably talking like, you’re in big trouble if you get to that point. But But anyway, so that’s rare, though. 

Dr. Justin Marchegiani: That’s super like these are very, very rare situations, you know, sub 1% of the population are going to be there. My never seen it ever. I have two patients with that. But most people already know about it, because someone in their family already had been picked up previously. Yes. So most people already know what especially today, you know, maybe 3040 years ago, not as much, but people that have had those issues have already been picked up. They already know genetically, if it’s in their family, and then once you know genetically, if it’s in their family attend to get tested for it. 

Evan Brand: Yep. Right? Well, let’s wrap this thing up. So as we mentioned, bloodwork is a piece of the puzzle. If you go to a practitioner, and they’re like I’m going to analyze your blood and tell you everything you need, they’re wrong, because you mentioned some of the clues into the immune section about parasite infections and all that. However, I will speak for you and say that you’re not going to depend on that bloodwork solely to identify parasites, you’re still going to be running comprehensive genetic DNA based school panels, you’re going to be running organic acid panels to look and deeper. So yes, you may look at those things. And I think it’s awesome that you gave us some insight into that, however, I’m not going to go to a guy who’s going to look at the blood and say, Yep, you’ve got parasites, let’s put this protocol together, I’m going to want more data. So blood is just part of that data. And it can be helpful, especially when you’re working with autoimmune people, because you and I like to look at these antibodies, and it’s very fun and satisfying. And it makes you look better when you could have a a woman come in with a TPO of 1000. And all you do is fix her gut and our TPO antibodies go down to sub 200. That’s exciting. 

Dr. Justin Marchegiani: Totally, that’s huge. So I think today is very great, great podcast, because we’re talking about actual things. We want people to kind of like say, Hey, you know, what’s it like to be inside Dr. J, and Evans head, and this is kind of it. And everything that we look at, we’re kind of like a detective, we’re putting like checkmarks in the column over here that support us going in this direction, or going in that direction. So we add up all of our checkmarks, right, and we’re kind of create what that differential diagnosis is, and what tests we’re going to do to dive in deeper in in whatever those avenues where those check marks are adding up. So that’s kind of inside of our head, we’re walking through you through our thinking. And if you want to dive in and reach deeper, you know, into work with a practitioner, like Evan or myself, you can head over to, you can schedule a consult with Evan or myself at And you can schedule we are available worldwide to help y’all with your functional medicine and natural health care needs. And if you want to get to the root cause we’re going to be the best person to to look at anything else you want to highlight here today. 

Evan Brand: Maybe just one frequently asked question, Well, I’m not where you live. Does that matter? Well, in the US, it doesn’t matter at all. We can run like a blood comprehensive blood panel, we can run that anywhere now. We’ll try to help people internationally in regards to providing maybe some codes or things like that to help people. But at least for the us know, you location does not matter. We haven’t had any issue with that. I think New Jersey for a while was getting a little more strict. But beyond that, no. I mean, nationwide, it’s a piece of cake. So as we talked about the beginning, create a panel, send a requisition form to your email, print it go get your labs drawn, you’re done. It’s awesome. percent was in New York, or was in New York or New Jersey was one of them. 

Dr. Justin Marchegiani: Yeah, both. 

Evan Brand: They’re both difficult. But was it for blood? Or was it for some of the functional or was it- 

Dr. Justin Marchegiani: For blood, but there are some still some Malin fingerprick tests that we have accessible to deal with patients like that. So we still have options for them. Maybe not quite as much. And then if they’re near the Connecticut border or the Pennsylvania border, we have also options there too, but we still have some mail and stuff. That’s helpful. 

Evan Brand: Cool, cool. All right. Well check out the sites We’ll be back next week. Take care.

Dr. Justin Marchegiani: Excellent. Have a good one, y’all. Take care. Bye.


Audio Podcast:

Analyzing Your Blood Test – CBC Blood Test Evaluation – Podcast #142

Complete Blood Count (CBC) Markers

Dr. Justin Marchegiani and Evan Brand talk about blood testing. Listen to them as they discuss about the assessment of significant imbalances in B vitamins or Iron in one’s blood. Know the importance of Vitamin B12 to having healthy red blood cells and determine why it is needed by people on a plant-based diet.

Learn about the tests and white blood cell markers which are significant in determining infections. Discover more about an H.pylori infection and understand how it can be addressed by using a functional medicine approach.


In this episode, we will cover:

02:36   Big Components of CBC

09:00   B12 and the Intrinsic Factor Binding It

11:31   Infection Components of CBC

17:22   White Blood Cell Markers

26:55   Stool Test and CBC Testing







Dr. Justin Marchegiani: And we are live on YouTube and Facebook. Evan, how are you doing, man? Happy Father’s Day Weekend!

Evan Brand: Yes, sir. Same to you.

Dr. Justin Marchegiani: I know. Steaming off; the countdown’s ten weeks and uh– and counting. [croostalk] Your excited?

Evan Brand: That’s it? Ten weeks?

Dr. Justin Marchegiani: That’s it.

Evan Brand: Holy smokes. It goes quick, don’t it?

Dr. Justin Marchegiani: I know. I’m trying to think about all the things I want to cram in before I’m uh – adapt. But I’m just hitting, kind of keeping a pretty simple low key life, so, nothing that’s on my to-do-list that hasn’t already been checked off.

Evan Brand: Great, man.

Dr. Justin Marchegiani: Awesome, and how’s your weekend though. Ain’t it fun?

Evan Brand: What did we do? Honestly, my days flow together so much. I mean, my work– my work and my life, in a great– so much, that I honestly can’t discern the difference between weekends, typically. But I know I went for a hike, and– Oh, actually, so yesterday, I took my brother out for a mountain biking adventure.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I thought I – you know, I thought I – oh, man I’m really not that in shape but then I got my little brother out there, who– he’s not in shape, at all. And I wasn’t out of breath and he was dying. I felt kind of bad. I thought he was gonna pass out at one point. So, we were like two (2) miles into the woods and you know, he’s hyperventilating. I’m like, “Okay, buddy.” Luckily, I brought some uh– professional grade electrolytes along, and so I gave him some of those and he was able to rebound and feel good enough to get back out to the car. So, that was yesterday. That was a blast.

Dr. Justin Marchegiani: Yeah, I mean, it’s amazing. The more, uhm – the more you have inflammation under control in your body, just your resiliency for everything, because the more inflamed you are, the more your body is kind of allocating all of its resources to putting out that fire, right? You don’t have carpenters go into a house while it’s on fire. The firefighters go into the house first. Same kind of thing with your body in– when it comes to performance. Getting the inflammation down helps on everything.

Evan Brand: I was just in better shape than I thought I was. I mean it was a pretty intense trail, and assuming that the adaptogens were probably still in my blood at the time when she was helping with performance, too.

Dr. Justin Marchegiani: Absolutely, we also got a new audio setup today so you can see we’re microphone free. Got a little tip from my friend Abel James on how to set some things up, and I think it may be working out pretty good. And hopefully, people on Facebook Live can hear you as well. So, hopefully. If not, coach up in the YouTube link, as well, to that Facebook live post so they can access it.

Evan Brand: Yeah. Thank you, Abel.

Dr. Justin Marchegiani: Yeah, very cool. And we’ll take questions here on YouTube chat as we go. But, today, we want to talk about Blood Testing. Starting out, looking at your CBC and your CMP. CBC is your Complete Blood Count, and your CMP is your Comprehensive Metabolic Profile. So, your CBC is gonna look of things, such as your Red Blood Cells sizes, like uhm– red blood cells, Hemoglobin, Hematocrit. It will look at thing– and then you also have something called NDC, which is like, MCV, MCA, MCHC. That’s just how big the red blood cell and the Hemoglobin is, right. MCH is Mean Corpuscular uh– Hemoglobin Mean Corpuscular Hemoglobin Concentration, and uhm– MCV is like uh – the width of the blood cells. So, it’s looking at, basically, how big the blood cells are and how many of them there are, and then, it’s looking at also the Hemoglobin content and Hematocrit content. And this is helpful because if you’re Iron or B12 goes low, you’re gonna see your Red Blood Cells, your Hemoglobin and your Hematocrit actually dropped, and actually same thing with your B12; you’ll start to see those drop. You’ll start to RBC, Hematocrit and Hemoglobin start to drop, so that can give you some indications if there’s a potential Iron or B12, and B12 in a Folate and B6 tend to come together. So, it can give you a pretty good indication of what’s going on under the surface. And again, we’re looking at these things from a functional perspective, so the ranges that we look at them at are gonna be a lot more sensitive than, let’s say, a pathological range for let’s say, Iron-based Anemia, right. Your Red Blood Cell marker may have to be below 3.8 for your MD to say anything, we may say below 4.1 on the RBC. Yeah. Same thing with the Hemoglobin, maybe under 11– 11 or so. They may look at it. We may say, “Ooh! Upper 11’s low 12’s for Hemoglobin.” Hematocrit, same thing, like 36, 38-ish, we may start to look at it. They may say 35 or below. So, we kind of have a little more of a narrower range, so for heading in that direction of being more Anemic. So, we know if there’s a B12 or Iron issue from just those markers. And then, we can dig in to look a little bit deeper by looking at the NDC’s, the MCH, MCHC, MCV– These markers get higher, bigger, or larger numbers if it’s a B12 or B Vitamin issue. And they may just stay low if it’s an Iron issue. But again, it may not have to go low but, typically, we differentiate the Iron in the B12, because the MCH, MCV, MCHC will start to go up when their B Vitamins start to get lower. And why is that? It’s because the maturation of Red Blood Cells. They start off really big and they actually get smaller as they get mature. Where, humans, right; we start off smaller and we get bigger, so, the exact opposite of human beings. So, if we don’t have enough B Vitamins, they get stuck in this bigger phase, and they can’t get nice and small like they should. Where, if there’s too much Iron, they actually get too small, right? If you look up– you know, that we’re Anemic, right? It’s kind of mean smaller, weaker, right? So, if we don’t have enough Iron, we can actually get too small if we don’t have enough B Vitamins. We can actually stay too big. So, that kind of just differentiates that. That’s kind of one of the big when I call deal-breakers. What we look at someone’s blood is being able to assess significant imbalances, either in B Vitamins, B12, Folate B6, and then the Iron.

Evan Brand: So, let’s get a bit of context about reference ranges, when you go to your conventional Doc, you’ve got Lab Corp or Quest, or some other Lab running your blood, and the doctor or the nurse calls you and says, “Doctor Justin, everything’s fine. You checked out okay. Go home.” Uh– really– you want to make sure you get a copy of all of your blood tests for many practitioner, because someone’s analysis, may not be the correct analysis. And like we’ll discuss a little bit today, we’re not gonna go too much into the numbers but we will give some about functional numbers. Anyone who’s almost dead, and anyone who’s alive, their getting factored in to the average. So, when you see that the reference range issue’s so huge if you’re anywhere within dead and alive, you’re okay. And for us, that’s just not the case because, if you’re listening to us, we want you to be the top one percent of health, top one percent human performance on the planet, and so the reference range is gonna be much tighter. So, I hear this time and time again, and Justin does too. Every single week, we hear our clients tell us, “Hey, my nurse said my thyroid was fine. Go home.” And then we looked at the thyroid and their TSH is just absolutely in the tank. You know we’re in, like, the single decimal point, through in like a point two (0.2) or point three (0.3), or the TSH is so high – they’re like a six or a seven, and they get told that they’re fine. So, don’t take fine as a correct analysis of your blood work. Get the piece of paper, and you can work with someone like us, and we can help to identify, “Are you actually in the functional range or are there adjustments that need to be made?”

Dr. Justin Marchegiani: Absolutely, and just the people that are seeing on Facebook, give me a thumbs-up or a comment. Let me know if you guys can hear me, or hear Evan’s side of the combo here. We got a new speaker setup, so we’d appreciate that feedback. So, I think we hit some good things, and again, typically, how laboratories are assessed is you got two standard deviations to the left and to the right, right? This is kind of what makes up our Bell Curve. And– so, you have your middle and then you have two – two standard deviations to the left and two to the right. And that those two standard deviations made what’s called the Bell Curve, and 95 percent of the population fits in that Bell Curve. Two and a half on the pathological low; two and a half on the pathological high, so what happens is, there’s always two standard deviations no matter what. So, what Evan said is true. So, as the population gets sicker, those standard deviations get wider and wider and wider. So, that range gets wider and wider and wider. So that’s – it’s really important, because optimal never changes. If here’s optimal, just because you get more sick, people stuck in that reference range, it’s gonna be polluted. Optimal will look more like it’s – it’ll look narrower and narrower as the range gets wider and wider. So keep that in mind. So, we hit the B Vitamins off. We hit some of the Iron stuff. That’s important. Iron’s gonna be more important with female’s that are menstruating, because hormone imbalances like Estrogen Dominance and low Progesterone and Cortisol issues can throw off their menstruation in their cycle. And that can cause excessive blood loss. So, if I see patients, you know, bleeding more than three days and greater than four tampons a day, we’re really going to the super supers[8:39], that can mean excessive blood loss. So, that’s one component. The next is Vegan Vegetarians. Again, really hard, you need to get – plant-based B12 sources aren’t gonna be the best. Even Vegans that are really healthy, they need to be supplementing B12.If you’re not, that can create a lot of problems. And then also, gut issues, right? If we have severe gut inflammation, if we have intrinsic factor antibodies in our stomach, if we have a lot of gastric inflammation in the stomach, it may be really hard to bind up that B12, ‘cause B12 is really interesting. We bind this compound to what called intrinsic factor, and then we– so here’s the B12 that comes into the body via the food, maybe some liver, some really good grass-fed. The intrinsic factor binds it. So, intrinsic factor is made by the Parietal cells using the same cells that produce Hydrochloric acid. So, if we have more gastric stress going on, it’s possible we may not– we’ll have less of these intrinsic factors. So when these factors hits the B12, it goes to the stomach, it goes into the small intestine, the Duodendum, the Jejunum, the Ileum. So, at the very end of the small intestine before it goes into the Cecum, the first part of the large intestine, that’s where it gets reabsorbed into the bloodstream. So, if we have any of those issues in the gut, that’s really gonna affect how we absorb B12. And if we have pathological low levels of B12, we can just have maybe immature, big, goofy Red Blood Cells, like we mentioned, or we can even go more pathological. We start to have nerve issues, Posterolateral sclerosis, Subacute Combined System disease. These are issues, where your Nervous Systems actually gets destroyed because you don’t have enough of that B12 in there to make enough healthy Red Blood Cells.

Evan Brand: Let’s go down that Avenue. Let’s talk about this that will impair stomach acid production. There’s a lot of things out there that people are doing. Things they’re putting into their body. Infections that are going on that could sacrifice this. And so, if we see Blood Tests that are gonna show low Iron, it could be just a Malabsorption issue, right? I mean, you– we see people all the time. They say their eating grass-fed meats but, they could still show up with low Iron because, they’re just not digesting it well or they had a prescription, uh – acid blocker that they’ve been using. Oh, by the way, just feedback for you. Stay close to the mic when you do your visuals, just because, when you go away, you sound so distant. And I know, probably 95 percent of our listeners are audio so, stay close.

Dr. Justin Marchegiani: Evan, I don’t ever want to be away from you man.

Evan Brand: [laughs]

Dr. Justin Marchegiani: No distance now. I’ll get extra close.

Evan Brand: Good.

Dr. Justin Marchegiani: Good feedback. So, we hit the uh– the B Vitamin stuff, right? So, also, platelets, too. Platelets, if they go low, that could be– also an Iron issue, too. Like the big components of CBC. Let’s shift gears if you’re ready to the infection components.

Evan Brand: Yeah, let’s do it. So, H. pylori is the first thing that comes to mind when you’re talking about Parietal cells. I mean, we see that – what would you say the average is? About one in three that you’re saying is infected in H. pylori? Maybe one in four?

Dr. Justin Marchegiani: Absolutely. I mean, here’s the deal. There are a lot of people out there that probably have H. pylori, and they’re symptom-free. So, h. pylori is a helical-shaped, kind of like a little screw kind of shape, uhm– bacterial creature that can burrow itself into the gastric lining. That’s the stomach lining. And it’s gonna be opportunistic. So, the more stressed you are, the more meal-compromised you are, the more your diet sucks, the more your lifestyle sucks, the more that thing will create problems. So most patients that are coming to see us, they’re either– most of them are coming ‘cause they have some kind of symptom that’s driving them in, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: You have some that come in because they want to be at their highest level, and they’re already good but they want to be better. So, if you have an infection, it’s– think it’s everyone’s goal to be infection-free. So, if there are infections there, we want to get rid of the infection. That’s like having a guest come in your house, leave the water on in the guest bathroom you never go in, and then you see the water bill’s like three times higher the next month. It’s the same thing. It’s just sucking resources, may not be financial resources, just maybe energy resources. Uh– mental, emotional resources, that are getting pulled out. Number two, they’re gonna affect, potentially, digestion. And, number three, it’s a ticking time bomb, ‘cause when you do get more stressed, and your immune system got weakened, that can really come in there and create problems.

Evan Brand: Yeah. So, what do you say to the practitioners who tell on their clients, “Hey, look. You’ve got H.pylori. You’re not symptomatic. Let’s just leave it alone – what’s not treated.” What do you say to that?

Dr. Justin Marchegiani: Well, I think we should always get rid of it, because it could potentially be a bottleneck on the digestive system. And then, number two, it will be sucking up some kind of resource on the body, so we wanna do our best to to knock it out. I think, the more resources you can have going towards performing to your optimal level, the brain function, to rebuilding muscle and healing tissue, and going to your healthy anabolic hormones. That’s better. We want to allocate our resources to things that are gonna help us grow versus frivolous things, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, it’s kind of like, investing, right? You want more money going to assets and things that really make your life uhm– you know, better: food, shelter – those kind of things, versus all the things that may not be as much of your priority.

Evan Brand: yeah. I think I told you this already but, I’ll say it again just to make sure it’s on the air. Is– I had a client who came to me a few weeks ago, uh– who went through   medical doctor. He did test, positive for H. pylori, and I said, “Did you get treated for it with the MD?” He said, “Yeah.” And I said, “Oh. Was it triple therapy?” And he goes, “No. They’re doing quadruple therapy now.” That’s for antibiotics instead of three because, H.pylori’s getting so resistant. We probably have to do a whole podcast on antibiotic resistant bugs and how big of an issue it is. But, long story short, the guy did four antibiotics at the same time, and tons of digestive complaints. Still showed up positive for H. pylori.

Dr. Justin Marchegiani: Wow.

Evan Brand: So, it didn’t work.

Dr. Justin Marchegiani: Right. It didn’t work, yeah. Triple therapy is typically Erythromycin, Amoxicillin, and, typically, Prilosec or Bismuth, uh– they used in there. I wonder what the fourth antibiotic they’re adding. Or the third, really ‘cause Prilosec isn’t antibiotic.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Erythromycin and Amoxicillin are– so that…

Evan Brand: I– I think, I’m pretty sure he said it was uh – it was Prilosec so, the acid-blocker and I think three antibiotics. I’m not sure what they were though, in terms of the strains or anything.

Dr. Justin Marchegiani: Yeah. I see so many patients that have uh– zero acid reflex or heartburn and they still put them on Prilosec. Which is just retarded because, it’s like if they’re not having issues with stomach acid and irritation on the gut, why are you putting them on a blocker that may decrease their stomach acid and more nutritional issues down the road. It’s so silly. I get it if they have a lot of the Acid Reflux but, if not, why are you adding another drug in there?

Evan Brand: Yes, there’s a couple markers I wanted to– I wanted to see if I could find them he, in our clinical handbooks on Blood Testing. There’s so many markers that show up as Hypochlorhydria. Do you know any writeup on the top of your head. I guess, you talked about Iron already, so if you have Iron issues, we know that, yeah, that could be yeah, excess of bleeding. But if you’re male, you could still show up low just due to Hypochlorhydria, right? Just low stomach acid?

Dr. Justin Marchegiani: Yeah, you can. Absolutely. That may not be pathological, right? Maybe more of a subtle kind of thing. And here’s the thing. When it comes to functional medicine, we’re moving so many needles, you don’t really know what needle per se is really making the difference ‘cause we may give you Hydrochloric acid, right, and some enzymes, but we may also try to get you to have more time chewing your food, and then drinking water away from food and eating in a more stress-free environment. So, you’re moving six or seven needles right there. I may say, go out get a little more sunlight and Vitamin D, right. So, there’s eight needles we just moved. So, in a double-blind Placebo-controlled trial, typically, they’re moving one needle at a time. Well, man, have you the slow boat to China if you’re moving one needle at a time as a functional medicine practitioner. It’d be so hard to figure out what is the absolute variable, and it will take forever to get patients to get better. That’s why I always say if you can glean from clinical research, do it. Like, you know, the research is the PODMED per se. But a lot of times, the clinical research that were doing, removing so many needles, it’s hard to know what one, but it’s okay because every needle we’re doing on the lifestyle side, we know is helpful. Like, it’s not ever gonna hurt anyone to be in a more relaxed environment to eat, or to drink water away from food, or to chew your food more, right? Those things are gonna help anyone for the most part. So, we combine all of those things with the other stuff and we may see improvements in the B12, or the Iron, or other Digestive things. So, sliding back to the H. pylori, we may look at it indirectly if we’re looking at a CBC, right? We may look at what’s called our white blood cell markers, right. And this is a general kind of indication of our Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils, right? Nutri School we learned it: never let monkeys eat bananas, right? That’s kind of the general jest. And then Neutrophil’s have the highest content, about 60 percent of your White Blood Cells. And Neutrophils all the way down to the uhm– the Basophils, which is like one or two percent. So, kind of keep that in mind. Neutrophils can go up or down for bacteria, Lymphocytes for bacteria and viruses, Monocytes for gut inflammation, bacteria and, potentially, parasites. Eosinophils can go up for, uh– typically, parasites and allergies, and Basophils for Histamine and allergies too.

Evan Brand: Now, is your typical blood test gonna have this broken down like that though…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …or you’re just gonna get a generic White Blood Cell Count?

Dr. Justin Marchegiani: Yeah, typically, you’re gonna have on your CBC your White Blood Cell Number, which will be all of those: Neutrophils, Lymphocytes, Eosinophils, Basophils, Monophils combined– Monocytes combined.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s your White Blood Cell Number. And then you can get uh– a breakdown of all of them. [inaudible]

Evan Brand: So [inaudible] get [crosstalk] a percentage.

Dr. Justin Marchegiani: You get a percentage breakdown, as well as the absolutes. So, the absolutes, the how much Eosinophil’s are in there, and then you get the number as a percentage too.

Evan Brand: All right, so let’s say, I just got my blood work done. I didn’t get the breakdown though. I’ve just got White Blood Cell Count, can we get general inferences about whether White Blood Cell Count– let’s say, their currently up. You can say, possibly active infection, as compared to if White Blood Cells were down, could you have said that that’s a Chronic Infection…

Dr. Justin Marchegiani: Hundred percent.

Evan Brand: …but the body’s not been able to fight it any longer?

Dr. Justin Marchegiani: A hundred percent. So, when you look at White Blood Cells, high or low, but high’s gonna be an active infection. That’s non-specific though. And if White Blood Cells are low, that’s definitely gonna be more of a Chronic Immune depleted kind of situation. And then, from there, we can run the actual individual White Blood Cells. We can infer uh– what may be happening there. So the typical pattern is like Neutrophil’s high, Lymphocyte’s low – that’s a common H. pylori pattern. High Neutrophils, low Lymphocytes, typically, one should get into the mid-60’s– middle-o-60’s. That’s maybe a problem.

Evan Brand: Now, let me clarify here. Is this high Neutrophil’s got a functional range or even like your conventional Lab Corp would flag you, “Hey, look. Your Neutrophils are high.”

Dr. Justin Marchegiani: Yeah. You probably would not– I mean, the functional range is gonna be in the low 60’s. The lab pathological range, typically, is above 70’s, some goes high as 75.

Evan Brand: So, maybe. Maybe your conventional lab will pick it up but,  maybe you got to use a functional reference range instead?

Dr. Justin Marchegiani: Exactly, a hundred percent.

Evan Brand: Okay. So, basically what we’re kind of getting at is we can detect stuff like this H. pylori. We can guess parasites possible based on some of these other components of a White Blood Cell Count but, if any of these stuff is off, whether you’re a White Blood Cell Count, just as a whole, regardless of the breakdown, if the whole WBC is up or down, we could say that warrants further investigation with something like stool, or urine organic acid testing tech sheet, look and prove on a piece of paper, H. pylori’s there.

Dr. Justin Marchegiani: A hundred percent.

Evan Brand: Okay.

Dr. Justin Marchegiani: You got it?

Evan Brand: All right.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: We got a couple questions. Let’s see Samuel asked about lots of Ketosis lately. He said, “Can you give us examples of a day of eating Ketosis?” It’s pretty much meat and fats. I mean, like, I’m probably on Ketosis right now. ‘Did some pastured sausage for breakfast, half of an Avocado, I would say I’m producing ketones right now. Samuel, same thing probably meat, meat and some veggies later for lunch, and meat and veggies for dinner. Like probably do a grass-fed steak tonight. Actually, you know what, I made Fajitas last night. I made some grass-fed beef Fajitas. So I’ll fry the– those again. That’s just bell peppers onions, and maybe a piece of dark chocolate. So, I’ll probably be Ketotic during that meal. Uh – Kendra loves blood tests analysis. Ocasious said, “how do you work” – how does she work with us? Uh – you can just Google Dr. Justin Marchegiani or go to his website Just in Health and then you can check out my website Samuel: How do you know if herbal treatment for H. pylori’s working? To eradicate it, are there any symptom during the two-month protocol? What would you say Justin? I mean, sometimes it’s not symptoms during the two-month protocol. It’s just the matter of the removal of bad symptoms. So, it’s like, stomach pain, like you told me. I said, “Man, I had this weird, sharp pain in my stomach.”

Dr. Justin Marchegiani: Right.

Evan Brand: You said, “All right, and you better look for H. pylori.” It might not be that symptoms, like more energy, but it might be the removal of things. Like instead of more energy, I phrased it as “the removal of fatigue,” or “the removal of gut pain,” or “the removal of diarrhea or constipation.” So, I’m kind of worried. It’s like the removal of the bad thing, like pulling off the layer as opposed to saying, “Here’s your positive symptom” if that makes sense.

Dr. Justin Marchegiani: Yeah, yeah. So you make your list of the conventional H.pylori symptoms, which will be, you know, gut irritation, acid reflux, gastritis, indigestion, constipation, diarrhea, like a lot of your big GI symptoms, right? But then, you kind of have your eight typical symptoms, which could be joint pain, mood issues, fatigue, depression, anxiety, uhm– brain fog, so, energy, right, so, a lot of those things, depression. A lot of those things are gonna be a typical meaning they’re not– they’re outside of the digestive sequela of symptom. So, we got to keep that in the back of your minds. So, typically, you’re either gonna see an improvement in some of those symptoms, right? So, if you have mood stuff, you may see improvements in the eight typical stuff, like fatigue, energy, joint pain, start to go down, you may have some typical gastric symptoms, like the bloating, the constipation, the diarrhea. So, you kind of make a list, and see what improves on the typical and see what improves on the eight typical. And again, most people are gonna see some level of improvement there but in general, the goal is to reduce, kind of pull those stressors out of our stress bucket. The more stressors out of that bucket, you may get better. Some people, if you could kill it too fast, they may feel worse during that killing phase. I can’t tell you how many patients I have, where we create, you know, a die-off reaction handout, if you have this issues, make sure you curtail the dose or adjust the tape right up. So many patients ignore that. They just go into the mindset,

“the faster, the better,” “the more I kill, the better,” so they feel like crap, and then, they don’t even do anything or follow the instructions to modify the dose. So, I always say if you’re really feeling like crap, that means you’re just stressing your immune system, your lymphatics, your detox. You’re killing things off too fast and your body’s having to deal with that dead debris. Slow it down. Add in some things to help with uhm– with the lymphatic flow. Change your tea. Maybe add in some binders, some bentonite clay, some charcoal, some citrus packed in. And then maybe, even add in some extra things for your detox phase 1 or phase 2 nutrients, to help push those pathways. But that’s a good start right there.

Evan Brand: I got a couple more questions here. Avie: are there any books you guys have read about functional medicine that you recommend? I don’t know if I would consider a functional medicine book. But Dr. Jonathan Wrights book, “Why Stomach Acid’s Good for You” I think is pertinent to today’s discussion. And it’s like nine bucks on Amazon. What about you?

Dr. Justin Marchegiani: Tsss. I got a book coming out, man, “The Thyroid Reset.” That’s gonna be a great book; all the practical things. I don’t give myself a plug but, it’s gonna be great because it’s gonna be all real practical things. So, look for that soon. And we’ll gonna get that out. I’m just – I’m too busy with patients, so I need to get someone on board to help uh– get it done, because I don’t want to take away from my helping patients.

Evan Brand: Totally, alright. Outside of your books– Your books gonna be a good one, I know. I’m excited. What about other recommendations?

Dr. Justin Marchegiani: Uh– from a functional medicine standpoint, I mean, I have– we have some books here that are more clinician-oriented, right here, on Blood Testing and such, that I use [crosstalk] for myself.

Evan Brand: Uh– Dr– Dr. Weatherby; he’s got – he’s got a good one. It’s titled, “Blood Chemistry and CBC Analysis.” That one’s a cool one. There’s a couple other once out there. What’s [crosstalk] it– what’s it…

Dr. Justin Marchegiani: I– I wouldn’t give – Izabella once had plugged the Hashimoto’s Protocol. It’s a really good book.

Evan Brand: Yeah. Izabella’s book was really good. What else did I read, so far, this year?

Dr. Justin Marchegiani: I got another book over here. Dr. Horowitz’ book, “Why Can’t I Get Better.”

Evan Brand: That’s a great book. He’s got a new one now, too, Horowitz. I can’t remember what it’s called. I think it’s… [inaudible]

Dr. Justin Marchegiani: Play off some word.

Evan Brand: Yeah, it’s like, “I Can Get Better.”

Dr. Justin Marchegiani: I Can Get – something like that. It’s like a play of that same theme. So yeah. Those are some really good things there too, for sure.

Evan Brand: You want to answer Kendra’s question? I’m gonna go back to the blood here.

Dr. Justin Marchegiani: Uhuhmn – so let me hit one thing. So, I talked about kind of the way blood cells stuff, and then, the breakdown of the blood cells. Now, there’s specific tests that you can do for us, specific H. pylori antibodies, right? IGA, IGG, IGN, and then also, you can do Breath Testing, and then also, Stool Antigen Testing so there’s more specific testing. But you can look at the CBC and you can infer and draw things from that, which is nice.

Evan Brand: Okay.

Dr. Justin Marchegiani: And then, what’s Kendra’s question?

Evan Brand: Yes, she says, “Do you consider elevated Eosinophils a good sign – a good enough indicator of infections or do you think Stool Test are always necessary?” I’ll give my two cents first. We run the Stool Test on every single new client, I mean, if we just depend it on blood test, I feel like our– us having all the puzzle pieces on the table would not be complete.

Dr. Justin Marchegiani: Exactly, and sometimes they can take a lot long time for those markers to drop. So, if you’re treating an infection, it may take like months like after the infections treated for those numbers to kind of slowly go down so, it’s nice to have more immediate infection markers that tell the story. But it’s good, because we– number one, it tells me, the clinician, that something’s wrong. And that we got to look deeper in that stool testing area. And then it gives me more ammo to get the patients to run the test that I think are best. So, that way, the patient’s more motivated because, they know, here’s the clinical direction that we’re going down. Here’s the clinical path that we’re going down. Here’s why we’re going down it.

Evan Brand: Yes. She had a follow-up question. She said, “Or rather should you not do a Stool Test if the CBC doesn’t indicate parasites?” No way, always do Stool Testing. I’d say, once or two times a year. Just a preventative, everybody should be doing Stool Testing because, here’s the deal. We can try to make the guesses and checks based on the CBC like all we think it could be this, we think it could be that, but let’s say, you’ve got, like, Klebsiella or Citrobac, or some type of bacterial overgrowth that can trigger autoimmunity. Well, let’s say you’ve also got H. pylori on top of that, or let’s say, you’ve got Candida, or let’s say, you’ve got Blasto with it. you know, the protocol’s gonna be different. If it’s just…

Dr. Justin Marchegiani: Yes.

Evan Brand: …yeast. We’re gonna do one thing, if it’s just bacteria, we gonna do one thing. If it’s bacteria plus parasites plus yeast, that’s gonna  be a totally different protocol so, if you just say, “Oh I think, this number’s off of my blood, therefore, I’m gonna take this gut supplement.” Waste of time.

Dr. Justin Marchegiani: A hundred percent. So, I think that’s essential because you’re gonna treat different infections differently. And then also, you want to know if the infection’s knocked out because, if you don’t see the CBC go down, you’re like, “Well, it’s just in the latency period. It’s gonna drop over the next few months. Where if you get the infection, you retest and the infection’s still there, you’ve a lot more clinical confidence to keep on moving and trying in different things versus the hate that you get. You’re not, kind of in, an uncertain state.

Evan Brand: Now, the question here, uhm– do you agree that low Melatonin on a BioHealth HPA Axis Spit Test– low Melatonin, do you believe that indicates gut dysfunction?

Dr. Justin Marchegiani: It definitely can. It can increase, or can be uhm– you know, something that I would add to the list of potential, differential diagnosis is, or what the root cause could be. ‘Cause if we don’t have the ability to break down, let’s say, Tryptophan, which then gets converted in the 5-HTP, which then gets converted into Serotonin, which then gets inverted into Melatonin, right? That that could be a potential issue. I also look at B6. I also look at the stress because, your body will burn through Serotonin. The more stressed you are, you’ll see that an organic acid test, you’ll see 5-hydroxyl to last, take a high or low. So that can be indication you’re burning up a lot of those uh– precursors there. Uhm– so, I look at the stress components, you know, adrenals and such. And I, also, would look at the gut component, for sure. And then make sure all the diet and lifestyle things are uhm– you know, the T’s are crossed and the I’s are dotted, right? HCL, enzymes, no infections, making sure sleep is getting all those things, but definitely that’s one thing I would add to the list to rule out.

Evan Brand: Yeah, it could be something simple as you look at your phone too close to bedtime. Low Melatonin showed up before [stuttering] your last Saliva Test.

Dr. Justin Marchegiani: Yeah, I mean, I would say, if you’re like running the test right before that, for sure. But if you’re kind of getting more of an average, so to speak, of the night and in snow, that’s probably not enough to not knock it down from an average standpoint. But, punctuated yes, I think that makes sense.

Evan Brand: Yeah. Let’s see what else we have. Questions here. Diana said, “Do you recommend Nystatin for Yeast Overgrowth to keep it in check while taking herbals? I can’t prescribe, and I would not prescribe it even if I have the ability to prescribe it, ‘cause I typically use like Saccharomyces boulardii, and I’ve just never had issues with– with Yeast Overgrowth, as long as people are doing the diet. And, a lot of the herbs that we use and, Justin, you want to add some stuff too. A lot of the herbs we use, like if we’re working on yeast Overgrowth, the parasites, or bacteria– they’re gonna be multifactorial. So, we may be using an herb that’s gonna also– let’s say we use Olive leaf for Oregano. That could kill bacteria but it could also kill Yeast as well.

Dr. Justin Marchegiani: Yeah, absolutely. So, I think uhm – nice that some of the antifungals uhm – may be needed for more severe issues but for the most part, you should always try the herbals first. And, you should always look at other infections because there could be other infections like Blasto or H. pylori, that could predispose that fungal overgrowth. And if that’s – that’s what’s predisposing it, a Nystatin, a Fluconazole, or an Amphotericin B. That’s not gonna fix the H. pylori, or the Blasto, right? So then, the root underlying issue is still there. While you uhm– you know, basically, you went outside, you pulled the weeds, at the ground level, versus pulling the roots up. So that’s the equivalent. Just – just puling the weed out of the surface and not pulling the root out.

Evan Brand: Yep, well said. Samuel said, “How accurate is the Breath Test for H. pylori?” I’ve personally, never actually recommend this one for a client, because the Stool Testing is just so awesome that I prefer to use that. But, Justin, what’s your – what’s your take on that?

Dr. Justin Marchegiani: Yeah, I mean, if someone has insurance, and they’ve met their deductible, you know, I’ll throw it on there an order from Lab Corp, but uhm – I find that patients may still have an H. pylori infection in their stool, and not have a comeback for a breath. The Breath is good for like acute stuff, but uhm – it’s not something I would just run b5y itself, and say, “Yeah, you’re good.” I’ll always wanna go to the Gold standard which is the H. pylori Testing. And again, we’ve been doing a lot of the DNA Testing for the H. pylori about BioHealth. You know, their #418 or their – the #401H. The H part of the #401 does the H. pylori. And they do great parasitology on their H. pylori. They beat a lot of Labs on that, which is awesome.

Evan Brand: Yeah, it is. Avie have a question, “ Should I wear a Blublockers all day on the computer or only  when it gets dark out?” I’m so glad you answered this. It drives me nuts when I see people promoting these BluBlocking glasses in them, like, out of it, hence, like a health conference and they’re just walking around the daytime, wearing your BluBlocker, it’s absolutely retarded, because you’re destroying – I’ve seen people on the Lab results, who said they’ve been wearing BluBlockers all day. They’ve destroyed their Cortisol rhythm because, their body never knows when it’s daytime. So – and this is not against you asking the question but, I see so many photos of people promoting them because they’re like trending and cool now. But it’s absolutely stupid to wear them during the day because, you can just use a screen software, like Justin and I talked about, called Iris, you can keep your screen at a 23 or 1,900 Kelvin. So, it’s pretty much Amber-colored, which is what I do all day. Because you still need those beneficial spectrums, you know. Those like 1,500 different spectrums you’re getting from sunlight. So, if you’re exposed to, like, an LED light, or a screen light from your computer, you can modify those lights to make it a better situation. But you absolutely still has to have those natural spectrums that come from the Sun. Otherwise, you’re really screwing yourself up.

Dr. Justin Marchegiani: Yeah, I mean, during the day, for me, I’m okay being a little bit overstimulated by light during the day, ‘cause that’s just gonna increase my Cortisol. So, if– as long as everything else is going well, I don’t have a significant Cortisol imbalance, I think it’s fine. I just use it at night; just when the Sun sets. That’s where I pull them out. And I have this one, like, brand now, that I put over my glasses. I’ll put them on, typically, between 8:00 to 9:00 – the last two hours before I go to bed, I put them on.

Evan Brand: Yeah. And I put it too early with the baby so, I mean, at that time during the summer, we’re going to bed before it’s even completely dark outside so, I just kindled down. You know, we’ve got like a little salt lamp to use as a night light, and turned that off. And, we’re good. So–

Dr. Justin Marchegiani: Love it.

Evan Brand: I got a little–

Dr. Justin Marchegiani: Love it.

Evan Brand: I got a little ranty there. I see these pictures of these BluBlockers. These people wearing them, promoting them on Health Conferences. There’s people doing like Facebook ads wearing the glasses during the day. It’s just makes me want to sock them.

Dr. Justin Marchegiani: Yeah, I think I had uhm – I had a Neurosurgeon on the jet cruise recently, and he had them on during the day. But his situation was different. He was up all night doing a Neurosurgery. So he had it on during the next day, because he was tryig to, I think, probably get to bed when he got home. So, I think he was trying to dampen it, and kind of tell his brain that it was night time, so he could get some rest. I think that was a different situation people watch that show. You’re probably thinking about him. I know, I could think of a couple of people that do it at conferences like a freak. I  won’t say their name but, I don’t– I just don’t understand during the day why that’s gonna be the best. I get it at night, right, because you don’t want to lower the Melatonin by upping the Cortisol from the light. So, that makes a lot of sense.

Evan Brand: Well, the Sun, I mean, right now, there’s blue light from the Sun. You’re getting blue spectrum’s during the day.

Dr. Justin Marchegiani: Right.

Evan Brand: And so…

Dr. Justin Marchegiani: Naturally.

Evan Brand: Yeah, naturally. So, it’s not – it’s not like you’re, you’re hacking sunlight. Sunlight is good. You’re never gonna be able to beat that in terms of the spectrum – the color– the color ranges.

Dr. Justin Marchegiani: Totally. Well, we just hit the CBC today, I think saved uhm– the comprehensive metabolic profile for next time. Because I– we’ve already done a good amount. We hit the key CBC markers, RBC, Hemoglobin, Hematocrit, right? We talked about the differentiating, the Iron versus the uhmm– the B12. We talked about the White Blood Cell panel, right? The White Blood Cell, we talked about the uhm – Neutrophils, Lymphocytes, Eosinophils, Basophils. And then one of their marker here, I’ll hit is– we’ll hit in the CBC and the CMP part next time. But you can do markers for Red Blood Cell and Magnesium, which is great but, Magesium kind of comes under the Comprehensive Metabolic Profile. So, we’ll talk about that. Intracellular versus extra cellular so, we always like to do if we can do, a specialty test for, like, the Magnesium Serum versus– I’m sorry. Red Blood Cell Magnesium – that’s better, ‘cause that gives us the window intercellular, inside the blood cell versus outside of that. Kind of what the blood cell swims in if you will.

Evan Brand: Yep. That would be fun.

Dr. Justin Marchegiani: Home. Awesome. Home. Any other questions, comments, concerns?

Evan Brand: We had one from Gupta here. Okay. Gupta: “ What’s the best hormone test?” Kind of a general question but, since we talked about Cortisol and Melatonin today, a lot of times, we’re looking at a salivary uh- Cortisol test, which is gonna tell us a lot about Gut Health. If you got high Cortisol, we know that’s gonna damage somebody’s gut. Uh– so that– that’s what I typically write in. Justin, what are you doing hormone-wise.

Dr. Justin Marchegiani: Yeah. Hormones I’ve been doing and going combination between the Dutch and then also doing more of the BioHealth, the Cortisol Awakening Response. So, we’ll run the #201 and the #205, nd then we’ll add the Cortisol Awakening Response, so we can look at zero, 30, and 60 minutes waking and see if we have that ice bump of Cortisol here, a bump at 30 and then a halfway drop down here. A lot of patients, they’re not even getting that, that Cortisol up. In your awakening response, we get a bump, 50 percent bump, a drop of about a third here, like that. And most people they aren’t getting enough, high enough, and they’re dropping down actually lower. So that give us a pretty much good window of what’s happening with our HPA Axis.

Evan Brand: And yeah, it’s so much more fun to have the Awakening response versus impervious times that’s just having that one morning reading?

Dr. Justin Marchegiani: It’s nice. It gives you a pretty good window what’s happening with the brain, and the hypothalamus-pituitary-adrenal axis, for sure. I love it.

Evan Brand: Stacey, thank you for the feedback. We appreciate it. Uh– Kendra said, She gives a podcast idea. “A Recommended Test: Serum, Urine, etc., For Each Essential Micronutrient: Magnesium, Zinc, B6, Fatty Acids, etc.” I’m gonna guess. You’re gonna tell her just to do a SpectruCell but maybe we’ll save that for future reference.

Dr. Justin Marchegiani: Yeah. I mean, SpectruCell will be great, ‘cause you get more intracellular nutrients there, but yeah, we’ll talk about that next time. There’s other markers that we can look at for Zinc, like Alcohol and Phosphatase, and Magnesium, like the Red Blood Cell Magnesium. So, we’ll say that for next time. We’ll dig in more.

Evan Brand: Cool. People can go check out They can check out Justin Store, custom formulations there, lab tests, scheduling consults with him– Then myself, just Evan Brand. E-V-A-N Brand dot com (, and check us out. We’ve got, what? Probably a combined total of five or 600 pieces of contents. So if there’s something there that we didn’t cover today I’m sure he have – in some form or fashion.

Dr. Justin Marchegiani: Yeah, just use the search bar on our site. A lot of people, they come in on some of the questions and they asked questions. Uhm– like about stress and things like that. Uh – we may not be able to answer more very generic questions but that’s why we go back to the site and just put that into our Search browser, and you’ll get uh– lots of Podcasts and other articles on that. So, we don’t mean to ignore you but, go back and use that Search Bar first.

Evan Brand: Yep, totally.

Dr. Justin Marchegiani: Cool. And you no longer the Not Just Paleo guy. You’re uh– you changed your brand. I mean…

Evan Brand: It’s on.

Dr. Justin Marchegiani: Evan Brand changes his brand. Is that a coincidence or what?

Evan Brand: It’s gone. The website, like, went down, and I said, you know what, this is it. I finally got it. I was able to purchase my– my name dot com. So, that’s what I did. Stacey: “Is it okay to take D3 on a regular?” Yeah, probably is. If you’re taking Vitamin K, or you’re doing grass-fed butter. Then, you’ve got the K that’s gonna help act as a traffic cop for the Calcium, so that you’re not upping D3 and then Calcium on your arteries but, just get your levels retested. I had a lady who has taken a bunch of Vitamin D. She got her levels tested. She was above a hundred and twenty (120) and that’s toxic, so you can’t have too much of the good things. So just get your blood checked. If you can get it through your doctor, cool. If you need to get it through somebody like Justin or myself, we can do it on uh– an out of pocket basis, as well, for blood. And, it’s always good to check. Make sure you’re about 60 units.

Dr. Justin Marchegiani: Love it, man. Love it. Well, anything else you want to mention here before we go?

Evan Brand: I don’t think so. People listen on YouTube. They can’t give us a review obviously. But, if you’re listening to the audio portion on iTunes. Give us a five-star review, ‘cause it helps sustain the top of the hills chart, and that way, this functional medicine approach can get to more people and then we beat out people like a Jillian Michaels, who are promoting, like, Calorie Counting and Weighing Yourself, and Weighing and Measuring Your Food, and all that other crap that we just don’t agree with. Is not necessary for you to be optimally healthy. If you give us a five-star review on iTunes, we beat out her, and then this info gets to people like you instead.

Dr. Justin Marchegiani: Hundred percent, man. Awesome. Well, great chat today, Evan.

Evan Brand: Likewise.

Dr. Justin Marchegiani: We gotta do it again, real soon.

Evan Brand: Yes, Sir.

Dr. Justin Marchegiani: Alright, take care.

Evan Brand: Bye.

Dr. Justin Marchegiani: Bye.



“Why Stomach Acid’s Good for You” by Dr. Jonathan Wrights

“Blood Chemistry and CBC Analysis” by Dr. Weatherby

“Hashimoto’s Protocol” by Izabella Wentz

“Why Can’t I Get Better” and “I Can Get Better” by Dr. Richard Horowitz

“The Thyroid Reset” by Justin Marchegiani



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.