Collagen Diet: Collagen-Rich Foods for Healthy Joints, and Skin

We know collagen is going to help with the joints because we know half of your bones are protein. We need good building blocks for our cartilaginous tissue and ligamentous tissue. Frankly, most people get most of their protein from muscle meats. That’s a problem because they’re not getting the knuckles, the bones, and the cartilage, as we would from old-fashioned soups. So, if you’re doing a lot of soups and bone broth soups, that’s great. If not, we really want to add extra collagen.

Click here to consult with a functional medicine doctor for more information on a good collagen diet and supplements.

I do 20 g of collagen in my coffee every morning. I think it’s amazing. I do my true collagen with some MCT oil and grass-fed butter. I love it. I think it’s excellent for skin, hair, nails, and just for overall prevention of bone loss and cartilage loss. We know the wear and tear that most people experience in their joints throughout the year, especially if they do a lot of long-distance cardio. You really need more building blocks to help prevent and mitigate the wear and tear, so you don’t have knee and joint replacements later in life. Collagen can really help decrease some of that wear and tear.

How do you take collagen?

I like adding collagen in my coffee in the morning because it has a nice little kind of creamer-like effect. It gives that little bit of frothiness which is wonderful. I also do it before bed. Sometimes I’ll do a little bit of collagen (glycine), magnesium, and vitamin C because vitamin C is a really important building block for making collagen. I find magnesium has some very good calming effects as well where there are plugs in the GABA or it’s just a natural beta-blocker as well. It can calm the heart and bring the heart rate down a little bit. I think magnesium does work on some of those GABA pathways as well and, of course, magnesium helps with blood sugar. You’ll get deeper sleep and better REM sleep when you have good magnesium. So, I love combining collagen and magnesium at night.

Where can you get collagen from?

You can get collagen from food via bone broth. Chicken skin is super rich in glycine, roughly 3.3 g for 3-1/2 oz. If you make chicken soup, throw the whole chicken in there. Get a rotisserie chicken from Whole Foods and or get the fattier cuts of the chicken at least with the bone and the skin, so that way you get the best of both worlds if you’re going to do it from a whole food source. Regarding seafood, wild salmon is going to be the best source of glycine.

If you want to learn more about the collagen diet and other good sources of collagen, click this link to schedule a chat with me!

Natural Herbs and Foods to Help Fight Stress

When you’re stressed, what are the important things? Blood sugar stability is really important because most people get on a roller coaster when they get stressed, meaning they’re overly gravitating towards alcohol and towards refined sugar. Their blood sugar goes up and then it crashes down, and then it creates more nervous system stimulation via adrenaline, epinephrine, and cortisol being stimulated to bring the blood sugar back up.

Click here to consult with a functional medicine doctor for guidance on which foods to eat for stress relief.

So, I find just keeping it really simple and really easy with your meals. You may be more nauseous when you’re overly stressed because stress hormone does cause you to feel nauseous. So, this is where you may want to do a soup or a simple smoothie, something really easy where there’s not a lot of digestion but you’re still getting some proteins and fat in there, whether it’s some collagen and some coconut milk or just sipping on some bone broth. Something like that’s going to have some good fat and good protein, and it won’t be hard to digest. So, if you feel nauseous, just still know you should probably be eating but just try to make it something very easy on your tummy.

Then think what are some of the nutrients your nervous system is going to need when you’re more stressed. So, the low hanging fruit, B vitamins. B complex is going to be very essential. Magnesium is going to be excellent. GABA and L-theanine are good things that are going to help you relax and wind down. Valerian root or passionflower, which are all connected to GABA and that inhibitory neurotransmitter that helps you just relax a little bit. It kind of puts the clutching gear and disengages the gearbox, so you can downshift so to speak.

I always go to nutrients first and then I go to my favorite adaptogenic herbs second. So, Ashwagandha is one of my favorites. Rhodiola is excellent and there’s holy basil, which are my favorite very relaxing and tonifying herbs.

If you want to learn more about herbs for stress relief, click this link to schedule a chat with me!

Nutrients to Help Make Serotonin to Help Improve Mood and Sleep

In today’s blog, I am going to share with you the natural ways to boost your serotonin levels and other alternatives. Let’s talk about nutrients to help support serotonin levels.

Click here to consult with a functional medicine doctor to learn more about boosting serotonin levels.

Serotonin is a really important neurotransmitter. Its building block comes from protein and amino acids, particularly 5-HTP (5-hydroxytryptophan) but serotonin has a lot of important roles in regards to mood, well-being, sleep, stress reduction, and happiness. So, all these things play a major major role in helping you feel good. If we have inadequate serotonin levels, that’s going to create a whole bunch of things. Once you start having sleep issues, mood issues, or stress issues then stress starts to hitch a little more. You don’t quite sleep as well. You don’t adapt to or deal with stress, not quite as resilient as well, and then a lot of times you’re just not going to heal and recover well either because serotonin is a precursor to melatonin. Melatonin helps you sleep and it’s also a very powerful antioxidant. So, a lot of good benefits there.

Serotonin is made from tryptophan and/or 5-HTP which is 5-hydroxytryptophan. Now, I personally like using 5-HTP better because there is an enzyme that’s kind of a governor on tryptophan converting downstream into serotonin. The 5-HTP bypasses that enzyme, so you can therapeutically bump up serotonin a little bit better with 5-HTP. So, we use 5-HTP and B6 that can really significantly improve serotonin levels. Anywhere between 100 to 600 mg per day can be very helpful. There are important cofactors that will also add. B6 is an essential B vitamin that helps with the synthesis. You may also want to throw in B12 or methylcobalamin, ideally methylated because these neurotransmitters need to be methylated. B12 makes a huge difference.

In the podcast, we talk about a study where they used antidepressants, not that I’m a huge fan of those, but they found that an antidepressant plus a methylated B12 improves depression symptoms by 20%. So, we know B12 and that methylation process is very important for your neurotransmitters. Also, we can throw folate in there because folate works a lot like brother and sister with B12. So, B6, B12, and folate (or B9 for short for folate) are really important. Those are your key methyl groups in regards to your B vitamins. They have a lot to do with methylation.

Of course, vitamin C can be very important because the adrenals play a major role in serotonin and stress. In that sympathetic fight or flight nervous system response, the adrenals play a big role in making cortisol and/or adrenaline to help manage or deal with or adapt to that response. So, for chronically firing our adrenals, whether it’s cortisol and/or adrenaline, and we start have HPA access issues meaning brain-adrenal communication feedback issues, that can make it hard for us to kind of calm down from stress and/or even ramp up to deal with stress. So, it’s kind of like it being really cold out, you put your heater on and you can’t quite mount the heater or mount enough of a response to create heat and warm your house up or vice versa if it’s cold. You need to be able to adapt and modulate to our environment. So, we need healthy adrenal function. A lot of times, I’ll add in things like various adaptogens like Rhodiola, Ginseng, Ashwagandha, and Eleuthero. These are great adaptogenic herbs to help us modulate and deal with stress better.

And then, of course, a good healthy diet is essential because inflammatory foods, food allergens, processed junk, grains, and refined foods are going to stress out our body. The problem with refined processed foods like grains and sugar is they can, in the short run, increase our serotonin and allow us to feel good. So, people say, “Oh, I’m an emotional eater.” What are you doing? You are essentially trying to artificially boost your brain chemicals up with junk food. It’s like whipping a tired horse to perform better. It’s like trying to drink coffee at midnight to get work done. It’s going to just throw off your sleep and you’re going to be tired the next day.

So, of course, there are always what I call constructive vehicles versus destructive vehicles. Destructive vehicles provide a short-term gain and long-term destruction if they are habitual. Constructive vehicles are not quite as an impactful short-term gain but long-term restoration, long-term healing, and long-term performance enhancement. So, that’s good digestion, eating protein, balanced blood sugar, and we can utilize amino acids like 5-HTP, B6, folate, B12, vitamin C, and adaptogenic herbs. These are very helpful in modulating our stress response. They also modulate how we perceive stress. The more you can perceive stress better, you don’t mount as much of a cortisol or adrenaline response because your perception of it is much better.

Things like magnesium can also be very helpful as magnesium kinda plays into GABA. GABA has a major role in the inhibitory neurotransmitter. It’s the downshift or it helps hit the brake, so things like GABA by itself and things like L-theanine are excellent. Adaptogenic herbs like passionflower or Valerian can be very calming. Even things like Kava or CBD could also have a very calming effect. So, there’s a couple of different things that we can throw in there.

When I’m working with the patients, I’m always saying to myself, “What’s the root cause?” Let’s set the foundation and make sure the root cause is supported. Let’s make sure able to break down and digest and absorb all the nutrients and make sure there are no underlying bottlenecks in regards to low enzyme, low acid, and gut infections. Let’s make sure we’re managing our lifestyle stressors and we’re doing our best to sleep good. Food is good, food quality is good, and hydration is good. I make sure those foundations are solid and then we can kind of get in there with other supplements and nutrients to help support those pathways.

If we wanted testing for neurotransmitters, I’ll do things like organic acid-based tests. Then we’ll look at a lot of the metabolites for these neurotransmitters, whether it’s serotonin where we will use 5-hydroxyindoleacetate (5HIAA) or we will use Vanilmandelate which is a marker for adrenaline or Homovanillate which is a marker for dopamine. Again, dopamine is a precursor to adrenaline, so it’s phenylalanine, tyrosine, dopamine, L-dopa, and then it can go down to epinephrine/norepinephrine or adrenaline/noradrenaline. It’s the same thing. So, these are catecholamines and they can convert a lot of these upstream neurotransmitters down. There’s some overlap in dopamine and serotonin symptoms. A lot of people that think they have serotonin problems may actually have a dopamine problem. So, it’s good to get tested as well. It’s good to look at the symptoms, make sure the foundation is set, and then you can dive in deeper to look at a lot of these nutrients.

Now, in my supplement line, we use things like Brain Replete which has an excellent 10:1 ratio of tyrosine or dopamine to serotonin. That’s a good combo product. It has all the precursor nutrients, too. Also, I use a product called Serotonin Replete which is excellent with 5-HTP with B6. I have a product called Dopa Replete which is just a tyrosine product that is nice for lower dopamine issues and for higher dopamine, there is a product called Dopa Replete Plus and that helps bump up dopamine more. It has got Macuna pruriens in there plus a couple of other compounds that are very helpful. It has L-dopa, tyrosine, EGCG, and of course, B6.

If you’re overwhelmed with how to increase serotonin levels, then click this link where you can schedule a chat with me!

Effective Ways to Increase Your Vitamin D Levels

Back in the 1980s, a guy named Edgar Hope-Simpson proposed that a seasonal stimulus was intimately associated with seasonal epidemic influenza. Long story short, winter comes and then all of the sudden viruses become more of a prevalent issue. There was this whole interventional study that showed vitamin D is reducing the incidence of respiratory infections in children. So, this was specifically talking about kids but there are countless of these for adults.

Click here to consult with a functional medicine doctor to find out how you can supplement with Vitamin D effectively.

What’s happening when the vitamin D levels are sufficient are a multitude of things but in particular, it’s helping to reduce Interleukin 6 (IL-6), which is one of those inflammatory cytokines that get people in trouble. So, if you can reduce your cytokines, that’s going to be beneficial. Also, another cool benefit is not only a sort of an antiviral but there’s some antimicrobial benefit. It can actually activate your immune cells to produce some antimicrobial like a natural antibiotic if you will by upping vitamin D concentration.

How do you take Vitamin D?

Is it just an ongoing thing? If you think you’re getting into trouble with illness, do you go high dose of it? It depends on what your levels are.

So, get a baseline first. I would say the lighter or more fair your skin is, probably the more efficient you are gonna be in converting vitamin D from the sun. The darker your skin is, the more melanin you have. You’ve got different spectrums and for example, a full-on African-American has the highest amount of melanin.

What is Melanin?

Melanin is like your natural UV block and it helps block your skin from the sun’s rays. So, due to evolution and where we evolved, there are people who live closer to the equator and there’s more UV light based on the angle of the sun hitting it. These people naturally evolve with more melanin in the skin. People that evolve further away from the equator get less direct UV light, so there’s less melanin in the skin because it’s all about making vitamin D.

So, the more efficient you are at making vitamin D, you probably will be able to get away with not supplementing as much or as frequently. The more melanin in your skin, the more you have to be on top of your vitamin D because unless you’re going to be outside 6 to 8 hours a day and you’re at a mid to low 30 latitude, you’re probably just not going to be able to ever make enough vitamin D. Therefore, you really have to be on top of everything in your testing.

Vitamin D Dosage, Testing, and Recommendation

For lighter skin, in general, a good rule of thumb is 1000 IUs per 25 pounds of body weight, especially in the fall and winter months. If you want to take a break in the summer, that’s fine. Just make sure you get a test here there to confirm it. The darker your skin is, you may even want to double that in the winter months. Then you may want to follow-up and retest in the early spring to see and to monitor where you’re at. If you’re someone who works outside, you have to make that adjustment. If you’re an office person and you’re inside all day, you also have to make that adjustment, too. So, in general, 1000 IUs per 25 pounds of body weight.

If you have darker skin, you may want to double that for the winter months, and then it’s always good to confirm some time in the winter and some time coming off the winter or early spring-summer to see where you’re at. We can always adjust accordingly and if there is any risk of autoimmunity or cancer, we probably want to be testing just a little bit more frequently. Once you know where you’re at, you can guess based on how well you’re doing.

If you want to learn about the most effective way to supplement with Vitamin D, click this link where you can schedule a chat with me!

The Top 5 Reasons Why Your Estrogen Levels are High – Men & Women!

Let’s talk about the top 5 reasons why your estrogen levels are high. We’re going to break them down today.

WHAT ARE ESTROGENS?

First, let’s look at the 3 major kinds of estrogens: E1 or estrone, E2 or estradiol, and E3 or estriol. In a woman’s regular cycle, it’s usually estradiol we’re talking about. When you start shifting to more menopausal and the ovary stops working, you start getting more estriol. The adrenals help in kick in a lot of DHEA and you make more estriol. Estradiol is more of the growth factor type of estrogen and estriol is a weaker estrogen.

Click here if you need to consult with a functional medicine doctor to learn more about estrogen and your hormones.

WHERE CAN WE FIND ESTROGENS?

  1. PLASTICS. You’ll get it when the plastic is warm like in a microwave or out of a plastic water bottle especially if it’s in the car and the sun is hitting it or it’s outside. That’s why you want a good stainless steel or glass water bottle if you’re going to go outside or leaving it in the sun. The microwave heat and the radiation is going to cause a big release of plastic chemicals there, the xenoestrogens. One of the big ones are the phthalates but also BPA. There are other types of BPAs that are new which are supposedly safe but there are still estrogen-like compounds there as well. These plastics can affect women and men as well. Men are actually going to be more affected by them because men aren’t used to having estrogen in their environment and getting a whole bunch is going to be a problem.
  2. PESTICIDES. These tend to have an estrogenic quality to them and if you’re eating foods that are not organic, you’re definitely going to be getting organochlorines and various pesticides in your environment.
  3. PHYTOESTROGENS. These are found in soy. For example, I had a vegan-vegetarian patient. We ran a Dutch sex hormone panel on her and her estradiol was through the roof and really high. Phytoestrogens can be a big one, so soy may be a problem. With vegan-vegetarian, there’s a lot of phony protein consumption like fake meat kind of stuff such as the Beyond burger where there are a lot of soy and estrogen-like compounds in there. There are also hormones in meat. You have to make sure you get antibiotic-free, hormone-free, and ideally organic and pasture-fed or if you’re on the Whole Foods scale, step 4 or step 5 is ideal. Step 2 is at least pretty good. Organic means no pesticides, no hormones, and also the food they’re eating has no pesticides or hormones, too.
  4. HIGH LEVELS OF INSULIN. Too much carbs drive high levels of insulin because insulin responds to a high level of blood sugar. The blood sugars in your bloodstream go up and your pancreas comes in. The beta cells make a bunch of insulin to bring it down and bring it into the cellar and converted to fat. So, high levels of insulin upregulate an enzyme in men called aromatase that converts testosterone, the male hormones, to estrogen which becomes a problem. Now, in women, a similar thing happens but it’s the exact opposite or the big switch. Their estrogen is converted to testosterone. So, women can actually get more androgen-like issues which results in weight gain, acne, hair growth, and sometimes you can see some libido enhancements on that. So, that’s the difference between men and women.
  5. POOR GUT HEALTH. In the gut, we make healthy good bacteria in our gut that help us absorb a lot of nutrients. A good healthy gut function helps us break down protein for good HDL levels and good enzyme levels. We need these to break down protein into amino acids which are really important for helping us to detoxify. So, detoxification helps us to excrete estrogens that we’re getting exposed to in our environments such as the pesticides, plastic, or something that you don’t even know you’re getting exposed to. Good healthy detoxification will help your body eliminate that, so that’s a good backup plan.Also, if we have a lot of dysbiosis, SIBO and bacterial overgrowth, we can make a lot of what’s called beta-glucuronidase. This is an enzyme that’s made by bad bacteria and it makes it harder to detoxify estrogen. The beta-glucuronidase takes conjugated estrogens and binds it to a protein that helps us excrete it out the body. It takes that protein and it pulls it apart. It takes the handcuffs off that protein, so that allows that estrogen that’s been deconjugated to go back into the body in the general circulation. So, if we have gut issues, that could be a major concern.

HOW DO WE ADDRESS THE PROBLEM?

We need things like cysteine, glycine, glutamine, sulfur amino acids, and things that help us methylate like B12, B6, and folate. So, these nutrients we have to get them in our diet via a good diet. We need to be able to break down and absorb those nutrients, so we need good digestion to get those things in there.

So, in general, we’ve got to make sure we have a good gut bacteria balance. Even fungal overgrowth can cause problems and H. pylori that can lower stomach acid and make it harder to break down nutrition on one side and then it can create this bacterial overgrowth enzyme that makes it hard to detoxify estrogen. These are really important components. If you have any issues with estrogen, you’ve got to look there.

Now, we may want to do things to help detoxify like make lifestyle changes, food changes, pesticide changes, make the changes in regards to plastics, and make in in regards to your diet, your glycemic load, and your gut. That’s a good first step to get to the bottom. There are also different things we may do to help upregulate detoxification to help get that estrogen. It may be activated charcoal or various soluble fibers. It could be things like bentonite clay. We could use things like DIM or Calcium D-Glucarate or glutathione, sulfur amino acids, and vitamin C. They’re all helpful in different situations. We would recommend them based on what’s happening but at least make the diet and lifestyle changes out of the gates.

If you want to find out the root cause of what’s happening, click this link where you can schedule a chat with me!

Top 5 Warning Signs of Hormonal Imbalance

Let’s talk about hormones. I’m going to dive into a couple of clinical pearls that I see in my practice from working with hundreds of female patients and male patients which have a major effect on modulating and supporting hormonal balance.

Click here for a consultation with a functional medicine doctor if you want to learn more about hormonal imbalance.

 

These are my top 5 hormonal balancing strategies:

 

  1. One of the first things in regards to hormones that’s very important, and this may be common sense but I try to give a lot of knowledge guided by experience, is nutritional building blocks for your hormones. Healthy cholesterol from animal products are very essential. Fat soluble vitamins like A, D, K are very important. Lots of good protein are also very important. We have steroid-based hormones that are going to be more cholesterol-based and we have peptide-based hormones that will also be protein-based. So, a lot of these protein, fat-soluble vitamins, and cholesterol especially healthy animal cholesterol are very helpful for hormonal building blocks. If you have a vegan-vegetarian diet or if it’s very nutritionally poor or there’s a lot of processed food, that may set you up with a deficit out of the gates for just hormonal issues. Remember: Make sure the food is nutritionally dense, anti-inflammatory, and low in toxins. That’s vital.

  1. Now, if you’re having a lot of good nutrition in there, the next thing is we have to make sure we’re able to digest it and break it down. So, if we have a lot of chronic acid reflux, poor digestion, constipation, or bloating, we know we’re not quite breaking down our food and our nutritional building blocks. That could tell us that we may have hormonal issues because we’re not breaking that down. Therefore, those nutrients can’t get into our body or get in our bloodstream and be taken throughout the body to be used as building blocks. So, if we have a bottleneck in the nutritional side, that could be a big factor.

  1. Stress, whether it’s emotional or chemical stress. If we’re eating foods that are inflammatory or we’re nutritionally deficient and we have a lot of emotional stress, what tends to happen is our hormones kind of go on two sides. We have an anabolic side which are the growth hormones — testosterone, estrogen, and progesterone — that kind of help deal with growing. Then we have anti-inflammatory hormones which would be cortisol and are catabolic. I always put progesterone in that category because progesterone can be used to make more cortisol. So, we have our anti-inflammatory and then our anabolic. In some, they kind of cross over. Insulin, growth hormones, and testosterone are anabolic. The more inflamed we get, we could have high amounts of testosterone because of PCOS and because of inflammation. So, some of these hormones kind of interact and cross over. With men for instance, the more inflamed men get and the more stressed they get, that can actually cause an upregulation of aromatase and could increase their estrogen. So, see how these things kind of cross react. Your hormones are going to be either pro-building or anti-inflammatory to reduce stress. So, for chronically and stressed out state, cortisol is going to rip up your protein and kind of decrease your muscle mass. As a woman, you’ll see your progesterone level start to drop and that will start putting you into an estrogen-dominant state because if we normally got 20 to 25 times estrogen than progesterone, that ratio starts to drop. Even if you still have more progesterone than estrogen, that ratios is going to throw you off and that can create breast tenderness, cramping, mood issues, excessive bleeding/menorrhagia, infertility, a lot of mood issues, back pain, and fluid retention. All those are possible situations.

  1. Xenoestrogens from the environment and foreign estrogens. They can come from plastic components, pesticides, herbicides or rodenticides, mold toxins, and heavy metals. They are going to disrupt our hormones. The easiest thing is eat organic, avoid plastics, and avoid a lot of the chemicals in the water because a lot of times you can get pesticide runoff or hormone runoff in the water. So, clean water and clean food, and then make sure it’s organic avoid the plastics as well. That’s a big, big thing. Plastics are probably okay if they are in a refrigerator or in a cold environment but ideally if you’re heating stuff up or it’s going to get exposed to light, you want some kind of a Pyrex or a glass container. It’s much better and really important.

  1. Last but not the least would be just making sure our detoxification pathways are running well. So, if we have good hormonal balance but we can’t detoxify it, then a lot of times we can reabsorb it. So, if we don’t have good sulfur, good glutathione precursors, good B vitamins, good methylation, N-acetylation and glucuronidation, we may have a hard time eliminating. Hence, we are re-absorbing a lot of our hormones. So, being able to break down your proteins, break down your amino acid and your B vitamins is going to help with your body’s ability to eliminate a lot of these toxins.

Summary:

Blood sugar, digestion, stress, xenoestrogens, and toxicity are really big. Those are the big 5 across the board. Try to apply at least one of these things.

If you’re struggling with hormonal issues and you want to dive in deeper, feel free to schedule a consult with myself.

Investigating Your Adrenal and Hormones With a DUTCH Test | Podcast #327

In this video, Dr. J and Evan talk about the adrenal glands in our body – to produce certain hormones directly into the bloodstream. These hormones will respond to stress and other necessities to our existence. Also, they are discussing the detailed test needed to identify the root cause of problems and what other materials and hormones are essential to keep our adrenals and body healthy.

To support the body naturally, Dr. J recommends using herbs such as maca and ashwagandha. Progesterone, estrogen, and estriol may be fit for a patient. However, it is essential to know that protocols may be different for every patient since presentations and lab results may differ.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:20     Labs At Home

5:07     Low Cortisols

9:37     Hormones

11:09   Dutch Tests

28:19   Useful Herbs

34:47   Healthy Estrogens

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Dr. Justin Marchegiani: And we are live. It’s Dr. Justin Marchegiani in the house with Evan Brand. Today we’re going to be talking about hormone and adrenal lab testing what we’re actually using in our virtual clinic to assess our hormone imbalances in our patients and different things that we’re doing to address those imbalances. Evan, how are we doing, man? 

Evan Brand: Good, excited to get back in the saddle here and talk about something that we can test at home, which is amazing. I think that’s the first benefit to point out about some of the testing you and I are utilizing is that many people now they care more about their health than ever obviously, the state of the world has convinced people that health does matter. You need to prioritize this stuff. And so we can send these labs to your door. And so the test that you’re going to be showing people today will be something that you can do if you’re listening via audio, you might miss the visual, you can go to Justin health YouTube channel and see the video, but we’ll be sure to make sure we talk about it in a way that you can still understand even if you’re just audio only today.

Dr. Justin Marchegiani: Yeah, if you’re listening to the audio, we’ll put a link down below for the video so you can see it. And also if you’re listening, you can go to Justin health.com slash YouTube and hit subscribe. Alright, so let’s dive in. And so we deal with patients from all over the world virtually that have all kinds of different hormonal imbalances. It can range from a menopausal woman with lots of hot flashes, mood issues, vaginal dryness, depression, skin elasticity, hair loss issues, it could be a cycling woman that has a lot of PMS. pmdd breast tenderness, cramping, back pain, mood issues, irritability, also infertility as well. And then it was a lot of different imbalances in between excess androgen issues like we see in pcls, polycystic ovarian syndrome, we may even see estrogen dominant issues just like which could be PMS as well. Could be infertility, could be fibroids could be endometriosis could be fibrocystic breast issues, all of these things are on the table and of course, even manage a male issues to could have men could have excess estrogen and or low androgen and or low or high cortisol and or low or high Da, da all these imbalances are potential, I always tell my patients, you have the right to have more than one issue at the same time. And you can also have a hormone imbalance and also have multiple gut infections too. Of course, it’s all possible, right?

Evan Brand: Yeah, people hearing that too. They’re like, what the heck kind of mumbo jumbo? Did he just say, and how does that manifest? Well, you know, low libido, too. I mean, that’s one that I’d say at least 90% of the people I’m working with, that’s a question we always ask is, you know how you drive. And sex drive is always terrible for people. I was actually a study that came out. And the vast majority of people surveyed said that they would rather scroll on their smartphone on social media than have sex with their partner. And I thought, Oh, God, is that where we are in the technology world that the phone is more desirable than our partners? That’s no good.

Dr. Justin Marchegiani: Yeah, definitely not good. 100%. So I just kind of laid out a couple of potential patterns there, we’ll kind of dive into them one by one will actually show you a real live patient lab here for y’all to kind of look at obviously, it’ll be centered regarding who the patient is. But we’ll put all that information out there for y’all. So you can kind of see how a lab looks out of the gate. So one of the first things that we do when we look at a patient, male or female, we’re going to look at adrenal function. And adrenal function is very important because your adrenals make cortisol. Cortisol is an anti inflammatory hormone. Most people in today’s day and age, they’re not under inflamed, they’re over inflamed. So having your body’s natural anti inflammatory system on board is vital, very, very important. Second is cortisol rhythm. Cortisol rhythm plays a major role in your circadian rhythm, which is waking up energy in the morning. Having good rhythm helps a lot with mood, and also lower cortisol at night. And that nice gentle taper of cortisol. So cortisol starts, it starts mid range, when you wake up, and in that first 30 minutes to an hour, it almost doubles. And then from there, it tapers down throughout the whole day. And we want a nice lower cortisol rhythm, lower cortisol level at nighttime, so we can wind down and relax not too low, when we start having maybe blood sugar issues, which could wake us up at night and not too high, where we could have problems going to bed because we’re too wired right, or not a reverse pattern, we’re lower in the morning, which means low energy and higher at night, relatively speaking, which could cause us to have too much energy at night and then we don’t get good sleep. So the adrenals play a really big role because of cortisol and its effects on anti inflammatory mood, rhythm, sleep, and then also especially for women listening men too, but da da da da sulfate is a precursor to a lot of our sex hormones, that helps with our female hormones. And that plays a big role in healthy, healthy reproduction. people. People think when they talk about female hormones or just thinking about having babies no your hormones there to reproduce you Yeah, reproduce the baby but also reproduce you which means healthy aging, healing recovery as a man to healing recovery. Healthy libido, good muscle building. In good building the ability to turn over your tendons and ligaments and bones, all these things require good healthy anabolic metabolism.

Evan Brand: Yeah, great point. You know, one thing you pointed out, which I think a lot of people miss with cortisol is you mentioned cortisol being too low at night and that impairing your sleep. See most people just a buzzword, or if they’ve ever heard of cortisol, they’ve heard of adrenal testing and things like that. They think, okay, high cortisol at night equals poor sleep. But you mentioned low cortisol at night or too low cortisol at night could also be an issue because of that blood sugar. And then what can happen is you and I’ve covered this before, but there’s some sort of a spike, right? Maybe an adrenaline cortisol spike in the middle of the night, is that what you think is happening?

Dr. Justin Marchegiani: Yeah, so with sleep issues, you could definitely see a low cortisol kind of going into nighttime or low cortisol during the night. And that can cause a drop in blood sugar, and that drop in blood sugar can then signal a increase in adrenaline. So adrenaline tends to come to the scene first, cortisol tends to come to the scene 1020 minutes later, or so. So you get this spike of adrenaline that’s very stimulatory, that increases cortisol. And then now you’re alert and you’re waking up, right? So we want to make sure higher cortisol, lower cortisol at night that’s causing a increase in cortisol is not happening due to blood sugar regulation. So we want good blood sugar, good healthy protein, and fats, maybe work on amino acids and melatonin production at around bedtime, and maybe have something by your nightstand to help stabilize blood sugar before in your end. Or if you get up like a nice simple college and smoothie, or a really good protein and fat base, simple bar by your nightstand to stabilize blood sugar, those are all really really good options to help you on the sleep side.

Evan Brand: So like if you had a good quality protein, fat, maybe some carb starts with dinner, but let’s say I don’t know, 9:10pm, you go to have a snack and you just do. I don’t know popcorn or I don’t know, handful of strawberry, some kind of a simple sugar, you think it’s possible that your glucose could spike and then it will crash in the middle of the night if you’re doing something too simple or too high on the glycemic index?

Dr. Justin Marchegiani: Well, it depends on how blood sugar sensitive you are. I mean, the two examples you gave are two different things, right? Because grains and popcorn are going to be a little bit more higher glycemic, higher sugar stuff, strawberries, pretty low glycemic and a lot of fiber there, so probably not as much with the strawberries. But could you have some strawberries and maybe a spoonful of almond butter, right or some kind of a good fat or protein probably better, right? It just depends upon what time you’re going to bed and what time you’re eating. Usually you see people that are eating around five or six o’clock dinner, and they’re going to bed like around 11. And there’s like a five hour gap between their last meal and sleep potentially. And again, it has to do with how dysregulated their blood sugar is and how weak their adrenals are. So it really depends. But if sleeps an issue, that’s one pattern we want to look at. We talked about da da playing a big role. If you’re a female going into menopause, that means your egg follicles are being used up essentially. And you’re not going to get that hormone production from that follicle that’s now no longer there. So we require a lot of the DA DA from our adrenals to now be made. And if our adrenal reserves on da, da are low, guess what? We’re not going to have that that backup battery that we had already to go right we’re in middle of, we’re just coming out of a bunch of storms in Austin here. And if you didn’t have a generator ready to go, guess what you you went without power for a while, well, that’s kind of like going into a spa, menopause is going into a storm with a generator that’s maybe three quarters empty. And so the adrenal is play a really important role as the backup generator for sex hormones. And so the better that generator is charged up, the easier you’re going to sail into menopause and not have all the hot flashes and mood issues and sleep issues and skin issues and hormone issues and vaginal dryness issues that you may have with lower sex hormone reserves.

Evan Brand: Yep, well said you’re ready to show us this thing. I’m sure people that are on video want to see what the heck we’re talking about. We can see some of the rhythms and also da da is measure two, which is cool. So when we talk about a cortisol test, we’re getting a lot more than cortisol to right we’re getting melatonin also.

Dr. Justin Marchegiani: Exactly. And then one last thing to look at is PCOS, which is also common. You see it more in younger women, you know, 20s and 30s. But blood sugar issues high level of insulin, this can really jack up testosterone and this can do a whole bunch of issues in regards to abnormal hair growth, you may see an increase in libido, some still go down. And then of course, weight gain is going to be another another big side effect there. Let me share my screen with you so you guys can see an actual lab test for y’all. Okay. All right. So while I get that going here, in the meantime, anything else you want to say about that, Evan?

Evan Brand: Well, you and I were talking about this before we hit record and that was the idea of retesting hormone. And so you thought well, based on a lot of people with progress, you don’t necessarily need to incur the cost again. So a lot of times you and I may run this as an initial snapshot, but depending on symptoms, you may not need to do this over and over and over again because a lot of the support We’re using a pretty broad spectrum. And they’re going to help regulate your rhythm regardless of where it’s at. Right? So initially, we may want to tweak one thing a certain direction or the other, but long term care wise, you and are using things that are pretty, would you just stay state stabilizing, not necessarily a big sledgehammer to the hormones.

Dr. Justin Marchegiani: It depends for me. So if someone has very, very low cortisol levels, or very, very high cortisol levels, and or significant estrogen dominance and low progesterone, the more significant the hormonal pattern, the more significant the imbalance, the more I want to retest less significant if we see corresponding symptomatic improvement, usually it becomes less necessary because the patient knows they’re getting better we can feel it, we can see it in their their physiological activation and how they’re sleeping, their mood, their energy, their libido, we can you know, their cycle, there’s just so many things that are improving that the patient is confident that we’re good. And if the imbalance isn’t major, right, they’re not a fertility case. They don’t have a major hormonal imbalance right there that may not be necessary, but I always kind of I’m on the fence always give the patient the ability to to make a decision on that. So this is my screen here, Evan, are you able to see it?

Evan Brand: Yep, we see it just fine.

Dr. Justin Marchegiani: So here’s a Dutch test that’s done with a patient whose kind of perimenopausal menopausal, meaning their cycles kind of been on and off hasn’t really had it for six to eight months or so kind of in that area of transitioning into full menopause, which is usually not having a cycle for a full year 12 months in a row. So they’re kind of in this Peri menopausal phase, and usually perimenopause and start to hit in your, in your early to mid 40s. When you start skipping months, maybe you start having some hot flashes like symptoms, whether it’s mood or libido or a hot flash stuff. And again, it’s always tough to say because perimenopause can easily feel like PMS too, right? I think that the biggest differentiating factor is not having all the hot flashes and not having the skip cycles. When it comes to more of the PMS like stuff, that’s usually a distinguishing factor. But we look at the Dutch test a couple things here. This is our cortisol pattern, our daily free cortisol pattern. And you can see you wake up here at a and your cortisol should taper up in the morning, this isn’t within the first hour and then go down throughout the day. So this patient actually started with a here, right, this is cortisol with a pretty good rhythm out of the gates. But instead of picking up 100% or so they actually went down. So they started here that having that nice rise, they went down This is big, this is a big problem, right not going to have the energy you’re not going to have that good rhythm that good up and Adam kind of energy in the morning and they trace low the entire day, relatively low and flat the entire day. So we call this a flat cortisol rhythm relatively speaking, it’s flat, they should be starting here a peaking up at B and then gently tapering down throughout the day. And they basically start at a at their highest point. And they go down throughout the day. So very low and flat cortisol rhythm. Now when we look at their cortisol levels, they’re free cortisol, which is a+b+c+d, this is what’s represented on the graph here. And again, if you’re listening on the podcast, click down below to watch the video link if you want, if not, we’ll just try to describe it. They’re free cortisol when you add a plus b plus c plus d is 73. That’s very low. So if you see this little gauge here, imagine this is like the volume knob on your stereo, this is all the way up high this star and this on the left all the way up low. So they’re almost all the way till the to the left. It’s like their volume knob is like 5% on it’s like having a whisper out of their stereo. So 73 is very, very low. Now this is the cool part, right? So normally with a salivary test, right, the Dutch test is the dried urine for testing comprehensive hormones. The benefit of this test is we get a window into free cortisol, but also total cortisol could its urine with a salivary test, we’d only be able to see this 73 number, which is the which is the free cortisol, that’s two to 5% of all cortisol is free, and biologically available. The other total, which looks at the free, which is the two to 5% Plus, everything else that’s protein bound, is give us a window into all of our cortisol, we’re making them this is the cool thing. We never would have this number on a free cortisol test from saliva. But you can see their total cortisol, which is everything is very high. It’s 93 04. Right? It’s way off the charts. Hi. So they have very, very, very low free cortisol, very, very, very high total cortisol. So there’s not like an adrenal fatigue issue or like a low adrenal pattern. Even though the cortisol is low, their adrenals are making a lot of it right. And this is a common pattern we see when there’s HPA access dysfunction. So if you go down to this page over here, you’re gonna see what the HPA axis is. I’ll go back and I’ll just explain this in a minute. But if we go down to this page here, the HPA axis we have this feedback loop from the hypothalamus and the pituitary. This is the HP portion of the HPA axis. And this communication feedback loop talks to the adrenals where we make cortisol with We make DAGA. And we have our free cortisol, we have our total cortisol, we have our DAGA, this feedback loop from our corticotropin releasing hormone to the adrenal corticotropin releasing hormone. This feedback loop is our HPA access. And when this starts to break down, and that feedback loop that miscommunication happens, this is where we start seeing a very high amount of total cortisol and a very, very low amount of free cortisol. Does that make sense out of the gates questions they’re having?

Evan Brand: Makes perfect sense. So what do you do?

Dr. Justin Marchegiani: Yeah, so let me continue to roll with that. Let me go back up here a little bit more.

Evan Brand: DAGA production look good there, though. That was nice to see.

Dr. Justin Marchegiani: Let’s kind of break it down. So I always hit things like this. I might order of doing things that way. I don’t miss anything. So the first thing I look at is cortisol rhythm. How’s the cortisol rhythm? Good in the morning. A and then B, C, and D morning after night are low, low, low. So normal, low, low, low. So definitely poor cortisol rhythm. How’s the cortisol amount? Well, free cortisol is low. Okay, total cortisol is high. Now, so I tend to treat someone more in the middle in regards to their adrenal support, I won’t over support their cortisol too much, because we know they’re making a lot. So we’re really going to focus on an in between amount of cortisol and more HPA access support in regards to adaptogenic herbs, we really have to support good adaptogens. This being a menopausal woman, or Peri menopausal, we’re going to support the adrenals. We’re going to support HPA access. And we’re also going to use herbs to support the estrogen and progesterone receptor sites, we’re going to do both Okay, so you can see her now the next part is sex hormones. So we talked about the total cortisol right free cortisol, low total cortisol high strong HPA access pattern, and then the sex hormone wise, estrogen Astra diawl is low. This is primarily the hormone that’s going to be used in cycling women, progesterone is low, they’re both equally low, you see how they fall in the same place in the dial. So if you’re looking at the volume knob, they’re both in the same place, they’re both low on the volume knob. Usually with estrogen dominance, we’ll start to see the estrogen knob higher up relative to progesterone. So that tends to give us a good ratio if we’re intact. So estrogen to progesterone ratio is good. But the hormones are just low altogether. And then testosterone for a perimenopausal woman it’s in the bottom 25% of the range. Not bad. For a perimenopausal woman, you know, top 25 or top third to half is ideal. Not bad at all.

Evan Brand: And this woman was not doing anything correct. She wasn’t doing any dapa or testosterone support-

Dr. Justin Marchegiani: Correct. And then I ignore total da da, I look at these numbers individually here, I look at da da sulfate, eat a clan alone and I look at them all separately. Her total da da number it looks okay. But that can give you a false interpretation. And again, I’ve been doing labs like this lab for six years, I’ve been looking at hormone labs for over a decade. So I mean, I’ve done 1000s of these things. So I always try to boil it down to the to the patterns and the data that matters and ignore the fluff.

Evan Brand: So how would this woman feel I think important to mention, you know, all these numbers, people may look at this and think okay, this looks like Greek so can you just explain how would a woman with that pattern be feeling we’re seeing that cortisol was okay?

Dr. Justin Marchegiani: Peri menopausal symptoms, a lot of Peri menopausal symptoms, libido, mood, hot flush stuff, skipping cycles, of course, low energy, mood stuff, all of those things are present for sure. And then look at her DAGA sulfate here, right? This is the backup generator of the sex hormones to the bottom 25% of the range. So this is the dial here, right? 170 she’s definitely on the lower part here that bottom 25% I like to group things based off a percentage, then the actual numbers don’t matter as much like I just say, hey, you’re in the bottom 25% of the reference range. I like my patience in the top half the top 25% or so. So I always look at things as a percentage. That way you don’t get overly infatuated on the numbers, the numbers can kind of confuse things testosterones in the bottom 25% not as bad there. But I mean, if we get the DAGA to the mid range, that testosterone should take care of itself because that’s gonna trickle downstream from DAGA to Android to testosterone. All of her androgens are okay, they’re all mid to upper 25% no problem. They’re her hormones are pretty balanced in regards to five alpha reductase. This is kind of the enzyme is very important to things going down a less androgenic pathway versus like DHT, which can be more associated with hair loss and prostate issues. And then if we go look at her estrogen levels over here, so this is progesterone, progesterone is calculated by pregnant a dial press plus alpha prineta dial so alpha and beta combined and we already saw her levels here. This is 1.9. I don’t know why the lab doesn’t show that number here. It should it’s like an error, but it’s 1.9 should be the progesterone number Now go look at the estrogen and that’s low. I mean from a cycling female we want at least 10 ideally 15 on the progesterone and then if we go look on the estrogens right, she’s low across the board. So estrogen is he one you know how you know it’s you want it has plenty in it, right? And that’s how we know it’s a one. And then Astra dial, this is your primary cycling estrogen. And it’s easy to because it’s got the prefix di and their di meanings two right, like two sets of dice die. And then we have estria, which is e three and the TRI prefix is how we know it’s e three. So for short e one e two, e three, or estrone estradiol estriol. And again, Esther dial will predominate when you’re cycling more, and estriol we should shift when you’re more menopausal, okay. And we tend to support more estria when they’re men appointment, women are menopausal. So her estrogens are pretty low across the board, you can see that you know, it’s gonna, these are all the metabolites downstream. But you can see, and again, if we want healthy estrogen metabolism, right, we have e to e4 and e 16, which are a different estrogen metabolites. And then you can see here, it goes down this protective pathway from a one to two hydroxy astone. And then that goes down into it and gets methylated into two methoxy. estrogen. And you can see here, right to keep it really simple. This 2.5 number on the estrogen metabolite should go down this pathway, at least half of that should be metabolized. It’s not so you can look at this at this methylation gauge. Don’t look at the numbers, just look at the gauge. So her methylation activity for metabolizing. Estrogen is actually low. So this is not getting fully metabolized. Now, why is that a problem? Well, one, she’s not metabolizing estrogen to her estrogen levels are low to begin with. So it just tells me that there’s some methylation detoxification issues that are a problem. Why could that be a bigger problem? Well, if we start supporting more da, da, maybe start supporting hormones better, this could cause a backup in regards to her hormones being metabolized, we may want to really work on supporting extra sulfur groups extra methylating nutrients, so there’s not a clog in these hormones getting metabolized. So, in general, we want to see at least half of this getting metabolized downstream. So if we look at two hydroxy, one, we want at least 1.25 there. And again, forget the numbers, it’s all represented in the gauge. So I want this gauge at least mid range. If the gauge is not mid range, and it’s on the lower side, it tells me we’re not metabolizing or methylating, our hormones actively, you know, as optimally as possible, and we may want to provide supporting nutrients to help that.

Evan Brand: So let me ask you this, if a woman, maybe she had run this and got the analysis from you, but then she just went to her conventional hormone doctor down the street, and he goes and puts her on some estrogen and maybe some progesterone, maybe some testosterone, how would that differ in terms of outcome based on this versus what you’re going to do?

Dr. Justin Marchegiani: Well, number one is they’re going to look at your extra dial just via the blood. And that’s okay. But it may not be able to look at free SSL dial as well. And most of the time, they’re not going to time it up at the right time of the cycle, you really want to time some of these things up around day 20 of the cycle to get a window of where progesterone is at. And then of course, you have to compare it to where in the cycle it is. And the next thing is no one’s going to look at how it’s being metabolized downstream. So we get a window into our total estrogen. All of our estrogens e one, e two e three, not just extra dial, we’re getting a window of progesterone as well. We’re getting a window into our androgens, we’re getting a window into d h, EA and our testosterone. And then we’re also looking at how it metabolizes downstream from 16 hydroxy from four hydroxy and to two hydroxy to four and 16.

Evan Brand: And then what’s the protocol? What’s the protocol for this woman?

Dr. Justin Marchegiani: So it depends. So off the bat, we may want to support estrogen metabolism a little bit better. That could be giving something like NAC it could be giving something like glutathione, it could be doing something like indole, three carbinol DIMM, or calcium to glucose, they could all be really good options. Even just giving some extra fiber could also be really helpful. Just to help out of the gates just to make sure there’s no bottlenecks there. Number two, we would support the adrenals accordingly, okay, we would support sex hormones as well. So depending on if she’s cycling or not, because remember, this woman kind of was skipping cycles. We would definitely do herbs like different kinds of phenotypes of Makkah that we use I use a product called feminine essence menopause as a special phenotype of Makkah. You can get that adjusted health.com slash shop and the female hormone section that’s wonderful because it works on upstream HPA axis. We may work on the in different herbs to help the HPA access to like ashwagandha which is wonderful at modulating that hi level of cortisol. And then depending on hormones, we may want to throw in some progesterone, especially if she’s cycling in the last half of the month. And we may want to throw in a little bit of estriol. It depending on if she’s cycling or not, if she’s transitioning into menopause at her age, right 52, I think is the age of this patient. Well, the average age of menopause is 4852. So she’s definitely on the later side. So she may be transitioning into menopause. And if she has no cycles for a period of time, we may want to throw a little bit of estriol in, but if she’s not, if she’s still cycling, we don’t want to do any sgl. Right now, we want to focus on good healthy herbal support for astron production, we want to focus on good da ta support, we want to focus on progesterone, the last half of the month, we want to also focus on good estrogen metabolism. We want to focus on really, really, really good HPA access, support, all of those things are going to be really, really important. I’m not going to give like an exact protocol on dosing, just because it’s you know, this is a very general kind of thing right now, I don’t have the patient in front of me, but it just kind of gives you a good idea. What what I’m looking at there.

Evan Brand: Totally. So someone may think, oh, they saw that high metabolized cortisol and they may need, they may think they need to come in and do something like relora, which a lot of people talk about to lower cortisol, that is not the right choice to do because her total, or the free cortisol is already on the low end. Correct. So like at nighttime, like if this woman says, Hey, I’m not sleeping good at night, you’re not going to come in and use relora are you because that would take the low situation and make it lower? Is that right?

Dr. Justin Marchegiani: I wouldn’t give something that would lower the free cortisol more like something like a phosphatidylcholine or serine. Right. But I would do some things to calm down the HPA axis for sure. So things that really can help calm it down. Because that total cortisol being really high is what’s telling me that there’s definitely HPA access issues. But I mean, you know, it’s possible some of these symptoms could could kind of conflict because our free cortisol so low and our total cortisol so high, but I wouldn’t overly lower the free cortisol, I would just focus more on adaptogens to help modulate over cortisol. Just the the overactivity, the overstimulation of the adrenals the whole, and that would still come in there and support with some pregnenolone and dapa as well. I wouldn’t overdo it either, though, because her cortisol is total on the higher side. So this is where it’s really important. Like, it’d be really easy to want to give this woman a lot of licorice and a lot of pregnenolone. Some of that may be necessary, but you may want to just take the fact take into consideration that she has a total cortisol level that’s very high. And we may want to have some kind of in between those. So we got to really look at that total cortisol production in relationship to the free not overdo it.

Evan Brand: Yeah, what you’re saying is because she’s desperate to feel better, right? And you want to give her more energy and you’re going to look at that rhythm and say, Okay, yeah, it’d be great to give her a boost here some licorice at breakfast time and maybe some lunchtime dose to perk her up. But you’re saying you can overdo it because of how high the total is in this case.

Dr. Justin Marchegiani: Yeah, very easy to do that.

Evan Brand: Yeah. And so then that would manifest how maybe anxiety heart palpitations, insomnia.

Dr. Justin Marchegiani: If we overdo it, yes, harpy, potentially heart pals, potentially insomnia, potentially, anxiety, all of those things are potential issues that you may see a problem with.

Evan Brand: Yeah, and this is why we love to to mix herbs to right you’re rarely going to be using an urban isolation, right? You’re going to be coming in possibly with ashwagandha. But you may come in possibly morning. Maybe she could benefit from something like some eleuthero. Some holy basil, maybe some other more stimulating things. If you don’t want to go too high on the licorice. Is that what you would do?

Dr. Justin Marchegiani: Correct. Yep. 100%. Cool. Any other questions there so far? It’s great to see it.

Evan Brand: I think this should should help a lot of people.

Dr. Justin Marchegiani: Yeah, in general, you really want to make sure you kind of clearly delineate where the patient is in their in their hormonal pattern. I think it’s really tough. The hardest part is when you have a woman who’s perimenopausal who’s still cycling, but is starting to not cycle and starting to switch into menopause. Because you’re kind of you kind of have two ways to handle a woman if they’re still cycling versus they’re not because hormones have a rhythm, rhythmic fashion, and you want to add them in, pull them out. And if a woman is more menopausal, you can keep hormones really in throughout the month, you’ll have to cycle them as much. And so I always err on the side of treating a woman like they’re cycling until they clearly delineate that they aren’t cycling, because if I start getting hormones monthly, daily, and that could throw off their their cycling pattern. I don’t want to do that right first, do no harm. Let the body clearly delineate where it’s at in regards to its natural hormonal patterns. So the hardest part in dealing with women, is if they’re perimenopausal transitioning to menopause, I really want their bodies to clearly show me that they’re ready to stop cycling and that’s why I always treat them like they’re cycling until it’s crystal clear they aren’t.

Evan Brand: Yeah, and then that The most common time for symptoms, right? So that’s probably the majority of what what people are going to feel in that stage of their life, they’re going to feel the most symptomatic in that transition time, or at least in what you and I’ve seen, this is probably the most common time a woman’s going to reach out for help.

Dr. Justin Marchegiani: 110% Yep. So it’s really, really important to kind of take a look at that and make sure that we keep that in mind. Absolutely. And then also, you know, we have different estrogen metabolism risks, right, we have different estrogen metabolites. So if we look over here, we have e one, e two, and E three. And when you look at these different metabolites, you know, he one tends to be a little bit more, you know, safer, right? He one tends to be a little bit more safer in regards to his to his detoxification, okay. And then when you look at e4, or sorry, two hydroxy, estrogen, right, or Astra dial here, this can go down pathways as well, are four that could be a little bit more damaging to DNA. So our four hydroxy, could be a little bit more damaging, as you can see.

Evan Brand: Let me ask you this real quick. So if you scroll down a little, it’s showing how on that pathway, you can get DNA damage, it’s showing reactive there. So we have to factor in what we learned from the stool test into this also, right, because if we see like a high beta glucuronidation problem due to bacterial overgrowth, isn’t that going to mess up this same pathway or my..?

Dr. Justin Marchegiani: Yep, it definitely can. And you can see here with the different, you know, metabolites, right, your four is going to be a problem area, right? So you’re for your your two hydroxy. Your two hydroxy going into the this four hydroxy right here could be a problem. Two hydroxy tends to be a little bit less damaging right here, especially if you have good CMT and methylation, when you go when you because all these things can can conglomerate. So you can see how e one e two and E three can all go side by side, they can all transition. But then you can see they can go down to 16 pathway, which tends to be a little bit more gentler. It can go down the four pathway, which can go into reactive oxygen species, it can also get methylated, right? What’s methylation, full eight, B six, right? b 12 really helps support methylation, Coleen, and then also gluta phi m can help decrease a lot of this too. So healthy gluten diet and healthy sulfur, healthy cruciferous vegetables, healthy digestion of our animal products. And that can help a lot of this, this methylation issue, and detoxification. And then of course, we have our E, two hydroxy. Over here, which again, methylation is very important, full A B 12. b six, Coleen, right, healthy cruciferous vegetables are going to be really important if you’re here. And we can even if it’s really high, we can even do things like dim, we can do things like calcium to glucose, we can do extra fiber, things like that to help bind it up.

Evan Brand: And the reason you’re saying this is so important is because we need to get out these excess hormones, right, we don’t want them just sitting in the tank, so to speak, after they’ve gone through this process. So you’re saying the gluco rate, the Bluetooth ion, the methylation, these are all the processes in the body to get rid of these, once they’re done is I don’t know what the right word is. But once they’ve been used by the body-

Dr. Justin Marchegiani: -agreed, though, your body will conjugate them bind that proteins to them and excrete them. And so we’re gonna really focus on a lot more gluta phone support more sulfur amino acids. If we see this guy over here, the four hydroxy ones higher. And then of course, you know, you can always give sulfur support methylation as well, which is going to be the B six, b 12, full eight, Coleen all of that as well. And this will support both of these two methoxy, two hydroxy, as well as four hydroxy. One, all of these are going to be very helpful, you can’t hurt to support any of those. And if we have anyone that has, you know, estrogen cancer, you know, risk? Well, we tend to if we need estrogen in someone’s more menopausal, we’re going to try to support more estria, which is going to be more cancer protective. But if someone has a previous cancer history, we probably will not do any hormones at all on the estrogen side. And just focus on progesterone as long as their their cancer is not progesterone sensitive, and good, healthy herbal support to help modulate some of the receptor sites.

Evan Brand: Yeah, awesome, awesome question there. This ties into a lot of stuff we do with the gut to which is really cool, because we’re often going to be in detox to we’re often going to be using Bluetooth ion for mold or chemical toxins, we’re going to be using calcium D glue, great to help with zero unknown or other mycotoxin removal, we’re going to be using possibly a methylated multi based on what we see with poor mitochondrial function on the organic acids test. So the cool thing that I’m seeing here, the trend is that the whole picture works together. So by working on the other body systems, we’re already really fixing the majority of stuff we’re seeing here plus the addition of some of the extra hormonal support.

Dr. Justin Marchegiani: Yeah, exactly. And then kind of the general ratio of healthy estrogens, is we like to see a kind of, you know, we have the, what’s called the estrogen ratio, where we look at Astra dial thrown relative to 16 hydroxy. Right? So it’s like we’re looking at basically each one. I’m sorry, e to e4 and 16. We like to see a higher level of 16 in relationship to four and two, right? 16 tends to be more cancer protective. Why? Because most of its coming from estriol. And then you can see two and four tend to be a little bit more from stronger estrogens, e two and E one are stronger estrogens, e three is a weaker estrogen. So we kind of have our two, four and 16 metabolite ratios, right. So you could say to four and 16, we want to have higher levels of 16 in relationship to lower levels of two and four. And again, it just depends upon how the metabolism is to right. If we’re metabolizing these things well, not as big of a deal, right? Because why these hormones come up higher typically is where they’re getting the hormones in our body from, from hygiene products, from plastics, from chemicals in our environment, or we’re just not metabolizing them. So we make sure the lifestyle components are dialed in, where we’re not getting them in our body and to we make sure that we’re metabolizing them as well. Does that make sense?

Evan Brand: It does it does and why we’re not metabolizing metabolizing them, I just wanted to make that clear to people that could be due to gut issues, right, there is a gut hormone component here.

Dr. Justin Marchegiani: Yeah, so the beta glucuronidaze enzyme really helps metabolize a lot of estrogens. And when beta glucuronidaze goes high, it takes the SD estrogens that would have handcuffs on them or a straitjacket on them that would be escorted out of the body. And it breaks those handcuffs and allows them to go back into general population. And so having good healthy gut levels is very important. Now, if you come down here a little bit more, this is kind of cool. We look at melatonin levels, patients mid range, not that big of a deal. These are the same markers over here. So we’re not worried. This is cortisone pattern, I don’t really care about it, it almost always is congruent. What we see on the cortisol side, you can see this kind of with more emotional stress issues. This is more like inflammatory stress. But almost always, they always tend to have a similar pattern as the other side. So I don’t really care as much, because you can see the cortisone pattern is almost the same as the cortisol pattern, right? And that’s not going to change protocol. It’s not going to change protocol. And the cortisol is the more physiological active compound, right? cortisol gets gets broken down downstream to cortisone, which is a weaker kind of metabolite, it’s the weaker sibling. So it’s not quite as it’s not going to be the stronger one we’re worried about. And these are all the same numbers on here. This test is very confusing if you don’t know what you’re looking at, because there’s a lot of repetitive data. That’s just more I think, so people don’t have to scroll around as they’re going over the labs. It’s kind of repetitive for the doctor so they can explain it to the patient. But if the patient’s looking at it, they think, wait, this is new, this is new, this is new. It’s just like this is like the third time they’re saying it not a big deal. All right, and then this is where we’re looking at some of the the markers here in regards to organic acids.

Evan Brand: How you can correlate to the Oh, I mean, have you-

Dr. Justin Marchegiani: It’s pretty good. It’s it’s on point, most of the time, sometimes it can be off, I always tell patients, if we have an organic acid test, like the gray plant lab or the Genova, we’re going to always listen to that one as the most important because that test is specific for organic acids. And there’s a greater sample there too, so it’s going to be more accurate. But if we have this test in by itself, we’ll still utilize it. So out of the gates, you can see here, b 12, this is for methylation looks pretty good 1.5, Santhi RNA can be six marker, kind of urinate look pretty good. glutathione is on the lower side, right? So with this patient, we may want to support either some kind of a sulfur amino acid or some kind of fluid found to help with estrogen metabolism. And again, it just depends out of the gates if we’re not providing a ton of hormone support. Her hormones are so low as well, it may not be a top priority out of the gate. If the person’s hormones were higher, definitely a top priority out of the gates. Okay. And then this is interesting. This looks at the catecholamines it looks at basically adrenaline, or catecholamine. do the exact same thing. By the way, norepinephrine, epinephrine, exact same thing. Three words that mean the same thing. I know it’s really confusing. So we have dopamine, which is the home of anolyte metabolite, and then we have vandalia Mandalay, which is a which is a metabolite of adrenaline or epinephrine. And so dopamine is a precursor to norepinephrine or epinephrine. So the more chronically stressed you you are you will pull dopamine, and so they have high levels of dopamine metabolism and high levels of adrenaline metabolism. What does that mean? It means this pathway, this pathway here is is redlined. So we’re really breaking down and metabolizing lots of dopamine, a lots of adrenaline, and that could be part of the reason why the adrenals are more depleted here, right. And so we may want to add in some amino acids to support some of the catecholamines catecholamines. Definitely stressed. Now, we just have to make sure as we add some of those support in that we’re fixing underlying issues. So we’re fixing diet, we’re fixing blood sugar, we’re trying to get sleep better. We’re not over exercising, we’re making sure all those things are, are pretty good. And then again, Melatonin is on the lower end of the range, but it’s at 24. The range is 10 to 85. So it’s not that bad. I mean, it’s in the bottom third. I only work on this if there’s sleep issues. And typically, I’m always going to be supporting melatonin with amino acid precursors. First, I’m never going to target melatonin by itself unless we absolutely have to. I rather give building blocks and let the body do with it what it’s going to do first, then force melatonin, but if we have to, we can at the lowest possible dose, like-

Evan Brand: What are you doing? What are you going to do for aminos on the homo vanolate vandal mandalay you’re mentioning there, you may come in and support aminos.

Dr. Justin Marchegiani: Yeah so if you look at the range, they’re not super high. It’s six remember, this goes six point four um high end of the range four to thirteen. So i’d probably come in there with some tyrosine. Definitely i throw in some extra b vitamins, extra b6, even though b6 looks good. Just because these pathways are going to be stressed, so i really want to make sure some of the b vitamins are there. Some of the extra amino acids are there. I’m going to work on some of the adaptogens for the adrenals, i’m going to work on some of the adaptogens for the female hormones, uh we’ll throw in a little bit of DAGA, we’ll throw in a little bit of pregnanalone building blocks as well, if we go look here –

Evan Brand: So would you come in and never do dlpa over tyrosine in that situation, would you go based on symptoms like if somebody was like super weepy and crying at the drop of the hat, would you say okay we’re going to go dlpa instead or you’re just going to have tyrosine?

Dr. Justin Marchegiani: I would just do tyrosine out of the gates. I’d only do more dlpa stuff if there’s like a lot more chronic pain because dlpa will tend to go down more of that beta endorphin pathway which could be helpful for chronic pain stuff. If not i would just hit more of the the tyrosine and the b6 and then really calm down the hpa axis. Does that make sense?

Evan Brand: Yeah it does.

Dr. Justin Marchegiani: And then again you could see here pregnanalone is an important building block that we like to use because it’s it’s the mother of all hormones. Now i like it but you don’t want to just take it willy-nilly. I like to always use the lowest possible dose and i like to use it sublingually to bypass the gut and you can see chronic. So you can see here pregnenolone can go downstream to progesterone, right and then you can see pregnenolone, um can also go downstream to DAGA which can then go downstream to our sex hormones right, potentially some of the androgens. Potentially some of the female hormones right go right from here to andro to e1, that goes to e2 and then that can go to e3, all right and then it can also go downstream to testosterone too. Okay and then it can also go downstream to your mineral corticoids which are right here DAGA to where’s um.. Aldosterone here? Help me find aldosterone, where is it there.. Uh andro e1 let me know if you can see it but there should be a pathway where it goes downstream to aldosterone which helps hold on to our minerals.

Evan Brand: Is it at the bottom scroll down i’m seeing it.

Dr. Justin Marchegiani: Maybe they left it out on this graph but there should be a pathway that goes down to aldosterone which is a mineral corticoid, which helps you hold on to your minerals as well. Now also too if you have progesterone right, but then you’re having a lot of like um inflammation right, you can go progesterone down to 17 hydroxy progesterone and then that can go down to cortisol right, so if you’re chronically inflamed you can create low levels of progesterone. Because progesterone is going from here right downstream to cortisol. So that’s why chronic stress and chronic inflammation could throw off your female hormone balance. Does that make sense?

Evan Brand: Yeah it does. Yeah it shows there too uh mother’s diet during pregnancy. Insulin, resistance, obesity, inflammation, hypothyroidism, licorice phthalates, I like how they put the information about what’s going to contribute to the problem that’s really cool.

Dr. Justin Marchegiani: Yep exactly. And then also you can see here you can go your cortisol right and then your cortisol this is your free cortisol here. Right, this is your your active cortisol. Um so this is your this is your free cortisol here, and that the free cortisol is going to be what we measure on the cortisol rhythm graph and then it can go down the um the cortisol. That’s more inactive right we have our the cortisol as well, which is part of our cortisone.

Evan Brand: We need to do a show. Let’s do let’s do another one on this and review our own. I’m going to get a new one. And let’s do it.

Dr. Justin Marchegiani: Yeah, absolutely. So our metabolized cortisol is thf plus th e right, this is our total cortisol and then our free cortisol which is the th the thf so f for free right, so when we look at this here when we look at this here the cortisol, right this is the free cortisol right and then the total cortisol is the free plus the e just an fyi so we’re looking at the cortisone plus the cortisol is what the total cortisol is on that on that graph above. Just so you guys kind of wrap your head around that. And they they left out the uh the aldosterone here. Let me just see if it’s there albosterone. No not there. So yeah. They left that out but that should be in there somewhere as well. I’ll put a i’ll put a graph on that all right. Anything else you want to highlight there evan?

Evan Brand: No. I would just tell people that this is a really good starting place. But i just want to make sure that if you go to just the hormone person that they don’t just treat this because i think it’s really important to understand that there is a massive issue with bacterial overgrowth messing up some of these pathways. So if you come in and you’re doing all these hormones but you’ve got the build up because of those glucuronidation pathway issues. I’m seeing that with mold too that these glucuronidation issues people are on hormones and sometimes they feel worse and i think it’s because they’re not addressing some of these other pathways. I don’t think it shows glucoronidation on this does it this this panel.

Dr. Justin Marchegiani: No no. That’s gonna be more on the detoxification side okay. Any question there?

Evan Brand: No. I’m i’m good.

Dr. Justin Marchegiani: Cool and then just so you guys can see i’ll pull this over here real fast so if we look at this one right here just so you guys can see it so normally progesterone. Um it can go from progesterone down here into aldosterone and so in general if we look here it should go progesterone to aldosterone. So this pathway here you’d see aldosterone kind of coming down here if it really extends it all the way. Just an fyi on that all right. Anything else?

Evan Brand: I think we hit everything pretty good here. So are you saying progesterone could help aldosterone problems?

Dr. Justin Marchegiani: Yeah exactly so if we support pregnenolone that could also help aldosterone issues also supporting licorice can help aldosterone there’s a basically a drug called fluorine f right there’s cortef that’s supports cortisol levels that are very low okay and there’s fluorina which supports aldosterone and licorice has a an effect of mimicking um aldosterone so that can be helpful because when your adrenals are really weak you may have a hard time holding on to your minerals and so that’s important because we need healthy blood pressure to perfuse blood to the brain oxygen to the brain and we also need good minerals to help our sodium potassium pump to work properly we need electrolytes for our nerves to work so. All these are really really important.

Evan Brand: So one last question then we should wrap it up. So if someone is taking adaptogenic herbs or doing adrenal supports they’re doing hormones they’re doing licorice. What’s the approach or protocol to doing this test if we get the test kit in their hands and they’re on let’s say an adaptogen blend. They’re Doing the ashwagandha, the licorice, and everything do you suggest taking a break or does it not matter we gonna we’re gonna see how the body’s functioning while on those herbs?

Dr. Justin Marchegiani: You’re talking about down the road?

Evan Brand: No i’m saying like right now they’re already on them.

Dr. Justin Marchegiani: If they’re yeah if they’re already on them it may not be bad to take a look at kind of where they’re at with them already on them yeah for sure that i don’t see that  being a bad a bad situation if they’re taking hormone support it just depends where they’re at i usually don’t like it the day of just because you can get an artificially high reading.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If it’s if it’s in your system that day so usually maybe take 24 hours off that way it’s not overly high in the system.

Evan Brand: but you still see the trend. Yeah i’m always on the fence about it because you’ve got so many people taking blends which is great. I think you and I have really helped educate people about adaptogens but you’ve got people taking so much and it’s like well are we seeing an artificially good cortisol pattern or is this really how your cortisol pattern looks so i think maybe a day or two off sounds smart.

Dr. Justin Marchegiani: Yeah if it’s herbs i’m not worried about those as much because that’s they’re going to be more modulating and it’s just where they’re at you know and if they tell me that hey i’ve been on them for the last couple of months and i’m feeling better good we’ll just have you stay on and we’ll just take that into consideration  on the test.

Evan Brand: Okay.

Dr. Justin Marchegiani: When we’re interpreting it because if they have some adrenal issues and they’re doing well with that well guess what we probably still want to make that part of their plan anyway we’re not going to change it too much right.

Evan Brand: Yeah well said.

Dr. Justin Marchegiani: Any questions there so far?

Evan Brand: No that no that’s it i think we should do a part two and review our own that’ll be fun i’m gonna get another one and run one on myself and you should do one too yeah i think that’s a great idea i like it a lot so.

Dr. Justin Marchegiani: I think we hit a lot of good stuff here hope um you know anyone listening you can see that you know Evan and i are kind of the real deal when it comes to this like we actually do this we’re in the trenches a lot of people that you may see online are kind of they’re like thought leaders from a um let’s say esoteric standpoint meaning they’re not actually doing this to not actually practicing so we try to differentiate ourselves by bringing actual information so just kind of know this isn’t theoretical stuff this is Kind of the real deal and and hopefully that gives you confidence to take action and to try some of the things maybe you want to dig in. Maybe you want to get testing maybe you want to reach out to Evan or myself. We’re here to help you out, if you need more help. Of course start with all the foundations, we have thousands of hours of free content because we know 99.9 of patients that that we work with or help, they’re doing it with our free content. We’re not even seeing them now if you’re ready for that next step and you want to dive in. We’ll put links down below so you guys can reach out evanbrand.com and reach out to Evan. Evan’s available worldwide and myself, Dr. J at justinhealth.com to schedule with myself as well. We appreciate you guys um connecting with us all anything else you want to say Evan?

Evan Brand: No people really appreciate it and yeah we’ll make sure  to have the link if you listen on audio your mind’s probably blown right now you thought what the heck just happened we will make sure to give you the link that way you can see this thing because the screen share is great and you just want to give you kudos you’re a great teacher and you’ve taught me a lot about the dutch too so i really appreciate it and your eye to detail on this thing is awesome and most people don’t have that eye so we we really look up to it and really appreciate it.

Dr. Justin Marchegiani: Hey thanks Evan really appreciate it. And if anyone has any hormone issues that are way out of balance and you want to double check it with some blood work too. I don’t have a problem with that either especially some of the androgens I always like to double check with blood if we’re seeing some chronically high stuff um feel free to do that as well. And i hope you guys enjoyed it. Feel free give us a share as well thumbs up and if you want to write us a review that gets us motivated. Um we’ll put a review link right down below if you want to write us a review on itunes. Appreciate it you guys have a phenomenal day. Take care now.

Evan Brand: Bye-bye. Take care y’all.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

Recommended products:

DUTCH Adrenal Test

DUTCH Complete Hormone Test

DUTCH Sex Hormone Metabolites

FemmenessencePRO

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:38        Exercise Movements, Use of Bands, Etc

9:06       Rowers

15:37      Hacks to Increase Exercise Performance

18:53      Post Recovery Stuff

29:39      Why Exercise is Important

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

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

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

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

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

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

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

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

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

Evan Brand: Cool. Any updates on your rower? 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Take care now. Thanks bye bye.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/staying-fit-with-adrenal-dysfunction-and-chronic-fatigue-is-it-possible-podcast-308

The Top 5 Causes of Chronic Headaches

Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.

Click here for a consultation with a functional medicine doctor if you are experiencing chronic headaches!

So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.

1. Food Allergens

Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain.  Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.

2. Food Additives.

These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.

3. Blood Sugar Fluctuation.

We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings.  This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.

4. Gut Infections.

Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.

5. Hormonal Issue.

A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues.  That low level of oxygen may also cause some headache issues as well.  Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.

If you have any questions about headaches, please reach out to a functional medicine doctor to find a way to fix your issue.

Oils That Cause Gut Inflammation

There are various top-causes for gut inflammation but a big one is an oil. The oil you use to cook or bake into foods could be a major culprit to your very uncomfortable gut inflammation. Let’s look at the good and stable oils vs. the unhealthy oils. 

Click here for a consultation with a functional medicine doctor if you have questions about what oils to use for cooking!

If you look at the standard American diet, just even a hundred years ago, your grandparents or your great grandparents, they did not have access to these type of oils. They were cooking with traditional fats. They did a lot of lard and maybe some beef tallow.

If I asked my grandfather, “What did your grandmother cook you and what did she cook it with?” She was not using soybean oil. She was not using corn oils. She was not using rapeseed oil, which is canola.  She was not using peanut oil. If they did something fried, it was going to be fried in possibly bacon fat, which came from the pig in the backyard of the farm or it was going to be cooked in some type of like a beef tallow, where the cows were on the back part of the farm.

When it comes down to fats, most plant fats are not going to be the best unless they are cold extracted or unless they are minimally processed to extract the fats. Partly because of the processes of extracting, it tends to damage the fats because the heat and the extraction process also makes the fats rancid and taste bad. There’s a lot of like deodorizing and filtration and different processes to make it more palatable that you would never be able to have at a natural state.

So the best plant fats are:

  1. Coconut oil because it’s a saturated fat and it’s more temperature-stable.
  2. Cold-press olive oil and good-quality avocado oil, which is primarily a monosaturated fat.
  3. Palm oil, which is more in a kind of saturated state.

There are some nut-based and some seed-based oils, but then you start ramping up the Omega-6 and those may not be the best.  There are some supplemental oils that are more GLA-based that I’ll give supplementally, like black currant seed oil but we’ll give it supplementally and that’s coming from great sources that are going to be in capsules that won’t be oxidized and such.

Bad fats are going to create a lot of oxidative stress and they are going to deplete a lot of your antioxidant reserves because if those fats are oxidized, your body is going to need a lot of vitamin C and vitamin E to help with the oxidative stress that those fats may cause your body.

Now what it you find a good fish with gluten-free breading so it’s not covered in wheat with some type of non-gluten containing flour, but then you’ve got canola oil. Do you think you’re still going to be net positive in terms of nutrition because you’ve still got the good fish, but yet you’ve got the inflammatory oils or would you say, just get you some grilled fish and then if you want to bread it, you bread it yourself?

There’s a product that we like of sweet potato fries that my wife will do for my son because it’s really easy, but they have a little bit of canola oil in there. So you have this kind of convenience factor where ideally if you could you always would want to put your own fat on there if you could and my easy saturated fat or my easy fat for cooking that’s plant-based would be avocado. I like avocado because it tastes a little bit more neutral. I do not like olive oil as much. Olive oil is better for dressings, but I’ll do avocado for cooking. If you have control over it, you always choose the better fat over the junky fat if you can.

So the interesting thing is like coconut oil and avocado they’ve become kind of trendy and I would say avocado is not going to be a traditional fat meaning, meaning like traditional people were probably not doing it because you’ve got to have some heavy-duty equipment to extract the oil, but coconut oil would be super traditional.  I mean, this would be something that has historical use.

Your big fats that are going to be plant-based would probably be primarily coconut. But your biggest ones that I think are going to be used more long-term from generation to generation will be your tallows, your bacon fat, your duck fat, and those kinds of things because saturated fats don’t go bad. They stay good for a long time because the carbon is saturated with 4 hydrogen bonds between them, which makes the fat really, really, really temperature-stable.

Take note of oils are that bad for your gut because they cause inflammation and oxidative stress.

If you have any questions about what the best oils to use for cooking, please reach out to a functional medicine doctor to learn more.

 


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.