How to Investigate The Root Cause of Your Gut Issues | Podcast #366
In functional medicine, it has long been familiar that gut health is paramount to the rest of the body. We didn’t fully understand why for years, although we knew the gut was the seat of the chronic inflammation and immune system. With the gut microbiome renaissance, we also need to understand how integral gut bacteria are to our health.
Dr. J and Evan discuss that screening for more serious underlying issues is essential. These may include gastric ulcers from an h.pylori infection, leaky gut, and other digestive system problems. Finding out whether these conditions are an issue also impacts how you manage gut health.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
3:34 – The Signs and symptoms of digestive disorders
7:35 – What tests are effective to find the root cause of gut issues
13:58 – The downside of ordering lab tests on your own
26:21 – Food template modifications that will fit for your gut health
Dr. Justin Marchegiani: Here, Dr. J, with Evan Brand. Really excited to have an excellent podcast today. We’re gonna be chatting about how to investigate the root cause of your gut issues. We see lots of patients come in and they’ve gone to see the SIBO doc or the Candida doc or the parasite doc or the thyroid doc and whatever the symptoms that they’re dealing with, magically that issue, that doc only focuses on is the problem, how coincidental right? And so, we want to talk today about having a holistic mindset not being necessarily attached to what the diagnosis or what we think is the root issue but really be focused on the outcome and the different tools we use and have to investigate and support healing. Evan, how you doing man?
Evan Brand: Doing good. And not to mention too, the conventional approaches, right, maybe they get to the SIBO guy or to the parasite guy or to the worm guy, maybe they went to the endocrinologist first for their hormone symptoms and then they got referred to the gastro doc and then the gastro doc did an endoscopy or a colonoscopy or a barium x-ray scan like you did to me and then they say oh you’ve got gastritis and that’s the only thing they can pull out of you is hey there’s some inflammation and then it ends there so whether you’re coming, listening from the conventional approach whether you have tried to go more natural holistic approach. As you and I’ve talked many times, people over-specialize and that’s the problem. You and I are what I would consider very good specialists but we also have a generalist undertone to us, meaning, we’re not gonna get caught up in just the SIBO, we’re not gonna get caught up in just the parasite, it’s rarely that simple.
Dr. Justin Marchegiani: Absolutely. It’s like, imagine, like you hired a handyman to come over and fix something in your home and the handyman just takes this Phillips flat head screwdriver and it’s like, or, I’m sorry, not, but let’s say a regular Philipps screwdriver and just say hey I’m gonna use this Philipps screwdriver even if it requires a nail, even if it requires a wrench or a drill, I’m married or attached to this Philipps head screwdriver and we don’t want to be attached to the tool, we want to go in, know that we have a myriad of tools in our tool belt and pick the right tool for the right job. There’s a nail, I’m going to pick a hammer. Hey, there’s a, you know, a wrench, you know, we’re gonna use something that is good for a wrench etc. So, we’re picking the right tool for the job and we are focused on the outcome, getting the results and we’re not focused on how we get that outcome, right? The vegan diet people, they’re gonna make it so everything is solved by a vegan diet and that’s it, right? And so, we are independent of the tools that we use to get the success that we need.
Evan Brand: Yeah. Yeah. That’s a great point and a lot of this comes from just experience but also our own personal journey too, I mean, you know, my story, you helped me through my story of having digestive issues and skin issues for decades of my life and we looked at the H. pylori, worked on that then it was parasites then it was bacterial overgrowth then it was Candida then it was mold, I mean, so, I went through the ringer personally and I think personal suffering but of course clinical experience really gives you the non-biased approach and I think that’s what you need because if you’re trying to just sell book or you’re just trying to just get clients in from a book you wrote on SIBO, as you said, everything’s gonna be SIBO and if somebody is not in that box, you’re gonna still give them the same treatment, you’re not gonna get them better and then they’re gonna move on and the average person who comes to us has already been to 5, sometimes 10 or 15 practitioners, so it’s not surprising when we look what they’ve done and they’ve still missed some of the pieces. So, why don’t we talk now about some of the pieces, like when we’re looking at someone with gut issues, what are the pieces we’re trying to lay out on the table in front of us to gather enough information to find what’s truly going on and then of course how to fix it.
Dr. Justin Marchegiani: 100%. So, the first thing that I think is essential is you got to do a good history, you have to understand how everything unwound, right? And so, when you look at most people’s history, a lot of times there’s poor diet, there’s usually some stress issues, a lot of inflammation compounded by junky fats, um, poor digestion, in general, not being able to break down proteins and fats, lots of refined sugar usually processed grains, excess omega-6 or trans fats and these things just continue to put the body in a pro-inflammatory state and what that means is, when you become overall inflamed at a higher level, your body starts to break down faster than it can heal and so the goal of being anti-inflammatory, right, is restricting a lot of the foods that drive inflammation, so your body can heal faster than you break down. So, there’s always this net buildup versus net breakdown and so when you’re breaking down over time what starts to happen is just as you know from a joint standpoint, you’re starting to feel a little bit inflamed, stiff from a mood standpoint, you may have anxiety, depression, obviously fatigue starting to creep in. Because, the more inflamed you are, your body’s having to deal and allocate adrenal resources to deal with the inflammation, to deal with the stress where normally those adrenal resources would help with energy and good mood and good circadian rhythm and so of course then that starts putting stress on the thyroid then you start having mood issues, temperature, hair loose and then of course the more stressed you are, the more that starts to suppress your body’s ability to digest optimally. So, HCl levels, enzymes levels, maybe bile salt levels start dropping. You start to have a harder time breaking down protein, breaking down fat. You may start getting burpee or gassy or more flatulence, now, your motility starts to go south typically more on the constipated side but you can still have more diarrhea too. And then, your absorption starts to go south and when that starts to go south, now you start to have, um, a bottleneck and all the nutrients, whether it’s B vitamins, flat soluble vitamins like A, D, E, K, whether it’s minerals or amino acids to help your brain chemicals or cholesterol to help your hormones. Those building blocks start dropping and then those pathways start getting shorted and they don’t have the resources to run optimally. And, when we don’t have the resources, more symptoms start to happen. And of course, this kind of compound in this whole journey is the immune system starts to drop and then when the immune system starts to get weaker, now, bugs start coming into the situation, whether it’s parasites or yeast overgrowth or SIBO or bacterial overgrowth or H. pylori. And again, we don’t have to be married to which one or which system is the one, right? But we have to look at things objectively and, um, I think it was Dr. Kaler said this to me over a decade ago, it was kind of a good line, he said, ‘patients have the right to have more than one issue, more than one infection, more than one hormonal imbalance going on at the same time, so don’t get married to one thing because you have the right to have lots of things going on.
Evan Brand: Yeah. Yeah. And you illustrated beautifully, just the constellation of symptoms that can happen. So, if someone is coming in with gut symptoms that’s usually the tip of the iceberg. Underneath that iceberg, just like your poster, you got right there. If we put the tip of the iceberg is gut under the water there, it could be the anxiety, the depression, the fatigue, the low sex drive, the cold hands the cold feet, the brain fog, the concentration issues, the memory problems, the skin issues. And so, once you do a good history, you’re also gonna be talking about pharmaceuticals too, what kind of like proton pump inhibitors were you on. That’s a big thing, like were you on acid blocking medications, were you on other things disrupting your gut. So, of course, figuring out, if you’re still on those medications, you’re not fully gonna get better, if you have a ton of drugs that are causing these side effects and then you get into the testing. Now, this is where you and I differ from other people. Some people, they’re married to the SIBO test and I don’t want to speak for you, I’ll ask you about this but me personally, I think a SIBO test is a waste of time because when we look at a GI map stool test, we’re gonna see a more detailed breakdown of specific pathogens like Strep and Staph and Pseudomonas. And the way I look at it is your mouth to your but is one long tube, so, if there’s dysbiosis in there identified on the stool or the urine organic acids, we can assume it’s probably in the small intestine but the protocol, the herbs that you’re gonna use, are gonna treat the whole thing. So, to me, I want to hear your thoughts on this too, but to me, if I see positive hydrogen or methane, all I’m going to go and do and say is gonna to be, ‘yep that makes sense’, but beyond that those breath tests are not really that helpful.
Dr. Justin Marchegiani: Yeah. I mean, a SIBO breath test is just looking, it’s an indirect measurement, looking at the gas created by the bugs, so methane or hydrogen gases that are created. So, if we can find bugs that typically produce those gases or an imbalance in but bugs that shouldn’t be there, then we know more than likely, there’s something going on in that SIBO realm. It doesn’t change the treatment that much because a lot of the herbs we use to knock down those bugs that they’re gonna be similar if not the same on the SIBO side. Now, my philosophy may be a tiny bit different than yours but I find anyone with these type of bug issues we’re running a comprehensive stool test and usually an organic acid test and on one or two of these tests, we’re gonna see either the bugs, the bacteria imbalances, whether it’s Citrobacter, Prevotella, Morganella, Pseudomonas, Klebsiella, or H. pylori or parasites. We’ll see these bugs elevated if we don’t almost always, we catch it on the organic acid side when we’re looking at 2,3 phenol acetate or benzoate or Hippurate or D’arabinitol for yeast, usually we’ll catch it there. If I don’t catch it on any of those tests on the stool test or the organic acid test then I’ll pull out a lactulose breath test but I’d say 99% of the time we never have to go that far.
Evan Brand: Okay. Okay. Good point. Maybe it’s a 1% of the time test for you and I guess what I would do if let’s say we missed it, we felt like we missed it on stool and urine, I might just come in or if sometimes if someone just has no budget to do anything, we may just look at symptoms scan history and just come in with some herbs and see how they do. And, a lot times, a lot of these antimicrobials, antifungals, anti-parasitic herbs, a lot of times it clears up the issue anyway so we don’t like to come in blind but in a few rare cases we have come in blind and we’ve still had good benefits. A lady just chimed in on the live chat here, my gut is not happy, chronic constipation after using pain meds for pain and recovery from five back surgeries. Yeah, that’s a common issue with the opiates, right? Because that’s gonna slow everything down so yeah, I guess the answer is eventually this person’s gonna have to try to get off those opiates, right? But there are some, maybe some brain-gut motility activators we can use, right?
Dr. Justin Marchegiani: Of course, you know, if you’re on those opiates, you probably had some surgeries and surgeries man, meaning typically anesthesia, maybe a lot of antibiotics along the way so that’s probably really screwed up the gut microflora. So, first off, you have to get to the root cause of the pain. Second thing is you have to have a good, uh, doctor to work with to taper you off those medications while providing anti-inflammatory support because you need whether it’s systemic enzymes or anti-inflammatory herbs plus that brain takes time to get rewired from the opiates because you’re processing pain totally differently. Remember, opiates don’t have an anti-inflammatory mechanism, they just block pain at the brain level which isn’t good because pain is a good indication like if I have pain in my ankle and it’s there then I can know okay I shouldn’t walk on it because I’m causing more damage, right? So, even if I were to take Ibuprofen and my pain went away, I would still want to be very careful, I don’t do too much on it because I’m gonna cause damage, right? So, most people that are chronically inflamed by these opiates, they’re just causing more and more damage because just because they can’t perceive the pain, they’re still causing this inflammatory breakdown.
Evan Brand: Yep. That’s true. Someone else has chimed in, my gut has been destroyed by many rounds of antibiotics. And, that’s super common, I mean how many times have you and I see that where someone comes in after a round of antibiotics, I mean that’s probably one of the top five things we see, right?
Dr. Justin Marchegiani: 100%
Evan Brand: They said they’re dealing with IBS-D so that would be diarrhea and eating a limited vegan diet. So, my first thought is, uh, oh vegan diet, raw leafy greens, if you’re dealing with diarrhea, vegetables are gonna irritate the gut, I would push you more towards getting some good animal proteins in even if you could only handle like a carnivore collagen like a beef peptide protein powder or you know collagen shake maybe with some organic berries that’ll be my first thought. How would you think about this one?
Dr. Justin Marchegiani: Yeah. I mean, you could definitely look at reducing some of the fermentable carbohydrates and really look at cooking and steaming a lot of those things so it’s easier to break down but you really got to reach out to a good functional medicine doctor that can kind of help navigate you through it because if you don’t have all the digestive enzymes and acids there, it may be hard to break these things down. Also, someone chimed in, what about Vagus nerve issues. So, this is kind of a classic area in functional medicine where people try to talk about things differently in a nuanced way and they’re just talking about the same thing in a different way but people think it’s a new thing, right? So, when we talked about like inflammation and adrenal stress, when the more stressed you are and the more you activate the sympathetic and the more inflamed you are, right? Guess what happens when inflammation goes up and the sympathetic nervous system goes up, the vagus nerve or the parasympathetic nervous system always goes down, does that make sense? So, when we talk about these things it’s implied that the vagus nerve or the parasympathetic branch of the nervous system that would helps with healing and recovery is always going to be impaired and so people talk about things kind of as a way to nuance themselves make them seem different kind of market themselves in a different way which is fine but, you know, the average person may get a little confused about it and so just know that, that’s kind of under same umbrella that we’re talking about. We talk about the vagus nerve or the parasympathetic, it’s being factored into this whole adrenal stress inflammation umbrella, I think, yeah, inflammation is the bigger umbrella then you can put adrenals and parasympathetic and sympathetic all under that umbrella.
Evan Brand: Yeah. Very true. Very well said. Teri chimed in, I’ve been experiencing constant belching, a new symptom for me. So, once again, you got to get the labs run, I want to look at your organic acid, see what’s going on there. Get a GI map stool test run. Are you on proton pump inhibitors? Are you taking supplemental acids and enzymes? How old are you? If you’re above the age 40, you probably have low acid, low enzymes, maybe gut infections too. So, with stool, urine sample and good workup, you could probably resolve belching. I mean, that’s a pretty easy one.
Dr. Justin Marchegiani: And, I strongly recommend, do not get these labs on your own because, just because you get a lab, you’re not gonna have any ability to know what to do next and that’s everything, right? You gotta know what the plan is next, uh, and then typically you wanna look at like when I order a lab, it’s in conjunction with we’ve done a b c d e f and then not the lab is gonna plug in at g. Does that make sense? So, it’s never just this is a or this is it. There’s a whole bunch of, sequence of things that we’re doing before we get to all the data from the lab. And so, when you work with someone, most people are gonna have that plug in at some level in the clinical chain downstream. So, most people think, oh this is just it, this is a, this is the whole piece of the puzzle and it’s not. So, just kind of keep that in the back of your head. I know that can be a little bit confusing when you’re a lay person coming in there but it’s important information. I think, just start off with a lot of the foundational things first, just kind of wrap your head around it. Don’t get kind of myopic in this tunnel vision. Oh, it has to be Candida, it has to be this, be very open minded that it could be many different stressors and just have that really good differential kind of diagnosis list of all the things that we’re gonna go and hit and not get overly focused on one thing.
Evan Brand: Yeah. Good point. I’ll also say too, I’m not saying go to your doctor who’s failed here for the last 10 years and try to ask them for organic acids test or stool test because even if they were able to run it which most of the time, they don’t have accounts set-up with the lab so they’re not going to. But even if they were able to and they run it, they’re not gonna know how to interpret it, they’re not gonna know how to make a protocol based on it. So, this is a shameless plug for you and I and what we do as functional medicine practitioners, we work clinically around the world with people. So, uh, Teri’s asking where she can get the labs from. It depends, uh, we use a couple different companies. It depends on where you live and what you got.
Dr. Justin Marchegiani: We’ll do this, we’ll put some links on the videos below so for you and on your site and mine. So, if you want to get it from us, I recommend getting it from us and then work with Evan or work with myself. We’re here to help you. We’ll put the links below or you can go to evanbrand.com for Evan or Dr. J here, justinhealth.com for me. And then, just to kind of highlight what you’re saying, I see so many people that have some of these tests sometimes and the first question is walk me through what your doctor ordered this test, said about it. Did they give you a real thorough review? How much time, oh, hey they just spent a minute, they just said x y z and it really was, I’m like wow, you know, you have all this information here and yet it really isn’t thoroughly addressed, I would say 90 plus percent of the time. So, it’s really important when you get these tests ordered. You really want to come through it thoroughly, so you can extract as much actionable information as possible. And, if your doctor doesn’t have that level of, uh, skill set of information on it, that’s fine, just find someone else.
Evan Brand: Yeah. You make a great point. I mean, so many times, I know, you and I have a section on our intake form where you can, like attach previous labs. I’ll see 5, 10, 15, 20 labs and I’ll be from a medical doctor or a chiropractic or some other type of practitioner. I’m like wow, they did a really good work-up on you. Like, how did this go, why are you coming to me, what was the protocol? Oh, they didn’t have a protocol. Like, well, why’d they run the labs? ‘Because I wanted them to’. Okay, then what did they say about the labs? ‘Oh, well, that was not bad but I could use a little improvement and so they gave me an enzyme’. And it’s like, they give you an enzyme, you’ve got 20 pathogens, you’ve got parasites, you’ve got H. pylori, you’ve got major gut inflammation and the sequencing of this is important too. So, even if they read a cookie cutter protocol where it says like take oregano oil, you might not be a good candidate for that if you’ve got a bunch of inflammation. Your gut’s irritated, you go throw a, you know, a nuclear bomb in there, you’re gonna irritate your gut more. So, the sequencing is important. So, I guess, just to highlight here what we’re talking about, it’s the sequencing. As you mentioned, when does the lab come in? That’s not just the end all BL tool, there’s other strategies you’ve implemented up until that point. And then, when you work in the killers, is it right out of the gate? Do you got to settle the gut first?
Dr. Justin Marchegiani: Yeah. It’s never. The problem is people have done, the patients come in and they’ve done a lot of different things. So, like maybe, they’ve tweaked their diet and so they think, okay I’ve made these diet changes, right, whether it’s enough or not is besides the point but they think, okay I’ve done these diet changes, check. Diet isn’t part of the equation, so in their mind they kind of check that off. So, when they see another practitioner, they kind of have this list of things in their mind they’ve checked off. And then, they’re like okay, I’ve already worked on the diet stuff. Yep, I’ve already done some digestive support. So when I lay out my plan, there’s kind of like, we’ll I’m not gonna do this because I’ve already done some of this or I’m not gonna do that. No. it’s like, if I give you a safe and the combination is 6 or 7 numbers. You don’t say we’ll spin number 33 on my other state therefore I don’t have to do it this time around. The combination has to be done in sequence together. The other analogy is cooking. If you want to crack the eggs after you bake the flour, well that cake’s gonna be pretty nasty, okay. So, it’s kind of the same thing as a sequence and just because someone has done something before in the past. One, it may not have been all the way there but we still have to plug that sequence back into the overall flow of things. Does that make sense?
Evan Brand: Yeah. It does. And I know
Dr. Justin Marchegiani: You’re smiling, so it sounds like that’s something that you deal with and hear a lot.
Evan Brand: Oh yeah. Yeah. Well, it’s just, you know, once
Dr. Justin Marchegiani: It’s so much easier dealing with patients that have done nothing that have no, um, no predisposition to like what’s next, they’re like a blank state because then you can kind of come in and there’s zero resistance and you can work through your flow. When people have done a lot of things and they think they’ve done everything in that area, it’s always hard, you kind of have to convince them to redo these things over again. That could be tough.
Evan Brand: Now, well, I’m just smiling because of the safe analogy, you know, you always kill it with the analogies and I’m also smiling because I don’t know if it was your kids or my kids screaming, I’m like, I’m pulling my headphone out like is that my kids is that Justin’s kids. And, one of the things that I hope you guys love and appreciate about us is that we’re dads, we’re family men at the end of the day. And so, we’re working, we’re hustling, we’re grinding with our clients but we’re implementing this stuff into our family we’re helping kids, our own personal kids, we’re working with kids clinically. I’ve got kids that are 1 year old, 6 months old, 3 years old that are clinically working with us to get help. And so, we’re practicing what we’re preaching with our family too and I just want to highlight that because there’s so many people out there, so many practitioners that they were so focused on medical school or their practice that they never have the chance to even start a family, you’ve got these mid 40s late 40s upper 50s practitioners out there. They have no family experience and I think that’s where you and I are different because we know when you’re working on a gut protocol. Let’s talk about that for a minute. When you’re working on a gut protocol with a kid and you’re like okay, we’ve got terrible tasting tinctures that we can try, we’ve got some capsules that maybe mom or dad can open up and put into apple sauce. You know, you and I have personally and clinically dealt with the logistics of implementing this stuff so even if you’re gonna get this perfect gut protocol put together, the logistics of following it and getting your kids to take it, 3-year-old Johnny who doesn’t want to take the Artemisia, you know, it’s like, well how do you get that in. That’s the important thing because the proper labs is a step, the proper nutrition is a proper step, the protocol is a step, but the implementation of it and then what do you do after step one and then you if they react to that herb, how do you go to step 2, this is where the hand-holding is necessary. So, you know, when we talk about labs, I think, it kind of devalues the art of medicine a little bit because you and I have so much artist, you know, artistry to what we do and it’s hard to translate that just with a lab test because, you know, anybody could start running labs and like you said we’ve seen 5, 10, 15 labs come in from previous practitioners but they did nothing with it. So, the real art is when you take the protocol, you take it with, you and I are injecting confidence and we’re injecting motivation. I talked with the client this morning who said that she came to me because she was so afraid of her gut symptoms and she came out of fear but now we have basically transformed that fear into empowerment and education and the labs were a tool to help change that. So, don’t put all your eggs in this lab basket, they’re still amazing, you and I still run them on everyone but there’s other stuff that’s injected into that lab that really makes the magic happen.
Dr. Justin Marchegiani: Yeah. 100%. I think, the hardest part too is you work on dealing with the stressors, with patients. You fix their stress. You get your digestion better. You fix a lot of the microbiome. You knock down a lot of the bugs. Again, in the realm of Candida or dysbiotic bacteria, it’s still going to be there. You’re never ever gonna knock it out 100%. So, there’ll always be a small residual bit, maybe lingering in the background, way beneath threshold but if the stress starts to come back or if people start to add too much of food that’s questionable into their diet, sometimes these things can come back and the amount of flexibility, some kind of can follow the 80-20 principle. If they’re right 80% of the time on things 20% they have a little bit of flexibility. Some got to do 95.5 or some got to be 100 but just really try to make sure if they cheat, they still keep grain free anti-inflammatory etc., like last night, I went to True Food Kitchen for my birthday, and I had some of the, um, their chocolate cookies which inside the cookie, it’s like cassava and banana based. So, that’s great. If I’m gonna cheat, I’m gonna try to do it in a way that’s not gonna cause me to get bloated or gassy or have any skin issues or you know, digestive problems.
Evan Brand: Uh, a lady commented and Dr. J seems super energetic today. Yeah. He’s a birthday boy. That’s why he’s feeling better.
Dr. Justin Marchegiani: Oh, yeah. No problem there.
Evan Brand: So that’s good. Another comment here, I wonder which lab test should I run, uh.
Dr. Justin Marchegiani: I would say just here, out of the gates, regarding labs, I don’t wanna name specific companies on these videos because if we change it in the future and someone just watches the video, um, that they may just go to the old one. So, we’ll put links down below. That way, if we decide to change things in the future then you could just go look at the links down below and so my staff typically will update this in the next 12 hours or so. Just check back at the end of the day or tomorrow, we’ll have everything in there so just keep an eye on that. In that way, if something changes, um, it’ll be reflected in the description below.
Evan Brand: But here’s what we can say, we’re still gonna run a stool sample, now, maybe that type or whatever.
Dr. Justin Marchegiani: Cutting edges, some kind of stool testing is gonna be great, right? Organic acid is gonna be excellent. I love that because of the, I mean, every now and then I’ll get a stool test coming back and the gut issues look pretty good like not too bad nothing crazy but then you’ll see a lot of yeast because sometimes you miss the yeast on the stool test, that’s common or you’ll see 3 or 4 markers like Hippurate, benzoate or 2,3-phenylacetate right or D-lactate really hides. Okay, good, I’m glad I had this extra net to catch it because the stool test missed it.
Evan Brand: I had that last week actually. You know, I had a lady and I kind of got freaked out at first, you know, I was looking at the stool and I’m like, oh my God, this lady has every gut symptom in the book and normally on page 3, page 4 you’ll start to see some crazy stuff going on. In this lady, it was clean, oh man, like, is she crazy, I didn’t really think that but you know partly it is like, uh-oh, where’s it coming from, is this really her stool test. Then we get to the organic acids and holy smokes, as you mentioned, oxoglutarate, D-arabinose, tartaric acid, tricarbolic acid, everything was off the charts and I go, oh, thank you Jesus we have the answers on the organic acid. So, that’s why we love to run both urine and stool because certain things get missed and it’s the synergy of the information from the labs. You may find a parasite on stool and then you may find the Candida on urine then you really go, oh holy crap, that’s where it’s coming from. So, um, let’s hit this other one here. There was a person
Dr. Justin Marchegiani: I want to hit one of the questions. Anthony wrote to me there, thanks Anthony for the great feedback, and again guys, we’re trying to interact with you guys live and I want to answer questions live, so this is like I call it, uh, functional medicine improv, right? You know, you get your comedy shows, this is our functional medicine show so I appreciate that. Thanks for the feedback Anthony. Isabella writes in waking up distended, right in the morning. So, with that, a lot of times, you got to calm down a lot of the fermentables in the diet. If you’re waking up distended in the morning, almost always there’s a lot of fermentation happening in the gut and these gases are being produced. Now, there’s a couple of variables that you can do to help that. One, you starve it out by reducing all the foods that feed that. Two, you have to be able to break down your food because even if it’s good food, if you’re not breaking it down well, it’s gonna essentially have the ability to rot and rancidify and putrefy. So, you got to make sure enzymes, acids, and potential bile salts are addressed because HCl, hydrochloric acid, and bile salts, if you have low levels of that, those things in and off themselves are actually antimicrobial. They have a mild antimicrobial effect, not like oil of Oregano, but they have a mild antimicrobial effect. So, if you have, like, digestive distress and you have poor levels of these things, guess what, these bugs are more likely to grow and of course we have to come in there and do some killing, you know, making assumptions that like if you have a lot of distention like there’s no fiber, there’s no raw vegetables even though you read all these things have this big salad, you know, you could steam some of these things, you may want to look at low fermentable things that’s great. You may want to make sure your stress is good and you’re chewing your food up really well and you’re you know avoiding hydrating outside of an ounce or two of, you know, water to swallow and some supplements so that’s kind of your starting point. And if you wanna reach out, Isabella, you feel free to use the link down below, you can reach to Evan and I.
Evan Brand: Let’s read the rest of her comment here because I think it’s helpful for people. So, she said that she tested negative for SIBO, I’m guessing that might have been a breath test and she said she’s 21 years old and it affects her daily life. So, when I hear 21-year-old female, a lot of bloating as you mentioned, I think the veggies, I think cutting out leafy greens, no salads, maybe or
Dr. Justin Marchegiani: If you do it, keep them low FODMAP and steam it or sauté it like I’m pretty sure Bok Choy and Kale. That’s low FODMAP, if you sauteed that in some coconut oil or some ghee or some kind of good animal fat, you’d probably be okay but test it, right. I’m all about testing not guessing.
Evan Brand: True. True. So, I think about hormones, I think okay, she’s 21, right? This is a healthy fertility age. Is there some sort of issue with hormone imbalances? Are there estrogen dominance type issues as well? What about breast tenderness? What about PMS, irritability? Are there mood issues as well or is it just an extremely distended belly?
Dr. Justin Marchegiani: Now, in the history that’s gonna come out with a good history because you’re gonna see it cyclically happen typically premenstrual or typically ovulation. So, a good history will fret that out. Let’s assume it’s every day, hormones are probably not the root cause but of course we know we’ve already talked about it, chronic digestive issues will eventually cause hormone problems because of the inability to digest the nutrients to make the hormones overtime.
Evan Brand: Good point. And, the bacterial overgrowth which will crank up beta glucuronidase. That creates the recirculation of toxins. So maybe that. What about birth control too? Is that in the equation? I start thinking about that so
Dr. Justin Marchegiani: Birth control pill will, it definitely has an effect on, um, alkalizing some of that tissue in the intestinal tract and the vaginal tract. That’s why one of the big effects that you see with, like birth control pills is yeast infections, right? Because it’s shifting the pH. It’s also creating a lot of nutrient deficiencies. So, if you have birth control pill issues, they can definitely put you in that microbiome, um, area where it kind of goes the wrong way there.
Evan Brand: Yeah. So, hopefully that helps and as you mentioned if you wanna reach out, you can. Dr. J at justinhealth.com and me at evanbrand.com. With a stool and a urine and a good workout, we could probably get to the bottom of that. I would say that digestive issues are something you and I have the most experience of out of anybody that I know because all the people that have failed others then they come to us.
Dr. Justin Marchegiani: Absolutely. The hardest part too is once you kind of get on that straight and narrow, finding out how much latitude you have, right? Some people, they may not be able to do dairy afterwards. Some may still have to be grain free, they can’t even do rice or, um, oatmeal, right? So, some people they got to be a little bit tighter on their diet. Some can be a little bit looser. And it’s hard. The hardest thing I think is with kids because kids, I mean, I have two, a two- and four-year-old boys, right? And most kids in their age eat like crap. It is just like absolutely mortifying to see how most kids eat. And, normal and typical are two different things, right? So, people say, I wanna be a normal kid, I wanna eat like a normal kid. It’s like no, you wanna eat like a typical kid, like normal 60 years ago was a totally different diet than normal today, right? 60 years ago, everything was mostly organic. Kids ate relatively, you know, whole foods and there wasn’t all the GMOs and all the crap and all the excess omega-6 fats and trans fats and people were eating good proteins in every meal and we had actually home-cooked meals and home-cooked dinners. That’s totally different today, right? And so, typical and normal are two different things.
Evan Brand: Yeah. Not many seed oils or non-existent seed oils or go back a little further, go back 5000, 15-20000 years in United States, even just a few hundred, you read the native American stories, I mean those kids were eating Bison, breakfast, lunch, dinner, you know, what were having, they were having Bison. If it was a time where they maybe didn’t get a kill, they had pemmican which is gonna be like a dried meat product, maybe some tribes, they would integrate berries into it. But if your food has a brand to it, now there are some exceptions like there are some really good companies that make Bison meat and all that but in general
Dr. Justin Marchegiani: The jerky, yeah, there’s some good stuff, there’s some decent paleo granola. If you can handle nuts and seeds then that stuff’s okay as well.
Evan Brand: But in general, my point is if your food has a brand to it, it probably has some level of processed. Now, if you say a farm, like a farm name, I don’t consider that a brand. I’m talking about, like Kellogg, that’s a brand. If your food has a brand to it, it’s probably not something good. I’m not looking at the brand of my wild blueberries, I guess technically they have a name or a store but they’re blueberries. So, you just got to think simply and as you mentioned long term, there may be dietary changes but overall, I think a lot of people can get back to foods that they previously avoided or were previously afraid of, not to mention, people that are afraid of meat, so many people are afraid of red meat. We interview people all the time and they say, oh, I eat red meat a couple times a month, I eat red meat every day, like why, and oh well you know, my cholesterol or my heart or my doctor said this and so there’s still so much programming. I think you and I forget, now, I know you have TVs and you probably have some exposure to this but in general I don’t have any exposure to pharmaceutical ads and so I forget just how much indoctrination and programming of dietary information people have and so part of the art of what we’re doing too is just removing any of the historical programming, they’ve had about certain foods. I think some people freak themselves out so much, they’ve been told a certain food is so bad for them, they go into it, thinking if I eat this steak, I’m gonna have problems and they literally will put so much stress and emotion into the worry of food. That then drives further symptoms.
Dr. Justin Marchegiani: Yeah. I always start with you gotta have a framework on how you analyze any data or any concept, right? So, my first framework that I look at anything with is old foods don’t cause new diseases, right? When you look at most of the diseases we have today, the regular there routinely Neolithic, right? They weren’t at the same level that we saw a hundred years ago, right? Obviously, we had different problems back then because we didn’t have the same level of water sanitation, indoor plumbing, antibiotics which you know for like, you get a major cut, you had an infection, you don’t have antibiotics, you could die, right? So, we have that, that’s different. So, Neolithic foods cause most diseases. And so, when you look at good proteins and animal fats and these kinds of things, they have been eaten for as long as you can go back. So, those typically aren’t going to be the problem, right? It’s mostly gonna be the processed foods, the excess omega-6. And also, you know, the whole vegan bent that’s something that’s not really supported by anthropological data. You look at the works of western price so you look at people that studied indigenous societies, almost always meat was consumed when it was available. The only societies that typically didn’t consume meat were societies that didn’t have access to it. And if you look at the works of Western price when meat was accessible, it was typically consumed. It wasn’t like, oh let’s just not consume it. It’s typically, they didn’t have access to it and when they did eat it. And so, people that tend to do really good on a non-vegan diet are your ectomorphs, these are people that can handle lots of carbohydrates. It’s impossible to do a vegan vegetarian diet for the most part and not be very, very high carbohydrate and also, typically, you also got to plug in a lot of protein powders to do it well, whether it’s free form amino acids, whether it’s collagen or pea protein or rice protein or hemp protein, mostly having to plug in a lot of amino acids to get enough especially if they’re trying to put on muscle and be, you know, on the fit side.
Evan Brand: It’s hard to be Vegan, it’s easy to be an animal-based person, I’ll tell you that. There’s just a lot of hacking, have to do. So, Isabella chimed back in, she was a little bit behind on the live stream so she chimed in here. So, here we go, we got some more evidence guys. I hope you’re having as much fun as we are because this is like a, you know, on the fly functional medicine, uh, workup here. So, she said, loss of period for six months as well, mood issues like anxiety and racing heart upon waking irritability which is what I was thinking some kind of hormone stuff. I’m a bit behind wanted to input that so.
Dr. Justin Marchegiani: The problem with a lot of those symptoms, it requires me having to ask a very important question, I won’t ask that question but we’ll just say the meat of that question begins with a letter v and we’ll just let people linger on that and Isabelle, if you want to reach out feel free. I think we chatted in the part, so feel free to reach out, I’m happy to help you.
Evan Brand: Yeah. Yeah. That’s a very, very good point and would make perfect sense especially with the timeline here. I would be wanting to look at some blood work. You know, actually, I had a woman last week, 33 years old, loss of period, other issues, we ran her blood, elevated D-dimer that indicates breakdown of clotting so we’ll leave it at that for today but mid-30s women should not be having elevated D-dimer.
Dr. Justin Marchegiani: Yeah, and we’re speaking kind of like we are in a very, uh, discrete type of manner because we want to keep this information flowing to you, okay, so people out there hopefully you most, you mostly get that and you want to continue to see us on the air. That’s our goal.
Evan Brand: Here’s another question then you and I can wrap this up here in a minute. So, can gut health issues cause high resting pulse and arrhythmias. Let me tell you my personal experience and maybe we could chime in on the clinical side too but when I had gut issues when I had H. pylori, I was anxious, I had issues with my blood pressure. I had heart palpitations. I had panic attacks. I had all sorts of mood issues. I had heart issues. I had sleep issues. I had skin issues. So, 100%, gut issues can cause this.
Dr. Justin Marchegiani: Yeah. The bugs in and of themselves definitely can cause anxiety so you can go type in their scientific studies, type SIBO or H. pylori and anxiety, there’s definitely mental health association, connection with the two. Also, if you have digestive issues, you tend to have hydrochloric acid issues. When you have hydrochloric acid issues, you tend to not ionize minerals and absorb minerals optimally. The two big minerals that are intimately connected with your heart and heart rate and heart rhythm are potassium and magnesium and a lot of times people aren’t getting sodium and chloride as well. So, the electrolytes have to be looked at and potassium and magnesium have to be looked at and most don’t get enough, you need 4 7 00 of potassium a day, most get half that and so I have a product called potassium synergy that does about 13 00 per 150 in magnesium or so side by side. It’s really hard to get enough. Most supplements for potassium stink, they’re like 50 or 100 milligram capsules so you got to take like 15 or 20 capsules a day so sometimes, you need to plug in a supplement if you’re having issues, I mean you can go look at the most potassium-rich foods, salmon, avocadoes, sweet potato. Those are really good options of course, um, some animal products as well, are going to be right up there as well. And again, avocados have twice the amount of potassium as bananas, I know we’re kind of o a carb-centric society. If I say potassium, you’re gonna say bananas, right? But avocados have twice the amount.
Evan Brand: Yep. Good call. Good call. So, long story short, gut issues definitely cause other issues, mood issues are very common. Fatigue is also very common and so that’s gonna affect neurotransmitters so we would be looking at all that. We’d be looking at neurotransmitters, gut inflammation, um, secretory IgA. You can look at fecal fat. There’s a lot of stuff that goes into that, that may affect the high resting pulse. Also, seeing a lot of things right now with viruses and high resting pulse rate. So, if there was a current infection, previous infection, pulse rate could be there. You mentioned potassium.
Dr. Justin Marchegiani: Hydration, sodium chloride and then your potassium, magnesium. Those are gonna be your big ones out of the gates. And then also, blood sugar, you know, some people, they really get into a stressed-out state if they wait more than an hour or so to eat. And if you have digestions, a little wonky, you may want to start with something really simple like some gentle ginger tea or some collagen amino acids or something really light and simple in the morning and some electrolytes even before that.
Evan Brand: Yeah. Yeah. Good call. Sometimes, you know, herbals, I might come in with like motherwort or passion flower, valerian, some kind of like calming ginger.
Dr. Justin Marchegiani: Yeah. I was looking at the nutrients first because the nutrients could be actually root cause and the herbals will never be root cause but they are a palliative supporting mechanism, right? You know, it’s like, you can do passion flower or lemon balm or you can do a benzo on the pharmaceutical side. It’s like obviously the herbs are better and then even before the herbs the actual nutrients that may be deficient that are driving it.
Evan Brand: Very good at all. I’m ready to wrap this up, if you are
Dr. Justin Marchegiani: Herbs aren’t going to have the, you know, the side effects so I’m always down with supporting something palliatively if they aren’t going to have the side effects or you know any of the negative consequences like some of the meds may.
Evan Brand: Yeah. Well said. Are you ready to wrap this up?
Dr. Justin Marchegiani: Yeah. Great chat with everyone here today. I’m glad everyone’s on the chat interacting. We really appreciate it. Functional medicine improv is our flow here, uh, you guys wanna reach out to evanbrand.com for Evan, Dr. J here, myself at justinhealth.com. We’ll put links down below. If you’re seeing it on youtube, you know, great, excellent. If you’re listening to this on itunes or any of the podcast places, there will be a video link below. If you wanna see us interacting as well, there’s that as well. And phenomenal chatting. Anything else, Evan?
Evan Brand: Yeah. If people wanna chime in and they want to watch, if you guys are listening or if they’re on my podcast because we’ll upload these on my show as well. If you want to check us out here on video, give or take somewhere around 11 to 12 eastern on Mondays on Dr. J, justinhealth YouTube channel. So, if you wanna look for us, join the party. Look up Justin on YouTube justinhealth, Justin Marchegiani, Dr. J something like that. You’ll find him on there and, uh, we’ll put the link in the show notes too. So, if you wanna join the YouTube community, you can. There’s what 60 something thousand on there. So, that’s pretty
Dr. Justin Marchegiani: Also on Rumble, also on Betshoot, also on a couple other places. So, we’ll put the links on the websites so you can get the banners, get the links but Rumble’s our new one that we’re going to just get more exposure, people.
Evan Brand: And you’re reuploading the YouTube videos too there, right?
Dr. Justin Marchegiani: Yep. You got it.
Evan Brand: No live function on there or anything yet?
Dr. Justin Marchegiani: Not yet. Not yet.
Evan Brand: Okay. Okay. All right, well, you guys take it easy, we look forward to helping you get your gut health back, just stay patient and don’t give up. And so, we’ll see you next week.
Dr. Justin Marchegiani: Take care of you all. Bye now.
References:
Audio Podcast:
https://justinhealth.libsyn.com/how-to-investigate-the-root-cause-of-your-gut-issues-podcast-366
Recommended Products:
The Gut Lung Connection – Your Gut Health Can Affect Your Breathing | Podcast #348
In this podcast, Dr. J and Evan talk about the connection between the gut and respiratory system. You might not immediately associate gastrointestinal problems with lung disease, but the two frequently coexist. The tissue and glands in your lungs and intestines are the same and react to the same triggers.
At first look, the operations of your digestive and respiratory systems appear to be somewhat dissimilar. Though, the systems are connected in a variety of ways. The digestive tract can function because of the outcomes of respiratory action and vice versa. In addition, the systems collaborate to deliver energy to the body’s cells.
Dr. Justin Marchegiani
In this episode, we cover:
3:08: Key factors of lung inflammation
7:48: Probiotics as regulator of immune response
11:56: Foods major role in gut-breathing connection
20:17: Available Testing and Herbs
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the gut, lung connection. This is really important. Lung health today, it is very important. We have to get good oxygenation. We have to make sure that inflammation from different microbes in the environment, whether it’s allergen or infections, we have to make sure that we’re able to still breath and transfer oxygen even with those stressors in the environment. We’re gonna talk about how the gut is connected to that, how inflammation in the gut can be bi-directional and can affect the lungs as well. So, let’s dive in. Evan, how are we doing today man?
Evan Brand: Hey. Doing really well. Starting this thing off, I was looking at some papers this morning. I told you this was just too important for us not to cover so in the journal of immunology from this year 2021, I’m just gonna read you one, really, really big thing here which is the fact that intestinal dysbiosis is associated with increased mortality in respiratory infections due to an exacerbated inflammation and decreased regulatory or anti-inflammatory mechanisms in the lungs and the gut and they say here, pointing to this important relationship. So, this was actually the first time I’ve heard. You and I have been talking about stuff for years, I mean, we’ve done between us both close to, you know, thousand podcasts and we’ve been talking about gut-brain axis, we’ve talked about the gut-thyroid axis, we’ve talked about the gut-skin axis but I don’t think we’ve ever hit on the gut-lung axis and so this paper is just really reviewing the literature on this and it’s absolutely incredible because guess what, the beneficial bacteria helps respiratory infections and there’s 30 pages, if not more, I haven’t even had a chance to review all the papers on this but there are countless, countless papers now and pages of papers showing that the probiotics actually can reduce the inflammation in the lungs, however, if you’re in the hospital or if you were in the unfortunate situation of being in a critical care unit, an ICU, you’re gonna be getting antibiotics more than likely and you’re not gonna be getting probiotics. And, we could go into the mechanisms but I think the mechanisms will probably bore people but long story short, there’s an increase natural killer cells and obviously decreases in inflammatory cytokines and there’s many, many other mechanisms but long story short, probiotics are absolutely amazing and we know that the antibiotics that you’re gonna get in these situations are gonna do the exact opposite.
Dr. Justin Marchegiani: Absolutely. Here’s a great study here. I know, we’re kind of referring to some of it. I’m going to share my screen here with the audience so everyone can see it, all right. Let me know if you guys can see this here. I’m gonna pull this up here so you guys can see it. All right. Can you see my screen there? All right. Awesome. All right. So, off the bat right, one of the key driving factors of lung inflammation is gonna be dysbiosis, right? Why is this? A lot of this has to do with the fact that bacteria, 80% of the immune system is in the intestinal tract, right? You have some in the GALT, which is gonna be the gastric associated lymphoid tissue, that’s in the stomach, right here. And then, you have the MALT, which is the mucosal associated lymphoid tissue. So, the mucosal, uh, that’d be the intestine. So, the small intestines in the middle here and then the peripheral on the outside is the large intestine. And so, a couple of the big things that you’re gonna see is when the immune system is overactive. One of the first things the immune system does is when it’s overactive, it actually creates inflammation, right? Part of inflammation is vasodilation so it can bring the immune system, the immune cells there to help fight it off. Think if you get bumped in the eye. What happens to the eye? It gets swollen, right? And so, you create this low-grade inflammation which is part of how the immune system works. The problem is, you know, most that inflammation that we’re seeing in people, it’s not an oops, I broke my elbow, it’s gone in a day or two, it’s a chronic low-grade inflammation and so you can see, um, when we add in things like probiotics over here, right, probiotics do a bunch of different things, they regulate the Th1, the Th2 immune cells, right? So, Th1, Th2, right, so that’s gonna be the natural killer cells on the Th1 side versus the antibodies on the other side and so, we have this balance between helper natural killer on the one and we have the antibodies on the two. So, we have this good balance and if they have it out of killer, like, let’s say we have higher Th2, you may see more allergies and things like that which can obviously stress out the lungs and obviously if we have some kind of infection in the lungs, we want good Th1 modulation because if the Th2 is really high, the Th1, those natural killer cells are gonna be lower. And so, you can see, obviously, it’s gonna express several viral defense genes. It inhibits various cytokines and chemokines so the chance of you having, um, what’s that, what’s the expression they call it here, it’s the inflammation after a virus kind of comes in and ravages the lungs
Evan Brand: Like the cytokine storm
Dr. Justin Marchegiani: Yeah. Cytokine storm and so this really helps modulate the imbalance in cytokines after the fact, right? And obviously, it’s gonna modulate immunoglobulins, that’s your antibodies, your IgG, IgA, IgM, IgG and then to modulate your innate and adaptive immune system and obviously it’s gonna help with the allergenic anti-allergenic property, so that’s gonna be a Th2 stimulator. So, you can see, it’s gonna really help modulate this here. And again, this article doesn’t even really address it but if we don’t have good gut absorption of let’s say of vitamin A or vitamin C or vitamin D, right, if we don’t have good absorption in the gut then obviously all those nutrients play a major role in modulating the immune system too. Any comments on that, Evan?
Evan Brand: Yeah. Well said. So, I’ll take it a step further. We see all sorts of dysbiosis, bacterial overgrowth, Candida, parasites, worms, gut inflammation coming from the diet. You alluded to the malabsorption. So, let’s say, you’re giving someone X amount of zinc, let’s say you’re giving someone X amount of quercetin and vitamin D and vitamin C and you’re thinking that you’ve got a good protocol, well, we talk about this all the time. It’s not really about what you eat or what you take, it’s about what do you actually digest, what do you absorb and what do you assimilate from that so the problem is I have first-hand experience now with some really, really intense medical cases, we’ll just leave it at that for now. And, this particular person has been getting vitamin C in a crushed-up tablet form where in reality, we should be getting IV vitamin C. So, it’s not just about what you get, it’s how you get it, it’s how much you get it, it’s how much what you get from what you’re taking. And, there’s a lot of issues and if you say you’re getting 2 grams orally in a crushed-up low-quality form, we know that Vitamin C. In general, we see it low all the time on organic acids testing. Maybe, you’re getting a tenth of that so you’re really just gonna get the therapeutic amount so a lot of people I find are either being fairy dusted or fairy dusting themselves because they’re putting so much hope into the products they’re taking and they’re just not getting much from that due to these underlying issues with the gut. And, you and I have beat the drum on the gut for freaking 10 plus years and we’re still having to beat the drum on the gut but I hope that you feel as good as I do about all the work we’ve done because we know that everything, we’re doing with the gut is improving people’s responses so that if they do get exposed to something, they gonna have a much, much healthier, better response to it.
Dr. Justin Marchegiani: 100%. I want to show one more article up here if you don’t mind. We’re trying to incorporate some of these new systems here so people can kind of see what’s happening with some of the articles that we’re looking at while we go live. I think it should be helpful. All right, there’s one thing I wanted to post here. So, we’re looking at different infectious stress on the lungs and what’s happening but look at what’s happening with probiotics, right? Probiotics are having an effect on modulating TNF alpha, Interleukin-6, it’s having also effects on modulating over here, your CD4 cells, these are your natural helper cells. Probiotics, actually, have a major role in modulating this whole immune response and so, you know, I think one of the best things you can do if you have poor gut health out of the gates here is potentially adding in some probiotics, uh, maybe adding in some fermented foods as long as you are getting bloated or gassy. Now, some people that have SIBO, these things may make it worse and so if you’re one of those people that probably won’t be the best thing but if you’re trying to be more in preventative mode, we probably want to get some of this dysbiosis under control and work on building up good bacteria after the fact, kind of my general analogy is you get your car washed before you get it waxed. You go and throw down seeds only after you’ve done the weeding in your lawn. Anything else you wanna add, Evan?
Evan Brand: Yeah. Except for like in acute situation, you might have to change the order of operations, you might have to go hardcore in it maybe some bloating, some burping, some gas, some kind of reaction, you know, you gotta make a pros and a cons list, right? There’s always a risk benefit analysis and those short-term effects from a probiotic if it were in the wrong order per se are not gonna be a huge deal, long-term.
Dr. Justin Marchegiani: Yeah. Absolutely. Let me just kind of, all right, good, so I think that’s really good. So, first thing I wanted to add on top of that is we know gut permeability is a major stress on the immune system because you’re allowing undigested food particulate potentially or potentially like endotoxins which are like the outer shell of the bad bacteria, potentially even mycotoxins from fungus or mold, right? These things affect gut permeability. When the gut is more permeable, that allows more foreign antigens, think of antigens as like foreign proteins, right, so you could put bacteria, viruses, food, all in that kind of anagen category. It exposes more things to the immune system and the more you expose bigger chunks of things to the immune system, the more responsive the immune system will be. And so, ideally, we don’t want to poke the bear, right? Think of it like, gut permeability is poking that sleeping bear and we don’t want to over stimulate that and create immune responses unless we really need to.
Evan Brand: Yeah. You know, what’s crazy too, this, I mean, we’ve seen so many things with obesity and you know worse outcomes and diseases and you know. I went to the restaurant yesterday, I got some delicious chicken wings, some grilled chicken wings and I look around and everyone, this is on a Sunday, everyone’s drinking mimosas and bloody Mary’s and whatever else and the majority of the people are obese and they’re getting pretzels and nacho cheese and then they get donut holes delivered to their table and then they get a sandwich with like six pieces of bread and the cheese is going off the sandwich and then they go and get chocolate cake afterwards. It’s like, my goodness, just imagine how much better we could be if people just had chicken wings like me for lunch. I didn’t have donuts, I didn’t have queso, I didn’t have freaking pretzel, I didn’t have bloody Mary, like, come on. People, it’s like, they don’t care about their health until they are forced to care about their health but by the time you get to that point it’s already too late so I guess my little rant here is just, I really want people to start taking their health seriously now. Stop waiting until you’re at rock bottom before you decide you wanna change things. Use this information that Dr. J and I are providing and implement it now, like, people listen, listen, listen and then the implementation is just not there. I really hope people implement the stuff you and I talked about.
Dr. Justin Marchegiani:100%. So, I mean, out of the gate, I mean, of course, you know, you have caught people on a bad day, maybe they’re 90%, you know good and 10% off and you caught them on their cheat day, right? But odds are that’s probably not the case but we have patients who are really good and may have a bad day every now and then. And so, hey fine, if you’re doing great and you’re on point and you’re in great health and you want to cheat every now and then, I always recommend trying to choose the least damaging cheat possible, right? That probably isn’t the best example of that but in general, food plays a major role, right? Because food’s gonna have nutrients to run your immune system, right? Our fat-soluble vitamins, our antioxidants, you know zinc, magnesium, selenium, all play major roles with the immune system. Our antibodies are made from proteins so if you’re not getting and digesting good protein, you’re not gonna be able to make good antibodies for your Th2 immune response and then obviously, if you’re eating inflammatory food, the more omega-6, the more you stimulate your prostaglandin E2, that’s more the side inflammatory side, the more you’re gonna have unprovoked immune responses and you’re just gonna be chronically inflamed and then you may have this cytokine storm we talked about because you don’t have good balance to your immune system and so, also, on top of that, right, we know how much carbohydrates, especially refined processed carbohydrate. It feeds a lot of bad bugs. So, if you have a lot of fungus overgrowth, yeast overgrowth, bacterial overgrowth, these bugs prefer refined processed foods, right? It’s gonna just be easier to digest, easier to feed them and so you’re gonna create overgrowths like that. And these bad bugs, obviously, produce other types of toxins in your body, right? Bad bugs eat your nutrients and poop. And then, instead, versus eating your poop and producing nutrients, right? Bad bugs take the nutrients you’re eating and they’ll produce more toxins and endotoxins and different metabolites, lithocholic acid, etc., versus producing B vitamins, producing vitamin K, producing different beneficial acids that prevent the colon from overgrowing, right? Probiotics, acidophilus, literally, translates to acid loving and so good probiotics actually produce and lower the pH in the intestinal tract which actually makes it harder for bad bugs to grow, right? Bugs tend to prefer an alkaline type of environment to actually grow in the lower intestines.
Evan Brand: That’s a great point. I don’t think many people know that about acidophilus. I’m glad you broke that simply for people that you actually want lower pH environment because that’s not really a place for these pathogens to thrive versus when you’re on proton pump inhibitors, for example, acid blocking medications or if you’ve got an H. pylori infection, you’re gonna have that higher pH, you’re gonna have that more alkaline gut and then that’s where things really get into trouble, I mean you and I, I think we’ve done a whole podcast on this but the brief spark notes are lower stomach acid, age, stress, not chewing your food, that’s gonna increase malabsorption and feed the bugs too. So, this once again goes back to the same thing and we’ve said 100 times you get your gut tested. Figure out if you’ve got this overgrowth going on. Don’t wait until you’re in a critical situation. We got to get your gut fix now. Think of working on your gut as preventative medicine. How revolutionary is that?
Dr. Justin Marchegiani: Absolutely. And then also, when you consume too much carbohydrate, we talked about how you’re gonna feed the bad bug. We talked about what the bad bugs do in regards to impeding nutrients, adding more toxins, pooping poop, right? There was one more thing I wanted to kind of highlight on that realm, we talked about the gut permeability and the overstimulating immune system. Also, high levels of carbohydrates, glucose looks very similar molecularly to vitamin C and so you have these macrophages, little Pac men and Pac women that go along in the lymphatic system and in your bloodstream. They gobble up bacteria, gobble up viruses, gobble up crud.
Dr. Justin Marchegiani: Also, high levels of carbohydrates, glucose look very similar molecularly to vitamin C, and so you have these macrophages. These little pacmen and pacwomen that go along in the lymphatic system and in your bloodstream. They gobble up bacteria, gobble up viruses, gobble up crud. Vitamin C kind of docks on that macrophage and and kind of supercharges the macrophage so it can gobble things up more. Guess what glucose can actually come in there, and docks on that macrophage, and it can decrease the macrophages’ ability to gobble things up. Now in literature, the literature logs to make things confusing, so there’s kind of like two sets of language. There’s like the lay language right where we’re kind of communicating it in a way that everyone gets it. In the literature, they’ll call it the phagocyte index, right P-H-A-G-O-C-Y-T-E-S, so phagocyte with a P-H, right? So go on PubMed, type in phagocyte index and you’ll see, that’s the macrophage. The ability to gobble critters and bacteria up, and so if we decrease the phagocyte index, it’s going to be just they’re not going to be able to gobble things up as much, and so this is really important and so high levels of glucose, high levels of insulin, which, again, glucose and fructose stimulate insulin production, right? And so, you’re going to have. Less gobbling of your pacman and pacwomen in your bloodstream to be able to control these critters.
Evan Brand: That’s crazy. Ok, so you’re saying if I’m in the hospital and the nurse or whoever brings me my lunch, which I saw when my grandmother was in the hospital couple years ago for heart issues. You know what they brought her for lunch? It was this little like packet of peanut butter which was corn syrup and like peanuts. And then I think it was probably a piece or two of bread and then it was a little Jelly packet. And guess what that was? Corn syrup and like fake artificial flavor and purple dye and whatever else. So, you’re saying that’s not the optimal diet for good macrophage. I guess you would call it bug eating per southeast.
Dr. Justin Marchegiani: No. One, it’s going to feed a lot of despotic bacteria. Two, it’s going to decrease the phagocyte index, so your body’s ability to gobble up the bacteria and such. And then I would say on top of that, the more insulin resistance you have, ’cause, how, how It works is right? You take in glucose, you take in fructose, right? When there’s fiber attached to it, it actually decreases; glucose and fructose is damage. I.e. like if I consume some fructose from blueberries 1, there’s a bunch of antioxidants with the blueberries. Bunch of different course. It ends and bioflavonoids and vitamin C on that. There’s also fiber so fiber kind of blunts the effects that you may get from fructose when you consume things like blueberries or strawberries. But when you consume fructose without the fiber, i.e., high fructose corn syrup, right or table sugar, which is sucrose to gross is fructose and glucose. High fructose corn. Syrup is just like 55-45 fructose to glucose. Where table sugars, half and half right? When you consume it without the fiber and out the nutrients. What happens is the body says ok, we gotta go store it in the liver. So, in the 1st place it goes to to dump that fructose is stored In the liver. Once the the fructose sources are done. There can’t store it anymore. It starts to convert it. With that, and then once the liver starts getting fatty, all this fructose just hangs around in the bloodstream and it’s creating all this oxidative stress. It’s like putting a barbecue sauce right on your chicken before you barbecue it. It creates this browning effect. And so when you have all this high level to fructose in your bloodstream because your liver saturated, your liver is now fatty. It can’t store anywhere else. You have high levels of insulin now you start browning all the arteries. And then what does that do? It creates inflammation and makes your platelets and your blood cells just more sticky. So you have increased chances of clotting. What’s going to happen when you have clotting in the lungs? It’s going to create a whole bunch of lung stress, right? Obviously hard issues if it’s in the heart. Brain issue is in the brain. And so if we can get the fructose and the high levels of insulin down, one, that’s going to help blood flow. It’s gonna decrease your oxidative stress reserves and so when you have high levels of oxidative stress, what does that? Due to your needs of vitamin E and vitamin A and vitamin C? It increases it, because your body is having to put out these fires and think of these antioxidants is like the fire extinguisher. So, it’s wanting to use all these antioxidants. And of course the fuel that feeds a lot of this stuff is going to be high sugar and crap that also feeds the bacteria, which then makes the immune response worse so you can see all these things, they kind of compound on each other one after another.
Evan Brand: Yeah, yeah, that was a great way to put it out so I was kind of picture in my head. This snowball effect that gifts. You and it gets nasty quickly.
Dr. Justin Marchegiani: It does. It really gets nasty.
Evan Brand: And then if you’re really, really bad and then you’re on the feeding tube, I mean we’ve seen, and I know you’ve talked about this before with your some of your work in the medical industry years ago. I mean, you’ve talked about some of this stuff they feed people. It’s it’s bad. These feeding type solutions. I mean, I’m pretty sure it’s just straight garbage. I don’t have an ingredient list in front of me, but I know it is not good.
Dr. Justin Marchegiani: Yeah, 100% and uhm… You know sugar is used, it hits that opiate receptor, right? It’s, it’s people use it to kind of modulate pain, modulate all the bad stuff that’s happening so it’s you know it’s very addicting. You know, once you’re stuck on it. We had a question come in, “How do you test for some of these things with the bacterial overgrowth?” So you can do a SIBO breath test Lactulose breath test. We can do one of the different organic acid tests that we’ll look at some of the bad bacteria metabolites like benzoate, hiparate 2, fat 2 3 phenylacetate, Indicam; These are different organic acid or bile acid markers that we can look at. Will also run good, comprehensive DNA stool tests that will look at some of these bacteria, and if they’re overgrown right, some of the common bacteria will see, or Klebsiella, citrobacter, prevotella, morganella, Pseudomonas, right? There are some of the common ones that we’ll see, and there will be elevated way outside the reference range when this happening.
Evan Brand: Yeah, you’ve got strep. You’ve got staff. We’ll look at Candida on the stool, even though it’s not as accurate as the urine will look at. The parasites too. What about like blasto and crypto and Giardia? What about H. Pylori infections? All these things add up against you, so our goal is really trying to get everything on paper and figure out what all you’re up against and the. Cool thing is. A lot of times, you and I are knocking out infections that maybe we didn’t even know were there because we can’t test for everything like we have really, really good testing. But I’m sure there are still different pathogens that we don’t even know, but the cool thing is with these herbs and with these synergistic formulas that we’re using clinically with people is that you may have some antiviral, antifungal, antimicrobial antiparasitic properties all to these same compounds. So you may knockout 4 different infections with the same nutrient as opposed to, let’s say a specific drug designed to target a specific pathogen, like an anti-giardia antiparasitic medication. Whereas herbs we may come in and knockout, giardia plus crypto, you know. Plus the H. Pylori all in one fell swoop, so that’s the benefit and not to mention. Let’s say it’s berberine, that we’re using for antimicrobial support. We may help support glucose there. We may, with some of these.
Dr. Justin Marchegiani: Yeah, yeah, there’s some of that.
Evan Brand: We may. We may lower inflammation at the same time as we’re eradicating the infection, so that’s just really beauty. Once you get the data, the beauty is that you can work on multiple mechanisms at the same time getting someone to the finish line fast.
Dr. Justin Marchegiani: Yeah, and also when you take some of these herbs, these herbs are going to have antioxidants in it so the oxidative stress that you kind of create with the killing of these microbes. These herbs are going to have some antioxidants present in them just due to their their phyto signature. Obviously when you take in an antibiotic, right, you’re not going to have a lot of nutrients or antioxidants present with that. They actually they can create more oxidative stress. Just going to PubMed type in antibiotics and oxidative stress or antibiotics and mitochondrial stress. There is a study supporting this, so the part of the benefits with the herbs is that you’re going to get some antioxidant nutritive properties ’cause based on their phyto signature and again, this is all going to be dependent upon. These herbs being higher quality right, not cheap ones, and if they’re grown in soils that have high levels of lead or mercury then that could obviously be a negative impact. So we want to make sure we’re sourcing out high quality herbs. That’s why we want to have a professional grade where we have third party testing on them to make sure they’re adequate. The next thing on top of that is there’s synergy between some of these herbs. So, for instance, you talked about berberine’s right very helpful. Barbarians also help modulate lipids, right, triglycerides, cholesterol, right. They also help with blood sugar and guess what? Berberine’s combined with warm wood our shown actually have antiviral qualities which is very helpful. So if you have any kind of lingering viral stress that can also be very helpful. I see people when we do gut killing, they, they may start to flare their herpes because their immune systems going after it. Sometimes that can happen too. Or there may be very helpful with their EBV or something else going on in their bodies. So we gotta keep an eye on all those things.
Evan Brand: That’s cool. Yeah, that’s really fascinating. Oregano 2, right? We love oregano will use that as a broad spectrum too. That has a lot of cool different antiviral into microbe properties olive leaf is another great one. That we use and…
Dr. Justin Marchegiani: Yep, olive liters of antiviral properties to anti inflammatory for sure.
Evan Brand: Sure, and it’s gentle. You know some of these things are just so gentle that even in young children that were seeing with these issues, I mean, I know with you and. I you know. I’ve actually had couple clients, they they’ve really tooted you and eyes horn. They say you know that you and doctor J or kind of the only guys out there with young kids that actually are doing functional medicine because so many people are doing like, functional medicine theory you know? Or maybe they’re clinician and they’re older. Maybe they don’t have kids, so I wanted to pass that feedback on to you that are our clients. They they really love that about us that we’ve got young kids, ’cause we’re implementing this stuff with our kids too. I know you and I have both done antimicrobial nutrients and other supportive stuff for our children, and it’s been really great because there’s so much fear and I, I guess you would just call it misinformation when it comes to to kids. Kids are so resilient, but they do sometimes need help and you know, you’ll often get the recommendation or the the comment that, Oh well, the pediatrician doesn’t know anything about that. For the kids, I will tell you, personally herbs are great for kids and we use protocols and kids all the time. There’s so much to be done with kids.
Dr. Justin Marchegiani: 100%. So, just kind of out of here just if we kind of re summarize what we’re trying to, you know, make sure you. Guys extract from here. Is number 1, beneficial bacteria is going to help modulate the immune system, decreased permeability, immune permeability, which or gut barrier permeability, which takes stress off the immune system. it’s going to modulate the cytokines the interleukins. So, when your immune system comes in there you’re not going to create more damage from the immune system, so it’s kind of like the firefight is coming in and you have a small fire and instead of putting it out with one of those portable little fire extinguishers they bring the whole big ladder and truck in there and spray so much water they knock down all your walls. It’s kind of like, well, that’s kind of an inappropriate response to that kind of fire. Same thing with your immune system. We don’t want your immune system to be creating stress and inflammation because the response is inappropriate, right? We could see this with other stress infection. We see it with allergies, right? And so we want to make sure we have good immune stress. We want to make sure that your gut is healthy where it’s extracting all of the nutrients we’re putting foods in there that aren’t feeding the bad bugs, but also providing lots of good beneficial healthy fiber and healthy full spectrum antioxidants and nutrients that help the gut in the immune system as well. Any comments on that Evan?
Evan Brand: Well, you know that just kind of spurred the five and we could do a whole Part 2 on this, but I mean there is a role of some leaky gut support outside of probiotics. During this, you and I have our own custom professional formulas that we use with various nutrients like Aloan, Muk and cama meal and other things that you can use to actually support the gut lining. So this would be another great thing to. Implement if you’re in these situations, maybe you’re unable to get testing because you know it takes. You know, couple weeks, turn around time or a little more, depending on what you’re doing. So if you’re kind of in a more acute situation, I think not knowing what you’re up against, you still could bring in some of these leaky gut supports now. And then if you’re in a situation like I’m telling you to wait before you hit rock bottom, wait before you know, don’t wait before you hit rock bottom. Don’t wait before you have to go. To the hospital work on your gut now. If we have all the data we can work you through these steps here and then we may have already gotten you to the gut healing point to where you’re not coming into this infection with a leaky gut. I would much rather someone come in with a healthy gut. We know we’re gonna, they’re gonna do far better and with this discussion you and I talked about today of the gut-lung axis, now is the time to focus on your gut, so you don’t have to focus on your lungs.
Dr. Justin Marchegiani: 100% and it gets great. Makes a lot of sense. So you guys listening to you enjoy today’s content here, we’ll put a list of some of the products that we use. Some of the probiotics that we that we specifically like in use with our patients. I’ll put some of the the immuno-nutrients that we’d like to kind of modulate the breathing pathways- quercetin stinging nettle-all excellent. I love ginger tea as well, we’ll put that in the links down below those are all excellent things. And of course some of the herbs that we like as well will put some of the clearing herbs that we like for the dysbiosis and such in the comments or in the comments, ah description below. And if you want to support us, you can purchase some of those things there. If you also want to reach out, we’re available for functional medicine consultation support all around the world. Will put that link down below as well; evanbrand.com to reach out with Evan. Doctor J, justinhealth.com to reach out with myself. Thanks so much. Evan, any last things you want to highlight?
Evan Brand: No. That’s it. If people need help, feel free to reach out. We’re here for you. We’d love to help you do, do an overhaul. You know what I mean? If we got to look at your system, let’s look at your system. Please reach out if you need help. Doctor J at justinhealth.com me, Evan, evanbrand.com. Would love to help you and we’re here for you.
Dr. Justin Marchegiani: Awesome! Alright. Have a good one everyone! Take care. Bye now.
Evan Brand: Take care. Bye, bye.
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How Your Iron Levels Are Negatively Affecting Your Health | Podcast #346
Iron is a mineral part of hemoglobin, the protein in red blood cells that transports oxygen from the lungs and throughout the body.
Dr. J and Evan also discuss identifying underlying issues to deal with them effectively. You could be having digestive problems, menstruating for women, or you’re not eating the right foods to source iron or adequately absorb it. So if your body doesn’t have enough iron, it won’t get enough oxygen, and your cells (powered by oxygen) won’t function efficiently. Suppose you’re experiencing symptoms of iron deficiency.
In that case, Dr. J and Evan suggest consuming vitamin C to help increase iron absorption, eat iron-rich plant foods, and have yourself tested to have comprehensive test results and fix your health issues.
Dr. Justin Marchegiani
In this episode, we cover:
1:19: What is iron deficiency and how to test it?
5:36: Iron-rich food template
10:04: Other issues to consider when dealing with iron deficiency
17:09: Iron deficiency in men
Dr. Justin Marchegiani: And we are are live! It’s Dr. J here in the house with Evan Brand. Today we’re going to talk about about iron levels and how can they negatively impact your health. Of course, we have two sides of the same coin here. We have high iron and low iron. And then, high irons going to be a bigger issue, right? Men don’t menstruate and women potentially, low iron is going to be a bigger issue because women menstruate every month at cycling; it’s a cycling age. Menopausal women, when their cycle tends to cease, then there could be more issues there. But out of the gates, women iron is going to be an issue. Most of the time if it’s hormonal issues and men’s going to be the opposite. We’re going to dive in and give you guys a crush course on both sides of the fence. Evan, how are you doing today, man?
Evan Brand: Doing well! Let’s jump right in. So looking at blood work. If you’re looking at a female, you and I test ferritin which we find conventional medical doctors rarely test ferritin. Ferritin being the iron storage protein and I did a whole video on Youtube. Those are my most popular videos ever on low ferritin and hair loss. We’ve seen how if your ferritin is let’s say 20, that’s far too low. You’re going to experience maybe some shortness of breath, major hair loss. If we can get the ferritine to 70, 80, or 90, women feel much better. Their hair stops falling out and they can catch their breath. So do you mind like, teasing a part when you’re looking at these labs, like total iron versus a ferritin. If you see a female with low total iron, are you really prioritizing that or are you after ferritin or are you going after both? How do you approach it?
Dr. Justin Marchegiani: Well the first thing that we look at with iron, we have to see how low it is.Okay? There’s func- I consider functionally low levels of iron. And um, and there could be um, you know more, I just say more acute levels of iron that are are more low. Right? We could have functional imbalances versus the more anemic that conventional medical doctors would say you’re low in iron. We have both side of the fence, right? We have the functional issues, and we have the pathological issues. So the first thing we look at is going to be a CBC, right? On the CBC we’re going to look at red blood cells, hemoglobin, and hematocrit. If we see those start to get low, especially red blood cells you’re going below 4, hemoglobin into the 11, hematocrit below 30s, we have problems. Danger will rob– the red blood cell size is dropping which is the hallmark of low iron. Because we need iron that attaches to hemoglobin that help us carry oxygen. So we have hypochromic microcytic anemia. These are going to be smaller red blood cells, right? Smaller blood cells are going to be on the iron side. On the B12 side, it’s actually the opposite; they’re actually bigger. It’s called megaloblastic anemia. They’re actually too big. The red blood cells are opposite. We think of humans, we start off as babies and as we get bigger right? Red blood cells, they start off bigger and they actually get smaller as they get older. And so, B12 is needed to mature. Red blood cells, and so if we don’t have enough B12, you’re stock in this more immature state which is bigger, and you don’t have enough B12 than you can’t get smaller. Now with the iron, it’s actually the opposite. You actually get too small when the iron is too low. And of course, you can’t carry oxygen which is really important because aerobic metabolism which is how we mostly generate energy requires oxygen. And so that’s like, you know partly the kreb cycle, the electron transport chain, and all that stuff um, requires oxygen. So on that front, just kind of out of the gates there, we’re looking at um, iron from that perspective. Red blood cells, CBC, hemoglobin, and then we can dive deeper into an actual iron panel. And that’s we’re going to look at serum iron, that’s going to look at iron in the blood. Then we can look at ferritin. It’d going to look at our storage form of iron. So iron serum and ferritin are two different things. So think of, You’re driving a car, right? You have your check engine,Or should say you have your gas gate, right, for your fuel, right. Your fuel gauge that’s kind of your ferritin. Are you on full are you an empty? The iron serum, that’s the fuel that’s in the– ready to be, ready to be um, combusted to generate energy. Think of iron serum, that’s what’s in the engine, that’s what’s in the blood right away. Ferritin is going to be what’s in the gas tank. So you know of course If you see iron low on the serum side, you wanna look deeper but it’s not beol or endol. You have to look deeper on what’s in the gas tank. That’s where iron serum um, sorry, that’s where ferritin will be more helpful and other markers like Iron saturation can be helpful too. Because that tells you how saturated the cells are, and also things like binding proteins. Um those tend to do the opposite, those tend to go up When iron goes um, goes down. So think about it, thinking about iron binding proteins is like fingers right. The more or hands right, the more hungry you are the more hands reaching out to grab stuff right. And so your body creates this protein and will try to reach out and grab these extra irons to create more binding proteins when iron is lower. It’s trying to get that much iron into the cells as possible. Does that make sense out of the gates?
Evan Brand: Yeah it’s a great breakdown. The analogy is super helpful. Because you know some of the blood chemistry training that you and I have looked at, some of the doctors, they will talk about the importance of ferritin. But that visualization of the gas tank Makes a whole lot of sense because you have doctors, if they do recognize low iron, they’ll treat that. But then if you see low ferritin, The woman still doesn’t have the results she’s looking for with regards to hair loss and catching her breath and all that. So once you get the ferritin levels up, Which typically I go for lactoferrin. What are you doing in terms of trying to get the ferritin back up? I know optimizing the gut is some of it, we can talk about that. But what about just straight supplements?
Dr. Justin Marchegiani: So first thing is you may see higher levels of iron in women that may have low iron. So you have to look at all the markers that I’ve mentioned because if they are inflamed, iron is also a reactive oxygen species right? Think of it as like It’s kind of inflammable if you will and so, and so when you are in inflamed because of poor food, poor diet issues, or toxicity issues, you may have higher levels of iron ferritin because of inflammation. If you’re really inflamed i always I like to make sure that it calm the inflammation down a little bit first before throw iron in there, it’s like gasoline in the fire. So you really want to make sure you know if iron’s really high or looks really high and then we see some inflammation markers like CRP also high, we see a lot of symptoms, right? Brain fog, joint pain, energy issues; Maybe we wait a little bit before we jump on that iron train right away. Maybe we just chew some iron rich foods, you know on the animal side and work on getting the inflammation down. So it depends upon where they’re at.
Evan Brand: That’s smart, let me comment on that real quick. That’s really smart and really wise to say, because people would just jump on that iron train right? Those doctors who prescribe iron probably low-quality form which is going create constipation and other problems. And if they are already having high iron Information due to some toxicity, that makes them worse. I had one high iron when I was first exposed to mold. I actually look back on some of my olde levels. My ferritin was high, my iron was high. And i did some pretty high potent seed turmeric extract, and i was able to get the iron back down. And i’m sure the blood donations may have helped too. But it was interesting to see that on paper, how my exposure to toxicity cranked that up a little bit.
Dr. Justin Marchegiani: Exactly and then There is a marker called Seruplasman Which is a marker for copper So sometimes copper and also affect iron as well. Again i’m not too worried of copper If you’re like Paleo and you’re eating high quality organic meat and high quality animal products. close your typically going to see the zinc and iron products cause you also have copper in there. So i don’t typically get worried about copper unless we’re really I don’t know, eating a lot of plant-based products. And we’re kind of deficient and some of those minerals, and so eating good quality animal products may not be that big of a deal. And also it’s good to look at if we’re doing iron, If someone is vegan or vegetarian, you know there’s different kinds of iron that we use right? So in my line, i have a product called vegan supreme which is an iron disglycente which is found in the glycine, which is good. It it’s better like conventional medicine which is ferrous sulfate which will be more constipating, leaving the stool black-er and darker. Glycinate tend to be pretty well absorbed so i like that in the glycine Which is same kind of amino acid and collagen and bone broth so i like that. Also, i would say depending on vegan vegetarian you may want to add some grass fed liver. Something like that that’s going to have some other nutrients like B12, vitamin A in there as well. Just depends upon how good or bad someone’s diet is too, if they can eat animal products. And so…
Evan Brand: How about lactoferrin? Do you use lactoferrin?
Dr. Justin Marchegiani: I mean lactoferrin it’s like it’s like a protein right? It’s gonna also… Yeah, it’s like a milk protein like it increases iron levels, kind of vitamin C in a senseWhere it increases that binding in absorption of iron, is that correct?
Evan Brand: Yeah, yeah. I’ve seen like a couple of iron lactoferrin combos that we’ve used. Man, it’s like rocketfield to get women back up really quickly.
Dr. Justin Marchegiani: Yeah for me i don’t typically use lactoferrin in general. I’ll do my iron supreme which is the bisglycinate, And then i’ll throw in some potential iron granular Is there a not eating enough animal products (Evan: like a liver) Yeah, like a liver glandular and a little bit vitamin C on top of that. But um, don’t you know, I see a lot of guys out there. I see people say “Don’t eat vitamin c, it’s going to increase your iron.” No, if you’re a guy, eat vitamin C it’s not a problem. It’s in every leafy green vegetable, every high quality fruit that’s out there, it’s too Important. Guys the solution to iron is just give blood. Get a comprehensive blood test once or twice a year. Maybe give blood once a year um, twice a year depending on how many blood tests you get, just give blood is the solution. Don’t avoid nutrient dense food that have vitamin c that would increase your iron. Just give blood and do some testing. Keep it simple.
Evan Brand: Yeah. That’s the fun part. When you do comprehensive panels like we’re doing. I just donated a blood, got blood work this morning. I gave a lot of tubes. It was probably not much as a donation, it wasn’t a pint but for me, it was a good slow drip out of my system If i’m running some blood panels throughout the year. And you get data. You get data out of it too.
Dr. Justin Marchegiani: I think it’s fun for sure So we talk about you know how to assess these are patterns right? We have our general cbc, we have Iron panel that will include Iron serum, ferritin, Iron saturation um, TIBC, UIBC, which are your similar binding proteins. You can also look up reticulocytes for baby red blood cells you’re losing blood. You’re gonna see a lot more red blood cells because the babies are being formed to kind of filling the gap of the older adult cells that were losing it; it there’s an ulcer or some kind of tummy bleed, IB you know, Irritable bowel disease kind of bleed in the intestines or colon or wherever. So that’s helpful to look at. And in general, you know, if you’re vegan, vegetarian, and you have a history of not getting iron in your body, you gotta fix that. That’s whole different podcast conversation about animal products. We’ll, you guys can go back to our channel, search for that, we had conversations, just on those topics. The second issue for women Is just to get rid of the hormonal Imbalances that are causing you to bleed too much. So if you are bleeding four more tampons, 4-2 days or more, probably just menstruating too much, you know classic cases of hemorrhagic if you will. And there’s probably a lot of estrogen dominance, way higher estrogen, lower levels of progesterone. Maybe progesterone is falling out soon in the cycle and some of the things are diving just excess bleeding and that’s possible too, and you gotta get to the root cause of why that is. Estrogen dominance usually some adrenal stress that affects some underlying issue that is causing that. And of course if you have a lot of digestive inflammation, whether in the stomach area or intestines, or lack of stomach acid, or enzyme you may not be able to break down the high-quality animal products that you’re consuming that could also create a bottleneck of absorption.
Evan Brand: Yeah when somebody here’s that, they might not realize how big of an impact that could be, right? When somebody here’s what you’re saying. It’s like “oh this gut Ingestion, digestion blah blah blah” But we’ve seen it on paper and clinically Where you have women that are eating paleo, doing breastfed meet, doing a great job with diet, and they’re still very low. Some of it like you said high you know, the excess menstruation but, i’ll tell you personally i’ve seen big changes with my wife’s energy levels after clearing her gut infections out. And we knew that she was having malabsorption. So, and so I mean when your 40 50 or 60 and beyond, you are making Left stomach acid due to age even if you’re eating that grass fed steak, and that liver capsule, who knows how much you’re getting from that. So to me, i think enzymes will be part of a good Iron supporting protocol because you know, people will say you are what you eat. But really, you are what you digest from what you eat. So i think This is a good point to bring up enzymes and acids to make sure that if you have H.Pylori Infection that could be something to address, that will be driving the low iron. Is that a safe statement to say? Is h pylori that big of a smoking gun, that it could drive blow iron due to the malabsorption?
Dr. Justin Marchegiani: Yeah, i mean there’s always you know. There’s always going to be different degrees of how that infection is causing a stress in your body. If it’s there, it’s chronic, it’s creating a lot of inflammation, digestive wise enzymes have dropped significantly. That may impair your ability to absorb usually there is going to be symptoms that will tell you the severity you know, just things like not having a good bowel movement, having a lot of bloating, or gassing, or flatulence, and gut inflammation, those are pretty good signs there’s stress going on there. Um, looking at your stools, how formed do they look, are you regular, are there undigested stool pieces in your stool? Those are all pretty good ideas that you’re on a bad track. So it’s good to look at that. Of course if you have chronic iron, and you’re fixing menstruation issues, you’re eating meat, you’re adding in Digestive support that’s all great. You probably want to look deeper and get your got tested and see if there are other bugs in your gut like SIBO, or just general dysbiosis, or parasites or h.pylori, or other issues that could be in place. You gotta look at all of it.
Evan Brand: Yeah. And you mention the inflammation I mean. That could be exposure, that could be the diet, it’s simple. It sound simple but It’s still worth mentioning. We still have so many women that are going to the starbucks drive-thru and getting a pastry, a bagel or a muffin, or whenever, and they have their coffee and that’s it. That’s it for their breakfast and they wonder why they are exhausted. I mean nutrient density is just foundational.
Dr. Justin Marchegiani: Yeah, nutrient density is really important and um, to really have good nutrient density You have to be eating some level of animal products. You’re just not going to get same level of nutrient density from an amino acids standpoint. You’re not going to get the iron, the b12. It’s harder to get the fat soluble vitamin A, I mean you can get some from b12, I mean some from beta-carotene but, you won’t get enough. And if you have insulin resistance, you won’t convert b12, you won’t convert beta-carotene well. You also won’t convert a lot of your ALA-based omega 3. It’s like flax and Chia. You won’t convert that to your longer chain EPA and Your DHEA fats which are good for inflammation in your brain. There’s a lot of precursor things that We just assume like “Oh, we’re getting iron from spinach. I’m going to convert that non-heme iron to non-heme based iron right.” No, I’m getting enough bioflavonoids In my vegetables that are vitamin A right? Well, no. That’s beta-carotene you may not convert that. Or same thing with um, i’m trying to think here what other analogies that you can do. So You have the plant-based iron, you have beta-carotene stuff, you have the vitamin, I’m trying to thank you for what else um, zinc and a lot of your minerals may be tied up in antinutrient plants. You might think you’re getting a lot of this vitamins and minerals but you may be having them tied up with a lot of antinutrients – the lectins, fitates, the mineral blockers, the trypsin inhibitors, and so you might think you’re getting some of these things on the nutrient label but, there might be some absorptions because of this nutrient blockers. Proteolytic enzyme blockers.
Evan Brand: That’s a good point. So far vegetarians-vegans listening, if you could get them on liver capsules, you’d say get them on some pastured liver would be a great option. If their opposed to that even, I mean what do you do? I’ve seen women from paper suffered for years, and I honestly just used the labs as justification to push them harder into something like liver capsules if they just absolutely don’t wanna do the meat.
Dr. Justin Marchegiani: Yeah liver capsules or going to be ideal That’s where i put my iron supreme which is a ferrous-glycinate, and add in some amino acids like collagen and some kind of free form amino acid to get the protein of without antinutrients and carbs in there as well ‘cause a lot of vegan vegetarian proteins, they’re just very carb heavy right? Rice and beans, quinoa, they’re just you know, they’re just 60, 80% carbohydrate for the protein to get in. So it’s hard if you need to keep your carbs down for insulin, For inflammation or fat burning means it’s hard to do that If you try to stick to a vegan vegetarian diet I need you can do that if you’re adding some protein or rice protein but then, you’re heavily reliant on processed food for most of your protein. And that’s not great so we don’t want to have things to be so processed, like we have to be overly reliant. It probably tells us that your diet needs to be tweaked and adjusted if you’re heavily reliant on processed food to get your nutrients up.
Evan Brand: Yep. Well said. So men definitely get your iron tested too I mean females are probably gonna be more symptomatic than men, meaning, the fatigue, the hair loss-that kind of thing with the low iron. But man, you can have symptoms from that. I will tell you i’ve had, when i went to donate blood, I found my hemoglobin was very high. They’ll cut you off by 20 It’s above 20. You have to get a prescription to donate blood, and then back at the therapeutic blood donation but I would like a 19.6. I felt like I was going to be mentally foggy, mentally cloudy and certainly more brain fog, and I would say my energy levels were a little bit less. And I ask some of the donation people like, “What would you think i will experience based on this level of hemoglobin?” They were like “Oh, man you’re high.” And I go like, “Ok, what should I feel like?” And they actually said exactly what I felt. They thought you would feel cloudy and then I would remember this feeling when donating a pint, boom! It was like this release. Like literally almost like an energy drink after I got that excess iron out. So i tell you, it’s very very therapeutic.
Dr. Justin Marchegiani: Yeah, and again iron is going to cause oxidative stress. So if you’re a male, and you are over accumulating iron you know, give blood. Get some therapeutic functional tests doneSo you’re actually losing blood via the testing means. And make sure that you know, taking in a really good high antioxidants you know, through organic vegetables, maybe low sugar fruit. Because at least the antioxidants that you’re getting in will help at least buffer the oxidative stress from the iron right? So at least you want to make sure Antioxidant levels from fruits and vegetables Are dialed in and we’re getting healthy. You know antioxidants and maybe through curcumin or other high quality nutrients that help buffer some of that, help offset some of it.
Even Brand: Yeah yeah cool well If you want to get tested uh, Dr Justin able to run blood work, I’m able to run blood work, we do it around the world which is pretty cool; I guess, technically blood work that we do In the United States. Little tricky internationally for blood work (Dr. J: It’s still better but it’s harder), yeah it is harder but for the other, for the functional testing which you can do functional blood testing and that’s what we do. Our panels are much more comprehensive than what you’re going to get down the street from your doctor. So if you need help you can you can reach out And just please let us know If you have trouble a lot of time people are begging their physicians to run a comprehensive fire oide panel, run the antibody, to run the ferritin, you shouldn’t have to beg someone to get these markers done. This is very simple we can literally get your requisition form the same day. You go straight to the lab, you don’t have to beg somebody to run it. So if you need help, please reach out to Dr. J justinhealth.com or me Evan Brand evanbrand.com. We would love to help you with this and other related things too. Whether it’s gut Infections we need to look for Four sources of inflammation driving this. There’s probably some root cause It’s not just magically going to happen like this. There’s probably a couple others– you know, It’s an entangled spider web If you will. So we’re going to kind of tease that. We love doing that; it’s very rewarding when you see a woman who is buying all these hair loss control shampoos and these special products and their get sucked in into by their hair salon, and they just simply needed to optimize their ferritin levels.
Dr. Justin Marchegiani: Yeah if your iron levels are low, It can impact your thyroid. If your iron levels are low, it can impact your adrenals because you need high quality you need to carry oxygen to be able to um, you have aerobic metabolism, you need to carry oxygen to have good thyroid function. If you don’t have good thyroid hormones Important for stimulating hair to grow, and of course if you’re not breaking down your protein, and or iron you’re not going to be absorbing all the proteins and facts to build up your hair to make our hair healthy. So all those things can play a major role. So guys get blood, get some testing done. Women, make sure people in general, women especially make sure you’re eating high quality animal products or at least something right. Maybe eat some egg yolk. Maybe eat some liver capsules. Just try to do something that ‘s going to meet the middle of it. And then outside of that, get tested as well, and if you’re female and you’re bleeding, you gotta look at the estrogen dominance, and you gotta look at the progesterone. Conventional medicine is just going to throw birth control pills at you and that’s not going to fix the issue. It’s actually going to compound and make the problem worse because estrogen pills can lower B vitamins-B-12, and Folate, and calcium. It can lower other nutrients and it actually makes your estrogen dominance worse right. It’s giving you more estrogen; giving you a consistent level which is better you know, having the up and down but, it’s not fixing all of the hormonal imbalances; Just covering things up. So If you want to get to the root cause, reach out to Evan Brand evanbrand.com or myself Dr. J at justinhealth.com, we’re here to help.
Evan Brand: Amen! You did a great job. I think we killed it.
Dr. Justin Marchegiani: Alright. Excellent. By the way, what are my ranges, uh, ferritin 30-40 enough for women, uhm, men you know 60-80sh i think pretty good for that, iron saturation 25 and up. And i think it’s a pretty good kind of starting point there. Maybe binding proteins below 300 that’s a pretty good thing out of the gates.
Evan Brand: Yeah, i had a woman with a ferritin level of 6 She can hardly get up a flight of stairs because she was so short out of breath, her hair was falling out In clumps, her husband is mad at her because she was clogging the shower all the time. Once we got her ferritin back up to the 50s, her hair stopped falling out. She felt so much better. She can run of the stair without passing out. I mean, it was just incredible so don’t underestimate this. I know you guys listen to us on a regular basis. Even some clients they tell us they listen to us while going to sleep. Don’t sleep on this issue. This is something you really got to address.
Dr. Justin Marchegiani: Yeah, it’s an important issue for sure. And for guys, with low iron yeah, vegetarian-vegan, make sure you’re not doing that. Vegetarian vegan, look at the gut. You are probably not absorbing or digesting or breaking It down. Get the gut, look deeper. All right Evan, have a phenomenal day, man! Great chatting with you!
Evan Brand: Take care now you too.
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The Top 5 Common Digestive Supplement Mistake – HCL, Enzymes and Bile Support | Podcast #338
As a functional medicine practitioner, Dr. J and Evan Brand see many clients who take dietary supplements regularly. But, as simple as it sounds, supplementing can confuse—and people often make mistakes. Do you think you’re taking all the proper nutrients and that you’re taking them the appropriate way? Let’s learn some common errors people make:
Dr. J highly recommends that you avoid having the symptoms cured rather than the source. Don’t just accept your signs and symptoms as usual; consult your doctor and express your concerns. Your doctor may advise you to do diet modifications and have yourself tested to find out the root cause and fix it. Also, watch out for over stressing. Stress can affect your decision-making and as well as your gut health. Another reason can be chewing your food too quickly that makes your digestive system suffer, inadequate water intake, or very few fibers in your diet.
Dr. Justin Marchegiani
In this podcast, we cover:
0:36 Common Mistakes in Using Digestive Support
12:03 Healing Gut Lining
15:39 Sex Drive and Libido Effects
17:59 Bile Support
21:48 Higher Fat Diets
25:09 Cooking our Food
31:04 Food Quality
Dr. Justin Marchegiani: We are live, it’s Dr. J here in the house with Evan Brand. Today, we are going to be talking about the top five common mistakes. When using digestive support. Again, we’re in the trenches with patients every week from all over the world. And this is a common issue that we see is people are not using digestive support correctly. And if we don’t break down our food, if we don’t emulsify it, break it down, utilize it absorb it, we’re not going to get the nutrients from that meal. So it’s not a given that we’re eating good food, we have to go through good digestive processes to get those nutrients and to decrease stress in our gut. So I’m really excited to dive in today’s topic on that.
Evan Brand: Yeah, me too. So I mean, I was doing digestive enzymes when I still had gut infections. So I know we put together a list here, and I’m gonna just go straight to the one that was a little lower down the list, which was, I think, possibly one of the big smoking guns for a lot of people is, and I technically should have written in our notes, not testing. My note was not addressing infections and how not addressing your gut infections leads to digestive problems, because if you’re someone who’s taking supplemental acids and enzymes, but you haven’t tested or treated yourself for parasites or worms, or H pylori, bacterial overgrowth, fungal overgrowth, mold colonization, you’re gonna have very limited results with your enzyme, enzymes and acids. So for me, I did that mistake. I just had high quality enzymes. I was taking those but yet I still had diarrhea and other gi issues years ago, because I had parasites, and I hadn’t tested or treated those. So that’s to me, I think the big one because people will go to Whole Foods or wherever, hopefully, they’ll buy from us because it’s professional quality, but they’ll buy enzymes take it and then they still have gi issues. They’re like, well, what the heck, I thought the enzymes were supposed to fix it.
Dr. Justin Marchegiani: Yeah, and I see that we see that all the time. Now the question is, why is that happening? So let’s go over some of the bugs and some of the reasons why that may happen. So first off, h pylori is a super common one h pylori is a bacteria that resides primarily in the stomach, you can also go a little bit into the small intestine, and H. pylori is going to produce an enzyme called urease. And urease is going to take protein from you know, which is the protein metabolite urea and it’s going to convert it into ammonia and co2. And so on a positive H. pylori breath test, we’re gonna see elevations in co2 after you swallow the urea from the breath test, and you’re also going to see a lot of ammonia. Now ammonia has got a pH of 11. And so that’s more on the alkaline side, so your guts only a two or three on the pH. So that can start to alkalize the gut and maybe throw off the digestive capacity because we need that nice that nice low pH helps activate enzymes and acids. Well, it actually activates more of the enzymes that can be pepsin, various proteolytic enzymes, and it sets the table for the pancreas and the gallbladder to produce more enzymes, lipase bile, when we get into the small intestine, so the acidity in the pH sets the deck it sets the domino rally, so digestion works downstream and so, infections like H. pylori can cause problems infections like cebo can also cause problems. SIBO is notorious for making it harder for that esophageal sphincter to close and so that esophageal sphincter can’t close is prone, you have proneness to having that acid rise up and burn your esophagus, right? Those are all potential problems. Also, any stressor or infection, whether it’s H. pylori SIBO, which is small intestinal bacterial overgrowth, or it could even be something like a parasite, these infections are going to create sympathetic nervous system stress. And so the more your nervous system is over stressed that sympathetic nervous system that fight or flight tone is being stimulated. What’s going to happen is that fight or flight is going to take digestive enzymes and acids, it’s going to reduce them, it’s gonna start shunting. A lot of the digestive secretions and the blood flow away from the blood away from the stomach and the core and to the hands and the feet to run, fight and flee because our body is trying to move blood and move resources to the areas that are most metabolically high and expenditure. And in a fight or flight circumstance, that’s going to be the extremities fighting, fleeing, running, and our bodies prehistorically driven that way, because you don’t want to be hungry. When you’re running. You don’t want to think about digestion, you want to be focused on getting away or fighting. And that blood has to carry oxygen so these muscles can work. And so that blood moves away from the intestines. And that’s part of the reason why these infections can really throw off your body, they can really increase that sympathetic nervous system and take away from that vagal tone vagas nerve, parasympathetic nervous system response.
Evan Brand: Yeah, I can totally relate. I mean, when I had infections, I was anxious, but I had nausea and I had no appetite. So I would sit down. I remember like yesterday when I was down in Austin, I would sit down at the dinner table. I just cooked an amazing bison steak and maybe I had some veggies with it. I remember looking at the plate and going Ah, I just can’t do it. And some of that was the infections But some of it was the stress from the infections. And some people, they’ll kind of demonize meats and say, Well, I don’t feel good. Like I just can’t do the meat. It’s not the meat in general. That’s the problem. It’s the infections, damaging the parietal cells, reducing the stomach acid, it’s turning that digestive fire back on, that’s really going to help you feel good with those meats. So I, it’s sad because people get scared away from the meat. But in reality, it’s some of these root causes that we’re talking about. And then you hit on this kind of primal response. This is totally normal, by the way, but it’s not normal in our chronic stress lifestyle. So occasionally, if we were stressed, it’d be great. Like you said, turn off the digestive system. So we can run. But the problem is, we’re are we’re always stressed. Now. We’ve never as humans, we’ve never experienced this level of chronic, ongoing stress. I mean, I pull my audience all the time, I’ll do a little polls on my Instagram page and ask people like how you’re feeling. Everybody’s stressed. Everybody’s overworked, everybody’s burned out. So this is an epidemic problem. This is not like a one off thing. This is everywhere. And I think we could transition now if you’re ready. And we could talk about how too much or too little HCl when you’re trying to get this digestive fire back on, there is kind of a sweet spot, and it’s going to depend on the people, it’s going to depend on gut inflammation, maybe diet, infections, and then let me just bring up before I forget, these infections are very contagious. So if you do have h pylori, it’s very probable that your spouse is infected as well. So if you’re someone working on your gut, and you’re not working on your significant others gut, you probably need to whether you’re running testing, or maybe you’re guessing and checking, which is not as wise, but we’ll see a husband or a wife come in to work with us clinically, they have good results and then two to three months later they go backwards. That’s often because the the infection came back due to the significant other and this could even be from children as well or even dogs. Like if you got a dog with h pylori, you’re playing with a slobbery toy, you’re throwing the slobbery toy there Nope, you pick your nose, you bite your nails, whatever boom, you could get, you know, exposed to the vectors that way too.
Dr. Justin Marchegiani: 100% So with the too much and too little HCl, some people their gut lining is so inflamed, they have atrophic gastritis, meaning that gut lining has gotten really thin. And they may not be able to handle much HCl, even though they need HCl, they may not be able to handle it and that becomes dicey. So it’s all about helping people where they’re at, even though they need something, if they can’t receive it, then we need a backup plan. And so you got to know what people are at. And so some people, their digestive system, or symptoms actually get better. With more HCl, even though their gut has a lot of problems, they have a lot of inflammation. Some people their gut lining integrity can still deal with the HCl when you start adding HCl. And it’s like they start getting better and you’re like, but your guts so inflamed, how were you able to receive it, but then patient a over here couldn’t receive it. So everyone’s a little bit different. And so if we’re going to try HCl, I mean, ideally, don’t try it. If you know there’s any alterations, coughing up blood in the stool. I had one person though cut people who had alterations, though, did it and they’re like, it helped my issues, I felt so much better, and actually my ulcer stopped. Now, that may be the exception. I’m just kind of highlighting if you are that person, tread lightly work with a practitioner. And of course, all reactions are dose dependent. So if you’re going to test it, try the very smallest dose you possibly can maybe even a little bit of lemon juice, or apple cider vinegar and some water, dilute it down and then test it. And if you overdo it, you can always try a little bit of baking soda in water to kind of calm it down if you irritated it. But ideally, don’t do it unless you’re working with someone that’s helping you on the functional medicine side. And if you do it, make sure it’s dose dependent on that side.
Evan Brand: Yeah, good call. So just we’ll give a couple numbers. I think numbers are helpful. So if you’re working in HCl, I know you and I we have some professional manufacturers we work with we make our own line of digestive products. We go pretty conservative, like 200 milligrams of butane per capsule. So we could dose that as low as one cap 200 milligram, we could go up to 3 4 5 6. So you could go I’d say 200 on the low end up to I personally don’t see a need much beyond maybe a couple of grams, 2000 milligrams, and even that, to me is sometimes too high for certain people. I just don’t like to push it. I know you and I’ve talked about that test where people will take a ton of HCl until they get burning and then back down from that dose but I prefer not to poke the beehives I personally don’t do that with people.
Dr. Justin Marchegiani: So I will do that within five or six capsules. It depends if someone has a lot of digestive distress. You know, we’re typically not going to go that high, but usually within five or six capsules, that tends to be okay. And Dr. Jonathan Wright’s book, why you do stomach acid, he talks about, you know, being able to go up to four to five grams of HCl. And again, I typically wouldn’t do that if someone’s having any alterations or any incredible gastritis issues. Usually we’re going to test at a much smaller level than that and even with them, we’re still starting at maybe one capsule and we’re gently going up and up. For taking the digestive support in the middle of the meal, because if your guts Ron and flame just enough of that acid leaning on that gut lining directly isn’t to be a problem, at least if there’s some food down, then think of the Oreo cookie, right, you get the cream that you get the the frosting in the middle of the HCl is in the middle of all the food, and therefore the body tends to mix it up. And then when it starts moving throughout the intestinal tract with the throat, the stomach, it’s not going to be as intense at the tissue area. And so that tends to be very helpful. And I’ll typically, you know, try it within four or five capsules, see if we have an improvement. Some people do, I hear doctors doing that up to 1020 capsules. And that’s I think you’re just messing with trouble, you mess up a fire there because your body has to use bicarbonate and from the pancreas, to start to neutralize the acid from the stomach. So like that Domino rally of digestion, you have all this kind mixed up in your stomach, that kind is all the food with the acids and the enzymes that has to get released from the stomach down into the small intestine. And so it’s nice low pH once that goes into the small intestine, right the dwad, then we start making a whole bunch of bicarbonate to neutralize that. Now bile acid will also be produced bile acids still an acid it’s still a pH of around five or so. So it’s still on the acidic side. People have written in o bile acids. Well, it’s a it’s a p it’s a pH neutral. Well, you know, we’re talking bile acids. bile is made up of bile acids, cholesterol, a lot of different substances. So the bile acids are in their very nature by their name on the acidic side. So typically, your body’s trying to take that pH and bring it up to a neutral pH and the more you stress it with tons and tons of HCl, there’s a greater chance that your bicarbonate system may not be able to handle it from your pancreas. And you could develop a peptic ulcer. So we got to be careful with that. Try to use HCl within a reasonable range. And if you’re going to test it, you know, just be careful with it. Just be careful. Make sure you’re taking a look at your gut and making sure you’re you’re you’re knowing what your calprotectin levels are and you’re in you’re taking it the right way.
Evan Brand: That is like the pinnacle of edutainment right there that was so entertaining to listen to. I’m picturing all this going on in the system, I’m learning at the same time. This is why I love what we do. This is so fun. All right, let’s go to let’s go to number two here on our list, which is supporting or healing the gut lining and how that’s very important to do possibly even before you get to the digestive support. So you and I are seeing tons of people that usually have been to previous practitioners or doctors or naturopaths or whoever before us. And so maybe they have healed their gut somewhat already. Or maybe they’ve been wrecked because other practitioners did too much. Or they did too hardcore things. I had one lady who she got put on really high biofilm busting support right in the beginning, she got put on the interface plus from Claire labs, which we can and do you sometimes but man it wrecked her gut, her stomach was so wrong. We had to do almost six weeks of gut healing support before we could even bring it any other support. And and that’s kind of a reverse order thing. Because you and I talked about this idea of healing the gut after you treat the infections, but man, in her case, we couldn’t do that. So I’ve seen firsthand what can happen if you do too much biofilm support, you’re aggravating an aggravated system, it’s just not good.
Dr. Justin Marchegiani: Exactly. And that’s why if we’re having someone with an inflamed gut, one of the first things we’re going to be doing is trying to really dial in digestive nutrients to heal the gut lining. So we may be adding in things like dgl, licorice, aloe, slippery elm, sometimes we’re going to do a lot of zinc or zinc carnosine. A lot of studies on zinc, helping to decrease gut permeability, which is really important, decreasing gut inflammation, there’s studies on zinc showing the decreased calprotectin in the intestinal tract. So that’s wonderful, of course, l glutamine. If you’re very histamine sensitive or very inflamed, sometimes I’ll clue to me can go downstream to glutamic acid and glutamate, and you may have negative symptoms there. Again, typically, I don’t see that and so we don’t see that. I say 95% of the time, there’s no problem with that. But we want to be able to use other nutrients to calm down the gut, vitamin u, which is vitamin oltre. You see that in like a lot of okra, things like that. cabbage juice, I would say Allah we already mentioned. And then of course, there’s just good old fashioned bone broth, and collagen peptides which are very, very high in glycine. And glycine is very important building block for the entire sites that make up the gut lining the entire sites or little cells that that make up the tight junctions and the gut lining in the intestinal tract. And so they love, love, love glycine, and of course, that the same cells that are helping to build the intestinal tract, they also help with detoxification. glycine is a very important compound and toxification. So if you have a lot of gut inflammation, your body’s going to be using a lot of that glycine for healing, inflamed tissue and maybe not running the toxification. So that’s part of the reason why you can have detoxification problems, because your guts chronically inflamed, it’s sucking a lot of the resources Is that it may be using for detox.
Evan Brand: Wow. Yeah, that’s amazing. So there’s a lot of talk Stephanie sent off. And I know some others have talked about using glycine to help glyphosate detox. Yep. So that’s pretty interesting mechanism there, you’re saying that the system can’t focus on the detox. If it’s so focused on the gut damage.
Dr. Justin Marchegiani: The body is always tending to deal with what the more acute matters. And if your guts Ron inflamed, it’s probably going to prioritize that over detoxification. And again, we don’t have like a test that to say that, we just kind of have common sense functional medicine, healing philosophy, the body’s always prioritizing stuff. And whatever the top stress is, the more apparent stresses, that’s where your body’s typically allocating resources.
Evan Brand: Yeah, and I don’t want to get too in the weeds on this, but I’ll just bring up an example of that, for example, sex drive and libido. When we see people that are chronically stressed and depleted, usually sex drive is going to go down or become non existent. I asked that question on my intake form is your libido adequate, and all the sick people know their libido is not adequate. And my interpretation of that is libido is really, a it’s a luxury to be able to do that. You’ve got to have some optimal things that happen. Obviously, there’s other mechanisms at play, but just at a simple basic level. You know, sex is a luxury when you’re running from a bear, you’re not going to, you know, be aroused if you’re running from a bear. And that bear could be your boss, or your spouse or your kids if they’re driving you crazy. And libido is like that, whatever. So that makes sense.
Dr. Justin Marchegiani: Yeah, and if you just look at how the the nervous system allocates sexual energy, so typically foreplay, or just, you know, that intimacy that you’re going to have before ejaculation, or before an orgasm, that’s all parasympathetic. And so you need parasympathetic nervous system stimulation for, you know, the foreplay aspect of intimacy. And if the parasympathetic isn’t there, that’s where you see premature ejaculation, right? Because ejaculation or orgasm is sympathetic. And foreplay is parasympathetic. And so if you don’t have parasympathetic stimulation happening, because you’re so stressed or so inflamed, it, you know, that’s where premature ejaculation or just not even being able to rise to the occasion, if you catch my drift, because that parasympathetic nervous system response is so squashed.
Evan Brand: Yeah, this is a huge problem. I mean, I’ve seen 20 year old guys that are jumping on Coke, the little blue pill, and you’ve got all these websites now that are promoting like off the market Viagra. It’s like, what the heck, like we have like teenagers and 20 year olds now like carrying around that that you know, used to be like, when you know, high school is kind of the cool joke thing to have. But you got a condom in your wallet. Now, it’s like you have a condom and you have Viagra as a teenager?
Dr. Justin Marchegiani: Yeah, I mean, that’s why you typically need a couple hours of stress free conversation and, and connection before before that kind of nervous system stimulation can happen. You can’t just go it’s harder to go into a stressful day, switch the switch. And then there you go. It’s just tough. That’s because of the nervous system. So we just got, we got to know that.
Evan Brand: Give us your comments. Do you want a functional medicine, optimization of libido podcast? If so, let us know.
Dr. Justin Marchegiani: We’ll chat about that’s great. All right, I would say next thing we can kind of we talked about the gut lining support, let’s talk about bile support. So bile is really important for fat digestion. A lot of women are going to be affected by bile issues, because it’s very common women, when they’re 40s, they tend to get their gallbladder removed. It’s a common procedure, you have any upper right quadrant pain issues, boom, they’re taking out your gallbladder right away. And your gallbladder is part of what concentrates bile, your liver will make it and then it stores it in the gallbladder. And then it gets released. It very specific times via coli cystic keinen cck stimulation, and cck is going to be stimulated when you have a whole bunch of fat and protein going getting released from your stomach into the small intestine so that we get to release it. It happens at a very specific time. And it’s concentrated 15 to 20 times more than just what your liver would drip it in. Because when you don’t have a gallbladder just chatter dripping. And when it drips, you can you can have bile acid diarrhea. And so that’s where you have to use bile acid sequestering agents to kind of calm it down. And we got to put our bile in at the right time. And so we may have to take supplemental bile definitely for life that we don’t have a gallbladder. If we have biliary insufficiency, we’re going to have to be taken bio as well maybe extra lipase, which is a fat enzyme from the pancreas. But if we don’t break down that fat, you know, we’re gonna see our stool start to flow, we’re going to start to see, you know, St Mark’s skin marks on the toilet, see, because the fat is, is streaking, it’s not well absorbed. And then you’re also going to see a lot more excessive wipes when you go to the bathroom when you clean yourself because it’s just the fat is streaky, right, it’s it makes a big mess. And so we got to break down that fat adequately and then we may have to add extra bile into digestive support may have to add extra label lytic enzymes as well. Also, if you’re a female or even a male, high levels of estrogen is going to make your bile flow more stagnant. So if your bile flow is more stagnant, you’re not going to have good biliary output. And I would say last but not least, if if you’re one of those people that got thrown into a low fat diet Well, when you go low fat your gallbladder is not emptying because it’s the trigger for gallbladder emptying is coli cystic keinen from fat consumption. If your gallbladder is an empty, empty, what happens all that bile, it can start to form bile crystals. And those crystals are sharp. And when you finally do eat a little bit of fat, it’s like giving a hug to a porcupine. All right, it’s gonna be quite painful. And so imagine your gallbladder contracting on it’s like giving that porcupine a big hug and you’re going to inflame that gallbladder. And so chronic low fat diets with a punctuated higher fat meal, and also coming in there with estrogen dominance, a lot of detoxification issues, not clear handling estrogen, well, maybe having a lot of estrogen in your meats in your pesticides in your plastics goes for guys, too, that could definitely screw up your gallbladder and cause biliary and fissures not enough bile flow to that gallbladder.
Evan Brand: Wow. Okay, so let me just clarify, because this is interesting stuff here, because people online, including us were really big proponents of good quality, pastured animal products, and high quality fats were a big proponent of that. But you’re saying that when a person comes in, let’s say they came from the brainwashing of the even 2000s, I mean, part of me want to say 1980s 90s, and 2000s. But it’s still, there’s still the low fat dogma still there, that’s still like one of the labels on a product low in fat that’s still marketed today. So this is still a trend. You’re seeing someone coming from that with gallbladder issues with infections with low stomach acid, then they try to go keto, carnivore, meat based paleo, whatever, they end up with problems. If they have like a gallbladder issue or a gallbladder attack, the doctor is going to blame maybe the fats and just cut the gallbladder out. But you’re saying there’s kind of a few steps, if you will, that have to be a prerequisite to handle a higher fat diet properly.
Dr. Justin Marchegiani: Yeah, I mean, why don’t we just have the propaganda of the 80s and 90s. And just the fact that calories in calories out, right, oh, you’re worried about how many calories you consume? Well, we know one gram of fat got nine calories in it, compared to four in the protein and four on the carbs. So of course, fat gets to be looked at more deeply on that side, because of the caloric intake. And then also, if you’re, you know, a lot of the studies on fat causing heart disease, which we know are all nonsense, we know that the meta analyses in the last 10 years show there’s no correlation with that, with fat and animal cholesterol, a lot of the studies in the 60s and 70s, they did not differentiate saturated fat with trans fats. And so they had a whole bunch of trans fats mixed in with a lot of these experiments. And you didn’t really get good data because they had the trans fats, which we know hydrogenated vegetable oils are terrible and bad for our health, we know that. So you got to pull out those confounding variables to really get good data. And so we know that in the last 10 15 years, that is not the case. And that cholesterol and fat is going to be fine. It’s really going to be the sugar of the trans fats, and maybe an argument for a lot of the refined processed vegetable oils, these vegetable oils during the processing of them, they get damaged. Because your polyunsaturated fats, omega six, they get damaged, and they create a lot of oxidative stress, and they get stored in your cell membranes for a long time.
Evan Brand: Yeah, these are these are super bad oils, and they’re everywhere. I mean, even at Whole Foods. If you go and look at organic potato chips, you’re still sometimes gonna see cottonseed oil, you’re gonna see sunflower oil, you’re gonna see canola oil. I mean, I get frustrated because Whole Foods kind of markets themselves as healthy. But if you go to like their I don’t know, if you call the buffet, but their hotbar, if you will, every single food item they have, there’s canola oil and everything.
Dr. Justin Marchegiani: Yeah, it’s just cheap. And then there’s also a lot of stuff on the olive oil being fake, right? So you got to look at that too. But that’s why at least half your fat should be high quality animal saturated fats, because one, those fats are just really stable, they’re going to be really temperature stable. And if you’re getting organic, decent fat, there’s no processing of that that’s going to damage the fat like you may have with a vegetable oil. But ideally, try to get cold pressed, try to get organic, try to get reputable brands that you know, aren’t going to be a blend of other canola oil mixed in which is terrible.
Evan Brand: Yeah, yeah, let’s hit another point, which is important is the fact that the bile has some antimicrobial properties and all these estrogen dominance issues you’re hitting on you’re hitting on the low fat you’re hitting on maybe the the no gallbladder. Yeah, it makes sense why we see so many women, for example, that have had their gallbladders removed, they have massive, massive gut infections.
Dr. Justin Marchegiani: Yep, correct. And so bile is antimicrobial. And so it’s gonna make it harder for bugs to grow in the small intestinal tract. And so just having good biliary output, it’s going to act like anti microbials and make it harder for these bugs and dysbiosis to grow. So having good fats in there, going to stimulate good bile stimulation and flow in that bile flow is going to help you emulsify and break down the fat and it’s also going to make the environment harder for bugs to grow. So it’s definitely a win win on both sides of the front there.
Evan Brand: Yeah, you and I don’t have any published studies to say hey, we had 278 patients and, you know, 275 had their gallbladders removed and all 275 had SIBO we don’t have it like published like that. But I know that you would agree clinically what we’ve seen, you know, combined over the last 10 plus years is that We see tons of SIBO SIFO issues and a lot of those people have gallbladder issues or they don’t have a gall bladder period. So it’s definitely, definitely correlated.
Dr. Justin Marchegiani: Yeah. 100%. And it’s good to look at that. No, I would say next thing we can kind of switch into is cooking our foods. I mean, sometimes fermentable carbohydrates, sometimes just the fiber in those foods, the rawness of the foods, the anti nutrients, lectins salicylates, females, can really be irritating to someone’s got if it’s already wrong. So sometimes just one cooking those foods can be wonderful. Sometimes even switching to a carnivore diet, as long as we can handle the fats and proteins can be great, because you’re decreasing all those anti nutrients, sometimes just really making sure everything’s really cooked and steamed and sauteed. Or maybe using an instapot, or some kind of a method really helped break it down. And then of course, low hanging fruit, like just chewing your food up really well to like almost like an oatmeal like liquid consistency, making sure you’re not overly hydrating with your meal, maybe just a couple ounces of water to get some pills down. But that’s it you’re hydrating, 1015 minutes before two hours after because water’s got a pH of seven, right? And your stomach’s a pH of two, two and a half and you add a whole bunch of seven, there’s a bunch of two and a half, you start raising the pH plus you’re diluting all your enzymes and ask for the potencies drops. So all those things matter.
Evan Brand: Yeah, here’s an interesting thing. I looked at some of the videos. And I interviewed him on my podcast too super cool guy, Paul Saladino, who wrote a carnivore book and he talks a lot about carnivore diets. He visited the Hodza tribe. And something interesting is he thinks that we’re really like over hydrating, like, if you watch these people, these tribal people, obviously they don’t have water bottles, and they don’t have really access to water the way we do. But he would notice they would eat an entire meal with no liquid. And then here we are in America, you go to the restaurant, and they’re like, what do you like to drink, sir. And if you’re like water, they bring you a frickin huge cup. I mean, it’s probably 1620 ounces of ice water. It’s cold, which I don’t know, people may debate me on this. I don’t know if ice water is necessarily good around meals either. I just feel like no, from an energetic-
Dr. Justin Marchegiani: Your stomach longer sits in your stomach longer because your stomach’s not going to release your internal body temperature is around 99 98 degrees, and you drink a whole bunch of 50 degree water, your body’s gonna hold that water in the stomach until it gets up to body temperature and then release it. I mean, very simple. Just drink a whole bunch of cold water and you’ll feel it sloshing around drink room temperature water and you’ll feel it move through your body way faster. When you move around. 510 minutes later, you won’t feel the sloshing.
Evan Brand: Ah, you know, see just intuitively I just keep I just drink room temperature water now they’re on a really hot day. Yeah, like some ice water. But just like normally, during the office hours, you know, I’m just drinking room temperature water and I feel so much better with it. But yeah, so sorry, I got on a little tangent. But I would-
Dr. Justin Marchegiani: It’s not a big deal. It’s not a big deal. If you do that and drink wine, drink cold water, just be careful of drinking really cold water right before a meal. Because it will take longer to move through. So at least if you’re going to do cold water, make sure it’s not 10 minutes before meal.
Evan Brand: Okay, Okay, understood. But anyway, the idea was like he saw these tribal people and how they’re how they’re eating and drinking. And, you know, they didn’t really do meal combining, there’s a lot of like, when you go to a restaurant, there’s this feeling that you got to have your meat and then your vegetable and then your potato. And obviously this is different. I’m not saying we all need to live like tribal people. But what I’m saying is I find it very interesting that their life is more what our DNA expects, meaning if they’re walking along and they stop upon a bush, they might just gorge on these berries. Or if they stop and find this bail Bob tree with a particular type of honey in it, they’ll cut open the tree, find the beehive they’ll eat just a meal of honey and then they get the kill and they eat just the meat so I personally have experimented with that like just meat, just berries just starch and just try to play around with it as opposed to doing the steak with the broccoli with the sweet potato and I personally do feel better on just those single items so I’ve I’ve definitely been leaning more that direction I feel significantly better.
Dr. Justin Marchegiani: Yeah, I think you know a couple of things one I think most of their meals are probably going to have more protein in it because if you kill an animal that that meat last way longer and if you look at a lot of the the fruit they were to have back then I’ve looked at a lot of these studies that they’re a lot more tart a lot more bitter they aren’t like overly sweet like we’ve due to hybridization and genetic selection we’ve kind of chose the sweetest berries the sweetest this so a lot of the fruits way sweeter than what you would have typically found in nature on average and things like honey would have been a rarity it wouldn’t have been something that you’re you’re have access to every single day and so we have access to it every day so you know if it’s something that’s every now and then it’s probably not a big deal but if they were doing honey like that every single day and they weren’t as active right because they have to be really active to hunt and kill and do all their stuff there may be metabolic issues.
Evan Brand: Oh yeah, I think I read he was just trying to keep up with the tribe. I want to say they were doing something like 10 miles a day walking I mean there’s an insane amount of steps.
Dr. Justin Marchegiani: Yeah, anytime one your stress is decent right because you know most of their life was just focused on the next meal right killing having their next meal obviously making sure shelter stable but once shelter is good Then really most of your focus is on food as a food and safety for the tribe. That’s it. You know, you’re not having to go pay a big mortgage down or worried about your kids private school, right? Yeah, that’s a different priorities right?
Evan Brand: Have you seen the organic strawberries lately? My god, they’re freaking huge. They’re like small apples, man.
Dr. Justin Marchegiani: Yeah, I had a couple over the weekend. They were like almost the size of my hand. I was like, Holy smokes!
Evan Brand: Because I kind of thought that organic was and I guess I thought wrong. This is me being dumb, I guess. But I thought that organic had a little bit of separation from the conventional practices meaning the hybridization process, but my god, you look at some of these apples now to their like softballs.
Dr. Justin Marchegiani: Oh, yeah, I mean, just farmers naturally over hundreds of years, they’re going to just start selecting seeds and, and crops that are going to be more tasty, just just natural selection of what sells. And so that tends to shift over time, where if things are just growing in Mother Nature, you know, we don’t quite have that ability to select it as much.
Evan Brand: Yeah, I don’t know if you’ve seen this, but I go, you know, I’ll be out in the woods and I’ll find some wild strawberries. They’re tiny. They’re like the size of your pinky fingernail.
Dr. Justin Marchegiani: Yeah. Real. Yeah. Yeah, no, totally. So yeah, but most important thing is the food quality. And, of course, if you have insulin resistance in your inflamed, you know, leaning to less sugar is always better. Just because your body doesn’t have you know, if you’re the hunza, right, and you’re walking 10 miles a day hiking and doing all these things, you have the ability to burn all that stuff up. No problem. It’s not a problem, but you have don’t have the ability to burn it up, what’s your body going to do with it, then it gets stored in the liver, and it’s stored in the muscles, and then when that’s tapped, it’s gonna get converted to fat. And you’ll get insulin resistance. We got probably that’s I’ve got to be careful that.
Evan Brand: Yeah, and the main last point, there was just adjusting how your food is cooked based on what’s going on with your gut. So if you’ve got infections, like for me, I’ve rarely ever do leafy green salads. Raw just doesn’t agree with my gut. And so I don’t do it. And I could, I’m sure I could work it in, but to me, I feel I feel good. My gut feels good. I feel good. So I’m okay with cooked veggies. And those work for me. So.
Dr. Justin Marchegiani: Yeah, worst case, just take your veggies laid out in the frying pan and put a really good saturated fat down and some sea salt, you know, and, and boil it, you know, for 20 minutes at 400 nice roasted vegetables are pretty good. As long as you’re using the good healthy fat on It’s wonderful.
Evan Brand: Yeah, would you recommend something like ghee, because if you go too hot with butter, you might get some smoke, right? So would you say ghee or what do you like?
Dr. Justin Marchegiani: You could do ghee or any Talos you could do a little bit of avocado oil. Avocado oil is pretty heat stable use got to make sure you’re looking at what the heat is. You don’t overdo based on the smoke point. Okay, that’d be cool. Anything else you want to hit on? I just think people that are listening here. If you’re struggling and you’re having a hard time, you know, feel free to reach out to someone like Evan and I would be happy to help you out. And you can see Evan at EvanBrand.com and feel free you can schedule with him worldwide, as well as myself, Dr. J at JustInHealth.com. Happy to help you guys out. also put your comments down below, let us know your thoughts on the topic. Let us know what you’ve done. What’s helped you in the past. You know, we learn a lot through our patients. Because you know, when you only have yourself that’s that’s only one person. But when you have 1000s of people that you can learn from you just see what works. You don’t need a scientific study to tell you because you see it, it’s real. And then we apply it to help our patients. And we really appreciate y’all sharing your stories here as well. And reach out links below for everything guys, and then make sure you share with family and friends that they could benefit. Please put it in their inbox or share it on social media. We really appreciate it.
Evan Brand: Yeah, yeah, well, awesome job. And yeah, once again, JustinHealth.com. Or EvanBrand.com, please reach out we’d love to help you. And you know, we didn’t talk about it too much today, because it’s more focused on other things. But testing is part of this protocol. So figuring out exactly what we’re doing, how we’re doing it, when we’re doing it, why we’re doing it, it is based on testing, we’re not just using you as a guinea pig, we are truly looking at calprotectin and stouter crit and Alaska as there’s, there’s so many biomarkers that we didn’t even discuss that we’re working into that. So I just want you to know that we’re not coming in blind here. We have data that we’re using, which helps us to guide these protocols. And that’s really where the magic happens is once you get to the get the data. So test, don’t guess, reach out if you need help. And we’ll be in touch next week.
Dr. Justin Marchegiani: Yeah, just to highlight that. On the digestive side, we’re looking at markers likes the adequate, which if that’s high, that’s a lot of mal digested fat. If we have a lot of calprotectin or lactoferrin, or increased immune response like IGA that means there’s stuff going on in the gut. And so it’s good to know that ahead of time so we can really quantify what’s happening, or maybe even gut permeability like Sanyo, and that can all be very helpful. So I’m glad you touched upon that. We’ll put links below guys for everything that you guys need to take next steps and you guys have a phenomenal week.
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Why is My Digestion Broken – Lab Test Interpretation of GI MAP with Lisa Pomeroy | Podcast #335
The digestive system is a winding and extensive part of the body. It ranges from the mouth to the rectum. The digestive system assists your body in absorbing vital nutrients and is responsible for getting rid of waste.
Because there are so many types of digestion issues, you might mistakenly dismiss them. Dr. J and Lisa emphasize that it’s essential to understand the root cause of digestion issues — as well as emergencies — so you know when to talk to a functional doctor and have yourself tested.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
3:31 – GI MAP Interpretation from a sample patient
Dr. Justin Marchegiani: Hey guys it’s Dr. Justin Marchegiani here. I am with Lisa Pomeroy. Really excited to have her on today’s podcast. We’re gonna be chatting about different kinds of lab tests. Everything labs really. Our goal today is to show, we’re gonna be really diving into the gut tests, really looking at gut function. One of the big tests we’ll look at is the GI map and how to interpret that and some of the big take-homes as we go through that to you know pull out action items as we address patient concerns. And the next one we’ll go into is the ion panel where we’ll get a really good window into mitochondrial function, neurotransmitter function, overall nutrient absorption, gut function, etc. So, really excited to have Lisa on the show today. Lisa, how you doing?
Lisa Pomeroy: Doing good! How about yourself?
Dr. Justin Marchegiani: Hey,doing wonderful. Really excited to, uh, chat with you, very good.
Lisa Pomeroy: Yeah.
Dr. Justin Marchegiani: Awesome. So, why don’t you let people know a little bit more about yourself me, you’re a clinician as well.
Lisa Pomeroy: I am yeah. I am a traditional naturopath. Um, I’ve done a bunch of differential functional medicine training programs. So, you know like, you I’m a graduate of Dan Kalish’s, uh, Kalish spectatorship. So, I love learning and a lot of the learning was something I had to do to try to get myself healthy. Because when we talk about gut issues, I had major gut issues. I mean, as young as seventh grade, I was having ulcer-like pain and unfortunately, no one I went to, knew about H. pylori, knew about testing for H. pylori, treating H. pylori, so I had to suffer in silence for another 20 years with severe stomach pain before I run the test on myself, found I had H. pylori and got rid of it.
Dr. Justin Marchegiani: Wow! That is crazy. What a story.
Lisa Pomeroy: Yeah, I come home from school and drink cabbage juice. I mean, I was that devoted because it’s the only thing that would help.
Dr. Justin Marchegiani: Yeah, intuitively you knew the vitamin you in there was helping.
Lisa Pomeroy: Exactly!
Dr. Justin Marchegiani: Yeah, so you really had to wait a long time, so that’s crazy because you must have so much appreciation for what we all do today. You have a lot of empathy for your patients. That’s great! It’s important to have that.
Lisa Pomeroy: Yeah, I talk to people and we’ll talk about like a five-year-old child or something and I just, you know, I’m just so grateful because it’s like I’m so glad that they have that the parents know enough to be getting this child help so they don’t have to suffer like I did for another 20-30 years with severe gut pain. You know, we find out that they have a nasty parasite in their gut and we get rid of it and they’re not gonna be nutritionally deficient and have all these gut symptoms for decades.
Dr. Justin Marchegiani: Oh, totally. Yeah. And it’s important, I mean obviously out of the gate, the labs are important to give us a lot of information that’s clinically actionable but you know diet and lifestyle, foundational things, a lot of these, you know, we probably don’t need a lab test per se. I mean, it’s good to have it right? I t’s nice to know, like okay, maybe there’s some gluten sensitivity, maybe there’s some inflammation, maybe there’s some immune activation and we should kind of start some diet changes and there’s some foundational things that you tend to find that just generally help most people out of the gates, you know, maybe sugar or gluten. What things you specifically utilize?
Lisa Pomeroy: Yeah, exactly! I mean, we look at the top pro-inflammatory foods in the diet. Most people say gluten, dairy, white refined sugar and ultra-processed foods. You know, those are gonna be some of your top things, where a lot of people will notice a difference, where you can pull it out, you know, you can do a trial where you, you know, you eat whole unprocessed foods, your whole fruits and veggies, roots and tubers, you know, that sort of things. You cut out the dairy you see how you do, so yes, testing can be helpful with that, but some of it can just be, you know, take it out and see how you feel.
Dr. Justin Marchegiani: See how you feel
Lisa Pomeroy: Exactly!
Dr. Justin Marchegiani: That makes sense. Oh cool. Why don’t we dive into some of the GI map testing out of the gates. I got a sample patient here, we’ll pull it up on screen.
Lisa Pomeroy: Okay.
Dr. Justin Marchegiani: We’ll kind of whip through it and we’ll try to keep it actionable. I mean, unlike a lot of shows, you know, you’re a clinician, I’m a clinician, you interact with patients and doctors throughout the week and so we’re trying to get people, real actionable information here.
Lisa Pomeroy: Yeah, great!
Dr. Justin Marchegiani: Can you see the screen here?
Lisa Pomeroy: I can. Yeah. It’s coming through nice and clear.
Dr. Justin Marchegiani: Okay, cool. So, we’ll just kind of start off, um right off the bat here, page one. So, we’re looking at a lot of bacterial pathogens, some parasite pathogens and viral stuff. I’ll let you, kind of take it away with the first part.
Lisa Pomeroy: Sure. So, basically what I want to see on this first page is nothing. You know, these are things that really don’t belong there. So, I want to see that less than DL which stands for below the detectable limit for all the things down the page. Now, some of these, we don’t necessarily need to interfere with, like that E. coli 0157, uh, that one is something it’s an acute pathogen. It’s actually, uh, like a foodborne pathogen and we’ve been seeing a lot of these pathogenic E. coli lately. They tend to peak in the late summer months, so July, August, September, we see a lot of them, just because they’re on the fresh produce, you know, the leafy greens, served lettuce, your basil, your berries. So, you pick them up and so we’re looking for symptoms. Now, this case, this is a very teeny tiny little level E0. So, that is something they either just picked up a very small amount or is mostly on its way out. And that’s where an E. coli like 0157, you know, is something that’s considered transient, self-limiting, it’ll go away on its own. Now, it may or may not give you symptoms. If you did get symptoms, they probably last for less than a week, probably get some diarrhea, some cramping, fever, nausea, that sort of thing. So, sometimes we’ll see these on the report and we go, okay, well, that explains why you had diarrhea two weeks ago, you know, you got a hold of this bug, but, you know, it may not be something we actually need to do something about.
Dr. Justin Marchegiani: But every now and then, you see the 01h57, I mean, you see, that with spinach a lot, these people will die every year with it. So, if it can be serious to people are, have a compromised immune system or gut function, right?
Lisa Pomeroy: Exactly! And that’s what especially the elderly, the young children, they are the greater risk of more severe types of infections and that’s where a lot of times people, you know, and a lot of times they know that were, you know, the time say they got some diarrhea, they run the test, they’re waiting for the results to come back. Usually, those symptoms are going to peak, before the results came back, so they know I’m having severe things are coming out both ends basically. I’m puking, bloody diarrhea. They should know they need to go to seek emergency medical care. And that’s something where, you know, usually by the time, we’re seeing people. Now, most people don’t get that severe, but if they would, they would have sought medical attention. So, usually, we’re seeing the side more like, oh yeah, I had loose stools for two days, I just my gut was a little off, you know. So, we may not to intervene, although, I always look for there’s deeper bigger issues because, really, you know, the body is meant to protect us from these infections, so if you were susceptible to picking up the E.coli on your spinach or your lettuce, you know, where was the stomach acid, shouldn’t that come in and killed what, you know, you ate and went through your stomach or what about secretory IgA, this is marker later on the test that tells you about gut immunity. You know, secretory IgA. Yep, there it is, yep. So, that one, if that’s low, you know, that’s a problem because that can actually engulf pathogens, so they can’t attach to the bowel wall, can take them so the immune system knows that’s a bad guy, we got to get rid of it. So, if you have a good stomach acid, good bile, those are antimicrobials to kill things, if you have a good secretory IgA, that’s your gut immunity, that’s gonna protect you, it’s our first line of defense. So, again, if I see an E. coli, I may not need to do some protocol to get rid of it, it may just go away on its own. But I’m looking for the deeper issues. You know, if you don’t have good stomach acid, you’re probably gonna pick up E. coli again next summer or whenever you again eat something that has it on it.
Dr. Justin Marchegiani: That totally makes sense. I’ll scroll back here to page one, so we can go in order, uh, and then obviously we have some other food poisoning types of bacteria here Campylobacter, uh, Salmonella, we may see in chicken. Do this change anything for you if someone still has something lingering and some gutted gut issues, I mean, you’re still going to try to address it with some herbals when it’s appropriate.
Lisa Pomeroy: Exactly! Yeah. Some of these and there is, you know, research keeps coming out where we’re thinking something like Campylobacter, you know, we think it’s something that just temporarily stays in the gut and then it’s gone. It’s kind of like a hit and run, where it does its damage and then it leaves the gut repairs. But, in some people, they’ve actually done some duodenal aspirates and find that, you know, they can actually find it still in the gut and the person hasn’t had that recent food poisoning incident. So, there is a little bit of a question with some of these, could they actually stick around a little bit longer and that’s definitely a problem too. So, if they show up on a single report, you know, say Campylobacter, shows up, my initial assumption is yeah, you probably ate some chicken or something lately that had it, but if I’m seeing repeated tests, maybe it’s a chronic colonizer or maybe you keep getting food poisoning, maybe you’re eating at some local fast food chicken place that maybe doesn’t have the best quality chicken or again, you have low stomach acid. It takes very few organisms to infect you if you have low stomach acid, so again, we need to look at, is this a chronic issue for repeatedly seeing it. Is this low stomach acid, low gut immunity, something’s wrong.
Dr. Justin Marchegiani: Exactly. And then same thing here, we have different types of sugar toxins which are, these are toxins actually produced by the E. coli, is that correct?
Lisa Pomeroy: Yeah, E. coli was kind of unique in that there’s, they’re all pathogenic E. coli. You can kind of lump them all together that, but they have different mechanisms of actions, different toxins they produce and so they kind of each got their own special name even though you can all just lump them all together, they’re just food borne pathogenic E. colis.
Dr. Justin Marchegiani: That are gonna produce different toxins that would create inflammation.
Lisa Pomeroy: Uhum, yeah.
Dr. Justin Marchegiani: So, either way, you’re gonna be, you know, trying to clean out the diet and use some kind of herbal to kind of knock it down so to speak.
Lisa Pomeroy: Yep, and I look at food quality, I also, you know, because something like, you know, again, chicken could be a source of Salmonella, Campylobacter. If you’re eating conventional chicken versus organic chicken. They found, you know, when they’ve actually done research studies on this the non-organic ones are more highly contaminated with these bugs than the organic plus they tend to be more antibiotic resistance. So, say, if you do get Campylobacter, Salmonella, chances are it’s going to be a very nasty type that’s not going to respond to treatment, if you did need treatment. Um, and then certain, techniques too like, you know, personally I get organic pastured air chilled chicken because there’s again how is the chicken processed, they can put it in a chlorine bath which is just essentially like a fecal soup, they have all of these chicken carcasses just in this big tub of chlorinated water. And so, if you have one contaminated chicken carcass in this big pool, it can contaminate other ones. Versus air chilled, they’re kind of, you know, just single hanging on their own, so again, they’ve done the research where air chilled is less contaminated with these microbes. So again, whether you’re susceptible or not, I mean, I still don’t wanna, you know, I do my best cleaning my produce, you know, buying good quality food. So, we’re looking at food hygiene, food quality, but you know, you do things the little things that you can do, when purchasing these things to prevent your exposure.
Dr. Justin Marchegiani: Okay, cool. We also skipped, I think C. diff out of the gate so C. diff is a bacterial infection, it can, it’s common in hospitals. High levels of antibiotics can mess up your gut and create an imbalance there, um, obviously toxins A and B together tend to be more synergistic and worse than just one. Do you want to add to that at all? Comments to that?
Lisa Pomeroy: Yeah, so a lot of people see this test and they panic when C. diff comes up because we know that C. diff can be a nasty infection. However, we have to keep in mind what this test is measuring, is the bacteria not the toxins. So, what this tells you is that, there’s C. diff bacteria in the gut that carries the gene that would allow it to produce toxin A and or toxin B. Whether it’s actually doing that at the moment is the question. So, what’s defined as C. diff infection is the bacteria are there actively producing the toxins and the toxins are whether damaging the gut causing the diarrhea, the classic C. diff presentation.
Dr. Justin Marchegiani: What is that?
Lisa Pomeroy: Now, a lot of people are actually colonized with C. diff, where the bacteria is there but maybe you have some good guys that are keeping it in balance preventing it from turning on those genes and producing the toxins and so that’s where it’s important to have the good bacteria there to not wipe them out by antibiotics or other things. So, we can’t differentiate between infection or colonization here, you know, this is just telling us, C. diff bacteria is there and you know, we don’t really want it there. Now, if someone does have symptoms that indicate a possible infection, you know, we certainly could do further testing and actually test those toxins to confirm. But a lot of people, if they say, well, I’m constipated, you know, probably not a C. diff infection, you know it’s, if they don’t present like those classic symptoms, it’s probably more colonization which is far more common but I still don’t want it there because it’s essentially lying in wait, waiting for the opportunity, you get a UTI, you take around antibiotics, now again, you killed the organisms protecting against this, so now, you do turn on the gene, get the toxins, get the C. diff infection.
Dr. Justin Marchegiani: So, we have the bacteria that has potential to make this toxin but it’s not necessarily show that the same toxin, they are b is present. It’s more the potential of it based on the bacteria.
Lisa Pomeroy: Exactly! This tells us about the bacteria and not whether toxins are actually being produced.
Dr. Justin Marchegiani: And this Clostridium, isn’t the same as on page two. This one is a little bit different but this is a kind of more the overall class where this is more of the specific type of Clostridium within that class. Is that correct?
Lisa Pomeroy: Exactly! So, C. difficile is a pathogenic organism that’s part of that large group.
Dr. Justin Marchegiani: That family.
Lisa Pomeroy: Yeah, but Clostridia actually has a lot of beneficial butyrate producers. So, this is just picking up, there’s a very small subgroup of maybe more pathogenic potentially harmful ones within the group.
Dr. Justin Marchegiani: Okay. Very good! Excellent! Anything you want to see down here? I mean we have you mentioned a kind of Salmonella, more connected to chicken and eggs, things like that, uh, cholera more waterborne. Anything else you want to say about Cholera or Yersinia?
Lisa Pomeroy: Yeah, so, Vibrio in the U.S. the most common source is actually seafood. So that’s what I’m checking to see if it’s like, okay Vibrio comes up, which doesn’t all that often but once in a while it will. I just check, you know, did you eat seafood recently and it’s always, oh yeah, I had some shrimp and you know, again, may or may not had those acute symptoms but you know often there’s recent seafood consumption. Now, in other countries, it’s more through the water, through, you know, just dirty water that has fecal contamination, here it’s usually seafood.
Dr. Justin Marchegiani: Okay, very good! And then, um, Yersinia, you said, is that seafood as well? That was just the vibrio?
Lisa Pomeroy: That’s just a vibrio. Yeah.
Dr. Justin Marchegiani: How about Yersinia?
Lisa Pomeroy: Yeah, that one can come through many different sources, um, sometimes it could be, you know, even raw dairy products, could be pork, you know, many different sources for food, uh, but this one actually can be a trigger for Hashimoto’s. So, it doesn’t show up.
Dr. Justin Marchegiani: It can.
Lisa Pomeroy: It can, yeah. So, it doesn’t show up all that often but if it does, I’m looking at the thyroid antibodies and other testing or seeing if there’s already a diagnosis of Hashimoto’s.
Dr. Justin Marchegiani: Very good! And then parasite wise, we have Crypto, E. histo, and Giardia, which definitely are the big three, right, um, Crypto primarily found in water, E. histo is going to be nasty little amoebic that people don’t know it’s in the top three to five causes of death in third world countries. It’s a nasty little bugger.
Lisa Pomeroy: It is!
Dr. Justin Marchegiani: And then Giardia, as well, which loves to hide in the gallbladder. I’m gonna let you kind of go into those one by one. Quick question, why do they have these parasites here and then on page four, a separate section for parasites? Why don’t they put them all in one spot?
Lisa Pomeroy: Yeah. My thought is that, you know, within the medical community, certain pathogens now are widely accepted as disease causing. So, like, pretty much, I mean a conventional doctor, a functional medicine doctor, they’re all going to say, you know, Crypto, Giradia, E. histo are bad. You know, we don’t wanna see those. Now, Blastocystis hominis, you know, most functional medicine practitioners will say that, that has a lot of potential to cause harm, linked it with Hashimoto’s and you know, hives and IBS. But from the conventional standpoint, they’re not entirely convinced because some people can have Blasto and not have symptoms. So, the ones on page four, there is research supporting that all of them have pathogenic potential but they’re not as widely accepted as a 100% pathogenic unlike the ones on page one.
Dr. Justin Marchegiani: Makes sense. I know a lot of people like Mayo clinic are starting to say, hey if you have Blasto and have some level of symptoms, well, you probably should address it, you know, most people that we see the problem is. Well, what constitutes a symptom from Blasto for instance we know a lot of gut issues can cause extra-intestinal symptoms like fatigue, brain fog, mood issues, sleep issues. So then, how do you really connect the dots? Obviously, we have diarrhea, constipation, acid reflux, bloating, right? But sometimes you get these extra intestinal ones which are a little weird.
Lisa Pomeroy: Exactly! Like Blasto, people say, oh well I have no gut pain, and then I start asking more about their symptoms like, oh well, I do have chronic hives, and I have joint pain and I have, you know, these other symptoms, it’s like. Well, I can show you research study that’s linked that to Blasto. Yes, it’s not a gut related system symptom, but it’s been linked to blasto.
Dr. Justin Marchegiani: 100% Yeah, very good.
Lisa Pomeroy: Yeah. Yeah. So, going over the page one pathogen, so yeah, Cryptosporidium, Giardia, those are actually both small intestinal infections, whereas the E. histo is a large intestine infection. Um, but Crypto and Giardia, often can be from the water, so we do have to look at drinking water and for Giardia, recreational water can be a big source too. So, again, a lot of these pathogens have their seasons. So Giardia, we can see more prevalent in the summer months because people are going in and swimming in lakes and streams and rivers and swimming pools and you know, or going water rafting or you know doing things recreational water parks and you just get a mouthful of water and chlorine doesn’t consistently kill it unfortunately. So, you still could get it or it could be your well water so I was always look to if we see Giardia, what are you drinking, you know, are you drinking well water, is it filtered, you know, are you, do you swim in lakes and streams, ponds, you have a swimming pool, so we always want to look at that because sometimes if there is, if it is well water and it has Giardia and you can often test your water for these bugs too, you know, we wanna make sure we’re getting rid of that source. Um, but yeah, I mean that could be, these can be nasty again. You can pick them up on the food. All of these have what they call the fecal oral route. So basically, if you know, again, it could be animal poop and stuff that just gets on your leafy greens because your cattle farm is next to your lettuce farm. There’s a little runoff and yeah, it’s hard to wash your produce. I mean, I still recommend soaking fresh produce in water with a little vinegar or hydrogen peroxide in it to try to kill those bugs. But even still, I mean, lettuce has so many little nooks and crannies, it’s hard to get it all killed.
Dr. Justin Marchegiani: Absolutely! And we probably want to make sure every patient that we see, the clinician that we see is recommending a good quality water at least a carbon-based one or ideally even at reverse osmosis just really make sure we filter out all those potential parasitic cysts plus water’s got a whole bunch of nasty things in it, like chlorine, like potential fluoride and pharmaceuticals that you want to filter out as well.
Lisa Pomeroy: Exactly! Clean water is a must whether it’s the bugs or the toxins.
Dr. Justin Marchegiani: Exactly! Any other comments on the viral pathogens here?
Lisa Pomeroy: Yeah again, those you know, again, tend to acute rather than chronic colonizers. Although, again, Norovirus, there is some evidence, it could be a chronic. But you know, these will feel often like a stomach flu. So again, you usually pick it up more your food like poisoning. But, some of these, you could pick up, like Norovirus, say you go to a public restroom, you touch the faucet handle and then you eat your lunch without washing your hands. You know, if you touch something with the virus, you put your hands in your mouth, you could pick up something like Norovirus from touching objects too. But, usually feels like a stomach flu.
Dr. Justin Marchegiani: Okay cool. Well, let’s drive into H. pylori here next, um, and also just a little reference range, um, tidbit for a lot of folks here. If you’re trying to figure out the reference range, you see, I don’t know, let’s say. Let’s go on to see where’s a good example.
Lisa Pomeroy: Well, H. pylori, it’s a big one too.
Dr. Justin Marchegiani: Yeah, but if you look at E. coli, you’re trying to figure out where this fits in the reference range. If the exponent is below the reference range, then you got to move to the left. So, this really is .00860 and then if its above, like this, this is e to the five, right, then you have to move to the right to make it just to make it equal, um, the exponents kind of throw a lot of patients off that I, I find when we go through them all.
Lisa Pomeroy: Yeah. Exactly. Yep. And it’s just, it’s in scientific nomenclature, yeah, it’s just otherwise, you have a ton of zeros. Yeah. It just cleans up the report.
Dr. Justin Marchegiani: Exactly!
Lisa Pomeroy: And there’s nice, like these are powers of ten, so you can get like powers at tens chart like e3 is a thousand. So, you can go, oh, that’s e3 is a thousand, take the 2.9 multiply it, that’s 2900 cells.
Dr. Justin Marchegiani: Exactly! Exactly! And then really quick here with the H. pylori. I haven’t seen the last year so a ton of virulence factors come back on my patients. Have you seen that as the lab kind of tone down the sensitivity with that? Have you noticed?
Lisa Pomeroy: It depends. Fortunately, we don’t see them often, which I mean the problem with virulence factors is they’ve been associated in the literature with higher risk of gastric cancer, gastric ulcers, cardiovascular disease. So, if you have H. pylori that has these attached to it, it has more potential to cause harm and disease. Now, I just saw one yesterday, where she has a history of H. pylori and unfortunately, she got it back again and she had it pretty much looked like this one. It had like four or five virulence factors, which is what she was dealing with before too. So, we do still pick them up, you know, again, fortunately, it’s not as often because this is the really nasty type of H. pylori, you don’t want to see.
Dr. Justin Marchegiani: Exactly! And then, regarding the reference range, this is above one. If someone is borderline or a little bit below, would you typically want to treat them or let’s say if they had symptoms, would you still want to treat them?
Lisa Pomeroy: Yeah. So, it becomes more of a clinical decision if it’s below that of a thousand cell threshold. But we have had people have like, this is a 2.9 e3. We’ve had people like a 2.6 e2, which is just 260 cells. They’ve had endoscopies and have been told that their stomach was covered in H. pylori and highly inflamed. So, sometimes, this can be the tip of the iceberg. We have to remember where is this infection located. This is a stomach infection. So, something in the stomach, you know it depends on how much is being shed into the GI tract that day. It’s got to travel 20, 22 feet through the intestinal tract to come out the other end. So sometimes, this is going to be heavily diluted from what we started out with. So, this could, yeah, so this could be a glimpse of what’s there. So that’s where there I, you know, it comes down to the clinical decision, does this fit. If someone comes in and they have gas and bloating and GERD and reflux and stomach pain and I see a borderline level, a moderate positive, I’m probably gonna do a protocol because it fits. Now, if this was a very low level and they had absolutely no symptoms and I looked through the rest of the report, their microbiome looks good, their enzymes look good, their gut immunity looks good, maybe it’s okay. Maybe they have good Lactobacillus and things keeping it in check. But I wanna see signs that it’s not causing any harm so that’s where I look at the symptoms, the history, the rest of the report.
Dr. Justin Marchegiani: That makes sense. And then with these cytotoxic proteins, are these more genetic type of risk factors because of the, because of the genes or are they specifically connected to the H. pylori and if you knock down the H. pylori, will knock down these cytotoxic proteins?
Lisa Pomeroy: Exactly! So, these are genes attached to bacteria. They’re not related to the person. So, as you kill the bacteria, the virulence factors go with the bacteria.
Dr. Justin Marchegiani: Got it! You can clear them as the bacteria gets knocked down. You can, you can knock down the bacteria that has those genes attached to it.
Lisa Pomeroy: Exactly! Like, if you have babA that just allows the H. pylori to stick to the stomach a little bit better. So, we have to, we might bring a little cranberry juice because that has an anti-adhesive property to it. So, we just try to undo that little trick that the H. pylori has which here, the babA allows it to stick so we’re going to do something so it can’t stick.
Dr. Justin Marchegiani: Oh, would that be a good recommendation if you had H. pylori without the babA?
Lisa Pomeroy: You could actually because there is research that shows that cranberry juice seems to kill H. pylori and just prevent it from ticking to the stomach wall. So, with babA, I definitely would include it but I also often include it just with H. pylori.
Dr. Justin Marchegiani: And then, if you address someone like round one and there’s still some H. pylori left or you didn’t move it a ton, are you gonna try a second round with different herbs and just kind of mixed them up? How do you address patients where you don’t quite get the result you want the first round?
Lisa Pomeroy: Yeah, and this is when we’re using herbs, especially the herbs we traditionally use things like mastic gum, DGL, Licorice, they don’t have the major impact on the beneficial flora. So, it’s not like we’re going in there with some really super strong herbs a lot of times that will just knock out everything and so we can often use repeated rounds of some of those herbs safely without disrupting everything else. But I have had people were, especially skin conditions where until we get that H. pylori less than DL, their skin won’t clear up. So, for me, I looked to see now if they’re feeling great if we knocked it down and there’s a little bit again, it’s always a judgement call but I’ve seen people with acne, with eczema, where until it hits a less than DL, they have the symptoms, the second they hit less than DL they’re gone.
Dr. Justin Marchegiani: So, are there any other herbs that you’ll pivot off the mastika or that you use synergistically with it or that you’ll rotate in if first round didn’t work that you’ll pivot on the second or third round with?
Lisa Pomeroy: Uhm. Yeah. So, a lot of times other organisms can actually promote the colonization of H. pylori like yeast is a big one I look for because there’s, yep yeah, and there’s actually research that yeast and H. pylori have what researchers call an intimate relationship. So basically, if there’s yeast and H. pylori together in the mouth or the stomach, the H. pylori can go and hide inside of the yeast and kind of seek refuge inside of it and then later come out when the coast is clear. So, if I see a bunch of yeast on the next page, I may need to bring in some antifungals at the same time trying kill H. pylori or it’s just gonna hide out and just come out later. So, that can be something we miss, you know, H. pylori can produce biofilms and hide inside a yeast. Some bacteria can produce hydrogen and that hydrogen also can fuel the growth of H. pylori. So, that’s where sometimes I do look at. Okay, let’s bring in some Berberine, some Oregano, some Neem, some Pau D’Arco silver, something that’s gonna also address the bacteria or the yeast or some biofilm disruptors like NAC, and acetyl cysteine, can break down H. pylori biofilms. So, I’m thinking about all of those things because those could be what we’re running into a wall.
Dr. Justin Marchegiani: Makes a lot of sense. Very good. Any of the comments on the H. pylori and then also like what are the big virulence factors to look out for, like a top three?
Lisa Pomeroy: Yeah, I mean, some of the nastier ones we’re thinking more like gastric ulcers, gastric cancers, cagA is one of those big nasty ones. Um, dupA, the dup is duodenal, so that one’s a little more duodenal ulcer. VacA, that again, is another one, where ulcers, cancer. So, I’d say, the three worst one, the cagA, dupA, the vacA. I mean, yes, babA is not a good thing but it’s more allowing it to stick to the stomach a little bit more, it’s gonna be a little bit invasive, a little more inflammatory. But, you know, those other three are just especially nasty.
Dr. Justin Marchegiani: Got it. The cag, the dup, and the vac?
Lisa Pomeroy: yeah
Dr. Justin Marchegiani: Okay. Very cool. And now we go into the normal bacteria. These are commensal flora, normal flora in the gut but we can kind of gain a little bit of insight what’s happening in the gut based on these imbalances. I mean, out of the gates we have, you know, just out of the gates, we have Lactobacillus, which is a beneficial flora that’s low so we’re certain starting to see low levels of beneficial bacteria. Anything you want to say kind of from this section down?
Lisa Pomeroy: Yeah. And again, we can tie this with other sections too like Lactobacillus actually lives in the stomach and it’s very antagonistic towards H. pylori. So, if I’m looking at this and going well, we have a nasty H. pylori and infection, we have low levels Lactobacillus, I’m gonna get, get a lactobacillus probiotic in here, to try to help not only get more Lactobacillus in the system because it’s clearly lacking but it’s gonna help push out some of that H. pylori from the stomach. Now, in general, I look at, you know, do we have highs, do we have lows, because even though these are good guys, too much of a good thing is a bad thing. So, I still don;t wanna see highs or lows. Now, lot of times, when things are low, it’s often something killed them. So, I look for a history, did you take antibiotics recently or things like artificial sweeteners, like you know, splenda, sucralose, it’s a chlorinated sugar, chlorine kills bugs including the good bugs, so we need to be looking at agian the diet. Are you doing something that’s killing these, do you eat GMO foods, food sprayed with glyphosate? Glyphosate is patented as an antibiotic, again it’s gonna kill your good bugs. So, are you doing something that’s killing them or are you starving them, you gotta feed your bugs, they like fiber, so if you’re restricting fiber in your diet, if you’re not eating lots of whole fruits and vegetables and beans and nuts and seeds and you know maybe some gluten-free grains. I mean all of these things have the fibers that these guys love.
Dr. Justin Marchegiani: 100% and so a lot of fibers, a lot of fruits, a lot of vegetables. If someone were to go carnivore, would you see a lot of these commensal flora drop typically?
Lisa Pomeroy: You do, unfortunately. Yeah. Unfortunately, we have seen some reports for people who are doing carnivore and especially if there’s low stomach acid, especially if there’s H. pylori, you’ll see, a lot of the ones, the opportunistic ones on the following page go really sky high and you’ll see lots of low levels here because these guys like their fiber. Now we don’t test some of the bile loving bugs here but you know if you were testing those, we would expect to see some of the protein degrading, you know bile loving ones, those are the ones that are gonna go up but they’re also ones that produce things like hydrogen sulfide which can be very pro-inflammatory in excess. So, while it may relieve some symptoms, I’d rather look at why can’t you digest your foods and vegetables and carbs and that kind of stuff. You know, there’s probably an infection like H. pylori or some dysbiosis instead of restricting your diet so severely and starving your good bugs, let’s get rid of these bigger issues, get you digesting better so you can have those foods again.
Dr. Justin Marchegiani: Very good. And so, out of the gates there, any specific changes that you’re gonna see, you’re gonna make outside of those recommended diet or lifestyles? Things for like Faecalibacterium prausnitzii, Akkermansia, any specific changes there?
Lisa Pomeroy: Uhum, yeah. So, Faecalibacterium prausnitzii is the major butyrate producer, so butyrates are very anti-inflammatory in your gut but it also has an effect in the brain. Butyrate produced in your gut will cross your blood brain barrier and have an anti-inflammatory effect in your brain, stimulates BDNF – Brain derived neurotropic factor, can help with anxiety. So again, we’re not just looking a gut impact here, we may see this is low with skin conditions and anxiety and all these other issues. But this loves fiber, loves resistant starch, so I might suggest, you know, let’s eats some, you know, rice that’s been cooked and cooled or some potatoes or roots and tubers that have been cooked and cooled because if you cook these foods and then you cool them it creates resistant starch. So, like something, like potato salad would, you know, Faecalibacterium prausnitzii would really happy with some potato salad. But also your fibers, you know, fruits and veggies, roots and tubers, all of that stuff but it wants fiber.
Dr. Justin Marchegiani: Very good. And what if some of those foods cause people to get more bloated or gassy like let’s say they have issues with nuts or have issues with legumes or lentils, would you suggest they continue to eat that even if they feel bad or listen to their body in that?
Lisa Pomeroy: Yeah. We always want to listen to the body, you know, some foods are just harder to digest than others so some people especially if your gut is very damaged and inflamed, maybe you can’t handle the beans, legumes, lentils right off the bat. So, we find different foods, you know, other fiber-rich foods that don’t cause that discomfort and sometimes it’s about portions too, so something like an apple. Maybe you can’t have a whole apple because it has a lot of fermentable carbs but you can have two apple slices or you can’t have a whole plate of asparagus but you can have two spears of asparagus and a stir fry. So, we’ll always look at those things but I also look at enzymes. You know, if you don’t have enzymes to break down these foods, you’re probably gonna feel too good with them. So, I’m always looking at elastase, one again later in the report if that’s low. I’m bringing in a pancreatic enzyme supplement because that not only helps with your gas and bloating and you know all those digestive symptoms but also helps of the dysbiosis because if you’re not digesting your food, your bugs will, so you’re giving them all you can eat buffet if you don’t digest your food. So, enzymes are really key and they’ve actually done some really cool studies finding that, that low elastase one is actually a more influential on your microbiome than your diet and all these other factors. You know, having poor digestion will highly influence what’s growing and not growing.
Dr. Justin Marchegiani: Very cool. Anything else you want to say about, um, the different families of bacteria so the conventional thinking is Bacteroides is very helpful very important to have in your tummy in good amounts, uh, Firmicutes the high levels of this one tends to so that you know the B for Bacteroides, B for beautiful, very beneficial. Firmicutes, one of these ones where high levels increase calorie extraction which potentially some correlation with weight gain in the literature. Any comments on these?
Lisa Pomeroy: Yeah, so again, it’s all about balance. So Firmicutes is actually where a lot of those butyrate producers are. They’re in this category. So, both, you know, we can’t say that either one is good, one is bad but good guys and bad guys in both categories so it’s just all about having that balance there. And yes Firmicutes, they can, you know, make you retain more calories from your food so you could gain weight, if they’re abundant but I’m looking at if your Firmicutes is getting too high it’s probably you’re eating too many carbohydrates or you’re not digesting them. So again, if I see this high and your enzymes are low, I’m getting those enzymes in there and we’ll often see this balance out.
Dr. Justin Marchegiani: Yeah. And then, you may want to address either fermentable, FODMAPs or even go lower carb as well?
Lisa Pomeroy: Yeah, depending on it again, I look at symptoms, I mean I don’t want to starve the colonic bacteria, so I’m just, you know, a lot of times just finding which fibers are triggering symptoms, can we get some enzymes in there. There’re actually enzymes now that are specific for digesting high FODMAP foods and so I’ll bring in something like that where you know they’ll say, we’ll I love onions, but you know I just get such terrible gut pain afterwards. You take this enzyme, you can eat onions. So, your microbiome, loves onions, you know. Yes, they are highly fermentable they can cause more symptoms but if you get the proper enzymes in there, a lot times you’re fine and your gut microbiome will thrive on those foods. So, I’m very careful about what I take out, because you know, I don’t want to trigger symptoms but I also don’t want to starve bacteria.
Dr. Justin Marchegiani: Um, very good. And then what about increasing Bacteroidetes, is anything specific to help with that?
Lisa Pomeroy: Yeah, so maybe again, it’s something you know, if they’re low we think about, you know, fiber again the whole like more plant-focused foods but something too we know about Bacteroidetes, they don’t like excessive fermentation, so that’s where again, I look and connect the dots here. H. pylori showed up, H. pylori in most people causes low stomach acid. If your acids low, you’re probably excessively fermenting your food. Bacteroidetes don’t like the pH shift that occurs as a result of that, so they’re just not going to do well. You know a lot of these bugs what’s growing is going to be determined by pH and oxygen levels. So, chances are, you know, if you get some plenty of fiber in the diet get rid of that H. pylori that’s suppressing the acid causing excessive fermentation, these again could just balance out.
Dr. Justin Marchegiani: Very good. Excellent. And anything else? Let’s hit the dysbiotic bacteria section. So, these are quite frequently going to be found in general dysbiosis or SIBO right? Um, Bacillus is kind of this beneficial spore like probiotic that you get in megaspore or thrive or lot of these newer probiotics that are out. Why don’t you take it from there so with this one there’s a certain threshold that you like to see it stay below but if it’s a little bit high, is that okay?
Lisa Pomeroy: Yeah. So, bacillus actually, a healthy gut should have some Bacillus in it so this is one we actually see a number next to that Bacillus species on every single report. So, an e4 e5 is actually pretty typical. With this one, I’m actually more concerned if I see a less than DL. To me, that’s more of a deficiency of this. So, you know, if it’s low, I mean, again we think about the diet and all those things we can supplement since we do have them available in probiotic form. Now, if it’s high there’s been a link between poor digestion and excessive levels. So, if it’s going high, I tend to think, okay what’s going on with stomach acid with enzymes with all of those things. So, that’s what I’m usually supporting if it’s getting high.
Dr. Justin Marchegiani: Very good. Excellent. Probiotic, enzymes if it’s getting high. Anything else with restriction of carbohydrate or FODMAPs at all?
Lisa Pomeroy: With that one, I don’t usually do too so much. It’s more just uh focusing on if something’s causing low stomach acid like H. pylori. We need to deal with that bigger issue but it’s often more just poor digestion, digestive dysfunction.
Dr. Justin Marchegiani: Very cool! Anything you want to say about the general dysbiotic bacteria below? We can start with the despotic section. I mean, is there any rhyme or reason of why one may proliferate in someone’s gut over another or is it just kind of the dumb luck of you know, too much sugar, too much carbs, antibiotic exposure, not cough beneficial flora to compete? How does like, why would one proliferate over another?
Lisa Pomeroy: Yeah, so there’s definitely certain conditions that will promote some over others. Like we see, Klebsiella there in that bottom section. It not only causes inflammation but it loves inflammation. If your gut becomes inflamed, it’s going to bloom. So, with this one if your gut is inflamed because you have a, you know, crappy diet because eating a bunch of food additives and proinflammatory foods. You’re lacking those good butyrate producers. You know, all of these things have changed in your gut to make it inflamed that’s gonna make your Klebsiella very happy and it’s gonna become overly abundant like this or things like, you know, certain things have been tied in the research with low stomach acid. So Streptococcus, you know, one of the top things, you’re going to see with low stomach acid again this individual is dealing with H. pylori. So, we’re probably going to see some high Streptococcus, which we do. Besides Streptococcus, Staphylococcus tends to show up with low stomach acid. Again, right above that there it is and Enterococcus. Now, Enterococcus here was more a moderate overgrowth but still it is showing up a little bit which it’s fitting with this pattern. The more things that you have showing up that fit that pattern the stronger it is. So, I’d say, the enterococcus, the Staph, the Strep, Klebsiella will see more with low stomach acid and even Pseudomonas. Pseudomonas thrives when there’s a lot of undigested protein around. So that’s another one where, this page to me looks like a classic consequence of having low stomach acid. So again, we have to think upstream what’s causing them, that correct that but we also may bring in some antimicrobial herbs because this has gotten to such a state where we may not be able to just get rid of these by dealing with those bigger upstream issues like H. pylori and low enzymes at this point.
Dr. Justin Marchegiani: So, the Enterococcus, Staph, Strep, and Klebsiella, when you see them elevated, there’s going to be more of a connection with low stomach acid and probably low enzymes too because those are connected as well right?
Lisa Pomeroy: Exactly! We often call this the digestive dysfunction pattern.
Dr. Justin Marchegiani: Okay. How do artificial sweeteners impact this or even things like pesticides will they have a kind of negative impact like an antibiotic. How does that work?
Lisa Pomeroy: Yeah, they can. That’s what they find a lot of the artificial sweeteners they find that they tend to kill things like Lactobacillus and Bifidobacterium, and yet they promote a lot of times it’s this one other phylum which is called Proteobacteria, so Klebsiella is a member of Proteobacteria. Pseudomonas is a member of Proteobacteria. But they’re really virulent, more proinflammatory organisms that will tend to bloom again with more inflamed conditions higher oxygen and they also tend to go up when we have food additives and chemicals and pesticides and all of that. So, you see a lot of the research, it’s kind of like the, the bad dysbiosis pattern you’ll see is these high Proteobacteria, like again, high Klebsiella, high Pseudomonas, with low butyrate producers like for Firmicutes, low Clostridia, low Faecalibacterium prausnitzii. So too many proinflammatory bugs not enough anti-inflammatory bugs.
Dr. Justin Marchegiani: Got it. And so lower butyrate, uh, not enough anti-inflammatory bugs and that’s more with what Provatella, Proteus, Fusobacterium, was the big ones there?
Lisa Pomeroy: Those are gonna be your more proinflammatory ones again. Yeah. Anything in your potential odder will trigger susception.
Dr. Justin Marchegiani: with low butyrate
Lisa Pomeroy: With low butyrate, yeah. Because that’s going to change the environment that will promote their growth.
Dr. Justin Marchegiani: And so, when you are working on producing butyrate, can things just like butter which is butyric acid, can that have an influence? Are you trying to also add in potential resistant starch or probiotic fibers or adding just actual Butyrate in there? What are, what are your thoughts on each one of those and what do you do to try to impact butyrate?
Lisa Pomeroy: Sure, yeah. I mean, butter or ghee it does have some butyric acid or butyrate. It’s just, it’s so small, it’d be hard to get therapeutic amounts plus a lot of people are dairy sensitive especially when their gut is damaged and leaky.
Dr. Justin Marchegiani: Can be for sure
Lisa Pomeroy: Yeah. So, if I’m going to supplement or try to get more butyrate in, I look at, I mean, we could use a tributyrin supplement, you know that can be really great like if I see, if all the butyrate producers are low and their calprotectin is high which is telling me their gut is inflamed and they have a lot of GI discomfort and they also have a lot of food sensitivities. Getting that butyrate in there directly can often calm things down or diarrhea. Butyrate can be terrific for diarrhea. We’ve seen chronic diarrhea that’s been going on for years or decades. Stop within a week of giving some tributyrin. So, sometimes I do give butyrate directly or IBD I’ll often use some butyrate directly because the gut is so inflamed that can be really helpful. But a lot of times, you know, people don’t necessarily want another supplement. You know if I’m not seeing those major signs where I definitely want to add it in, I may just be let’s feed the butyrate producers. Yes, we can give the end product but you’re still not feeding them, you know, I always think of like the butyrate is more like giving you healthy soil that’s going to promote their growth but you still got to feed them. They’re not gonna grow if you don’t feed them. So, you got to get the fiber in there, so I look at, you know, you can feed them with the fiber, you could get the butyrate in there and maybe you want to do both. They find that actually giving the butyrate and the fiber which is promoting the environment and giving the fertilizer to feed them, you get an even stronger impact. So many different options what we may do, any combination of those.
Dr. Justin Marchegiani: So, if it’s only those bacteria are in the lower sides. If they’re higher, would you also still want to do that?
Lisa Pomeroy: Depends what we’re seeing, I mean, again, if the gut is highly inflamed, I may bring it in or there’s terrible diarrhea, I may do it more for symptomatic relief. But, you know, if those bacteria are in good shape, you know, we don’t necessarily need to do that to encourage them to grow by shaping the environment but there’s still other reasons, we might use butyrate.
Dr. Justin Marchegiani: Is it more of a concern when they’re higher or lower?
Lisa Pomeroy: It’s low that it’s more there’s usually a deficit of the short chain fatty acid butyrate if they’re low because if there’s low population, they’re not making enough butyrate
Dr. Justin Marchegiani: That’s less than DL you’re looking at, right less than DL
Lisa Pomeroy: Yes, these aren’t the butyrate, those are on the previous page, um.
Dr. Justin Marchegiani: You’re talking about the commensal stuff here.
Lisa Pomeroy: Yep. Yeah. So, the three markers that represent them are the Firmicutes phyla, at the very bottom. Yup, the Clostridium class and then Faecalibacterium prausnitzii.
Dr. Justin Marchegiani: Okay, got it. These are the big three, Clostridium, Faecalibacterium and Firmicutes, these are the big butyrate producers.
Lisa Pomeroy: So, there’s low, if they’re low you just could try feeding them or if the guts really inflamed again, they don’t like an inflamed environment so you may bring the butyrate in to try to take down some of the inflammation and then give them the fiber and now they’re really gonna grow.
Dr. Justin Marchegiani: Got it. Okay. Very cool. Anything else you want to say about the like Citrobacter or these despotic bacteria individually, I mean, a lot of these are gonna be commonly found in SIBO right, but because it’s a stool test and all of it, it’s moving through the intestines, we wouldn’t necessarily say this SIBO unless we had like a breath test but we could say that’s a kind of a generalized dysbiosis.
Lisa Pomeroy: Yeah. And some of these bacteria we look at like Klebsiella, Pseudomonas, they just live in the small intestine that’s just their area that they hang out but it’s not necessarily SIBO, you know, yes, they’re in the small intestine but SIBO is when there’s too many overall bacteria in the small intestine, sometimes you just have a dysbiosis. You know, it may just there’s not, overall, it’s just Klebsiella and Pseudomnas are too high.
Dr. Justin Marchegiani: And so, you’re gonna utilize like a breath test, a lactulose, where you’re looking at hydrogen and methane gases and see if they’re really elevated to really know that.
Lisa Pomeroy: Yeah. If you wanted to see more of that SIBO picture, is there too many bacteria in the small intestine because maybe you had food poisoning incident before and your migrating motor complex that kind of that street sweeper isn’t working well to push the bacteria out. But if I’m looking at these, yes, these are in the small intestine, they’re overgrowing you know, maybe there’s other things overgrowing in the small intestine with them but you know to me it’s something, I’m looking at, you know, low stomach acid, low enzymes, is a huge factor with bacteria in the small intestine. So many cases, we can work on digestion, H. pylori, get some antimicrobials in there and often takes care of those whether even though, they’re in the small intestine versus a colon.
Dr. Justin Marchegiani: Cool. Anything else you wanna say about these individual dysbiotic critters?
Lisa Pomeroy: Yeah. Well, Klebsiella, since this one shows up, these are, you know, besides being very proinflammatory, they are putting, you know, putting you at increased risk of perhaps developing autoimmune condition. So, like Klebsiella is something that’s been linked with rheumatoid arthritis, ankylosing spondylitis, IBD. So, if you had that perfect storm, if you have the bacteria which is your trigger, you have a leaky gut and you have the genetics that make you predisposed to getting say rheumatoid arthritis. It could lead to that down growth. So that’s we’re seeing signs, you know, maybe you don’t have rheumatoid arthritis now, but 10 years, 20 years, 30 years from now, if you don’t do anything about Klebsiella, it could turn into that. So that’s where again we look from a functional medicine perspective, you know, we wanna try to head off a lot of these symptoms too and that’s where we can get a glimpse into that now, with the stool testing to try to get rid of this. Now, so it doesn’t become a future problem.
Dr. Justin Marchegiani: Very cool. Anything else you wanna say on these down below the Proteus or the Fusobacterium?
Lisa Pomeroy: Uhm. Yeah. Now, some of these actually live in the mouth, so Klebsiella lives in the mouth, Provatella lives in the mouth, Fusobacterium lives in the mouth. So, we can’t forget other microbiomes too. So, they’re part of the oral microbiome. And there’s actually a lot of overlap. I think it’s like 45% of the microbes are similar between the two. So, we always have to look at oral health, dental health, if someone has issues in their mouth maybe they need to get their teeth cleaned, get an infection dealt with. Because if you’re swallowing these bacteria every day in your saliva. Now, if you have low stomach acid, you don’t kill them very well as they pass through the stomach so you could get too many in your intestinal tract because there’s low stomach acid but you could also too many in your intestinal tract because there’s too many in your mouth. So, we have to be always looking at the health of the mouth too and what’s coming above the GI tract.
Dr. Justin Marchegiani: I’m a big fan of flexing either with colloidal silver or hydrogen peroxide and if you’re sensitive you can always dilute at 3%, that’s very helpful at knocking down some of those bugs, do you agree?
Lisa Pomeroy: Exactly. Yeah. Exactly. A lot of people like water picks and they’ll do different things and mix and sometimes they’ll alternate too and yep and even the nasal, I mean you have to figure, you know, what’s you know, is being swallowed there from the nasal passages.
Dr. Justin Marchegiani: Post nasal drip stuff
Lisa Pomeroy: Yep, we’ll squirt some silver or something up to the nose too to try to kill something that’s in there, that’s being swallowed and getting down in the gut.
Dr. Justin Marchegiani: Very good. Let’s dive into yeast. I typically don’t see a lot of yeast come back on these labs. When I do it’s usually beneath the reference range sometimes it’s positive but a lot of times I tell patients, if I see it here and it’s not DL then it’s probably a concern. I mean on the organic acid testing which we can talk about at a later point we’ll see things like D-arabinitol or D-arabinose, which is a really good yeast, uh, marker which does, I do find that tends to come up a little bit more frequently than, uh, this test. What’s your take here?
Lisa Pomeroy: Yeah. So, yeast again, we have to keep in mind, it can grow lots of places. You know, it can grow in the mouth, in the stomach, in the small intestine, in the large intestine
Dr. Justin Marchegiani: Skin, Fingernails
Lisa Pomeroy: The skin, yeah. So, I mean of course, anything outside of the GI tract is not gonna show up in the stool. If you have a toenail and fun-fungal infection a scalp fungal infection. It’s not gonna come out in your poop unless it’s also in your gut. So, we always have to keep in mind people say oh I have a yeast problem at my toenail, why didn’t it show up. It’s like probably localized to your toenail. Now, of course, again, we have the dilution factor. If you have thrush, if it’s more in your mouth and not so much in your colon, we may not see a hug amount in the stool or even in the stomach because it’s gonna be diluted out as it travels, so this is really good at looking at like especially the lower bowel because it’s right there ready to exit. The higher up in the GI tract you get, the more dilution is going to play a role into it. Where sometimes maybe you will see it more in organic acids in a urine test than in the stool. If it is a little more upper GI. although, I mean we do pick up DNA that’s coming down from the mouth, the stomach as H. pylori shows up small intestine. But this is something where if it’s detected at all to me that’s a problem because yeast overgrowth tends to cause a lot of symptoms especially hits the gut and the brain. So, a lot of people will say yeah, I have the gas the bloating, you know, the constipation, the diarrhea but it’s also the brain fog, the memory loss, I can’t remember where I put my keys, it’s no cognac, I just, my brain doesn’t work like it used to.
Dr. Justin Marchegiani: The acetaldehyde produced from Candida right?
Lisa Pomeroy: Exactly. Candida produces so many toxins, a lot of those affect the brain or they have the, the sugar cravings so it’s like, I want to get healthy and I want to stop eating all these carbs and candy bars and everything but I just can’t, you know, It’s the Candida calling out for. So, you gotta knock out the Candida.
Dr. Justin Marchegiani: On the extreme side, you could have auto brewery system, um, syndrome, when you’re actually creating your own fermentation with it. The story of this is true, a gentleman got pulled over and he was tested being drunk on the breathalyzer but it was actually yeast in his gut that like made their own little brewery in there and created alcohol from that metabolism that got him drunk and a lot of cognitive people that feel drunk, feel brain fog, it could be from that yeast and all that fermentation happening
Lisa Pomeroy: Yeah, and other organisms can do that too, Klebsiella, another one that could do that too.
Dr. Justin Marchegiani: Ah, interesting. Good, very cool. And then, does it matter, I mean obviously Candida tends to be the bigger yeast most people know about that and you have some subspecies here. Any difference is it, does it matter, are you treating them the same way? Do they differentiate in symptoms at all?
Lisa Pomeroy: Yeah. It’s hard to say in symptoms I mean a lot of the yeast behave the same, a lot of times we’re doing similar protocols anti-fungal, you know, fatty acids like caprylic acid, undecylenic acid, herbs like Pau D’Arco, berberine, oregano, so we’re typically addressing them the same. Now, these are all can be normal inhabitants of the gut like Candida, it’s, you should have Candida in your gut. You know, it has a purpose, the whole thing is it’s all about balance. You get too much of it creates all these toxins and excess you can get symptoms. So same thing with these and some of them are actually in your environment like Rhodotorula is something that we sometimes see a little bit of that showing up and certain areas of the country seem to have it more just in the environment. It’s kind like a pink colored fungi. So, I tell people like do you have like a pink colored ring around your toilet or your tub something like that in your bathroom, it could be Rhodotorula.
Dr. Justin Marchegiani: Interesting. Anything else in this?
Lisa Pomeroy: That’s the main thing with the yeast there. Yeah.
Dr. Justin Marchegiani: How about the viruses?
Lisa Pomeroy: Yeah. So, the main reason, the viruses are on the panel is when these viruses are reactivated in the colon, they’ve been linked with IBD. So, we’re looking for that association there with you know colonic viral reactivation. Now of course we know that these viruses can live in many organs and tissues like Epstein-barr virus and the thyroid gland. So, it doesn’t mean if these don’t show up that you don’t have the virus somewhere else in your thyroid, liver but this is looking more of the IBD colonic link.
Dr. Justin Marchegiani: Very cool and we have different parasites as well, we kind of already chatted about Blasto earlier, but can you give us kind of the reader’s digest from on the critters here, on the bugs.
Lisa Pomeroy: Yeah, so again, all of these can cause symptoms in some cases very severe now these the ones I’d say tend to cause the worst symptoms, would be the Blastocystis hominis and Dientamoeba fragilis. Especially in kids, we can see, you know, kids with just terrible tummy aches and pain and issues maybe failure to thrive they’re just a little underweight for their age and you know, just a lot of behavioral issues. We see Dientamoeba fragilis come out a lot. Both the Blasto and D. fragilis have been linked with IBS and studies. So, we do often see some quite significant symptoms with them. Uh, now some of the oddball things, extra intestinal you may see, you know, with like joint pain, I think, Blasto and Endolimax nana is another one. I’ve had a lot of people where it’s like I think I have Lyme disease and so we’ve run a lot of good because Lyme disease, you need a good test because it’s hard to find. But if you do a good Lyme disease test, you know, when it comes up negative, you know, we’ve had people do that and it’s like, we’ll it’s negative what do I have, I mean, this joint pain is awful and it’s Endolimax nana, so it has affinity for collagen related tissues, so you can see some pretty nasty joint muscle tendon, ligament issues with that one.
Dr. Justin Marchegiani: This is more collagen based huh?
Lisa Pomeroy: That’s the Endolimax nana.
Dr. Justin Marchegiani: Oh yeah.
Lisa Pomeroy: Yeah, yeah so that’s what I look for with that one well I’ll, you know, if I see it show up and they’ll say well I have no gut symptoms. It’s like, well when you work out at the gym, do you see an injury prone where it’s like oh I was lifting weights and now I twisted my shoulder and oh, now it’s trying to run and now my ankle hurts and you know or they just go I’m you know 29 and I work out, I go for a run and I’m so sore and stiff in the morning. I don’t think I should feel like this for 29 years old.
Dr. Justin Marchegiani: Exactly.
Lisa Pomeroy: Yep.
Dr. Justin Marchegiani: Very cool. Anything else on these Pentatrichomonas at all?
Lisa Pomeroy: Yeah, I mean again, some of these just vague, just general gut related symptoms. You know, any of these really could cause gas bloating, abdominal pain, discomfort, constipation or diarrhea. So you know, just general like IBS type symptoms.
Dr. Justin Marchegiani: Very cool. Anything about the worms? I don’t see the worms come back as much. I really don’t. Do you?
Lisa Pomeroy: Well, we don’t see a lot of worms, you know, fortunately because they are a little trickier, you know, we often do recommend deworming medications because it is very difficult to kill them with natural means. But yeah, worms can be quite nasty, um, you know, some of these are, you know, small intestine too, and things like the you know, Ascaris is a roundworm, you know, it doesn’t, you know, some of these worms like the, the hookworms and things, they actually attach to the bowel wall, so they kind of stay in place, I mean, they could, you know, suck your blood and stuff, you know, get the nutrients from the blood. But Ascaris is kind of free-floating there and the problems is because it’s free-floating, it’s not attached, it sometimes gets into places where we really don’t want it and so they found it migrating into things like your gallbladder and you know, your lungs and other places so that one, I mean the big issue with these worms are they can create blockages in some cases with those big worms, you know, sometimes, there can be blood loss, nutritional deficiencies too because if they’re you know sucking your blood and damaging your gut, you could have impaired nutritional absorption. Now, in the U.S., we typically, don’t see these massive infections where there’s like a big ball of worms but you could have a couple worms and they could be causing a lot of issues. Yeah.
Dr. Justin Marchegiani: Interesting. Very good. And then anything else with the, I think, the Trichuris, that’s the whipworm, right? Um, Nicator, is that a hook I think, not sure hook or whip but either way. Different, different, other different worms there, which we’re gonna treat either with, you know, typical medication like Mebendazole, Albendazole, Vermox, or higher dose wormwood or Artemisinin, also tends to be very helpful with some of these too.
Lisa Pomeroy: Yeah. And again, some of these, they all have different ways you can get infected, like some of them it could be walking barefoot on a sandy beach, you know, others it could be. Yeah. some of those worms
Dr. Justin Marchegiani: Trichuris
Lisa Pomeroy: Yeah. And in others you could be, you know, you’re exposed to it through like there’s pork tapeworms and you know beef tapeworms and stuff so again it’s looking at food quality and making sure that it’s cooked thoroughly. You don’t want to go to a restaurant and get the rare hamburger or be eating, you know, a rare
Dr. Justin Marchegiani: Make sure, its good restaurant, make sure the quality is good.
Lisa Pomeroy: Exactly.
Dr. Justin Marchegiani: Make sure it’s like Wagyu from like a five-star restaurant at least. Yeah, for sure.
Lisa Pomeroy: Yeah.
Dr. Justin Marchegiani: Cool. And then down below, we have a couple of markers here out of the gates. The steatocrit right, which is the marker for maldigested fat, so if we see a lot of fat in the stool we’re thinking of potentially either gallbladder flow issues, maybe stones that are affecting the flow maybe we don’t have enough acids because acid is really important for the gallbladder to trigger and contract make CCK, elastase and another marker for the pancreas and enzyme production and again if you have low enzymes, um, HCl or acids is an important stimulator for making and activating enzymes. Any comments on those?
Lisa Pomeroy: Yeah. So exactly. Yeah. so steatocrit has to do with fat malabsorption. Now ideally, I’d like to see a less than DL here. So, I really don’t want to see malabsorbed fat showing up in the stool. Like this one. Isn’t terrible at six so six percent of the stool was some undigested fat but it’s still it’s not ideal, I’m looking for signs why might that be, is there a bile issue, is there a lipase issue. Those are the major things that are digesting your fat, your bile from them you know, produced by the liver, secreted by the gallbladder or lipase is a pancreatic enzyme so for me then you know, if I see this, I look at the elastase one to go, okey what’s the lipase looking like. Elastase, one healthy control usually above 500. So, this individual, I’d say okay, Lipase is probably a little low because were only 388, so chances are if we get a good pancreatic enzyme in here with a nice amount of lipase, will clear up this fat malabsorption too.
Dr. Justin Marchegiani: Very cool. And then any feedback on the Beta glucuronidase, well that’s a, I mean, we’ll just like talk about it out of the, out of the bat. This one has a major effect from dysbiotic bacteria producing it right and so but it also can affect hormone metabolism so you have these bad bugs maybe it’s Klebsiella or gram-negative bacteria like Proteus or Citrobacter. It’s gonna make this enzyme that is going to take conjugated estrogen and it’s gonna deconjugate it and allow the estrogen to go back into the circulation. Comments there?
Lisa Pomeroy: Yeah. Yeah. Exactly. We look at sources. Now, bacteria is the number one thing I look for. Do we have those species over growing that produce it so then I go flip back to page two and three and go, do we have E. coli, do we have high Bacteroidetes or Bacteroides fragilis, uh, do we have
Dr. Justin Marchegiani: So you may look here, so you may look at Bacteroides, you may look at E. coli or what else? Anything else?
Lisa Pomeroy: Uh, the Bacteroides fragilis, Bacteroides fragilis at the top there. Um, Clostridium class and Firmicutes phylum some species, I mean those are large groups but there’s some in there, if those are high it may also be coming from there.
Dr. Justin Marchegiani: Now, this person doesn’t have a lot of those either and they still have it.
Lisa Pomeroy: They don’t, yeah.
Dr. Justin Marchegiani: Again, it’s a sample but
Lisa Pomeroy: Yep. Now the next page do they have Staphylococcus. Uh, they do and really high, yeah, we have Staphylococcus species. Staphylococcus can also produce it. So, this person, I’d be going, okay maybe the Staphylococcus is the where it’s coming from so if we get the staff down, we could bring this down. Yeah, the problem is especially we look at you know say this is a you know a menstruating female. You know, she’s producing a lot of estrogen and she can’t get rid of that estrogen so they say beta glucuronidase kind of comes around like a pair of scissors so say you know your toxin your estrogen goes to the liver goes through glucuronidation which is a detox pathway and the body kind of packages it up nice and neat for elimination so it puts the estrogen in a box puts the lid on the box ties and nice little bow around the box. Well, your beta glucuronidase comes around like a pair of scissors snips of ribbon, lifts the lid, let’s the estrogen out so now estrogen gets to get reabsorbed recirculate and now you get estrogen dominance so now you have PMS and menstrual cramps and breast tenderness and all of those types of symptoms. So, yep.
Dr. Justin Marchegiani: Very good. And then occult blood, we could see this potentially from blood in the stool, ulcerations, could be ulcerations in the stomach working its way down a lot of times I find It could be from hemorrhoids. It’s a common one too. The outer veins and the rectum area. They’re just, they’re dripping a little bit or the women out there on their menses too that could potentially drive that you’d be back there
Lisa Pomeroy: Exactly, yeah so ideally, I like to see under five that would be considered negative. 5-9 that’s where we often think oh, did you collect during your period, are you constipated, do you have hemorrhoids, no, that’s a typical range, anal fissures, maybe a constipated there’s a little tear or something. Above a 10 that’s our red flag because above a 10 we have to consider that you know this could be IBD, colorectal cancer, polyps and we just don’t want to miss any kind of pathology here. So, this is where we look to see is there something that makes sense or a diagnosis that makes sense say I see an occult blood of 35 well the person has ulcerative colitis. Okay now, we know why there may be blood it makes sense. But if it’s a 35 and there’s no known reason for this to be then we may need to repeat it, you know some of the acute pathogens again. If we go back to page one that E. coli, you know, uh, the 0157. That one can cause bloody stool. So, say that they got this nasty E. coli from a hamburger. Yep. And the, the EHEC, the enterohemorrhagic E. coli. Yeah. So, they could cause bloody stool so maybe, if there was a little bit of blood it was from an E. coli or something just passing through. So, if it’s above a 10 we often start by just repeating the occult blood to see was it some fluky thing where it was an acute pathogen or something but if you get two positive occult bloods it’s often referring out to see, you maybe need a colonoscopy because again we just don’t want to miss, we’ve caught early-stage colon cancer by catching some of these, you know, occult blood levels that are creeping up.
Dr. Justin Marchegiani: uhum, absolutely. And then we have IgA which is gonna be an immune marker that’s you, your kind of your mucosal membrane that kind of hits all the mucuses, so mouth, intestinal tract, vaginal canal, urinary canal, so if we see something high, that could be some kind of an immune stress. Your immune system is fighting and going after, if it’s low it could be just chronic stress that’s depleted that immune system that made you more vulnerable. Any thoughts on that?
Lisa Pomeroy: Yeah, exactly. I mean for me, low is a much bigger problem than high. High means the immune system’s working.
Dr. Justin Marchegiani: Working, yeah. It’s good.
Lisa Pomeroy: yeah. It’s attacking some microbe or some food but I mean that’s what it’s supposed to do, if something’s threatening it, it should go up, it should try to resolve it. Low means that it’s just it’s burnt out from wear and tear that constant assault and it just can’t mount a response and when it’s low you’re going to be more vulnerable to the E. coli and the Yersinias and the H. Pylori and the parasites because this is our first line defense, you know, we got to have this nice and robust.
Dr. Justin Marchegiani: Absolutely and then gluten antibodies, how often do you see this positive and I find it’s gonna drop if someone’s on a healthy diet they could still be gluten sensitive but it will go down so it may not be the best indication of hey, you’re gluten sensitive, um, and you may get a false security because you kept your guten out and then you’re thinking, you’re okay and you can add it back in but it’s gonna be kind of exposure based, right?
Lisa Pomeroy: Exactly, yep. In order for the body to produce antibodies to something, it has to have that current exposure. Now, gluten antibodies can last three to six months in the system from a single exposure, so if they’ve had gluten in the last three to six months it could still be elevated from that but if someone if say they come in and they say I’ve been gluten free for five years, I shouldn’t be seeing elevated antibodies. If I am, there is a problem, it’s sneaking in somehow and we do often see this. I saw, I think two people earlier today who were diagnosed celiacs and it was high. That’s not good. That means that they’re still having that exposure so we’ve got to figure out where it’s coming from that is not a good thing and they’re telling you, really have to
Dr. Justin Marchegiani: Yeah, and what do you do when people are like, no I really haven’t been getting exposed. I tend to say well, is there cross contamination, is it potentially going high because maybe there’s an egg allergy or they’re eating some rice that’s technically gluten-free but could still react or is it still dairy thing what other foods could trigger that?
Lisa Pomeroy: Yeah, so first I look for actual gluten cross contamination because most cases it’s actually gluten, they didn’t realize that the oats, oats will be contaminated with gluten unless they’re certified gluten-free so it could be they’re eating their regular old quaker oats, you know, they’re gonna have gluten, so we gonna look for those or they’re sprouted bread. Yeah, it’s Ezekiel bread. It may have less gluten but still has gluten so we gotta look for that or oh my boyfriend eats gluten and I kiss him right after I, you know, after he eats the hamburger. That’s gonna be a step.
Dr. Justin Marchegiani: That’s possible.
Lisa Pomeroy: Or they kissed their dog, they feed their dog, regular gluten kibble and they kiss their dog. So, I looked at all of those, um, and they found that you know, eating out in restaurants. They did this great study a couple years back and they said about a third of all restaurant meals that you’re being told are gluten-free tested positive when they’re actually tested and that went up to 50% for gluten-free pizza and gluten-free pasta. So basically, if you go out to a restaurant, you order the gluten-free pizza or pasta, it’s a 50 50 shot whether you’re actually getting gluten or not.
Dr. Justin Marchegiani: Yeah. It tends to be, usually if you’re going out, if you’re getting like a steak or some steamed vegetables, usually you’re okay tends to be more in the sauces, the thickeners or even a spice and so worst case you just, you season it yourself with your own sea salt at the table or something just to make sure it’s its clean.
Lisa Pomeroy: And some things too, I mean I actually you know because I am gluten sensitive, you know, gluten triggers Hashimoto’s for me. So, I went gluten-free like 14 years ago and my antibodies dropped and never come back because I’ve stayed gluten free.
Dr. Justin Marchegiani: That’s great.
Lisa Pomeroy: But I do test. I have this little testing device and you could put a pea sized portion of the food in the device, it takes about three minutes and it’ll tell you if it had gluten or not. So, I will test if I buy some new food, especially if it says manufactured in the same warehouse with wheat, dairy and all that kind of stuff or if I don’t know say if I want to eat, I can put the food in the device and know if its gluten-free or not. So
Dr. Justin Marchegiani: Wow, so what’s this device called?
Lisa Pomeroy: It’s called Nima. It’s N-I-M-A. So, it’s a Nima, Nima Partners Company, you can buy it through. It’s cool little device, you have to buy these capsules that are one-time use but you put the food in the device, so anytime I buy anything new any packaged food, even supplements, I run it through my Nima. Because, I was being glutened by a cinnamon powder like I run one of these tests on myself and my anti-gliadin was a little high and I thought was a test wrong that this is impossible I’ve, I’ve been gluten free for over a decade this got to be wrong so I bought a Nima then this a few years back and tested everything I was eating and an organic cinnamon powder the company grinds fresh in their facility tested positive and I was eating this almost every day. I stopped eating it, seven months later retested, antibodies gone.
Dr. Justin Marchegiani: Wow, okay. We’ll put a link up on screen put it on the show notes that’s uh, that’s crazy, very cool.
Lisa Pomeroy: If I’ve ruled out that, that’s the first thing I look for because the majority of people, it is just gluten contamination. Now if we’ve ruled that out then I looked at okay there’s about six foods that are cross-reacted with gluten, there’s dairy, there’s yeast, there’s corn, there’s millet. So, then we start to look at
Dr. Justin Marchegiani: other things
Lisa Pomeroy: Yep. Other things that you know if you’re continuing to eat dairy then maybe there’s an issue there. Yeah, it’s, they recently changed the website, I think it’s Nimapartners.com
Dr. Justin Marchegiani: Okay cool. I’ll put it below in the show notes. Anyone’s listening back and you’ll get that. That’s great.
Lisa Pomeroy: So sometimes we have to remove cross-reactive foods so there can be other factors but you know, the problem is once you’ve lost oral tolerance to gluten, you can’t get it back. It’s the only food we know of that your body creates memory B cells to so, it is something like for me being gluten-free for like 14 years I shouldn’t have antibodies but if I start eating gluten again, I will have antibodies because I’ve lost oral tolerance.
Dr. Justin Marchegiani: That’s why I like the genetic test because you don’t have to necessarily challenge it or know you, if you have the HLA DQ2 or eight or you know one alpha, one beta, one or three then it’s a good chance that you have that those gluten sensitivities and you should probably stay away from it.
Lisa Pomeroy: Um, yeah.
Dr. Justin Marchegiani: Any feedback on the genetic testing for the gluten.
Lisa Pomeroy: Yeah, I think it’s helpful, I like all these tests, I mean they always give you a little different piece of information so I think it’s helpful, you know a lot of times correlating the genetics with what we’re seeing here. So, I mean the genetics don’t tell you, you are having a problem versus this tells you are having a current problem. So, I like both and sometimes people need the information from both because just seeing the genetics, you know, they go, well I could have a problem but is that enough you know, a motivational factor to keep me from eating gluten versus I see this and it’s high then I know, okay, my body is really not happy right now because of the gluten I’m eating. I definitely need to go gluten-free. So, it depends what motivates someone and again if they haven’t eating gluten for a while, I don’t want them challenging it, you know, they could certainly again run this as is like myself eating the cinnamon, I though, I was gluten free but I was being glutened so it showed up. So, I tell people run the test as is look at your genetics and I’d rather you do that than reintroducing gluten and now starting that inflammatory cascade that’s going to last for three to six months.
Dr. Justin Marchegiani: Very cool. Well let’s just wrap this up, your last couple of markers and by the way, I know we chatted about, uh, probably a little bit ambitious wanting to go into the, uh, the ion panel but I’d love to have you back soon, Lisa and really dive into the ion panel. Would you be open to that?
Lisa Pomeroy: I would, I love talking lab test interpretation.
Dr. Justin Marchegiani: Very cool, so out of the gate here, calprotectin, really good tests for inflammation produced by the white blood cells in the intestinal tract, it’s a protein and of course, Zonulin is that protein, that’s a sign that those tight junctions are being unzipped in the intestinal tract and potential gut permeability. Comments on that?
Lisa Pomeroy: Yeah. So, calprotectin is a kind of a general marker for intestinal inflammation. Now with IBD, we can see this exceptionally high. Usually, yeah, the two things that are going to cause your highest levels are acute pathogens so again something like that nasty food poisoning E. coli or something like your IBD type thing. You could see upper hundreds or even thousands with that.
Dr. Justin Marchegiani: Yeah
Lisa Pomeroy: Ideally, I wanna see under 50. So, a lot of people will see things like an 87 or a 120 where I go that’s higher than I’d like, so again, we start looking at, okay, what’s causing this colonic inflammation, again, are you lacking butyrate producers, do you have too many of these proinflammatory bugs, do you have a parasite like Blasto hanging out in your colon. So, we’re looking at all those other factors that could be causing inflammation. Or again, some of the food additives, you know, maybe you like to go your grocery store and get rotisserie chicken. A lot of rotisserie chickens have Carrageenan in them. Carrageenan is a known proinflammatory food additive. So, there’s little things we can sometimes do to bring down our gut inflammation but yeah, so that one’s gonna tell you about if your gut is inflamed or not, Zonulin tells you if your gut is leaky. Now Zonulin will, you know, go up, you know, it’s triggered by things like gluten and gram-negative bacteria. They have an endotoxin, LPS in them. So, gluten and LPS are the top two triggers for Zonulin, so again I’m looking for is antigliadin high, do you have a lot of these bacteria that are overgrowing or again do you eat GMO foods like glyphosate is another trigger for Zonulin. So, if this is high, we need to look for, what’s triggering it and then we’re probably gonna need to do some gut repair, you know, maybe we want an L-glutamine based powder, you know, because we want to make sure that the gut damage is being healed up the tight junctions are restored, the integrity of the gut barrier is restored.
Dr. Justin Marchegiani: Very cool. And then Lisa, you’ve given us so much information here. This is excellent. I’m going to recommend this to my patients here to get a kind of a little bit more of a deeper dive, if they want more intel. This is excellent. Um, if people wanna find out more about you, where’s the best place to go?
Lisa Pomeroy: Yeah. So, I have a couple different websites, I work with practitioners and right now I’m, you know my practice is closed to taking in new clients but, you know, may open up in the future, so my more client website is my last name Pomeroy, so pomeroynaturalhealth.com. Now, if there are practitioners who want more, you know, help on lab interpretation for their patients or if they’re interested in the different training courses I created, that website for practitioners is pomeroyinstitute.com
Dr. Justin Marchegiani: pomeroynaturalhealth.com for patients. pomeroyinstitute.com for practitioners. We’ll put the links below here, so people can get to that faster. Anything else you want to leave listeners today with, Lisa?
Lisa Pomeroy: Um, I guess, just you know, they say all health begins in the gut and I’m a believer of that because I had so many issues, I mean, you almost name a pathogen on this report I’ve had it. Everything from roundworms to just about every Protozoa to H. pylori. You know, I’ve had it all and I know how much, you know, it just wreaked havoc on my gut for decades so starting very young. You know, my parents would always think she’s coming down with a stomach flu because she just puked out of the blue. You know, it was just the H. pylori and everything else, my low enzymes. So, I had just terrible terrible gut and so I mean for me was the functional lab testing that found these issues. I mean, that found the H. pylori, the parasites, the low enzymes, everything else and I just think you know for me it’s just so important on why I get so passionate about this. For me, it was giving me the answers that I needed to restore my health. So
Dr. Justin Marchegiani: Excellent. Well, you have a great story at least, you did an excellent job for sending me information and I think uh, people that are watching are getting a lot of information out of it. So really appreciate it, look forward to have you back on the show real soon.
References:
https://pomeroynaturalhealth.com/
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Activate the Parasympathetic Nervous System to Improve Recovery | Podcast #310
While often overlooked, the role of the nervous system in recovery is paramount. In this video, Dr. J and Jodi Cohen – a bestselling author, award-winning journalist, and founder of Vibrant Blue Oil. They highlight the key physical and mental/emotional factors that stress the nervous system, activate the parasympathetic nervous system for optimal recovery, and how it is connected to your vagus nerve, and how it can affect motility.
We often hear meditation and massage are two potent techniques to help with physical recovery from exercise and lower the body’s mental stress response. Jodi here also introduce oils that are so stimulatory, most especially to your vagus nerve, which large divisions of this nerve extends to the digestive system. Also, the vagus nerve sends commands (when the body is not under stress)that slow heart and breathing rates and increases digestion.
Check out this podcast and learn more on how you can apply this to your daily living!
Dr. Justin Marchegiani
In this episode, we cover:
0:18 Parasympathetic
3:54 Vibrant and Blue Oils
7:38 Clove and Lime
20:08 Nutrients that Support the Oils
23:02 “Essential Oils to Boost the Brain and Heal the Body”
Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here really excited to have a awesome podcast guest today Jody Cohen is going to be talking about the parasympathetic summit, which is going to be all about how to promote parasympathetic nervous system, which is about helping your body heal and improve. Jody, welcome to the podcast.
Jodi Cohen: Oh, my God, so honored to be here. Thank you. And I feel like the timing is perfect. For people who don’t really know what parasympathetic is your nervous system, your autonomic nervous system, which controls your automatic functions like breathing, heart re digestion, immunity has kind of two gears, when your body thinks there’s danger and it has to survive, it presses the gas pedal, and kind of routes all of your blood flow and your oxygen to your arms and your legs so that you can either fight back or flee. And then the danger passes, and you hit the brakes, which is the parasympathetic, and everything returns to normal. And it’s kind of like cleaning up after the party, right? You can digest your food, blood flow routes back to your digestion. And what happens especially now when we’re so anxious, you know, anticipatory stress makes the body think it’s in danger, we kind of get stuck in the wrong gear. And so all of those maintenance cleanup health functions, kind of get put on the back burner. And if they stay on the back burner forever, your health kind of suffers.
Dr. Justin Marchegiani: People talk about the parasympathetic nervous system, a lot of times that’s connected to the vagus nerve, correct?
Jodi Cohen: Yes, exactly. Your Vegas nerve is really the gearshift between that fight or flight, sympathetic state and the rest and digest parasympathetic state.
Dr. Justin Marchegiani: Yeah, and the Vegas that that terminology means the wanderer, so it’s the nerve that goes from the brainstem and kind of wanders down and it hits all of the, the organs like you talked about a lot of digestive impacts regarding the parasympathetic because we need good HCl and enzyme so like to be able to get access to all of those nutrients. And to break all your proteins and fats and antioxidants down, we need good digestive support and getting into the parasympathetics helps that.
Jodi Cohen: Yeah, I could actually the Vegas nerve wanders through every organ of digestion. So it triggers your mouth to release saliva, which helps start to break down those proteins so that they’re better absorbed and your stomach releases hydrochloric acid, it helps the pancreas release digestive enzymes, the gallbladder release bile. And then the most important thing that people don’t know is it kind of helps with the motility wave. Think of it as kind of like, you know, the moving walkway that goes through your system and make sure that things don’t stay too long in your gut and cause like cebo, or, you know, IBS or any problems, you know, and also make sure that you don’t get constipated, so that things leave, so that when you’re kind of stuck in fight or flight sympathetic dominance, all you know that the moving walkway doesn’t go and that’s when problems occur.
Dr. Justin Marchegiani: So anyone listening to this right now, if you’re liking what you’re hearing, make sure you click down below, we’re gonna put a link for the parasympathetic summit right down below, so make sure you subscribe. I was part of that summit along with a 30 other-
Jodi Cohen: I know, I know. I can’t. Well, you know what it is I am anxious. And so I started really early. And so I had almost everything done a month before the deadline. And then wonderful people like you who I’ve loved and admired said Oh, can I get on? I’m like, oh my god. Yes.
Dr. Justin Marchegiani: That’s great. That’s Yeah, very cool. So I urge everyone listening to subscribe to get access to that awesome info. So you have a website vibrant and blue oils? Yeah, you use a lot of oils that kind of help people promote healing relaxation. Can you give me like a top three lists that you use to kind of get that parasympathetic nervous response activated?
Jodi Cohen: Yeah. And I just want to back up the reason I found oils, um, I, my now ex has been attempted suicide and had to be hospitalized. And once I knew he was safe, and it wasn’t my job to keep him alive. I hit rock bottom, the kids were five and seven at the time, so it wasn’t super convenient to sleep all day. And I you know, I knew enough and it was my adrenals I kept trying to ingest remedies to help the adrenals and nothing was working. Um, a friend brought over oils, and I kind of made up a blend that I topically applied for the adrenals and it worked right away. And what I didn’t realize is chronic cortisol leads to inflammation of the gut. So my gut was so damaged, that nothing I was taking, like ingesting was really getting absorbed and assimilated. So that’s how I got into oils because I realized, oh, even if your gut is really messed up, you can still smell things you can still you know, we know that like nicotine patches or hormone creams go in through the skin. So that’s why I got started in oils. And then I started realizing because I’ve been in clinical practice. The blind spots, you know, if someone is deficient in vitamin D, that’s easy. You can supplement with vitamin B, if they’re stuck in parasympathetic or a second sympathetic, that was hard, you know, in a lot of the remedy is that, you know, you can teach people to breathe or meditate people, that’s hard. It’s not like an instant skill, you can say splash your face with freezing water, you know, which causes the blood flow to come to warm it up. People don’t like it either. It’s uncomfortable. They didn’t like gagging cells with a tongue depressor. But what I realized because the anatomy of the vagus nerve, as you said, it starts at the back of the head. And then it splits and whines around both sides. And it’s actually most accessible and the thickest, kind of right here. Like if you touch behind your earlobe, on your master bone. It’s like the width of a piano court there, you know, and it’s smaller and other places. So that’s why they actually do this kind of surgery, it’s a little bit like a pacemaker surgery. And they implant an electrical device here, and then a battery down below me, it’s pretty invasive. But you can use oils, oils are super stimulatory like clove, which has a million other benefits. And then lime has really small molecules, it’s kind of like, you know, when you combine colors, you can take blue and red, put them together and you get purple, which is different than you can add white and make it lavender. You know, you can combine oils, and it kind of draws the best from both of them. So I created this blend, parasympathetic, that’s clothing line. And what’s super cool is, you know, you might not be able to deep breathe, you might struggle with meditation and fall asleep, but you can dab a little thing right here, you can carry this in your purse, this is a really easy thing to comply with. And then you feel better. You’re like, Okay, I’m not constipated. Okay, my I don’t feel bloated. Okay, I feel a little bit like calmer and less anxious. You know, and, as you know, like the supplements that people know, help them, like they feel less tired. They’re really good at compliance. Once you figure out this is working for me, you’re all in.
Dr. Justin Marchegiani: And it’s a good replacement. For some people, they’re they’re already used to like reaching for a medication, well, let’s try something a little bit more natural. That’s going to have a good benefit. It’s not going to have the side effects. And it’s the least you know, good step to other healthy things. I imagine. Yes. What you’re doing oils, you’re probably now thinking about the food you’re eating and other Yes, your habits too. So it kind of creates an awareness, I imagine as well.
Jodi Cohen: Yeah, and definitely that cascade. Yeah. You know, it’s like crawl before you walk, walk before you run. Yeah. Once you’re like, Okay, I did that, like I used to in yoga. You know, sometimes these teachers would be so sneaky and suddenly you’re doing like a handstand or headstand. And you’re like, had no idea I could do that. What else can I do?
Dr. Justin Marchegiani: Right? That’s awesome. Very cool. Yeah, you have that parasympathetic lead, I think you say clove and lime. Is that true?
Jodi Cohen: Yeah. Yeah.
Dr. Justin Marchegiani: I would think like, you’d have maybe like a lavender or something like that. I’m just curious what your –
Jodi Cohen: Well, you know, originally, no, no, and a lot of people that’s a great question. Originally, I was thinking like, Oh, it’s parasympathetic. It should be sedated. You know, when oils like lavender Kammen meal. No, we know that they’re all relaxing, you know, frankincense, even the resins? Yeah, um, but I realized that what it is, is you need to stimulate it. It’s kind of like, if you think about, you know, the old cars, we actually have to manually shift gears is to do something active and energizing to kind of change lanes. So this stimulates the vagus nerve, and in stimulating it, it’s like, oh, you know, I’m switching gears.
Dr. Justin Marchegiani: And you’re using that access point, with the nerves a little bit more superficial and more Yes, to get access to it.
Jodi Cohen: Exactly, exactly. And the other cool thing is, um, you know, there’s a researcher out of tufts Michael Vanek, or talks about the vagus nerve infection hypothesis. And basically, it’s this idea that the vagus nerve has such a broad depth and you know, it gets into your system everywhere. So any kind of small minor infection can basically the body can pick it up as you’re infected, and it goes into like cell danger response or sickness response. So you get tired so you don’t move chronic fatigue syndrome, you have pain so you don’t move fibromyalgia. A lot of these things can be traced to an infection in the Vegas nerve and the most likely one of the doctors on the summit, Marco Rubio, he did this extensive research where he was taking ultrasounds of people’s necks, and he was finding that often the Vegas nerve was infected there because, you know, we have all these toxins in our mouth that drain out and you know, and they’re exacerbated if you have like metal amalgams or any kind of cavitation you know, that has been compromised your root canal. So think about, you know, congestion point a bottleneck. You have toxins draining along the trigeminal nerve, they intersect with the Vegas nerve, you know, the neck has the structure of the limb, the blood vessels, the nerves, you know, any kind of compromise if you know as a chiropractor if things Aren’t flowing that can get congested. So the toxins accumulate here. clove actually has, it has this constituent called eugenol. And it’s been used in dentistry for years because it does two things. It numbs the pain and it actually helps to address the underlying toxins. So if there is a toxicity or an infection, that’s, you know, think of it like you’re on an airplane, right? If you’re in a row of seats, and you’re in the middle row, and the people on either side of you are not petite people, you’re not getting that armrest, you know, you’re really compressed and congested. So if the Vegas nerve is congested, it’s bumping into the vascular system, you’re not getting the blood flow, it’s bumping into the lymph, you’re not getting the drainage. So anything you can do and Dr. Russo actually walks you through step by step, how they started to, you know, topically apply remedies to cause less congestion in the lymph and all of a sudden the Vegas nerve. You can see it in the pictures. It’s kind of amazing. What kind of evidence was he doing his trials. He was using Christine sharpeners, he created their Sophia flow cream, which is a combination of essential oils and then other remedies. But what’s interesting is that most people don’t think about topically, you know, most people are kind of like have lymphie need to dry better shirt rebounder, you know that we don’t really have anything for that. But we do. It’s these topically applied remedies, we actually have a limp oil. It’s a lot of menten and things that kind of help open up vasculature and drainage. And she uses some oils in her product too. They’re both good, right? You know, it’s kinda like you get out there, right? Yeah, exactly.
Dr. Justin Marchegiani: There’s a lot of ways you can skin a cat so to speak. Did you choose those oils? Was it your own clinical experience? Was it research that you saw? How did that?
Jodi Cohen: Yeah, that’s a good question. So the reason I got into nutrition was my own squirmy kid. You know, my first kid was super easy. I just assumed I was this great. Mom had another 120 minutes later.
Dr. Justin Marchegiani: I’ve seen that having two kids now I know exactly what you’re talking about.
Jodi Cohen: Yeah. And he was just wild, a wild child. Like I really thought, like, you know, like, you have the parenting baby proof people come to your house. And they’re like, and here’s this oven lock, because some kids climb in the oven, you know, and with my first one is like, no, no kid, kid climbs in the oven. Oh, number two, you just like that, that I had that kid that did those things. And a friend noticed that he was being really well behaved. And then another mom handed out like a Ritz cracker and he Jekyll Hyde. And she said, You know, my brother was on Ritalin his whole life. And it turns out, he was just allergic to weird foods, you should check that out. I thought, I’ve done everything else, I can certainly do that. And we took them to nutritionist. She said he’s really sensitive to corn, soy and dairy. So we changed his diet. And we had a different kid the next day. Wow. Yeah. Yeah. And I was like, how did I not know this? So I went back and got a degree in nutrition was trying to work with other screaming kids. And I mean, you know, like, if they can’t, if they’re wiggling all over it, it’s really hard to like, assess them. So I learned this technique called muscle testing, that’s a really good way to kind of ask the body questions, and it’s what I was doing in my practice to help identify what remedies were good for kids. And so when I first got introduced to oils, I was really, I have never been at this kind of rock bottom, like just so mentally and physically exhausted, like literally getting up to do anything felt like a strain. So, you know, someone gave me this box, and I’m so drained, I’m like, all right, I can muscle test. So basically, it’s intuition I muscle test I, every we have a blueprint in the body, right? There’s a blueprint for what healthy adrenal tissue is supposed to look like. And sometimes you do things and you don’t really realize that’s what you’re doing. That’s what I’ve been doing my practice the whole time is kind of identifying what organisms stress, and then using supplements to help return that organ to balance so it would function well. And so that was kind of the lens that I was looking through when I was making these formulas. So I was like, Alright, what what combination, you know, we humans have a blueprint. And plants also have blueprints. And humans and plants are bio familiar. So we share similar blueprints. So kind of like you can combine different colors to you know, match a picture in a landscape, you can combine different oils to match the blueprint of a healthy organ. So I was using intuition to come up with the formulation, you know, for a start, kind of identify this needs to be in it. And then I would play with what you know, 10% of this 20% of this, the different variables and then I have a team of people that kind of help me test it, and they test and then they can kind of mentally say like you We increase, you know, the Roman kameel from, you know, 12% to 13. So we’re just constantly refining and tweaking it. And then I go and I research, you know, okay, why? Why does balsam of Peru, which is a resin that’s drawn from these plants in you know, the Amazon in Peru and Brazil seem to help with sleep? What chemical constituents are present in this plant? Why is it working? And I would every single time be like, Oh, that makes complete sense. Why this is helping. And so that’s, that’s my process. It’s a little bit nutty, but it always seems to work.
Dr. Justin Marchegiani: Interesting. And you know, I also, I’m just curious, though, with your son, what were the oils that really helped because one thing I like about oils with kids, is some kids don’t want to swallow stuff. And they may be something in reverse, right? So it’s hard to get them to do stuff. So you can kind of covertly put some on your fingers rub their behind their ears and kind of get it in their bloodstream. So I like that what oils that you found were the best on on Macs.
Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here really excited to have a awesome podcast guest today Jody Cohen is going to be talking about the parasympathetic summit, which is going to be all about how to promote parasympathetic nervous system, which is about helping your body heal and improve. Jody, welcome to the podcast.
Jodi Cohen: Oh, my God, so honored to be here. Thank you. And I feel like the timing is perfect. For people who don’t really know what parasympathetic is your nervous system, your autonomic nervous system, which controls your automatic functions like breathing, heart re digestion, immunity has kind of two gears, when your body thinks there’s danger and it has to survive, it presses the gas pedal, and kind of routes all of your blood flow and your oxygen to your arms and your legs so that you can either fight back or flee. And then the danger passes, and you hit the brakes, which is the parasympathetic, and everything returns to normal. And it’s kind of like cleaning up after the party, right? You can digest your food, blood flow routes back to your digestion. And what happens especially now when we’re so anxious, you know, anticipatory stress makes the body think it’s in danger, we kind of get stuck in the wrong gear. And so all of those maintenance cleanup health functions, kind of get put on the back burner. And if they stay on the back burner forever, your health kind of suffers.
Dr. Justin Marchegiani: People talk about the parasympathetic nervous system, a lot of times that’s connected to the vagus nerve, correct?
Jodi Cohen: Yes, exactly. Your Vegas nerve is really the gearshift between that fight or flight, sympathetic state and the rest and digest parasympathetic state.
Dr. Justin Marchegiani: Yeah, and the Vegas that that terminology means the wanderer, so it’s the nerve that goes from the brainstem and kind of wanders down and it hits all of the, the organs like you talked about a lot of digestive impacts regarding the parasympathetic because we need good HCl and enzyme so like to be able to get access to all of those nutrients. And to break all your proteins and fats and antioxidants down, we need good digestive support and getting into the parasympathetics helps that.
Jodi Cohen: Yeah, I could actually the Vegas nerve wanders through every organ of digestion. So it triggers your mouth to release saliva, which helps start to break down those proteins so that they’re better absorbed and your stomach releases hydrochloric acid, it helps the pancreas release digestive enzymes, the gallbladder release bile. And then the most important thing that people don’t know is it kind of helps with the motility wave. Think of it as kind of like, you know, the moving walkway that goes through your system and make sure that things don’t stay too long in your gut and cause like cebo, or, you know, IBS or any problems, you know, and also make sure that you don’t get constipated, so that things leave, so that when you’re kind of stuck in fight or flight sympathetic dominance, all you know that the moving walkway doesn’t go and that’s when problems occur.
Dr. Justin Marchegiani: So anyone listening to this right now, if you’re liking what you’re hearing, make sure you click down below, we’re gonna put a link for the parasympathetic summit right down below, so make sure you subscribe. I was part of that summit along with a 30 other-
Jodi Cohen: I know, I know. I can’t. Well, you know what it is I am anxious. And so I started really early. And so I had almost everything done a month before the deadline. And then wonderful people like you who I’ve loved and admired said Oh, can I get on? I’m like, oh my god. Yes.
Dr. Justin Marchegiani: That’s great. That’s Yeah, very cool. So I urge everyone listening to subscribe to get access to that awesome info. So you have a website vibrant and blue oils? Yeah, you use a lot of oils that kind of help people promote healing relaxation. Can you give me like a top three lists that you use to kind of get that parasympathetic nervous response activated?
Jodi Cohen: Yeah. And I just want to back up the reason I found oils, um, I, my now ex has been attempted suicide and had to be hospitalized. And once I knew he was safe, and it wasn’t my job to keep him alive. I hit rock bottom, the kids were five and seven at the time, so it wasn’t super convenient to sleep all day. And I you know, I knew enough and it was my adrenals I kept trying to ingest remedies to help the adrenals and nothing was working. Um, a friend brought over oils, and I kind of made up a blend that I topically applied for the adrenals and it worked right away. And what I didn’t realize is chronic cortisol leads to inflammation of the gut. So my gut was so damaged, that nothing I was taking, like ingesting was really getting absorbed and assimilated. So that’s how I got into oils because I realized, oh, even if your gut is really messed up, you can still smell things you can still you know, we know that like nicotine patches or hormone creams go in through the skin. So that’s why I got started in oils. And then I started realizing because I’ve been in clinical practice The blind spots, you know, if someone’s deficient in vitamin D, that’s easy. You can supplement with vitamin B, if they’re stuck in parasympathetic or a second sympathetic, that was hard, you know, in a lot of the remedy is that, you know, you can teach people to breathe or meditate people, that’s hard. It’s not like an instant skill, you can say splash your face with freezing water, you know, which causes the blood flow to come to warm it up. People don’t like it either. It’s uncomfortable. They didn’t like gagging cells with a tongue depressor. But what I realized because the anatomy of the vagus nerve, as you said, it starts at the back of the head. And then it splits and whines around both sides. And it’s actually most accessible and the thickest, kind of right here. Like if you touch behind your earlobe, on your master bone. It’s like the width of a piano court there, you know, and it’s smaller and other places. So that’s why they actually do this kind of surgery, it’s a little bit like a pacemaker surgery. And they implant an electrical device here, and then a battery down below me, it’s pretty invasive. But you can use oils, oils are super stimulatory like clove, which has a million other benefits. And then lime has really small molecules, it’s kind of like, you know, when you combine colors, you can take blue and red, put them together and you get purple, which is different than you can add white and make it lavender. You know, you can combine oils, and it kind of draws the best from both of them. So I created this blend, parasympathetic, that’s clothing line. And what’s super cool is, you know, you might not be able to deep breathe, you might struggle with meditation and fall asleep, but you can dab a little thing right here, you can carry this in your purse, this is a really easy thing to comply with. And then you feel better. You’re like, Okay, I’m not constipated. Okay, my I don’t feel bloated. Okay, I feel a little bit like calmer and less anxious. You know, and, as you know, like the supplements that people know, help them, like they feel less tired. They’re really good at compliance. Once you figure out this is working for me, you’re all in.
Dr. Justin Marchegiani: And it’s a good replacement. For some people, they’re they’re already used to like reaching for a medication, well, let’s try something a little bit more natural. That’s going to have a good benefit. It’s not going to have the side effects. And it’s the least you know, good step to other healthy things. I imagine. Yes. What you’re doing oils, you’re probably now thinking about the food you’re eating and other Yes, your habits too. So it kind of creates an awareness, I imagine as well.
Jodi Cohen: Yeah, and definitely that cascade. Yeah. You know, it’s like crawl before you walk, walk before you run. Yeah. Once you’re like, Okay, I did that, like I used to in yoga. You know, sometimes these teachers would be so sneaky and suddenly you’re doing like a handstand or headstand. And you’re like, had no idea I could do that. What else can I do?
Dr. Justin Marchegiani: Right? That’s awesome. Very cool. Yeah, you have that parasympathetic lead, I think you say clove and lime. Is that true.
Jodi Cohen: Yeah. Yeah.
Dr. Justin Marchegiani: I would think like, you’d have maybe like a lavender or something like that. I’m just curious what your –
Jodi Cohen: Well, you know, originally, no, no, and a lot of people that’s a great question. Originally, I was thinking like, Oh, it’s parasympathetic. It should be sedated. You know, when oils like lavender Kammen meal. No, we know that they’re all relaxing, you know, frankincense, even the resins? Yeah, um, but I realized that what it is, is you need to stimulate it. It’s kind of like, if you think about, you know, the old cars, we actually have to manually shift gears is to do something active and energizing to kind of change lanes. So this stimulates the vagus nerve, and in stimulating it, it’s like, oh, you know, I’m switching gears.
Dr. Justin Marchegiani: And you’re using that access point, with the nerves a little bit more superficial and more Yes, to get access to it.
Jodi Cohen: Exactly, exactly. And the other cool thing is, um, you know, there’s a researcher out of tufts Michael Vanek, or talks about the vagus nerve infection hypothesis. And basically, it’s this idea that the vagus nerve has such a broad depth and you know, it gets into your system everywhere. So any kind of small minor infection can basically the body can pick it up as you’re infected, and it goes into like cell danger response or sickness response. So you get tired so you don’t move chronic fatigue syndrome, you have pain so you don’t move fibromyalgia. A lot of these things can be traced to an infection in the Vegas nerve and the most likely one of the doctors on the summit, Marco Rubio, he did this extensive research where he was taking ultrasounds of people’s necks, and he was finding that often the Vegas nerve was infected there because, you know, we have all these toxins in our mouth that drain out and you know, and they’re exacerbated if you have like metal amalgams or any kind of cavitation you know, that has been compromised your root canal. So think about, you know, congestion point a bottleneck. You have toxins draining along the trigeminal nerve, they intersect with the Vegas nerve, you know, the neck has the structure of the limb, the blood vessels, the nerves, you know, any kind of compromise if you know as a chiropractor if things Aren’t flowing that can get congested. So the toxins accumulate here. clove actually has, it has this constituent called eugenol. And it’s been used in dentistry for years because it does two things. It numbs the pain and it actually helps to address the underlying toxins. So if there is a toxicity or an infection, that’s, you know, think of it like you’re on an airplane, right? If you’re in a row of seats, and you’re in the middle row, and the people on either side of you are not petite people, you’re not getting that armrest, you know, you’re really compressed and congested. So if the Vegas nerve is congested, it’s bumping into the vascular system, you’re not getting the blood flow, it’s bumping into the lymph, you’re not getting the drainage. So anything you can do and Dr. Russo actually walks you through step by step, how they started to, you know, topically apply remedies to cause less congestion in the lymph and all of a sudden the Vegas nerve. You can see it in the pictures. It’s kind of amazing. What kind of evidence was he doing his trials. He was using Christine sharpeners, he created their Sophia flow cream, which is a combination of essential oils and then other remedies. But what’s interesting is that most people don’t think about topically, you know, most people are kind of like have lymphie need to dry better shirt rebounder, you know that we don’t really have anything for that. But we do. It’s these topically applied remedies, we actually have a limp oil. It’s a lot of menten and things that kind of help open up vasculature and drainage. And she uses some oils in her product too. They’re both good, right? You know, it’s kinda like you get out there, right? Yeah, exactly.
Dr. Justin Marchegiani: There’s a lot of ways you can skin a cat so to speak. Did you choose those oils? Was it your own clinical experience? Was it research that you saw? How did that?
Jodi Cohen: Yeah, that’s a good question. So the reason I got into nutrition was my own squirmy kid. You know, my first kid was super easy. I just assumed I was this great. Mom had another 120 minutes later.
Dr. Justin Marchegiani: I’ve seen that having two kids now I know exactly what you’re talking about.
Jodi Cohen: Yeah. And he was just wild, a wild child. Like I really thought, like, you know, like, you have the parenting baby proof people come to your house. And they’re like, and here’s this oven lock, because some kids climb in the oven, you know, and with my first one is like, no, no kid, kid climbs in the oven. Oh, number two, you just like that, that I had that kid that did those things. And a friend noticed that he was being really well behaved. And then another mom handed out like a Ritz cracker and he Jekyll Hyde. And she said, You know, my brother was on Ritalin his whole life. And it turns out, he was just allergic to weird foods, you should check that out. I thought, I’ve done everything else, I can certainly do that. And we took them to nutritionist. She said he’s really sensitive to corn, soy and dairy. So we changed his diet. And we had a different kid the next day. Wow. Yeah. Yeah. And I was like, how did I not know this? So I went back and got a degree in nutrition was trying to work with other screaming kids. And I mean, you know, like, if they can’t, if they’re wiggling all over it, it’s really hard to like, assess them. So I learned this technique called muscle testing, that’s a really good way to kind of ask the body questions, and it’s what I was doing in my practice to help identify what remedies were good for kids. And so when I first got introduced to oils, I was really, I have never been at this kind of rock bottom, like just so mentally and physically exhausted, like literally getting up to do anything felt like a strain. So, you know, someone gave me this box, and I’m so drained, I’m like, all right, I can muscle test. So basically, it’s intuition I muscle test I, every we have a blueprint in the body, right? There’s a blueprint for what healthy adrenal tissue is supposed to look like. And sometimes you do things and you don’t really realize that’s what you’re doing. That’s what I’ve been doing my practice the whole time is kind of identifying what organisms stress, and then using supplements to help return that organ to balance so it would function well. And so that was kind of the lens that I was looking through when I was making these formulas. So I was like, Alright, what what combination, you know, we humans have a blueprint. And plants also have blueprints. And humans and plants are bio familiar. So we share similar blueprints. So kind of like you can combine different colors to you know, match a picture in a landscape, you can combine different oils to match the blueprint of a healthy organ. So I was using intuition to come up with the formulation, you know, for a start, kind of identify this needs to be in it. And then I would play with what you know, 10% of this 20% of this, the different variables and then I have a team of people that kind of help me test it, and they test and then they can kind of mentally say like you We increase, you know, the Roman kameel from, you know, 12% to 13. So we’re just constantly refining and tweaking it. And then I go and I research, you know, okay, why? Why does balsam of Peru, which is a resin that’s drawn from these plants in you know, the Amazon in Peru and Brazil seem to help with sleep? What chemical constituents are present in this plant? Why is it working? And I would every single time be like, Oh, that makes complete sense. Why this is helping. And so that’s, that’s my process. It’s a little bit nutty, but it always seems to work.
Dr. Justin Marchegiani: Interesting. And you know, I also, I’m just curious, though, with your son, what were the oils that really helped because one thing I like about oils with kids, is some kids don’t want to swallow stuff. And they may be something in reverse, right? So it’s hard to get them to do stuff. So you can kind of covertly put some on your fingers rub their behind their ears and kind of get it in their bloodstream. So I like that what oils that you found were the best on on Macs.
Jodi Cohen: Yeah, so I definitely use parasympathetic. But you know, kids are so intuitive. Like, I think as we get older, we forget or we feel uncomfortable that you know, when the phone’s ringing, we somehow know it’s going to be our mother or, you know, we lose track of that. So with kids, I always kind of do a smell bar and I let them pick whatever they like best he loved orange. And orange is, you know, all of the citrus blends are really calming. And they also help with focus. And you know, a lot of them that are expensive, like Neroli and bergama. You know, those are kind of touted, but orange is super affordable, and kids love it. So he would like to smell that we’d have him do that before he did homework. You know, I give him a little foot rub before bed. But that was just I just let him pick it That was his favorite. But the ones that helped him the most. Definitely parasympathetic adrenal, because he’d get really wire you know, he was like a firecracker. He was always on. So just helping him to calm down. And then sometimes like liver because he, you know, he he inherited my ashkenazic liver, which is, you know, I think the reason that a lot of the traditional Jewish foods are like beets, borscht, chopped liver, you know, we eat all of the foods that we need so that our liver actually works because I think we have a little bit of a genetic detriment-
Dr. Justin Marchegiani: When you use that adrenal and liver, what would those oils be to support those organs?
Jodi Cohen: Yeah, I have it all listed out on my site. But and actually in the I have a book coming out in March of 2016, that I’m going to share the recipes because with COVID It breaks my heart, you know, you really can’t get anything into Australia these days. And it’s super hard to get things to Europe and I and India and I have these people that are like I think my, my poor husband could really benefit and I’m like, Oh my gosh, I’m just going to give out the recipe.
Dr. Justin Marchegiani: That’s March 2021. Right?
Jodi Cohen: March 2021, March 16. It’s an essential oils to boost the brain and heal the body.
Dr. Justin Marchegiani: Awesome. That’s great. So what else can people do? We talked about parasympathetics. Right. We know the adrenal plays a major role and different things. Obviously, food nutrition can help with that. What are some things clinically they use? Yeah, clients or on the oil side that you see adrenals.
Jodi Cohen: So Titus, two, who’s a colleague and a functional neurologist, which means that he is looking at what part of the brain You know, it was cute. At one point, I took my son to a functional neurologist, and he had all these little personality things that I thought were him, you know, like he couldn’t walk a straight line to save his life. He would like what diagonal Walker, he would always spill stuff on himself, he had no spatial awareness. And it turns out, his left brain was much more dominant than his right hemisphere of the brain. So we have Dr. Robert millio, who really talks about using oils to kind of balance the hemispheres. And to kind of a quick parasympathetic trick Titus two talks about how anxiety and panic attacks is over activation of your right frontal lobe. And so to kind of calm and balance that you then activate the left frontal lobe, and that puts the two hemispheres in balance. And functional neurologists use essential oils a lot in their practice, because your your nose, your olfactory nerve, you know, number one goes directly to you know, sometimes in the body, the right brain controls the left body, your olfactory channels go directly to this frontal part. Yeah, exactly. So you can just smell something, you know, it can be anything you like, it can be lavender, it can be orange, it can be parasympathetic, you know, you can actually like dry breathing, plug one nostril, smell through the left nostril, that activates the left frontal lobe balances the brain, you feel less anxious. I anxiety is my thing. My daughter’s thing too. I have panic attacks, I have all these things and that always helps you I basically, even if I’m walking my dog, this is in my pocket in case I need it. So that is my favorite quick fix.
Dr. Justin Marchegiani: What about high levels of cortisol? Obviously, high levels of cortisol can cause anxiety, right? So you mentioned maybe that plays a big role. Anything you do to help with the high adrenaline or high cortisol state? Yeah, add any like nutrients in to kind of be supportive to those oils.
Jodi Cohen: I mean, there are tons of nutrients that are helpful. And you know, if you’re able to digest like, there are a lot of adaptogenic herbs that I love, like ashwagandha rhodiola. But one thing that I’ve, I think that oils work like adaptogenic herbs, like one of the things, you know, I’ve done those 24 hour cortisol tests where you’re spitting in the tube. And what I found is that it’s not flatline. It’s not like my cortisol level is either too high all the time or too low all the time. You know, it’s too high at night when I’m trying to go to sleep and too low in the morning when I need energy. Exactly, exactly. Yeah. And you know, if you think about the nutrients that you can take the supplements, you kind of have to turn it right. You know, like, if you’re already too high, and you’re taking something that makes it higher, that’s not going to be such a positive experience. So with oils, we have two blends. One is the adrenal blend that just kind of evens you out. If you’re too high, it takes it down or too low brings you up, and then one for the hypothalamus. And this is something that most people don’t talk about, they just assume that all cortisol is related to the adrenals, not realizing that it’s a bit of a cascade, the hypothalamus, pituitary axis, your hypothalamus in your brain controls all your endocrine organs, it’s constantly reading the environment and signals in your body to figure out how do we return it to balance you know, like, when you’re driving, at one point, you might be a little too far to the left. So you just course correct, your hypothalamus is your course corrector. And it does that by sending chemical messages to kind of the COO, the one who executes your pituitary gland, which then sends message to your thyroid, your adrenals, all of your endocrine organs. So sometimes it’s called this negative feedback loop, the hypothalamus sends these messages out, then messages come back. And it kind of course, corrects, like, oh, we’re good on cortisol, we don’t need more. And if the, you know, the hypothalamus is kind of overwhelmed, you know, like, my friend likes to say you can’t move along when the house is on fire, you know, if there’s so much going on, it can be like your phone, and it just doesn’t get the right information and send things out. So we have a blend, it’s hard to get things into the brain. I mean, that’s the biggest challenge. And the biggest Aha, with oils, they’re super small and fat soluble. So they cross the blood brain barrier. So we have one, it contains pine, which has a lot of research on it, but you just put it right here. And it’s almost like it sends the right frequency, the right blueprint, whatever you want to call it, to return the hypothalamus to balance so that it’s then sending better messages to the adrenal so that you’re not so hyper cortisol or hyper cortisol.
Dr. Justin Marchegiani: That’s good. Excellent. Yeah. So you got your book coming out this March 16 2021, what’s the book gonna be called?
Jodi Cohen: It’s called “Essential Oils to Boost the Brain and Heal the Body.” And you can grab it on Amazon presale, Amazon pre sells anything, you know, you basically they match the best price ever. So if you if you’re a bargain shopper, and we’re actually going to have a gift card so that you can add a stocking stuffers so that if you want to buy the book, you know, we’ll send you a little coupon that you can put into the stocking with like a deal on getting an oil like parasympathetic to go with it. It’s great.
Dr. Justin Marchegiani: Yeah, and your favorite so far as what parasympathetic.
Jodi Cohen: I love parasympathetic. And honestly, with everything that’s going on, we have a blend called circulation that has a lot of Cyprus, I’ve found and a lot of clinicians have found like, if you’re concerned about getting sick, Cyprus does a really wonderful job of kind of protecting the lung lining. So, you know, they talk about this current concern, it kind of happens in two phases, right? It either gets into the lungs and the lungs lining a solid and it doesn’t go any further and it was a minor cold, or it gets into your system and causes a cytokine storm. So you kind of want to make sure that that bouncer at the gate of your lungs is really working well. And so the circulation oil, I just put over my lungs and also helps if I need to, I’m on deadline and I have to get something done. I put a little bit at the base of my skull, because that improves oxygen flow in the blood and when you have more blood and more oxygen flow, it’s easier to focus.
Dr. Justin Marchegiani: Love that. That’s awesome. Very cool. Well, any other clinical pearls so we have the parasympathetic summit, um, in that but other great speakers 50 Plus you said we’ll put the link down below so if you guys are loving it, click down below make sure you register. We also got the link for Jodi’s website, vibrantblueoils.com those are gonna be there for you as well. March 16 2021, we’ll get the book up there pre presale Amazon like anything else. Go you know, listen to the show. Listen with?
Jodi Cohen: You know what’s funny? Like we’re about to come into Thanksgiving, holiday gratitude. And the fastest way that you can shift yourself into parasympathetic is mindset and gratitude. So if you’re worried about what’s going on in the world, just focus on what you’re grateful for. It could be something as simple as the ability to move your body and to take a breath and to have you know, it’s a gorgeous day here in Seattle to have a sunny sky, you know? Yep. So, you know, I guess I would just like to leave on that. Note that how you choose to experience the world is in your control, and you can always be grateful for things.
Dr. Justin Marchegiani: I like it. Yeah. When you need the world to kind of conform to the things that you want, then you tend to be like, let down yeah. When you can basically put your focus on the things that you want to appreciate, right? Yeah, in the driver’s seat. So like, that’s definitely an empowering.
Jodi Cohen: Yes. Yes. You always get to be you always are in control of how you feel and how you think.
Dr. Justin Marchegiani: Well, thanks so much, Jody, head over to vibrantblueoils.com, parasympathetic summit links down below. Hope you guys enjoyed today’s podcast. Have a good one. Jodi, great chatting with you.
Jodi Cohen: Yeah, so I definitely use parasympathetic. But you know, kids are so intuitive. Like, I think as we get older, we forget or we feel uncomfortable that you know, when the phone’s ringing, we somehow know it’s going to be our mother or, you know, we lose track of that. So with kids, I always kind of do a smell bar and I let them pick whatever they like best he loved orange. And orange is, you know, all of the citrus blends are really calming. And they also help with focus. And you know, a lot of them that are expensive, like Neroli and bergama. You know, those are kind of touted, but orange is super affordable, and kids love it. So he would like to smell that we’d have him do that before he did homework. You know, I give him a little foot rub before bed. But that was just I just let him pick it That was his favorite. But the ones that helped him the most. Definitely parasympathetic adrenal, because he’d get really wire you know, he was like a firecracker. He was always on. So just helping him to calm down. And then sometimes like liver because he, you know, he he inherited my ashkenazic liver, which is, you know, I think the reason that a lot of the traditional Jewish foods are like beets, borscht, chopped liver, you know, we eat all of the foods that we need so that our liver actually works because I think we have a little bit of a genetic detriment-
Dr. Justin Marchegiani: When you use that adrenal and liver, what would those oils be to support those organs?
Jodi Cohen: Yeah, I have it all listed out on my site. But and actually in the I have a book coming out in March of 2016, that I’m going to share the recipes because with COVID It breaks my heart, you know, you really can’t get anything into Australia these days. And it’s super hard to get things to Europe and I and India and I have these people that are like I think my, my poor husband could really benefit and I’m like, Oh my gosh, I’m just going to give out the recipe.
Dr. Justin Marchegiani: That’s March 2021. Right?
Jodi Cohen: March 2021, March 16. It’s an essential oils to boost the brain and heal the body.
Dr. Justin Marchegiani: Awesome. That’s great. So what else can people do? We talked about parasympathetics. Right. We know the adrenal is play a major role and different things. Obviously, food nutrition can help with that. What are some things clinically they use? Yeah, clients or on the oil side that you see adrenals.
Jodi Cohen: So Titus, two, who’s a colleague and a functional neurologist, which means that he is looking at what part of the brain You know, it was cute. At one point, I took my son to a functional neurologist, and he had all these little personality things that I thought were him, you know, like he couldn’t walk a straight line to save his life. He would like what diagonal Walker, he would always spill stuff on himself, he had no spatial awareness. And it turns out, his left brain was much more dominant than his right hemisphere of the brain. So we have Dr. Robert millio, who really talks about using oils to kind of balance the hemispheres. And to kind of a quick parasympathetic trick Titus two talks about how anxiety and panic attacks is over activation of your right frontal lobe. And so to kind of calm and balance that you then activate the left frontal lobe, and that puts the two hemispheres in balance. And functional neurologists use essential oils a lot in their practice, because your your nose, your olfactory nerve, you know, number one goes directly to you know, sometimes in the body, the right brain controls the left body, your olfactory channels go directly to this frontal part. Yeah, exactly. So you can just smell something, you know, it can be anything you like, it can be lavender, it can be orange, it can be parasympathetic, you know, you can actually like dry breathing, plug one nostril, smell through the left nostril, that activates the left frontal lobe balances the brain, you feel less anxious. I anxiety is my thing. My daughter’s thing too. I have panic attacks, I have all these things and that always helps you I basically, even if I’m walking my dog, this is in my pocket in case I need it. So that is my favorite quick fix.
Dr. Justin Marchegiani: What about high levels of cortisol? Obviously, high levels of cortisol can cause anxiety, right? So you mentioned maybe that plays a big role. Anything you do to help with the high adrenaline or high cortisol state? Yeah, add any like nutrients in to kind of be supportive to those oils.
Jodi Cohen: I mean, there are tons of nutrients that are helpful. And you know, if you’re able to digest like, there are a lot of adaptogenic herbs that I love, like ashwagandha rhodiola. But one thing that I’ve, I think that oils work like adaptogenic herbs, like one of the things, you know, I’ve done those 24 hour cortisol tests where you’re spitting in the tube. And what I found is that it’s not flatline. It’s not like my cortisol level is either too high all the time or too low all the time. You know, it’s too high at night when I’m trying to go to sleep and too low in the morning when I need energy. Exactly, exactly. Yeah. And you know, if you think about the nutrients that you can take the supplements, you kind of have to turn it right. You know, like, if you’re already too high, and you’re taking something that makes it higher, that’s not going to be such a positive experience. So with oils, we have two blends. One is the adrenal blend that just kind of evens you out. If you’re too high, it takes it down or too low brings you up, and then one for the hypothalamus. And this is something that most people don’t talk about, they just assume that all cortisol is related to the adrenals, not realizing that it’s a bit of a cascade, the hypothalamus, pituitary axis, your hypothalamus in your brain controls all your endocrine organs, it’s constantly reading the environment and signals in your body to figure out how do we return it to balance you know, like, when you’re driving, at one point, you might be a little too far to the left. So you just course correct, your hypothalamus is your course corrector. And it does that by sending chemical messages to kind of the COO, the one who executes your pituitary gland, which then sends message to your thyroid, your adrenals, all of your endocrine organs. So sometimes it’s called this negative feedback loop, the hypothalamus sends these messages out, then messages come back. And it kind of course, corrects, like, oh, we’re good on cortisol, we don’t need more. And if the, you know, the hypothalamus is kind of overwhelmed, you know, like, my friend likes to say you can’t move along when the house is on fire, you know, if there’s so much going on, it can be like your phone, and it just doesn’t get the right information and send things out. So we have a blend, it’s hard to get things into the brain. I mean, that’s the biggest challenge. And the biggest Aha, with oils, they’re super small and fat soluble. So they cross the blood brain barrier. So we have one, it contains pine, which has a lot of research on it, but you just put it right here. And it’s almost like it sends the right frequency, the right blueprint, whatever you want to call it, to return the hypothalamus to balance so that it’s then sending better messages to the adrenal so that you’re not so hyper cortisol or hyper cortisol.
Dr. Justin Marchegiani: That’s good. Excellent. Yeah. So you got your book coming out this March 16 2021, what’s the book gonna be called?
Jodi Cohen: It’s called “Essential Oils to Boost the Brain and Heal the Body.” And you can grab it on Amazon presale, Amazon pre sells anything, you know, you basically they match the best price ever. So if you if you’re a bargain shopper, and we’re actually going to have a gift card so that you can add a stocking stuffers so that if you want to buy the book, you know, we’ll send you a little coupon that you can put into the stocking with like a deal on getting an oil like parasympathetic to go with it. It’s great.
Dr. Justin Marchegiani: Yeah, and your favorite so far as what parasympathetic.
Jodi Cohen: I love parasympathetic. And honestly, with everything that’s going on, we have a blend called circulation that has a lot of Cyprus, I’ve found and a lot of clinicians have found like, if you’re concerned about getting sick, Cyprus does a really wonderful job of kind of protecting the lung lining. So, you know, they talk about this current concern, it kind of happens in two phases, right? It either gets into the lungs and the lungs lining a solid and it doesn’t go any further and it was a minor cold, or it gets into your system and causes a cytokine storm. So you kind of want to make sure that that bouncer at the gate of your lungs is really working well. And so the circulation oil, I just put over my lungs and also helps if I need to, I’m on deadline and I have to get something done. I put a little bit at the base of my skull, because that improves oxygen flow in the blood and when you have more blood and more oxygen flow, it’s easier to focus.
Dr. Justin Marchegiani: Love that. That’s awesome. Very cool. Well, any other clinical pearls so we have the parasympathetic summit, um, in that but other great speakers 50 Plus you said we’ll put the link down below so if you guys are loving it, click down below make sure you register. We also got the link for Jodi’s website, vibrantblueoils.com those are gonna be there for you as well. March 16 2021, we’ll get the book up there pre presale Amazon like anything else. Go you know, listen to the show. Listen with?
Jodi Cohen: You know what’s funny? Like we’re about to come into Thanksgiving, holiday gratitude. And the fastest way that you can shift yourself into parasympathetic is mindset and gratitude. So if you’re worried about what’s going on in the world, just focus on what you’re grateful for. It could be something as simple as the ability to move your body and to take a breath and to have you know, it’s a gorgeous day here in Seattle to have a sunny sky, you know? Yep. So, you know, I guess I would just like to leave on that. Note that how you choose to experience the world is in your control, and you can always be grateful for things.
Dr. Justin Marchegiani: I like it. Yeah. When you need the world to kind of conform to the things that you want, then you tend to be like, let down yeah. When you can basically put your focus on the things that you want to appreciate, right? Yeah, in the driver’s seat. So like, that’s definitely an empowering.
Jodi Cohen: Yes. Yes. You always get to be you always are in control of how you feel and how you think.
Dr. Justin Marchegiani: Well, thanks so much, Jody, head over to vibrantblueoils.com, parasympathetic summit links down below. Hope you guys enjoyed today’s podcast. Have a good one. Jodi, great chatting with you.
References:
https://parasympatheticsummit.com
Audio Podcast:
The Best Bone Broth for Gut Health
By Dr. Justin Marchegiani
Bone broth seems to be all the rage these days, but what exactly is it about this bone juice that has everyone obsessed? Bone broth is so much more than a trendy drink: it has the power to aid in healing many modern issues, from leaky gut to wrinkles!
The Power of Bone Broth
What is Bone Broth?
Bone broth is made from animal bones, tendons, ligaments, marrow, skin, and other flexible connective tissues. In modern times these parts are usually discarded as they aren’t easily eaten on their own. However, when simmered in water for long periods of time, animal bones and tissues make a healing nutrient-dense elixir. The best bone broths are made from the parts of organic, grass-fed animals. To pack even more nutrient density, you can also add organic vegetables to turn bone broth into a flavor-packed sipping broth or use it as the base for a soup.
Bone Broth’s Secret Weapons: Collagen and Gelatin
The protein providing strength to animals’ (including humans!) bones, cartilage, and tendons is called collagen. When cooked, collagen turns into gelatin, a jello-like substance.
The best bone broths contain collagen and gelatin which provide your body with a host of immune-boosting properties, amino acids, and gut lining support to aid and heal many modern ailments.
Healing Benefits:
Bone broth is easily digested, unlike many other foods which can be hard to break down. But the real power of bone broth is that it is actually healing to the digestive system. It has been found to aid in cases of leaky gut, IBS, food allergies and sensitivities, and much more.
Collagen is a protein that forms the GI tract lining. Consuming the collagen and gelatin in bone broth helps heal the walls of the gut lining, preventing food and toxins from escaping and causing inflammation and other damage outside of the tract. This is major good news for those suffering from poor digestion and gut-related health issues (leaky gut, IBS, Crohn’s).
The collagen and gelatin from bone broth are also great for anti-aging effects. They keep the skin youthful by reducing wrinkles and improving elasticity, aid the growth of hair and nails, and strengthen your bones! Collagen also helps to reduce the appearance of cellulite over time.
Essential nutrients such as calcium, magnesium, potassium, sodium, phosphorus, and silica are all electrolytes in bone broth which keep you hydrated, help with bone health, and can reduce brain fog and fatigue.
The amino acids found in bone broth include glutamine, arginine, glycine, and cysteine, and proline. Together these amino acids offer a wide range of benefits, including:
- Skin elasticity
- Build up the walls of the intestines
- Aid in proper bile and stomach acid production
- Enhance the immune system
- Anti-inflammatory, reducing oxidative stress and autoimmunity
- Promote human growth hormone
- Liver detoxification support
- Generate glutathione
Where to Find Bone Broth
You can make bone broth yourself, at home! Below is my favorite recipe for cooking up a big batch of anti-aging bone broth. If you are someone who would prefer to purchase bone broth, or are looking for something easy to take on-the-go, I recommend Kettle & Fire bone broth. Kettle & Fire is the best bone broth I have found, and they use premium ingredients like 100% grass-fed bones, organic produce, and apple cider vinegar to create a delicious and nutritious product that is easy to heat up and sip, or use as a base for soups and other recipes! Bonus: it’s also paleo and keto friendly! You can check out Kettle & Fire bone broth here.
Takeaway
Bone broth is incredibly simple to make, especially when looking at the benefits reaped from consuming this healthy elixir. The collagen, gelatin, amino acids and minerals in collagen make bone broth an incredibly simple and powerful solution to create healthier joints, skin, bones, and gut. If you’re looking to try my favorite bone broth for both flavor and health benefits, click here.
Sources:
https://blog.kettleandfire.com/4-amazing-ways-collagen-bone-broth-heal-your-gut/
https://www.ncbi.nlm.nih.gov/pubmed/23949208
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358810/
Scaldaferri F1, Pizzoferrato M, Gerardi V, Lopetuso L, Gasbarrini A. The gut barrier: new acquisitions and therapeutic approaches. J Clin Gastroenterol. 2012 Oct;46 Suppl:S12-7.