The Top 5 Causes of Bloating | Podcast #364

Abdominal bloating occurs when the gastrointestinal (GI) tract is filled with air or gas. Most people describe bloating as feeling full, tight, or swollen abdomen. Your abdomen may also be swollen (distended), hard, and painful.

Dr. J and Evan describe that gas is the most common cause of bloating, especially after eating. Gas builds up in the digestive tract when undigested food gets broken down or when you swallow air. Everyone swallows air when they eat or drink.

On the other hand, they also talk about different components of why you may be having to bloat that you may not notice. Plus, available testing and lifestyle modifications you need.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:57 – The role of acid-pH level in the digestive system
5:01 – The link of depression and anxiety to bloating
10:02 – The benefits of probiotics and effects of stress to digestive health
18:17 – Functional medicine strategies and testing to find the root cause of bloating

Dr. Justin Marchegiani: Really excited to have a podcast today. We’re gonna be diving into a couple of different topics. The big one here is gonna be bloating – one of the big root causes of bloating. We’re gonna talk about it from a biochemical functional medicine perspective. Evan, how are you doing man? What’s going on brother?

Evan Brand: Doing pretty well, excited to dive in and talk about gut infections. I think that’s probably the first place to start because you and I have run thousands of urinary organic acids and genetic stool tests over the years. And years ago, you know, we used to use a three-day stool test. Now, with technology improvements, we could do a one-day one sample stool test and we can uncover so much. So, I’ll just kind of riff on things. I know we like to title things just for marketing purposes and call it top five but we may go into 15 by the time we’re done because just right off the top of my head here, high gut inflammation like how calprotectin may be an issue, low pancreatic enzyme function, bacterial overgrowth, where we’re gonna measure the dysbiosis, H. pylori infections, parasites, worms, specifically Clostridia and Candida can cause a lot of issues with bloating. So, in general, I would just say any gut infection but we can break that down as much as you want to. It could be a huge cause of bloating. And, the problem is this, when you go to a conventional medical doctor or a gastroenterologist and you get some sort of bloating remedy or some sort of digestive aid, maybe an acid blocker, antispasmodic medication. Obviously, these are not addressing these infections. You could take acid blockers for the rest of your life and never clear the H. pylori that’s driving the low stomach acid which then drives the fermentation in the gut which then drives the bloating. So, I just want people to have in their heads a clear mindset of what are you taking, is it actually fixing the problem, are you just masking your symptoms. And in the case of an acid blocker, you’re actually putting yourself deeper in the hole because you’re taking low stomach acid that’s driving heartburn or an infection and you’re making it worse.

Dr. Justin Marchegiani: 100%. So, you know, the first catalyst for good digestion is a nice low pH. That good acid pH, we need good hydrochloric acid to make that happen. So, we need essentially hydrogen ions to bind to chloride in our gut and so we need chloride from minerals. So, we need good minerals, good quality sea salt that helps make stomach acid on our own. Now, if we’re under a lot of stress and our adrenal glands are in stress overdrive, it could be cortisol high or low imbalances, as well as adrenaline issues, right? It could be high or low cortisol stress issues that could put us in a fight or flight state and that sympathetic nervous system stimulus is gonna negatively impact our body’s ability to start with making stomach acid and digestive secretions and of course that stomach acid is almost like an antimicrobial. Think of like using lemon or apple cider vinegar is a natural cleaner right. They recommend these online. You can make natural cleaners usually some kind of acid as the foundation of the formula because acids are antimicrobial and so think of acids in your intestinal tract as being antimicrobial. They also, some kind of help tighten the sphincter, the esophageal sphincter from the stomach into the esophagus. It gets tightened with good acidity and so part of the reason why we get bloating and a lot of these gases rise up to the esophagus is inadequate levels of acidity and that keeps the esophagus open and then what happens when that esophagus is open over time, the fermentation acids that occur can actually, eventually irritate the bottom of the esophagus because we didn’t have enough acids to trigger that good closure in the beginning.

Evan Brand: Yeah. Yeah. So, then you’ll get these, what are called silent reflux issues sometimes it’s called GERD. And once again, prescription drugs are what’s the common remedy but once again it’s not the root cause. It may reduce the symptoms because if you have that backwash it’s gonna help slow the backwash down but it’s not gonna fix the sphincter so we might come in with extra betaine hydrochloric acid or if you’re extremely inflamed which is that someone can’t tolerate a low dose of it but then we could do something like apple cider vinegar with a meal sometimes bitters. I personally don’t do bitters, I just do HCl and enzymes.

Dr. Justin Marchegiani: Yeah. We can always test it with ginger. We can always test it with an acid like lemon, lime, or apple cider vinegar, start with a teaspoon of that and mix in a couple ounces of water and then kind of work our way up from there. So, acidity is a really important first step. Of course, if we have inefficient, um, inefficient acidity levels we can almost guarantee, we’re probably gonna have poor enzyme levels and probably gonna have poor bile acid levels, right? Bile acids are important because they help break down fat and bile acids are also slightly acidic, right, in the name of bile acid and it’s also antimicrobial. So, just like we talked about the acids having an antimicrobial benefit on the HCl side, also, bile acids have an antimicrobial benefit. We see in SIBO, a hallmark of SIBO is bile aids insufficiency and so with SIBO we don’t have enough acids there on the bile side so then we have a hard time breaking down fat and then a lot of times that fat will create indigestion, petrification because it’s not being broken down. Now, when we run certain stool tests, we’ll see increases in a metabolite called steatocrit, which is a breakdown of the fat that means it’s not being broken down in the stomach. It’s coming out at higher levels which means we’re not breaking it down. So, steatocrit is a big deal because steatocrit, if we don’t have good fat digestion, we probably have some protein digestion issues, we probably have some enzyme and acid issues and we probably have, um, some gas issues, bloating issues because these things require good digestion and if they’re not being broken down well, we’re probably getting some methane or hydrogen gases kind of rising up from that.

Evan Brand: And you know, we’re taking on the subject of bloating but it’s very common that someone with these issues you’re describing, they’re also gonna have issues with energy and probably mood like anxiety and depression because you’re mentioning this issue with fat digestion, protein digestion. Now, you’re not gonna get the aminos that you need to fuel your neurotransmitter so it’s very rare that somebody’s gonna come to us and say, hey I’m just bloated and I have nothing else. Usually, along with that bloating, you’re gonna have these tangential symptoms too like anxiety, depression, fatigue, and so I encourage people, you can focus on one smoking gun like bloating as your big thing you’re coming in for but you gonna make sure you understand there’s a bigger, deeper connection to your mood issues too. So, this is the person who’s on break, uh, someone just commented about severe brain fog. We could hit that too, uh, but somebody might come in and say, hey I’m bloated and then you tease apart their case and you go, oh so you’re actually anxious too. You’re on antidepressant and an acid blocker and this happens every day, all day. So, just to clarify, number one, we hit a low stomach or we hit infections first. Number 2, low stomach acidity, you mentioned low bile in the gallbladder. Also, let’s give a shout out to people that don’t have a gallbladder, what about these poor people, they’re gonna need a lot of supplemental help for the rest of their life. And so, unfortunately, this is a very very common procedure done in the U.S., where the gallbladders are removed and so these people are gonna need some purified bile salts forever in my opinion. Well, what’s your…?

Dr. Justin Marchegiani: Absolutely! They’re definitely gonna need bile salts and some extra enzymes like lipase but again, you gotta get to the reason why that gallbladder issue even happened. Now, most people, it’s women in their 40s who have an overweight issue and so what tends to be driving, that is usually food allergens whether it’s grains or inflammatory foods but also estrogen dominance. So, if you have an imbalance in estrogen, estrogen is gonna help promote more fat storage so you obviously have more estrogen more fat storage. A lot of times you’re gonna have PMS issues too so you may be moody, irritable, um, sleep issues, uh, you could have fibrocystic issues, uh, tenderness, a lot of pain around PMS time. So, you gotta get to the root cause of that as well. So, we started out with just bloating but you can see how then this estrogen issue can affect bile levels and good bile flow because estrogen causes everything to get really stagnant and not flow well and then you’ll start having mood issues and PMS issues and maybe even fertility issues. So, you can see how you start at one point which is bloating, which is the topic of the video but then it can spiral down this other kind of tangential pathway.

Evan Brand: Yeah. Not to mention two, let’s just say it started out with heartburn, I just want people to kind of visualize this. So, let’s say it starts out with heartburn. You go to the target and you buy Prilosec, which is over the counter acid blocker medication, you reduce your stomach acid even more but you feel some relief from the heartburn and let’s say your spouse had H. pylori, you guys pass that between each other, so now you’ve got even more reduction of stomach acid levels, you’re on the acid blocking medication. Now, you’re anxious, you’re starting to get depressed, you’re getting a bit of fatigue. As you mentioned, now, you’re getting some hormonal issues, some hormonal issues like breast tenderness or PMS or ill ability, you’ve got this dysbiosis growing in your gut so you have this bacterial infection. It could be multiple things, Strep, Staph, Klebsiella, Pseudomonas, Bordetella. And now, you’ve got beta-glucuronidase issues. Now, you’re recirculating all this estrogen. You’re creating more problems with the gallbladder. Maybe, you get the gallbladder removed. Now, you’re in really big trouble then that leads to the diet so then you read some guy on the internet who says, you need to be doing 70 – 80% vegetables. So now, you’re doing all these veggies and you’re even more bloated and you’re even more gassy and you don’t know why. So, you’re eating broccoli, you’re trying to force all these leafy greens down, a lot of vegetables. Maybe, you’re doing a lot of avocados, these higher FODMAP foods that are fermenting in the gut. This is the case where you’ve got a really, to me, the best, most beneficial thing I’ve seen for these cases, get the diet very simple, focus on good quality animal proteins and for a time being minimize your vegetables so that you can let the gut rest.

Dr. Justin Marchegiani: Yeah. Absolutely. From a solution standpoint, yeah, good proteins, good fats and then if we’re gonna do vegetables, make sure they’re cooked steamed, sauteed, maybe use an instant pot and try to make sure they’re on the lower fermentable side. Now, that being said, next, what’s another driving factor of bloating? increase in fermentable vegetables. Now, people are hearing all kinds of things about probiotics being helpful. Well, they are. There’s a lot of good benefits to probiotics and the microbiome and the endogenous nutrients they produce. They, um, whether it’s vitamin K2, whether it’s different B vitamins, really helpful. It also produces acidity which helps keep a lot of bugs and bacteria from growing in the gut, totally helpful. Now, if you already have a lot of bacterial overgrowth and bad bugs growing, sometimes, these extra good bacteria can actually cause more bloating, more gas. And then, of course, because they’re fermentable they can also create histamine too. So, the histamine may create more brain fog or headaches, more destruction there. So, you may have more histamine symptoms, you may have motility issues because they’re producing hydrogen methane gases maybe and that may cause either diarrhea on one side or maybe more constipation on the other side, definitely possible.

Evan Brand: Yeah. Yeah. Good call on the histamine. And so, some of these bacteria on your gut, they’re gonna be releasing histamine too. So, if you’re combining high histamine foods, you’re doing leftovers, let’s say, last night, you made a steak, you’re cooking that leftover protein. That’s gonna be higher in histamine. Combined with the histamine being produced from this bacterial overgrowth problem, yeah, you mentioned brain fog, skin flushing, rashes. So, once again, here we are talking about bloating but we’re trying to elucidate this big spider web of other symptoms that may be going on.

Dr. Justin Marchegiani: Correct.

Evan Brand: Um, also, what about a stress component meaning someone just simply not chewing enough, they’re rushing through their meals. I think this from a mechanical perspective. If you look at your average person, I mean I saw somebody on the highway the other day, I don’t know if it was a donut, a piece of pizza, it was some kind of junk. I couldn’t tell exactly what it was but either way there’s still people trying to do makeup, scrolling on their smartphone, eating a piece of pizza, all while driving on the highway at the same time and we wonder why they have digestive problems. So, maybe we talk about the impact of not being settled when you are eating and this sort of like, this parasympathetic process that digestion is supposed to be our ancestors, they didn’t have that level of stimulation while they were trying to eat. I mean, maybe there was a wolf trying to come, get their bison killed but beyond that there wasn’t this big sympathetic stress underneath all of our meal times.

Dr. Justin Marchegiani: Yeah. We kind of started out the video talking about the parasympathetic-sympathetic balance and how important that is because the parasympathetic is part of that rest and digest that gets the digestive secretion going. It stimulates all the blood flow into the organs, the intestines. So, of course, setting really good boundaries for your meal, you know, I recommend kind of kind of go into a meal five times or ten minutes, just kind of relax, do some deep breathing, have some appreciate, appreciation about your day, the food in front of you, you know, just whatever blessings you have in your life, just try to really get to that parasympathetic state with just good breathing in the nose, right, four to five nasal breaths in and out. Focus on whatever’s good in your life, appreciation. Whatever you have to do, whatever kind of resonating prayer to put you in that state when you just feel better and then go into that meal keep it quiet or if you want to listen to something that kind of allows you to feel good and feel rested or relaxed, that’s fine. And then, go into that meal and make sure you chew your food really well. Try to avoid a lot of hydration with the food, you know, a couple of ounces of water for swallowing some pills or digestive support is fine but try to get into that meal, like, I just had to have a good routine. Get some good hydration ahead of time, try to go into some kind of meditation or prayer for five or ten minutes ahead of time to really get that parasympathetics going and then go into your meal and really just try to chew things up pretty well too, you know, about 30 chews per bite of food on the average, kind of get your food chewed up to about an oatmeal like consistency so it’s really broken down well that’s allow the enzymes and the acids to work a lot better too.

Evan Brand: Yeah. You know, what’s interesting is a lot of people are kind of pressure into these business meetings like with their boss or with their co-workers, there’s this like work-meeting-lunch deal where people are going out with people they probably wouldn’t associate with outside of the workplace and they’re going and eating with those people. And so, I would just tell you, if you don’t like it and that’s not your vibe, don’t do it. If you feel more comfortable, more relaxed eating by yourself, don’t do it. I mean, I remember, l had some stressful conversations over lunch and dinner tables before with people over the years and I leave feeling like I didn’t eat anything and that my mind was so focused on even if it wasn’t a negative conversation. If it was on some sort of business deal or the state of the world or something and then I’m eating. I would get up from the table. I’m like, oh crap, did I eat and I didn’t process that and it would sound maybe like unnecessary advice but I think a lot of people need to be picky of what they talk about it at the dinner table.

Dr. Justin Marchegiani: Yeah. I think anything that’s gonna keep you in that parasympathetic state is great, you know, save the more stressful things before or after and I think, also, just have good boundaries. Try to make sure you get at least 20 minutes for a meal, um, to yourself, you know, I mean, if you don’t have 20, if you can’t put 20 minutes in your schedule for you to consume some good food and put yourself in that parasympathetic state then you got some boundary issues and you got to really work on roping in your schedule and getting some control over it, at least so you have that 15-20 minute to yourself and you can really process that food well. And again, I’m not saying there won’t be some exceptions or some stressful days here or there but on average try to make sure 80 to 90% of the time, you really have control over your schedule to that degree.

Evan Brand: One of my favorite things to do even in the wintertime here, if I’ve got blue skies. I’m taking my shirt off, I’m going to sit on my front porch where I’ve got a nice comfy front porch patio chair and that chai is warmed up by the sun so I just take my shirt off sit there barefoot and in the chair and eat my bison burger for lunch and the sunlight is a mast cell stabilizer so I noticed the sun helps me if I have any kind of food reactions, the sun will stabilize that, obviously there’s nitric oxide benefits. There’s likely some nervous system benefits circadian rhythm benefits. So, for me, if you can get fresh air on your lunch that’s great and what the heck does sunshine have to do with bloating, well, I mean there’s even some studies on sunlight improving the diversity of your gut and we’re outside all the time now. So, if you just type in like sunlight microbiome, you can read the papers on this, it’s in a microbiology journal about how exposure to the UV rays can improve the gut diversity so it’s no surprise that all these people in offices buildings all day, they got poor diversity. Obviously from other things but lack of sunshine is a negative factor for your gut health.

Dr. Justin Marchegiani: Yep. Yeah. Absolutely. I mean, also, there’s other bugs that are out there I think we already kind of talked about H. pylori because that can affect the stomach and that can decrease, um, acid production and thus when acid production is down, we know enzyme production is also down and then that can also affect biliary function, biofunction, so we know H. pylori is a big thing. Other bugs can be problematic, right? We already mentioned SIBO, which could be a whole bunch of different bacteria that are overgrown in the small intestine that could be Citrobacter, Prevotella, Klebsiella, Pseudomonas, Morganella, right? It doesn’t really matter the actual bugs but if there’s an overgrowth there, they can definitely disrupt digestion creating different gases on the methane and hydrogen side and that can create obviously more bloat. Other parasites can cause problems too. So, we see things like Blasto, Blastocystis hominis, right? E. histo, D. fragilis, Giardia, Cryptosporidia, these are all other bugs that could be problematic. Then even things like fungal overgrowth like Candida overgrowth, whether it’s a Rhodotorula species, Albican species, these types of imbalances can cause problems. So, it’s good to test and really make sure that we look at the whole microbiome and see what’s out of balance or not and then from there food wise, I mean, of course, general refined sugar, refined grains, right? These processed foods, excess fiber, lots of raw vegetables, uh, fermentable carbohydrates, right? These things are gonna be on the list, as well. And so, we’ll kind of add those. There are a lot of different things that we have to look at so I kind of gave you the top five or six on this list. Anything else, um, Evan, you wanna add to it?

Evan Brand: Well, I would just say that if you’re coming into this conversation, you’re listening, maybe you don’t have much background and listening to people like you and I talk about functional medicine strategy. Some of this may just go right over your head. You may just tune out because you’re hearing these things which sound exotic and they sound rare, like H. pylori. I don’t have that. Giardia, what the heck is that? Blasto, though I don’t have that. You know, I just have bloating. The reality is these are very common things. The problem is the testing that’s used in the conventional gastroenterology world is very outdated and very insensitive, meaning there’s a lot of infections that go missed and even if these infections are tested for, it’s not likely that you’re gonna find an accurate result. And so, what we’re talking about, these are not rare situations, you and I, between us both, we’ve seen several thousand clients and patients across the world over the last decade and we can tell you that these issues are something we see every day, all day. So much so that in fact when I see a whole big list of infections on the stool test, I don’t get shocked by it. Yep. Uh-huh. That’s it. That’s what we’ve got. So, if you’re listening to this, you’re like, ‘man, that’s not me. I’m just bloated and tired.’ Well, there’s a reason for that. And so, I highly recommend you get tested, figure out what the heck you got, going on because if you’re not testing, you’re guessing and if you’re going and taking probiotics or random enzymes and you don’t feel better or you’re confused about what you should actually taking and not taking and you’re building up a supplement graveyard. It’s time for you to get tested and figure out what the heck you’re up against. And so, if you need help, you can reach out clinically, Dr. J is at justinhealth.com. you can reach out and do consults worldwide. So, we jump on a video call just like we’re doing here, Zoom, facetime, skype, we can look at your labs that you run at home and we can figure out what’s going on and make you – a game plan to get better. And if you need help for me, it’s Evan, evanbrand.com and either one of us, Dr. J, justinhealth.com, evanbrand.com, we’re here to help you and the cool thing is you can reverse these issues and you can get to a point where you don’t even recognize your gut health. I mean, if I look back at myself even 10 years ago, I had such severe IBS. I did every diet under the sun and I made some progress but it wasn’t until I looked at my gut that I really made the magic happen.

Dr. Justin Marchegiani: 100%. And so, just to kind of highlight a couple of things out of the gates, um, we’ll put some links below as well to some of the lab tests that we recommend, whether it’s the stool testing, whether it’s the organic acid testing which does look at bacterial and yeast metabolites. I love the organic acid because it’s very good at picking up Candida and yeast overgrowth, where a lot of times those tool testing will miss that and of course the, um, breath test will not touch any yeast overgrowth. So, it’s nice to have whether it’s stool test, whether it’s the GI map, whether it’s an organic acid, whether it’s a conventional lactulose, breath test, these are all good tests. We’ll put links down below. So, if you guys want to look at getting some of those to start out at the gates, you feel free, you can. Also, I like to compare and contrast like what we do versus the conventional gastroenterologist. So, most gastro docs, they’re just trying to rule out significant pathology, significant disease and so they may cross off the list by doing some kind of an endoscopy, which is camera down the mouth to look at inflammation in the stomach or esophagus and if they see esophagitis or gastritis, you know, what they’re going to do, they’re gonna recommend some type of PPI or Gaviscon or some type of a coding agent to kind of help reduce the inflammation but they’re not gonna really fix the root cause. Most of the time, they pull you off acids, which may be helpful in the short run but it’s forever altering your ability to break down protein or fat and it also can shift your bugs in a negative direction because now you don’t have the good acidity to keep the microbes down. You need the acidity to activate enzymes, you need the acidity to activate your bile salts. So, someone’s jumping in on the questions here saying that hey they feel better on keto but now they’re feeling more constipated. Yeah, super common because what’s happening is you’re cutting out a lot of the foods that are causing problems but you haven’t fixed your digestion, you don’t have enough acidity, enzymes, bile, there may be some bugs that are still impacting digestion and this is why being on good proteins and fats can be helpful but they also reveal weak links in your digestive chain if you’re not breaking down food well. So, just kind of getting back on the gastro doc kind of bandwagon, they’re gonna be looking at pathology inflammation in the stomach, you know, ruling out the big things like blood, um, in the ulceration in the stomach, you know, usually you’re gonna know that because you’re coughing it up but you’re seeing it in your stool. If you have irritable bowel disease symptoms like Crohn’s or ulcerative colitis, usually, you’re gonna have significant inflammation in the stomach, usually significant diarrhea, blood in the stool, they’re gonna rule that out and then what and then for the most part, once the big pathology things, ulcerations, cancer, massive amounts of inflammation are ruled out, they’re gonna typically give you like IBS diagnosis, whether it’s IBS-D for diarrhea or IBS-C for constipation and they’re gonna just manage whatever symptoms whether those symptoms are with different drugs. So, if it’s constipation, they’ll use laxatives. If it’s diarrhea, they’ll use things like Imodium or Pepto Bismol or anti-inflammatories. They’ll just modulate the symptoms with drugs and that’s it and they’re not gonna really get to the root cause. They’re gonna just try to spot the treat and then that’s where people come to us because overtime, those drugs will become less and less effective, you have more and more side effects, you’re not fixing digestion, you’re creating more nutritional deficiencies, maybe more gut permeability issues, maybe more autoimmune stuff and so these patients then come to us because they’re just tired of putting band-aids over band-aids.

Evan Brand: Yeah. Well said. I forgot to mention the endoscopic procedure that is super common, uh, they wanted to do that on me, years ago, when I had IBS and I denied that because I even back then I had read about these infections that people were acquiring from getting scoped meaning the last person that they put the tube down, they didn’t properly clean or sanitize that so then they stick it down your throat and then you leave the hospital just to investigate and as you said, the only thing that’s gonna come out to that is they may say gastritis which is super generic. It doesn’t tell you anything about these infections and they’re not gonna give you an herbal protocol to address the infection causing the gastritis. But now, you’ve left the hospital with Clostridia or some other possibly antibiotic resistant infection that’s involved to evade the sterilizing and cleaning procedures. So, I’m all about non-invasive, accurate, functional medicine testing and that’s why we love what we do because there’s a very rare, maybe one every five years, yeah, is there a case where I’m like yeah, you need an endoscopy because there’s something crazy here.

Dr. Justin Marchegiani: Yeah. Usually, with an endoscopy or colonoscopy which is gonna be going up the rectum to look in the colon. Usually, there’s gonna be blood in the stool, some type of significant inflammation, whether it’s excessive diarrhea, excessive inflammation, excessive blood in the stool, excessive weight loss. It has to be at the extreme ends for that to make sense. Most people just have inflammation and a lot of times the tests won’t kind of tell you enough about the root cause, they’re just gonna put you on medications to manage the symptoms and that’s where you’re kind of stuck in between. Now, a lot of my ulcerative colitis, IBD patients, they’ve already done that. Yeah, so then, it’s like all right, they’ve kind of already crossed that off their list any weird cancers, ulcers, it’s already done, they know, they’re just being managed with Lialda, Prednisone, a biologic and then it’s like, now what, right? And so, we still have to get to the root cause of that and get the immune system chilled out and figure out what stressors are there so we can get on top of that too.

Evan Brand: Yeah. I mean, I know you and I have seen countless emails being sent to us with pictures of colons and you know different things from these scopes like hey there’s my scope results, you know, what do you have to say about it and the answer is always the same. Okay, there’s something there, let’s work on the infections. And so, uh, yeah, someone in the chat, uh, shelly said, yes that they all recommended me, every time, I go to the doctor. So, yeah, that, I mean that’s all they’ve got, they don’t have the stuff that we’re using maybe in 20 years from now you can go right down the street and get done what we’re talking about but for now you’ve got to seek out somebody like us that’s gonna be able to help you, uh, there’s one person in the chat too asking about a viral impact on the gut, it’s real. I did a whole section of that in my better belly course about that virus in the gut and so it’s definitely a big factor.

Dr. Justin Marchegiani: Yeah, and just to kind of, uh, speak, kind of on the line here, so, um, we can, we don’t get censored, there’s certain viruses that are out there, right? There’s an ACE2 receptor site that gets impacted in these different viruses and the ACE2 receptor site, there are a lot of them in the gut and these receptor sites are really important for absorbing amino acids and so if you have any of these maybe chronic viral issues, one of the good things that you can do is actually extra free form amino acids to allow these receptor sites to absorb these amino acids easier, right? I think the free-form amino acids are already broken down. So, if you have this chronic immune stress and you’re having a hard time recovering from the immune stress adding in some additional free form amino acids can be very, very helpful on the healing side.

Evan Brand: Yeah. I’ve seen a lot and there’s papers on this too but I’ve seen it clinically too. People post viruses that will look at their stool, there’s gut inflammation, there’s low secretory IgA, so we can see there’s been some damage and so we have been able to resolve it. So, yeah, we’ll wrap this thing up but if you al need help, please reach out clinically, we mention the websites one more time, Dr. J, that’s justinhealth.com, me evanbrand.com and we’re here to help you guys, so you can reach out and we’ll get to the bottom of this.

Dr. Justin Marchegiani: And sometimes, we’ll even use some kind of an elemental diet with people that have chronic digestive issues just because it can be hard, breaking protein and fat down and these are really good, important nutrients but sometimes we just got to break it down for them and using some kind of an elemental or a modified elemental, where maybe you make the first four to six hours of the day, really easy to process in some kind of smoothie or shake that has most of the amino acids in free form, maybe the fats more easy to process like in an MCT oil or something like that and then we use a lot of the vitamins and minerals all broken down. That could be very helpful and give the digestive system a chance to rest and some people they notice this because they just feel really good when they fast and so if you fast and you feel really good that’s excellent but you’re still not fixing the problem of getting nutrients in the system so that’s where using some kind of an elemental type of shake can be really helpful.

Evan Brand: Yeah. Well said. Well, I’m done. I feel like we’ve covered a lot of good stuff here.

Dr. Justin Marchegiani: Excellent. Yeah. I mean someone asked one question about flour substitutes. It just depends on where someone’s at, so flour, it’s a processed food so out of the gates, if someone wants, um, like a starch, um, I recommend maybe a greener banana, maybe yucca, cassava, maybe a Kabocha, spaghetti squash. Just look at some of the fibers, uh, non-starch, I should say, more starchy carbohydrates that are gonna be grain-free, see how you do with that. And then, if you want an actual flour, you can look at it like an arrowroot or you can look at it like a cassava is pretty good because it’s still grain-free but it’s still gonna be on the processed side. So, ideally, try to keep it grain-free so you don’t have extra gluten sensitivity connection with those.

Evan Brand: Yeah. Definitely. That’s what I was gonna say too. Potatoes, rice, a lot of these things can still create problems for people. I’ve had many people feel like crap on some of these gluten-free breads. So, yeah, it’s still processed garbage in my opinion.

Dr. Justin Marchegiani: Yeah. And then, someone wrote in about the, um, the onions there. Onions are very high in FODMAPs and that can be a problem and so if you head, your gut feeling a lot better and you can come back in and you’re noticing FODMAPs are creeping into your diet and causing a lot more bleeding definitely kind of, you know, rain that back in and see how much that back in and see how much that kind of brings you back to homeostasis.

Evan Brand: Yeah. This person told, uh, they said that they’ve had similar issues with cabbage, brussels sprouts, and other similar veggies. So, yeah, I mean I would go more animal-based. See how you feel with just some meat and some berries for a little while. Maybe if you tolerate a little bit of some organic pecans, if you want to do a little bit of nuts but do like a bison burger and a handful of blueberries for lunch and see if you feel better. I suspect you will.

Dr. Justin Marchegiani: Yeah. At least, just try, you know, cutting out the higher FODMAP foods because when you address microbes, right? You starve it on one side with restricting certain foods that can feed it, you can kill it with certain herbals and then you crowd it out with probiotics. And so, sometimes, we have to go back to the killing side and kill the microbes out a little bit more but I always just see how much the starving kind of works. Get the starving going again and then if you have to kind of return to a protocol, where we knock down the microbes with herbs, we can always do that too.

Evan Brand: Yeah, and we’ve made these protocols a lot. It’s really fun to combine and mix and match and get the synergistic effect of this herb plus that herb. I mean, that’s where the magic really happens and there is an art to this too like you said when to cycle things on when to cycle them off, so there’s not just this one cookie cutter thing that you have to do. You really got to just work with the person. Certain herbs are used for certain parasites, certain ones we use for bacteria, certain ones we use for fungus. It depends on what you got, most of the time it’s a combination of all these bugs.

Dr. Justin Marchegiani: Awesome. Hey, Evan, great podcast today. Hope everyone at home listening enjoyed it. Feel free to share with friends or family. Put your comments down below. Let me know what things that you guys have tried at home that have worked well or haven’t. Really appreciate the conversation. Evan, have an awesome day man.

Evan Brand: You too, take it easy.

Dr. Justin Marchegiani: Take care. Bye.

Evan Brand: See you. Bye-bye.

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

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.