What Are The Strategies to Treat Fibromyalgia and The Firbo Summit | Podcast #291
Hey, guys! Here’s Dr. Justine Marchegiani and Dr. Roger Murphree talking about things to be checked and pointed out in dealing with fibromyalgia.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain with fatigue, sleep, memory, and mood issues. Dr. Roger shared that the frustrating thing is there are still doctors who don’t believe that it exists, and those who do, don’t understand it.
Some issues reported by most patients with fibromyalgia include pain, lack of sleep, tired/fatigue, brain fog, restless leg syndrome, adrenal fatigue, and more.
Watch the entire podcast to learn more about this disorder and interesting approaches on how to fix it!
Dr. Justin Marchegiani
In this episode, we cover:
0:38 Diagnosing Fibromyalgia
10:13 Approaching the Issue
20:14 Unique Treatments
25:16 Infection Pattern with Patients
32:50 Compromised Immune System
Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani with Dr. Rodger Murphree here. We’re going to be chatting about fibromyalgia and the fibro summit coming your way. Dr. Roger, welcome to the podcast How we doing?
Dr. Rodger Murphree: Hey Dr. Justin, so glad to be here. Thanks for having me. This is gonna be fun.
Dr. Justin Marchegiani: Yeah, I’m really excited to be part of your summit as well. That summit will be coming out, I think on September 28. So we’ll put some links down below so you guys can get subscribed to the summit. So let’s talk about fibromyalgia. It’s kind of one of these, you know, subjective diagnoses, right? A doctor kind of comes in and you and they do these like they look for different tender spots. How does that diagnosis work?
Dr. Rodger Murphree: Well, you know, the frustrating, frustrating thing about Fibromyalgia is there’s still doctors who don’t believe it exists. There’s, there’s still some out there, have that mindset and those that do don’t really understand it, they don’t really know how to treat it and then tell their patients to learn to live with it and the diagnosis is one of elimination. So there’s no really definitive Lead test after that will show you right. And it typically takes you know, three or four years and half a dozen to a dozen doctors before you finally get the diagnosis. And you’re right it typically is a you know, it’s a hands on type of examination but but after they’ve done all the the other workup to rule out, you know rheumatoid arthritis or any type of autoimmune disease or Ms. And then eventually you get the, you know, the diagnosis of fibromyalgia and you kind of stuck with that because it’s kind of a good thing and a bad thing. I mean, it’s good to finally get a diagnosis. But once you do get that diagnosis, it follows you forever. And a lot of times it didn’t serve you very well.
Dr. Justin Marchegiani: Yeah, totally. So you go online and you look you can you can get a an image of all the different kind of tender pain spots that they’ll they’ll kind of rub gently and they’re kind of looking for this central allodynia this pain that’s, that’s it’s, it’s not proportional to the amount of physical stimulus stimulus you’re putting in when you’re touching these different spots, whether it’s the shoulder, collarbone, neck arm, just kind of the different joint. So the doctors coming in, they’re going to be running maybe, AMA, HLAB 27, all of these kind of autoimmune markers. If none of them come back, then they’re going to that physical examination. And if there’s pain in those spots at all right, then then that’s kind of the diagnosis, but it’s not really helpful outside of the fact that you know, you got it, but we got this kind of path in the road, we have functional medicine, and we have all of these biologics and pain meds. So what happens next?
Dr. Rodger Murphree: Well, you know, the thing is, once you get the diagnosis, oftentimes, I think people have a sigh of relief, because they, they think, oh, at least you know, I’m not crazy because a lot of times, they’re made to feel they they’re lazy, crazy or just a hypochondriac. And nothing can be further from the truth. I mean, nobody would want to make this kind of stuff up that you can’t sleep. You know, he had this diffuse, sometimes disabling pain, no energistics, exhausted, irritable bowel, restless leg syndrome, low moods, anxiety. You know, nobody wants to Make that kind of stuff up but totally the diagnosis then unfortunately what happens is you get past from more you know another doctor you know, you get you get on this medical merry go round. And every doctor you come in contact with, if you mentioned any symptom, any condition, they’re going to try to sweep your fibromyalgia symptoms underneath the Fibromyalgia rug and tell you Oh, yeah, the, you know, the, the stomach pain that you have. That’s fibromyalgia. Oh, yeah, the, you know, the thrush the chip on your tongue. Oh my gosh, there it is the migraines and you know, all these all these are warning signs or symptoms and symptoms or just telling you, you know, telling us that there’s something under underlying this symptom that is, you know, where’s the we need to be looking for the causes, and not treating the symptoms, but unfortunately, once you get that diagnosis, really most doctors just happy to change and learn to live with it, they’re not going to keep looking for the underlying causes.
Dr. Justin Marchegiani: Yeah, I tell my patients this all the time, like most of the time conventional medicine, I, they’re looking at the downstream symptoms, and typically a diagnosis is a bunch of symptoms that are in an organized fashion, right with a lot of the central allodynia pain, right? That’s your fibromyalgia, if it’s if it’s autoimmune type of pain, where there’s autoimmune markers, maybe that’s rheumatoid arthritis. So you’re just looking for these different symptoms and in these different pattern and once you have those symptoms, they give you an ICD 10 code and then from there, they can prescribe your drug. Now, Fibromyalgia tends to come together a lot of times with chronic fatigue so you get people that are sore, and also tired. Now, we know in functional medicine, that there may be other kind of root causes upstream like with the gut or with the hormones or the adrenals or the thyroid, what are like just the top three like root cause patterns that are upstream that you see are driving a lot of the fibro symptoms downstream.
Dr. Rodger Murphree: Well the main thing Justin is there at this allodynia, which is this low pain threshold, right? For them, their pain is magnified and you and I can go, you know, we can go get a massage, we can shake cans, we can, you know, hug our partners, we can do things that you know wouldn’t bother us at all but the fibromyalgia patient any that stimulation, which could send them over the top that so pain is magnified? Yes. But that pain is coming from it can be from wear and tear osteoarthritis or osteoporosis, bone loss, it can be from scar tissue. Past surgeries, it can be from nerve damage, it can be from elevated blood sugar issues, but they have central sensitivity pain syndrome, which means their nervous system is over ramped up, and pain is magnified. And the place to start with these individuals is you’ve got to raise the pain threshold and the best place to do That is making sure that they have plenty of serotonin. So brain hormones, you know you’re familiar with your serotonin level, the higher your pain threshold, and the higher your serotonin level, the less anxious you’re less depress your more mental clarity app. And less likely you have are to have IBS because you have more serotonin receptors in your intestinal tract than you do in your brain. So the place to start for these individuals is number one making sure that they have plenty of serotonin because anybody that has true true fibromyalgia, they’re going to be deficient in serotonin and that’s one of the main driving factors of the underlying symptoms that they have.
Dr. Justin Marchegiani: That’s interesting because serotonin we know comes from the amino acid tryptophan right? So I find common thread is going to be poor digestion, in a lot of these fibro patients. So poor digestion, maybe low stomach acid, low enzyme, maybe their diets poor, maybe They’re not eating enough protein, maybe they kind of were on a vegan vegetarian kick. Maybe there’s a gut infection that’s impeding digestion as well. How much do you see digestion? Being an impediment as well as maybe digestive infections too?
Dr. Rodger Murphree: Well, it’s certainly a big part of it, for sure. And in the Fibromyalgia community, what we see is that genetically some of them at our disadvantage, just the way God made them. Yeah. Convert trip to fan into five, proxy trip to fan they have a block and they’re kind of around kind of an enzyme pathway. Yeah. And because that conversion is not made, they’re at a disadvantage. So they’re, they’re low and seratonin. Certainly, you know, you
Dr. Justin Marchegiani: B6 playing a big role in that too?
Dr. Rodger Murphree: Yeah, so the cofactors as you bring up, you know, to make seratonin you need tryptophane, which turns into hydroxytryptophan, the B vitamins in particular B2 B3, and then any vitamin C and magnesium that’s what Yes, you know, No one has an antidepressant deficiency, you know, yeah. But you could have a five HTP deficiency or B vitamin deficiency and yes, you probably have a magnesium deficiency, if you have fibromyalgia, but the place to start for these individuals is making sure we get that serotonin level up. And when we do that, we see their pain threshold goes up. Absolutely.
Dr. Justin Marchegiani: Yeah, I see that a lot. I run a lot of organic acid tests, and I’ll look at five hydroxy and dolo acetate, and usually that’s very high or very low. So there’s usually a burning or a total depletion issue there. And I’ve never seen a fibro patient with really good digestion. There’s always some bloating, some gas and cebo or a gut infection. I almost always see that. Now what’s your take on beta endorphin? Because beta endorphin is kind of our natural opiate, and it’s made from 19 amino acids. So I mean, obviously, we see this amino acid kind of trend there any feedback on beta endorphin?
Dr. Rodger Murphree: Yeah, one of the things that you don’t have a patient’s do they fill out in the new patient questionnaire, they’ll have a brain function questionnaire, little survey and it across the board, it shows that they’re low in serotonin, but then they may be deficient in dopamine and opioids and some of these other things that show that they have other amino acid deficiencies besides five HTP. Bingo. No, no. So it definitely shows up. That’s a pattern that we see that they’ve Yes, deficient in these amino acids for, you know, whether it’s genetics, or you know, poor diet, or there’s something that’s compromising their ability to be able to absorb these nutrients like SIBO, or leaky gut or some type of bacterial overgrowth.
Dr. Justin Marchegiani: Yeah so my strategy, I’m curious to get your so my strategy is I try to figure out a way to get the sympathetic nervous system in check, because most of the time, the adrenals is that kind of gateway between, you know, the sympathetic nervous system. It’s kind of how that when you interpret stress, you’re making adrenaline, you’re making cortisol and when you have that level of stress, you’re going to be burning up a lot of those neurotransmitters. So I try to get the adrenals under control, and then I’ll I work on supporting more of those amino acids, more of those cofactors. I try to get tests so I can get specific. What is the root issue? And I’m just curious to know your take on that. How did what’s your kind of out of the gates approach?
Dr. Rodger Murphree: Well, there’s for me from doing this for 20 years, found there’s four key things that have to really be addressed. Because if you got 15 tax in your foot, and two or three tax, you’re not going to notice a difference. And that’s-
Dr. Justin Marchegiani: A great analogy. Excellent analogy.
Dr. Rodger Murphree: You know, what they’re doing is they’re taking resveratrol, or, you know, they’re taking coq10 or tumeric and those things, those are great. But if you don’t pull out a bunch of tacks real quick, you’re never going to see a difference. So totally. It’s the analogy that we’re all born with a stress coping savings account. And in that stress coping savings account, we have certain chemicals that allows us to be able to deal with stress. So we have serotonin, dopamine, norepinephrine, cortisol, DAGA, Panasonic acid, cortisol, these things Are there and anytime we get under stress, we’re using these chemicals to deal with stress. But those who have fibromyalgia, they haven’t bankrupted their stress coping savings account. So they have this deficit. And then when they, you know, get up to face the day, they’re already done, you know, they just don’t have those chemicals they need. So the first thing that’s gonna happen is we got to replenish that stress coping Satan’s count. And that is done by deep, restorative Delta wave sleep. So if they’re not getting a good night’s sleep on a consistent basis, they’re going to have many of the symptoms that we you know that we associate fiber Imagine if you’re not getting deep restorative sleep, your inflammatory chemicals are increased by 40%. They’re going to have more pain. If they’re not getting deeper short asleep, their pain threshold goes down so pains magnified. They’re going to obviously going to be tired gonna have fatigue, brain fog, which is a common symptom of these individuals. Eero bow, you have more as I mentioned, more serotonin receptors. In your test or trial, you’re doing your brain. restless leg syndrome starts to show up. Once they can get a consistent deep restorative sleep, then they’re going to see that many of those tacks we can start to pull those out. So the first place to start is deep restorative sleep, making sure they’re getting plenty of serotonin. And then the next place is, as you already mentioned, is the adrenal fatigue. But because they get a good night’s sleep, and they start to feel better, then even though they’re cautioned not to do that, do this, you know, in my book, they’ll go out and do things hadn’t been able to do in years, and then they’ll have a fibro flare and they’ll be back in bed because they don’t have the stamina, or resiliency to stress, physical stress, mental stress, real or imagined. And so if they don’t fix their stress coping glands, the adrenal guess, be vulnerable. The third thing is in your already mentioned up mentioned this astutely. You, you’ve got to fix any kind of gi issues. Yeah, amongst with digestion or problems or elimination, you know, problems absorbing in every fibromyalgia patient I’ve ever worked with last 20 years. There’s something there whether that’s SIBO leaky gut, yeast overgrowth, parasites are just reflux and malabsorption. They’re not absorbing, they’re huge. That’s that’s got to be fixed. The last thing, which really could easily be the first thing, it’s you’ve got to lay the foundation with high doses, but the right combination of vitamins, minerals, amino acid and central fatty acids, because if you don’t have these building blocks, you can’t make these hormones and chemicals that they need to write themselves. In. Now, most people have tried a multivitamin. They tried this, they tried that. But what they’ve taken is, is so inferior to what they need, they’re they’re looking And things like, a Centrum silver or one a day.
Dr. Justin Marchegiani: Oh, yeah.
Dr. Rodger Murphree: Which is you know, based on the RTA the recommended disease allowance, right? Yeah, it’s just enough to get, you know, keep you from getting scurvy, or berry berry, it’s not gonna, you know, provide optimal nutrients that you need to be healthy is, you know, so So it’s this, this four pillars that I think are just crucial you got to get those. And then, you know really once you do that you’ve pulled out a lot of tax, you may be pulled out 10 or 12 tax. Now there’s three texts that are still left, and they’re still giving you trouble. But at least you’ve made this dramatic impact. And then you’ve got to go look for what are some of the underlying other underlying conditions that may be driving the symptoms like, you know, problem with their thyroid?
Dr. Justin Marchegiani: Yeah, it’s really interesting because not all the tax create the same amount of pain. So sometimes it’s the eight tax you pull that out, so Whoa, a really big improvement and sometimes you pull them out. And then the improvements delayed like it’s like, oh, I’m starting to see a five or 10% improvement one to two months later. So it’s interesting. Where the compliance factor like really getting the patient’s mindset on board is is crucial because it’s never going to be a meet every now and then that you get a miracle tax. Sometimes it’s too late. So you got to paint that big picture and compliance is big. And when you talk about some of the nutrients, you do have a really good multivitamin that you formulate or what what should people be looking in their multis at certain doses at certain the quality of the nutrients? What should they be looking for, Dr. Roger?
Dr. Rodger Murphree: Yeah, so years ago, when I start treating Fibromyalgia we had I had a medical clinic where we had five medical doctors work for me. And we did high doses of IV therapy. So we did Myers cocktails back then. Yeah. And we found by doing that, Justin that if we gave them these vitamins and minerals, that they slept better, they had less pain, he had more energy, they had better mental clarity. They just felt better. But it wasn’t practical for people every day couldn’t do it hooked up to an IV. Yes, years ago, I developed this thing called the CFS fibro pack, which has high doses of vitamins, minerals, amino acids and essential fatty acids in there and some other things like malic acid, magnesium, potassium sparks a to help drop the cellular energy, it but you can find something, you know, similar for you but, but that is the cornerstone of what my patients take. They take that, as well as some other supplements like a good digestive enzyme, an over the counter adrenal cortex, supplement and then the five HTP that makes up this thing called the jumpstart protocols, that people who read my book, they’re encouraged to try that on their own and get as far as they can before they reach out to me to set up a phone console.
Dr. Justin Marchegiani: Interesting. And you mentioned the serotonin which you mentioned lowers that pain threshold which is which is really important. But we know serotonin also is that precursor to melatonin. Which helps to sleep and you mentioned the Delta wave in the sleep. So it’s kind of like, everything’s kind of connected. It’s not just like, one web, it’s like you hit one web, it moves the whole spiderweb. So you Okay, you you increase the pain threshold, and then you help the sleep. And then the sleep helps the adrenals and the adrenals help the inflammation, and it just keeps on spiraling.
Dr. Rodger Murphree: Yeah, it’s all connected. You know, it’s a myriad connections there. Yeah, the five HTP increases your natural sleep hormone melatonin by 200%. So that was when I started doing the research on that. Well, it’s been two decades ago, and found that correlation, it was a no brainer to start putting my patients on that. And then thankfully, along with making the serotonin, it really encourages them to be able to wind down and be able to get a good night’s sleep. Now there’s some other things typically have to add to that sometimes adding some additional melatonin to the five HTP. But the five HTP has been extremely helpful for these folks.
Dr. Justin Marchegiani: And if you’re not getting I mean, if you’re not getting the optimal results regarding sleep, I mean, imagine you may keep the five there to help with the serotonin so the pain improves but Wendy added melatonin to the mix. When does that happen?
Dr. Rodger Murphree: Bite promote sleep protocol it’s they start off with 100 milligrams of five HTP 30 minutes for bed with a little bit of grape juice doesn’t take much, but the grape juice is going to cause the body to release insulin to help pull that serotonin pass the blood brain barrier. Yeah, going to the stomach just a little trick. And then if they don’t fall asleep within 30 minutes, then that in sleep through the night, the next night they go to 200 milligrams and then they need to they get a 300 milligrams, but they get up to 300 milligrams and they’re still not falling asleep or they’re not staying asleep. That’s when I would start adding the melatonin preferably sublingual melatonin somewhere, you know three milligrams or so and they and they can increase that up each night up to about 12 milligrams and, and then hopefully that does the trick. If it doesn’t. Then I would add things like gamma means butyric acid GABA. So I have a little sleep form that I put together that it’s combination of GABA and l theanine, ashwagandha and delirium, and passion, passion flower, that can be taken to really calms them down before bed. But it’s even more useful for those individuals who wake up at, you know, two, three o’clock in the morning can’t go back to sleep, they can take this product called Delta sleep, or something similar. And it allow them to fall back to sleep within, you know, 10 minutes or so, and it doesn’t make them feel hungover, dopey or sleepy The next day, like some of the prescription medications would.
Dr. Justin Marchegiani: Tat’s great. I think we’re just really dropping a lot of key clinical pearls here. So if you’re a patient and you’re have these kind of issues, try to glom on to one or two of these things. I think it’s really important especially if you’re in that Fibromyalgia camp, you really want to work with the practitioner because there’s a lot of as Dr. Roger gave the example of tax you got to pull out and these are a couple of one or two key tax, but there’s always a Plan B a Plan C a plan D, it always seems easy when everything works with Plan A the first time around, but I think Dr. Roger will probably agree a lot of times you have to dig deep into that tool basket with a lot of other plans too. Would you agree?
Dr. Rodger Murphree: Oh, absolutely. But I think you’ve got to lay the foundation for what, what trips people up with fibromyalgia and those trying to treat Fibromyalgia is they try to put the cart in front of the horse, you know, is you know, there’s such a unique individual. And a lot of times they may go to an integrative doctor or maybe a function doctor. And, and he or she will, okay, let’s put you on biomechanical hormone replacement therapy because that’s, you know, as a female, it’s, you know, that’s a lot of times what they do, but that may not work and usually does it you to me, these four steps that I just mentioned, that
Dr. Justin Marchegiani: Do you mind if we repeat the steps one more time, what they are?
Dr. Rodger Murphree: Deeper store to sleep. You got to replenish your stress coping stages account. And the way you do that you you make deposits into your stress coping savings account by going into deep store to sleep. So you’ve got your peritonei level up. So five HTP and then the second one is you got to fix adrenal fatigue every everybody as far as adrenal fatigue, so I use adrenal cortex glandulars for my patients. And then number three was digestive issues. I put everybody on digestive enzyme and then if they need other treatments for cebo, leaky gut or things we’ll deal with that. And then the last one was a good high dose, multivitamin mineral formula with essential fatty acids Fishel, malic acid, extra magnesium, which is so important, but those four things provide the foundation really to build upon it really, you know what it does? It’s, if you kind of think of you know, if you got this complicated jigsaw puzzle. And you just throw all the pieces out on the table. And until you get the corner of the puzzle, right? You’re, you could just be looking forever to put the pieces together. But once you get the corner, now everything starts to come together, you can build that puzzle. So the first four things, make up one core in a corner, I’m sorry. And then the puzzle starts to come together. But you may have to, you know, find another piece of the puzzle that’s, that’s eluding you could be a problem in your thyroid. Could be a problem with yeast overgrowth could be a problem of food allergies. But if you don’t get that first corner, boy, you’re going to struggle, you’re really going to struggle.
Dr. Justin Marchegiani: Totally agree that makes a lot of sense. Now, when you’re working with patients, are you testing their adrenals? And it sounds like you’re finding a lot of low cortisol in your patients. Is that true?
Dr. Rodger Murphree: Yeah. So I think you know, we These individuals are very complicated ideally, although I do have programs where they can try to do it themselves to talk about that in the book. Ideally you want to test I mean, you’re not trained in functional medicine. You know, you don’t want to guess you really want to try to laser in find out where the key linchpins for helping these folks and you want to know what’s going on. So yeah, when I’m when I’m doing a four sample saliva test for their adrenals, I see it’s all over the place. So it’s low. In the morning, it’s bottomed out and sky high first thing, you know, because they’re not yet now drive that, that level up. But it’s about really balancing that out because it’s, you know, very well, a lot of times we’ll see that there. DAGA is it then of course, our levels, okay. But their DAGA is really high. And that’s a sign that the body’s trying to hang on. Yeah, but it was going to bottom out right. Or they’re gay is bottomed out and of course, all levels are bottomed out. So you had treat both of those, or you may find, like I do a lot of patients is that they have a low cortisol in the morning. And then as the day goes on, you know, it should, it should keep going lower. But for, for these individuals, their cortisol level actually spikes towards bedtime. So there’s like they’re catching their second window.
Dr. Justin Marchegiani: And they just rhythm almost.
Dr. Rodger Murphree: All day they’re exhausted. And then about nine o’clock they catch the second wind and like, Oh, well, I haven’t been able to do anything all day. Let me go clean up the kitchen or straighten up or you know, wherever it is, and then they miss the window of opportunity to get in bed on time and now they’re, you know, they really just continue to throw their sleep wake cycle into further Helter Skelter.
Dr. Justin Marchegiani: That makes sense. Do you test any of the total cortisol? Do you do any of the urinary cortisol as well to get a window into free as well as total?
Dr. Rodger Murphree: I don’t. I don’t do that and find it. I guess. Probably just from doing this for so long, I know that the majority, I would say when I say the majority, I mean 98% of them are gonna have a problem with their adrenals. And if I can just make sure what the pattern is, then I can on the right supplements that will you know, that will correct that.
Dr. Justin Marchegiani: Yeah, that makes a lot of sense. What also do you see in regards to an infection pattern like pate with patients? I’m seeing h pylori blastocyst is hominis. Sometimes you see things like epstein barr, maybe even a Lyme issue, what kind of infections Do you see? And it sounds like you kind of have that priority. You hit those four pillars that you mentioned. Right? adrenals and, and the nutrients and the sleep and etc. And then you kind of do dive into infections later, is that part of when you’re addressing the gut stuff? Where do the infections come in? And what are the top maybe three or five infections that you see that play a role with fibromyalgia?
Dr. Rodger Murphree: Probably the most consistent one is yeast overgrowth. So I test everybody for yeast overgrowth, test, everybody for parasites. blastocyst is hominis definitely shows SIBO is definitely a thing that is for whatever reason, you know, I think you kind of run into these patterns where you you know you get one and you get two then you get you know dozens I’m at a time. Mold issues certainly starting to show up. But definitely infections are there. I’m really careful not to go after them. Initially, certainly not aggressively because we Fibromyalgia they, they they can’t handle the stress they bankrupted their stress coping chemicals, and they bankrupted their stress coping gland. So stress is magnified. I don’t want to get aggressive on treating yeast or SIBO or some of these things that show up until I get them going into deeper storage of sleep. Start working on their dreams and then yeah, absolutely. Then you have to look at you know, definitely h pylori shows up as well. You have to start dealing with those because that’s something that’s going to be leftover that’s going to create, if it’s, you know, if it’s if it’s leaky, God is you know, that’s going to create More information and more pains. Yes, with at some point.
Dr. Justin Marchegiani: I just really wanted to highlight that for the listeners because this is probably the biggest mistake I see with a lot of my patients and people that I connect with online is we just live in this generation that’s antibiotic driven. Oh, you have an infection, staph strep STD, here’s an antibiotic knock it out. And that can be stressful on the body. Number one, it wipes out the microbiome which affects the immune system, gut permeability, but it’s stressful going after an infection. And when you don’t have the reserves, your sleeps already amassed, you’re nutritionally deficient, you can’t digest that’s like a big stress ball on that bucket or another five tacks underneath that foot. So I’m really glad that you highlighted that.
Dr. Rodger Murphree: Yeah, you know, and I think that’s the thing is what you want to do with fibromyalgia you want to try to find and fix the underlying causes, because really, you know, Fibromyalgia is just a name. It’s all it is, is a name given to a group of symptoms that people have in common, and we call it fibromyalgia. And so if you can start to find and fix each underlying cause Eventually you’re going to get your life back and that may take you know, that may take different things but certainly the God is you know, that’s number four you have to you know, you have to fix that.
Dr. Justin Marchegiani: Totally. And you mentioned a couple of different things and I know the protocols are going to be specific to each individual person and where they’re at. I get that so people that are listening, I want you to just talk about do you have like a couple of your favorite herbs on the gut side and also do you have a couple of your favorite herbs on the virus side and how much do viruses play a role in this whole thing?
Dr. Rodger Murphree: You know, as far as I don’t use a lot of herbals I do use some but I don’t use it. He is some may think think that that in the fiber match community. A lot of them have chemical sensitivities have issues. A careful what you what you do in the having said that I also really recommend everybody a food allergy test because food allergies, right masqueraders but for digestion, the first thing I do is put them on digestive enzymes or on the team You know, make sure that we we start from the beginning, you know, make sure they’re digesting their food.
Dr. Justin Marchegiani: That’s key. Yeah.
Dr. Rodger Murphree: If they have issues with with yeast overgrowth, or even SIBO then I’ll turn to things like bio seed, which has oregano, and berberine and some of these golden still herbals in their-
Dr. Justin Marchegiani: Black walnut, ekinesia. Yep.
Dr. Rodger Murphree: But I don’t use a tremendous amount of herbals, just for the fact that I really find that using the right doses of vitamins and minerals, essential fatty acids and amino acids typically start to turn these individuals around, you know, but but definitely there is a place for for berberine and undecylenic acid and caprylic acid. I mean, there’s definitely those can be incredibly helpful for these folks.
Dr. Justin Marchegiani: How about the virus stuff? Do you use any natural antiviral supports, and what viruses Do you see in And what are your like top three on the anti viral side?
Dr. Rodger Murphree: You know, it’s interesting that I don’t see a lot of viruses, which really surprises people when I say that I used to more so than I do now, let me let me explain why that is. You know, people think of fibromyalgia is being driven by a virus, and they can’t have viruses. But if you look at you know, Fibromyalgia is on one end of this clothesline, and chronic fatigue syndrome is on the other end of the clothesline and sometimes they get lumped together and you can have both, but if you look at true fibromyalgia and true chronic fatigue syndrome, with true fibromyalgia, their symptoms are number one pain, right, but they can’t sleep and they have no energy and, and then if you look at the true chronic fatigue syndrome, they can have trouble with their sleep and they do have achy flu like pain. And obviously the number one symptom is no energy, so fatigue, but the difference between the two is that those are Fibromyalgia don’t necessarily have anything wrong with your immune system. Those with chronic fatigue syndrome all have some type of immune dynamic, something that is, you know that is compromised that so that they’re always fighting off some type of infection. And absolutely in those individuals, you got to go after that, find out what that is and use things like lacto Fearon, or using thymus extract some of these things in Oilers system that can be incredibly, incredibly beta one, three glucan some of these things that I use for these individual, but you know, it’s odd because over the years, for whatever reason, I have attracted less chronic fatigue syndrome patients in the last probably 10 years, than I have fibro to me fibro, and I hate to be careful how I say this. Yeah, Ramalgyia is I won’t say it’s easy but for me it’s it’s there’s a system that seems to work chronic takes syndrome. Once you start working with that, if you’re not careful, you open up Pandora’s box and you find that not only is it viruses, but then you also have parasites and you have Lyme and many things that you mentioned, that tends to be more down on this end of the clothesline with property syndrome, than it does fibro.
Dr. Justin Marchegiani: And you’re differentiating that between the fact your fibro have the central allodynia that’s just the wound up nervous system the pain spots at the joints and throughout the body, but they don’t really have the energy problems or energy still pretty good is that the differentiating factor?
Dr. Rodger Murphree: Know the difference because we’ve thought about them and they have many of the same symptoms as those with chronic fatigue syndrome. Yeah, separates and you can be anywhere along the clothesline, you know, but what separates the two is that those with chronic fatigue syndrome always have a compromised immune system.
Dr. Justin Marchegiani: And your by your saying compromised immune system, so they the fibro patients still might have fatigue, but you’re just not seeing what a diagnosed autoimmune condition along with fibro or they get sick a lot. How are you defining compromised immune system?
Dr. Rodger Murphree: So for those who have fibromyalgia, they, they normally don’t have problems with random sore throats. They don’t have swollen lymph glands. If we test them, they don’t show antibodies to epstein barr virus, or cytomegalovirus kraftig syndrome, you’re going to see elevated epstein barr virus cytomegalovirus herpes viruses, they’re going to get random sore throats out of the blue. They’re going to have palpable lymph nodes, you know, they’re gonna be swollen glands. Oftentimes, they have issues with laryngitis, they just lose their voice for days at a time because they get so exhausted. With fibro, you can have some of that. But that’s not the norm in kraftig syndrome. That’s the norm.
Dr. Justin Marchegiani: So I’m just trying to wrap my head around this because the diagnoses are kind of a little bit flaky. So if these fibro patients still have they’re still really tired, right? What’s the conventional different like, if you’re a conventional Medical Doctor, what makes you diagnose this person with chronic fatigue with the immune stuff, but these people over here without the immune stuff, they’re still tired. What what allows them to get that chronic fatigue diagnosis on the conventional side?
Dr. Rodger Murphree: I think typically it comes down to the doctor that they see. So that’s more familiar with complex syndrome, they’re probably going to get that diagnosis than they would fibro. If you said doctor this more for me with fibromyalgia, they’re going to get that diagnosis. And right now you got even though there’s not a lot, you probably got more doctors who are familiar at least with fibromyalgia, they don’t really know how to treat it. Then they have conflict syndrome that that illness, chronic fatigue syndrome is something that most doctors really don’t know anything about.
Dr. Justin Marchegiani: And there’s another name for for fibromyalgia over in Europe, right it’s the mycologia with it with the name Britain Europe.
Dr. Rodger Murphree: Yeah, what now for [inaudible] syndrome is myalgic encephalitis so with us.
Dr. Justin Marchegiani: Yeah, okay. And so it sounds like to me it’s not necessarily the diagnosis that matters it’s more the immune symptoms of antibodies to these different viruses and then that chronic immune reaction lymph nodes chronically sick is that is that kind of if we kind of really boil it down is that more specific you think?
Dr. Rodger Murphree: Yeah, but I think we got to be careful because I think there’s a misconception that Fibromyalgia is an autoimmune disease ever seen that in any in you know, we’ve been looking for the smoking gun, it’s not there. So I don’t believe Fibromyalgia autoimmune disease. We don’t know if chronic fatigue syndrome is it probably could have an autoimmune component to it. We haven’t found that yet either.
Dr. Justin Marchegiani: So a lot of thyroid autoimmune people that have fiber though?
Dr. Rodger Murphree: Now that I was gonna say is see a ton of autoimmune hashimotos thyroiditis. So with in the patients that I work with F5 about 70% of them have something wrong with their thyroid. Many of those have Hashimotos many, many of those with hashimotos have never been properly diagnosed. So they have the, you know, the festering symptoms they had for 5-10 years. No one’s ever checked their antibodies or thyroid antibodies. So that they never knew they had it. But yeah, definitely that, but you know, I don’t see. I don’t see lupus. I don’t see rheumatoid. I don’t see sjogrens I don’t, it’s there. It can be, you know, could be could be a companion to the Fibromyalgia but it’s not what’s driving the fibromyalgia.
Dr. Justin Marchegiani: Yeah, cuz I see did you see patients though with a lot of the hashimotos and the fibro and of course I do find that like gluten. Cutting gluten out really helps a lot of the the pain symptoms and I know gluten plays a big role of gut permeability. So even though the research may not show that I have a sneaking suspicion there has to be something underneath the hood, or we wouldn’t see a lot of these connections. When you address them, they improve prove a lot of those fibro symptoms.
Dr. Rodger Murphree: Yeah, you know, and you know, that’s one of the big conundrums for fibromyalgia. I think there’s just so many things that are wrong.
Dr. Justin Marchegiani: Yes, the hard part.
Dr. Rodger Murphree: Can write itself the way that you and I were trained in chiropractic school that innate intelligence. You know, we’re born with this incredibly inborn healing Dynamo system, that normally we don’t have to think about taking 12 breaths per minute or pumping blood to 60 miles of arteries and veins, we just write these things. But with fibromyalgia, those systems get get compromised the hypothalamus, the pituitary adrenal HPA axis, when it gets under too much stress, it can’t regulate these different systems. And now because of that, you see, so many symptoms start to show up, because so many systems are not working like they’re supposed to. And that’s incredibly challenging for the doctor that wants to try to try fibromyalgia, most most work because it’s too complicated. And it’s incredibly challenging for the patient. Because where do you start?
Dr. Justin Marchegiani: No, I totally agree. And you’ve done a great job during the podcast just to kind of outline a couple of the really good pillars. Obviously we have the fibroid, the fibro summit coming up in the next two weeks on the 28th. So really excited. We’re gonna put the links down below as well. I see a book on the shelf back there. Is that your book? Would you mind put it on screen?
Dr. Rodger Murphree: Yeah. So this is my Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome book. It’s in his fifth edition, the sixth now? I didn’t November so yeah, labor of love. You know, for the last 20 years, you know, it’s been my mission to help those with fibromyalgia, learn how to live healthier, happier, more productive lives because you know what they’re being told right now Justin is just learning to live with it. But you know, I want to learn to live with chronic pain, no energy, brain fog, insomnia, restless leg syndrome, irritable bowel mean. That’s it. That’s not living that’s existing. So, you know, the fibro summit is an opportunity for individuals with fibromyalgia, to get a breath of fresh air, sort of set off all the doom and gloom out there. They actually can learn from people like yourself, she did a fantastic interview, all about thyroid, we did a deep dive into this interview. So people like yourself are sharing incredible information, that if you have fibro or even if you just want to be healthier, there’s so much we share in the summit, about mold and parasites and adrenal fatigue and insomnia and leaky gut and gluten intolerance and food allergies, huge. If you’ve just can’t get a few little key things from these interviews. It may be the missing piece of the puzzle that you need to put it all together and get your life back.
Dr. Justin Marchegiani: I mean, that’s awesome. Now, if patients want to get a hold of you, they’re like, great, I’m going to get the book. I’m going to get the summit. I’m going to start applying some of this stuff, but I want to work with you. How did patients work with you?
Dr. Rodger Murphree: Yeah. So appreciate that. They can go to yourfibrodoctor.com and there’s free videos in there, blogs, free protocol and a tremendous amount of free information so I encourage you to check out, see if it resonates with you. If it does, you’re on the right track.
Dr. Justin Marchegiani: That’s great. We’ll put the links down below for the book, for the summit, for Dr. Roger’s website. Dr Roger, anything else you want to leave the listeners with? Do you have a youtube channel or a podcast? Anything else people can get more info about you?
Dr. Rodger Murphree: Yeah so we do have a youtube channel and you’ll see that on the website, a blog, both of those podcasts coming soon. And you’re going to be one of my first guests by the way. We’ll be coming soon and I just want to say thank you. I want to thank you for for everything that you do because the information you’re sharing is so needed and without people like yourself taking the time, making the time because I know you’re busy just like I am and you’re dedicated to getting the the message out there, that you you know that you don’t want to be just treating symptoms. You really want to be finding and fixing these underlying causes whether you have fibromyalgia or you have migraine headaches or type 2 diabetes and your podcast which I’ve been checking out here recently is just fantastic. So thanks for what you do.
Dr. Justin Marchegiani: Thank you so much Dr Roger. Really appreciate it. And people listen to so much information here especially if you’re coming at this with fibro or chronic fatigue, it’s hard to grab a lot of these things. So just rewind it, listen to it again, try to grab one thing that Dr Roger said. Try to get the book, get access to the information and make sure you get on that summit. Amazing great speakers there. Dr Roger thank you so much for being a part of today’s podcast.
Dr. Rodger Murphree: Thank you Justin so appreciate it.
Dr. Justin Marchegiani: Thank you.
References:
Audio Podcast:
Dealing with Co-infections and Fibromyalgia | Podcast #284
Here comes another episode of Beyond Wellness Podcast. It turns out that herbs are just more powerful than we know. For this episode, we have Dr. Bill Rawls, who went live with us to discuss co-infections, fibromyalgia. Also, Dr. Rawls shares more information on some of his favorite herbs to address co infections and also formulating them into supplements.
Dr. Justin Marchegiani
In this episode, we cover:
02:13 Special Herb Formulas by VitalPlan
10:19 Manufacturing
13:25 Dr. Rawl Personal Health Journey
23:40 Gut Infections, Lyme Infections
32:11 Keeping a Strong Immune System
Dr. Justin Marchegiani: And we are live. It’s Dr. Justin Marchegiani in the house with Dr. Rawls. We have an exciting interview, we’re going to be talking about co infections. We’re going to be talking about fibromyalgia. We’ll be talking with Dr. Rawls here about, you know, formulating supplements, some of his favorite herbs to address co infections as well as real live clinical experience. I’m really excited to have Dr. Rawls on the podcast Doc, how are we doing this morning?
Dr. Bill Rawls: Oh, wonderful. Thank you. Thanks for having me.
Dr. Justin Marchegiani: Well, thank you. Awesome. So how did you get into this field? Because obviously you were trained as a conventional medical doctor and you’ve had to go from go from medical school and get all this experience about things on the functional integrative medicine side. How did you make that journey from conventional medical doctor to more holistic, functional medical doctor?
Dr. Bill Rawls: Yeah, sometimes life forces you into things that you’re not expecting. I actually went into ob gyn as my specialty because I dealt with wellness and was not heavy Lee And embroiled in medications. So it was it was definitely more active. But it came with really bad night call and bad health habits bad night call my health crash by the time I was at the end of my 40s call it fibromyalgia. Later I found out I was curing the microbes that come with Lyme disease. And my conventional colleagues couldn’t help me. They couldn’t figure it out. They and so I turned away from conventional medicine, became certified in holistic medicine, but found my real salvation with herbal therapy and ultimately got my life back and nowadays 62 better health than most people.
Dr. Justin Marchegiani: Wow, that’s excellent. That’s really good. So I know you kind of have a lot of specific herbal formulas that you’ve created, you know, you’re over at RawlsMD.com, VitalPlan.com as well. And some of your herbs I find very interesting. Can you kind of talk about why you choose why you’ve chose some of the herbs that you have? And just some of your favorite clinically, as well, as you know, personally, because I think you have a story with some of these as well. Can you touch upon that?
Dr. Bill Rawls: Oh, sure. Yeah, it’s, well, first of all, there are a lot of herbs out there that I think have value for Lyme disease, in really any kind of medical condition, especially chronic conditions. And even I think there’s some applications to things like COVID Yes, that are important. Herbs have antimicrobial properties, because if you look at what the earth is, it’s plant chemicals, what we call phytochemicals. So all plants producing a wide spectrum of chemicals to to protect themselves from various kinds of microbes, insects, free radicals, everything else. So when we take in that fight of chemistry of the plant, it’s especially intense and wild plants that we call herbs, we gain those benefits, we’re basically embracing the natural defenses. Where where it differs between plants is evolution, you know, one plant that evolved in one place will have a different spectrum of phytochemicals than another plant that evolved and another place. So like rhodiola, which is a really nice adaptogen and helps you to stress is grows in really harsh northern climates. So it’s not as much producing antimicrobials, but it produces chemicals that help resist stress, because that’s what the plants having to deal with. Whereas cat’s claw from the Amazon, while it’s having to deal with a lot of microbes, so it’s producing a lot of antimicrobials. So in our formulas, I typically use a balance and I think this is really Really important, um, the antimicrobial herbs like cat’s claw. Another one that I like is [inaudible], Japanese knotweed, garlic if you use a stabilized extract, [inaudible] is another one. Yeah, there’s there’s really a nice list of antimicrobial herbs. And these herbs have direct antiviral antibacterial properties. In fact, some of those herbs, there was actually a study out of John Hall, Johns Hopkins recently that showed these had better and some of these herbs had better antimicrobial properties than antibiotics, which is really cool. But, but you’re not getting just those those antimicrobial properties. You’re getting things that also stimulate immune system and drive things. But you can make the immune system too hot, you can drive it too hard. So I typically balance it with what we call immune modules. It hurts like reishi mushroom and cortisol and salvia militarize, which is a species of red sage. Okay, and so these things balanced the immune system and keep it from getting too hot. And that combination together, along with other supportive ingredients like Luna file can really do wonders for a lot of different conditions.
Dr. Justin Marchegiani: Now I find a lot of medical doctors, they kind of jump on the functional medicine or like the CO infection line bandwagon. A lot of them go really heavy on antibiotics, and I noticed you haven’t really taken that path. Have you evolved to this position? Were you more on the antibiotic path? Is there a place for antibiotics? It seems like you lean more to the herbs because it’s the immune building qualities, the immune modulation, the viral replication, a little bit more supportive than killing what’s your take on the strategy that you’ve chosen versus some of the antibiotics.
Dr. Bill Rawls: Yeah, You know it again, faith drives where you go in life so much. And when I when I, I struggled with fibromyalgia for years, and to get over that I started changing my diet, doing better health habits, etc, started doing some herbs. But then I found that I had the microbes was fine, but I immediately jumped on antibiotics and they made me much sicker very rapidly. So, I really was forced in this other direction of herbal therapy. And it was really years before I started figuring out why you know, what’s going on here? You know, I just said there’s a study from John Hopkins showing that some of these herbs were better than antibiotics. No, why are antibiotics such a problem? The problem with antibiotics is they’re indiscriminate. They’re, they target specific microbes, and they they’re very intense. So what happens when you use an antibiotic is you start a race as soon as you start that antibiotic, it’s like will I kill off the targeted the microbe I’m targeting before I kill off all my normal flora and destroy my gut and my system, which trashes my immune system even worse. So when you look at acute infections, and acute pneumonia, acute Lyme disease, antibiotics are effective, because they knock down the numbers. But this thing that antibiotics eradicate microbes is an absolute myth. There is no antibiotic on earth that will completely eradicate a pathogen. It’s always up to the immune system. And a good example of that is if you’ve got an elderly person or someone with AIDS, that has no immune system left and they get something like a pneumonia. It doesn’t matter how much antibiotic you give them, and they are going to die. That’s all right. Do it.
Dr. Justin Marchegiani: I find that I find that to be 100% true where antibiotics may be better for more acute infection. But like you said, I think combining the herbs along with it or like right after it just because of the immune building effects. There’s also a lot of data on the fact that antibiotics can create a lot of mitochondrial damage and oxidative stress. And the nice thing about Mother Nature’s antibiotics, they tend to be packaged with a whole bunch of antioxidants as well. And actually nutrition and a lot of cases, right. some herbs actually have extra nutrients like magnesium or zinc and such and can help support the body on the nutritional side as well. And I imagine when you’re seeing a person and there, they have co infections, you may be using other nutrients along with the herbs. I think you already just alluded to glutathione what other nutrients Do you like to stack in there to really work on building up that patient’s immune response?
Dr. Bill Rawls: Sure. Well, just to finish it up on the herbs, I guess, you the when you look at that complex biochemistry of Europe, you’ve got Think about the fact that the plant, it has to kill off the pathogens and not destroy its own normal flora. Yeah, one interesting factor that I found with the herbs is herbs tend to balance the microbiome. They don’t kill the normal Flora like antibiotics do. So you can use them long term for years and years and years without having that bacterial resistance and without disrupting normal flora. So that makes them a really, really useful tool. So in our regiments, we use primarily herbs, but there are some other nutrients that are found to be valuable. As topped the list NAC is a good one and acetal cysteine has a lot of value. Basic vitamins can be beneficial like and but using the natural forms of vitamin E, like the natural phalates instead of fully acid. Correct, some basic minerals, those things are most important for someone who’s struggling with chronic illness though and may not be absorbing those nutrients for healthy people, they don’t need those those nutrients as much. But struggling with chronic illness, I think they can be very important in that recovery process.
Dr. Justin Marchegiani: Very interesting. And when you source the herbs, how important is the quality because I imagine you know, just like we go out and we can buy meat from McDonald’s, we can also buy the grass fed organic meat from the from the butcher or the local farmer down the street. How important is quality when you’re sourcing supplements? Because I mean, you’re manufacturing your product. So you’re choosing the raw material that you’re buying.
Dr. Bill Rawls: Yeah, everything you know, and if I can do it, I would grow everything myself and process it all the way through but it’s not practical because what you find is like I said, rhodiola grows in an Arctic regions where catalog grows in the Amazon. So if you want to get that that full spectrum, you’re going to have to get different herbs from different places. So it is really a matter of the trustworthiness of the company and whether they’re doing the things that we need to do. And that tends to cost more. We, you know, I have a supply chain manager that I can I work together sourcing herbs, and we’re looking for the suppliers that we can trace it back to the form that we can, you know, we know that this particular farm is doing the right things to potentiate the value of the Phyto chemistry of the earth. And we know that because we do testing, so some of it is third party testing that the supplier does that you get a certificate of analysis that defines it is the species that you’re looking for that it has that photochemistry that you’re looking for, and it doesn’t contain contaminants, chemical contaminants, like heavy medical, metal, organic toxins, but we don’t stop there, we actually take a sample of that extract that’s coming from that supplier. And we have independently tested to make sure that that’s, that’s the truth. And then we actually test three times during the manufacturing process to make sure that everything is being mixed properly, and that our customers are getting what they want, and that we’re going to have something that actually works and that is the thing that I can do that it’s a real proof in the pudding is that the products work and, and we’ve had great success with them.
Dr. Justin Marchegiani: Very good. Yeah, cuz I know like I’ve seen like supplements on Walgreens and CVS, I manufacture my supplements too. And I see things on the shelf. I’m like, that product is too cheap. I know if I buy kilograms of that raw material. At a bulk rate, not even encapsulating or testing, it’s costing more than what’s on the shelf. So I know there’s definitely a quality impact and people tend to look at and price shop, but quality supplements definitely cost a lot more you get what you pay for, for sure.
Dr. Bill Rawls: Oh, absolutely. Yeah, yeah, no, no. And it’s worth put the money in something that has the value that does have those credentials find.
Dr. Justin Marchegiani: Absolutely. Now, I know you had a personal health journey, you kind of mentioned with certain co infections in fibromyalgia, which specific herbs or nutrients really move the needle for you that helped you get over some of the infections you were dealing with personally?
Dr. Bill Rawls: Yeah. That’s where I think about Lyme disease, I think a little bit differently. And a lot of other practitioners out there, in that. I feel like more than anything else, what we’ve got here is an insult to the immune system. Mm hmm. And that is true. Driving the whole thing. So when we look at these things that we define as co infections, borrelia, and all the different species of microbes, most of these things are not highly virulent, they don’t have a high propensity to cause disease. Like me, I probably had been carrying these things in my body for years and years, it wasn’t until I trashed my immune system that I got sick. So when you look at this concept of microbiome in the body, we all have pathogens were riddled with access. And if you pick up certain things from ticks, then you’re going to increase your risk of chronic illness. But that’s not going to happen unless you actually trashed your immune system. So whether you’re talking about the vizia, or different species of rickettsia, borrelia, or anything else, all of these things are commonly carried harbored by people that do not become ill ever So typically when I’ve seen patients with the chronic illness, what we call chronic Lyme disease, typically they all have a story, you know, you can trace it back to a perfect storm of factors. It’s, it’s nice, you know, most people, it’s not like, well, I remember the tick bite and I got sick right after the tick bite. When I go back and asset history, it’s more than that. Oh, yeah, you know, my house burned down my business laughs My wife left and I had all this stress. And that’s when I became ill. So I think when we’re looking at this concept, we’re talking about all of the different pathogens in the body start becoming active because the immune system has been suppressed and it becomes a vicious cycle. So we have these things throughout our body.
Dr. Justin Marchegiani: Imagine with yourself, you could probably try to trace it back to residency and years and years of being on call, and and maybe you know, I know medical school, there’s not really much education on nutrition. So maybe your nutrition wasn’t the tip top at that time, but that kind of be the sequence for you if you were to go back in time with that stress.
Dr. Bill Rawls: Oh, absolutely. Yeah. You know, I was more I think enlightened. I was trying to do the right thing back in the 80s as far as nutrition, but we were getting bad information. You know, it was like, Oh, you got to eat all this whole grain.
Unknown Speaker
*crosstalk*
Dr. Bill Rawls: Yeah. And you know, so it wasn’t until later when I started to question those things. And I was well off gluten before the gluten free craze came along smart but yeah, you know, I I promoted good health practices in my practice, but you take call every second to third night that you don’t sleep and then back in the 80s. It was good people were questioning the value of well Do we really need to sleep added on into that. So yeah, so when I wasn’t on call, it’s like I was going to make up for all the time I was on call by not sleeping. And I was averaging maybe four hours of sleep most nights. And it caught up with me along with just pushing that stress button way too hard and eating on the run. You know, I was telling people how to eat. I wasn’t doing it because I didn’t have time.
Dr. Justin Marchegiani: So when you start with the patient, right, what are some of the simple diet and lifestyle changes that you’re making? It sounds like you’re having cut out gluten, which I find to be a huge game changer for me, I kind of lean on to a paleo template and then we kind of adjust macros and such and some people, you know, have autoimmune they need to cut out more foods. Some have a lot of SIBO and maybe even need to do you know, more restrictive things like fodmap but what are some of the foundational things that you do diet wise starting out and it sounds like you kind of set the foundation first and then and then do some of the others immune killing stuff maybe later on when they’re more supported. Is that right?
Dr. Bill Rawls: Yeah, we do have In the protocols that we do, we have a diet, a progressive diet program that’s in phases. It’s probably a lot like what you’re doing. But it’s just getting people off processed food. So when it comes to diet, I have three rules, three primary rules that I follow for myself. One, eat more vegetables than anything else. By the end of the day, you should have eaten more vegetables than any other thing. Solid. Number two is eat fresh food that comes from living sources, which I think is really important and that cuts out most of the processed food. Number three, donate any more calories and then you need in a day. And if you do those things, if you can find a way it doesn’t matter whether you’re a vegetarian or eat meat or have some carbohydrates or eat some grains, you know if you’re doing those basic things, You’re probably going to going to gravitate toward a healthier diet. But the big thing for me that I did years and years ago and lost 30 pounds pretty quickly in the process was just giving up bread and things made with flour. That single thing was huge.
Dr. Justin Marchegiani: Mhmm. And then when you’re seeing people with CO infant, I think it’s really it’s, you know, solid information. Like I always tell patients start with the low hanging fruit because, one, you’re increasing nutrients on one side, and two, those are foods or they’re suppressing your immune system. So you get a double whammy there. you support the nutrients that support the immune system, and then you decrease the stressors. So it allows that to come up a lot faster and better. How are you assessing Lyme? How are you assessing these co infections? Do you do any specific testing? Are you using symptom survey? Do you do any energetic muscle testing? What’s your perspective on assessing?
Dr. Bill Rawls: You know, when I when I did a medical practice, I did a lot of different kinds of testing. I went through a phase where I was doing just tons and tons of functional medicine testing. And I, as I went through time, I found that I used those things less and less and found less value in them because I could learn so much just by talking to the patients. And I think that’s what so many doctors, especially conventional doctors don’t do is there’s really no rewards in our system for talking to patients. And that’s where you really learn the information. But when we look at this thing we call chronic Lyme disease. I’m not I can I see most illness is more of a continuum with chronic immune dysfunction right in the center. So I think there are people out there that have all the symptoms of chronic Lyme disease that aren’t carrying borrelia but they are carrying other microbes like borrelia, and they have immune dysfunction. So it’s basically all The same symptomatology, even technically they don’t have Lyme disease. And when you look at that, and that that concept of this disruption of the microbiome and picking up all of these opportunities to mystic microbes as we do through life, because we do you know, we pick up bartonella from pets, we pick up mycoplasma, we pick up chlamydia. So these are non tick borne things that all of us pick up that can cause the same symptoms. But about a year or two ago, I sat down in and researched all the microbes that I could find that or have the characteristics that we call stealth microbes, they live inside cells, they they manipulate the immune system, they tend to just have a presence deep in tissue inside cells. And I found well over 100 species of microbes that have the potential to be involved with this kind of chronic illness but can also be present In the body without causing illness. So there are a lot of potential things out there. So everything we’re touching the things that we’re testing for just really, it’s a drop in the bucket, you know, we’re barely scratching the surface. And that’s the cool thing. When you use comprehensive herbal therapy, you’re addressing all of these different things. So it often doesn’t matter is much. So I tend to use testing when people aren’t getting Well, you know, we put them on a basic protocol, change their diet, change their approach to life to put them on a regimen of herbs, and then if they’re not getting Well, well, that’s an indication that to seek out different kinds of testing, but most of the time 50% of the time or more, they will need it.
Dr. Justin Marchegiani: That’s great. In my practice, clinically, you know, we set the foundation we work a lot with you know, adrenal stress because the adrenal is kind of our the big interplay with that sympathetic nervous system so we a lot of times we see cortisol imbalances or cortisol rhythm issues, usually from HPA access disruption. So we fixed the stress, we fixed the diet, really support the hormones and you mentioned like rhodiola as being one big, big fan of those adaptogens. And that really supports the immune system. I find addressing a lot of stealth gut infections, I tend to prioritize that first because I know 80% of the immune systems in the gut. So if someone has h pylori or SIBO or maybe a Giardia infection, I clinically find knocking that down one helps them digest their food better. So they’re getting more nutrition from their food. But to these infections aren’t there they are creating gut permeability. They aren’t creating as much inflammation. What’s your take on gut infections and how do you sequence addressing gut infections in relation to like Lyme co infections?
Dr. Bill Rawls: Yeah, it’s, you’re right. You know, a significant portion of the immune system is surrounding the gut because the gut has so many challenges with we’ve got so much stuff coming Through our gut, we’re feeding all of those microbes. And if you’re eating bad food, you’re feeding bad microbes. Those microbes are very active as far as neurotransmitters they produce that affect our system, and damage to the colon itself. So you ended up with leaky gut, which I did, I was I did food sensitivity testing when I was in the throes of everything. And I was sensitive to 70 75% of foods that I was eating. And it was because and you see that commonly with leaky gut. So once the gutters damage, you get proteins that are flooding across. So a lot of times I didn’t know whether it was the microbes causing the symptoms or the food sensitivities causing the symptoms. And a lot of times it’s both. So yes, addressing that gut dysfunction is really important. Diet is the first step of course, because what you feed your microbes is so remarkable. Important some people find value with probiotics. I think it’s kind of hit or miss. And I think we’re you know, we’re still learning with probiotics but the thing that I found that addressed those those kinds of problems, more than anything else with the herbs again, especially herbs like berberine and berberine, containing herbs and others that support the gut. slippery elm is really good for protecting the gut and allow it to heal. But the other herbs that I mentioned also have some benefits to the gut to so the herbs tend to suppress the bad microbes suppress the bank microbes in the gut that are causing the SIBO suppress Canada. And if you’re, you know, getting people on good foods that are cultivating that, that normal, healthy Flora then then then you’ll get there. What were the struggle for a lot of people though, is our standard American diet is so bad and that’s what people have been used to since they were children. It’s really, really hard to move them over to a good diet. It’s a very gradual process. So we started out with a pretty strict diet that we, you know, use foods that don’t cause typically cause food sensitivities that cultivate good gut flora and move people to a better place beyond that.
Dr. Justin Marchegiani: That’s great. I know some of the herbs that you know one of your famous products advanced biotic you have the Japanese knotweed, the cat’s claw, the Andrew graphics, the sask. Birla, which are great for some of these co infections. Do you have any favorite specific herbs that you like for just general parasite cleansing or just some of the herbs you’ve had really good success with clinically?
Dr. Bill Rawls: Well, all of these things have parasite capabilities. The cat’s claw and underground fists are traditionally been traditionally used. Going beyond that, for people that feel like they need a parasite. So, defining parasite, we’re generally talking about intestinal worms, which are multicellular organisms. And they’re good a classic combination is Artemisia, or warm wood, and black walnut and clove. And those are pretty stronger. So I don’t typically use them long term. Not everybody will need to, though. I mean, it’s, you know, the difference between what we call parasites that are multicellular organisms and the microbes that are in our body which are single celled organisms, protozoa, bacteria, viruses, etc. The all of the the microbes can reproduce within the body, whereas multicellular organism cannot. The only way that you can get intestinal worms is ingesting either eggs or larva. So you have to have that constant re inoculation. These things are not breeding inside your body. So once they die off, they’re gone. If and the only way to perpetuate those things is to keep reenact you lating yourself.
Dr. Justin Marchegiani: How do you categorize amoebas? Like like blasto or like [inaudible], how do you categorize?
Dr. Bill Rawls: Well, they can they can reproduce in the body but but so some of those things are common and and they can take up residence and hang around for a long time, but your typical worms do not. So people in this country don’t have a big load of worms because we don’t have contamination of our food, typically with eggs, or or larva which comes from fecal contamination is really common in third world countries but we don’t carry as much of an intestinal burden, probably less than humans have ever carried. And in this country, it’s pretty much in been endemic throughout human history because of fecal contamination of food. And again, it’s still really common in third world countries, but not as common here. So I find that just most of the standard herbs would be under graphics and cat’s claw and those kinds of things will gradually take care of those problems. But then for people who feel like they have Giardia or can be Dora the kinds of things that they picked up, which do happen. That Art Museum close, but well not combination is great. And there are other ones that are good too. I mean, that’s a nice thing about herbs. There’s so many choices.
Dr. Justin Marchegiani: That’s very cool. Now clinically, is there is there any like low hanging fruit like it’s underrated people don’t really think about it as like a big clinical mover but you know for you, it’s better A big clinical success. In your practice, you use it a lot, but it may not be well known any like, Is there one or two big clinical pearls that kind of come to the tip of your head?
Dr. Bill Rawls: Hmm. Wow, probably just herbal therapy. I mean, I think that has more healing you than anything else out there. And there’s no doubt about it. And it’s just, it’s that different approach. You know, so much of what we do and how we’re how I was trained as a conventional doctor, is you, you take the patient, you collect the symptoms, you do a physical exam, you do labs to find the diagnosis and you treat the diagnosis with drugs or whatever. But what I started doing after my life changed by by chronic illness was working backwards to instead of asking the page, asking how a patient is He’ll ask why? Why is this patient You know? And so in my protocols, I always step back to look at the patient’s life, you know, what are they eating? how impressed what kind of exposure to microbes that they have? What kind of exposure to toxins, you know, that list and going down that list, and I always found answers. And most of the time, I could help a patient Well, before we even got to the point of finding the diagnosis.
Dr. Justin Marchegiani: I agree. I think a timeline history is so important I interview patients I like to find out Hey, when did things first start to go sideways? What was going on? And then what happened five years later after you move what happened after the divorce? I like that really understand with that timeline, the stressors and how did it impact you? Did you ever come back from it that you resolve it? Where are you at now and it gets really important because the history I think you know, good doctor will tell you history reveals a lot. I think that’s powerful. Next up any thoughts on this whole COVID crisis. I mean, we can go into it from you know, just your medical perspective, being a medical doctor as well as you know, what are things you’re doing to help protect you and your patients just to keep your immune system strong?
Dr. Bill Rawls: Yeah, yeah, that’s we can have a whole nother big session on COVID. And I, I followed it from the beginning. And it’s, it’s quite an enigma. You know, the thing about this Coronavirus that makes it very frustrating is that most people don’t get very sick. It’s not nearly as virulent as I think everybody thought in the beginning. And typically, that concept of virulence is important. If something is very highly virulent than most people will get sick and you can identify the people that are sick very readily and you can quarantine them that’s why quarantine works so well for something like a bola virus. That’s why quarantine worked with the previous SARS and Mears outbreaks because those those microbes were much more virulent, they made people sick. So you could identify the people that were sick and quarantine them and contain it. This thing isn’t nearly as virulent you know, it’s looking at as they’re coming out with serology, it’s looking like this, the the mortality associated with this virus is closer to influenza, maybe even less than a year, I’ve seen that and half of people barely get sick at all, may not even have its symptoms of a common cold. So it is very, very difficult to control it. So whereas I think isolation was a good idea in the beginning to get let the hospitals catch up with supplies and everything else. Because some people do get really, really sick with this thing. Then I think that was a good idea. But I think as we go through time, it’s great. Going to become less and less and less valuable because it’s just going to destroy the economy. But what I don’t hear and what I really, really frustrated about is when I listened to the news when I listened to the medical establishment, I am hearing the latest statistics and what drug they’re looking for all of which have side of really bad side effects and when we’re going to get a vaccine so we can actually control this thing, and absolutely nothing about immune health. Nobody is promoting the importance of immune health. And what I can tell you is the people that keep their immune system healthy, have a much, much, much lower chance of ending up in the hospital and dying from this thing. And, and, you know, we’re just not hearing anything about that. And we do know something about some of the herbs. Some of the things that are already out there have been found a habit tivity again, Against previous Corona viruses. So Japanese knotweed Chinese skullcap some of the things that we’re actually using for line actually have good value have been shown to be effective for Coronavirus glue to fire them has been shown to reduce the severity of the the illness. Ginger, good old ginger tea has been shown to decrease the potential for these viruses defined for the to the respiratory tract. Yeah, so you’ve got all these and vitamin C, Vitamin C is extraordinary zinc. So we have all these natural things and we’re hearing nothing about them. In fact, they’re even being demonized by some people as Oh, we don’t know anything about that because nobody studied it yet. But and this knee jerk thing to to to incriminate natural therapy is being non effective, even though there’s evidence to the client Contrary, nobody’s looking at so I’ve found that to be hugely frustrating.
Dr. Justin Marchegiani: I 100% echo those sentiments. I think we are playing a defensive approach, washing hands social distancing, I think we kind of know intuitively to stay away from people that are sick, right? And, you know, a we can learn to wash your hands. That makes sense, but we need to get offense right. And the offense, like you mentioned, are some of those essential nutrients like I’ve been recommending ginger tea for over a decade. I mean, like you mentioned, the viral replication aspect for ending the virus from sticking on. You know, in this case that that h2 receptor site, you also mentioned, the lethality aspects and I’ve been talking about this quite frequently. And the data coming out of studies out of MIT, USC, Stanford, so when you calculate you know, mortality rate, people listening at home, right, you take the numerator, which is how many people died and then you put it over a denominator how many cases they are. The problem is there’s about 25 to 50 times more people that are part of that denominator that we don’t even know about. So then when you add the 25 to 50, then that makes that death rate a lot lower number two, if there’s 25 to 50 times more people now we got a lot more herd immunity out there, which is preventing that infection from being passed around, which I think is vitally, vitally important. And the other third issue I have is, I don’t know You can tell me because you’re in the medical you know, seen more. They created two diagnostic codes for this infection you owe 7.1 you owe 7.2. You owe 7.1 is an objective diagnosis with the PCR testing. Ul 7.2 is an epidemiological diagnosis that does not require any objective testing. If you have any upper respiratory tract symptoms and you die. You can be classified as you Oh, 7.2 totally subjective. Do you know any other diseases that have two diagnostic criterias and one that’s totally subjective.
Dr. Bill Rawls: Well, I yeah. Coding System is-
Dr. Justin Marchegiani: Is the flu like that at all?
Dr. Bill Rawls: No, I’m not sure about the flu. But I tell you, the whole coding system is a mess. And I think you and I are right on the same wavelength without one. You know, when when I started hearing, I mean, you’re being really immersed in this concept of microbes for the past 20 years. And just that concept of virulence has been very, very important to me that I don’t think a lot of doctors, including many infectious disease experts, really don’t understand the concept of virulence and how important it is and how these microbes function. But when I first started hearing the reports out on China, they were saying, okay, you know, the mortality that is 2.5% so it’s like, Okay, well, right up front, that’s a whole lot less than SARS, which was 10%. So we’re dealing with something that’s very much less virulent. And then they were saying, well, 80% of people will not be medical care, and that the testing that they were doing it was was not widely available. So right up front, I’m going, Okay, let’s put two and two together here. We’ve got a stated mortality of 2.5%. That of the cases they know about, but probably at least 50% of the mild cases aren’t being reported at all. Yep. And they don’t know about them. That means the actual mortality is probably around point 5% or lower. And now that we’re getting around to doing serology testing, that’s about where it is. Not to say this isn’t a serious illness, and yes, people are dying from it. And I’m not suggesting that we should be complacent about that. But I do think that we should be like you said morally offense of doing things to protect our elderly people that have immune problems. For everybody doing things to protect their immune system, herbs, better diet, sleep, everything, social distancing is very reasonable. But I think that people aren’t approaching this thing from a common sense point of view.
Dr. Justin Marchegiani: I agree. And I’m gonna be doing a video on this later on. Today I guess some of the data from Italy which are 2-3 weeks ahead of us in this whole situation. But this data showed about all the people that passed from the infections– 61% have 3 or 4 comorbidities and over 90% had at least 1 comorbidity. And the average age of death is 90 or 81. I look at that and you gotta say, the working age, economy will be shut down or should have a more strategic way. Quarantined people like Sweden, Brazil, that’s number 1. The second component on top of that is the Covid 19 tends to not be doing as well with people that are put on ventilators. 10% survive. So there’s something different with the ventilators, corona vs the flu. I have some thoughts on it, do you have any takes on that?
Dr. Bill Rawls: Well I think anytime someone is put up on the ventilator, it’s always low. I mean their whole system is struggling and their lungs are all fluids. But ventilators in general are just really really hard on the body. And it’s anybody ends up in ICU and has a ventilator, they are going to have a very long recovery if they survive. Unless its for like a destructive procedure, something like that, where a person is healthy in the beginning but yeah, this virus does seem to act differently than influenza. It affects cells differently than it can, it has a modus operandi that’s different from influenza. But as you mentioned earlier though I think there are [inaudible] cases of probably influenza. They got bundled under covid too. And there could been some co infections that people have both in influenza and covid. If you look at this thing, there had been like, millions and millions of cases like 15 million cases of influenza since october and the death rate for influenza the last time was 15,000 people in the United States and this is a virus that we have a vaccine for. This vaccine does not work a lot of the time, people are dying and people don’t have a healthy immune system. So, you know it’s been kinda crazy that we got all these spotlights focused on this person on the ICU bed, struggling for covid, you shine the camera down away, struggling with influenza. It’s been such a visible thing and then neglecting some other things out there too.
Dr. Justin Marchegiani: I totally agree. Use your strategy in using extra ginger, I like that. I think you said Vitamin C and Vitamin A. Are there any specific things, also NAC got a big one with viral application and keeping mucus and inflammation in the lungs and helping those pathways. Is there anything else you wanna highlight that you’re doing in an offensive approach, aside from washing your hands and standing away from the people?
Dr. Bill Rawls: Well, what i’m doing is I take immune modulating herbs and I think this is something looking at covid. One of the things that the virus does too is the immune reaction so it can be severe and creates a storm and is very damaging. And it has evidence that some stimulating anti microbial herbs like echinacea and astragalus can actually enhance the storm because they’re heating things up you know. So I think the immune modulating herbs are really impt. Take reishi, cordyceps. But I also take some antimicrobials that are not quite so hot. Our products with [inaudble] japanese knotweed, and we have chinese skullcap these are things that are commonly active. We have a product with glutathione and NAC. I think glutathione is just as valuable. Something that you know you just pick up little bits of information. we get our glutathione from a company called Century and I spoke to the medical director when we were deciding on that as an ingredient, and he said you know I’ve been working with a group of high
cystic fibrosis, in cystic fibrosis is an excess of mucus and there’s a glutathione mechanism
behind that, and he said you know I’ve got him on this product and they’re living normal lives and it just stuck with me. So this the glutathione NAC both have some wonderful new coletek properties and some supportive health promoting properties in the lungs. Vitamin C another study from years ago medical school that really hit home is you know humans of the only humans of primates are the only creatures that don’t produce vitamin C. All other creatures do. And there was an experiment where they took rats and they took the rats and they just tested them in a non-stressed situation and they were producing about the equivalent of us taking 200 to 500 milligrams of vitamin C a day. So they stressed these rats and then measured how much vitamin C they were putting out and it was the equivalent of us taking 21 thousand
milligrams a day.
Dr. Justin Marchegiani: Wow!
Dr. Bill Rawls: It just shows that when we’re stressed we burn up a lot of vitamin C, and we use it. Well I typically I’ve been taking extra each day but if I get sick with a cold or a flu I take about a thousand milligrams an hour up to about 6 hours so I’m taking anywhere from 3 to 6,000 milligrams a day. Effort stories if some places doing 16,000 I typically use the buffered vitamin C, take a little bit of zinc with that and the herbs and and drink a lot of ginger tea these days. Yeah I’m following good social isolation practices. You know most of my work is from home now so I’m using good common sense. I’m definitely not being cavalier. I don’t want covid or anything else but you know I was doing that before I’m pretty clear about these things as it was and I’m doing everything I can to keep my immune system healthy and those things are just really critical. With covid or anything else.
Dr. Justin Marchegiani: I know well the interesting thing is you know 20 years ago if you were in your OB practice right now you’d be shut down but you’re still able to help people and I’m still able to help people with with the whole virtual environment we have right now so we’re really a really benefiting from the technology and the times we live in.
Dr. Bill Rawls: Yeah, thank you.
Dr. Justin Marchegiani: Well doctor, is there anything else you want to leave us with? I’m gonna let the listeners know Dr. Rawls, his website is RawlsMD.com. We’re gonna put the links down below. Dr. Rawl supplements that is VitalPlan.com we’ll put the links down below and then my favorite product that he has is the advanced biotic, we’ll put that down below. Doc you also have a book coming out, so I’d love to have you come back on the podcast when that book comes out. We can chat about that. Is there anything else you want to leave the listeners here today?
Dr. Bill Rawls: After I took a year off of my life and a lot of people have found that valuable right now, I’m working on a book called for about healthy aging, and the how important this concept of microbes in the microbiome, and immune system gets in the healthy aging process or the aging process and just staying healthy as you age, so hopefully in some months, three months, six months we’ll have all that done out there. But thanks for the opportunity. It’s been a real pleasure
Dr. Justin Marchegiani: Thanks Dr. Rawls. We’ll put all the links that you mentioned down below and love to have you back in the next few months when that book wraps up. It was excellent chatting with you. Have a phenomenal day and you stay healthy.
Dr. Bill Rawls: Awesome, thank you very much.
Dr. Justin Marchegiani: Bye now.
References:
Audio Podcast:
https://justinhealth.libsyn.com/dealing-with-co-infections-and-fibromyalgia-podcast-284
Fibromyalgia Natural Solutions – Dr. J Podcast #159
Dr. Justin Marchegiani and Evan Brand discuss about Fibromyalgia including its cause and symptoms. Learn how some of the symptoms connected to it such as anxiety, depression, IBS, memory problems are also seen in other health conditions.
Listen as they talk about some of the viruses, infections, gut health, heavy metals, thyroid and adrenal imbalances as possible contributing factors or underlying issues leading to unfavorable health symptoms. Gain some valuable information regarding natural solutions and lifestyle changes that you can do to combat these symptoms.
In this episode, we cover:
02:15 Fibromyalgia Symptoms
03:48 Viruses and Infections
07:20 Gut Health
10:31 Adrenal Issues
13:19 Heavy Metals
Dr. Justin Marchegiani: It’s Dr. J here in the house. Evan, how we doing today? Happy Monday!
Evan Brand: Hey, man! Happy Monday to you. Life is good.
Dr. Justin Marchegiani: Yeah. We had a little technical difficulty here. But we are rolling. The show must go on. So, any any updates for me here that you want to bring to my attention before we dig in and get dirty?
Evan Brand: Well, I’m just excited. I’m excited to talk with you about fibromyalgia. This is one of those things in that category like IBS where the conventional doctors—
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand:.. give people diagnosis and then they just end up with drugs in their pockets and they don’t have any real success. And people struggle for years and years and years, they end up with these other symptoms that come along with fibromyalgia like anxiety or depression or IBS. And once again, conventional Docs, they just don’t really have a high success rate with this issue.
Dr. Justin Marchegiani: A hundred percent agree. And fibromyalgia is one of these interesting types of diagnoses. Basically you have to have uh—central allodynia pain, which is kind of like this uh— pain that may be true like 11 different random spots of the body. So they look for these different pain, tender spots, shoulders, chest, hips, back. And they are looking for like at least 11 out of the 17 or so spots. And if you have it, great, you have fibromyalgia, right? Coz basically what is a central allodynia? That means your nervous system is so hypersensitive that it’s dectecting, you know, you rubbing like this, just things that shouldn’t cause pain. It’s sensing that it’s pain. And that’s the biggest issue coz the nervous system is so upregulated, it’s like having an antenna that’s so hypersensitive that it’s picking up stations uhm— that shouldn’t be picking up. And it’s the same kinda thing. Your nervous system is an antenna that’s picking up all these nociception or pain sensation where it shouldn’t be. So we want to get to the root cause of why that is. Go ahead.
Evan Brand: Yeah. There is uh—conventional drug that a lot of people end up on. The Lyrica, which I’m sure you’ve heard of.
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand: Huge pricing commercials for it. And I’ve had people taking that and they just don’t notice much and then sometimes the side effects, maybe not without drug, buy any of the drugs, can be worse than the actual thing that you’re trying to fix into the first place. So that’s just— it’s scary because when you want to get a root cause answered, you’re not gonna get it unless you start running some of these functional medicine testing that we’re talking about. So I just have a list of symptoms I wanted to read that could come along with the fibromyalgia. So that could be anxiety, that could be concentration and memory problems, depression, fatigue, headaches, irritable bowel syndrome. Now, that sounds like a lot of other things that we need to talk about.
Dr. Justin Marchegiani: Exactly. And here’s the thing, right? A lot of people may have gluten sensitivity or hypothyroidism or heavy metal issues or gut microbial imbalances, the issue is that some people may manifest with Hashimoto’s. Some may manifest with fibromyalgia symptoms who have a lot of the central allodynia pain. So it is interesting because some people, they can have the exact same core underlying issue, but have a totally different diagnosis. And all of diagnoses is a constellation of symptoms that are typically put into one category, right? The chronic pain symptoms—that’s gonna be in the fibromyalgia category. Memory symptoms—that’s gonna be in the category. Fatigue symptoms— that could be in the thyroid or adrenal category. Gut issues— depending on where that inflammation is located, that could be in the Crohn’s or Ulcerative Colitis or there’s no inflammation in the tissues that can be in the IBS category like you. So this is where it’s tough because all conventional medicine is tyring to categorize known symptoms in the categories call the “disease”. We are trying to trace it upstream. And the hard part about functional medicine is certain people can have the exact same imbalances and manifest with totally separate diseases. That’s the hardest part people to wrap their heads around.
Evan Brand: Yeah. Let’s go into the viruses. My wife when she had joint pain several years ago, you said, “Evan, the first thing you need to look into is going to be some of the viruses.” And so we got a blood test run on her. She did not show up with Lyme, fortunately, but she did show up with the cytomegalovirus and then also the mycoplasma. Can— so can you speak about those a bit? And how that could be causing joint pain that could get misdiagnosed?
Dr. Justin Marchegiani: A hundred percent. So there are certain infections like mycoplasma is one of them they can manifest in the joint tissue, for sure. So that’s one of those conditions that an infection can really be driving a lot of that joint pain. And we know certain infections and certain imbalances can manifest with certain symptoms. Like we know that hypothyroid issues, low thyroid function can manifest having low thyroid hormone in joint pain. We also know like infections like mycoplasma can also cause or call the lower thyroid function and then potentially manifest in joint pain. We also know it could potentially manifest in the joints and you know certain antibiotics like Minocycline to help knock it out. We prefer to use some of the herbs coz it tends to be safer on the gut microbiome in the long run, number one. And then with your wife symptoms, we notice that she already had a pretty good diet. And there was a tick bite involved in your wife’s last issues. Is that correct?
Evan Brand: That’s right.
Dr. Justin Marchegiani: And so because of that, you know, we were leaning towards, “Hey, let’s just to after the infection and see what happens.” And when we knocked out the infection, everything got a lot better. So that was good to see that.
Evan Brand: Yeah. It was so— it was so it was so easy, too. So simple. Just modify the immune system, all of a sudden things are better. So, if you have fibromyalgia or you have joint pain and general pain stiffness, you gotta make sure you roll those in. So go to your doctor if you’ve got a natural path or functional medicine practitioner, that’s even better. Try to get them to test you for the Lyme, plus the co-infection. So coz like I said she had a negative result for Lyme, but she was positive for these other things, Cytomegalo and the Mycoplasma. So you gotta go look for them.
Dr. Justin Marchegiani: Hundred percent. So, again, any issue any like disease issue, like if you’re someone and we’re focusing on fibromyalgia today because that’s got a certain bit of symptoms that manifest in pain. So if you resonate with that, great. This is going to help you. If you don’t resonate with fibromyalgia symptoms, but you have something else, this podcast is still gonna be helpful because we always trace it back to the underlying imbalances, which can manifest itself in different symptoms. But one thing that’s gonna be uniform across the board is looking at the gut. The gut is really important coz that’s where a lot of your immune system is. 70 to 80% that’s where your body digests and breaks down nutrients, that’s where uhm—your— essentially you digest and break down all the food you’re eating. So if we’ve a bottleneck in the breakdown of our nutrition, we’ve a bottleneck in how our immune system functions, if we have a leaky gut and your immune system’s being overreactive, or if we have an infection there, that can create a lot of underlying stress that may manifest itself in different symptoms. And again, kinda linking it back to fibromyalgia, if you have these chronic pain issues, those 11 kind of places a central allodynia pain to touch, right? Your diagnosed 11 places of pain on your body, at least. And you have the fibromyalgia, the diagnosis, then we definitely have to rule out the gut. And again, here’s a thing that really throws people for a loop is that you can have gut issues and not have gut symptoms – that’s the really hard thing. You may not have the bloating, the gas, the diarrhea, the constipation, the acid reflux, and you may still have a gut issue.
Evan Brand: Uh-hmm. H. pylori we see it every week in the clinic. So if you’ve got H.Pylori, you’ve got that bacterial infection, that’s suppressing HCl production, therefore you’re not digesting your food. So if you’re seen floating stools or you’re seeing undigested food particles in your stool, that could all be adding up to this whole picture of the depression, the anxiety, the fatigue. Maybe even skin issues, too. So maybe you don’t have the fibromyalgia diagnoses, but you’ve got fatigue, depression, anxiety maybe some sleep problems maybe some skin issues. That could all be tied into leaky gut— that intestinal permeability. It could be something as simple as H. pylori or like Dr. Justin Marchegianientioned, it could be H. pylori plus Mycoplasma plus maybe some bacterial overgrowth like the SIBO case or plus parasites, which is something we often talk about, plus fungus. You know, typically it’s not just one thing. Most of the time, by the time people get to us, they’ve been suffering for quite a long time and therefore, there’s usually a handful of things that we’ve got to address. Now on the thyroid, is the pain going away just a side effect of you fixing your thyroid? Like all the sudden thyroid function improves and the pain just goes away. Could it be that simple if that were your biggest root cause?
Dr. Justin Marchegiani: Well 100%. So you can see it quite frequently that just getting someone on some T3, some thyroid hormone can really help because they may be on thyroid hormone, T4, but they’re not able to convert and activate it. So there’s TSH, right? The pituitary hormone that most conventional docs measure to look at thyroid function may look nice and pretty but they’re not making that conversion from T4 to T3. So their T3 levels may be low, and if you come in there with some activated T3, you may start to put some of their thyroid symptoms on remission. Now, we have to understand, from a functional medicine perspective, what’s palliative and what’s root cause. So we have to make sure we actually fix the underlying conversion issues, if it’s nutrient or if it’s inflammationm if it’s gut, if it’s immune. And we also had to fix the underlying nutrient absorption issues, the infections, the autoimmunity, right? So whatever those issues are. So, we kinda understand that there are certain natural medicine things we can do. There are palliative, which are great. And there are certain things like, I think you mentioned earlier about the uhm—your child has a little bit of eczema and you know, putting a little bit of coconut oil in there helps. But you recognize, that’s palliative not root cause. So we try to get to the underlying foods that may be causing it. Same thing in this analogy with thyroid. And thyroid, low thyroid hormone can express itself in about 70 different symptoms—hair loss, fatigue, uhm— brain fog, anxiety, right? All these different symptoms. Also, the pain symptom is one of the.
Evan Brand: Yup. Well said. And if it’s Hashimoto’s, if it’s an autoimmune thyroid condition, that T3 could help symptoms improve. In this case, you could get more energy, could help reduce pain. But if you haven’t stop that autoimmune attack by addressing infection, supporting the adrenal glands, making sure the diet is dialled in, and you don’t have any foods that are creating antibodies against the thyroid. You know, those are some of the big three needlemovers you got to have on board to fix this thing at the root and not just be stuck on T4 or T3 or combination for the rest your life.
Dr. Justin Marchegiani: Hundred percent. So we also know that adrenal issues— adrenal imbalance is not necessarily adrenal fatigue, of course, you know, most people in the conventional medical world will hear adrenal fatigue and think adrenal failure like Addison’s disease, okay? Which is valid but we also know that there can be imbalances in cortisol that may not be a full disease failure kind of situation. It may be just lower adrenal cortisol issues, lower DHEA because of HPA axis dysfunction. And if that’s the case, we want to make sure we support that because adrenal, zero adrenal glands produce cortisol, which is your natural anti-inflammatory hormone. And again, people that have chronic pain issues, a lot of times, we put on like COX 2 inhibitors, things like that. Severe pain, of course, Opioids is an Oxycontin, which is a another big issue in itself. But also, Prednisone and Corticosteroid drugs that basically have the ability to knock down inflammation, the problem is, why aren’t your own glands working enough to cover up that inflammation, too? So, if we get the adrenals working better, we can kinda make some of our own homemade Prednisone on our own—our own homemade Corticosteroids to help cut that inflammation down.
Evan Brand: So talk about what happens. Let’s say somebody is on the steroids long-term, that’s also going to affect the adrenals as we’ve seen on some lab results.
Dr. Justin Marchegiani: Yeah. It will throw off some of the feedback loop, so will disrupt the HPA axis, that’s the brain talking to the adrenals. That’s that nice feedback loop or that kind of internal thermostat that our body has. So we do have that there that we have to work on because that can affect that thermostat. Uhm—number two, it can really throw off your blood sugar. So taking a lot of synthetic steroids that when we create protocols for a patient, we may use small amounts of precursor hormones like Pregnenolone or DHEA. And these are gonna throw things off in the same way that a drug would. Because these drugs are very, very powerful. They can mess up the feedback loops. But if you’re using a corticosteroid, it can really mess up your blood sugar and in the long run, it can even create osteoporotic situations. It can really thin out the bones. It can really weaken the gut lining because these steroids break things down,right? They’re anti-inflammatory but they are also very catabolic. So it’s great in the short run, right? When we get back on track, but not good in the long run coz it can really mess up our glandular physiology. How that—how our hormonal systems work. And the feedback loops that kinda keep them connected.
Evan Brand: I think it’s worth mentioning heavy metals, too. I don’t think it’s good to be
necessarily the number one cause for most people, but we notice that if there is a gut issue, let’s say somebody does have these gut bugs, they could have a detox problems, too. Just coz their body, their liver is just so overburden. Let’s talk about metals a bit. So could be just amalgam fillings or could be occupational exposure or could be too much of a lower quality or too big of a fish like a tuna that’s causing issues. Let’s talk about that for a minute.
Dr. Justin Marchegiani: 100%. So we can definitely have toxicity issues like Mercury which can be very inflammatory. Mercury also is similar to the halide group so it could fit into the receptor site where Iodine would typically bind in. Fluoride and bromine can also pinch-hit there as well. So that can create a lot of issues regarding that. Mercury can also jam up the mitochondria. I mean feel free and go to PubMed and just type in “Mercury and mitochondrial function” and you’ll see increase in heavy metals can decrease mitochondrial function. And again, as—as glycolysis and our Krebs cycle turns and we have betaoxidation on the flipside, we generate about 36 ATP’s per pump and those ATP’s work is kind of the cellular currency for energy, right? It’s how our body kind of you know, creates energy and you know, has aerobic metabolism to create ATP, which is our body functions and that’s kinda the byproduct of having a healthy metabolism.
But if we go in there and all these gears are moving spitting out all these ATP, which is basically cellular energy, and we messed that up, we throw kind of a monkey wrench into the gearbox, that’s gonna prevent optimal ATP function, which is gonna throw off our energy and our body ability—our body’s ability to function, right? Lower energy is gonna create symptoms. Anytime you have lower energy, you tend to start having brain fog issues, mood issues, fatigue issues, pain issues, sleep issues because energy is the byproduct of a healthy metabolism. So when energy goes, metabolism is going down. And when that’s starts to go, other symptoms tend to manifest as well.
Evan Brand: Yeah. I’ve gotta say two things. One is glyphosate. If you’re not 100% organic, make your goal to be a 100% organic as close as you possibly can. I love that people are honest. I had a guy who on his intake form, I asked the question, “What percentage or diet is organic?” He said 0%. I’m like, “Man, you’re getting glyphosate.” We can measure it. We can prove it on a piece paper, but just know if something is not labeled organic, especially your fruits and veggies, assume it’s contaminated with glyphosate. Just like Justin mentioned about Mercury, antibiotics, glyphosate. Those are all mitochondrial killers and so there’s nothing worse that you could possibly do than have glyphosate in your system. Now, fortunately, you can detox it by using the sauna. There’s other methods that we talked about but just make it a goal. Throw out the—you know, go donate or throw out the non-organic stuff. Swap it out. Pay the extra buck. Pay the extra 2 bucks. It’s gonna be much, much more valuable in the long-term and much cheaper in the long term because you’re gonna prevent yourself from having health issues associated with glyphosate toxicity.
Dr. Justin Marchegiani: Hundred percent. Hundred percent. I had a conversation with someone recently that say, “Hey, you you realize organic food doesn’t have any more nutrients than conventional food.” And I said back to them,”Well, it depends.” There are some studies that do say organic food does have more nutrients. I mean there are some people that say that’s there are some studies by Temple University that shows a much higher level in nutrition with organic food than conventional food. I just think it depends on what kind of organic we’re talking about factory farm, you know, big corporations have started labeling things organic. And again, are they gonna have the same high level as a local farm regarding fertilization, you know, rotating the crops. I mean, if you just have an organic farm without pesticides, but you just continue to heat that crop season after season, don’t let it rest, don’t switch spots, and don’t you know, add synergy to the land, right? Some synergy is like, for instance, when the cows pass on their— basically have their manure, their bowel movements, you’re bringing the chickens afterwards to kind of help uh knock out all the grubs, right? Which prevents other animals from coming in. So you can add synergy to the land that helps, number one, increase uhm— fertility to the soil, right? Increases that top soil. But number two, it helps other past and creatures from growing, which can create havoc down the line. And so, in other words, uhmm—some people can really hit that soil hard and decrease the nutrient densities of the organic food. It has less nutrients, anyway. But anyway, so let’s just pretend this person is right. They told me organic food has the same nutrition as conventional food. Alright. Fine. We do know the research is quite conclusive that organic food has less pesticide residue. Of course, coz to be organic, you can’t have pesticides on it. So just the fact that— let’s the nutrient’s density is the same from organic food. While I’m definitely not getting the pesticide exposure, which Evan mentioned earlier with Glyphosate or Roundup. It’s so important. coz there are so many studies on that coming out that it’s very toxic on the body, on the liver, on the gut. And essentially many other places.
Evan Brand: You know, the European Union, they’re successfully banning it. I’ve been trying to keep up with this is much as I can. It looks like glyphosate is seeing the end of the rope in the European Union. I hope something is to follow in the US, but I just don’t think it’s gonna be anytime soon here.
Dr. Justin Marchegiani: I agree.
Evan Brand: One of the thing I wanted to mention is on the CDC’s website about fibromyalgia, they say that much much much higher rates of ankylosing spondylitis occur with fibromyalgia and Justin and I mentioned this on a mini podcast. That’s an autoimmune condition. And so it sounds like what they’re saying without saying it because maybe they’re not noticing the link, is that this whole thing is likely just a autoimmune issue. The IBS, like you mentioned, the Crohn’s or the Colitis, the Hashimoto’s, like this could all just be autoimmunity at the root. And we’ve just got to go through all of our causes and fix the autoimmune issue and then all of a sudden you can reverse the symptoms.
Dr. Justin Marchegiani: Hundred percent. And again, there’s like over a 180 autoimmune conditions. So my analogy is anytime you have a physical chemical or emotional stress, or you know, imagine having this fancy pearl necklace, every time you put tight, that’s a physical chemical or emotional stressor in your life. And let’s just say every little spot where that pearl connects to the necklace, they’re not all the same strength. There maybe some part to that chain that are little bit weaker. Think of that as genetic predisposition at work. You’re gonna have certain genetic links in the chain that are going to be a little bit weaker. Now what does that mean to you, as that stress comes on, that part of the chain may be more likely to break than another part. Let’s say Pearl 33 is more likely to break them Pearl three or Pearl four, right? Now, Pearl 33 may be ankylosing spondylitis. And that stressor may be Roundup or could be Hashimoto’s or let’s say Pearl 4 is Hashimoto’s for someone else, right? So think of every little link in that chain as a different disease that could manifest if that link is broken. And where that link you for you, is gonna be based on your genetic predisposition. What we have control over is not pulling that damn chain type. Let it go. Let it relax, right? How do we do that? All of the diet and lifestyle things. Just cutting the Round up out. Eating organic. That pulls the stress off. And getting that good sleep, having good thoughts, fixing your gut, fixing infections, making sure you can digest and break down all that really good food that you’re eating. Get your hormones under control if there’s imbalances there. Does that make sense, Evan?
Evan Brand: Oh, it sure does. I mean, just like you picture a big wall think of like a submarine. You’ve got a 1000 switches in all these red switches are flipped on. We’re just gonna go down the list and just flip all those red switches off, and all of a sudden you turn off, you’ve not pulled the trigger. You’ve got the loaded gun, but we’re just gonna decide not to pull the trigger. People think that like genetic testing is the end-all be-all and “Oh, my gosh! I’m genetically predisposed to X.” It’s like that doesn’t change the protocol at all. That just means you need to be even more diligent. If your family had a history of this condition or other conditions, you just have to be more diligent. That doesn’t mean you’re toast. That doesn’t mean you’re definitely going to get XYZ disease or condition. That just mean you got pay attention. You’ve gotta make sure you’ve got all the pieces going in your favor.
Dr. Justin Marchegiani: Yeah. And I pretty much work with the genetic stuff. I don’t get so hyper fixated on it. I just assume the worst for everyone. And that way, we’re making the changes in hydration, with sleep, with water, with toxicity, with gut. We’re not gonna give synthetic folic acid. We’re gonna give super high quality methylated B vitamins. We’re just making that assumption for everyone because I can’t be hurt by making that assumption in that direction. If I make it the opposite direction and say, “Hey, it’s okay. You probably don’t have a folate issue. I’m gonna save some money and put some crappy synthetic folic acid in my multivitamin instead of high-quality activated folate. Then I can go wrong, right? I may save a little bit of money but because we’re interfacing with our patients daily and weekly, we know that we’re better off rolling the dice in favor of there being an issue with that. So we always have the higher quality nutrients in there to cover our butts.
Evan Brand: Yeah. And I had a a woman who emailed me this morning she said, “Evan, I had a reaction to gluten. Do you think it’s time that I go get tested for celiac?” And I told her, “It’s better cheaper and likely safer just to assume that you’ve got a massive allergy to gluten,” Then you just need to stay way because really, going to the gastroenterology process where they make you eat— what is it two slices of bread for like a week or two and then they cut out a piece of your intestine to try to see if all those cilia where destroyed or flattened. And then a lot of times, there’s even false negatives there. So you could do all that work. Destroy your body, create inflammation and then say, “Oh, it says negative.” It’s like just stay away and be more diligent. Don’t tell people that it’s a preference. Just tell it— tell people at a restaurant it’s a gluten allergy. Make they change their gloves. And you’re gonna be much safer as opposed to waiting for that diagnosis. So that’s kinda what my message is. If you have these symptoms, maybe you’re not been officially diagnosed with fibromyalgia, but you’ve got these symptoms, you’ve got pain and the sleep and fatigue. Just go ahead and think, “Okay, maybe I’ve got XYZ but now I’ve just gotta start working on all these big pieces we talked about.
Dr. Justin Marchegiani: Hundred percent. Yeah. Makes a lot of sense. And someone’s chiming in here on the YouTube live here, chat saying that uhm—their local farmer told him it’s certified organic, allows them to spray toxic pesticides two times a year. Not sure what kind of certification that is. Typically, the USDA certification’s pretty good. The fied has to be—the land has to be for three years without pesticides to even get that certification. So I’m not sure if we’re talking about the same USDA certification, number one. And a lot of farmers they’ll use other compounds that tend to be a little less toxic to help with spring. So like for instance we have our property done which had to use probiotic spray and we tend to use essential oils. And again, there may be chemicals in there, of course, but they may be harmonious and have less toxic burden. I’m more worried about the toxicity of the pesticides. And let’s say you bought an organic food that was, you know, in one of these farms that was spray twice a year, well, isn’t that gonna be better than a farm that’s sprayed weekly?
Evan Brand: Right.
Dr. Justin Marchegiani: So I’m kinda like good-better-best. Hey, if I’m gonna cheat or if I have a choice option between something that was spray weekly versus twice a year, I’m still gonna go with twice a year because that toxicity burns is gonna be good. Also, we can just utilize the Clean 15 and the dirty dozen. Great, if we’re gonna buy a food that’s conventional or somewhat conventional with pesticides. Let’s look at the Clean 15 and see the foods that have less pesticide residue and avoid the dirty dozen and/or just get a really good uhm— vegetable or fruit wash that you can wash off some of the external pesticides at least.
Evan Brand: Yeah. And some of the regulations under the USDA, there’s a difference between 100% organic and just certified organic. So, obviously, the best thing to do which is contact a local farmer, which is what I do. I buy some bison meat and other products locally. And I know that they don’t ever use chemicals ever and if they do have to use chemicals, they’ll tell you. And they’ll say, why, what happened how much, what did they actually use. So if you just look up local harvest and go look up type in your ZIP Code, your location, go find some local people and just talk with them. That way, you don’t have to guess anymore whether something’s actually legit from the grocery store. I still go to the grocery, but I try to source other things outside where I can check the person’s hand. It’s just a lot more viable experience that way.
Dr. Justin Marchegiani: Yeah. And again, we just have to do your best, right? Sometimes we don’t have the best options you know, when we’re traveling or we’re going out to eat. But if we can control the 80 to 90% when we’re home and we’re in our house and the foods that we choose in our area, that’s gonna be the most important thing. Also, when you’re healthy, you get a little bit more wiggle room; when you’re chronically sick, you don’t. So if you’re chronically sick, then you really got to be careful and make the best decision possible and uhm— if you’re not, then 10 to 20%, I’m totally okay with. And if you’re going to get exposed to things, activated charcoal is a great option uhm— taking some extra detox support may be helpful, too. So all that’s really good if you know you’re gonna be getting exposed to not so good things.
Evan Brand: Yeah. Take in your enzymes, too. Take in your acids, your enzymes. You and I both use enzymes that are gonna contain special ones that helps. So if you do get to it. exposed to gluten, that can help reduce the flareup. If you are sensitive, you are react to it.
Dr. Justin Marchegiani: Exactly. And then James here, talks about uhm— his fatigue still lingers daily, can’t shake it. Thyroid tested good with me, uhm—Modafinil works great and gets me to the day. And Modafinil or Provigil aspirin is a big fan of it. Not a huge fan long term. I mean I think it’s not fixing any of the underlying issues. So the diet helps I mean I would look more at the adrenals, I’d look more at the mitochondria. I forget your specific case, James, I know you’re doing good for a while. So if you just had a backward slide recently, we’d wanna chat and figure out what underlying stressors have creeped up or make sure the infections are gone, or make sure the mitochondria are functioning as optimal as possible. So I wanna look a little bit deeper. I’m fine, though, using Modafinil Provigil punctuated time frames, you know, a work deadline comes up, major stressors you know, you have to induce some extra stuff on the weekend with your family or work stuff, then fine. Take that to really upregulate your body but just keep in mind there’s something deeper we got a look at. And just you know, things like sleep and things like hydration and people forget those all the time.
Evan Brand: Yup. Very simple but sometimes the most simple stuff moves the needle.
Dr. Justin Marchegiani: Yeah. I mean Daniel talks about here, uh— talks about what can cause jellylike lumps in the semen sometimes painful to pass. Well first off, I would do like a urine analysis first, just to make sure there’s nothing, no UTI your uhm—you know, nothing that’s kidney or bladder base. Make sure there’s no infections in the piping, so to speak. Uh—again, I would also rule out epididymitis. Make sure there’s no infections in the epididymis. There could be a bacterial issue that’s just causing these uh— the semen to kinda agglutinate or stick together. And also, even just run a sperm analysis. Just to make sure this— the semen are actually alive and it’s not a whole bunch of dead semen uh— in there as well. So, I would look there first. If the diet’s good, if everything else is good, I would just make sure any type of infections and that urinary area are also clear too. E. coli, those kinda things.
Evan Brand: Awesome. Well, we gotta wrap up. Both of us gotta get back to our calls, but we hope you guys enjoy the show and leave us questions. You can leave us questions in the future. So if you didn’t catch this live, go to Justin’s YouTube channel. Go on his video, write in your questions, we’ll try to answer as many as we can or will save those for future show. And then same thing for topics. If you have topics that you want us to address, please put them on there. And if we need to reach out for a consult, check out Justin’s site. It’s Justinhealth.com You can schedule a consult. If you wanna schedule a consult with me, check out my site EvanBrand.com and we are happy and willing to help you. So please reach out if you’re suffering around the world, just phone in and Skype consults make it easy for us to help you.
Dr. Justin Marchegiani: And check us out on our podcast channels, too. We’re trying to do our videos here on YouTube, but we’re also trying to record everything in higher-quality audio. So, if you want to hear us in some higher quality audio, check out our podcast channels. Again, if you go to Evan’s site, EvanBrand.com or my site, Justinhealth.com click on the podcast and you can subscribe to get updated, audio as well. Anything else you wanted to add, Evan?
Evan Brand: I think that’s it. Awesome and Ross, yeah, Mastic Gum is great for H. Pylori. Awesome show today, Evan. Great as always. Appreciate your energy and your insights and let’s chat real soon.
Evan Brand: Likewise, man. Take care.
Dr. Justin Marchegiani: Take Care. Bye now.
Evan Brand: See you.
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