The Gut Connection With Urinary Tract infections (UTI) and Yeast Infections | Podcast #367

Urinary tract infections (UTIs) are a common medical problem affecting millions of people worldwide. The primary source for UTIs is presumed to be the gut. That’s why in this video, Dr. J and Evan talk about how gut bacteria can contaminate the urethral opening, eventually propagate themselves in the bladder, and cause symptoms of a UTI and possible yeast infection.

They also added that women are significantly more likely to get UTIs than men. It is due to anatomical differences that make it easier for disease-causing bacteria to travel to the urinary bladder after accidental transfer from the bowels. They also discuss the other clinical and evidence-based factors with helpful tests to find the root cause of these issues.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00  – Introduction
1:53   – Urinary System
10:54 – Antimicrobials and probiotics
18:55 – UTI and Yeast Infection

Dr. Justin Marchegiani: Excited to be here with Evan Brand. Today, we are gonna be chatting all about the gut connection with urinary tract issues, UTIs and yeast infections. Really excited to dive into this topic. This is the common female topic that we deal with. I mean, men deal with UTIs as well but men have a longer urethra area so it’s harder for men to have UTIs with them. Women have a much shorter urethra so bacteria can make its way up to the urinary tract and blood much faster and easier and so probably more of a female issue but we’re gonna dive in. The physiology is similar between the two so men listening will still get something of it as well. Evan, how are we doing today?

Evan Brand: Hey, doing really well. And so, looks like about 90% of infection in the bladder, 90% of these cases of these infections of bladder, urethra and kidneys, it’s all related to E. coli, which of course E. coli are in your poop and can generally just take route up that way and they can migrate and populate within the urinary tract and so women obviously know these symptoms if they’ve had it but it’s you have to urinate more frequently, it’s painful urination. It could be pressure in the pubic area. It could be fatigue. It could go more severe into kidney injury but most women are usually so miserable before they get to that point that they end up doing some sort of conventional treatment. So, why don’t we just talk about the conventional approach because I think it’s great to highlight what people are doing and then what we’re doing differently that we may argue is a far more sustainable solution without the side effects. Antibiotics are gonna be huge and we’ve got some statistics on this. Antibiotics are prescribed for 33% of women to combat a UTI before the age of 24 but of course these synthetic antimicrobials are not without short- and long-term consequences.    

Dr. Justin Marchegiani: I’m gonna just share one thing here on screen just so everyone can see. So, you can see the female anatomy, right here is the urethra, here’s the bladder so you can see a very short distance from the urethra to the bladder. You can see here in the male anatomy, right at a much longer distance to get up here. Obviously in the urinary tract, you’re just typically with the UTI, it’s the bacteria that’s making its way up here, okay, into the urinary tract that’s causing the infection like Evan already mentioned that’s mostly gonna be bacteria, right?  Usually on the UTI side, it’s gonna be E. coli there, can be some Pseudomonas, it’s mostly E. coli. And so, it’s really easy for women to get bladder infection because you can see it goes up faster. Again, things like birth control pills we’ll talk about and antibiotics really shift the urinary pH and the intestinal pH which has a major effect on the bladder and the urinary tract and it makes it easier for bacteria to grow that tends to be why women are a little bit more susceptible than that for bladder infection obviously but in general you’re gonna see that with birth control pills because how estrogen affects the pH and then also women when they menstruate, right, just that whole vaginal area right there, sloughing off that endometrial lining. All that blood flow does shift that whole entire are to be way more alkaline because bloods around 7.3 pH so it does shift that whole vaginal tract to be more pH higher on the pH side which can increase other bacterial infections more on the vaginal side but hopefully that helps. Any comments on that, Evan?  

Evan Brand: Yeah. It’s totally interesting and this is stuff that maybe you didn’t pay attention to in school and biology class but now in adulthood it’s a lot more important and I think people just don’t even understand the anatomy of it and this is something that according to the research here, 25% of people treated for UTI, they will experience a recurrence 6 – 12 months later. So, I mean, that’s a quarter of these people that now have another UTI and they just go on this merry-go-round. And of course, every time you go on these antibiotics, you’re damaging the mitochondria, you’re damaging your gut microbiome in total, so it’s not just this one thing that you’re doing, it’s the sum to your system and it can really add up.   

Dr. Justin Marchegiani: Yeah, when we deal with urinary tract issues, I kind of look at, okay, you have yeast issues over here. They’re kind of, they intermingle right and how the different things happen. You have bacterial issues over here, right? So, your UTI issues are primarily bacterial, right, affecting the urinary tract. You can have BV, bacterial vaginosis, that’s another bacterial issue. Usually, Gardnerella bacteria is one that’s affecting the vaginal canal. So, a little bit different, right? Different, you know, same general area, different anatomy per se. You’re gonna have similar sequelae of tissues affecting it, right?  The big difference with the BV issue is you’re gonna get the potassium hydroxide odor which is, that’s kind of the fish smell. That’s what the bacteria in the vaginal canal does, it creates that potassium hydroxide that’s the fish odor. You’re not gonna quite get the odor with the UTI but you will have the burning during peeing. So, that’s gonna be the big differentiating factor. Sometimes, more odor on the BV but sometimes you can have none and then of course more pain during urination on the urinary tract issue and then if that continues to be left up that bacteria will eventually continue to go north and eventually hit the bladder as you can see that anatomy pretty short on video here. But, one of the big common issues is I would say like the big three, anytime I look at this problem, they tend to be the same. It’s gonna be a combination of antibiotic use so we’re wiping out a lot of the good flora in our intestinal tract which also affects the vaginal or urinary microbiome and then that affects the beneficial probiotics that actually make hydrogen peroxide like probiotics usually make hydrogen peroxide which is antibacterial. They’ll make different acids, glucuronic acid, they’ll make acidic acid. Different acid acids that actually help keep the microbes in check. They make hydrogen peroxide H202 and it keeps a lot of the bad bugs down. So, the first thing is we have a wiping out of the beneficial flora that also drive yeast overgrowth too so the same thing where it wipes out the good stuff, the beneficial probioflora, the probiotics the Bifidobacter, the Lactobacillus. The different species within the Bifidobacter and Lactobacillus, right? There’s Rudaea, casei, plantarum, lactis, these are all beneficial species, okay, that keeps the bacteria in check but also when you knock down a lot of the good stuff that can also causes this rebound overgrowth and yeast and that’s a lot of doctors today even on the conventional side tend to give an antifungal after an antibiotic in a lot of these female patients because they see a lot of these symptoms happen frequently. 

Evan Brand: Wow. And, you’re mentioning the antibiotic that starts this whole cascade and that’s not necessarily the antibiotic to treat an existing UTI and then we’re talking about these recurring UTIs. We’re talking antibiotics for something simple like, I’ve heard of some women going in for a dental cleaning or something just that seems benign and then boom the antibiotic just really had forced them to take another fork in the road with their gut health and of course the vaginal health is affected. 

Dr. Justin Marchegiani: Exactly. Now, with urinary tract issues, I mean they’re simple things, right? Sometimes, just after intercourse, after sex, just not peeing. Sometimes that sperm and the semen being up there can kind of create some issues with bacteria so urinating after sex can be very helpful. You’ll see it with younger kids just wiping the wrong direction, right, essentially wiping back to front bringing some of the bacteria in the stool into that urinary vaginal area can be a problem. Sometimes different contraceptive methods like that involve, like a spermicidal intravaginally can sometimes mess up the milieu of flora in the vaginal tract. Having bladder stones or kidney issues can sometimes have problems, going in for a surgical procedure where they put in some of a catheter, you know, those are, you know, gonna be way unlikely but you know just kind of given the gamut of those across the board. And then of course, you know, the antibiotic exposure and I would even say just too much sugar, too much carbohydrate, a lot of bacteria like acellular easy to digest refined processed carbs. So, more carbohydrates, more sugar, more grains, more flours are definitely gonna work, you know, increase those microbes’ kind of having a feeding frenzy if you will.   

Evan Brand: And, how can you find this out? Well, there’s an easy to do at home test that you can buy for less than 10 bucks. You can do these test strips at home. These urinary test strips and if generally, you see a dark purple, you’ve got a big issue and so it’s something that people should have on hand if you’ve suffered for a while. I know a lot of women; they just hate having to go to the doctor’s office and get tested and then they leave with another antibiotic and then they’re on this merry-go-round. So, we talked about the conventional approach, they really as far as it goes antibiotics 

Dr. Justin Marchegiani: So, with the test strips, I think most of them are primarily looking at either immune cell in the urinary tract. I think, a lot of times with yeast or bacteria. They’re looking for, like leukocytes or leukocyte esterase, they’re looking for bacteria or I’m sorry immune cells in there. I know, some of the yeast ones are looking at pH so they’re looking at a more alkaline type of pH. The more alkaline the pH moves from six to seven to neutral, right, neutral is around 7. Into the 7-ish range, that tends to say that okay we have more yeast issues or we’re starting to move back in the direction of bacteria if we’re starting to see some of these leukocytes moving into the urinary tract. 

Evan Brand: Yes. It’s kind of an indirect marker, right? You’re looking at those leukocytes and that’s what you would be seeing in terms of like, the light purple, dark purple, extreme purple on the test strips.  

Dr. Justin Marchegiani: Yeah. So, they’re looking at the immune system starting to come in there and obviously with a BV issue, bacterial vaginosis. They probably need a swab to see what’s going on there, see if it’s like a Gardnerella or a Pseudomonas or Klebsiella, you know, what the bacterial species is. Now, typically with yeast issues in the urinary tract, I’m sorry with, uh, yeast infections primarily gonna be Candida or Candida subspecies. With BV, it’s primarily Gardnerella and with UTI’s it’s gonna be E. coli, typically.    

Evan Brand: Now here is the cool part. Are you ready to talk about some of the transitions you hit on the diet piece of a bit of sugar process things? Maybe we should hit this first and then we’ll talk about, like, the functional strategies that kind of thing. You and I were talking about this before we hit the record that so many people, they want the solution to an issue like this but they haven’t even got the foundation styled in, in regards to their sleep, in regards to stress, proper hydration, nutrient density, lack of antibiotics if possible. Just those foundational pieces, a lot of times, are gonna keep women in a place where they’re not gonna end up with this problem so if you’re just tuning in, somehow you found us and you’ve not been listening for a while and you’re just now hearing us and you’re looking for this magic remedy, you got to make sure you get the foundations in order first because in theory, this should not happen if you’ve got the foundation style then.  

Dr. Justin Marchegiani: Correct and so first thing out of the gates is just foundational things like hydrating enough because if you have a UTI issue just having constant good water flow and also you know with some electrolytes in the water that can be very helpful kind of having an antibacterial effect. And just keeping that good water flowing, the solution to pollution is dilution so that can really kind of keeping things flushed down. Obviously, being very careful if you’re having antibiotics. Why did you have the antibiotics? Was it for routine preventative things? Was your diet off and your immune system’s weak and you got sick and you needed it? Why, right? So, you want to look at that and if you had chronic antibiotic use, you know, what does the bacteria in your gut look like because odds are, if your bacteria or yeast imbalances are present in the vaginal tract or the urinary tract, you probably, also have issues in the digestive tract. You may have SIBO, you may have bloating, you may have gas, you may have poor digestion, low enzymes, low acids, H. pylori, parasite infection, you may have to look deeper in the intestinal tract and actually work on knocking down some of those microbes fixing the gut and then really work on repopulating some of the good bacteria after the fact to really work on fixing the gut because you start to fix the gut pH and the gut bacterial milieu that does help improve IgA levels and that does help with the immune system in the vaginal area as well. 

Evan Brand: Yeah. Well said. So, if you’re coming in with the UTI, most of the time, there’s gonna be more than just a UTI present. There could be as you mentioned a number of, we have someone coming in and UTI or recurrent UTI is one of their complaints, I can tell you, you and I are gonna wanna run the stool panel and we’re gonna run organic acids because we’re gonna want to look at the whole microbiome and certain things may get missed on the stool and the urine should feel in the gaps like we might find Candida in the urine and it got missed in the stool. So, stool and urine, there are things that your typical doctor and your lab locally is not gonna run. They might run a urine panel but this is not the same urine panel as an organic acid, we’re talking something far more advanced, far more comprehensive whereas the urine panel, locally, is primarily just gonna look for bacteria or maybe leukocytes as you mentioned you might get a positive or a trace or something like that but it’s not a detailed description of what’s going on you mentioned several bacteria too, like Klebsiella and Prevotella, we can identify this on a stool panel. So, that’s why it’s so important to get the data and could we just throw a woman on an herbal UT formula, we could but you know, we want to do our due diligence, we want to do a good work-up on these people too to make sure that we’re not just cut straight to the chase and we skip something huge that we would find on these tests.  

Dr. Justin Marchegiani: Right. I mean a lot of the antibiotics they’re gonna be using are gonna be like Bactrim or any of these kinds of, um, Mors, Augmentin’s a big one. Bactrim and Augmentin, those are a couple definitely be very wary of any of the fluoroquinolone families because they have significant side effects regarding tensing tendons and ligaments and mitochondria so be really careful of using fluoroquinolones. Of course, when we work these patients up, we’re doing a really good history so we understand how everything came to fruition regarding the UTI, yeast infection or bacterial vaginosis. We’re trying to understand it, right? Obviously, with certain things like yeast infections, BV, like making sure things are dry in that area. If you’re in a very moist environment keeping things dry helps because yeast and mold love a very moist environment. So, keeping things dry tends to be very helpful. Soaping up some of those areas you’d be very helpful too that you can use a really nice, um, as long as the mucosa is not like really, um, irritable, you can really use a really nice sulfur soap especially in the outside air if there’s anything yeasty on the outside are, anything internally. There are definitely internal things that we can do. So, on the internal side, just getting water in there, maybe helpful using raw cranberry juice, not anything with added sugar but raw organic cranberries, you know, 4 ounces at a time diluted some water is pretty good. You can drink that. That’s gonna have a nice low pH in it, which helps prevent the bacteria from growing. It also helps with some D-mannose in the cranberries. Can also internally do things like different berberines, can be very helpful, that’s excellent boric acids, another excellent compound. You gotta be careful with these by, enlarged by itself because they can be a little bit irritating so you want some nice things that provide some moisture whether it’s aloe or shea butter. There’s different, like moisture compounds that can provide the moisture so you don’t dry out that tissue as well. 

Evan Brand: You know, how about some of the suppositories. Have you used those before? I’ve seen some of these like pH suppositories, those have been helpful, also I think it’s integrative, I know Aviva Romm did a talk or an article on it one time. There was a specific probiotic that we had used, I think, it was called pro-flora that we had used, uh, that was supposed to be inserted vaginally and that was like a game changer for BV and some other related issues. So, not only taking oral probiotics but vaginal probiotics as well. That has been a game changer for many women. It’s not something we have to go to a lot but it is a good tool if someone just in bad shape and the conventional strategies failed them or made them worse then something like these vaginal probiotics are helpful. So just to be clear, there’s some strains specifically for vaginal health that are taken orally but then there’s also other blends that you can insert vaginally and the women have reported great success with those. 

Dr. Justin Marchegiani: Yeah. You want to make sure the hydration is there, whether it’s aloe or beeswax or shea butter or coconut oil, some of those can be helpful. Again, the antimicrobials that we may use would be the boric acid, some of the neem, some of the different berberines. And again, we may want to also add probiotics in and around there that can be very helpful. In regards to, like yeast issues or, um, UTI issues, you got to be very careful because when you women menstruate, well more with yeast and more bacterial vaginosis because that’s affecting the vaginal canal more. When women menstruate, that blood is like 7.3, right? So, that’s very neutral to alkaline. So, when you’re menstruating, you’re taking that acidic pH in the vaginal tract and you’re moving it backup to a more neutral pH when you menstruate so that’s gonna actually make it easier for bacteria and potential yeast to grow and you could have a BV issue or yeast issue that can happen due to your menstruation. So, when you’re already more susceptible in that vaginal area, you know, you gotta, you may actually wanna do a suppository in and around your period too, because that pH is gonna move up and that can start to cause microbes to grow. Some women have to be more careful with that, you know, if they have a chronic yeast or bacterial issue just to make sure it doesn’t come back. 

Evan Brand: I want to hit a few more herbs and then I want you to riff on the birth control conversation because I think that’s huge. So, you mentioned berberine and some of the other related herbs. Also, we’ll use the antifungals at the same time. So, you and I have our own custom blends that we use and so we may use something like Pau D’arco, French tarragon, horse tail, olive leaf, things that have antifungal and antimicrobial properties. So, that’s the cool thing about what we do is as you mentioned Backstrom or some of these other conventional strategies. It’s just a big sledgehammer, right? It’s not a targeted tool. It’s one sledgehammer. We don’t know exactly what we’re gonna kill but it’s an antibiotic, were just gonna drop the nuclear bomb into your gut and we’re gonna disturb not only your gut microbiome, we’re gonna negatively affect the production of your nutrients in your gut. We’re gonna negatively affect your mitochondria. We may knock out the UTI but as you saw in the papers, 25% of those UTIs are gonna come back within 6 months to a year and so when we’re coming in with these antimicrobial herbs, also, throwing in antifungal herbs, that’s where the magic really happens because there could be a combination as we talked about. It’s rare to see just UTI, it could be a combination issue meaning there’s some Candida, there’s some bacterial problems, maybe there’s parasites in the gut too. Maybe there’s H. pylori like you mentioned. And so, that’s the fun part is when you take a blend and you’re working people through this protocol. You’re now knocking 4,5,6 issues out all at once in one fell swoop when they originally just came in with the complaint of UTI. When you do the labs, you wanna uncover so much more and that’s where the beauty is. 

Dr. Justin Marchegiani: 100%. Here’s one study here looking at the perceptions using contraception birth control pills. So, usually this is like a synthetic estrogen mostly, right, an ethanol, estradiol. I’m looking at the influence on the vaginal microbiota and so really the take home here inside of the gate, the vaginal state was significantly modified hormone administration apparently corrected the alterations uh, but has the potential of being an accurate tool. Where is it? Right here, um, there it is, I’m sorry. Statistically significant association between, this is, um, this is contraception and normal microbiota was observed after three months when the vaginal microbiome was modified at 6 months inflammatory reaction was detected in almost half of the women. So, only seven women but you can, it created an inflammatory state in the vaginal microbiota and then also yeast colonization was increased and it created an inflammatory reaction in three out of seven women and it altered some of the beneficial bacteria in the vaginal area. Now, small study but you can see, you know, three out of seven, it affected this and this is what we see clinically with a lot of our female patients is some of these things can be affected because it’s affecting: one, it’s creation; two, it’s causing yeast to grow impacting some of the good bacteria and how does it do this, it does it mostly via LDH. If you alter someone’s digestive pH, right, let’s say you give them a proton pump inhibitor, you’re gonna have all kinds of digestive issues and maybe even nutrient deficiencies that can affect things long term. Obviously, with birth control pills, there’s other things they do, they can create issues with nutrient absorption or they can cause nutrient deficiencies in areas of B vitamins, folate and also calcium and magnesium. So, we see a lot of women that do birth control pills have a lot of those nutrient problems. So, if you’re on a birth control pill, ideally, it’s better to use something that’s more barrier based or if you want to set it and forget it method, you know, potentially looking at the ParaGard which is a copper IUD, you just have to make sure you can handle the copper. I find if you want to set it or forget that the copper tends to be better than the hormones but ideally, you know, a barrier method it’s not internal all the time. It’s probably better so that just kind of gives you a couple options there. 

Evan Brand: Yeah. I’ve heard some stories, some horror stories about the copper ones too. So, like you said it cold be a problem but

Dr. Justin Marchegiani: Not everyone has problems with it. I mean, women that like tend to cramp a lot, they could have, because that cramping, IUD being in that uterus sometimes that can cause pain but it just depends kind of where women are, you know. Some parents may be pushing kids to have a method because they don’t want their kid getting pregnant and maybe they feel like they aren’t responsible enough at maybe 18 or 19 and they set it and forget it method. If you want that, I would recommend doing the ParaGard before you go to a hormonal method. 

Evan Brand: Yeah, for sure. And, not to mention too we’re already in a society of so much estrogen dominance and you and I have done podcasts about the impact of gut imbalances in issues with the glucuronidation pathway which is then causing further issues. So, we could see this estrogen problem in a woman who’s not on birth control. You could still see that manifest in this way and so that’s why you’re getting off of the xenoestrogen, you’re cleaning up your makeup. You’re getting rid of plastics. You’re fixing your gut. You’re improving detoxification. All these other functional medicine strategies are directly impacting your ability to beat this situation. So, we know, we always want people to look at the big picture. Don’t just look for the magic, uh, like, berberine, Pau D’ Arco remedy. And there’s a question here in the chat, ‘how many Pau d’ Arco capsules is needed for someone who has Candida in their gut?’. I have no clue because we rarely use it in isolation. We’re always gonna use it in a blend. And I doubt you have just Candida. You’ve probably got other issues too. 

Dr. Justin Marchegiani: Yeah. Somewhere when they come in, they could have a combination of a little bit of a bacterial, a yeast issue, UTI thing. That could be a kind of combination of 2 or 3 different things happening. This one may be more predominant. So, we never wanna just go all in on one thing. Again, if someone’s having vaginal issues specifically, there’s gonna be things that we insert intravaginally like some of the boric acid, like some of the neem or the berberines and we’ll probably interchange in some probiotics because part of the big problem is you have to get the bacteria flora in the vaginal area, back up to where it should be because it’s the good bacteria that will help keep the other bad bugs in check through their natural acid and hydrogen peroxide production. 

Evan Brand: Well said. 

And so, the point I was making is that I don’t want people listening and going okay just give me the freaking remedy. What’s the natural urinary tract remedy? That’s what I’m here for. And we’ve talked about some of those, you know, the mannose, the cranberry, the berberines, the Pau d’ Arcos, the French Tarragon, this whole blend, you know, that may be the solution but what got you here is important. Have you fixed the other issues that have gotten you here. And so, I hope people see the big picture. Sometimes, you and I are happy to just go boom, hit the oregano oil and were happy to just throw out just this natural solution but like you said before we hit the record, you don’t want people skipping out on the low hanging fruit. 

Dr. Justin Marchegiani: Exactly. And so, it’s always good to do history. I find the big issue is antibiotics can be a big factor. I also find just some of the low-hanging fruit like the intercourse and hydration can also be a big factor as well. You’ll be surprised. And so, my wife comes to me, she’s like, ‘my friend has this issue, what should I recommend?’. Well, it’s hard, I can’t really recommend a lot of things because I don’t know much about them if eating like crap and they’re not hydrating and they’re drinking lots of soda and they’ve been on lots of antibiotics, you know, I may say, hey, all right, do this [24:34] but that’s gonna be palliative and not fix the whole lead up and how everything went down. And so, the lead up and I call it the timeline history of how we get to this point matters so much because, you know, if not, you were just becoming naturopathic doctors that are using nutrients and herbs like MDs use drugs. Now, again, I think that’s better because a lot of these things are natural, have less side effects but still we want to be holistic and still root cause. 

Evan Brand: Yeah. Well said.  That’s the problem. There’s a difference between naturopathic approach to this issue and functional medicine approach to this issue. So, I think you made that clear, which is, you go to the naturopath, it’s hey, here’s the oversee, functional medicine is gonna come in and say, ‘okay, well, how did you get to the UTI?’. Oh, you took antibiotics, you’re on birth control for 20 years, you had a sexual partner who had extremely poor microbiome health, maybe there was some issue there, maybe you had multiple partners, maybe one of them had H. pylori. You have low stomach acid. You ended up with dysbiosis, then you got Candida overgrowth, then you drank too much alcohol, you loved to do wine in the evenings. You ate a little too much chocolate, you know, it’s like, that’s the more investigative route and that’s where people need to be thinking.  We’ve got friends that are naturopaths, good people, but you just got to go deeper most of the time.  

Dr. Justin Marchegiani: Yeah, and a lot of times too, if I’m, if someone has chronic issues, I wanna know more about their gut because the microbiome has such an impact especially with IgA and with the overall immune system. So, if there’s chronic issues in the vaginal area, you have to look up to the intestinal tract. Very important. 

Evan Brand: Yeah, and you would say there’s gotta be some link between the low secretory IgA that you and I are seeing on the stool test and what’s going on with the vaginal microbiome too, right? You would assume that’s a system-wide defense shield that’s gonna be affected.  

Dr. Justin Marchegiani: Yeah. It’s part of the mucous membrane barrier. So, mucous membranes in the eyes, the mouth, the intestinal tract, the urinary tract, the vaginal canal. So, if we see low IgA issues in the intestinal tract, that barrier is a little bit weaker. Think of the force field, you know, you see star trek, they put, like their force field up, right, so they, so when the Klingons go to shoot them, it kind of bounces off, right? Think of the force field we have in our intestinal tract and our vaginal canal and our urinary canal that kind of protects and so probiotics can help, obviously getting rid of the dysbiotic microbes can help, avoiding a lot of things that create the imbalances to begin with, which would be a lot of the antibiotics or maybe pesticides or GMO foods that produce a lot of antimicrobial compounds too. All those help avoiding those things too. 

Evan Brand: You know, what’s happening even in the functional medicine world, is that everything’s becoming isolated. Are you noticing that? Like people are focusing on just the gut. So, it’s like this leaky gut formula, this leaky gut protocol and they’re ignoring the fact that you just mentioned this IgA, this mucosal barrier is kind of a system-wide problem. So, there could be oral, vaginal, gut all at the same time, all related to the same dysfunction of these force fields being down. I think it’s just marketing, right? People just want to market that they’re the gut guy, they’re the parasite guy, they’re the Candida guy. I think that’s just a marketing probe but hopefully people are seeing this and of course if they’ve been listening to us for months or years, they’re seeing that this is a system-wide problem, it’s just manifesting in this way. 

Dr. Justin Marchegiani: Yeah. In the functional medicine world, a lot of people market to niche areas and symptoms which is fine because a lot of people when they get focused on something, they think they have these issues, they’re going into google or they’re typing that issue. So, for you to be relevant and for that person that has health issues to find you, you do kind of have to market to a symptom but then when you find that person and you talk to them, you wanna make sure that their approach is globally where they look at things holistically and you’re not seeing the gut person that only deals with the gut and they’re not looking at your thyroid or your anemia or your low glutathione. They’re not connecting the dots. So, you got to make sure they’re still able to connect the dots but multiple systems and they’re not just focused on one issue. So, it’s okay for doctors to market to that, you just have to make sure that their philosophy is a holistic philosophy that encompasses everything in there. 

Evan Brand: Yeah and holistic spelled w-h-o-l-e a wholistic, the whole thing, the whole body, the whole person, not just holistic as in natural, it’s gonna be the whole piece and I think that’s where I suffered for a long time because I focused on my gut for so long but I was ignoring toxicity issues, I was ignoring dental issues, I was ignoring tick bite infections. So now, oh crap, I see the whole picture and I would miss that if I just dialed in the gut so and that’s what you and I do. We’ve done this over with clients worldwide, we look at the whole picture. If you’re suffering, if you’ve been through the conventional rabbit hole or maybe you’ve been fortunate to avoid the conventional rabbit hole, you don’t want to go down it but you need help, feel free to reach out. Dr. J and I work with people around the world. We can send these labs that we’re talking about stool and urine. These are at home, these are non-invasive. It’s rare that we need to do invasive testing but most of the time it’s at home functional medicine tests can be sent to your door, you do them, you send them back to the lab. We get the results. We jump on a call. We run you through them. We interpret those. We make a protocol for you and get you better and get you off the merry-go-round. So, if you need help, feel free to reach out, Dr. J is at justinhealth.com and me, evanbrand.com and you can reach out, book a call with us, we’d love to talk with you, help you, find and fix the root causes if you just have UTIs and you think that’s all it is, maybe you’re right but maybe not, either way, we’re gonna help you get to the bottom of it. 

Dr. Justin Marchegiani: Very good. Excellent. So, for women that are listening and kind of want to recap here, first thing, make sure your diet is right, keep in the process refined sugar, grains, flours out, makes a huge difference. Omega-6, seed oils, in general, should be reduced as well. Hydration, make sure hydration is good, clean and filtered water, um, you know, good mineral water, especially if you have more health issues, more minerals in there is gonna be better. Next thing out of the gate, you know, urinate after intercourse, those kinds of foundational things. If you have chronic gut issues, definitely, get your gut looked at. If you’re on hormone, if you’re on birth control pills, definitely get your hormones looked at and figure out why you’re on them. Most women aren’t even on hormone or birth control pills for birth prevention. They’re on it for off-label issues like acne or headaches or lots of PMS and so most women could totally get off it because they’re not even using birth control pills for the original intention. They’re for off-label use and so that would require looking deeper at the hormones. Next, you can get tested, you can do either a, um, a MONISTAT test to look for yeast, you can get those at the drugstore, you can do one of the strip tests to look for leukocyte esterase or I think it’s nitrites in the urine for more of the UTI issues and of  course, if you have a lot more of the odor-like, uh, issues, you can get a vaginal swab from your OB or your primary to rule out any of the BV issues as well, again, similar solutions, you know, some maybe more internal in regards to what we recommend, some maybe more internal like with swallowing pills so maybe internally, intravaginally and of course the more chronic the issue is, the more we have to really support the vaginal microbiome with the right beneficial bacteria getting in there internally as well. And then, of course, just keeping up with a lot of the menstruation because that can really affect a lot of the, um, the bacterial issues and yeast issues in the vaginal canal because it’s gonna shift that pH from very acidic to more neutral to alkaline at that time of the month when you menstruate. So, hopefully, that’s a good kind of crash course, out of the gates and kind of you guys understand kind of our spitball kind of philosophy and how we look at the whole history and really connect the dots and we have our little toolbox of all these things but we just got to make sure it’s catered to the history.  

Evan Brand: And alcohol too, I think, we briefly mentioned it but alcohols got to go. It’s just, it’s not gonna help you. It’s going to promote all sorts of issues. It’s gonna aggravate the immune system. It’s gonna affect your IgA levels. It may promote dysbiosis and it may promote more yeast problems and so I’ve heard many stories where a woman’s like, oh yeah we went to Napa Valley and we drank wine and ate chocolate and salami and cheese all weekend and now I had a flare up. It’s like, well, yeah, duh, I mean, that’s incredibly damaging. Everything that you’ve done, you binged on wine all weekend so I think wine kind of gets like this people think that they’re not drinking alcohol. Somehow, they think they’re getting off the hook. Oh, it’s just wine, like, it’s so socially cool, it’s like coffee. It’s like coffee and wine, like wine is so accepted into the culture but it can be a big problem, I tell you. Some of those California women, the ones in San Francisco, like, it’s part of the culture here. I had one woman argue with me that she didn’t want to get off alcohol. I said, well, what if it’s gonna help your gut. She’s like, well maybe I’ll consider it. So, sometimes as practitioners, we’re having to bargain with people and try to make trades and make healthy swaps, we’ll swap it for this and try this and what if you do a binder afterwards. So, sometimes, you gotta work with people, they’re not just in a vacuum. We got to work with them and help educate them so that they’re more dedicated to the lifestyle changes but I just want to mention alcohol because I think a lot of people, don’t even consider the impact it has on the gut but then on this flora.    

Dr. Justin Marchegiani: Yeah. A couple things with alcohol, number one it’s diuretic so it will increase the frequent urination and kind of make you more dehydrated so good hydration helps prevent a lot of that bacteria from growing. Number two, out of the gates, you know, it may be necessary out of the gates for the first month so as you get things under wrap. There’re also healthier versions of alcohol. I mean, you can always get, like a Cosmo martini that has the fresh lime juice in there and cranberry juice. Just make sure it’s, like not the cranberry with sugar or the lime with sugar. Make sure, it’s fresh lime or actual juice cranberries with, like a nice Tito’s vodka, I mean, Tito’s vodka is, um, it is charcoal filter, right? So, it’s gonna be really clean and you can get some nice cranberry and lime in there that should be almost be beneficial in a way, obviously, you know, keep it, you know, a drink or two maybe once or twice a week max but once you better that maybe a good option to add things back in and just stay away from a lot of the sugary stuff and of course the glutinous drinks and you’ll be in a lot better position.   

Evan Brand: Yeah. It’s a funny thing you have to mention. There’s got to be real cranberries because most of the time you go to a bar, it’s like that. It’s garbage. The heart or it’s the high fructose corn syrup concentrate. 

Dr. Justin Marchegiani: Yeah. So, worst case, you can always just do a fresh lime squeezed in there and see if they have anything that’s just a pure, you know, extract and that’s a much way to do it. Of course, dry or white wines and you know just a good Tito’s vodka is always great with just the lime in and of itself. That’s an easy way to do it and keep the sugar and junk down but also keep a nice acidic pH there which is helpful for the vaginal area. 

Evan Brand: Yeah. We’ll hope, as you mentioned, no I think we covered It so if you need help, we mentioned the links here Dr. J, that’s Justin at justinhealth.com. You can reach out for consult worldwide. Me at evanbrand.com, either way, we’re here to help you guys. We love what we do. We have a blast and it’s fun to educate people. It’s fun to empower people and take back your health and it’s possible. Whatever you’re dealing with it’s possible to make progress so just keep your head up. Stay motivated. Don’t always run straight to that antibiotic if there’s another way. You may try another solution. If you’ve been doing this for a decade now and you’re still battling it, you’re not out of the woods yet, it’s time to look deeper.    

Dr. Justin Marchegiani: Excellent. Great chat, Evan. Everyone, have an awesome week. We’ll talk soon. Take care of you all. 

Evan Brand: Take care, now. 

Dr. Justin Marchegiani: Bye now. Peace. 

Evan Brand: Bye-bye 

How to Get Your Energy Back Post-Infection | Podcast #365

When people start to feel better after an infection, it is often tempting to return to previous levels of work, leisure, and social activities. However, too soon, trying to do too much can often be counter-productive. It is easy to get caught up in a ‘boom and bust cycle of activity that can prolong your recovery.

Dr. J and Evan discuss that if fatigue and other symptoms persist, it’s important to remember to allow yourself time to recuperate by finding the right balance of rest, relaxation, and activity for your circumstances. It is essential to listen to your body and gradually build a physical and emotional recovery plan that can help you get back to your life and stay on track without experiencing too many setbacks.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
5:11   – The essential vitamins to boost your immune system
10:12 – What is the goal of the Krebs Cycle?
14:06 – Mitochondria and microbiota dysfunction in viral pathogens;
17:12  – The role of mitochondria, oxidative stress, and the response to antioxidants in chronic fatigue
20:08 – The neurotransmitters from amino acids and tryptophan pathways in B6 deficiency

Dr. Justin Marchegiani: With Evan Brand, really excited today. We’re gonna have a nice conversation on how to get your energy back post-infection. This is the topic that we’ve been getting a lot from our patients and again a lot of our inspired podcasts and videos come from real life clinical work with patients. So, we’re excited to bring you the real-life actionable information here to improve your health. Evan, how you doing today man? What’s cooking?

Evan Brand: Hey. Doing pretty well, uh, cooked some bacon this morning and that was about it with some organic blueberries and so I’m feeling good. my brain is clear and I look forward to helping people on this energy conversation, you know, so many people have chronic fatigue post-infection and they’re not fully bouncing back and so, I think that there are some easy low hanging fruit strategies that we can talk about but I’m just gonna jump straight to the big smoking gun which is looking at your mitochondria. We’re seeing a lot of issues with mitochondrial dysfunction or mitochondrial damage. I’m also seeing issues with neurotransmitters. So, I think, if you are to pick one and only one functional medicine test to look at to investigate yourself after this infection and fatigue, it would be the organic acids because you can get a great window into not only your gut health. We know that with infections, it does damage the gut, we know that there are ACE2 receptors in the gut so people that are ending up with irritable bowel or diarrhea or other problems during and post infection, we can look at that. A stool might be smart too but if you had to start with only one thing maybe the window into your gut via urine organic acids would be good enough. But more importantly, I want to see what the heck is going on with mitochondria and what kind of damage do we have because once you have the data then you can put together a protocol to fix it. 

Dr. Justin Marchegiani: 100% agree. So, we know with chronic inflammation, especially like, post-viral inflammation. We know one of the biggest drivers is gonna be oxidative stress, right? So, oxidation is nothing more than your body losing electrons, right? And one of the big things that helps oxidation within any type of infection pre, ideally, we’re doing these things pre to mitigate al of the oxidative stress that’s happening at the mitochondrial level but simple low hanging fruit, out of the gates, is gonna be glutathione, vitamin C, these are really powerful antioxidants. Vitamin D even kind of fits in that category, right?  Your big antioxidants are ADEK, um, I’m sorry, no, those are your fat-soluble vitamins but E is gonna be an antioxidant A is gonna be an antioxidant, right? I would even say E and K would for sure but your B and C are gonna be your water-soluble kind of more antioxidants for sure but the big are gonna plug in, you know, post-viral oxidative stress and/or pre is glutathione and vitamin C, out of the gates. And we can also look at low-hanging fruit on the mitochondrial side, which plugs into the Krebs cycle and the electron transport chain is gonna be B1, which is thiamine. I would say B vitamins as a whole was great but B1 has a major, major role and I’d even say B5, as well, pantothenic acid. So, you have thiamine, B1, right? You have Riboflavin, B2. You have niacin, B3; Pantothenic acid, B5; Pyridoxine, B6; biotin, B7; folate, B9; B12 is your methylcobalamin or hydroxyl or adenosine. And so, we’re talking B1 and B5 are gonna be big when it comes to post-viral fatigue. Those are really, really important nutrients that we can add in out of the gates and, why it’s all of this oxidative stress that’s happening when this infection is present. And so, the more you can do things like hydrate, keep inflammatory foods down like the excess Omega-6 fatty acids, um, keep the carbohydrate and the sugar in check, right? That’s gonna play a major, major role in not adding fuel to the fire if you will as well.  

Evan Brand: Yeah, and you can do oral glutathione. So, we have a combination product, which is an acetylated glutathione along with an acetylcysteine. So, you can give your body the nutrients to make more. You can give the precursors but then you can also take just straight glutathione. There are some liposomal versions. There’s reduced glutathione. There’s a nebulizer version that you can take so you can inhale glutathione if you feel that there was some lung involvement. You may consider doing both. I personally did both. I did oral and I continued to do oral glutathione daily and then, also, during the acute situation, nebulized glutathione with silver. And then, you mentioned B vitamins and you can measure all this, right? So that’s the important thing is, you know, you’re shouting out all these different names but people can look at this, right? We can look at this on organic acids. We can look at the various B6, B12. You can’t look at every single nutrient in the body but you can look at a ton of nutrients from one urine sample. So, it’s pretty awesome. And then, vitamin C, believe it or not, we’re seeing a lot of issues with viral infection and acute scurvy, which is pretty interesting. If you just put it some of this data and scurvy into the research, I guess, it’s due to the oxidative stress. It’s happening quickly and every single person I’m seeing post-infection is showing low vitamin C. So, we’re just keeping people on 2 to 3 grams every day. We’re doing a powdered version with a mixed ascorbate. So, you probably don’t want to do just straight ascorbic acid and you probably wanna do like a sodium ascorbate, magnesium ascorbate, if you can get some citrus bioflavonoids in there too and just take it ongoing. Don’t wait until you’re sick. We, as a family, we just take vitamin C ongoing because we know it’s important for the health of your capillaries and all that. Can you speak on that for a minute? Like vitamin C and skin and collagen, I mean there’s a role in other things. People think vitamin C, immune, but there’s other benefits to see, right?

Dr. Justin Marchegiani: Yeah. Vitamin C plugs into making collagen, which is all of the connective tissue for your skin, uh, hair, you know, cartilage, vitamin C is really important for that. Vitamin C is a very similar molecular structure as glucose, right? Don’t quote me but it’s similar to I think C6H12O6 or O8, it’s right in that molecular area, looks very similar. So, what does that mean?  That means, vitamin C has a docking site on the macrophage that actually goes and gobbles up bacteria and potential viruses and it’s gonna use that vitamin C that docks onto that macrophage to deal with the oxidation. So, I kind of think of it as like a firefighter going into a house and the vitamin C is like that fire fighter bringing that hose to squelch that fire, to squelch it, right? That’s kind of what I see vitamin C as, right? And, it’s almost like with the macrophage, it has a docking site and that glucose can actually come in there because it looks very molecularly similar to vitamin C and it can almost dock on that receptor site on that macrophage and take that vitamin C where to be used. It’s almost like giving the fire fighter a water hose, taking the water hose out and giving him a gas hose and he doesn’t even know. It’s almost like that and that’s why glucose and high levels of glucose and when it comes to a lot of these post-viral illnesses, you’re gonna see people that have very high levels of blood sugar, insulin resistance and even the extreme on the diabetes side are gonna have most of the side effects of most of the issues partly because of the oxidative stress, partly because of poor levels, you know, when you have insulin resistance that’s gonna affect oxygenation, right? Because, you’re not gonna have good blood flow and when you have poor blood flow and poor oxygenation, we need oxygen to plug into that mitochondria as well. It’s part of, you know, the key nutrients, right? We talked about B vitamins, B1, B5, very important to plug into the Krebs cycle. Well, guess what, when you have a high level of blood glucose and you’re on that pre-diabetic to diabetic side, right, 110 to 126mg/dl on the blood glucose side, your body has to process that and if you just go pull up, you know mitochondria, Krebs cycle and nutrients, right, you’re gonna see all the nutrients that are involved in that Krebs cycle to process that glucose because how it works in the Krebs cycle, everything gets funneled down to acetyl CoA, right? So, you have glucose comes to acetyl CoA, fatty acids come to acetyl CoA, they can also go this way into ketones and then you have protein coming down to acetyl CoA. Acetyl CoA pumps around the Krebs cycle twice and if you look, there’s gonna be nutrients that have to come in there to help that acetyl CoA to come around and a lot of those nutrients are gonna be B vitamins, magnesium, amino acids and so, if you’re coming in with lots of glucose and you’re not bringing in a lot of nutrients to funnel down to the acetyl CoA side, you’re gonna run that Krebs cycle twice and you’re gonna be using more B vitamins than you’re coming in. So, you can actually create a lot of nutrient deficiencies and oxidative stress when you consume a lot more glucose because it’s a transaction fee for your body to process energetically. 

Evan Brand: Nice. Nice. That’s a great way to put it. And, the truth is people are coming into this infection with nutrient deficiencies already due to bacterial overgrowth problems, Candida problems, maybe post-antibiotic therapy, you know, they have issues with the gut now and they’re not making enough of their nutrients in their gut. And so, a lot of people will just depend on diet and they’ll simply, well, can I just get enough on diet, can I just eat liver and grass-fed steak and all that and get enough nutrients from that and I’ll say, look I’ve tested and I know, you have too. Over a thousand people and many of those people were already dialed in with their diet for years before they got to us. Paleo, carnivore, autoimmune, paleo, we’ve had people that have been doing an incredibly job with nutrient density and they still show up with nutrient deficiencies and so I would love if everyone could just eat their way out of this situation but I just think with the modern stress that we’re under we’re dumping a lot of those Bs. You’re mentioning all these that are fueling this cycle. We’re so depleted and burned out emotionally, physically, chemically, we’re exposed to toxins. We’re just not living in Paleo time, so Paleo, you can’t just like paleo your way out of this and you know, that’s why I used to call my podcast years ago ‘Not just Paleo’ and then I got rid of it, just call it Evan Brand now but, um, that was my whole thought at the beginning. It was like, man, if everybody could just eat their way out this and get enough Bs in the diet then you and I wouldn’t be needed. 

Dr. Justin Marchegiani: 100%. Let me just kind of break this down for people just so they can get a better understanding of what’s happening here. So, when we have oxidative stress, oxidative stresses, we’re losing electrons. What’s the whole goal of the Krebs Cycle? The whole goal of the Krebs cycle is essentially gathering up electrons. Okay, so, you have fats like I mentioned before, they’re all funneling down to Acetyl-CoA. Proteins all funneling down to acetyl-CoA, right? Then you can see on the carbohydrate side like I mentioned, look at a lot of the nutrients that are involved in funneling the carbohydrates down to acetyl-CoA, different B vitamins, okay?   

Evan Brand: Zoom in so, 

Dr. Justin Marchegiani:  B1, B2, B3, magnesium, all play really important roles and then look at the carbohydrates, look at the amino acids that are involved. Cysteine, that’s a major precursor of glutathione, serine, really important for stress. Glycine, that’s your major amino acid in collagen, right? This is why, when you’re stressed and you’re sick, it’s why your grandma tells you to have chicken soup, right, especially with the whole bone in there because you’re getting a lot of these amino acids in a liquid form. So, if your tummy doesn’t feel good and you’re nauseous, right, because the infections tend to really cause nausea because your energy is going to fight an infection versus digestion. So, it’s trying to shut that down. That’s why your grandma said chicken soup, right? Ideally, we keep the noodles out now. Now, look at the fats, right, look at where the fats can go so the fats go down to acetyl-CoA but it can also go and create these ketones, right. This is beta-hydroxybutyrate. This is a ketone, okay? Now, really important here. So, we have this acetyl-CoA, right, this is kind of our energy currency that everything gets converted from our three major macronutrients, fats, carbs and proteins. And again, if you’re listening at home, there’s a video version of this of me going through it. I know, it’s a little confusing but I’m going to try to make, break it down. Acetyl-CoA comes around this citric acid cycle or Krebs cycle. It’s the same thing. It goes around twice, okay? And you can see GSH that stands for glutathione. Fe stands for Iron. So, if you’re a female and you’re very low iron or you’re anemic or vegetarian vegan, that could be a problem. 

Evan Brand: So, let me pause there, really quick, because I want to point out something. You’re showing here on this cycle that you’ve got to have not only glutathione but you’ve got to have iron so you gave a shout out to the anemic women and what I want to point out is that the women that came into this infection, anemic, which is extremely common. Women have hormonal imbalances. It’s an epidemic problem so many women have heavy periods or maybe post childbirth, their period was screwed up and they’re having heavy menstruation. So, they’re coming into this anemic or they’re coming into this with low ferritin and then that’s compounded by maybe a mold exposure where now they have low glutathione levels. The way you’re showing this cycle here, if you come in with low iron and low glutathione, you’re in big trouble.   

Dr. Justin Marchegiani: You’re in big trouble. And, women are more predisposed because if they have hormonal imbalances, guess what happens to their period, they get heavier. Heavier period, they’re just gonna lose that iron. Now, men on the other side, men have it, you know, they can have increased iron. They can cause oxidative stress because iron is like, you know can be like gasoline on the fire if it does get too high, right? But you can see glutathione, iron, you can see B vitamins, you can see magnesium, you can even see manganese here and you can see different B vitamins. And, what they do is you’re creating NAD and FADH and they’re grabbing hydrogen, they’re grabbing electrons, okay? So, typically comes around here twice and you get usually two NADHs and one FADH2 per cycle and then essentially all of these things will jump into the electron transport chain next. If I could find that section here, but the electron transport chain is the next big step for that kind of gathers nutrients but for really, for today’s talk, this is the really most important thing and then just kind of highlight, you can see some of these toxins over here that come in, right? You can see fluoride, Hg is Mercury, As is gonna be, uh, arsenic, Al is gonna be aluminum. So, you can see some of these toxins, how they can kind of come in there and sabotage some of these things. And, to kind of highlight one thing, this is an article we saw here. Mitochondria and Microbiota dysfunction with post-viral issues, you can see how the gut microbiome also plays a certain role and why is that? Well, I think, because 80% of the immune is in the gut so if you have a pathogenic or dysbiotic microbiome, it’s gonna affect toxins being produced, right? It’s gonna put you right here in a hyperinflammatory state, right? We already have a lot more cytokines being produced if we have an illness and so we have to be able to calm down our immune system’s inflammation to what’s happening from an immune stress standpoint. And so, the microbiome plays a big role, iron dysregulation, reactive oxygen species, right? Vitamin C plays a major role here. Vitamin, uh, glutathione plays a major role there as well.

Evan Brand: Yeah, right there, look at that one, the mitochondrial, the heightened inflammatory oxidative state may lead to mitochondrial dysfunction and so this is what we’re seeing on paper. We’re seeing this in the stool test. We’re seeing this in the organic acid test, this issue with the gut with the mitochondria. 

Dr. Justin Marchegiani: Yeah. It talks about platelet damage too which is important because what do platelets do, those are your clotting factors. And so, if we can have increased coagulation cascades, that means more clotting, right? And, you can see more clotting events, more thrombosis is that’s a blood clot, right? And so, you can see furthermore, mitochondrial oxidative just make, may contribute to microbiota dysbiosis altering coagulation and fueling inflammatory oxidative response leading to vicious cycles of events. So, this is really important and so things that we can do to be on top of the fatigue is gonna be the same things that we can do to help mitigate a lot of the inflammation. That’s gonna be keeping blood sugar in check, adding in some of these additional B vitamins, um, adding in anti-inflammatory anticoagulants. What do those look like? That could be ginger. That could be curcumin, which has anti-inflammatory and anticoagulation effects. That could be adding some extra Cod liver oil that has more vitamin A in it, which is a really powerful antioxidant but it also has natural blood thinning aspects because of the extra omega-3s in there. So, there’s different things we can do to really help reduce a lot of that inflammation. Any comments on that, Evan?  

Evan Brand: Yeah. On the more intense side of supporting hypercoagulability, lumbrokinase is gonna be your most powerful. That’s your earthworm-based enzyme, which is just a cool, cool thing. Natto, there’s also serratiopeptidase, so there are other enzymes that you can use and I personally take those. I take lumbrokinase, one per day just ongoing and it’s been very helpful. I also did a podcast with Dr. Thomas Levy, all about vitamin C IV and he’s got some dark field microscopy photos of people that we’re having blood clotting issues and the vitamin C along with ozone and IV was like a game changer and vitamin C can help energy too, so I don’t want to get too deep in the rabbit hole of blood clots but we’ll just say that the vitamin C is helpful for energy also. 

Dr. Justin Marchegiani: 100%. I want to show you guys one other journal article here, role of mitochondrial oxidative stress and antioxidants when it comes to chronic fatigue and so one kind of thing here, it talks about the known role of oxidative stress and how it can relate to essentially fatigue, as well as, potential, uh, specific therapeutic treatments for the mitochondria so that’s really powerful. And, you know, here are some of the big things, they’re gonna talk about vitamin C, talk about B vitamins, talk about glutathione and then also some of the more natural anti-inflammatory things but you know, each study is going to find out focus on a couple of their major things but, people in the literature are looking at these things. It is real and, um, we’re seeing it in our patients and we’re trying to apply some of these things to get people’s health back.  

Evan Brand: Yeah. So, the way you look at this is what you can do to protect against oxidative stress, we covered that glutathione. What can we do to help support the Krebs cycle? We talked about B vitamins. You’ve also got just things that are gonna help the mitochondria in general, like CoQ10 and then also you can do things like PQQ and there’s other nutrients that actually create what’s called mitochondrial biogenesis where you can literally make new mitochondria. And so, I don’t think it’s in that paper, it does mention CoQ10 there but 

Dr. Justin Marchegiani: Right here in the mitochondria, there are enzymes and coenzymes such as vitamin E, CoQ10 to remove ROS, that’s reactive oxygen species to prevent DNA damage. So, these are really powerful things that we can add in. For example, low CoQ10, they’ll see an increase in damage, so Coq10, PQQ, you know pyro quinolone, right? Vitamin E, and then, you know, we try to give Coq10 with vitamin E together for that same reason to prevent a lot of the oxidative stress while fueling the mitochondria. Any comments on that? 

Evan Brand: Yeah. Look at the next part there too, talking about exercise. People that come in with chronic fatigue and how they’re having an increased oxidative stress after exercise and that’s a problem that we’re seeing a lot too is people that now are having, uh, post-exertional fatigue, people that are crashing. Even athletes that were really high performing people that now their performance is just in the tank and a lot of that is just this ongoing oxidative stress and mitochondrial damage that’s not, that’s not been supported and you can’t just exercise your way out of this and I get kind of annoyed when I see like those motivational videos of people that are really sweaty like you just nee to suck it up, you know, pain is weakness leaving the body. It’s like, no, you’re wrong, you got to fix the mitochondrial damage. I hate those like raw-raw videos because it’s ignoring all the nutrients. That video really needs to be talking about, hey get your glutathione up, get your ribose up, get your CoQ10 up, come on people, like that’s what he used to say.  

Dr. Justin Marchegiani: And this is a similar marker that we use on the organic acid test, the one that we use 8-hydroxy-2-deoxyguanosine, this is very, very similar to that. But this is a marker for oxidative stress so we’ll actually use the same marker on a, um, on a mitochondrial test on the organic acid. So, we’ll look at some of these things to get a window of how stress these pathways are so that’s very powerful. 

Evan Brand: Yeah. Ribose is amazing. Carnitine is amazing. Acetyl-L-carnitine is amazing. Also, you know, let’s hit the, let’s go up a little bit like that picture there was a like a neurotransmitter picture there that you had. Maybe, we should talk about that a little bit because it’s not directly gonna be a mitochondrial support, yeah, right there, but I think, that’s cool to point out too, which is that, if we’re coming in with nutrients like phenylalanine or tyrosine, eventually some of that may convert over to your neurotransmitters but then also your adrenal hormones like epinephrine and I think a lot of people and I know you see this too, a lot of people are showing up with just low brain chemistry across the board. And so, I’m thinking out loud with you that like, the real magic remedy is the mitochondrial support plus throwing in some of these neurotransmitter supports as well. 

Dr. Justin Marchegiani: Well, that’s why we talked about B vitamins and I kind of went to the gamut, look how important B6 is in regarding the synthesis of tryptophan to serotonin, really important so you can see how B6 deficiency is really important in this process to convert this inflammatory product here, quinolinic acid, uh, back to tryptophan, it needs B6 or to avoid that whole thing it needs B6 so that’s really important. So, B6 is really important in the synthesis of amino acid tryptophan to serotonin, very important.   

Evan Brand: And so, vegetarians, vegans, obviously, you’re gonna be at increased risk of issues and your recovery is not gonna be as good as someone who’s getting these good animal proteins because you’re gonna be getting adequate tryptophan and other nutrients from your animal-based products. So, even if we could get these people on eggs, if we could get these people on organ capsules, if we could get these people on even like a protein like, I’ve got one we call carnivore collagen, which is a like a beef peptide, I mean something you gotta supplement at some level if you’re not eating those foods. So, please, if you’re a vegetarian vegan and you’re exhausted then look at some of this and hopefully we can convince you to change and improve your diet a bit. 

Dr. Justin Marchegiani: Yeah. No, I totally agree. I think that’s really important. I want to see if there’s anything else here, I want to highlight now because that’s enough, that’s powerful enough. Anything else, you wanted to highlight there?

Evan Brand: Well, we hit the urine, we hit the stool. Looking at the gut, you showed the study about the gut changing, we’ve seen that, I mean, you and I were talking about that march of 2020, I mean that was 2 years ago. We were talking about being affected. And so, obviously, our message is the same that it’s always been is get your stool looked at so we can see what kind of dysbiosis do you have going on because if you’re taking all these supplements, you’re doing all these foods but you’ve got malabsorption or you’ve got gut inflammation. You’re not gonna, you know, people say you are what you eat but you really what you digest from what you eat. So, if you have all these other issues in your gut, the grass-fed steak is not gonna be as valuable to you. Now, I’m not saying stop eating it, I’m saying still eat it but we’ve got to improve the digestion and assimilation of that. 

Dr. Justin Marchegiani: 110%. And one thing here, I just want to highlight here, just to kind of this article, it’s talking about mitochondrial function in infections in the gut because we’re trying to talk about mitochondrial and energy post-illness, that could be a viral illness, it could also be a gut illness, right? Because, it’s talking right here, even virus dedicated virulence factors and talks about downstream of an infection. It’s fascinating that a plethora of immune responses but, uh, be it against viruses, bacteria or LPS. LPS is lipopolysaccharides or endotoxin, this can come from H. pylori, this can come from SIBO, or dysbiotic bacteria and they strongly impact tht mitochondria which is really, really important because they’re toxic, they kind of throw a monkey wrench in how the FADH and the NAD is kind of moving around the Krebs cycle, collecting hydrogens and then bringing into electron transport chain. It talks about, um, governed by the mitochondria can be translated into active therapeutics to boost immunity against pathogens to over immune responses under control in the case of inflammatory disorders. So, essentially, the more you have these infections there, the more inflammation your immune system creates that can actually impact your mitochondria. Again, when you have a lot of these illnesses, it’s not just the stress from the illness, it’s the immune response from your own immune system that creates inflammation that can actually disrupt your energy pathway. So, sometimes, you’re just fighting against yourself. And so, using nutrients to help modulate the immune response i.e., glutathione, Vitamin D, vitamin C, right, really important nutrients there. I’d also say, you can do things like curcumin, or resveratrol as well. You can have immune modulating effects. These are powerful. So, it’s good to kind of get your immune system in check. Most people that are having longer term, we call it kind of long haulers type issue. It’s typically their immune system has over responded and it’s just creating so much inflammation. So here, this illness, they’re no longer testing positive for whatever this illness is and they’re prolonged 2 to 3 months out and they’re feeling like crap still, it’s because they really didn’t get their immune system’s inflammatory cascade in check afterwards.    

Evan Brand: Yeah. Well said. So, a couple comments. Number one, you can improve your energy by simply fixing your gut and that’s exactly what that data is showing and that’s exactly what you and I have seen and done clinically, hundreds and hundreds of times. People that were exhausted coming in, we give them a gut protocol, sometimes, not even giving them energy supplements because on paper they look good and all of a sudden, their energy level doubles and all we did is fix their gut so that’s the number one comment. And then number two comment is that, people need to stop waiting for some illness like this to take them down before they take this stuff serious. I mean, you and I are all about preventative approaches meaning getting your mitochondria, you gut, your brain chemistry getting all that stuff optimized now so that you’re a warrior on a daily basis so that when you do come across something like this and there probably will be more things like this that you do to get exposed to, you’re ready and you’re able to handle it and you’re not coming in so sick and looking for this emergency therapy at the end stage, it’s, in some cases, it’s too late. I think, a lot of times you can turn it around but you should have been working on your health years ago before you got this stage.  

Dr. Justin Marchegiani: Yeah. And a lot of it is, you know, anytime you have some type of illness coming up, the more you can be on top of a lot of these key immune modulating anti-inflammatory nutrients ahead of time and or during versus coming in at the end when the inflammation is super high. It’s like coming in when the fire is a little baby fire and knocking it out versus having a full five alarm and trying to stop it, right? That’s kind of the analogy. So, I always recommend telling people have a couple of nutrients. You may not be taking it everyday but they may in your medicine cabinet is kind of like a, um, you know, last ditch kind of effort to kind of come in there if you start to feel a little bit ill so on my line, we have Immune Supreme, which is nice because you have some green tea in there, you have some echinacea, you have some medicinal mushrooms, you have some antioxidants and some immune modulators, that’s kind of cool. Have that in your medicine cabinet. You start to feel the tiniest thing, start taking that to get that immune system, obviously, you can ratchet up, vitamin D, vitamin C. These are easy first line things, if you have any NAC or glutathione, we can ratchet that up. These are easy things that we can do to kind of take charge of our health and prevent our immune system from throwing us off.  

Evan Brand: Yeah. Well said. And, if you need help clinically, we do offer one-on-one consults around the world with people so we’re very blessed to be able to help so many people by getting the proper testing done, making the proper protocol to get you better. So, if you don’t test, you guess, you got to see what you’re up against first, look at your Bs, look at your gut, you know, once we get the data, we can help you more accurately and you’re gonna save a lot more money, a lot more time and a lot more suffering and you’re gonna get out of the dumps out of the trenches, out of the depths of hell, depression, whatever you’re dealing with. You’re gonna get out of that faster if you’re using clinical data and you have a tour guide to your body. So, if you need help clinically, you can reach out to Dr. J at justinhealth.com for consults worldwide or me, Evan Brand at evanbrand.com and we’re here for you guys. So, we look forward to helping you out.  

Dr. Justin Marchegiani: 100%. I appreciate it. Yeah. Anyone that wants to reach out, Evan already gave you the links, really appreciate it. Comments down below, I really appreciate your feedback on that and also, we’ll put links down below with some products that we chatted about. We have different ones that we recommend in our line. Just wherever you go, make sure you get them from a professional grade company because raw material does matter in the supplement world. You can buy, you know, the equivalent of the grass-fed steak from the local farmer or you can get it from McDonald’s, right? And so, we want to get the high-quality raw material that’s tested to make sure there’s no impurities and just building blocks are excellent. Evan, excellent chatting with you man, really appreciate it. Guys, um, have an awesome week and we’ll talk soon. Take care you all. 

Evan Brand: Take care, now. Bye-Bye. 

Dr. Justin Marchegiani: Bye. 

 

Post Viral Immune Support To Improve Energy | Podcast #363

What you eat after a viral infection, when symptoms of fatigue persist, can have a marked impact on your speed of recovery. Dr. J and Evan discuss that specific foods need to be avoided or included in your diet to improve your immune system. So what are the truth and the evidence about diet and post-viral immune support?

The good news is that most people will benefit from some considerations when recovering from illness or infection. Having post-viral fatigue means that you will not have your usual energy to think, shop, prepare or eat as before. Be very practical and kind to yourself. Dr. J and Evan added that diet modification is vital in your recovery.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
1:57   – The role of acid-pH level in the digestive system
5:01  – The link of depression and anxiety to bloating
10:02 – The benefits of probiotics and effects of stress to digestive health
18:17 – Functional medicine strategies and testing to find the root cause of bloating


Dr. Justin Marchegiani: And we are live. It’s Dr. J in the house with Evan Brand. Evan, how you doing man? How are your holidays? How’s everything going brother?

Evan Brand: Everything’s going pretty good. I’m trying to start 2022 off with a bang. I suspect it’s gonna be a better year than 2021. People are becoming smarter. They’re becoming more educated. They’re becoming more resourceful. People are waking up. There’s a lot of, we’re in the great awakening and so I think, this is an important time to be alive and an important time if you’re a parent, if you’re a husband, a wife, if you’ve got kids, if you’re a teacher. It’s important time to keep your eyes open and keep your ears to the ground because stuff changes quickly and you got to be like a little speedboot. You got to be able to take turns quick, you don’t want to be the titanic right now, you don’t wanna be slow in taking big turns, you gotta be nimble in these times and so what I’m alluding to is just you got to be able to navigate the world of health which is quickly evolving and that’s true. What we’re trying to talk about today is post viral fatigue and really that’s just the title but this really could apply to bacterial infections and parasites and mold exposure but we just wanted to try to zoom in a little bit specifically on post viral fatigue and things like Epstein Barr virus, many people are familiar with and there’s a lot of people that report their chronic fatigue, picking up after something like EBV, we’ve seen it a lot with the virus going around now which would probably get flagged and censored so we won’t say it but you know what it is and there’s a lot of post, uh, viral fatigue going on from that and so you and I have dealt with some of that, you’re still going through the thick of it right now but I think you’re coming through pretty well, you’re still working and obviously you’re on your feet right now literally standing so that’s exciting and yeah.  

Dr. Justin Marchegiani: For the listeners, I had COVID last week, actually symptoms started on Wednesday. Really two hard days of symptoms, I was able to work the whole time though, I mean I think that the symptoms for my COVID that were, um, tough was I would say achiness and then like sensitivity to cold like it was like 45 degrees out and it felt like it was minus 10. So, I would say sensitivity to cold and then also getting really hot at some points, getting out where I would sweat through my shirt. So hot and cold, achiness/ headaches and then like easily out of breath but I mean for me I mean, it was still fine where I could work and still do the things I had to do. So it wasn’t that bad, I mean, I had a flu in 2013 where I was literally laid up for over two days and I couldn’t do anything so I know laid up feels like it wasn’t even close to the flu of 2013 for me, that was really hard. So, definitely, um, not as bad, I actually was my own worst enemy because on Friday I was feeling like really good like 80-90% better and did like 2-3 hours of housework like cleaning my house like doing all this different stuff because it was a beautiful day and I’m like all right let me get on top of some work, work 3 hours probably walk like 15,000 steps and that next day there was a major relapse in how I felt. It was probably like I went backwards 30-40%. Here I was at 80% probably going backwards to 50. I was like whoa what happened and so then I just kind of got in the straight and narrow and just said okay I gotta really make sure I kind of make sure I kind of keep it easy until I get back to 100% because, you know, um, it just you didn’t realize how much, uh, things could go backwards so fast so you really gotta wait till you get a 100% on things and so overall I mean the only thing lingering for me right now is a slight bit of um out of breathiness and, uh, this little lingering deep tickle cough like right now you can feel it like someone’s tickling the back of your throat with your finger and you want to cough to scratch it, kind of like that and so that’s where I’m at now. That’s like kind of makes it feel like I scratch it right there, right. So, I’m doing some ginger tea, I’m doing with the Manuka honey that soothes it like that helps with the irritation. It’s not knocking the cough down. Doing some, Elderberry, um, doing some thieves, uh, natural cough drops with essential oils, um, also doing some nebulizer so I’m doing some glutathione nebulization so those are couple of things I’m doing and then obviously sinus flushes, the amount of mucus that is coming out of me is out of control so sinus flushes are really, really important because if you do not flush your sinuses, the amount of stuff that stays inside of you, oh my God. So, flushing my sinuses out 3-4 times a day, you know, really good saline reverse osmosis with a little bit of silver in there to kind of keep things flushed out is helping a lot. So, that’s kind of where I’m at but honestly feeling pretty good, um, the whole family got it purposefully, my wife had it and I’m like come over here honey gave her a big kiss and then I kissed all my kids, I’m like we’re done. We’re gonna get this thing all together, be done with it all that way we’re not, you know, I get it next month and then I’m isolating for two weeks and then my kids get no we’re gonna get it all at the same time and surprisingly my kids’ symptoms were 80% less than the adults, super, super minor.  I couldn’t believe how minor it was for the kids, so very interesting. So, that was kind of my experience with, uh, with the big C, uh, so to speak. And also, the big correlation I was listening to someone talk about this, the, a lot of the post C symptoms that we see after, right, people that have dysglycemia, and blood sugar issues tend to be a big driving factor of a lot of these post viral symptoms afterwards. Talking about post-viral fatigue, one of the big things is make sure you manage your glycemia, meaning you’re having good protein, you’re having good fats, you’re not eating a bunch of refined sugar, grains, those kinds of things. Make sure you put good metaphorical logs on the fire, good proteins, good fats to really work on blood sugar stability. 

Evan Brand: Yeah. Yeah. We’ll I’m glad that you’re coming through it. Regarding the shortness of breath, I would kind of put that in the same category as the post viral fatigue because that shortness of breath can create fatigue and the best thing that’s helped me and has helped many clients is doing the color oxygen. So, ChlorOxygen, you can get that on amazon, it’s readily available. And it’s just a, it’s a liquid chlorophyll extract. So, when you do that within probably 5-10 minutes, you can feel a difference, so it’s like C-h-l-o-r-Oxygen, ChlorOxygen. I would probably do 10-20 drops up to 3 times per day. That thing is absolutely incredible. You can go as high as one tablespoon in 20 ounces of water and just sip on that throughout the day. I had one guy in New York, major, major issues with shortness of breath in the acute and the long term and that ChlorOxygen literally just turned his situation around. So, I’d get some of that stuff. 

Dr. Justin Marchegiani: So, it’s C-h-l-o-r Oxygen?

Evan Brand: Yeah, ChlorOxygen. Yeah, and it comes in a little bottle tincture and it’s incredible. Also, something I’ve used personally, I’ve used with several clients too is Ailanthus. Ailanthus is three of heaven which is an invasive tree. I see a lot of it in Kentucky but you can buy Ailanthus tincture and that one is also really, really good. 

Dr. Justin Marchegiani: Interesting. Is this the one, right here, Is the ChlorOxygen? 

Evan Brand: Yeah. That’s the one. Yep. 

Dr. Justin Marchegiani: Okay. Cool.

Evan Brand: Get you some of that but should help because that’s the problem is, you know, the shortness of breath was pretty bad for me and I felt better, you know, I got infected a long time ago. It was like August 2020 and then six months later that’s when I started to have some shortness of breath which I was like, holy crap and so luckily, I was able to knock it out, uh, with Demectin and uh, yeah, Demectin really helped me and then the nebulizer and the ChlorOxygen, I would say that combination was an absolute game changer, luckily, I haven’t had any issues since then. But what we are seeing is that the mitochondria have a role in this and some of this post-viral fatigue we’re seeing is due to mitochondrial damage so I’ve been fortunate enough to see a few dozen people now. And in terms of organic acids testing after the virus, and we are seeing that the mitochondria definitely showed dysfunction. You and I talked about this many times on other podcast about the mitochondria. We can measure the dysfunction and so what we’re doing is we’re coming in with mitochondrial support nutrients so CoQ10, we’re coming in with carnitine, ribose, a lot of these amino acids and B vitamins like riboflavin which can help fuel the krebs cycle and then also we can use things like PQQ to help get the mitochondrial biogenesis going, meaning we’re literally making new mitochondria so we can measure this on paper. So, if you guys are suffering, you know, one of us can reach out or you reach out to us rather and then we can get the urine looked at because we can measure this. You don’t have to guess where is this fatigue coming from. If it’s a mitochondrial induced problem, we can measure that. Now, you have permission to have multiple things wrong with you so there could be a dopamine problem, there could be a mitochondrial problem, there could be toxin problem. So, rarely is there one issue causing this fatigue but the goal is for us to try to get as many puzzle pieces laid out in front of us and then make an appropriate protocol.    

Dr. Justin Marchegiani: 100%. I’d say, the worst thing about COVID for me right now, coffee tastes bitter like it tastes bitter, almost a little bit sour, does not taste like coffee. I’ve almost been like I’m not even gonna drink it right now until this thing gets better because it does not taste that good but for me I’m just alright, I got, you know, 20 grams of collagen in there, I got some good fats, I kind of look at it as like a meal replacement for me. So, that’s probably the worst thing the whole time. For me, it kind of felt like a cold. I’d say a mild, mild to middle of the road cold. The only thing that really surprised me was that, that back swing where I was like 80% better and then went backwards that was the hardest thing. 

Evan Brand: And, it could have been you overdoing it for sure, I mean, 

Dr. Justin Marchegiani: oh, you totally did. 

Evan Brand: Yeah. I mean I did have a little bit of that too where I kind of felt like I was better, overdid it and then I heard it again, so. 

Dr. Justin Marchegiani: Yeah. 100%. So, excuse me, anything else you wanted to highlight on that so far? I would say post-viral stuff, the things that I’m doing right now and I recommend people do, in general, are gonna be Adaptogens and I like medicinal mushrooms. So, Shiitake, Maitake, Reishi. Reishi is great. I love it because it does deactivate viruses. It does build up and support the natural killer immune cells so I do like that, uh, any type of ginseng, Ashwagandha, these are things that help support energy production, support the adrenals, help buffer the HPA excess. So, any of these types of things are gonna be, uh, helpful too.  

Evan Brand: You need to get on some Lion’s Mane too for your taste because what I’m finding is that the nerves are damaged and that’s affecting the sinus. So, the sense of smell, sense of taste, some of that is related to nerve damage. So, I would probably hit Lion’s Mane, maybe like two caps twice a day. That’s been helpful to restore the sense of smell and taste in some people. 

Dr. Justin Marchegiani: It’s probably not damaged. It’s probably just more inflammation, right? 

Evan Brand: Well, the long-term stuff, I’m talking to people just long-term. I’m talking to people that you know 6-8 months later say, I still can’t taste or smell. Bringing in Lion’s Mane, like 2 caps twice a day. It takes a few months but you know it does increase nerve growth factor and so I think that’s the mechanism. 

Dr. Justin Marchegiani: That’s interesting. Yeah. I do have some Lion’s Mane. I’ll definitely add that in. I mean, I think medicinal mushrooms are gonna be really good to, um, be on top of, uh, just supporting your immune system and like helping with, um, the body regenerate and heal better. 

Evan Brand: Yeah. Gabe was asking a question in the live chat on YouTube. How did you guys catch it? I don’t know, I mean I work from home. You know, I’ve got a home office, uh, Justin has a home office as well, you know, I do go out, uh. 

Dr. Justin Marchegiani: Personally, it’s the new variant. The new variant has an R-naught of seven, which is that’s equal to, uh, measles so the delta variant had an R-naught of 2 or 3 so that means for every one person that gets it, it can be passed to 2-3 on average, right. The new omicron variant, it’s seven, so you can literally pass it to seven people so I think my wife was in a yoga class with three people and they were like spread out across that broom like they were like way you know spaced apart, you know, for just all the safety reasons and it was still able to get it so my whole take on omicron, it’s very, um, I think the symptoms are milder than delta for sure. That’s what everything’s been reported but, um, it’s way more contagious. Everyone’s gonna get it at this point, you just gotta have your plan and, um, be ready ahead of time, right? People don’t have a plan and then when they get it then they get stuck and they feel like they have to go to the hospital and you don’t have as many options there so try to have a, um, outpatient plan ready to rock and roll but yeah, you’re gonna get it because the, um, our knot on this thing, right, is that seven which is at a level close to measles so it’s right there. So, if you haven’t got it yet, you will. Anything else you wanna highlight on the immune side, on the post-viral stuff obviously I’m a big fan of ginger, I think ginger is nice because it’s anti-inflammatory, anti-viral, uh, helps with lymphatic. So, if your kind of like have a lot of like stagnant lymph in the chest area or in the neck I really keeps the lymph moving all that’s very helpful. 

Evan Brand: Yeah. There was, uh, one person that commented if you’ve had delta you should have some memory T cells that will help if you get infected. Yes supposedly. Supposedly, um.

Dr. Justin Marchegiani: Yeah. You definitely should have memory T cells as well as memory B cells, right? So, even if you were to get sick again, um, you’re gonna be able to recruit antibodies way faster, right? Normally when you get sick if you’re first time getting exposed to an infection it takes about a week or so to really get those antibodies ramped up and so even if you were to get sick twice, you’re gonna be able to make those antibodies inside of, you know, 24 hours or so. So, you’re gonna be able to bring those antibodies to the table a lot faster and so that’s, um, that’s pretty cool. That’s pretty helpful. 

Evan Brand: Yeah. Other strategies, uh, post-viral fatigue hyperbaric oxygen has been helpful. I’ve seen several clients that luckily have lived in a city where they’ve had access to do hyperbaric oxygen. Essentially, what it is, is it’s replicating being under water under water about 10 to 12 feet so that pressure is helping to get oxygen deeper inside of you. So, some of these tissues may have been starved of oxygen. This sort of mild hypoxia or hypoxemia, you know, you can basically reverse that by getting the hyperbaric oxygen. There are some people that can do there’s oxygen cans, little portable oxygen shots, if you will but it’s nothing compared to an oxygen concentrator with the hyperbaric oxygen so that’s good ongoing, I mean, I’ve had clients with Lyme that have done hyperbaric we know that’s incredible for traumatic brain injuries and concussions and that sort of thing. So, even if this is just a long-term fatigue problem, not related to viral issues at all, you know, hyperbaric is another good tool, you’re looking at probably around 100 a session but, you know, what, what’s your health? What is your health worth? So. 

Dr. Justin Marchegiani: Exactly. One thing I did was very helpful was use my infrared sauna the last couple of days. That was helpful, just getting a really good sweat in felt very good, you know, raising that body temperature up can be very helpful just at um at your body knocking down viruses. That’s part of the reason why you get, um, chill while you get the nutshells but, uh, why you get a fever right. It’s part of the reason your immune system is actually knocking down some of that bacteria and or viruses by doing it that way so using an infrared sauna can be helpful too. 

Evan Brand: So, look at your mitochondria, get your organic acids test done, we can measure that and look at mitochondrial function come in with specific support whether it’s B vitamins, adaptogenic herbs like Rhodiola, you mentioned, Siberian ginseng or Eleuthero. There’s medicinal mushrooms like cordyceps which there is some benefits. There are some papers on cordyceps and athletes and improving blood flow. There may be some level of oxygenation that happens with cordyceps too. So, cordyceps, reishi mushroom, I think the Lion’s mane for the brain and for the nerves would be beneficial, the ChlorOxygen for any of the shortness of breath along with the fatigue, rest, I mean just getting good quality sleep, making sure you got to do whatever you can to get good quality sleep. So, all the same sleep hygiene habits we’ve talked about for a decade together apply in regards to candling down at night if you need some passion flower. Even melatonin, there’s some really cool studies on melatonin. We know, it’s a very powerful antioxidant and we are seeing higher doses of melatonin be beneficial. So, in general, somewhere around 5 milligrams but there are some papers going wat up 30 – 40 – 50 milligrams and beyond. I don’t know a ton about the high dose so I’ll just tell you that the regular dose standard dosing is better than nothing. 

Dr. Justin Marchegiani: It was that melatonin?

Evan Brand: Melatonin. Yes. 

Dr. Justin Marchegiani: Yeah. Usually, it’s like the higher dose is like 10 milligrams and that’s gonna help with the oxygenation and then 30 – 500 milligrams for the arginine that’s to really increase the oxygenation. 

Evan Brand: Yeah. The arginine for like nitric oxide production. Beet powder, you know, beet powder would be good too. So, anything you could do to create some vasodilation is gonna be smart. 

Dr. Justin Marchegiani: Very cool. Anything else you wanna add, Evan?

Evan Brand: I think that’s it. If you need help, reach out, get tested, hopefully you get back on the full mend here so, keep, keep rolling. You’re doing a great job and hope everybody is doing well and we’ll be in touch next week. If you need help clinically, please reach out. You can reach out to Dr. J at justinhealth.com or me, Evan Brand, at evanbrand.com. We’re happy to help you guys. Keep your head up. keep moving forward.   

Dr. Justin Marchegiani: I think the big thing out of the gates is to make sure you have time to sleep, rest. Don’t overdo it. Just know your body still needs more time even when you, when you’ve gotten through the whole thing to recover. Don’t overdo it. That’s really important. Keep the foundational nutrients dialed in so that would be like zinc, vitamin C, vitamin D, you know, you can keep those things in there. You may not have to use them at such a high level that you did with the infection but keep some of those nutrients. Don’t go from something to nothing. Keep something in there the whole time, find a medicinal mushroom that you like, find an adaptogen that you like. Maybe keep a little bit of ginger tea going. Something that has some antiviral support and um, you know, try to get a little bit of movement but if it’s making you feel winded then just try to do just enough where you can feel like you’re doing something but not where it’s overly taxing you. I think it’s really important to kind of meet that right in the middle. 

Evan Brand: Last thing, two last things, a low histamine diet is generally pretty helpful because there are a lot of issues with mast cell activation being triggered from this. So, a lower histamine diet, fresh meat, and no leftovers is very important. And then, histamine support. I’ve got a product called histamine support but essentially it’s quercetin plus some other nutrients so anything, you can do to stabilize your mast cells that’s gonna be helpful because muscle activation can cause fatigue, meaning, after the viral issue was over, the immune system can sort of have PTSD for lack of a better terminology and the immune system will go into this crazy state where it will shut you down so that fatigue trying to rebuild that energy back up is re-regulating the immune system so like the quercetin, other mast cell stabilizers are very helpful. 

Dr. Justin Marchegiani: Love it. Love it. Love it. Makes total sense and again not everyone’s gonna have that issue but you know, it’s kind of good to know if you fit into that camp. Those are a couple of strategies out of the gates. Anything else, Evan?

Evan Brand: No, that’s it. Take it easy. If people need help, reach out justinhealth.com and evanbrand.com will be available. 

Dr. Justin Marchegiani: Yeah. We’re here to help you guys. I’ll probably be back later on today here. So, keep a lookout, comments down below. Let us know your thoughts on the topic, we appreciate a review. We appreciate shares to friends and family. Really helps us get the word out. You guys have a phenomenal day. We’ll talk soon. 

Evan Brand: Take it easy. Bye-bye

Dr. Justin Marchegiani: Bye you all. 

 

Natural Solutions to Address Eczema | Podcast #361

If you live with eczema, you know what it’s like to search for relief from red, itchy skin. You’ve probably already tried a variety of products. Unfortunately, some items can leave your skin feeling drier and even more irritated.

Dr. J and Evan emphasize not giving up hope yet! In addition to medications, there are many options you can try at home to help with your symptoms. They talk about drugs and natural remedies that may help replenish moisture and protect your skin’s natural barrier.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
4:29 – What is Eczema and Its Signs and Symptoms?
6:51 – The Comparison between Eczema from Rosacea
10:38 – What to eat and not to eat when you have eczema
16:20 – Helpful products that can help avoid and or alleviate Eczema
19:25 – The link of glutathione in skin conditions


Dr. Justin Marchegiani: In the house with Evan. Today, we’re gonna be talking about natural solutions to address eczema at the root cause level. Really excited to chat about this topic here today. Evan, how we doing my friend?

Evan Brand: Hey, doing better. I was super stiff over the weekend so I thought, my God maybe we’ll do a whole, like stiff neck podcast but for now I’m mobile and I’m on my feet so that’s good and excellent. We’re recording this in December and winter is usually a time when people start coming of the woodwork with more skin issues and I think a lot of it is because they’re indoors more than in spring, summer, fall and so if they’re indoors and they don’t have good indoor air quality, they’re gonna be exposed to more dust, mites, molds and other toxins which may aggravate or irritate the skin. Also, in general, when you start to kick on the heater, you’re gonna be drying out your home and so generally your humidity level in your home may be like in our house it’s give or take 10% lower than it is in the summer so with the whole house dehumidifiers, I keep our house at 40% in the summer but in the winter with the heater on, man, we’re down into the mid20s, 25, 28% humidity. That’s pretty dang dry so sometimes it could just simply be an environmental change like that but I think some of it is also related to the toxins that people are getting exposed to. And now instead of playing outside with their kids, now they’re inside all day with their kids and their skin is reacting to those toxins so you’re really got to get your air quality dialed in and the winter to me just exposes the poor air quality that people have. 

Dr. Justin Marchegiani: Yeah, 100%. I mean especially this time of the year, we have our humidifiers on, it has a tiny bit of moisture into, um, the ventilation system because it’s like, you know, in the upper teens, low 20s so just adds a little bit in there just to take the edge off, I mean that can be helpful to add a little more moisture to the air obviously, you can do more moisturizer on the skin. Remember that is gonna be your internal moisturizer. So high quality coconut oil, grass-fed butter if we can tolerate those things. That’s gonna be the best way to do it but obviously we can add more moisture directly onto the skin but we wanna always internally moisturize with good fat and again hydration as well that’s the carrier for that moisture to the skin so that’s a really important thing. I remember in college, just having chronically dry like my legs were really dry all the time and I realized, you know, at that time I was trying to be a little bit lower fat because I thought that was healthier and I started kind of understanding okay more coconut oil, more saturated fats, I’m like all right and then I noticed the dryness really improved and went away so fat consumption is really important thing for natural moisture to skin. 

Evan Brand: You know, what is interesting now that you mentioned that, I mean, years ago, like my wife and I first got together, I mean, we were eating grass-fed beef but I wasn’t really prioritizing the fats, I wasn’t necessarily seeking them out, I was just maybe cooking with a little bit of butter but I wasn’t intentionally going for good fats and I remember in the wintertime having to put lotion on, man, I don’t use lotion at all anymore. I literally don’t need it, my hands are perfectly dry, they’re not itchy, they’re not patchy like it’s a miracle and you kind of forget where you’ve come from. Once things start to improve, you forget that that used to be a problem where I used to have to put a lotion on. Imagine how much of a hit to the lotion industry you could create if you could simply get everyone optimizing the strategies we’re talking about today, I bet we could reduce the need for lotion by 80%.   

Dr. Justin Marchegiani: Oh, totally, 100%. 

Evan Brand: And to mention conventional lotions are actually one of the big triggers of eczema because when you look at conventional lotions and some of these products that are advertised, you’re getting into propylene glycol, you’re getting into artificial fragrances, you’re getting into many, many synthetic toxic chemicals that people are lathering on their skin just to supposedly fix their skin but they’re actually making their skin worse so you mentioned like topical coconut oil. There’s many good, like, organic shea butter type lotions out there, like Dr. Bronner’s, they make a really good lotion, um, the everyone brand, I know they make a good soap, I believe they make a good lotion too. Trader Joe’s, they had a pretty good quality, low priced lotion that was really clean ingredients so that’s the problem is like people are trying to do things to fix their skin but they’re actually making it worse with these topical toxins. 

Dr. Justin Marchegiani: 100%. Now, when it comes to eczema, eczema does have an autoimmune component, right? So, eczema is a type of dermatitis, just to be 100% clear. So, think of, you know, dermatitis, think of, like skin inflammation, essentially dermatitis, the derma, that’s the second layer of the skin, epidermis first. Derma, um, dermis is the second layer and then essentially, um, titis is inflammation and so you have different types of dermatitis. Okay, so you have atopic which is kind of the one that eczema, uh, falls into. Atopic is the major one that you’re going to see there. There’s other kind you’ll see contact dermatitis which is kind of what poison ivy kind of falls into. There’s this dyshidrotic eczema, where you get more blisters. There’s hand eczema, there’s neurodermatitis, which is another one as well. Uh, there’s nummular eczema as well and then there’s one last one called stasis dermatitis. Those are the big ones. So, atopic is gonna be where eczema falls under and there’s an autoimmune component, there’s all kinds of studies showing that people that has celiac, Crohn’s, irritable bowel disease issues, lots of different autoimmune issues, there’s an increased risk of eczema, so there’s an autoimmune component there and if you look at a lot of the medications that are used to address eczema, you’re gonna typically have like your anti-inflammatory steroids like cortisone which are gonna be topically rubbed on that area. The problem with that is, it tends to not actually fix it. It just calms it down but it can also thin out that skin and make it more prone to have a flare-up later on so it can be helpful in the short run but you’re kind of robbing Peter to pay Paul, right? And then you have other medications like, um, Eucrisa or Elidel that are, like, kind of more on the calcineurin inhibitors. They’re kind of an immunosuppressant so there’s definitely like an autoimmune component there because you’re coming down the immune response to kind of like chill out, um, the eczema and it can be helpful, those kind of medications could be helpful if you’re working on fixing the underlying root cause, the problem is most people don’t address the root cause and they just rub these medications on and then the problems continue to stay at the root level and so over time it’s gonna come back and get worse and worse and worse because you can’t just suppress the immune system in the long run and expect for a lasting solution. So, these medications may be okay if you’re working with someone to really get to the root cause so that’s pretty much what conventional medicine has for options. It’s gonna have those things. Now, just kind of highlight, um, you have eczema, you have Rosacea and psoriasis, they kind of have an overlap, all right, there’s like an overlap with these three conditions and I want to just kind of show a comparison guide for this because it’s really important. I want to just highlight this really quickly. Um, okay, here’s what I want you guys to see. All right, perfect. So, out of the gates, right, all of these skin issues are gonna have redness with all of them right, eczema, rosacea, psoriasis, they’re both gonna itch so there’s gonna be similar out of the gates the big thing with psoriasis, you’re gonna see a lot of the silver and white scales. That’s gonna be psoriasis and the difference with rosacea, you’re gonna see a lot more flushing across the skin, all right. Both are gonna have dry skin, both can have raised bumps. Psoriasis sometimes raised here says none. But the big issue is rosacea, more of a flushness with the redness. Psoriasis, more of the silver, um, scaliness. That’s the big difference. Just so, if someone’s like, what do I have, right, um, that’s kind of the big thing out of the gates there. Hope that makes sense. And there’s a couple of things I wanted to highlight with eczema is food components make a huge difference so autoimmunity, autoimmune diet plays a big role, really reducing inflammation makes a big role. Trying to cut out a lot of the scents and fragrances can play a huge role so of course like free and clear types of, um, laundry detergent, you can do all has a free and clear, Seventh Generation has a free and clear. There’s all kind of different brands that have a free and clear, um, all’s recommended by the, um, eczema dermatology association. So, you really wanna cut out all scent’s fragrances, dryer sheets that play a huge role out of the gates. 

Evan Brand: Yeah, it’s a big, big stressor and it’s a big stressor for people like me that have to smell it, people don’t wanna smell that crap anyway but you’re poisoning yourself, you’re poisoning your children too, you’re sending them off with those synthetic fragrances and those are irritating to the skin but also those can affect the hormones too, I mean, synthetic fragrances, in general, can have some xenoestrogen type compounds to them, meaning that you’re gonna be increasing the estrogen. We’re in a highly estrogenized society and that creates a big problem. Hormonal changes, hormonal imbalances, they are a big factor in skin issues and we see that with a lot of women that have irregular menstrual cycles or maybe heavy bleeding or something that happened especially after childbirth. A lot of times, they’ll be skin issues that would pop out and we fix it in a roundabout way and I want to go back to one thing you said earlier which was the fact that people that have eczema, they may be linked or more common in people to have issues like celiac and that of course takes you to the big gatekeeper of these skin issues which is the gut and so you and I found with hundreds and hundreds, now we’re into the thousands of clients between us that the major way to fix the skin is to obviously do some of the easy low hanging fruit like you said get rid of scented detergents and all that but it’s really focusing on the gut because if you have gut infections, I mean, if you even look at like some of my very, very old earliest YouTube videos, when I have H. pylori and other gut infections, my skin was nowhere to where it is now in terms of my skin health. My skin health in the last seven years has gotten way better and honestly, it’s just been by working on the gut, my diet was already dialed in back then so I just wanna address one thing with people which is that if you’ve already gone polio or autoimmune or keto or carnivore, you’re eating good quality food and you’re still struggle with your skin, you’ve got to dig deeper, it’s time to look in and see if you’ve got these gut infections, bacterial overgrowth, candida, all these things inside your gut are gonna be making toxins disrupting your gut barrier. So, I don’t care how much bone broth you drink, you’re not gonna fix your skin if you don’t fix these infections.

Dr. Justin Marchegiani: Absolutely! I mean there’s two categories, right? Infants and kiddos, right, in the first year of life, they’re gonna be a lot more sensitive because of their immune system, so, I mean, of course, the big thing you have to look at is high quality breast milk and really got to look at what the mom’s consuming. The mom’s consuming a lot of potential food allergens. I recommend an autoimmune diet out of the gates. Sometimes, we even have to look at potentially pulling out salicylates. Salicylates can be anti-nutrients in vegetables. Here’s a couple things out of the gates, right. Salicylates are natural chemicals found in many fruits and vegetables, they’re really good things and so out of the gate, I wanna pull these foods out as a means of calming down and chilling out the immune system. Uh, this is really important so you can see, kind of the negligible, the low, the moderate, the high and the very high. I just try to tell patients to, like focus on the 80-20 because there’s so many foods that are, like, really good for you that are high in salicylates and a lot of times it’s not about being perfect, it’s about calming down, you know, kind of the 80-20. So, what are the 20 of things that you eat the most frequently that are the most high and we’ll try to sub that and put that in the negligible to low category that can be really helpful as well. So, you can see the different vegetables, you can see the different nuts and seeds, you can see the different, obviously, meats tend to be on the lower side unless you’re doing a lot of processed stuff, that’s where you get into trouble there. 

Evan Brand: That’s why so many people do so well with carnivore-ish diets. That’s kind of what I say I’m eating carnivore-ish because I still do berries, I still do rice and I feel okay with that, um, I still do on occasion, I’ll do some organic pecans as kind of a treat and those are delicious and those don’t appear to affect my gut or my skin. So, in general, if you’re going for more animal based good-quality fats, you’re knocking out as you mentioned, you’re knocking out salicylates, um, you’re knocking down lectins, you’re knocking down oxalates, you’re knocking down all these things.  

Dr. Justin Marchegiani: Yeah. Here’s my oxalate guy. We may wanna look at oxalates as well. There’s kind of a members area for my patients here. If you’re a patient, you have access to this area, top right-hand corner of my website. And you can see I have a low oxalate handout as well and again I don’t recommend going crazy out of the gates. I just try to look at what’s the 20% of food that you eat the most and let’s try to cut out the high stuff out, right, and then sub that with the lower one out of the gates. That can make a big difference especially if you have a baby who has a lot of eczema issues. If we can really get a good autoimmune diet, kind of get the oxalates and the salicylates down, that could make a big difference. But, like Evan said, we have to look at gut microbiome stuff, we have to look at things you may be getting in contact with in regards to detergents, even essential oils on the skin. Some of these things can be stressful on the body, so we really got to calm all of these things down. Got to look at good bacteria, maybe have to address bacterial imbalances. Again, if you’re not a baby, you’re an adult, we have to look at the hormones because of times if you’re chronically stressed hormonally with the adrenals or you have estrogen dominant issues as a woman that can affect your immune system and that can make you prone to having some immune imbalances and your immune system is kind of hyper responding and overly sensitive and of course we definitely test the gut because we have SIBO, bacterial overgrowth, dysbiosis, H. pylori, fungal overgrowth, right, fungus and candida can actually produce oxalates too so you can have endogenous oxalate production via candida. These things can stress out your body thus stressing out your immune system. So, really looking at the adrenals, looking at cortisol, looking at the female hormones, estrogen and progesterone dominance, really looking at the gut are you able to digest and break things down, are the anti-nutrients in vegetables a problem. Again, I hate cutting out the anti-nutrients in vegetables, if we don’t have to because there’s a lot of good food there. So, cooking these foods down can help but it’ll lower it a notch. It won’t take a high food to make it a low food. It may not make a high food, maybe like a medium food. So, cooking obviously, avoiding a lot of the raw salad steaming sauteing can help a little bit and kind of lessen that load for sure. 

Evan Brand: Yeah. Well said. Detox is important and detox can get screwed up by your gut infections. We’ve talked about this before but there’s a pathway called glucuronidation in the body and this gets impaired due to bacterial overgrowth. So, sometimes we’re coming in and fixing the gut but then we’re also trying to upregulate these detox pathways so that could include specific support for the liver that may include binders that may include liver gallbladder combinations, maybe there’s some acid and enzymes that we throw in. You know, when you look at someone’s face or just their skin in general, to me, it’s really the window into their gut, into their immune system. So, if you see somebody with just major, major issues with their face generally, there’s a gut problem, I had a woman, she was young when she first started with me, I think she was around 20, 21, and we got on facetime together and my God, her face was so terrible, she hardly wanted to be seen on facetime but she said, I think, it’s important for you to see me, to see how bad this is, I’m like, yeah, I appreciate you showing me this, and man by the time we got through working through some of the tests and the gut protocols her skin was flawless and I even had to ask her like do you have make-up on, I just want to clarify and confirm do you have makeup. No, I don’t. so, it’s amazing to see what you can do and timeline wise, I mean, we’re talking maybe a few months but within a couple of years, I would say you could completely reverse many of the skin issues that people are suffering with and that’s actually a really short timeline, I mean, we’ve seen people that have had skin issues for decades and as you mentioned they’ve been on these topical steroids or other medications for a very long time and not once has the dermatologist ever said, hey maybe you need to go animal-based with your diet and see how that goes. I’ve never heard that conversation, if you’re a dermatologist out there practicing like that let us know maybe we can chat with you, but in general, that conversation is not happening at all. 

Dr. Justin Marchegiani: Yeah. I’m in a lot of eczema groups online, on Facebook and it’s amazing how resistant parents are and I just, people are, in general, to change in their diet when it comes to eczema. It’s unbelievable. They’re like oh, I’m gonna go get this food allergy test from there, like, dermatologist and like most of the time that’s just like an IgE kind of skin prick test and then again IgE stuffs, you know, it’s okay, but it’s, that’s kind of more on the anaphylactic side that tends to not be the massive driver of course, you know, if you have any IgE stuff like environmentally like dander and cedar in Austin, obviously we can get a really good high quality HEPA filter with a activated charcoal filter as well to kind of filter a lot of this stuff out to keep the indoor environment good. I’ll put, we’ll put some links down below for the recommended air filters that we use with our patients. Cutting out all of the scents and fragrances in detergents in laundry, everything, no dryer sheets, all that stuff makes a big difference. Keeping the skin moist does help because if the skin’s already dry, you’re more prone to itching, if you itch it, you increase the inflammation, it’s this vicious cycle and the problem is if you’re kind of naturally oriented a lot of the things that may have like an essential oil or something in there that may be more natural that you may think is helpful because the immune system is already hypersensitive that may actually  flare it up and make it worse and so one of the things that we’ll use, it’s just a really clean super hypoallergenic moisturizer. I’ll put a couple in the links down below that I found to be successful, there’s a couple off the back of my head, I could think of, um, uh, Vanicream makes one called Vaniply, that’s a really excellent one. There’s one by a La Roche-Posay, it’s a Lipikar Baume, that’s another really good hypoallergenic one. Aveeno makes one that’s decent with a little bit of oatmeal in there, the colloid and the oatmeal can be helpful but keeping that skin moist can be helpful so you’re not scratching. It won’t fix it though, right, there’s no magic solution but it will at least help to calm it down and then I find like if you’re a mom and you’re breastfeeding your kid, you have to change the foods that you’re eating because that is going to get passed down to your child and can stimulate their immune system and so typically for a good month or so and then we do a very methodical reintroduction, I know with my wife, eggs were a big trigger for a while and now she can do eggs and like my kiddos can do eggs but for a while, they couldn’t and so we had to keep that really under control for a bit and probiotics did help as well and really helping to support good bacteria help but we had to really do everything kind of full cycle and we did use a little bit of that Elidel calcineurin inhibitor, just a little bit to calm it down but it’d be like foa a day or two and then we would do all the other things and salicylates were a little bit problematic as well so we did try to cut some of those things down and it’s like the, imagine the immune system’s all wound up and we’re just trying to calm it down, calm it down and once you have it below a threshold so to speak, you kind of have a little bit more wiggle room but until you calm it down to that level, you don’t quite have that ability to move. 

Evan Brand: Yeah. Yeah. Well said. There was one other paper too we were looking at on glutathione and this was just a, it was a quite old study but still very, very timely in terms of like glutathione. We have it in our conversations all the time and depressed glutathione levels were observed in patients with psoriasis, eczema, dermatitis and other skin issues and so we know that glutathione is gonna be depleted when you’re exposed to toxins whether it’s chemical whether it’s mold toxins or other things, we often see glutathione levels depleted and this is one of your master antioxidants and so you may need to work into the detox protocol, sometimes that can aggravate people so you just gotta work with the practitioner on this because I’ve taken too much glutathione and reacted poorly to it before so you got to go slow  and steady with it, sometimes it’s gonna flare people up if they’ve got a big toxic load and it starts mobilizing things that may overwhelm your system and you may feel worse or have some sort of like a die off or what feels like a Horkheimer reaction. What about zinc too? Do you want hit on like some nutrients for skin too?   

Dr. Justin Marchegiani: Yeah. So, I think, out of the gates, like probiotics are really helpful. Omega-3 plays a really great role in anti-inflammatory. Vitamin D plays a good role in modulating the immune system. If you’re doing glutathione and you’re breastfeeding mom, be careful because you don’t wanna overly mobilize toxins out of the breastmilk, so you may wanna go really gentle on that or maybe a little bit of NAC and just kind of naturally, you know, increase that very slowly as long as you don’t have any die off, you’re probably okay. I would say zinc is also gonna be excellent as well, it’s gonna be a good building block for the skin, really good building block for the immune system so is selenium, so some of these may just get in a really good multivitamin, uh, some you may get from eating high quality grass-fed meat, fish, some green vegetables, seafood. So, a lot of these may come from whole foods sources, as well as, supplement sources as well. And then, you know, we have some really good anti-inflammatory things that we can do whether it’s curcumin, resveratrol, these are kind of plant-based antioxidants that are very powerful, also, there could be a histamine connection as well. And so, histamine from the environment, from allergens, you know, good air filtration is excellent and then we can do things to help modulate the immune system, like quercetin, like stinging Nettle. These can be very helpful and very calming on the immune system in regards to the histamine response. Anything else you wanna highlight there?

Evan Brand: Yeah. Well said. I think it’s a good start olive lead, we use a lot too and some of the gut protocols and that may help some of the skin issues too. So, it really just depends. I don’t want people to just go out and buy everything we just mentioned and assume it’s gonna fix their issues, I think it’s really important to try to get a good work-up and figure out where your issues are coming from, I think it’s great to be able to look into some of the topical stuff, get rid of your conventional shampoos and conditioners, go high quality organic products with your skin care but beyond that you really need to get some investigation done and figure out what the heck is going on because for years I was doing good clean products topically but I still have skin issues and it was all because of my gut. So, I really encourage people to reach out if you need help. Dr. J and I work with people around the world so we can get at home lab testing done to where we can investigate the root cause of your skin issues and often, we’re gonna be using urine and stool. Those are probably the two most common things you’re gonna be looking at and these are far more effective than what you’re gonna get run from a conventional doctor. We’re gonna be able to tell you what the heck is going on. Your dermatologist is not running stool tests but they should because the issues they’re seeing in their clinic would certainly be improved if they could fix the issues that we’re finding on these stool panels so I think it’s really important to test not guess, figure out what the heck we’re dealing with because you could take probiotics for your whole life and never fix these infections.  

Dr. Justin Marchegiani: Totally. Yeah. I agree. And again, if you go to the dermatologist, it’s pretty typical, right? They may recommend like oatmeal bath or a diluted bleach bath or Eucrisa or a corticosteroid or Elidel. They may recommend these things but that’s not gonna be the solution. Again, some kids naturally grow out of it because their immune system evolves, gets better, their gut becomes less leaky naturally, um, maybe they start making healthier food choices as their parents become more aware of what’s going on, right? There’s a lot of different things that can shift and things can just, kids can grow out of it, and if you’re an adult that probably may not be that way. It’s a little bit different there. So, you’re really gonna have to make changes and you really have to look at the root cause and not just get hyper obsessed with just something topically that’s gonna fix it and that’ll be it, probably not the case. And so, you really have to look at the gut, you really have to look at stress, you have to look at how digesting and breaking down your foods, you have to look at the nutrients that modulate your immune system like zinc and selenium and vitamin D and glutathione, you have to look at gut bugs that can have a negative effect on your immune system and also beneficial bacterial balance. These play a massive role and again you may have to get stricter with the diet, like some people, a paleo template may be enough. Some have to go to way more extremes like autoimmune, cutting out salicylates or at least being salicylate and oxalate conscious that may have to happen as well.   

Evan Brand: Yeah, and the good news is this stuff is in general pretty reversible, I mean, like I said, we’ve seen amazing before and after, working with people, and it’s just a wonderful thing because there’s so much of your confidence level that comes from having good skin, I mean, in regards to seeking new jobs getting a raise, finding a date, finding a spouse, I mean, your kids, wanting your kids to not have any, uh, self-confidence issues so I mean, I just tell you just the impact of skin, it could change your income if you don’t feel attractive enough, may be you’re not gonna seek that higher paying job or maybe you’re not gonna seek that raise, If you have self-confidence issues because of your skin or maybe you feel like you can never leave the house without making makeup, I mean skin is one of those things that really is important to address so sometimes it seems like a vanity-based thing but that vanity really does turn into success and so I think it’s really important for people not to feel self-conscious and just you know that you can fix this thing so no matter how down in the dumps you are you gotta keep digging.

Dr. Justin Marchegiani: Yeah. And skin can be a really good sign if you’re healthy or not and it’s  a lot of times, it’s gonna tell you if you have gut issues, gut, uh, food allergy issues, microbial imbalances, also, consuming good fats, good collagen, good proteins, this is the building block of your skin, so you really wanna make sure you have good dietary, nutritional foundations and we chill out a lot of the food that’s gonna throw off our gut bacteria. Now, topically, there’s a couple of things you can do topically, I mentioned some of the moisturizer that can be helpful to provide moisture relief which then helps decrease the itching, which then decreases that perpetual inflammatory cycle, there’s some soap that you can do that are descent, um, I find just a 10% sulfur soap can be excellent. It’s been used in dermatology for decades but just 10% sulfur soap unscented works wonderfully. Usually, the sulfur comes from like volcano ash or some type of, uh, soil that’s very high in sulfur but sulfur has an anti-inflammatory quality to it. It can have some anti-fungal, anti-bacterial quality so that it can be calming. You don’t wanna lather it on too long because it can be very drying to your skin. But sulfur is good and again, it’s just one part of the equation. There’s no magic solution, magic soap, magic potion, that’s gonna fix it but it can be very helpful as long as you’re plugging in all the other things to the big equation.

Evan Brand: I wonder if that’s because it’s helping with detox support on the skin or something, I mean, if you think about glutathione and the sulfur connection there. I’m mentioning topical sulfur that’s pretty interesting. 

Dr. Justin Marchegiani: Yeah. Topical sulfur, I mean it’s a lot of different data on it being very helpful for acne, I mean with that it can be very cleansing for the pores, cleaning out the sebum, there’s also the anti-inflammatory effects to it, very helpful with like seborrheic dermatitis, psoriasis, eczema, so I think it has some anti-inflammatory qualities, um, to it, I mean it’s been used in dermatology for decades so it’s natural so I kind of like it. 

Evan Brand: Very cool. Well, I think we’ve covered everything I wanted to cover. 

Dr. Justin Marchegiani: Yeah. I mean I think a lot of it too, with the sulfur is. There could be a fungal, bacterial imbalance issue, right? And I do think sulfur does have antibacterial, anti-fungal, it also helps break down a lot of the keratin, excess in your skin, so like if you have, um, a keratosis pilaris (KP), where you kind of feel like the bumps in the back of your arm, it can kind of help break down those excess keratins that form in the pore so the back of your arms don’t feel as bumpy, so that’s really good too. I know, a lot of women have that. Of course, you know, getting your omega-3s up can also help that too, omega-3s and zinc. 

Evan Brand: Yeah. I was gonna say, my kids had a little bit of that early on. We just bumped up the omegas and then boom, we knocked out the keratosis pretty easily so that’s, that’s probably one of the easier things to address. Sometimes, this thing gets tricky, like you mentioned, there’s no magic bullet or potion, a lot of times it’s a combination of us getting small gains and different categories of the body. 

Dr. Justin Marchegiani: Yeah, it’s nice. Just get a nice 10% sulfur soap and you know lather that up, put it on your kids for like 30 seconds, rinse them off, it can be a very helpful kind of cleanse out that keratin, keeps the pores really healthy and it’s totally natural. So, I’ll put some links to the ones that I like, uh, down below on the ones that I personally use. 

Evan Brand: Sounds good. Well, if people need help, they can reach out, we work with people online so wherever you are in the world with skin issues, we’re happy to help. You could reach out to Dr. J at justinhealth.com or me, Evan Brand at evanbrand.com, and we’re happy to work with you, help you run labs, figure out what we need to do to get you feeling better, more importantly get your skin looking better. If you have issues, don’t give up, uh, it’s okay, we’re gonna get you taken care of.  

Dr. Justin Marchegiani: Absolutely. And to be a great functional medicine practitioner to really solve a lot of these things, you have to be a master general practitioner, you really have to understand the gut hormones, diet, skin. You really have to kind of connect everything together. If you’re like a master skin person and but you don’t have the diet or anything else to kind of interweave and connect to it then you’re not gonna be able to help your patients 100% so, it’s really important that you, if you’re working with someone, you find a master generalist that really understands how all the systems connect and you don’t want to just work with the hormone person or the gut person, you wanna work with someone that really understands the connection so that’s really important that people are interviewing their practitioners, really try to make sure they have a full 360 kind of perspective on it and if you wanna reach out, evanbrand.com for Evan, they’re be link there for Evan. And for myself, Dr. J. at justinhealth.com. We are available worldwide to help you all out and we’ll put links down below for some of the recommended products that we talked about today, things that we actually use with our family and patients. Outside of that, Evan, phenomenal chat with you man, you have an awesome week, and everyone listening appreciates your support, comments down below and share with our friends and family. 

Evan Brand: Take good care. See you next week. 

Dr. Justin Marchegiani: Thanks. Bye you all. 

Evan Brand: Bye-bye. 

 

 

Functional Medicine Strategies to Help Improve Your Sleep | Podcast #360

Hey, guys! In this video, Dr. J and Evan discuss several functional medicine strategies to better your sleep. Achieving better sleep can lead to many health improvements. Here we’ve provided a list of suggestions from a functional medicine perspective for better sleep. Please note, this list is not meant to be implemented in its entirety. Instead, pick 3–4 changes to implement to improve sleep quality.

Some suggestions are to avoid alcohol (wine, beer, and hard liquor) within 3 hours of bedtime; avoid anxiety-provoking activities close to bedtime. As much as possible, go to sleep and wake up at the same time each day because it will help train your biological clock. Also, decrease the light in your bedroom by using a dimmer or reading light with a dimmer.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – The importance of light exposure in your overall functional capacity
7:30 – The effect of Vitamin Deficiency in sleep-wake cycle
11:58 – The benefits of water filtration in pineal gland function
13: 59 – Fluoride exposure affecting sleep patterns;
16:53 – The The nutrients that play a big role in the quality of sleep


Dr. Justin Marchegiani: Evan, how are you doing today man?  

Evan Brand: Hey, I’m doing really well, I’m refreshed and rested and I think it’s due to some of the supplementation of nutrients that we’ll probably dive into today which is on the topic of functional medicine strategies for sleep issues which are epidemic in modern society. By the way, in Amish society, I was actually doing some slides this morning in a fatigue course that I’m working on before you and I jump on here together and then researching what’s called the old order Amish. These are like the super old school. There’s like a different level of Amish like some will have indoor plumbing, some don’t, some will use a smartphone but they only use it for phone calls that kind of thing but the old order, those are like no phones, no electricity, nothing. Anyway, they have less than 1% of depression, they report virtually zero insomnia and they have 10x, 10-fold the light exposure variation of the general population and they were found to have virtually zero prevalence of seasonal affective disorder which is like a seasonal depression. So, when you look at the Amish, they’re doing a lot of things right that we’re doing wrong in regards to our light exposure which then creates not only mood issues for us, more supposed advanced humans that use technology but also with our sleep and the real mechanism is because we’re not fully charging our batteries in the day. So, this study on the Amish and their light exposure, what they did is they put a light meter almost like a watch on their wrist and they track these Amish people for a couple of weeks and then they compare them to your modern person working in an office environment an indoor environment and because in an office environment, you’re getting such low intensity of bright light, you’re not really fully charging that cortisol in the morning, you’re not getting that initial spike whereas the Amish, they’re working outside, they’re getting that natural sunlight exposure. Even in the winter months, they still had 10x the light exposure of modern, you know, I guess you’d call them civilized people, uh, city people and so that’s a cool like free thing to do which is something honestly, I didn’t realize until I looked into this research. I’m much, much less like mopey in the winter than I used to be. I mean we’re almost in December when you and I are recording these years ago, maybe a decade ago when I had gut issues and all sorts of problems, the winter was so depressing for me. It doesn’t really bother me anymore. I kind of embrace it and I think honestly, it’s because even in the middle of the day at 12’ or 1’oclock, I’ll go outside and just get natural sunlight if I sit on my front porch the way our house is structured there’s not much wind. So, even on a day where it’s 15 or 20 degrees. I could sit out there with no shirt on and get that sunlight exposure. I always feel better, my mood is lifted, my circulation, my blood flow and my sleep is way better on those days as opposed to days where I don’t get out and get that bright light.    

Dr. Justin Marchegiani: Yeah. That totally makes sense. That vitamin D is very, very important, also just getting that good sunlight in the morning kind of gets, it resets that circadian rhythm. So, circadian rhythm is light and cortisol driven as cortisol drops, melatonin increases, this kind of inverse relationship of cortisol to melatonin, so the light kind of helps rest that so you get on the right schedule there as light stimulates cortisol, it hits your pineal gland, it kind of helps charge up the pineal gland as well, very important for melatonin synthesis at night time because as cortisol drops, we have this natural circadian rhythm, cortisol’s highest in the morning, drops throughout the day as it drops, melatonin can increase at night and that light really kind of help reset things so that’s very important. Also, very important as well, melatonin it’s kind of like a hormone kind of neurotransmitter made from the pineal gland, right this area here in the brain and it’s made from amino acids to 5htp or tryptophan, L-tryptophan, it’s an amino acid that’s a building block for melatonin and important cofactor for it as well was B6, as well, an important B vitamin, very important cofactor. So, if we’re eating nutritionally deficient foods, lots of processed carbs, not getting good quality B vitamins, not digesting our protein well, you could see poor digestion and poor nutrient density in the food could easily affect sleep quality.   

Evan Brand: You know what, this is interesting too and sorry I knocked over my water bottle, I was trying to grab my phone to pull up at the D-minder app to look at when you can actually synthesize vitamin D because that’s only at certain times of the day especially when you’re in a more northern latitude. So, anywhere south of I think it’s the 37th latitude, there’s a vitamin D winter and so today believe it or not, it says right here in the app, today which we’re recording is November 29th, it says today is the last day of the year where I can get Vitamin D and I can only get it today from 12:13  to 12:49, so there’s literally barely 30minutes today is the final day to synthesize vitamin D and then that’s gonna last this quote vitamin D winter, meaning that the angle of the sun is gonna be to low in the sky to synthesize vitamin D that will last until I want to say it’s about February, I can’t remember right off top of my head but it’s usually December give or take to January or February. There’s almost a month or two where you can’t make any vitamin D, so I will be supplementing a little more and there’s actually a 20 20 paper on this that was called Vitamin D and sleep regulation and long story short, vitamin D supplementation improves sleep disturbances. It says that vitamin D is involved in the pathways of production of melatonin. So, I didn’t know that, I thought that it was primarily a cortisol, melatonin you and I talked about the seesaw of high cortisol in the morning and at night cortisol drops, melatonin rises bit apparently, the vitamin D receptors and the enzymes that control their activation and degradation interplay with melatonin, so there you go you learn something new every day. 

Dr. Justin Marchegiani: Yeah. So, it’s working on what device, so vitamin D is working on melatonin receptor sites? 

Evan Brand: That’s what it sounds like. Yeah, it’s working on synthesis of melatonin. 

Dr. Justin Marchegiani: So, synthesis, so you have part of the, that’s what I think I mentioned like charging the pineal gland. I think charging the pineal gland to get in that good light that’s I think you need that good UV light to stimulate melatonin production and then you also need the raw material, right? You need the 5htp tryptophan amino acids, you need the B6, those are all really important cofactors and the light kind of, is an important stimulator to help make it, as well as, time it up too, right, it really times up that rhythm, uh, one of the best things when you have time zone issues. Is get up in the morning to watch that sunrise, you can even do a little bit of caffeine as well to stimulate the cortisol, so you get the cortisol increase while you’re seeing the light. The pineal gland sees that ultraviolet light coming in, it syncs up your rhythm and you do a little bit of melatonin at night and that kind of gets your rhythm right back on track. So, anyone’s traveling time zones, it’s one of the best ways to get back on track, see the sunrise in the morning with a little bit of caffeine and then sunset at night with some melatonin, that gets the cycle all dialed in.  

Evan Brand: So, here’s another paper in the neurology publication and it just said that low vitamin D levels are significantly associated with longer time to fall asleep. Excessive daytime sleepiness and underlying conditions and sleep restricted individuals. So that’s interesting because I know years ago, I was vitamin D deficient and my sleep was worse. Now, granted I had other issues too, I want to make sure, you and I talked about the gut a bit but years ago, it’s interesting to think that my low vitamin D could have been a contributing factor to my sleep problems. 

Dr. Justin Marchegiani: Yeah. I mean, it’s definitely, you know, a variable, there’s a lot of other issues too. I mean the first thing we’re gonna look at is we’re gonna look at circadian rhythm. So, we’re gonna test cortisol levels and rhythm. We’re gonna see it all throughout the day because one biggest thing that happens, the more stressed and inflamed you get, is you get either a flattening of the cortisol or you can get a flattening with an increase at night and that can make it really hard to relax, really hard to settle down, obviously the flattening throughout the day can cause lower energy the first half of the day as well as a flat mood, right? Because cortisol is a glucocorticosteroid, gluco meaning pertains to energy and stress, corticosteroid meaning inflammation, so it’s a natural anti-inflammatory. So, yeah, we don’t have that arch cortisol in the morning, energy can below and that nice drop at night really helps us relax so that’s one of the first tests we’re gonna look at and then of course, we know melatonin is made from protein. It’s nice to see what’s happening with the protein side of the fence because if we don’t have good just stupid things like, hey I’m vegan vegetarian, I’m not eating enough protein, or I don’t have enough hydrochloric acid or enzymes or I have chronic gut issues like SIBO, IBS, H. pylori, gut bugs, and that’s maybe creating a bottleneck and also creating an inflammation in the gut which is then moving through the tight junctions into the bloodstream, moving it’s way to the brain that could affect the brain, brain inflammation, HPA-axis function, that’s brain talking to the adrenal glands and that could affect everything for sure. 

Evan Brand: Yeah. I mean, when I had gut infections, my sleep was disturbed sometimes just because of pain in my gut, I mean so how many people have IBS that also have sleep problems, I can tell you it’s quite a lot, we work with that all the time and another thing too is the parasites, I mean, some argue that the parasites are more active at night. Some people report crawling and other weird sensations of parasites and I will tell you with stealth infections like Babesia, for example, which is an intracellular parasite. Babesia causes major problems with sleep in particular it’ll cause night sweats so some women think of it as hot flashes but it could be Babesia and unfortunately, I’ve had a lot of tick bites over the years and I can tell you with personal experience with Babesia that it would cause me to wake up at about an hour to after I went to bed. So, if I went to bed at nine I would be up by 11, sometimes sweating, sometimes no, but I would just be wide awake it was almost this infection was driving some sort of cortisol response, so after treating these type of infections usually the sleep problems go away and then as you mentioned we could supplement amino acids in the meantime especially because if someone has gut issues, we know they’re not gonna be synthesizing enough serotonin from their gut because the vast majority is made in the intestine. So, if you’ve got gut bugs and you don’t sleep well, you gotta fix the gut bugs if you wanna sleep well. Can you supplement melatonin and 5htp? Yes, and those are very nice natural things but they’re still band-aids, they’re not the root cause. So, like you said a stool test is something that could be an order, a urine test to look at the brain chemistry too because we could see dopamine and serotonin levels and then you mentioned cortisol which we could do via saliva or urine and we could see those inverse patterns. So, another thing I wanna mention is like, Relora. Relora is like a patented version of two different barks. There was one paper on it that it reduced cortisol levels by about 18% in four weeks. Now, I don’t recommend if you have sleep issues, just to go take this, you wanna test not guess. So, I don’t think it’s wise and I’m sure you would agree for people just to go take things that affect cortisol without knowing what your up against. I think it’ll be better for you to try to get some data first. So, don’t assume that because your sleep sucks that you have a cortisol problem because sometimes, we’ll test people that are wired at night and surprisingly they have low cortisol. Maybe it’s just emotional stress or something else but it’s not a cortisol problem and then sometimes people feel okay but at night their cortisol levels triple, where it shouldn’t be and then that’s where the nutrients come in to help to move it in the right direction. 

Dr. Justin Marchegiani: 100%. There also some things out there talking about pineal gland, that’s the gland that makes melatonin could, uh, get calcification and some of the calcification could be connected to fluoride and so may want to think about a high-quality water filtration system at least an under-counter RO system reverse   osmosis that filters out a lot of the fluoride. Just because that’s gonna be essentially it’s a prescription drug in the water and you’re getting an uncontrollable amount, so it’s really good to have a good water filtration system so I have a whole house carbon-based system, as well as, a under the counter reverse osmosis system. So, I’ll highly recommend having both but at least have one for your drinking water in that way you can get a lot of the crap out of the water. So, we’ll put a couple of links of water filtration products that we personally use and recommend ourselves throughout with our family as well as patients. And so that will help at least improve the water quality because that could have a connection with, uh, pineal gland calcification. 

Evan Brand: Yeah, you know, I got into fluoride years ago, just fluoride research and the toxicity of it and how even places, most major cities they add fluoride to the water, you know, so you’ll have like in Kentucky relatively decent water but then at the end they add fluoride to it which is just really criminal based on all the research we know about fluoride lowering the IQ and things like that and so when I was working out of a brick and mortar at a chiropractor’s office, we actually had a few x-rays where people had neck injuries from car wrecks and this might sound crazy but we were able to actually see the calcification on the x-ray, you know, if we were doing like a more of a head type x-ray for some of these neck and head injuries, you could literally see almost like this little darker spot or might have been bright white, I can’t remember, depending on the x-ray machine but you could see it and I was asking the chiropractor like what is that and he’s like well that’s the pineal gland. He’s like maybe this calcification thing is real because you’ll read that online, some people labeled it a conspiracy but I think there’s totally something to it and I have seen images of that. 

Dr. Justin Marchegiani: There’s one study right here, I’m looking at right now, it’s 2018 study, they’re looking at fluoride exposure and sleep patterns among adults and they’re talking about essentially, you know, looking at that level and they’re looking at fluoride exposure affecting sleep patterns. I’ll put the study here in the links but one of the conclusions here reached at the very end, let me kind of scroll down to it said chronic low level fluoride exposure may contribute to changes in sleep cycle and regulation and sleep behavior among older adolescents, U.S. additional prescriptive studies are warranted to examine the effects of fluoride on sleep patterns and determine the critical window of vulnerability for patients and so essentially they’re saying chronic low-level exposure, right. What about higher-level exposure, right? What about the extra fluoride in your toothpaste too, right? These are all some extra things that, you know, it’s just something you want to make sure that you have clean water and one benefit of clean water is keeping the fluoride out which could affect your sleep, also other stuff in the water such as potential parasites and bacteria that may not get hit by your typical chlorine and as well as potential pharmaceutical drugs. So, good health, uh, filtratration is gonna be wonderful. We’ll put the recommended links for the products that we use down below. 

Evan Brand: Speaking of drugs, why don’t we mention drugs. People that are doing different pharmaceuticals for fatigue or for mood issues or for ADD or ADHD, I mean people that are doing stimulants, you know methamphetamine derivatives, a lot of these people depending on the half-life, depending on the metabolism of the drug, depending on people’s digestion, depending on maybe that with caffeine or other stimulants, I mean that’s a huge problem and we are an addicted society to stimulants, I mean caffeine is probably the number one stimulant used worldwide but certainly I have tons of clients even teenagers unfortunately 14,15, 16-year-old, they are taking pharmaceuticals like Vyvanse or other really, really stimulating things to supposedly help them focus better but then they can’t sleep at night so then they’re on social media at night, they’re looking at their blue light screen which is gonna be suppressing melatonin production all night. Now, they’re laying in bed, scrolling on TikTok while they supposed to be sleeping and so there’s no wonder, we have so many teenagers that have depression and anxiety issues too because good sleep is really important for good mood and I tell you, if I don’t sleep as well, mood’s not as good and that’s just common sense because the glymphatic system, ‘G’ like Gary, the glymphatic system works when you’re sleeping and this is almost like a, think of it like a brain detox and with not enough sleep or quality sleep, that system doesn’t work and then our brain, we just can’t think clearly, we make worse decisions, we have less ability to react like in terms of driving and reaction time and speed, I mean, the brain really takes a hit when we don’t have sleep, you know, good quality sleep. 

Dr. Justin Marchegiani: 100%. Well, let’s talk about some other nutrients that are very important. So, obviously, things like magnesium, very important, magnesium plugs into the mitochondria Krebs cycle supposedly at a minimum 300 to a thousand enzymatic roles in the body. So, it plays a large role in what’s going on with our health and with relaxation. Also, I like to combine a little bit of magnesium and some collagen which is very high in glycine. So, glycine and magnesium are super, superchargers for relaxation and really getting the parasympathetic nervous system up, very relaxing, very calming as well. So, I like that as just kind of a nice diet and lifestyle strategy and again if you make up a lot to go a pee, you may wanna give yourself an hour or two before the bed, before sleep, before you have that, at least an hour so you can kind of pee and get all that extra water out of your bladder. So, a good hour or two, very helpful, very relaxing, very calming. Of course, general lifestyle strategies like wearing good blue blocking glasses, um, just kind of mitigating a lot of the light stuff at the end, putting a lot of your lights on dimmer switches where you can at least not knock down a lot of the intensity down 80% or so, so that’s not stimulating cortisol and lowering melatonin. So, the light at night hits that pineal gland, it’s gonna raise your cortisol and lower melatonin because cortisol and melatonin are in an inverse relationship. Cortisol up, melatonin down so that’s very helpful.  

Evan Brand: Yeah, I mean, humans we’re so smart that we’re stupid and we brought the sunlight indoors whereas compared to the Amish, guess what, guess how much nighttime light exposure they have, virtually nothing. Number one, they don’t have electricity so if they want light it’s gonna be a candle and the intensity of a candle, number one the candle is gonna be amber red, there’s gonna be very, very minimal blue light coming from the candle and the intensity of it is a fraction of a single light bulb so, you know, you really screwed up by bringing lights indoors, I mean, they’re awesome but I try not use them so at night we’ll just use like a salt lamp at night, just salt lamps scattered around the home and those are relatively, uh, orange color and then relatively low intensity and then also, you mentioned the glycine. The glycine is awesome, I take glycine almost every day, it’s about, give or take 3 grams, just for a scoop of it and interestingly when my wife went in for a, to get, she had one mercury amalgams which are heavy metal that can affect sleep too, so we’ll talk about detox support, I think we should at least mention it. But when she went in to get her, uh, one silver removed, they actually gave her a glycine mouth rinse which I thought pretty interesting and she said it killed her out, like they had her almost like sit around and then swallow and she said it just chilled her out right before the procedure so it’s kind of like a natural, you know anti-anxiety formula that they were using in the dentist office so that was net. But let’s talk on detox support because I think we’ve talked about this before or at least I’ve mentioned in various podcasts but like histamine can be a problem with sleep so you know sometimes people need to go on like lower histamine diets and then if people have mold or other issues affecting their histamine then maybe like quercetin like a natural antihistamine would be helpful for sleep and or binders so like clays like zeolite clay can actually bind to histamine unlike charcoal. I don’t believe charcoal can but I have seen some stuff on clay binding to histamine so I will take a combination binder of some clay charcoal silica blends before bed and that does help my sleep and you know my wife, she definitely reports that she sleep better if she does charcoal before bed so the mechanism is probably that it’s binding up any nutrient or any toxin rather that’s gonna be stimulating a stress response, some people might benefit better with sleep remedies before bed and some might benefit better with detox remedies maybe you do both but maybe separate them by half an hour or so.  

Dr. Justin Marchegiani: That makes a lot of sense. I’d also say, be careful of fasting too much, some people, they do really well with intermittent fasting and it can be helpful, some need to have some protein and some fat and a little bit of carbs before bed because their blood sugar may go low while they’re sleeping. So, if you find yourself waking up in the middle of the night, you know, one of the best strategies is to have a little bit of a mini protein shake whether it’s collagen, magnesium kind of a coconut milk, maybe a little bit of berries in there just a little bit of protein a little bit of fat maybe a little bit of carbs, see if that kind of stabilizes your blood sugar. The goal is if your blood sugar gets too low, your body can utilize cortisol and adrenaline to pick that blood sugar back up, the problem is cortisol and adrenaline as it picks that blood sugar back up, it also wakes you up because it stimulates you, right? And then, you can fall out of sleep and that’s a big concern so managing blood sugar before bed and or if you wake up can be very helpful and I will also do some sublingual formulas if people wake up just to kind of help get back to sleep. Again, the problem with it is if you’re like an hour or two away from when you’re supposed to get up that can be problematic because maybe you’re a little bit drowsy going into the morning but if it’s the middle of the night and you got like three hours or so then you can definitely take that and that’ll help you get back to sleep but, you know, good diet lifestyle strategy is super important and then we have, you know, we have to look at the circadian rhythm and the cortisol levels at night and in the morning because, you know, we’ll look at these, we’ll test these with our patients and that’ll give us a good insight and one of the big things is just trying a little bit of food and or shake in the middle of the night and if that helps you get back to sleep or a little bit before you go to bed, if that helps you from waking up and there’s probably a blood sugar connection.  

Evan Brand: Yeah. If you’re listening to this and your head is spinning, uh, we do consultations and so this is how we tease things apart so you’re just getting an insight into our brains so you’re just kind of tuning into Justin and I riffing, we didn’t plan this, we didn’t schedule this talk in terms of like how are we gonna dive into this, this is us riffing and so I hope you guys enjoy this flow because this is how we think, we’re approaching a situation with a client who comes to us and says, hey I’ve got sleep problems, we’re running through this is in our head almost instantly, the cortisol, the blood sugar, the stress, the emotions, the gut, I mean we’re just kind of filtering this in our head, we’re processing it, we’re listening to your symptoms we’re matching up gut symptoms with skin issues, with mood issues, with sleep issues and then we’re creating almost this mental map in our head, we’re creating this like spider web of what part of the web is disrupted in this person, where do we need to go, what part of the web do we need to reconstruct to get this whole symphony working together because sleep is really a complex thing. There’s a lot of things to be going good, to have good sleep, I mean, it’s no surprise wherein an epidemic of people taking sleeping medications because as you’ve listened if you’ve been somewhat paying attention through this podcast, you’re hearing there’s a hormonal component, there’s a neurotransmitter component, a gut component, an infection component, a blood sugar possibly a blood pressure component, a heavy metals and other toxins components so this thing can get really complex and so if you just go to the doctor and you get ambient or a sleeping medication, all you’ve done is put yourself in somewhat of a drug coma, you’ve done nothing to fix any of these root causes and if you have toxins or other issues creating the sleep problem, you’re just getting farther and farther away and it’s really sad to see how commonly the sleep medications are passed out like candy because what they don’t tell you it’s very difficult to get off of those drugs especially if it’s in the benzodiazepines category where it’s like an anti-anxiety and sleep remedy like lorazepam, those things are incredibly addictive, incredibly powerful drugs that are very hard to get off so we just prefer you guys, think root cause. It doesn’t have to be revolutionary but I guess it is because the conventional medicine approach of this stuff is garbage and then, uh, that was a little mini rant. One other thing.

Dr. Justin Marchegiani: Yeah. Yep. 100% right though Evan. 

Evan Brand: So, one of the things CBD can be helpful so there, you know, there’s so many states now that have medicinal cannabis to where you can get a tiny bit of THC. I’m not saying that people need to get high to sleep but I have found that clients in these legal states where they can get like a three to one or a five to one ratio so what that means is like say five parts CBD to one part THC, some of these sublinguals or topicals or sprays or edibles or gummies or flowers concentrates, whatever they like that can be enough to help regulate the nervous system. I think the mechanism is probably tamping down inflammation but there’s probably some nervous system component to it as well and so if you’re in a state where you can’t do THC, you could at least do CBD or try to get some organically grown plants and you could do give or take 10 to 20 milligrams is what I’ll do in tincture form put in under the tongue and it’s not like a sedative, it’s not gonna patch you out in the middle of the day but it will help you be a little more rested so sometimes I’ll do a combination of like the GABA chewables that I’ve got, a couple of motherwort tincture which is like a heart calming herb and then a little bit of CBD, something like that triple combos is pretty awesome. 

Dr. Justin Marchegiani: Yeah, you know, I do like that a lot. That makes a lot of sense. So, deeper right kind of root cause stuff, we’re always looking at diet, we’re always looking at blood sugar, we’re always looking at inflammation, we’re always looking at circadian rhythm and adrenal function, of course females if we have estrogen dominance and low progesterone is very important for calming and activating the parasympathetic. We want to look at the hormonal imbalances that could be driving things, um, also chronically low thyroid low T3 levels, you can see associated with insomnia and sleep issues, got to look at the insulin, got to look at the thyroid connection there as well, got to make sure we’re digesting and breaking things down, uh, very important. The hard part is anything can cause everything, that’s the hard part so we have to look at the underlying root cause mechanisms, we have to look at the person as an individual we have to look at their diet and lifestyle habits, we have to kind of timeline their history out so we can understand all things that happened, as they either got better or worse in their condition that tells me a lot and of course we go to test, we got to make sure that we’re not guessing but assessing what the root causes are, that’s very important. 

Evan Brand: Oh yeah. Well said, bringing up the thyroid there in the final hour, that’s very important and tons of people with Hashimoto’s right, autoimmune thyroid, they may have this attack on their thyroid where all of a sudden they’re leaking out thyroid hormone and then boom they’re anxious and wired in the middle of the night so great call on that and sometimes like thyroid calming herbs may need to be used and I believe technically in some of these thyroid calming blends we’ve used, I think motherwort is in there, I know Bugleweed is in there but I think motherwort might be in there too. 

Dr. Justin Marchegiani: Yeah, also Melissa or lemon balms, another calming one too. Yeah. So, they’re a very common kind of relaxing. Some of them really work on getting GABA really upregulated and, uh, and going so that’s super helpful. So, people if you’re listening here and you wanna dive in deeper at you know what the potential root causes could be with your sleep or health issues, you know, feel free to head to evanbrand.com, all right, Evan works with patients all over the world and or myself Dr. J here at justinhealth.com, we are available worldwide, they’ll be info where you guys can click, you guys can connect with us and our staff and we’re more than willing to help you, we do specific lab testing, we look at diet lifestyle strategies, we’ll look at potential toxins because sometimes mold or other toxicities can play a role. We’ll really get to the root cause so we can, not just kind of get you sleeping better, we get you healing and feeling better overall, that’s really the key. 

Evan Brand: Yeah. Last thing here, sleep issues are really just the tip of the iceberg. It’s very rare to find someone with just sleep issues typically there is a like I mentioned a mood component maybe anxiety, depression, uh, generally it’s lumped into fatigue as well, maybe joint issues, gut issues, skin issues, I mean, so if you find somebody with just sleep issues, cool, maybe that’s an easier case for us to fix but many times fatigue is in the list and sleep, they often go hand in and obviously. So, this is not just important for you to get good rest, this is important for you to have more energy during the day so you can be more productive at your job, be a more productive parent, a business owner, entrepreneur or whatever you’re doing in your busy life. It’s really important that you get this thing dialed in. So, take your sleep issues seriously, please reach out if you need help. Dr. J at justinhealth.com or Evan at evanbrand.com and we’d love to help you. 

Dr. Justin Marchegiani: Very cool. I’ll put on some of the studies on fluoride as well than below and we’ll put some of the recommended products that we use for water filtration as well. All right Evan, good chat with you man. Hey everyone, have a phenomenal week and we’ll be back. Take care, you all. Take it easy. 

Dr. Justin Marchegiani: Evan, how are you doing today man?  

Evan Brand: Hey, I’m doing really well, I’m refreshed and rested and I think it’s due to some of the supplementation of nutrients that we’ll probably dive into today which is on the topic of functional medicine strategies for sleep issues which are epidemic in modern society. By the way, in Amish society, I was actually doing some slides this morning in a fatigue course that I’m working on before you and I jump on here together and then researching what’s called the old order Amish. These are like the super old school. There’s like a different level of Amish like some will have indoor plumbing, some don’t, some will use a smartphone but they only use it for phone calls that kind of thing but the old order, those are like no phones, no electricity, nothing. Anyway, they have less than 1% of depression, they report virtually zero insomnia and they have 10x, 10-fold the light exposure variation of the general population and they were found to have virtually zero prevalence of seasonal affective disorder which is like a seasonal depression. So, when you look at the Amish, they’re doing a lot of things right that we’re doing wrong in regards to our light exposure which then creates not only mood issues for us, more supposed advanced humans that use technology but also with our sleep and the real mechanism is because we’re not fully charging our batteries in the day. So, this study on the Amish and their light exposure, what they did is they put a light meter almost like a watch on their wrist and they track these Amish people for a couple of weeks and then they compare them to your modern person working in an office environment an indoor environment and because in an office environment, you’re getting such low intensity of bright light, you’re not really fully charging that cortisol in the morning, you’re not getting that initial spike whereas the Amish, they’re working outside, they’re getting that natural sunlight exposure. Even in the winter months, they still had 10x the light exposure of modern, you know, I guess you’d call them civilized people, uh, city people and so that’s a cool like free thing to do which is something honestly, I didn’t realize until I looked into this research. I’m much, much less like mopey in the winter than I used to be. I mean we’re almost in December when you and I are recording these years ago, maybe a decade ago when I had gut issues and all sorts of problems, the winter was so depressing for me. It doesn’t really bother me anymore. I kind of embrace it and I think honestly, it’s because even in the middle of the day at 12’ or 1’oclock, I’ll go outside and just get natural sunlight if I sit on my front porch the way our house is structured there’s not much wind. So, even on a day where it’s 15 or 20 degrees. I could sit out there with no shirt on and get that sunlight exposure. I always feel better, my mood is lifted, my circulation, my blood flow and my sleep is way better on those days as opposed to days where I don’t get out and get that bright light.    

Dr. Justin Marchegiani: Yeah. That totally makes sense. That vitamin D is very, very important, also just getting that good sunlight in the morning kind of gets, it resets that circadian rhythm. So, circadian rhythm is light and cortisol driven as cortisol drops, melatonin increases, this kind of inverse relationship of cortisol to melatonin, so the light kind of helps rest that so you get on the right schedule there as light stimulates cortisol, it hits your pineal gland, it kind of helps charge up the pineal gland as well, very important for melatonin synthesis at night time because as cortisol drops, we have this natural circadian rhythm, cortisol’s highest in the morning, drops throughout the day as it drops, melatonin can increase at night and that light really kind of help reset things so that’s very important. Also, very important as well, melatonin it’s kind of like a hormone kind of neurotransmitter made from the pineal gland, right this area here in the brain and it’s made from amino acids to 5htp or tryptophan, L-tryptophan, it’s an amino acid that’s a building block for melatonin and important cofactor for it as well was B6, as well, an important B vitamin, very important cofactor. So, if we’re eating nutritionally deficient foods, lots of processed carbs, not getting good quality B vitamins, not digesting our protein well, you could see poor digestion and poor nutrient density in the food could easily affect sleep quality.   

Evan Brand: You know what, this is interesting too and sorry I knocked over my water bottle, I was trying to grab my phone to pull up at the D-minder app to look at when you can actually synthesize vitamin D because that’s only at certain times of the day especially when you’re in a more northern latitude. So, anywhere south of I think it’s the 37th latitude, there’s a vitamin D winter and so today believe it or not, it says right here in the app, today which we’re recording is November 29th, it says today is the last day of the year where I can get Vitamin D and I can only get it today from 12:13  to 12:49, so there’s literally barely 30minutes today is the final day to synthesize vitamin D and then that’s gonna last this quote vitamin D winter, meaning that the angle of the sun is gonna be to low in the sky to synthesize vitamin D that will last until I want to say it’s about February, I can’t remember right off top of my head but it’s usually December give or take to January or February. There’s almost a month or two where you can’t make any vitamin D, so I will be supplementing a little more and there’s actually a 20 20 paper on this that was called Vitamin D and sleep regulation and long story short, vitamin D supplementation improves sleep disturbances. It says that vitamin D is involved in the pathways of production of melatonin. So, I didn’t know that, I thought that it was primarily a cortisol, melatonin you and I talked about the seesaw of high cortisol in the morning and at night cortisol drops, melatonin rises bit apparently, the vitamin D receptors and the enzymes that control their activation and degradation interplay with melatonin, so there you go you learn something new every day. 

Dr. Justin Marchegiani: Yeah. So, it’s working on what device, so vitamin D is working on melatonin receptor sites? 

Evan Brand: That’s what it sounds like. Yeah, it’s working on synthesis of melatonin. 

Dr. Justin Marchegiani: So, synthesis, so you have part of the, that’s what I think I mentioned like charging the pineal gland. I think charging the pineal gland to get in that good light that’s I think you need that good UV light to stimulate melatonin production and then you also need the raw material, right? You need the 5htp tryptophan amino acids, you need the B6, those are all really important cofactors and the light kind of, is an important stimulator to help make it, as well as, time it up too, right, it really times up that rhythm, uh, one of the best things when you have time zone issues. Is get up in the morning to watch that sunrise, you can even do a little bit of caffeine as well to stimulate the cortisol, so you get the cortisol increase while you’re seeing the light. The pineal gland sees that ultraviolet light coming in, it syncs up your rhythm and you do a little bit of melatonin at night and that kind of gets your rhythm right back on track. So, anyone’s traveling time zones, it’s one of the best ways to get back on track, see the sunrise in the morning with a little bit of caffeine and then sunset at night with some melatonin, that gets the cycle all dialed in.  

Evan Brand: So, here’s another paper in the neurology publication and it just said that low vitamin D levels are significantly associated with longer time to fall asleep. Excessive daytime sleepiness and underlying conditions and sleep restricted individuals. So that’s interesting because I know years ago, I was vitamin D deficient and my sleep was worse. Now, granted I had other issues too, I want to make sure, you and I talked about the gut a bit but years ago, it’s interesting to think that my low vitamin D could have been a contributing factor to my sleep problems. 

Dr. Justin Marchegiani: Yeah. I mean, it’s definitely, you know, a variable, there’s a lot of other issues too. I mean the first thing we’re gonna look at is we’re gonna look at circadian rhythm. So, we’re gonna test cortisol levels and rhythm. We’re gonna see it all throughout the day because one biggest thing that happens, the more stressed and inflamed you get, is you get either a flattening of the cortisol or you can get a flattening with an increase at night and that can make it really hard to relax, really hard to settle down, obviously the flattening throughout the day can cause lower energy the first half of the day as well as a flat mood, right? Because cortisol is a glucocorticosteroid, gluco meaning pertains to energy and stress, corticosteroid meaning inflammation, so it’s a natural anti-inflammatory. So, yeah, we don’t have that arch cortisol in the morning, energy can below and that nice drop at night really helps us relax so that’s one of the first tests we’re gonna look at and then of course, we know melatonin is made from protein. It’s nice to see what’s happening with the protein side of the fence because if we don’t have good just stupid things like, hey I’m vegan vegetarian, I’m not eating enough protein, or I don’t have enough hydrochloric acid or enzymes or I have chronic gut issues like SIBO, IBS, H. pylori, gut bugs, and that’s maybe creating a bottleneck and also creating an inflammation in the gut which is then moving through the tight junctions into the bloodstream, moving it’s way to the brain that could affect the brain, brain inflammation, HPA-axis function, that’s brain talking to the adrenal glands and that could affect everything for sure. 

Evan Brand: Yeah. I mean, when I had gut infections, my sleep was disturbed sometimes just because of pain in my gut, I mean so how many people have IBS that also have sleep problems, I can tell you it’s quite a lot, we work with that all the time and another thing too is the parasites, I mean, some argue that the parasites are more active at night. Some people report crawling and other weird sensations of parasites and I will tell you with stealth infections like Babesia, for example, which is an intracellular parasite. Babesia causes major problems with sleep in particular it’ll cause night sweats so some women think of it as hot flashes but it could be Babesia and unfortunately, I’ve had a lot of tick bites over the years and I can tell you with personal experience with Babesia that it would cause me to wake up at about an hour to after I went to bed. So, if I went to bed at nine I would be up by 11, sometimes sweating, sometimes no, but I would just be wide awake it was almost this infection was driving some sort of cortisol response, so after treating these type of infections usually the sleep problems go away and then as you mentioned we could supplement amino acids in the meantime especially because if someone has gut issues, we know they’re not gonna be synthesizing enough serotonin from their gut because the vast majority is made in the intestine. So, if you’ve got gut bugs and you don’t sleep well, you gotta fix the gut bugs if you wanna sleep well. Can you supplement melatonin and 5htp? Yes, and those are very nice natural things but they’re still band-aids, they’re not the root cause. So, like you said a stool test is something that could be an order, a urine test to look at the brain chemistry too because we could see dopamine and serotonin levels and then you mentioned cortisol which we could do via saliva or urine and we could see those inverse patterns. So, another thing I wanna mention is like, Relora. Relora is like a patented version of two different barks. There was one paper on it that it reduced cortisol levels by about 18% in four weeks. Now, I don’t recommend if you have sleep issues, just to go take this, you wanna test not guess. So, I don’t think it’s wise and I’m sure you would agree for people just to go take things that affect cortisol without knowing what your up against. I think it’ll be better for you to try to get some data first. So, don’t assume that because your sleep sucks that you have a cortisol problem because sometimes, we’ll test people that are wired at night and surprisingly they have low cortisol. Maybe it’s just emotional stress or something else but it’s not a cortisol problem and then sometimes people feel okay but at night their cortisol levels triple, where it shouldn’t be and then that’s where the nutrients come in to help to move it in the right direction. 

Dr. Justin Marchegiani: 100%. There also some things out there talking about pineal gland, that’s the gland that makes melatonin could, uh, get calcification and some of the calcification could be connected to fluoride and so may want to think about a high-quality water filtration system at least an under-counter RO system reverse   osmosis that filters out a lot of the fluoride. Just because that’s gonna be essentially it’s a prescription drug in the water and you’re getting an uncontrollable amount, so it’s really good to have a good water filtration system so I have a whole house carbon-based system, as well as, a under the counter reverse osmosis system. So, I’ll highly recommend having both but at least have one for your drinking water in that way you can get a lot of the crap out of the water. So, we’ll put a couple of links of water filtration products that we personally use and recommend ourselves throughout with our family as well as patients. And so that will help at least improve the water quality because that could have a connection with, uh, pineal gland calcification. 

Evan Brand: Yeah, you know, I got into fluoride years ago, just fluoride research and the toxicity of it and how even places, most major cities they add fluoride to the water, you know, so you’ll have like in Kentucky relatively decent water but then at the end they add fluoride to it which is just really criminal based on all the research we know about fluoride lowering the IQ and things like that and so when I was working out of a brick and mortar at a chiropractor’s office, we actually had a few x-rays where people had neck injuries from car wrecks and this might sound crazy but we were able to actually see the calcification on the x-ray, you know, if we were doing like a more of a head type x-ray for some of these neck and head injuries, you could literally see almost like this little darker spot or might have been bright white, I can’t remember, depending on the x-ray machine but you could see it and I was asking the chiropractor like what is that and he’s like well that’s the pineal gland. He’s like maybe this calcification thing is real because you’ll read that online, some people labeled it a conspiracy but I think there’s totally something to it and I have seen images of that. 

Dr. Justin Marchegiani: There’s one study right here, I’m looking at right now, it’s 2018 study, they’re looking at fluoride exposure and sleep patterns among adults and they’re talking about essentially, you know, looking at that level and they’re looking at fluoride exposure affecting sleep patterns. I’ll put the study here in the links but one of the conclusions here reached at the very end, let me kind of scroll down to it said chronic low level fluoride exposure may contribute to changes in sleep cycle and regulation and sleep behavior among older adolescents, U.S. additional prescriptive studies are warranted to examine the effects of fluoride on sleep patterns and determine the critical window of vulnerability for patients and so essentially they’re saying chronic low-level exposure, right. What about higher-level exposure, right? What about the extra fluoride in your toothpaste too, right? These are all some extra things that, you know, it’s just something you want to make sure that you have clean water and one benefit of clean water is keeping the fluoride out which could affect your sleep, also other stuff in the water such as potential parasites and bacteria that may not get hit by your typical chlorine and as well as potential pharmaceutical drugs. So, good health, uh, filtratration is gonna be wonderful. We’ll put the recommended links for the products that we use down below. 

Evan Brand: Speaking of drugs, why don’t we mention drugs. People that are doing different pharmaceuticals for fatigue or for mood issues or for ADD or ADHD, I mean people that are doing stimulants, you know methamphetamine derivatives, a lot of these people depending on the half-life, depending on the metabolism of the drug, depending on people’s digestion, depending on maybe that with caffeine or other stimulants, I mean that’s a huge problem and we are an addicted society to stimulants, I mean caffeine is probably the number one stimulant used worldwide but certainly I have tons of clients even teenagers unfortunately 14,15, 16-year-old, they are taking pharmaceuticals like Vyvanse or other really, really stimulating things to supposedly help them focus better but then they can’t sleep at night so then they’re on social media at night, they’re looking at their blue light screen which is gonna be suppressing melatonin production all night. Now, they’re laying in bed, scrolling on TikTok while they supposed to be sleeping and so there’s no wonder, we have so many teenagers that have depression and anxiety issues too because good sleep is really important for good mood and I tell you, if I don’t sleep as well, mood’s not as good and that’s just common sense because the glymphatic system, ‘G’ like Gary, the glymphatic system works when you’re sleeping and this is almost like a, think of it like a brain detox and with not enough sleep or quality sleep, that system doesn’t work and then our brain, we just can’t think clearly, we make worse decisions, we have less ability to react like in terms of driving and reaction time and speed, I mean, the brain really takes a hit when we don’t have sleep, you know, good quality sleep. 

Dr. Justin Marchegiani: 100%. Well, let’s talk about some other nutrients that are very important. So, obviously, things like magnesium, very important, magnesium plugs into the mitochondria Krebs cycle supposedly at a minimum 300 to a thousand enzymatic roles in the body. So, it plays a large role in what’s going on with our health and with relaxation. Also, I like to combine a little bit of magnesium and some collagen which is very high in glycine. So, glycine and magnesium are super, superchargers for relaxation and really getting the parasympathetic nervous system up, very relaxing, very calming as well. So, I like that as just kind of a nice diet and lifestyle strategy and again if you make up a lot to go a pee, you may wanna give yourself an hour or two before the bed, before sleep, before you have that, at least an hour so you can kind of pee and get all that extra water out of your bladder. So, a good hour or two, very helpful, very relaxing, very calming. Of course, general lifestyle strategies like wearing good blue blocking glasses, um, just kind of mitigating a lot of the light stuff at the end, putting a lot of your lights on dimmer switches where you can at least not knock down a lot of the intensity down 80% or so, so that’s not stimulating cortisol and lowering melatonin. So, the light at night hits that pineal gland, it’s gonna raise your cortisol and lower melatonin because cortisol and melatonin are in an inverse relationship. Cortisol up, melatonin down so that’s very helpful.  

Evan Brand: Yeah, I mean, humans we’re so smart that we’re stupid and we brought the sunlight indoors whereas compared to the Amish, guess what, guess how much nighttime light exposure they have, virtually nothing. Number one, they don’t have electricity so if they want light it’s gonna be a candle and the intensity of a candle, number one the candle is gonna be amber red, there’s gonna be very, very minimal blue light coming from the candle and the intensity of it is a fraction of a single light bulb so, you know, you really screwed up by bringing lights indoors, I mean, they’re awesome but I try not use them so at night we’ll just use like a salt lamp at night, just salt lamps scattered around the home and those are relatively, uh, orange color and then relatively low intensity and then also, you mentioned the glycine. The glycine is awesome, I take glycine almost every day, it’s about, give or take 3 grams, just for a scoop of it and interestingly when my wife went in for a, to get, she had one mercury amalgams which are heavy metal that can affect sleep too, so we’ll talk about detox support, I think we should at least mention it. But when she went in to get her, uh, one silver removed, they actually gave her a glycine mouth rinse which I thought pretty interesting and she said it killed her out, like they had her almost like sit around and then swallow and she said it just chilled her out right before the procedure so it’s kind of like a natural, you know anti-anxiety formula that they were using in the dentist office so that was net. But let’s talk on detox support because I think we’ve talked about this before or at least I’ve mentioned in various podcasts but like histamine can be a problem with sleep so you know sometimes people need to go on like lower histamine diets and then if people have mold or other issues affecting their histamine then maybe like quercetin like a natural antihistamine would be helpful for sleep and or binders so like clays like zeolite clay can actually bind to histamine unlike charcoal. I don’t believe charcoal can but I have seen some stuff on clay binding to histamine so I will take a combination binder of some clay charcoal silica blends before bed and that does help my sleep and you know my wife, she definitely reports that she sleep better if she does charcoal before bed so the mechanism is probably that it’s binding up any nutrient or any toxin rather that’s gonna be stimulating a stress response, some people might benefit better with sleep remedies before bed and some might benefit better with detox remedies maybe you do both but maybe separate them by half an hour or so.  

Dr. Justin Marchegiani: That makes a lot of sense. I’d also say, be careful of fasting too much, some people, they do really well with intermittent fasting and it can be helpful, some need to have some protein and some fat and a little bit of carbs before bed because their blood sugar may go low while they’re sleeping. So, if you find yourself waking up in the middle of the night, you know, one of the best strategies is to have a little bit of a mini protein shake whether it’s collagen, magnesium kind of a coconut milk, maybe a little bit of berries in there just a little bit of protein a little bit of fat maybe a little bit of carbs, see if that kind of stabilizes your blood sugar. The goal is if your blood sugar gets too low, your body can utilize cortisol and adrenaline to pick that blood sugar back up, the problem is cortisol and adrenaline as it picks that blood sugar back up, it also wakes you up because it stimulates you, right? And then, you can fall out of sleep and that’s a big concern so managing blood sugar before bed and or if you wake up can be very helpful and I will also do some sublingual formulas if people wake up just to kind of help get back to sleep. Again, the problem with it is if you’re like an hour or two away from when you’re supposed to get up that can be problematic because maybe you’re a little bit drowsy going into the morning but if it’s the middle of the night and you got like three hours or so then you can definitely take that and that’ll help you get back to sleep but, you know, good diet lifestyle strategy is super important and then we have, you know, we have to look at the circadian rhythm and the cortisol levels at night and in the morning because, you know, we’ll look at these, we’ll test these with our patients and that’ll give us a good insight and one of the big things is just trying a little bit of food and or shake in the middle of the night and if that helps you get back to sleep or a little bit before you go to bed, if that helps you from waking up and there’s probably a blood sugar connection.  

Evan Brand: Yeah. If you’re listening to this and your head is spinning, uh, we do consultations and so this is how we tease things apart so you’re just getting an insight into our brains so you’re just kind of tuning into Justin and I riffing, we didn’t plan this, we didn’t schedule this talk in terms of like how are we gonna dive into this, this is us riffing and so I hope you guys enjoy this flow because this is how we think, we’re approaching a situation with a client who comes to us and says, hey I’ve got sleep problems, we’re running through this is in our head almost instantly, the cortisol, the blood sugar, the stress, the emotions, the gut, I mean we’re just kind of filtering this in our head, we’re processing it, we’re listening to your symptoms we’re matching up gut symptoms with skin issues, with mood issues, with sleep issues and then we’re creating almost this mental map in our head, we’re creating this like spider web of what part of the web is disrupted in this person, where do we need to go, what part of the web do we need to reconstruct to get this whole symphony working together because sleep is really a complex thing. There’s a lot of things to be going good, to have good sleep, I mean, it’s no surprise wherein an epidemic of people taking sleeping medications because as you’ve listened if you’ve been somewhat paying attention through this podcast, you’re hearing there’s a hormonal component, there’s a neurotransmitter component, a gut component, an infection component, a blood sugar possibly a blood pressure component, a heavy metals and other toxins components so this thing can get really complex and so if you just go to the doctor and you get ambient or a sleeping medication, all you’ve done is put yourself in somewhat of a drug coma, you’ve done nothing to fix any of these root causes and if you have toxins or other issues creating the sleep problem, you’re just getting farther and farther away and it’s really sad to see how commonly the sleep medications are passed out like candy because what they don’t tell you it’s very difficult to get off of those drugs especially if it’s in the benzodiazepines category where it’s like an anti-anxiety and sleep remedy like lorazepam, those things are incredibly addictive, incredibly powerful drugs that are very hard to get off so we just prefer you guys, think root cause. It doesn’t have to be revolutionary but I guess it is because the conventional medicine approach of this stuff is garbage and then, uh, that was a little mini rant. One other thing.

Dr. Justin Marchegiani: Yeah. Yep. 100% right though Evan. 

Evan Brand: So, one of the things CBD can be helpful so there, you know, there’s so many states now that have medicinal cannabis to where you can get a tiny bit of THC. I’m not saying that people need to get high to sleep but I have found that clients in these legal states where they can get like a three to one or a five to one ratio so what that means is like say five parts CBD to one part THC, some of these sublinguals or topicals or sprays or edibles or gummies or flowers concentrates, whatever they like that can be enough to help regulate the nervous system. I think the mechanism is probably tamping down inflammation but there’s probably some nervous system component to it as well and so if you’re in a state where you can’t do THC, you could at least do CBD or try to get some organically grown plants and you could do give or take 10 to 20 milligrams is what I’ll do in tincture form put in under the tongue and it’s not like a sedative, it’s not gonna patch you out in the middle of the day but it will help you be a little more rested so sometimes I’ll do a combination of like the GABA chewables that I’ve got, a couple of motherwort tincture which is like a heart calming herb and then a little bit of CBD, something like that triple combos is pretty awesome. 

Dr. Justin Marchegiani: Yeah, you know, I do like that a lot. That makes a lot of sense. So, deeper right kind of root cause stuff, we’re always looking at diet, we’re always looking at blood sugar, we’re always looking at inflammation, we’re always looking at circadian rhythm and adrenal function, of course females if we have estrogen dominance and low progesterone is very important for calming and activating the parasympathetic. We want to look at the hormonal imbalances that could be driving things, um, also chronically low thyroid low T3 levels, you can see associated with insomnia and sleep issues, got to look at the insulin, got to look at the thyroid connection there as well, got to make sure we’re digesting and breaking things down, uh, very important. The hard part is anything can cause everything, that’s the hard part so we have to look at the underlying root cause mechanisms, we have to look at the person as an individual we have to look at their diet and lifestyle habits, we have to kind of timeline their history out so we can understand all things that happened, as they either got better or worse in their condition that tells me a lot and of course we go to test, we got to make sure that we’re not guessing but assessing what the root causes are, that’s very important. 

Evan Brand: Oh yeah. Well said, bringing up the thyroid there in the final hour, that’s very important and tons of people with Hashimoto’s right, autoimmune thyroid, they may have this attack on their thyroid where all of a sudden they’re leaking out thyroid hormone and then boom they’re anxious and wired in the middle of the night so great call on that and sometimes like thyroid calming herbs may need to be used and I believe technically in some of these thyroid calming blends we’ve used, I think motherwort is in there, I know Bugleweed is in there but I think motherwort might be in there too. 

Dr. Justin Marchegiani: Yeah, also Melissa or lemon balms, another calming one too. Yeah. So, they’re a very common kind of relaxing. Some of them really work on getting GABA really upregulated and, uh, and going so that’s super helpful. So, people if you’re listening here and you wanna dive in deeper at you know what the potential root causes could be with your sleep or health issues, you know, feel free to head to evanbrand.com, all right, Evan works with patients all over the world and or myself Dr. J here at justinhealth.com, we are available worldwide, they’ll be info where you guys can click, you guys can connect with us and our staff and we’re more than willing to help you, we do specific lab testing, we look at diet lifestyle strategies, we’ll look at potential toxins because sometimes mold or other toxicities can play a role. We’ll really get to the root cause so we can, not just kind of get you sleeping better, we get you healing and feeling better overall, that’s really the key. 

Evan Brand: Yeah. Last thing here, sleep issues are really just the tip of the iceberg. It’s very rare to find someone with just sleep issues typically there is a like I mentioned a mood component maybe anxiety, depression, uh, generally it’s lumped into fatigue as well, maybe joint issues, gut issues, skin issues, I mean, so if you find somebody with just sleep issues, cool, maybe that’s an easier case for us to fix but many times fatigue is in the list and sleep, they often go hand in and obviously. So, this is not just important for you to get good rest, this is important for you to have more energy during the day so you can be more productive at your job, be a more productive parent, a business owner, entrepreneur or whatever you’re doing in your busy life. It’s really important that you get this thing dialed in. So, take your sleep issues seriously, please reach out if you need help. Dr. J at justinhealth.com or Evan at evanbrand.com and we’d love to help you. 

Dr. Justin Marchegiani: Very cool. I’ll put on some of the studies on fluoride as well than below and we’ll put some of the recommended products that we use for water filtration as well. All right Evan, good chat with you man. Hey everyone, have a phenomenal week and we’ll be back. Take care, you all. Take it easy. 


References:

https://justinhealth.com/

https://www.evanbrand.com/

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Audio Podcast:

https://justinhealth.libsyn.com/functional-medicine-strategies-to-help-improve-your-sleep-podcast-360

Why Do I Have Low Motivation – Functional Medicine Solutions | Podcast #358

Motivation is the process that initiates, guides, and maintains goal-oriented behaviors. It is what causes you to act, whether getting a glass of water to reduce thirst or reading a book to gain knowledge.

In this video, Dr. J and Evan Brand talk about the physiological issues behind your decreasing motivation and the functional medicine strategies, hormones, and lifestyle changes you need to do to improve your mood and overall health function.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00  Introduction
1:41  What are the root causes of low motivation?
4:14  The physiological explanation of low motivation
8:39  Functional medicine strategies to improve motivation
10:53 The role of thyroid function to your body’s overall function
16:38 Lifestyle upgrade to boost your motivation


Dr. Justin Marchegiani: We are going to be talking about motivation. Really excited to have a nice podcast on this topic. Evan, how we doing today this morning? 

Evan Brand: I’m doing really well. I’m feeling really motivated. Hence, this topic on motivation. You know, I look around on society and I just see the way that people carry themselves. You know, we’ve become so casual in terms of dress. I mean, when you see people that are just coming out at restaurants, they’re wearing Crocs and sweatpants and, you know, hoodies. People just don’t appear to take good care of themselves, in general. And maybe that’s different in other cities but even talking to people when I bought a sports coat. I talked to the guy at the suit store, and he agreed with me that over the last 20 years, people just become so casual. And with that casual dress, I think that changes people’s level of motivation. When I’m in sweatpants and a hoodie, I feel less motivated, and less ready to charge the world as opposed to when I have on even something like a polo. I think, maybe that’s part of it, but I know there’s a lot of chemical, neurotransmitter, and gut reactions, you know, better involved too. So, what do you think, I mean, am I, am I onto something with the clothing? Have you seen a change even in your lifetime with people? 

Dr. Justin Marchegiani: Well, I think people like, I talked to a lot of patients and friends and like, ‘oh you get to work at home and see patients all over the world. That’s awesome, that must be so easy to just kind of get up and get ready’. I’m like, well I still shower and kind of get ready like I’m going to the office anyway, I wanna look good, I wanna feel good, I wanna feel clean, I wanna feel fresh, plus I wanna be able to jump on a video or see a patient, I wanna have a higher level of professionalism on how I look. So, I do think there’s energy just like you said, in just that look in the park, dress in the park feeling good, right? I think that all helps. I think it moves the needle. That makes sense.  

Evan Brand: Well, let’s see some of the root causes of that. I mean, low motivation, in general, the first thing that I think of and maybe your average listeners thinking of, they listen to us for a while, they’re gonna think of dopamine. And that certainly one potential cause and we can measure that using urine organic acids testing. So, we’ll look at the markers for dopamine on that test that we can see, and I would say that 90% of people I test are pretty low and the other 10% are people that have Clostridia bacterial overgrowth. You and I have talked about this before, we did a whole show of Clostridia, I believe, but the mechanism is that if you have Clostridia which is a certain type of bacteria in the gut that will actually inhibit the enzyme dopamine beta hydroxylase and then you have this build up of dopamine. So, you have some of these mood issues that’ll happen because of your gut. So, if you fix your gut, that high dopamine markers normalize. But otherwise, I see, generally, pretty low dopamine and maybe you and I can kind of break down why is that happening. I think chronic stress is a big one. But I wonder if there’s a role of like excess caffeine, have you seen anything look like too much coffee, your stimulants depleting dopamine, what about drugs like the Adderall drugs, that kind of stuff.    

Dr. Justin Marchegiani: Yeah. I think we’ve, with motivation, it’s a couple things right. We have kind of the psychological kind of mindset aspect, I think that’s really important. So, I think number one, you gotta enjoy what you’re doing or you have at least kind of know what your talents or your skills that you’re at. So, you can work on doing things that one you enjoy and two you are actually good at. So, you can perform at a higher level, right? I think it’s a combination of those two things. And I think, also, there’s some people that what if you’re not good at things, right, so I think early on if you’re younger and you’re listening to this as you grow up, you really wanna look at developing talents. tacks and skills set. And you really wanna look at the marketplace and say, ‘where, um, where’s your gaps in the marketplace in regards to skill, whether on the health side or on the tacks side or on engineering. We really wanna look at where you kind of plug yourself into the marketplace, whether there are opportunities and then it’s also good to evaluate your kind of natural talents and skill sets. You kind of look at, you know, what people tell, I’ve always told you good at. There’s different tests out there whether it’s a Myers-Brigg personality test or, uh, I think another test out there called DISC, D-I-S-C test. There’s different tests out there that kind of help you understand, kind where your natural talents are at and then also just really observing and being aware of what you really enjoy doing. Usually, things that you enjoy doing, tend to be better at it because you don’t mind working harder at it. I think those are important, so then when you start doing things, you’ll really enjoy it. Now, on the physiological side, chronic stress well either acutely raises cortisol all over time. That cortisol can become lower which can affect energy and mood and cause your body to break down faster. And of course, that same level of adrenal stress can also lower dopamine, lower adrenaline which can then affect focus and motivation at a biochemical neurological level too. So, I think it’s good to look at both of those, so we can test the adrenal gland and know what’s happening at the adrenal level. We can also look at the neurotransmitters, the organic acid testing and look at various metabolites for Homovanillate, which is a metabolite for dopamine and then Vanilmandelate, which is a metabolite for adrenaline. We can get a window and into both of those metabolites and see how the brain is functioning on the inside.  

Evan Brand: Yeah. That’s a great point. People that are just doing stuff that they don’t enjoy, I mean, how are you gonna be motivated for life if you make up, you don’t enjoy it. I talked to a guy who picks up our garbage and he loves it. He loves his job. He loves driving around with a big truck all day and he makes a great money doing it. He’s happy. So, some people are gonna look at that and say, ‘oh, this garbage man, what a terrible life’. And some people, they enjoy it. So, I do think ultimately as they say if you love what you do, you’ll never work a day in your life. I still love what I do but I still, I feel like it’s still work, I mean, I enjoy it but when I’m away for too long on vacation, I don’t enjoy this much. I rather be working, I really do. I love helping people. I’m really addicted to the hustle and grind of helping people feel better. There’s so many people suffering. For you and I, I think, we’re in a good spot-on loving what we do, but then on the brain chemistry side, I would say that I certainly struggle on. I had gut issues, I certainly struggled with low energy, and partly low motivation and low focus and for a period of time I had trouble reading certain books, like my brain, I just couldn’t process. I had to read, read certain phrases or if someone said a phone number to me, I couldn’t remember just a simple 7-digit phone number. So, I definitely had some brain fog associated with gut issues. And on paper, my endorphins and my dopamine were a bit low. So, I think looking at these mechanisms, I would say Candida, something we could mention too because we know Candida produces acetaldehyde, which is kind of similar to an alcohol molecule and so some people are a little bit drunk on their own Candida overgrowth. So, if somebody that has a lot of sugar cravings or if you have a white coated tongue or if you tested positive for Candida on urine, organic acid, stool testing, we gotta fix that Candida because that’s directly gonna impact your mood, your motivation and your focus. 

Dr. Justin Marchegiani: 100% Now, I work with patients, right? And I look at a lot of the physiological imbalances. So, let’s say there’s hormonal issues, let’s say it’s a female, it’s estrogen dominance, right, lower progesterone, estrogen out of whack, there’ll be a lot of PMS, mood issues, irritability issues. They’re poor energy because of chronic adrenal stress, they’re not digesting their food well. There’s a lot of mitochondrial imbalances, B-vitamins, CoQ10, L-carnitine. You know, it’s hard to be motivated when you have a lot of these physiological imbalances, because it takes fuel to run this system. So, when I look at patients, I get them motivated to fix these things. You know, it’s hard to get someone motivated to just fix their mitochondria or fix their adrenals. So, I always look at, hey what are these health challenges that you’re having right now. What is preventing you from being, doing, or having in your life right now? Like, what do you want to be doing, being you’re having in your life that you’re not able to because of your energy or because of your chronic digestion, because of your, um, mood issues? What is that? I try to get really clear what those things are because if I can figure out, hey, we’ll it’s affecting me for working out whole day, it’s affecting me, um, being able to spend quality time with my kids, then we can lean on, okay we are gonna make these diet changes, so we can help you get back to spending better time with your kids or so we can have you focusing and doing better at work at closing deal, whatever that is. So, if we figure out the why, then we can lean on that why to get people to make the right changes because it’s the really the why is the essence of it. And that really helps to get people motivated. So, there’s the mindset motivation and there’s the physiological biological biochemical side. So, we wanna work on both. So, when I tell people to make these diet changes, not just making these diet changes, we’re gonna do these so we can help move the needle in this area or that area. So, it’s kind of like using psychological tactics that help keep your patient motivated. It’s also important.   

Evan Brand: Nice. That’s really a good point.  We have some part of our population, where there are just biohacker people who wanna see the numbers, right? They wanna see the numbers get better, and they’re happy enough to see succinic acid go from a 24 down to a 5. And we go okay, great we had major progress, the mitochondria look better on paper. Some of our people, they’re cool with just the numbers, but I agree with you, you gotta bring the emotional piece to. It’s not enough to say, ‘hey, I wanna get your dopamine higher because I want you to have enough energy to get out of bed, make your bed, get dressed, wear something nice, get to the office as you close the deal’. There’s a whole symphony of emotion and the neurotransmitter, the mitochondria, the adrenals, all firing together to make life nice and make life enjoyable. And I just see that the number one leading cause of disability in the U.S. is depression and so, I don’t know, I just feel like there’s so much on top potential, on top productivity out of the population, if we can just simply get the gut improve, get the mitochondria improve, get the neurotransmitter improve. I mean, we could totally transform the country. 

Dr. Justin Marchegiani: Yeah. I totally agree. I mean, I think simply, out of the gates, it starts with food. So, it starts with high quality food, organic, right, low toxin, eating good proteins, eating good fats. I think being more of a fat burner for most people is super important because we just tend, if you just look at micronutrient trends over the last 56 years, we just consuming more processed carbohydrates and of course the fats are shifted to more, kind of polyunsaturated omega-6 kind of vegetable oil. I think number one out of the gates is we switch to higher quality, better, more stable fats whether it’s on the grass-fed meat, high quality fish or if we do any plants it’s gonna be more on the mannose, right, olive oil, some avocados, those kinds of things. That’s important on the fat and then we try to restrict the lot of the refined grains, refined sugar and that’s some kind of first step and make sure that the quality there. in regards to organic, um, no added hormones, some things like that in the pot. That’s a good start for anyone right there. And then from there, we can look at the different hormonal systems. So, if we have chronically high cortisol, usually that’s more of an acute thing but that can cause anxiety, that can cause irritability. Usually, there’s a tire of wire that kind of thing there. And then of course as we have chronic stress, that adrenal pattern can move more to a lower cortisol stay, and that can cause energy low motivation low mood. So, we wanna really look at the adrenals. They’re part of that stress handling system. So, when we look at things that drive the adrenals its physical, chemical and emotional stress and so we wanna make sure there’s nothing on the emotional side that’s driving a problem, right? Marriage issues, kids issues, financial issues, whatever that is, we have to make sure, we’re at least addressing it and it’s in our forefront, we’re not just kind of putting your head on the sand. Physically we need to make sure we’re not overexercising or under so we’re getting some movement or we’re moving our muscles or we’re not overly sedentary, we’re not doing things that cause us pain, right? So, that’s important. Of the chronically in pain, we see a soft tissue person or a chiropractor to really get to the root of that. And of course, what we really focus on is the underlying hidden chemical stressors, that’s just the food sensitivities, the gut imbalances, the dysbiosis, the leaky gut, the hormonal imbalances, the low thyroid, the adrenal imbalances, the hormonal issues, um, the mitochondrial dysfunction, the toxicity, mold, heavy metals, right? So, this is where we, we come in there, we focus on the chemical stressors that play a major input on the adrenals and we chronically stress the adrenals, adrenaline is also produced by the adrenals to kind of get cortisol mobilize and chronic adrenaline stimulation will pull dopamine because adrenaline is a post cursor essentially to dopamine. So, it goes dopamine 🡪 adrenaline. It’s over chronically sti, in a stressed-out state. Your body will make adrenaline and will pull from dopamine to make adrenaline. And dopamine is important for that I love you feeling, it’s really important for focus, dealing with stress and staying motivated. So, we have to get that, the underlying reason why we pullin’ out that dopamine downstream, we have to get the adrenals fully supported.   

Evan Brand: Yeah. Well said. I’m glad you mentioned heavy metals too. I mean, people and their brain issues could simply be related to mercury toxicity. If you’re someone just walking around and you’ve got a mouthful of amalgam fillings, we know those are estimated 50-ish percent mercury give or take and we know that mercury directly affects dopamine. If you simply just type in, mercury and Parkinson’s or mercury and Alzheimer’s. There’s a lot of links to these toxins and brain neurodegenerative issues. So, if you’re somebody who’s just so poor motivation and it’s more on the extreme side, you might get this amount of amalgam out of your mouth. And for my grandfather, he’s pushing 80-years-old, believe it or not, the local, biological then said he’s already having memory issues, it’s too late. The issue of pulling out the mercury could create more problems. He just said, leave it alone. But if you’re 40, 50, 60, 70 maybe you’re still at that age where you can start working at heavy metal detox, maybe you’re using some sort of binder for the meantime but ultimately, you’ve got to remove the source. So, I mean, if you got heavy metal in your mouth, no matter how much chlorella, charcoal, or clay you take, you’ll still get metal on your mouth. So, that could be a huge issue for your motivation and you gotta resolve it. 

Dr. Justin Marchegiani: 100% out of the gates. Also, low thyroid can be a thing. Low thyroid can affect mitochondrial function. It can affect mood. It can affect energy. Obviously, thyroid hormones play a major role in your overall metabolism. And if your metabolism is low and slow or more than likely your motivation would be low. So, it’s really good to look at thyroid function. Now, if you go to your conventional doctor that just gonna look at TSH typically and again if your TSH is overly high, let’s say greater than three and a half four. You know, that’s probably be pretty good sign. There’s probably thyroid issues downstream happening with T4 being on the lower side or T3 being, let’s say, below that 3.0 marker in the United States metric. Um, but again, TSH may still be adequate, let’s say below three and you may still have problems with thyroid hormones downstream, with T4, with T3. Maybe there’s an elevated antibodies because there’s some autoimmunity. It’s kind of like smoldering there. So, you really wanna look at running a full thyroid panel and your conventional medical doctor would typically not do it. So, you gotta reach out to kind of more natural, functional medicine first to do it. So, if you guys want to get that kind of testing done, Evan and I, we all do that testing. So, evanbrand.com, justinhealth.com. There’s links there where you can work with us if you want that type of in-depth testing. But low thyroid can be a deal breaker and it can, in most thyroid issues are autoimmune. So, you have to fix the gut. You have to fix the food. You have to fix all of the digestive issues to really get that usually under control. 

Evan Brand: Yeah. Good point bringing up thyroid. So, I’ll bring up another kind of related one which could be anemias, right? If you got low ferritin, for example, you’re gonna be so exhausted if you have some type of anemia that that’s gonna really affect your motivation as well. So, I get kind of annoyed, to be honest with you, when I see people posting these motivational tracks. It is usually some super fit dude, possibly he’s on steroids, he’s flipping a tire and then yelling over the microphone, and it’s like, ‘you gotta get up and you gotta just do it’. And it’s like, you can’t just do it, like, I love that you’re, you know, 28 years old or maybe you’re on growth hormone and you’re flipping this tire and you’re motivated. But that type of talk goes only so far. And from our functional medicine mindset, like I said, I kind of get annoyed, because then you have this woman, maybe 50, 55 and she looks at herself in the mirror and she’s not happy on what she sees. She got insulin resistant, the diet is not dialed in, the guts affected, the neurotransmitters are low, but mitochondria are damaged because she got exposed to, uh, tick bites and molds. This motivational dud ranting over the microphone, he does not have a friggin’ clue about any of these functional strategies. And so, people then think that motivation is just this simple thing that you could just turn on or turn off. If I could just give motivated, I could do this or that. And it’s like, look, it’s way deeper than that, it’s way deeper than this dude just giving you some hoorah jumping the CrossFit class. And that’s why, that’s all this day. 

Dr. Justin Marchegiani: Yeah. I’m not a big fan of RAW, RAW stuff because it ignores physiology. I mean, I think there’s the RAW, RAW stuff can be helpful if it shifts your mindset. But mindset cannot be overcome physiology in the long run. It’s like people gonna, uh, an Anthony Robbins, I think Tony Robbins is great, he has a lot of strategy mindset stuff but you come out of this event so motivated. And it’s like, now what, right? It’s kind of like you’re driving your car, right, your old, used car, nothing’s wrong with it but your own E. Some guy comes up next to you and in like a Ferrari and it’s like, ‘man, you just got hit the back gas pillar, go’. And it’s like he hits the gas pillar, he’s out of sight and you’re like, ‘yeah, I don’t have fuel in my car and I kind of force cylinder under horsepower car, yeah I can’t do it. So, the first thing you gotta do metaphorically is you have to fill your tank of a gas. Get the car, get the gas in the tanks if you have fuel. And overtime, upgrade your car, upgrade your health, right? And we start with food quality, we start with good fats and proteins, we start with addressing glycemic issues, not overdoing or removing the processed sugar and the grain, dialing in the carbs on what you need, sleeping better. That’s like trading in your car at the car dealership, right? Literally, just by doing that, you’re starting to upgrade internally and of course from there we can always go down the functional medicine path and look at these hormone systems, adrenals, thyroid, gut function, mitochondrial issues. But we can at least upgrade the car and the fuel by making these simple lifestyle choices that are free and then from that, that gives you more motivation, now you have more energy, now your brain is clearer, so now you can, you know, be clearer on what your goals are. You can get very motivated, you can set timelines to your goals, right. What’s the difference between a goal and a dream? A goal has essentially a dream with an endpoint, a timeline on it, right. I’m gonna achieve this point, right? Take your dreams, make it your goal by putting an aid on it and some action items to go on it. And that takes energy and focus. And if your brain is foggy and overly tired, that’s gonna be problematic. So, I think, just work on those simple things and then once you get a little more motivation there then what’s next. And so, the things that I looked at when people are stressed and depleted, brain inflammation plays a major role with low motivation, so if we can cut out the foods, if we can add in B-vitamins, B6, magnesium, good health omega-3 fatty acids, that’s gonna help with the brain inflammation. That’s gonna help with the neurotransmitters. And then from there, we’re gonna look deeper at the box. This could be SIBO, bacterial overgrowth, H. pylori, parasites and getting the gut really cleaned out is gonna help shell out a lot of the brain inflammation because inflammation is bidirectional. Inflammation in the body can make its way to the gut and create a problem. Inflammation in the gut can make its way out of the gut into the bloodstream by leaky gut permeability causing inflammation in the brain. 

 

Evan Brand: Yeah. Well said. We could start to bring in some of those vitamins, like the omegas, we can bring in some phosphatidylserine or phosphatidylcholine, we can bring as you mentioned the B-vitamins, maybe some Ginkgo, possibly nootropics like the racetam family, pretty common phenylpiracetam or others oxiracetam. A lot of nootropics out there that you could use, but there’s so many people like in the that they’re taking these different nootropics but they’re not addressing anything in regards to their gut or anything, whether hormones. So, I think it’s… 

Dr. Justin Marchegiani: Yeah, I have a product in my line could, Dopa Replete Plus which has tyrosine and will have an actual pure L-dopa. That’s a good one. Or someone’s coming out of the gates, I would just even just be using pure tyrosine, pure L-tyrosine with some high-quality B-vitamins can be really helpful because you need the B-vitamins as a cofactor to really help convert to some of these neurotransmitters, some of these amino acids to become the actual neurotransmitters. 

Evan Brand: Yeah. You can feel it pretty quick. I mean, that’s the cool thing about amino acids, is that you mentioned. A lot of times, you know, when we pitch people our services, we’re like hey, sign up, you know, give us a call evanbrand.com, justinhealth.com. People haven’t, they haven’t enough motivation to be miserable to do that. Sometimes, I don’t even think about people, they know they want to help but I think they haven’t enough motivation to even call us and reach out to us. So, if you’re one of those people, we’re here but, in the meantime, yeah, maybe you use a little bit of tyrosine. It gets you motivated enough to even reach out to get further health because I think a lot of people get overwhelmed at what’s gonna entail in regards to diet changes. Like, oh, that’s overwhelming, you’re gonna make me cut this out, lifestyle changes, you’re gonna make me cut that out, like oh my God or now I gotta go to bed at 9’oclock, you know, that’s too hard. So, we used this little tool, this functional medicine tool to help motivate people to get them through the protocol. Because you and I could design a perfect protocol, mitochondrial support. We’ve got the gut dialed in. We’ve got the detox, the binders. We got the liver, the gallbladder, the adrenals. It’s all taken care of. But, it’s only if somebody follows through so then you get to the part of compliance which we could do part 2 on that of you want. Like, how do you stay on track but making the plan and getting the labs is the first step and getting the people to follow through is the second one. I think progress ultimately gets people going, because they’ll feel how much better they are but somehow, so, what we’ll use somebody’s brain nutrients just to get them off to get through and follow through.

Dr. Justin Marchegiani: Yeah. From a mindset perspective, it’s kind of like if you have pushed a car before right. You push the car. The hardest thing we’re pushing a car is overcoming the initial inertia of the car, from not moving to moving, right? That’s the hardest part. And so, when we’re dealing with people’s health inertia, it is just getting a couple of habits of moving in the direction that allows the car to start moving. Now, the amount of energy you need to put into that car to keep it moving is far less, right? It’s far less because you overcome the initial inertia of it being stock to moving. That’s kind of health is. You kind of make like a couple of small changes now’s the ball’s rolling and then now you can add, you know, you just can sleep for a little bit, add a little movement in there, and a couple of supplements and now we have a lot more now it becomes even easier to keep that going. And then of course, the key is now, okay, all the energy going into it was moving to the four steps of learning right. It’s unconscious incompetence, you don’t know what you don’t know. Now, you’re consciously incompetence, you know what you don’t know, you’re at least aware of these things. And then you go from step 2 to step 3 you’re consciously competent, someone’s helping you but there’s a lot of energy to keep doing the right things and then ideally you start to move into the level of unconscious competence where it’s automatic, right? It’s like someone who drives a standard transmission, everyone who’s done that they know, like, they’re starting on doing clutch, shift, what, their heads going down looking at the gearbox to stir up. It’s tough, right? But then eventually it’s like, clutch, shift, 1,2, 3, right? It’s easy, downshifting no problem. You don’t have to worry about it, it’s like you’re in automatic transmission because you get the whole thing. So, that’s kind of, well, where habits are, you just start with the ones that really bears the most fruit and then you go up from there. So, that’s kind of kind of look at out of the gates.     

Evan Brand: Well, look, you just did a live on camera because you’re like oh, we’re talking about in that booby. Whip up a capsule, and then boom you pop your aminos just like that. That’s kind of how I am too with protocol, I mean I’ll just feel how I am; I need a little bit of this, a little bit of that. And I’m just consciously making these micro calculations throughout the day. Oh, little low heat, op stressful day, hit the adrenals a little harder.  We’re constantly making these twigs, it’s just a really good place to be. 

Dr. Justin Marchegiani: Yep. I’m gonna go hit some push-ups and some kettlebells, wings, and a little bit of rowing here in a minute. And I’m gonna, um, you know, use some. So, I just try, you know, surround myself with good tools that I could plug into throughout the day to keep that momentum going and then, you know, foundational things, food, water, sleep. So just make sure you, and then of course you can plug in some movement along there right. Those are your three to four big check marks that you gotta hit during the day. And as you start getting that, you can build up from there and that gets you that foundation you need.  

Evan Brand: Yeah. Sleep is huge. So, we’d done a podcast on that but we’re always happy to do more. So, we’re wrapping out for now though. People can reach out if they need. We work around the world via facetime, uh, zoom, skype, you know, phone. We can do. We send labs everywhere and you can reach out to Dr. J at justinhealth.com and you can reach out to me, evanbrand.com and we’re happy to help. And we’ll look at some of these things and we’ll help investigate what could be going on, why’re you struggling. We know that you wanna get that dream business that dream goal, but you gotta make that a reality by optimizing these systems. So, that’s exactly what we do on ourselves on a day-to-day basis. Just literally just boost these neurotransmitters as we’re talking here. So, once you get these tools and place, you’re just gonna be driving, you can take over the world if that’s what you want.

Dr. Justin Marchegiani: 100% evanbrand.com, justinhealth.com. We’ll put links and recommendations for different things that we talked about product wise in the description of the video. Evan, awesome chat with you as always, my friend. We’ll talk soon.

Evan Brand: You too man. Take care. 

Dr. Justin Marchegiani: Evan and I, we’ll go now. Bye-bye.

Evan Brand: Bye-bye. 


References:

https://justinhealth.com/

https://www.evanbrand.com/

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Audio Podcast:

https://justinhealth.libsyn.com/why-do-i-have-low-motivation-functional-medicine-solutions-podcast-358

 

Functional Medicine Approach for Urinary Tract Infections (UTI) | Podcast #356

One of the most common human infections is one that people rarely speak about. Urinary tract infections (UTI), also known as bladder infections, impact 10-20% of women at least once a year, and the specific treatment intervention is prescription antibiotics. Middle-aged women with chronic conditions like autoimmunity, dysbiosis, and hormone dysfunction are regular patients in functional medicine, so regular taking of antibiotics could pose a problem.

Dr. J and Evan talk about that when optimizing microbiome health, hormone production, and immune tolerance, it is crucial that bacteria are allowed to thrive, and antibiotic use poses a warning to that opportunity. With that said, if urinary tract infections (UTI) are among the most common conditions physicians see, and we are attempting to avoid circumvent antibiotic use, what functional medicine approaches do we have?

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
6:31 – N-Acetylcysteine in protecting the urinary bladder
11:17 – Foundational strategies in keeping the urinary tract healthy
17:10 – Antibiosis versus the association of N-Acetylcysteine, D-mannose, and Morinda Citrifolia fruit against UTI
19:11 – Men’s role in preventing UTI


Dr. Justin Marchegiani: Dr. Justin Marchegiani here with Evan brand. And today we are excited to talk about functional medicine approaches to address UTI or urinary tract infections. My immune system is just a little bit under the weather, so I’ll be channeling my inner Barry White today. Really excited for that. Evan, how you doing man? 

Evan Brand: Hey, pretty good. Yeah. I hope you feel better and get back to kicking butt, which you’re still kicking butt but most people would call it in but I’m glad your brain is working enough and we’re gonna get this thing done. So, 

Dr. Justin Marchegiani: I haven’t had a sick day over a decade. I don’t, I don’t plan to have a sick day ever.  

Evan Brand: Good. Good. Good. Alright. So, now, uh, with UTI, I mean this is something that’s extremely common. We see it a lot in young children because their poop gets in to their urinary tract whether they’re wiping the wrong way or whether this is a young child that’s still using diapers, so I’ve seen it with our children, we’ve worked on our kids. I’ve seen it with a lot with the kids I worked with clinically. And then adults we see this a lot, where a lot of it is due to sexual transmission. I mean we’ve seen many cases where if we support the female, the male is the vector and the woman start to get almost resentful towards their husband because they know every time, they have sex they’re gonna end up with UTI. So then, that really affects their sexual health and their relationship. And so, today’s podcast hopefully will encourage people to take this seriously and we’ll have some strategies you can implement to get both you and your spouse if that’s what’s happening and better shaped where this is a non-issue. 

Dr. Justin Marchegiani: Do we have any data on the semen quality, the semen quality affecting, uh, urinary tract infection of females?

Evan Brand: I’m gonna look it up but I know clinically and I know you’ve seen the same thing that we hear that story all the time of where everything is fine and then boom they have sex and then all of a sudden it’s they have a UTI. 

Dr. Justin Marchegiani: Yeah. I know in, um, in men 

Evan Brand: So, here’s the study right here, semen culture and the assessment of genitourinary tract infections in the male. It says here is, uh, contributes approximately 50% of the cases.

Dr. Justin Marchegiani: Yeah. I wouldn’t be surprised if nutrient deficiency has a lot to do with it because I know zinc is very high in semen, right? Um, very important for the health of the sperm and I know zinc also has anti-bacterial, anti-viral qualities to it. So, I wouldn’t be surprised if someone’s more nutritionally deficient they’re gonna have less zinc in the semen and that less zinc will make it harder, make it easier for bacteria and other critters to grow. So, just a thought, again, you know, we try to, you know, high level thinking, you know what’s the mechanism, look at all the downstream signals that could be one component though. 

Evan Brand: Yeah. It’s talking about these different types of bacteria in this male study talking about how it plays a role in genital tract infections and some of these are natural inhabitants of the male urethra which can contaminate semen during ejaculation. So, there’s your answer.  

Dr. Justin Marchegiani: So, it’s almost like men could have a subclinical kind of UTI. 

Evan Brand: Exactly. 

Dr. Justin Marchegiani: That could be affecting it. So, if you’re a female having chronic UTI issues, you have to have your partner looked at or addressed. And we’ll talked abour natural strategies of course keeping sugar down is going to be one of the big ones because one of the biggest bacteria involved in UTI is gonna be E. coli. E. coli you’ll see high in bacterial imbalances in the gut, you can also see some, I think some Pseudomonas in some as well as some Klebsiella but it’s mostly gonna be E. coli.

Evan Brand: They were talking about E. coli and even Mycoplasma in that study, which kind of interesting. 

Dr. Justin Marchegiani: Yeah. Exactly. I know, um, yep, that’s a big one for sure. 

Evan Brand: Some part, you know, some families or couples, they’ll end up just going to using condoms because obviously that’s gonna work and that’s gonna prevent the critical transfer but really the better thing is to get the health of your spouse improved and so, if you’re a female who’s done some of the conventional strategies, let’s kind of go into that now. Some of the conventional stuff that’s being done and we’ll compare it to the functional strategies but if you’ve done some of this stuff and you’re still struggling that’s when it’s time to get your spouse on board. And I know, you and I, we really like to work with couples and we like to get the whole family healthier together because we find that if we just focus on the female that her results are not as good and you know, this actually kind of carries over into H. pylori and all the work, you and I do with gut infections because we see cases where a female will use herbs successfully to eradicate certain infections in the gut. She’ll then get reinfected from the spouse even not into sharing cup, spoons, drinks, kissing and then they’ll get infected. So, as much as I can, I’m trying to bring the husband on board into these health protocols. 

Dr. Justin Marchegiani: Yeah. So, a couple of things out off the gates that men can do to help support the women is cut the sugar out of their diet or at least drop it down to the point where you’re not growing some of the microbes in the urinary tract. That’s helpful. You can also add some things in. Like ginger is actually very helpful so maybe some ginger kombucha can be good or some really strong ginger tea is wonderful. You can also add a little bit of Manuka honey because there’s a lot of data on Manuka actually decreasing E. coli and Staph in the urinary tract. So, these are some simple kinds of easy things. You can even take some raw cranberry juice. Raw cranberry juice is very high in D-mannose, which is a large sugar molecule. The body does not digest but it creates like, uh, magnet-like effect. It’s like dragging a magnet across a surface and grabbing iron filings and pulling them out. Think of the iron filings is the E. coli and so it kind of pulls them out. So, those are some easy simple strategies for some men out of the gates is ginger, cranberry. I would say just make sure you’re hydrated enough, right solution to pollution is dilution, Manuka, and keeping the sugar down. Those are excellent strategies out of the gates. 

Evan Brand: Yeah. And NAC, so we wanted to talked about NAC because NAC has been pulled from Amazon and this nutrient is getting harder to access as just a regular consumer. Fortunately, we work with professional companies, so we still have access, we still do manufacture NAC-Glutathione combos but there was a paper that we have here on NAC and the cool thing is I know you’re taking NAC right now.  

Dr. Justin Marchegiani: Yep. I’m taking up to four grams a day to help biofilms if in the sinuses, it also, um helps with decreasing virus replication in case I have any viral stuff going on. I think I have personally just a little, uh, rhinovirus. That’s what I personally think and then outside of that, um, increasing glutathione, antioxidant support, biofilms, helps with mucus, so it keeps the mucus kind of flowing from. So, it’s, so it doesn’t, um, impair oxygenation and blood flow. 

Evan Brand: See, if you can pull up or highlight that paper, I just shared on the screen there. You know, for folks listening you’re just missing out on this part of it, but that’s okay, we’re just trying to just show you at least maybe a couple of studies a week. That kind of 

Dr. Justin Marchegiani: Yeah. If you’re listening, yeah and if you’re listening here, we’ll put the video link below, so don’t worry about it, just come and check about it later and we’ll put the link down below. 

Evan Brand: All right. So, this is titled, N-Acetylcysteine Protects Cells from Bacterial Invasion, I like how they call it an invasion, and Displays Anti-Biofilm Activity against Urinary Tract Bacterial Pathogens. So, long story short, they discuss using antibiotics, which were really, we can dive into that. But really that is the conventional approach with this stuff, and the problem with antibiotic resistance problems and so you’ll have women that’ll do these formulas whether it’s in this study they’re talking about cipro which is dangerous stuff. I don’t like the sound of cipro at all, for many of the potential permanent tendon issues and other side effects associated with it. 

Dr. Justin Marchegiani: Yeah. Cipro’s in the fluoroquinolone family which can negatively impact mitochondria and connective tissue so if you’re gonna use antibiotic, try to use one, not in the fluoroquinolone family. Maybe amoxicillin, a tetracycline, just talk to your MD if you’re gonna go that route, to avoid that antibiotic at least. 

Evan Brand: Yeah. But here’s the conclusion, NAC is a non-toxic, antibiofilm agent and can prevent cell invasion and formation by uropathogens. So, once again, NAC for the win. This stuff is incredible. 

Dr. Justin Marchegiani: Yep. And again, with antibiotic is like I’m always about, let’s do the more natural things first and kind of go, least invasive to more invasive, right? And antibiotics to be the top part of the more invasive side. 

Evan Brand: This is interesting, I guess this was an Australian researcher, doctor who put this study together. They’re saying here that in Australia, you know, there’s an estimated 150 million infections and this is 12% of hospitalizations. 

Dr. Justin Marchegiani: UTIs are?

Evan Brand: For UTIs

Dr. Justin Marchegiani: Wow. Holy smokes. 

Evan Brand: And 30% of all women have a recurrent episode of UTI and then of course the problem with the UTI, right, UTI kind of sounds like, oh it’s not too bad. But I mean this stuff gets up and infects your bladder that gets really bad and then it can even farther ascend and then infect your kidneys and then that’s when you get into a really big trouble and that’s where they talk about sepsis and some of these other literally and potentially fatal infections from UTI. So, when UTI is kind of one of those, it sounds like, it’s just like this easy, not a big deal, but it can turn into a big deal. 

Dr. Justin Marchegiani: Yeah. So, just kind of like out of the gates, like what are the symptoms of UTIs, right obviously, like pain, pain during urination, you can see a lot of cloudiness in the urine, right? Potentially, even blood in the urine. It can have a really strong smell as well. It can even create pelvic pain in that area that pelvic or pubic area for sure. It can also move up so women have a very short urethra unlike men, that urinary tract can go to the bladder very very easy just because the distance is really short, so once it goes to the bladder, right, you’ll see pelvic pressure, you may see blood in the urine, frequent painful urination, lower abdominal discomfort and then it can continue going up from there into the kidneys. That’s where’s you’ll start noticing a lot of back pain, flank pain, um, you may notice starting to get chills and fever and maybe nausea and vomiting. And usually, once it starts to get into bladder into the kidneys, you know, you may want to look at seeing conventional medicine for the antibiotic at that point, definitely in the kidney. But, I mean, I think if people can be educated about this and be on top of it, I think you can avoid a lot of that upstage, um, conventional need for medications.

Evan Brand:  Well, like many other things that we’ve talked about. Early treatment is key. So, if you can come in and hit some of this stuff hard with D-mannose, your N-acetylcysteine, we use these cranberry extracts very effectively. You and I have also used some professional formulas that contain hibiscus and parsley and horsetail. So, the goal really, I think is to try to break down into like three main categories. So, you go the biofilms, breaking components like your NAC for example or you could add in like natto, Cerezyme or some sort of other proteolytic systemic type enzymes maybe even lumbrokinase would help. So, that’s your number one is your biofilm busting. Number two, you’ve got your antimicrobials that you and I use like bearberry, barberry maybe even clove or oregano might be helpful. Silver, I think, is worth to mention. And then, I would say the third mechanism of action is the anti-adhesive properties so you’re really trying to help flush things out. So, that’s where just hydration comes in. 

Dr. Justin Marchegiani: Yeah. Mannose. 

Evan Brand: And some of these herbs, 

Dr. Justin Marchegiani: Mannose too. 

Evan Brand: Yeah.  

Dr. Justin Marchegiani: Because that’s gonna pull, that’s gonna help pull the E. coli off like iron filings, right, like I gave that under the gates. So, just couple of foundational things. We’re kinda, we’re kind of hitting some of the meat here, I want to just kind of make sure we set a good foundation. So, out of the gates, women are gonna be more prone because of a couple of reasons. Okay. Number one, we talked about the intercourse and the injection of semen that may either have bugs in it or it may just essentially expose a weaker urinary tract so of course the first thing is hydration if you’re a female and getting up after the sex, getting vertical and going to the bathroom. Get that urinary tract moving, get’s some hydration in you. That’s a really good first strategy our of the gates and of course if you’re prone to having UTIs, you may wanna have a powder of D-mannose like we mentioned or some of the formulas that Evan mentioned, some D-mannose, Uva Ursi, um, parsley is excellent maybe a little bit of silver but you can just start a little bit of D-mannose, a little bit of cranberry extract and a little water and drink that before bed or you know, after a, um, interaction like that. The next thing is, if you can look at the hormones, right, hormones can play a big role so you have the high, you have the low. So, women that have very high levels of estrogen especially women that are on birth control pills that’s gonna shift the urinary tract pH based on the high levels of hormones, that can make it easier for the E. coli to grow because E. coli does not like an acidic environment. And when you started to make the environment more alkaline, right, you usually hear alkalize or die well not necessarily. The urinary tract if it’s alkaline can actually grow bugs, so birth control pills can actually cause the bug to grow to the alkalinity.  You can also see the opposite, right, the goldilocks effect. When women go into menopause and their hormones drop, low hormones can also have an impact on the immune system in the urinary tract and that can cause, it can be more, you can be more prone to have UTIs if you’re menopausal with low progesterone, low estrogen because that plays a role in the environment and the immune system and the IgA levels in the urinary tract and so not too hot, not too cold, right? Not too much hormones, not too low hormones, so birth control pill on one side too much, menopausal issues, low hormones on the other side. You really need to work with a good functional medicine person to get the hormones dialed in it, may not be a simple, hey take to something that you may have to fix the hormones too. 

Evan Brand: Yeah. Good call, good point, bringing that up. And that’s more of like a longer-term thing. That’s like if you’re trying to get well and stay well, that’s stuff we’re gonna be looking at. So, is it possible to come in and use some calcium D-glucarate or something like that to help that pathway and get rid of the excess estrogen? I think it could help but is it going to like acutely get you out of the UTI maybe not so I think it’s good you’re mentioning to have a plan meaning like a long-term health functional medicine health plan that then prevents you from having to do some of these acute strategies we’re talking about.  

Dr. Justin Marchegiani: Yeah, I mean there’s a palliative kind of, um, non-root cause support that we have but we try to always package in the palliative stuff with lifestyle changes that make it more holistic and make it more root-cause and then we also dive into the hormonal aspect and also, I would even say gut aspect. I’ve seen imbalances in the gut bacteria, shift and influences the urinary tract microbial balance too. So microbial imbalance in the gut has a way of shifting microbial imbalance in the urinary tract and it could be just 80% of the immune systems in the gut and that’s having a major effect. It could just be some of this stuff’s working its way down there through moving the intestinal tract. It has a way of shifting or migrating or moving in some way, you know, those kinds of things. But either way look at the gut, that’s where a lot of the immune system is. Look at the hormones, look at medications that could be influencing these things. Look at hydration, those kinds of the root, I think starting situations, you really wanna have your head wrapped around. 

Evan Brand: Yeah. In regards to testing you can do this at home. They have companies that make at home UTI test strips that you can do, where you just urinate on the strip and you’re gonna be able to test your leukocytes and they have a little reference range that you can look at and basically the dark on most of these it’s purple, the darker the purple, the more severe the infection is. And we had incredible results with our daughter using some of the D-mannose, we some chewable versions, we did some of these herbs mixed in some apple sauce and we retested using these little pee strips and I want to say, I’d have to ask my wife to confirm, it was either two or three days, we completely got it from a deep dark purple indicating a very intense UTI to nothing. It was completely white. So, the brain is called azo, A-Z-O. And they also make other things, I think they make like ovulation strips and that kind of stuff for more like female health. But this urinary test strip, you’re looking at maybe ten bucks for a pack of these. So, if you do have suspicion or if you’ve had chronic UTIs, this is something that I would recommend you at home because so many times you and I hear a story of a woman having to schedule an appointment, get into the doctor. Yep, I have a UTI. It’s like you could have done that and figured it out at home in two minutes for 10 bucks. The accuracy is very very good. 

Dr. Justin Marchegiani: Absolutely. 100% And of course, um, there’s some tests if you do like a uroscopic or a microscopic urinalysis, you know, we’ll be looking at leukocytes, we’ll be looking at protein in the urine. We’ll be looking at pH, we’ll be looking at potentially bacteria. E. coli, looking at the actual microbes in the urine, that’s helpful and then obviously just from a diet, just for me a lifestyle strategy. This is obviously going to pertain more to kids, right? Just teaching your kids how to wipe the right way, right? Females, front to back, kind of common sense, but kids obviously develop blood habits and that could be a simple, easy lifestyle methodology. They can, they can fix that problem and just getting more water, more hydration, if, um, kids have a compromised immune system due to the too much sweets, um, obviously artificial sweeteners like aspartame, Splenda, those can impact the microbes as well. Those things can compromise the immune system and shift the micro, the micro, um, kind of balance, microbiota balance in the gut and in the urinary tract. 

Evan Brand: Yeah. Let me show this one more thing. Do you mind bringing this, highlighting this paper? 

Dr. Justin Marchegiani: Yeah. Absolutely. 

Evan Brand: There’s one more that we wanted to show people, this was just titled, Prospective study to compare they said antibiosis, they’re talking about antibiotics versus NAC, D-mannose and Morinda fruit and the conclusion of the study at the bottom here, D-mannose and NAC resulted in similar to antibiotic therapy. So, even if somebody wants to nitpick and argue, well antibiotics are like

Dr. Justin Marchegiani: Better. 

Evan Brand: They’re not. They’re not. Now, I’m not saying that in a severe situation where your kidneys are affected and you’re going septic, I’m not saying, I’m going to try to do this, but I’d be doing all of it, I’d be doing the mannose, the NAC maybe the antibiotic if I had to, but I mean, based on the stuff you and I’ve seen clinically based on more than what we’ve looked at in these papers alone. I mean, the cool thing about PubMed too, is you’ll be able to have related articles pull up like you could go into this one. D-mannose and Hibiscus and Lactobacillus probiotics. You know.  

Dr. Justin Marchegiani: Yeah. Probiotics are gonna have a major influence as well due to the acidification of that area. I mean, you can depend, depending on where you’re at, you could potentially even do intervaginal probiotic, you know, you could put the capsule in let it dissolves or you can mix it in, uh, with little, a little bit of aloe or shea butter or coconut oil, something that’s gonna dissolve and um, you could essentially mix it in, you know freeze the cube or refrigerate the cube so it’s solid and then insert intravaginally and that will kind of dissolve and then it will contain some of those nutrients to help support the vaginal canal and depending on where you’re at for some yeast you could even do that same thing with boric acid too. I recommend some kind of a carrier though, just so, it’s uh, just so, it’s not as abrasive if that canal or that tissue is really sore or irritated it just provides some moisture to that area as well and won’t irritate it. And if you’re unsure test the, test the moisturizer whether it’s aloe or shea butter or coconut oil, test it before you put any of the extra stuff in it, so you know, if that’s a problem at all.    

Evan Brand: You know, what I’ve also seen to be beneficial, I’ve seen some homeopathic vaginal suppositories for UTIs. I don’t know much about them, but I’ve had women try them and they have worked, when everything else failed, so I think you should be open to it. And the probiotics are game changer too, as you mentioned, you could do intravaginal with the capsule it’ll just dissolve or just oral probiotics has been helpful so as you mentioned the gut, you know, that’s something we’re gonna look at. So, if we see a female who suffer with UTIs and we see she’s got a lot of issues on her stool test, you know, we can’t say directly, hey this is why you have UTIs. But if we fix the stuff in the gut, chances are high that they’re gonna suffer less and less frequently from UTIs. It’s really, really important as you mentioned you got this vaginal microbiome, you’ve got the oral, you’ve got the gut, you’ve got the skin microbiome, so, I mean if anywhere there’s dysfunction or dysbiosis going on, I think they can affect the whole system. 

Dr. Justin Marchegiani: Absolutely. And then, men play a part of the role, you know, in this whole thing. So, get your sugar consumption down, better hydration, could always throw in a little bit of ginger or cranberry kombucha that’s a really easy simple thing. Just to add in as a routine. Sometimes, it’s easier to add things to a routine than pull things out. 

Evan Brand: Well, think about how many men, you and I have seen and work with over the years with gut issues so, I mean getting their gut straightened out too is gonna be my goal because I’m sure that’s gonna affect what’s we’re seeing in these paper zone like semen quality, and they’re not passing these microbes, you know, via sperm. So, man, you gotta get on board. Women just I, you know, I feel bad for them because they take a lot of the blame, they take it upon themselves like there’s something wrong with them and in many cases, there definitely are issues with the dysbiosis and the female but in the men they kinda get off the hook so, we’re calling all the men out here, you gotta get involved too, you gotta get your health involved. If you’re over there, eating pizza while your wife is sitting here cooking a paleo meal, you gotta get on board because, you know, this is a team sport here. 

Dr. Justin Marchegiani: Yeah. And you can always use a barrier method if not, right, that’s an easy way at least in the interim and then also just getting the hydration up and avoiding the sugar can make just a huge difference. Sometimes, it’s not even 100%, just an 80 20 can make a huge difference on that. 

Evan Brand: I know how men are, being a man, so if the wife says, uh, honey you’re gonna have to use condoms for the rest of our, uh, sex life, I think that’ll be a, easy quick motivator to get them on board and they’re natural. 

Dr. Justin Marchegiani: Totally. Yeah. I find like kind of in the men sphere, there’s like two kinds of men. There’s like the men that are like biohackers that are like always into like optimal performance trying to improve and get everything kind of optimized in their health and their life and their come some guys that they kind of just, they’re  a little bit more slow to the punch and they’re motivated by what the rest of their family is doing, their wife’s doing, and then their wives kind of get them on board, there’s like kind of two classes like that, I think me and you tend to be more in the biohacker class and we see a lot of biohackers that are in, right, you know, that are really motivated and they’re all about performance, performance and then some their wives are more on that side of the fence and the wives kind of get them motivated but most of the time though, once someone can see their life improve and usually if you get healthier, you don’t just improve in the urinary tract, you improve in cognitive, mood, libido, energy, digestion, so women, if you can get your husbands on board, they’re gonna see a lot of buy and hopefully other areas and hopefully you’ll be able to get them a long-lasting buy in which is really important for energy and just, you know, people being, um healthier which is important. 

Evan Brand: Yeah. Well said. We can mention this comment here that came in the live chat and then we can wrap it up. We’ve kind of hinted at this but we didn’t say it directly, when we talked about UTIs, I mean a lot of times, we are referring to the bacteria but in many cases there’s a yeast component too, so there’s a fungal component, here’s the cool thing though, you and I are always using blends and these blends are not only antimicrobials but also anti-fungal, anti-yeast. So, someone in the comments here wrote that they kept getting UTIs even after getting treated until they started yeast treatment and that’s a cool thing. Think about if you come in with antibiotics, so let’s just quickly compare the conventional and functional approach. You come in and do the antibiotics, those are not anti-fungals, but if we’re using something like bearberry, barberry, berberine, cloves, silver, Saccharomyces boulardii probiotics, we’re creating an antifungal, anti-microbial, anti-parasitic protocol all in one, which is awesome because sometimes we’re killing multiple birds with the same stones and that’s why we love what we do. 

Dr. Justin Marchegiani: 100% and of course, you know, a good history will kind of figure this out, based on you know, if you have a new sexual partner or not, STDs always can be a thing, so we’re looking at Chlamydia, maybe Gonorrhea, right? And so, these types of infections, I think we could probably see some improvement with some of the natural things especially if we add in silver and such but these types of things, if you’re not having results, they may require a special kind of antibiotic, if that’s at play. And so, obviously, you know, it’s gonna be history dependent, if you’re in the steady relationship then that may not be a thing or if you’re not sexually active that probably isn’t gonna be a thing but it’s always good to kinda keep that in the back of your differential list of things that you kind of work up through from least likely to most likely. 

Evan Brand: Yeah. Good call. So, on that NAC paper, it actually did talk about Chlamydia and it talked about the mycoplasma and there was a couple others in there and it was talking about the anti-adhesive, anti-biofilm properties of the NAC. So, even if it were STD, I think NAC is something you’d still wanna implement. 

Dr. Justin Marchegiani: Yeah, I mean, usually you’ll gonna see some level of discharge too with some of the STD stuff but worst case, you know, you can just tested try some of the simple things out of the gates. A lot of times the history will tell you, especially if you know, if you’re, um, had intercourse in the next day, you know with your husband or partner and the next day you’re starting to feel some issues, then it’s probably gonna be on the E. coli side of the fence which is 90% of the time, so you know, if you have 90% odds with something, we’re gonna go with that out of the gates for sure.  

Evan Brand: Yeah. Okay. So, testing strategies just to summarize, you could do the at-home test strips for this, we think a good stool test would be, in order to figure out what’s going on with you’re gut and how’s that affecting your microbes down south same with your partner, if we can get them on board, get your stool looked at, a urine test is helpful too because we’re gonna be able to look to Candida overgrowth and other types of fungal colonization. So, we like the organic acid, so an oat, a stool and some of the at home test strips, I think that would be a great starting place because you could do other things, blood work, and as you mentioned like the urinalysis and like in the conventional lab, you could do that too. But you might not, if you do these top three. 

Dr. Justin Marchegiani: Absolutely, and then the big symptoms that would differentiate an STD over UTI are gonna be like more systemic symptoms, so like nausea, fever, swollen joints, sore throat, symptoms that are kind of gone more systemic and of course there can be some localized symptoms that can be more severe like extreme discharge, severe rash in that area, blisters in the genital area, but look for more systemic type of symptoms that could be driving that. 

Evan Brand: Okay. You’re saying more systemic symptoms would be what? 

Dr. Justin Marchegiani: The ones I just mentioned, so pelvic

Evan Brand: No, would be a UTI?

Dr. Justin Marchegiani: No, that’s gonna be more of an STD, so think of STDs are more severe therefore the symptoms are more severe. They’re more systemic. So think of systemic symptoms are things that are more severe, localized symptoms, right, that means the microbes haven’t spread as much and they’re less severe, so more severe think of the STDs. 

Evan Brand: Got it. And then you mentioned in the beginning if the UTI is more severe that’s were the back gets involved in the case of the kidneys, you know, there are people that, they perish due to UTIs if they go septic so obviously, you would have a lot more issues than you would know by then. You’d be in real bad pain.

Dr. Justin Marchegiani: Absolutely. Yep. 100%. And again, like you know, UTI, on a desk, can go to the bladder and then the kidneys and then, you could have a fever, you could have these things, so as a UTI gets more severe that could definitely drive the symptoms up as well. But usually, what people can see it because it’s just following that urinary tract, it’s going from the urinary tract to the bladder, to the ureters and then up to the kidneys. So yeah, usually you can see that and feel it, the pain starts to move up. Well, anything else, you wanna add? 

Evan Brand: No. I’m just gonna say, we work with this issue all the time. We’re really happy to help people and to provide solutions to what have been a major issue. A pain, an issue and like I said with people’s sex life and with just people’s personal health. I mean this is something that’s a big burden for a lot of people especially women. So, we’re really happy and fortunate to have outside of the box tools that we use with great success and we don’t only back it up with clinical experience, we backed it up with some of the research we’ve dove into and the professional formulas we use are tried and true. So, if you need help, please reach out, we’d love to help if you wanna reach out to Dr. J you can at justinhealth.com justinhealth. If you wanna reach out me Evan Brand, you can do so at evanbrand.com and we both work worldwide via facetime, phones, skype and we send products to your door, so if you need to get any of these labs done, investigate you, it doesn’t matter if you’re in California or Oregon or Michigan or Florida or New Mexico or Australia or Canada or Europe, we can do it, we can help and we work with people around the world, we have for decades so it’s just a true, true pleasure to get the hands-on experience with this issue because I think the most empowering thing is to know that you’re not a victim meaning you’re not just going to have to go on antibiotics. That’s just the foghorn of the conventional approach, and it’s just so empowering and inspiring to know, there’s other ways, other tools, there’s other approaches that are very, very successful. 

Dr. Justin Marchegiani: 100% Yeah and if you guys enjoyed it evanbrand.com, justinhealth.com. There’ll be links right there to work with us. Hit that thumbs up, helps the search algorithm improve so more people can see our information and give us a share, give us a comment, write us a review, we’ll put links below to do that. Thanks, y’all, you guys have a great day, we’ll talk soon.   

Evan Brand: Take care. 

Dr. Justin Marchegiani: Bye Evan. 

Evan Brand: Bye. Bye.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/functional-medicine-approach-for-urinary-tract-infections-uti-podcast-356

 

 

What are the Natural Anti-Inflammatory Agents for Pain Relief

In general, we have our COX pathways. Now, Arachidonic acid can feed those pathways. A lot of excess, junky, refined Omega-6 from animal products can definitely feed those pathways. That sets the table like gas in the kitchen where a little spark can take it off.

Click here to consult with a functional medicine doctor for recommendations on natural pain relievers.

Where to find anti-inflammatory agents:

  1. Natural herbs like ginger can help with COX-1.

  2. Fish oil is excellent for COX-2 at high doses. If you do high doses of fish oil, you can increase what’s called lipid peroxidation because fish oil is a polyunsaturated fatty acid. It’s more unstable. It’s got more double bonds in it. Omega-3 means three double bonds. The more double bonds that are they are, the more unstable the fatty acid is to heat things like that and the more, let’s say it can be oxidized. So, having extra vitamin C or extra vitamin D on board when you’re taking extra fish oil just to make sure you don’t have oxidation is great, and we already talked about things like systemic enzymes.

  3. There is also curcumin but liposomal curcumin is better due to the absorption or something with black pepper in it helps with absorption, too.

  4. Frankincense or Boswellia.

  5. White willow bark which is kind of how aspirin is naturally made though aspirin works more on COX-1. So, aspirin can be your other natural source and you can do white willow bark which is the natural form of aspirin.

  6. There are things like Tylenol but Tylenol works more on the central nervous system perception. So, it decreases the nervous systems’ perception of pain. Note: We have to be careful of Tylenol as it can actually chronically reduce glutathione. So, if you’re taking Tylenol longer-term, you definitely want to take it with NAC and/or some glutathione, just to be on the safe side.

  7. At the extreme example, we have opiates which block pain receptors in the brain, the opiate perception of the brain. It’s not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive.

  8. We can block some of these natural pain perceptions with CBD oil. So, CBD is another great way to reduce the perception of pain.

In general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation.

If you have osteoarthritis, rheumatoid arthritis, sports injury, or you’re just trying to heal maybe postoperation, these things may be something to implement and then obviously work in all the other root causes, too. You are not just what you eat. You are what you digest from what you eat.

So, if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair or falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place.

If you need to reach out to talk about your pain and inflammation issues, click this link to schedule a chat with me!

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

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

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

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

How do you take collagen?

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

Where can you get collagen from?

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

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

Natural Herbs and Foods to Help Fight Stress

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

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

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

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

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

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


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.