Signs and Solution for Gut Inflammation and Leaky Gut | Podcast #351

In this video, Dr. J and Evan stress the importance of what you eat and how it impacts the rest of your body. However, what you might not realize is how your food is digested in your body, and when it gets inflamed and leaky, how do you fix it?

A lack of digestive enzymes can cause leaky gut syndrome—another unfortunate result of chronic inflammation in the digestive system. Many culprits cause leaky gut, including stress, medications, poor food choices or quality, alcohol, cigarettes, and even hormone changes.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
1:08  – Poor Gut Health Connection to Virus.
4:31  – What is the role of bile movement and production?
11:16 – The influence of gut michrobiota on Inflammation and Insulin Resistance
19:29 – General recommendations on carbohydrates and for a healthier gut


Dr. Justin Marchegiani: Hi! Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the signs and solutions of gut inflammation and gut permeability or leaky gut for short. Really exciting topic. We see it a lot in our patients every single day. Evan, how are we doing today man? 

Evan Brand: Hey. I’m doing really well. I can’t remember if we covered this on the podcast or not, this specific study but there was a paper that came out all about leaky gut and worsen outcomes with the virus and so people could put in the, you know, what virus in PubMed and leaky gut and we’re finding that a lot of people with leaky gut that’s actually one of the precursors and that’s what’s leading to worse outcomes so this is more important, It’s always important but this is more important now because we know that there’s a massive link and I’ll actually pull this up here and I’ll show you this, American Society for Microbiology, they did this. Did we talk about this yet or not? 

Dr. Justin Marchegiani: Let’s talk about it. Let’s go ahead. 

Evan Brand: This particular paper. Let’s bring it up there. 

Dr. Justin Marchegiani: Let me check here. Oh yeah. Let me add it on. Go ahead.

Evan Brand: Yeah. So, there we go. So, poor gut health is connected to severe blank, new research shows and long story short, you can go into this microbiology article but long story short they actually show a picture too. Let me see if I can get to that picture. Here we go. That was the picture. I think, we already showed this picture but forgive me and people listening on audio. Basically, we’re just showing that viral particles with a leaky gut are gonna be able to get into the circulation and that’s gonna increase your inflammatory response so the real goal of today is making sure that your gut is in good shape because therefore you’re not gonna have leakage into your circulation. You’re gonna be far far better if you have that healthy gut barrier. So, that was really kind of the spark notes of that but that’s like a 19 pages paper that you can dive into and many people I think have thought of leaky gut as kind of trendy topic that only people like you and I talk about but this is finally, actually getting into the mainstream. So, I hope gastroenterologists are gonna realize the importance of addressing the gut and I hope they actually start taking it more seriously. Right now, it’s just antibiotics that’s really the only thing that gastroenterologists do for gut, right? I mean steroids maybe and immune modulating drugs in the case of like, ulcerative colitis and Crohn’s but beyond that there’s not really much leaky gut conversation going on. 

Dr. Justin Marchegiani: No. There’s not and again, really, a leaky gut has an effect, right? Or we’ll call it gut permeability, right? If you go on PubMed, a leaky gut is like a slung. If you want to really find it, you want to look at, you know, gastrointestinal permeability, right? These are gonna be the big things, it’s the tight junctions, the epithelial cells and the small intestine, they start to come apart like my fingers here interlocked like I’m saying a prayer, they come apart and then you can see lipopolysaccharides undigested food particulate can slip out. So, this is, um, this is part of the major, major mechanism. Now, with gut permeability, it’s an effect not a cause so I always tell patients, we don’t go in and treat leaky gut, we treat the corresponding vectors of inflammation that drive gut permeability so that could be food allergens, that could be immune stressors like virus, parasites, small intestinal bacterial overgrowth, general dysbiosis, poor digestion, antibiotic exposure, creating rebound overgrowth, fungal overgrowth, you know, just poor digestion, lots of stress, increased sympathetic tone and adrenal stress, that’s shutting down the digestive system and making gut permeability more probable. So, these are the big vectors so we always wanna draw a line. What’s the root cause and what’s the effect and gut permeability is in the effect not necessarily a cause.  

Evan Brand: Yeah. I’ve seen a lot of, even advertisements now on social media for all these leaky gut healing formulas and that kind of stuff and it always has the word heal involved but you could take as much glutamine and whatever else you want. You could go into an elemental diet and all of that. It’s not gonna get rid of these big root causes and certainly for me, I tried some gut support but ultimately it was resolving my parasite infections. That was the most important thing for me and so, you can test for this. This is not an uncommon situation; you and I personally and clinically see parasites every single week. So, when you hear this idea of like, oh, it’s a third world country problem, you haven’t traveled to Mexico or anything like that. That’s just crap, I see it all the time and I had them and I was not out of the country and I had multiple parasite infections and then that affects your bowel flow, right? Can we talk about the bowel for a minute, what’s the role there, because you and I talked about how you have to have adequate bile to act as sort of a natural antimicrobial but how is this happening. What do you think are the big driving factors for why bile production is just not good? 

Dr. Justin Marchegiani: Well, first off, we look at the domino rally of digestion. The first thing that has to happen is good, nice aesthetic pH in the stomach. So, we need adequate HCl in the stomach, hydrochloric acid that lowers the pH and again, lower pH tends to have an antimicrobial effect, right? So, if we have to bring the pH down a little bit, that makes it harder for bugs to grow and that pH is also responsible for activating a lot of proteolytic enzymes in our stomach so if we have a good pH, we activate our enzymes, that starts the digestive cascade, we make it harder for bugs to grow and then once all that kind that mixed up food and enzymes and acids and all the stuff in our stomach is all mixed up. That’s called chyme, C-H-Y-M-E, that gets released into our small intestine, our pancreas then produces a bunch of bicarbonate to bring that pH back up to around neutral but that pH being nice and acidic, it triggers bicarbonate and then it also triggers cholecystokinin production, CCK, which then causes the gallbladder to contract so then you get a whole bunch of bile that comes out, you get a bunch of bicarbonate that comes out of the pancreas but then you’re also gonna get a bunch of lipase and proteolytic enzymes, trypsin, chymotrypsin lipase, lipolytic enzymes is coming out of the pancreas as well. So then, you bring the pH back up, you add the fat digestive enzymes, the proteolytic enzymes and then you also stimulate that bile production which then emulsifies that fat. Think of emulsification as you have a nice greasy pan where you cook some bacon on, right? Throw under water, you feel the fat on the pan, throw some dawn soap on there, it emulsifies it. It breaks that up so then you can get it all out the intestinal tract and be able to absorb it, carry on, mycells and be able to use it for lipid bilayer, hair, skin, nail, energy all that stuff. Prostaglandins. 

Evan Brand: Yeah. Well said. And though bile is produced by your liver but it’s stored in your gallbladder so people that have had their gallbladders removed which is a very common surgery, a lot of surgeons are very happy to remove gallbladders, I think in many cases, they may have been saved with fixing these other upstream issues but, well, once it’s gone, it’s gone. So, people listening that have no gallbladder, you have to take that into consideration. There was a study here in 2018, it was in the annals of gastroenterology, it found that poor bile flow can contribute to the development of inflammatory bowel disease. So, you’re really setting yourself up and find all the time with people clinically when they come in, they’ve had gallbladder removal, we see a lot of issues, we see massive bacterial overgrowth problems in these people and I think that’s partly due to not having enough bile being stored anymore like you and I have talked about it before, I think you said it was a 10x concentration in the gallbladder, is that right? 

Dr. Justin Marchegiani: 10 to 15x. Yeah. 

Evan Brand:  So, you’re missing out on that when you have just liver production, you don’t have that storage facility. I mean you have some but just nowhere near what you would have had if you had your gallbladder. So, please. Try to save your gallbladder. You got to fix these upstream infections because that’s gonna be and get off proton pump inhibitors with the help of your doctor if you can because we know that, that suppression of stomach acid is gonna lead to the overgrowth which then fuels these downstream issues to not happen the domino effect, it literally gets stopped or prevented by the PPIs.

Dr. Justin Marchegiani: 100%. And so, we need good, think of bile, it’s an emulsifier, it breaks down fat, it’s also an antimicrobial and so we create antimicrobial environments by having good, nice, low pH by having good enzyme and acid levels that also helps and then also by having good bile output and plus the longer that food sits there and rots and putrefies because we are not breaking it down into its constituent parts, right? Then it’s gonna create future petrification, fermentation, and rancidification. Essentially proteins and fats and carbs are rotting, right? Then you can get gas and bloating and that just creates this incredible breeding ground for bugs to grow. It’s like you can have this beautiful home that you take care of but if you leave the garbage in there like, a week too long it’s gonna get like, stinky and then you’re gonna get a whole bunch of bugs attracted to it, right? Same kind of thing in our microbiome so it’s really important that we stay on top of, you know, those good health practices.   

Evan Brand: Let’s hit the symptoms and signs and symptoms because people know most of the gut ones but there are some that you and I find clinically that maybe people wouldn’t think are a gut symptom, right? It might not manifest outside of that so we can cover the stuff like unusual color texture, smell, messy poops, you have floating stool. You have maybe alternating diarrhea, constipation, bloating, gut pain. But, what about like, skin issues and what about anxiety and depression and hormonal imbalances and brain fog. I mean, you and I have seen, we lost count how many times we’ve seen cases where we simply just fix the gut and all the sudden, this depression is lifted. I had one client named Miranda, who she had been depressed for, she said quote 20 plus years, all we did is do a gut protocol. I gave her no antidepressant herbs. We simply just did a gut protocol and when we did a six-week follow-up, she said her depression was 90% better and when she said 90% better, she didn’t even sound too excited and I said, are you realizing what you just said to me. You’ve been depressed for over 20 years and you’re 90% less depressed in six weeks of doing a gut protocol like do you realize how profound that is and she goes oh yeah, I guess that is amazing. Thank you. And, I think people, they get so used to feeling a certain way that when the clouds lift. They’re almost not even ready for it but depression, anxiety, I would put at the top of the list for mental health issues connected to these gut inflammation problems, I will tell you. And, you and I discussed this I remember calling you one-night years ago is probably like coming up on be six, seven years ago was like 2014, 2015 and I was like man, I’m having like a panic episode or something and this was when I was living down in Austin and it was H. pylori. It was driving that because as soon as I cleared the H. pylori, all those weird episodes of panic completely disappeared and I’ve seen that more than just the n equals one, me, I’ve seen it many, many times. So, if you have anxiety problems, you go to the psychiatrist. They’re not going to suggest you have gut infections but that’s something you need to be thinking about. 

Dr. Justin Marchegiani: 100%. Yep. 110% for sure. Anything else you want to add in that topic?   

Evan Brand: If you’ve got mental health issues, look in the gut maybe even look in the gut before you look in the brain. Now, obviously, we’re gonna be doing organic acid testing and other things to look at neurotransmitters so we’re gonna check out dopamine, serotonin. We’re gonna look at what’s called quinolinic acid so we can look for actual brain inflammation or brain toxicity related to gut infections like sometimes Clostridia, we’ll see will drive up the quinolinic acid markers but we still have to fix the gut. So, if you have a family member, they’re anxious, they’re depressed, they’re fatigued. We’ve seen a massive link between chronic fatigue and gut infection. So, there’s another big one that people may not recognize, the gastro doc may not suggest your chronic fatigue is from a gut infection but it certainly can be skin issues as well. My skin was a wreck years ago. I had major acne even though my diet was clean. It was my gut.  

Dr. Justin Marchegiani: Totally. I also wanna highlight one other kind of variable here. I think it’s really important. I’m gonna pull this on screen here. I think this is really interesting. So, an interesting abstract here and it’s looking at the influences on the gut microbiome on inflammation and insulin resistance so this is interesting because we talk about insulin resistance, right? Consuming too much carbohydrate and refined sugar. All carbohydrates get broken down typically into glucose, fructose or a combination of the two, right? And so, the more sugar that gets released into our bloodstream that gets broken down whether from refined sugar, sucrose which is fructose in glucose, high fructose corn syrup is fructose in glucose 55, 45 concentration and then of course we have starches which get primarily broken down into glucose and then we have fruit which is more on the fructose side. These things all have an impact on our blood sugar and the more insulin resistant we become, we, it drives inflammation. It’s hard to utilize these fuel resources and these fuel sources to get deposited in our fat because our muscles don’t have the ability to store it. our liver loses the ability to store it. We don’t have the activity level. We don’t have the mitochondria stimulation to burn it so we store it as fat. Now, this article is interesting. It talks about obesity as the main condition that’s correlated with the appearance of insulin resistance. Think of this as when your cells get numb to insulin. Now, this is on screen here. People that are looking if you’ve got mental health issues on the audio version, we’ll put the link below for the whole video. Whole bacteria, their byproducts and metabolites undergo increased translocation through the gut epithelium. Translocate, let me give you the translation on that. Here’s your gut. Leaky gut happens, right? Where it talks about gut permeability and things start to translocate meaning move from the inside of the gut back into the bloodstream, right? So, it translocates through the gut epithelium into circulation due to the degradation of tight junctions. This is a leaky gut, right? Here. And it increases intestinal permeability that culminates in inflammation and insulin resistance. So, what this says is the inflammation caused by gut permeability caused by gut permeability caused by lack of enzymes, bile, food allergens, all the gut microbiome issues can actually drive inflammation and insulin resistance. Now, it makes it harder for your mitochondria to generate fuel because you’re not able to get that fuel into your cell and you start to become more of a sugar burner. It’s very difficult to burn fat when you have high levels of insulin, Very, very difficult. So, several strategies focusing on modulation of the gut microbiome using antibiotics, again, we would use antimicrobial herbs, probiotics and probiotic fibers are being experimentally used to um, in order to reduce intestinal permeability, increase the production of short chain fatty acids. Guess what, things like butyric acid, medium chain triglycerides. Those are all very helpful. And again, this helps promote insulin sensitivity and counteracts the inflammation. So, really, really important here. This study, influence of gut microbiome on subclinical inflammation here and this is the 2000, see what’s the study, 2013 study so we’ve known this stuff out for a long time here that the gut microbiome plays a major role on your blood sugar, blood sugar handling and if you’re a diabetic or someone with insulin problems, you need to be looking at the gut. Yeah. look at the diet, look at, you know, getting your diet and your macros in order, make sure your food quality is good and then look at really getting the microbiome dialed in to really help. That could be a missing piece of the puzzle for people that have really changed their diet but not quite gotten the metabolic benefits of losing weight yet. 

Evan Brand: Wow. That’s a good point. You know, when I think back, when I had gut infections, my blood sugar was definitely not as good. I mean, 2 to 3 hours is as far as I could go without having to eat a meal. Now, I could fast all morning and not eat till 1 pm and I’m perfectly fine. I think there is an adrenal component too. I think I’m in a lot better place with that but I can tell you that certainly after mixing my gut, my blood sugar and blood stability is much better. So, I think you’re onto something with that paper and how people that even have gone paleo or animal based or keto. That still has issues with blood sugar regulation. That could be a sign of gut issues and I think even If diet dialed in in some cases what like you’re showing here, there could still be issues with the blood sugar. So, sometimes, it’s portrayed as like just fix your diet and everything else falls into place but you have to consider these other factors and also, I’ll throw in at the, you know, 11th hour here, mycotoxins, we know that mold toxins significantly affect the gut barrier and create a leaky gut. They damage the mitochondria, and we know that certain mycotoxins promote the overgrowth of bacteria like Clostridia and Candida. In fact, the lab will tell you that on paper, for example mycophenolic acid, it’s a very common mycotoxin that we see that comes from water damaged buildings. You breathe that in, that’ll then affect the gut and allow the overgrowth. So, if you’re just treating the antimicrobial herbs or fungal herbs and you’ve missed this giant mold exposure that can still affect the gut, still affect the brain and people won’t get fully better. So, that’s really the beauty of what we do is we try to work through all these puzzle pieces and help you because you could have this guy who says everything is gut and you go all the way down this gut rabbit hole and not get fully better or you go all the way down this insulin resistance rabbit hole and you still miss the smoking gun. You got the leaking dishwasher and your whole kitchen cabinetry. We had a woman in Texas last week, her dishwasher apparently leaking for years. Her entire kitchen has to be replaced now. She’s looking at 25k, just to replace her whole kitchen and she’s been to 10 doctors, 10 practitioners and nobody’s figured it out and I’m not trying to toot my own but I’ll just say I kept suspecting something because she said that she would always feel weird while she was washing dishes at her sink. She would get a little bit of a headache, feel a little bit sick to her stomach, said, ‘huh, is it possible that something’s leaking?’ and then boom brought in the remediator and they found it. There was a leaking dishwasher black mold everywhere.   

Dr. Justin Marchegiani: Yeah. Mold plays a major role in stressing out the immune system. It can create gut permeability within itself and then obviously drives the insulin problems. And also, people that eat this type of diet, I mean, it’s natural when you have microbiome issues to create a bunch of sugar because these foods are from an evolutionary standpoint, things that had a lot of sugar in it ended up having a lot of nutrients in it, right? Oh, a bunch of berries, some honey, right? And they were very rare in society. It was hard to find a lot of these things. Even fruit, you know, back then, tended to be a lot more sour and bitter and we’ve kind of hybridized and you know selectively grown fruits that tend to be sweeter and more, uh, and more plump and luscious now they taste. And so, we have sweeter fruits today and so it’s natural for people to want to crave all the crap that feeds the bad bugs because the bugs are producing chemicals to make you crave these foods. So, you have to be educated and understand that these foods, even though you’re craving them, you need to like not listen to those cravings sometimes and really shift your gut in it. If it shifts your macronutrients in a way to starve out some of these bugs, it can make a big difference.   

Evan Brand: Yeah. Well said. I mean, a lot of fruits hybridize now too as you mentioned to be sweeter, so like a strawberry. I’ve seen strawberries as big as my hand sometimes, like, ‘God’, you know wild strawberries, they’re tiny. I mean they’re like the size of a fingernail, if you’ve ever seen wild strawberries out in the yard, very tiny and definitely not anywhere as sweet as the other ones. So, when you hear people talk about fruit, like our modern fruit, like you said it’s not really, it’s more like candy with some, it’s like natural candy as opposed to the more ancient fruits so If I can find like some heirloom apples and that kind of stuff, I’m totally into it. 

Dr. Justin Marchegiani: Exactly. And you know, my general recommendation with carbohydrates, just make sure you earn it, make sure you’re not in a place where you’re inactive and try to get some activity because sugar goes three directions: gets stored in the liver and muscle, okay, so, if you’re working out, you’re always draining that muscle every day, you have a storage reservoir for it a little bit in the liver; It goes to fat or it stays in the bloodstream and gets burned up by the mitochondria essentially. It gets burnt up mitochondria-wise by the muscles etc. So, it’s gonna go either stored, burnt, you know, it’ll stay in the bloodstream but burnt up by the muscles of mitochondria or it gets converted to fat. So, if you’re doing things that allow you to utilize the glucose in that bloodstream, not as big of a deal, but that’s what you really have to look at what activity level is and you have to work with your functional medicine doctor about dialing in those macros and some people they need to starve out certain macros especially the fermentable carbohydrates and a lot of the inflammatory foods especially grains, legumes, dairy. Those things are really, can be, drive a lot of inflammation and that can keep your sympathetic nervous system and your immune system on high alert which just drains a lot of energy from you. Food allergens can make you fat and they can drain energy from you. Yeah. Seeds too. You know, I cut out almond seeds, nut seeds. Yep, even some eggs too for sure. 

Evan Brand: I cut out eggs for her while greens, I mean, some people are way overdoing it on the leafy greens. I can’t tell you the last time I ate a salad. I don’t really care. I don’t do leafy greens. I used to but, you know, I see way too many people doing these like kale smoothies. I had a lady doing like a pound of kale a day. Oxalates were off the chart. We know those affect the gut barrier too so there are downsides to plants. 

Dr. Justin Marchegiani: Yeah. I mean, it’s all about, you know, how you tolerate it, can you eat and feel good afterwards, how does your stool look? Do you see a bunch of undigested particulates? If so, you may want to work on just chewing your food up more. Taking some enzymes. See if that helps or sauteed it a little bit and see if that moves a needle. Again, there’s almost always a way, we can adjust things so it works but everyone’s a little different. 

Evan Brand: If you need further help, you can reach out to Dr. Justin at his website, justinhealth.com. Now, we do worldwide consultations, phone, facetime, skype, whatever it can connect to, we do it. Lab tests are sent around the world. It’s awesome we have distributors to work with. We can get these things to your door. We sign off on it and get you rolling so we can investigate and look deeper. So, justinhealth and then for me Evan Brand, it’s evanbrand.com. You can reach out and we’re both happy to help you. We love what we do. We’re very blessed for the opportunity to be in the trenches. We’re always improving our own health. We work on our families, our children. We work on everybody around us. We’re always trying to improve them and to be able to do it clinically too is just great. We learn so much from you all and we like to be the shining light in a world of darkness where people have been to countless practitioners and the stuff that to you and I is just common everyday conversation, functional medicine stuff. This stuff to some people is like wow why has nobody ever mentioned that to me before. And for us, it’s like, oh yeah uh-uh, we do it with everyone. So, we look forward to helping you uncover your root causes if you have gut inflammation, what’s going on. There’s something under it so don’t give up, keep pushing forward and please reach out if you need help. We’d love to help you.  

Dr. Justin Marchegiani: Yeah. Evanbrand.com, work at Evan. Dr. J, justinhealth.com, works with me. We are here with you guys. And, put your comments down below. Let us know the different things that you guys are applying, what’s working, what’s not and if you get overwhelmed listening to this. Try to take at least one action item out of it. I would say action items from a supplement standpoint. We’ll put our recommended supplements down below. We have different hydrochloric acid and enzyme support products that we’ll put down below for links. That’s always low hanging fruit. Again, diet wise, you know, a good autoimmune, lower fodmap diet can really be a good starting point and I would say for liver gallbladder, you know, we have our different formulas. I have one called liver supreme and again some of the hallmark nutrients in these products are gonna be bile, phosphatidylcholine, taurine, some products will have things like Tudca, which can be very helpful for biliary flow. Beetroot can be really helpful. if I didn’t mention Ox Biles. These are all maybe some milk thistle, very supportive for liver, gallbladder function, liver-gallbladder flow. So, very beneficial, we’ll put the links down below so if you guys enjoy the information and you wanna take action feel free to take a look at some of those links and support the show by grabbing some of those products and Evan will have his links down below as well. Anything else, Evan, you wanna add?

Evan Brand: I think, I said, we give people the links. Make sure you subscribe to the podcast if you’re listening on apple that’s probably where most people find us if you’re looking up. Justin’s show, make sure you subscribe there or my show, Evan Brand. We don’t care how you’re listening, you know, obviously we cross pollinate. We put these on each other so make sure you’re subscribed to both of them so you don’t miss it and we appreciate it. give us a review too. I think we should probably do a giveaway. I know some people giveaways so we can give away a book or you know free supplement or something but, in the meantime, give us a five star review on apple, we would love it. That’s how we stay up in the rankings so that we can actually share true functional medicine education to the masses because right now there’s still a lot of people that are in the top charts just theory. They’re not clinicians. They’re not in the trenches every day, all day, I mean we look at an exhaustive amount of lab testing that helps us to really dial the stuff we’re saying in. We then sprinkle in some studies and we stay up on the research but you could keep your head in the research all day and totally miss what actually works and it’s all about what actually gets people the results. So, keep that in mind and make sure you subscribe. Give us a review on Apple, we’ll love you forever. Thank you. 

Dr. Justin Marchegiani: 110% All the links will be below for you guys. Alright, thanks a lot. Evan, great chat with you man. Have a good one. Bye everyone.  

Evan Brand: You too, take it easy. Bye-bye. 


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/signs-and-solution-for-gut-inflammation-and-leaky-gut-podcast-351

Recommended products:

Enzyme Synergy

TRUCOLLAGEN

Liver Supreme

Digest Synergy

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Genova NutErval

The Top Causes of Gut Inflammation | Podcast #260

It’s Thanksgiving season! For today’s episode, Dr. J and Evan Brand talk about diet and lifestyle strategies during the holidays, how the food we take causes a few gut inflammation, how we address it and how we can treat it. Check out this podcast to learn more.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover: 

00:01 Thanksgiving, Instant Pot

06:38 Oils for the body

13:34 Food additives

20:55 Stress

28:52 Circadian rhythm

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Dr. Justin Marchegiani: And we are live it’s Dr. J here in the house with Evan Brand. Evan, how are you doing man? How was your Thanksgiving?

Evan Brand: I’m doing very good. I made my first Turkey. And it turned out wonderful I was in the in the Cooksey this year and I really enjoyed it. We did a pasture fed turkey that we got from like 20 minutes down the road. And we did the brine we went to Whole Foods and got this like organic seasoning Brian combo that we put in a big ol VAT basically let the turkey sit in there for 1314 hours and rubbed a bunch of grass fed butter on it the next day, put some herbs and stuff on top and bake the bad boy, I want to hear about your experience because because baking is kind of boring. You did something a lot more fun.

Dr. Justin Marchegiani: Yeah, I’ve been smoking my Thanksgiving Day Turkey for the last five years. You know, being in Austin and with Texas barbecue. I was like hey, let’s let’s let’s do it. The old Texas style so I got a trigger smoker. I think we did. I posted an Instagram and Facebook picture honest I didn’t want it wants to take a look, you can feel free to head over to my Facebook or Instagram page. And we smoked it. I think it was Apple, cherry and oak. And it came out great did about four hour time cooked it about 250 to 280 degrees or so. And it came out phenomenal. So really great.

Evan Brand: Well other people can do Turkeys like people that are in other countries, if you don’t celebrate Thanksgiving, it doesn’t mean you can’t smoke a turkey. That’s the interesting thing. Like we do these really, really good meals, but it’s only for like one day a year. It’s like why not smoke a turkey? Just randomly maybe we should do that.

Dr. Justin Marchegiani: I like it. I mean, I paid a little bit more money to have the turkey be like pasture fed, organic, high quality. So great meal. Excellent. My animals are still benefiting from all the the kind of the, let’s say all the cartilaginous connective tissue that I could scrounge off the carcass afterwards, so they’re loving it.

Evan Brand: Oh, yeah. Speaking of I threw the carcass out in the woods and my shih tzu she went out there and found it and I guess she gorgeous herself on the carcass and so she spent the rest of the day you can guess what she was doing. She was throwing it all up. She ate her her body weight and carcass. Oh man. That’s crazy. Very cool. So that was a bad mistake and then the turkey vultures came in the next day and finish the carcass off which was pretty cool to see. That is cool. Excellent. The life cycle thank you for the turkeys. Yeah circle of life totally.

Dr. Justin Marchegiani: Well, that’s cool. I mean, we’ve talked about a lot of diet and lifestyle strategies during the holiday. So you know some of the sites that I did good quality mashed potatoes grass fed butter, we did a gluten free grain free pumpkin pie kept it really simple. And then we just did it like green beans with some bacon in there. Some asparagus. Some squash, kept it really simple, really clean, high quality food. So it was overall great, great holiday love Thanksgiving.

Evan Brand: Yeah, we did green beans and the pressure cooker the Instant Pot which turned out good aids, put some garlic salt in there. It took like six minutes. Throw your green beans in threw in some butter threw in. She might have threw in a little avocado oil too. I can’t remember. But then some garlic salt, and of course some bacon six minutes. It was perfect. We did bake sweet potatoes, slice them up. Just put some cinnamon and coconut sugar on them with butter, put them in the oven, bake them. What else did we do almond flour muffins. Those were good. Put some almond butter on top of those bad boys. That was kind of our dessert. And yeah, so people talk about their board, and then they go off their diet. So we’re kind of transitioning into the topic of gut inflammation and the causes of it. Yes, but a lot of people sabotage themselves because they say that they get bored of their diet and they don’t know what to eat. But you could eat sweet potatoes and Turkey and green beans all the time and be totally healthy and not bored.

Dr. Justin Marchegiani: Yeah, it’s typically not a good excuse. Because people that say that say they’re bored. It sounds like their diet is that of a world traveler where they’re eating all this fine cuisine. Every now and then I see it but most of the time it’s not. It’s kind of like boring grains are boring, boring, kind of conventional. Food I think I’ve seen data on it that the average person only eats 12 foods in their lifetime on at-

Evan Brand: I’ll believe it.

Dr. Justin Marchegiani: So the fact that someone’s like well I’m bored it’s like yeah yeah but on average you’re not eating that many foods and you can really create a lot of variety eating some of the you know, paleo template foods there’s a lot of options especially with me obviously any kind of meat any kind of vegetable within reason and then healthy fats and then dialing in the carbs according to what you need and really emphasizing on food quality is important so I like that also in support man, mashed potatoes 10 minutes Easy peasy done where like you may be boiling potatoes for like, you know 45 minutes to an hour or baking them for an hour before you mash them. So really saves time. Now this may be a dumb question, but are you you’re not mashing those beforehand. You’re just throwing in like the chunks and then pressure cook the chunks. Not even a chunk, man, just the whole potato. Oh, wow. Okay, like I just throw the whole potato in done 10 minutes. Put it out, throw it on a Pyrex tray, maximum Mash mash mash mash butter salt done, beautiful like, Okay, I’m gonna try it the Instant pot really saves a lot of time you can do ribs on that thing and like 30 minutes or normally may take you five hours, I think is a really good invention. The only issue with the Instant pot is you just got to be really focused and you got to make sure that you vent it when you open the thing up. And also make sure that little kind of little thing that pops up. It’s like a little kind of meter device that pops up make sure it falls back down below so you know it’s not pressurized when you open it up and a couple of patients will burn themselves or you can read stuff online where people open it up and it is like a bomb if you open it up without depressurizing

Evan Brand: and thank you to today’s sponsor Instant Pot.

Dr. Justin Marchegiani: Yeah, Instant Pot! I’ll put will put our Amazon links below so if anyone wants to access the Instant Pot will put the link below we’d like it. It’s really good.

Evan Brand: That is a joke. They’re not technically sponsoring the podcast but I did see some good Black Friday deals on those. So even if you’re listening to this like a year from now, I mean the instant pots generally 100 bucks or less. So I think it should be It should be in your cooking strategy. And that way, you’re not going to be eating some of the garbage that we’re talking about, like industrial seed oils. Why don’t we talk about this, let’s dive into some of these big causes of things that people are doing to destroy their gut lining.

Dr. Justin Marchegiani: Yeah. And just to highlight one more thing before we move on is anytime we talk about a product, we’ve actually used it ourselves and we like it. So we want to be 100% authentic about products, if we if we like it, and we’ve used it, we will talk about it just know if we are talking about it. It’s because we’ve used it and we like it. we approve it. Awesome. So let’s go dive into so you were just talking about the some of the top things that drive gut inflammation, take it away.

Evan Brand: Yeah. So the the big oils, that’s that’s the problem is a lot of these oils. And if you look at the standard American diet, just even 100 years ago, your grandparents or your great grandparents, they did not have access to these type of oils. They were going to be cooking with your traditional fast like they’re going to be doing a lot of lard and maybe some beef tallow Some of these traditional fats like if I asked my grandfather, what did your grandmother cook you? And what does she cook it with? She was not using soybean oil. She was not using corn oil. She was not using grapeseed oil, which is canola. She was not using peanut oil. And if they did something fried, it was going to be fried and possibly bacon fat, which came from the pig in the backyard of the farm, or it was going to be cooked in some type of like a beef tallow where the cows were on the back part of the farm. my grandpa’s grandparents had like 300 acres, and they had a bunch of cows back there. So it wasn’t, hey, we’re going to take this canola oil, we’re going to coat which really annoying as I’ve seen some gluten free fish out there like some breaded fish, but the problem is it’s loaded with canola oil. So it’s kind of like do you take the risk, like the pros and cons does the implement the implement inflammatory component of the canola oil does that counteract this this damaged Seed Oil, does that counteract the benefit of the cod or the salmon or whatever else you get? And the answer is, I don’t know. I think you kind of have to choose your battles. What’s your what’s your comment on it?

Dr. Justin Marchegiani: Yeah, so when it comes down to fats, most plant fats are not going to be the best unless they’re cold extracted, or unless they’re minimally processed to extract the fats, partly because of the processes of extracting attends the damage to the fats, because the heat and the extraction process also makes the fats rancid and taste bad. There’s a lot of like deodorizing and filtration, and different processes to make it more palatable that you would never be able to have it a natural state. So the best plant fats are going to be obviously number one is coconut oil, because it’s a saturated fat, it’s any more temperature stable. And then number two would be like either a cold pressed olive oil or a good quality avocado which is primarily amodo one saturated fat and then premier something like a palm, which is more in a kind of saturated state. And then of course, you can do outside of that, and avocado oil would be pretty reasonable. And those would be my top ones on the plant side. Is there anything you wanted to add there, I mean, there are some nut based some sea based oils, but then you start ramping up the Omega six. And those may not be the best. There are some supplemental oils that are more GLA based that I’ll give supplementally like black currant seed oil, but will give it supplementally and that’s coming from great sources that are going to be in capsules that won’t be oxidized and such that will be really good and you know, wouldn’t be an oil, I hope it wasn’t my top animal or top plant based fats. And yeah, that’s going to be really helpful because bad fats are going to one create a lot of oxidative stress. And they’re going to deplete a lot of your antioxidant reserves. Because if those fats are oxidize, your bodies need a lot of vitamin C and vitamin E to help with the oxidative stress that those fats may cause your body.

Evan Brand: Very true. Let me ask you the question about the The breading so like you find a good fish, but it’s a gluten free breading. So it’s not covered in wheat. But it’s some type of non gluten containing flour, but then you’ve got canola oil. Do you think you’re still going to be net positive in terms of nutrition because you still got the good fish, but yet you’ve got the inflammatory oils? Or would you say, just get you some grilled fish? And then if you want to read it, you read it yourself?

Dr. Justin Marchegiani: Yeah, I mean, I’m, I’m on the fence with that there’s a product that we like, I think it’s Alexis, and they have two potato fries. And my wife will do that for my son just because it’s really easy, but they have a little bit of canola oil in there. So it’s like Ah, so you have this kind of convenience factor where ideally, if you could, you always would want to put your own fat on there if you could, and my eat my easy saturated fat or my easy fat for cooking. That’s plant based would be like avocado. I like all avocado because it tastes a little bit more neutral. I do not like olive oil as much olive oil is better for dressings, but I’ll do it Hello for cooking so I’m kind of on the fence with that but I would tend to if you have control over it You always choose the better fat over the junkie fat if you can.

Evan Brand: Yeah, yeah, well said so, the interesting thing is like coconut oil and avocado, they’ve become kind of trendy and I would say avocado is not going to be a traditional fat meaning like traditional people, we’re probably not doing it because you’ve got to have some heavy duty equipment to extract oil but coconut oil would be super traditional. I mean, this would be something that help historical use

Dr. Justin Marchegiani: Yeah, I mean, if you’re eating a whole avocado you’d be able to have access to that that wouldn’t be a problem but the the actual oil portions what you’re talking about, right yeah,

Evan Brand: I’m talking just you know, pouring it in your in your pan and cooking something with it.

Dr. Justin Marchegiani: Yeah, your your big fats that are going to be plant based would probably be primarily coconut. But then your your biggest ones that I think are going to be used more, you know, long term from generation to generation will be your like your Talos, right? Your bacon fat, your duck fat, those kind of things because saturated fats don’t go bad, right. They stay good for Long time because the carbon is saturated with four hydrogen bonds between them, which makes the fat really really really temperature stable.

Evan Brand: It’s beautiful. Alright, so we hit the we hit the oils, those are bad, they’re bad for your gut. They cause inflammation, oxidative stress, food additives. Let’s talk about those next. Here’s the hard part is food additives are in literally everything you could even go and get like an organic. I was looking at some organic gravy, like a gravy mixture, but it had added stuff to it like maltodextrin and flavors and stuff like that. And so of course you always there’s a spectrum right there’s the straight garbage MSG, caragenin Splenda type things that will go into but then you’ve got the spectrum where maybe you find organic spices that had a little flavor added but it was an organic flavor, and you don’t worry about it as much.

Dr. Justin Marchegiani: Correct. Yep. I like that the spices and the flavoring are going to be big, MSG, aspartame, they’re going to be more excited toxins. They can increase brain fog. They can stimulate your brain neurons to death, so to speak. That’s where some of that data came from. So not the best thing long term. And of course, you know, inflammation in the gut can create inflammation in the brain. So if you’re listening to this, and you don’t have any gut issues, most people associate foods or additives or bad fats with gut issues, but a lot of times it could just be increased inflammation. And that inflammation could be manifesting from joint pain or headaches or mood issues or brain fog. So just remember when we talk about some of these things, it may not necessarily be connected to a digestive issue or a gut issue. And that’s the hardest thing people to wrap their heads around.

Evan Brand: Yeah, let’s talk about this study we’ve got here on food additives, specifically Splenda, it’s ridiculous. You’ll see things that are promoted as healthy but then they have added Splenda to them. You have to there was a paper it was 2018 inflammatory bowel disease was the paper I guess I don’t see any other any other journal it was from but long story short, Splenda. It says here in the in the conclusion of the study Is that Splenda promoted dysbiosis. And we did a whole show on that. We’ve done many, many, many on dysbiosis. But basically an imbalance of good and bad bacteria, which then creates inflammation, intestinal permeability, and on and on. But all you could do that just with Splenda. So it’s like, oh, I eat paleo, but yet I put Splenda. We’re like when those little fake drink packets, you know those little Have you seen those the little packets where it’s like a fruit punch and you put it in your water, but it’s got Splenda instead of stevia. It’s just

Dr. Justin Marchegiani: not good. Not good. Yeah. If you want something like that, you’re much better off getting their Sweet Leaf brand and put a couple of drops of stevia in there with something like that or using an essential oil like lemon or lime or just grabbing a lime or lemon and just squeezing in and that’s a much better way to do it.

Evan Brand: I like to do monk fruit, I’ve got a lot of some monk fruit liquid. And so we’ll just take half along half a lemon, about five drops among crew and you’ve got an amazing lemonade and you’re not going to need any of those little face. Splenda, flavor packs, they’re just terrible.

Dr. Justin Marchegiani: Yeah, and with flavoring in general, you want to make it a minority of the time, because when you’re putting something a whole bunch of sweet stuff in there, and your tongue is hitting sweet your brains like program that sweet means calories. And calories also mean sugar as well. So there could be a minor insulin spike that could happen. And it’s just not good to program your brain. Sweet, sweet, sweet, no nutrition, no calorie. So it’s not good to have that long term. But if we’re kind of doing an 8020 thing, and that’s kind of in your 20%, and you’re trying to use a healthy cheat option as a replacement, I think it’s fine.

Evan Brand: Yeah. And you’re saying, basically, the body’s getting tricked, even if it is a natural sweetener. You don’t want to hit that sweet button over and over.

Dr. Justin Marchegiani: Yeah, I just want to draw a line between everyday staples and things that are healthier cheat options that’s in the healthier cheat option. categories, not a healthier staple category.

Evan Brand: Yeah, you don’t want to live on like the stevia soda, for example. 

Dr. Justin Marchegiani: Exactly. Yeah, exactly. Your Much better off staples would be Topachico Pellegrino filtered water, maybe add an essential oil to it or add a squeezed lemon or lime. Those are going to be more of your staples and these other things they’re going to be in your 20% category.

Evan Brand: Let’s talk about this to those another paper that we had here on karijini which is a seaweed based polysaccharide. A lot of times it’s put in toothpaste, but it’s often in a lot of food and like sauces and anything that needs to be thick. So a lot of times now you’ll see caragenin free in certain products, but that also can exacerbate inflammatory bowel disease. And there are some papers on both splenda and Caragenin, so caragenin is probably healthier than Splenda. But it can still negatively affect the gut. And at the end of the day, we’re just saying eat real food because if it’s not processed, if it’s a process, paleo style food, it could still have some negative qualities to it.

Dr. Justin Marchegiani: Got it? Yep. 100% 100% agree. Yeah, you have a courageous And there’s another one I forget. That’s like an emulsifier. Like that was like guar gum. Yeah, that’s what it is. Some of those I think are also a little bit higher at fodmaps, too. So people that have significant tseebo can sometimes get a little bit more bloated from some of those things. So it’s good to keep those in mind. I know there’s I think its native forest. It makes the coconut milk coconut cream without the guar gum. So another thing that could be there, there’s some studies showing that can be beneficial and not bad. So kind of go back and forth on it. So if you have a negative implication with it, that could be it and you may want to just find a healthier, healthier option. Yeah. What’s next on the list you want to talk about? Well, let’s go over gut infections. We talked about gut infections all the time. We see patients that come in that think their issue is a Candida or they think it’s an H. pylori, and sometimes it can be all the all of the above, and we don’t even know that. So it’s really important that we get some good testing done. It’s really important that when we have a gut infection, we have to have a sequence and how we deal with it. So people that have got infections you got to make the day changes you have to work on the digestion first because those can be serious impediments for your body healing. And the gut infection a lot of times can be part of the reason why you don’t feel good. Sometimes it can be all of the reason, but I’d say most people, it’s part of a couple other things that are happening. But people you know, we’re in a culture that’s very antibiotic driven. Oh, you have staff you have strep, kill it now antibiotic, you know, laser beam focused, hit it. And that may not be the case. And number one, it can be a big letdown. People are like, Oh, man, you know, that didn’t that wasn’t it. But number two, a lot of times they can feel worse. So you really want to make sure if there is an infection, that you have a plan that’s comprehensive in nature, that’s addressing what’s going on and again, this may be a little different if it’s totally acute, like hey, I’m in Mexico, I’m feeling great. Boom, I eat something. I feel like crap, I have diarrhea I have. Okay, we may create a different plan based upon the clinical history leading up to this point, and then how acute the symptoms are

Evan Brand: Im glad you mentioned too there’s a sort of an order of operations to that too, because there may be higher priority infections driving inflammation, as opposed to if you’ve got some Candida. Yes, Candida can be a huge problem. I did a whole summit on Candida. But if you had h pylori, we’re going to prioritize H. pylori over Candida because it’s going to affect much, much more mechanisms in the body.

Dr. Justin Marchegiani: 100% 100% I’d also say next thing is just adrenal stress. In general, we know that high levels of cortisol are going to decrease gut barrier function, it’s going to break down IGA or immunoglobulin A, which can have a beneficial effect on helping the immune system it can gobble up or potentially attack some infections that may make their way into the gut. The idea that like you get exposed to an infection, and that you automatically get infected, isn’t necessarily true. So there’s a couple of ways that may happen. Number one is you get exposed to a large amount of an infectious material overwhelms overwhelms your immune response and you’re sick no matter how healthy you are. This could be like, you’re healthy, you go for a hike, you drink some lake water, boom, you got grd or you’re sick. There’s that. There’s also Hey, you get exposed to just, you know a lot of different microbes over time. your gut is stress from cortisol and IGA imbalances. Maybe you have some food allergens too. Maybe your stomach acid and enzymes have dropped. Now boom, a stressful event happens. Now you start getting sick, because your gut your digestion, your inflammation accumulates. All stress summit’s are accumulates in the body, and the gut barrier breaks down and cortisol and stress can go high, which can cause your gut barrier to break down. And then when it finally drops, that’s going to make it hard for us to deal with inflammation. It’s gonna make it hard to build back that immunoglobulin barrier. And it’s going to make it hard to have energy and deal with stress.

Evan Brand: Yeah, so when people hear stress, they kind of just tune out because they’re like, everybody talks about stress. What am I supposed to do just meditate and do yoga. So here’s kind of the, I guess the granular in the flesh example of what could happen. Let’s take someone who has a bad boss, and every Monday when they go to work, they get a knot in their stomach, they feel sick to their stomach, because they know they’re going to go in, they’ve got this micromanaging boss that they hate, or I’ve got somebody that wears perfume that makes them sick next to them. So they have this fight or flight reaction, every Monday morning, and then Tuesday and on and on and on. So it might not be that your relationships are stressed, it could be but your relationships could be great your family life, your kids, I mean, your home life, all that could be great. But then you have this stress everyday of a boss that is still enough to degrade the gut barrier and cause issues over time. And we’ve seen that happen where, let’s say the boss gets transferred out and then they have a new boss that comes in and it’s a better boss and all of a sudden this person’s got complaints magically goes away. It was just because of that fight or flight reaction getting turned off. They were able to relax it. They’re just And then that parasympathetic healing reaction came in and started to work on the gut.

Dr. Justin Marchegiani: Yeah, many people, they kind of like categorize their stress, they kind of just say stress is, and they put it all their stress in the emotional category, work relationships, family finances, but they forget that the gluten that a meeting, or the Gup is now putting stress on my body. So now my emotional reserves drop. So instead of being able to have three or four emotional stress problems at one time, now I can only deal with one. And then now I’m flipping out on my kids or I’m arguing with my wife and we’re fighting more or losing my cool at work part of that is is because that emotional stress bandwidth drops when other stressors come in. So it’s like, people just kind of look at emotional stress, like it’s this, this thing unto itself and I just have to change my strategy or or meditate more, but a lot of times, fixing the other stressors that we talked about, allow more bandwidth to be allocated to that part. The system.

Evan Brand: Oh, well said Amazing, amazing, important point. It’s like, Okay, I’m gonna eat my avocado toast, and then go do yoga. It’s like, Ah, you gotta realize that bread or whatever it is that processed stuff is damaging the gut. So you could just have a completely stress free life. You might even be retired. But yet you had a donut, and then you feel like crap. And you don’t know why it sounds so simple. Like when we pointed out, it’s like, duh, but I’m glad you brought it up because people skip out on that. They don’t realize, Hey, I ate this. Now I damaged the gut. Now I have this emotional response, or I have an overreaction, because then then you get into the whole conversation of blood sugar too, right? It’s like, Okay, I’m eating these foods that are causing the blood sugar to spike and then crash and spiking crash. That is a stress. Even if your life is not stressful, you’ve still got stress

Dr. Justin Marchegiani: 100% and again, a lot of these things, they aren’t intuitive. The reason why they’re there are Our radar is because we see it clinically play out over and over and over again. It’s like, Hey, you change the diet, you you see some new nutritional compounds or nutrients are low in the person’s diet, we stopped them that we fixed digestion, hey, there may be an infection we work on that we support the adrenal, and now the person’s productivity at work. And they’re like, yeah, work isn’t as stressful. It’s okay, because your bandwidth has been freed up. It’s like you got this program in the background, that is just sucking up all of your RAM. And then now we close down that program or we update the software and get a better version for your operating system. And it’s like, boom, now, things aren’t as big of a deal.

Evan Brand: Not to mention, if we throw in some adaptogenic herbs or some liver support, you really start to have a lot more RAM available. So it’s amazing because people they may not have much change in their day to day life, but the way they respond to that day to day stress is significantly better. And that’s priceless.

Dr. Justin Marchegiani: And I see it can affect women a little bit more because of their cycle. And a lot of women they know like always week before their cycle, they are up in arms regarding headaches or breast tenderness or back pain or mood stuff, or they’re just losing a lot of blood, which causes them to be anemic. And then they have low iron and their energy drops. So a lot of times it can compound a lot of those female hormones and make them feel not good for a week. And so a lot of times, the first thing we see with women is that PMS starts to go from maybe seven days to like one or two. And that’s a huge thing, or their irritability or breast tenderness switches a lot. Because with women, progesterone is actually a precursor to their stress hormones. So when they start getting stressed, they lose their progesterone, and they start becoming estrogen dominant. And then all of those estrogen dominance symptoms, some I just mentioned, start to become activated.

Evan Brand: Yeah, the thing the the issues with the hormones are more apparent during the cycle,

Dr. Justin Marchegiani: it’s more apparent. So if you’re a woman listening to this and your PMS starts getting worse. That’s the first thing we Look at is what stressors have been activated. You know, women’s cycles are more women’s hormonal rhythms are more intricate. They’re like a beautiful Symphony that has the the, the the wind instruments, the string instruments, the percussion instruments. And when one instrument starts to go off, that Symphony turns to noise pretty fast for men are just kind of, like a foghorn, are kind of like a one note instrument that’s just kind of in the background the whole time. So it’s a little bit it’s a little bit harder to knock that the foghorn off. But the symphony, it’s easier to make it sound not so good, fast.

Evan Brand: Yeah, the women are like, Oh, he just won me over. He called my hormones and beautiful Symphony.

Dr. Justin Marchegiani: It’s a lot of stuff happening underneath the hood. And it’s amazing when you can just get the estrogen dominance under control, and now you’re not as anemic. And then now you’re able to carry oxygen better and your mitochondria works better and your thyroid works better. And then also when your progesterone levels come up a little bit more. Now you’re able to open those Gabba chloride channels. You’re not as anxious you’re not as Moody, the estrogen dominance drops to the breast tenderness and the muscle contraction causing the back pains now gone. It’s amazing what happens. And some women, it’s sad they live some have half their cycle is is almost like a PMS kind of up and down wagon. The goal is maybe we have one or two days or maybe it’s a half a day and it sneaks up on you. That’s the ideal goal. And it’s because you know, the husband’s benefit too. And the women are far more productive, and they feel better.

Evan Brand: Absolutely. Yeah. 

Dr. Justin Marchegiani: And also just kind of like comparing contrasting, you know, what are your options, right? Ladies listening, you know what your options are? It’s going to be birth control pill, and then those have their own side effects. It’s going to be an antidepressant. And that’s pretty much it. And then if you’re menopausal, maybe it’s the HRT hopefully they’ll recommend the Premarin provera which is horse hormones, right? So those are your pretty much your three options. And then of course, you know, ibuprofen, might all those kind of things to manage any pain or cramping, you don’t really have that much so and none of its true causal, right. None of its true causal.

Evan Brand: Yeah, so I just want to point out that just because something is common doesn’t make it normal so if you and all your female co workers or your female friends you all complain about your periods together and oh my god my periods so miserable my PMS and my husband better watch out today it’s like ah yes common but not normal My wife is a breeze through her cycle and even in the postpartum period, it was great and her cycle came back normal and there wasn’t anything crazy and I think it’s just because we’ve we’ve tried and put so much work into this years and years and years you do start to get this point where Hey, the periods sneaks up on you and you had the golden points

Dr. Justin Marchegiani: we wanted to sneak up on them or at least get it down to like one or two minor days versus you know major or even a week or plus of major stuff.

Evan Brand: And this is not a pipe dream. This is a reality that we see all the time clinically and thousand percent and also.

Dr. Justin Marchegiani: Hundreds for sure. Yep, hundred percent. Also, let’s go talk about circadian rhythm or sleep stuff right? We know sleeps a big deal because That’s where we recharge a lot of our hormones, our adrenal and our neurotransmitters. And these are really important for stress. So if we don’t recharge these glandular systems, if we don’t recharge our neurotransmitters, that our ability to deal with stress gets forwarded. And the more we’re not able to deal with perceived stress, the more our guts going to be broken down and affected, the more our sympathetic nervous system will be affected. So it’s a lot of stress is perception based where you could take someone who has a larger bandwidth to deal with stress, put them in the same situation and they may not have the same physiological sympathetic nervous system response because they have more bandwidth than you. And then if that response isn’t happening, then they’re not going to have all the side effects of you know, the sympathetic nervous system, decreasing stomach acid or enzymes are breaking down their gut lining or making it hard to break down food. So the more we can allocate good bandwidth through recharging our neurotransmitters adrenaline dopa mean Gabba recharging are glandular systems, right pituitary adrenal thyroid ovaries, the better chance testicles, a better chance that we are going to be able to deal with stress the next day.

Evan Brand: Yeah. Well said, Well, we’ve got a couple papers on this. So why don’t we talk about this here regarding the circadian rhythm disruption. You know, we’re talking to people specifically that are working night shift or swing shift, or people that are just using artificial light at night. They’re not protecting themselves from the nighttime EMF and light exposure, even just a couple of days, which is kind of hard to believe but even just a couple of days of circadian rhythm disruption. So what that means is I’m talking to the people who they go to bed at 9pm on the work day, but then they stay up till midnight or 1am or 2am on the weekends. Just those two to three days is enough to create changes in your gut, increasing the pro inflammatory bacterial species. So long story short, you need to go to bed at the same time, every day. You’re not typically going to benefit. I mean, maybe you have more social life and you go out and I don’t know drink some poison at the club and poison your gut and start to kill your liver even more. And then you stay up all and then you’re hungover the next day. I mean, God, I just don’t see the benefit of that lifestyle if that’s what you got to do. Okay, but just know hey, there’s paper showing you doing those weekend benches just on Netflix, if even if you’re like, I don’t drink alcohol evidence, poison, I know you’re right. Okay, you stay up till 1am watching something. But on the weekday, you went to bed at nine, that is still messing up your gut and if your gut is messed up, then you really can’t afford to, to lose that benefit. That could be another 10 or 20% of your issue right there.

Dr. Justin Marchegiani: Correct. So do your best. People are going to stay up later on the weekend. It just is going to be what it is. So we can always use extra magnesium. We can use glutathione before bed. If we’re going to drink alcohol, we can always use activated We can make sure we do our best to get to sleep a little bit more to get sneak it up on the back end and just do our best to maybe take a tiny bit of melatonin or a little bit of natural sleep support to kind of get us back on track start the week. So we kind of have like our goal of perfect and then we have things that we can biohack to get us back on track and still cheat a little bit.

Evan Brand: Call me boring. And maybe it’s just because I have kids that are young, but I go to bed pretty much the same time every night. So maybe in five years, you’ll be listening to this podcast and be like, oh, Evan, remember when you used to go to bed at nine every day? Or 10? You know, I don’t? Maybe Maybe I’ll change but for now, every night is about same time for me and I feel good.

Dr. Justin Marchegiani: Yep, I agree. I think it’s great. A couple of the things on medication side of the fence we we got to talk about this is important. So there’s a couple of different medications that I consider to be destructive. Number one are going to be the antibiotics and sometimes it may be necessary if you’re in a difficult situation. But if we can have a couple of tools that we can utilize, we may be able to avoid it right we have different herbs that we can use. Oil of oregano golden sea We have different formulas like in my gi clear line, we have chapter one through six that will use in certain occasions and evidence the same as you will with you, you have some of the microbiome products that are used in similar situations, a lot of times this can be beneficial and prevent the need for antibiotics to be just given right off the bat number one. And then of course number two would be things that affect digestion, proton pump inhibitors on nippers, old pentapresol, any acid blockers or h2 blockers that are designed to disrupt or lower stomach acid can be a big deal because that’s going to make it hard for you to break down your food. Think of HCl as your natural kind of bleach or disinfectant for the dirty picnic table, right. So it keeps the gut microbes from growing out of control. It helps break down the proteins, it starts initiating all the domino reactions for digestion. And that good acidity helps close the esophageal sphincter and prevents things from also rising up as well.

Evan Brand: I’ve seen probably no joke within the last six months to a year 50 to 100 children ranging from six months old to 15. And above years old, have kids that are clients of mine that were put on proton pump inhibitors by their pediatrician or by the gastroenterologist. I’m talking like you got a one year old kid that has some skin rashes, or there’s something going on maybe it’s burping or maybe it’s gas or something’s just not right with a one year old. And they don’t even bring up diet changes at all. If they’re still being breastfed. They don’t bring what’s in the mom’s diet into the consideration. It’s just here’s a PPI for a one year old. I mean, it’s almost criminal.

Dr. Justin Marchegiani: It is, I mean, they’ll do the tagamet a lot of times, and most of the time, it’s just the, the mom typically is eating a food allergen that’s usually driving it or they’re just could be some needed some extra probiotics and that can be a big one. So we’ll do some of the infantis blend of probiotics to help with some of the newborns And we’ll really look at some of the food allergens in the mom that can help a ton.

Evan Brand: There’s dysbiosis and kids all the time though, man, we’ve talked about this before, but my daughter when we first ran her stool test, she was around two years old, and she had various parasites and bacterial overgrowth, got rid of that retested showed up with H. pylori, got rid of that retested showed up with some other bugs. And so these bugs are everywhere. We don’t expect you to avoid them tap water, soil food, I mean, your kids are playing in the dirt, you’re playing in the dirt. Hopefully, you’re going to get exposed to these things. A lot of people ask us the question of Hey, Dr. J. Evan. How do I avoid these you can’t it’s just a matter of you trying to be resilient enough and you have, like you said adequate levels of stomach acid to prevent if you do drink tap water or you eat the sushi and you get exposed to blasto. Hopefully your HCl kills it off and it doesn’t become an infection. But most of the time, people are too stressed and too overwhelmed and that system, the protective response is altered or reduced

Dr. Justin Marchegiani: 100% 100% Last thing I wanted to highlight was just environmental toxins. This could be things ranging from heavy metals, like aluminum or mercury or lead that could be damaging to the gut lining and also the neurological tissue. Right. Remember your nervous system and your entire nervous system is located in the gut. So that can have a big impact and as well as things like mold and mycotoxins, as Evan knows, environmental mold, can cause lots of gut issues I’ve seen it caused lots of digestive distress, bloating, I seen it affect motility. And then of course, when that happens, then it can affect your vestibular system, mood, energy, everything else. So I’d say molds a big one. I’d say heavy metals are a big one and of course, environmental estrogens whether it’s pesticides or plastics, whether it’s Bisphenol A or dioxin or Falaise, any of these compounds that are kind of in plasticizer compounds.

Evan Brand: Yeah, your chemicals in your food, which we always talk about killing your good bacteria. That’s basically an animal biotic, you know, glyphosate is essentially an antibiotic in the sense that it kills good bacteria and promotes dysbiotic flora. So, yeah, I think that’s a huge point. 

Dr. Justin Marchegiani: I think it’s important and we can talk about, you know, each one of these topics could be one podcast in and of itself, and they probably already have since we have hundreds in the bank, so anyone listening really enjoys the content, click below, make sure you access some of the great handouts and great links on our websites. We have transcriptions as well that you can get access to. And if you want to dive in deeper because you think one of these things may be an issue with you feel free. Click below to access Evan brand calm or just in health, calm me, Dr. Justin, and we can dive in deeper and work on getting to the root cause. any last comments, Evan?

Evan Brand: I would just say we’re really grateful to be in the opportunity to help people so most of you all we’re just helping you because you’re listening and you’re making changes but if you feel like you’re buying random supplements, you don’t know what you’re doing. You’re building up a supplement graveyard. hire some help. I know a lot of people they they don’t want to That because they feel that they need to, like maintain their pride or like I’m a biohacker I’m going to do it myself. It’s like, I try that. I mean, you know how much Justin’s helped me, we help each other, you know, so so we’re in this to, we’re not in it to prove that you can do it by yourself. We’re in it to make sure that you can get better and get back to enjoying your life. So don’t try to like be a hero. It’s okay. You’re not a failure if you need help from somebody.

Dr. Justin Marchegiani: Yeah, if you need a functional medicine, Sherpa, you know where your guys in general you don’t go hike Mount Everest without a Sherpa without a guide to help you. And that’s what we are the equivalent of so hope everyone enjoys it. If you enjoy it, share it with a friend or family or member a loved one that is struggling or need some of this support. It’s totally free. 99.9% people we don’t even work with directly they’re just utilizing this free content. So we just ask that everyone to utilize some of this information so they can get healthier first. It helps everyone become a better parent, a better person, a better employee, a better entrepreneur helps everyone in every single way possible. So we love that and it’s our country. the contribution to the world. Anything else, Evan?

Evan Brand: Oh, that’s beautiful, beautiful way to end it. Nope. I’ve got nothing else you all take care.

Dr. Justin Marchegiani: Hey, excellent, everyone, have a great day. Take care. Take care. Bye bye bye


References:

https://justinhealth.com/

Audio Podcast:  

http://justinhealth.libsyn.com/the-top-causes-of-gut-inflammation-podcast-260

 

The Importance of GI Testing and the GI Map | Podcast #259

Today our topic is on the importance of gut testing. This kind of testing is kind of what we use in our functional medicine processes. It can pinpoint the precise and accurate levels of different types of microbes in your gut. Know the pros and cons of gut testing and why it is very important. Check this podcast we have with Evan Brand.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:36 Contributing factors to Gut Inflammation

11:30 H. Pylori

14:31 Overgrowth category

26:13 Immune System Health

36:34 Antibiotics

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Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand hope everyone is doing fabulous here today, we are going to be talking about the importance of gut testing. Super, super important is a couple of modalities that we use kind of at our functional medicine tool belt. And gut testing is super important. We’re going to kind of go in the ins and outs of gut testing why it’s important. We’re going to break down some of the GI map actual testing as well. And we’re going to go through what a typical test looks like. What we’re actually assessing what we’re looking for infections, functional analysis, other intestinal health markers, like inflammation IGA levels, beta glucuronidase, steatocrit, elastase we’re going to break it all down. We’re trying to bring everyone actionable information that you know a lot of doctors, a lot of people you see online, they’re not releasing things So a lot of the stuff they talk about, it’s kind of theoretical, and it’s not really applied. So everything that we’re talking about today has actually been applied with thousands of patients so hoping everyone enjoys. So while we’re on the topic, Evan, how are you doing today, man? 

Evan Brand: I’m doing pretty good. I’m trying to look for a stool test. It’s like really bad because it’s more fun right when you see ones that just have tons of infections on there, and I’ve got it I’ve got a good one here that we can dive into. I was just trying to find one with a high beta glucuronidase because that was one key point that I wanted to talk about with you is that many people are sick because of having high Beta glucuronidase which is an enzyme that goes high due to bacterial overgrowth in the gut. And so many people talk about, Well, you’ve got to take calcium gluconate right? People discuss calcium gluconate as a supplement to help lower high basically granted days now this is like your average person at the grocery store is not gonna have that This conversation but we’re talking in the functional medicine world, if you’re working with a practitioner, they may look at you. And if they know what they’re doing, they may say, hey, yeah, you should probably do calcium gluconate. But that’s not the root cause the root cause is figuring out. Why does this person have high beta glucuronidase in the first place? Yeah, we can take nutrients to lower this and we can take nutrients to lower inflammation. We always have to work backwards. So why don’t we talk about the backwards piece? What what are the contributing factors to the gut inflammation? We’re seeing what are the contributing factors to the Secretory IgA being low? Why does this happen?

Dr. Justin Marchegiani: So first thing first is we have to do an adequate history. How did we get here? That’s like the first question that everyone needs to be asking themselves, and their functional medicine doctor needs to be kind of reviewing with them. So a lot of people, there’s usually a history, that portion that reveals this. So when I come in and I do a history, I do a timeline history. I try to figure out how the person got here. So there’s two scenarios, there’s either the person got to this position where they’re sick and not feeling well, acutely. I was in Mexico, I ate some bad food. Now I’m sick, or most of the time, there’s a chronic insidious bit to it, where there’s been some stress, emotional stress, physical stress, chemical stress, bad food, poor digestion. And then the kind of stress has been going in a downward pattern health symptoms have been getting worse over time, and then boom, they get sick, acutely, but it’s not really acutely, there’s been a downhill kind of spiral the whole time. So number one, there is totally acute, feeling great. And now they’re not number two, it’s this chronic downward decline, boom, they get sick. And that’s a number three is it’s just chronic, and there’s no timeline. There’s no event at all. It’s just a gentle downward slope. So three ways that kind of health symptoms unfold, one very acute to a downward decline followed by an acute Episode and it could be a couple of acute episodes by the way may not be may not be one. And a lot of times there could be an autoimmune flare involved in there. And number three is it’s just a gentle downward decline with no acute episode. So those are the big three scenarios. So we have to really look at Hey, when was the last time you remember yourself feeling good? Walk me through the timeline over the last 1015 years? When did things start to go sideways? Was it when you were eating some bad foods and gluten? Was it when your diet was poor? Was it when stress or sleep was poor? Was it when you started going through menopause or having some hormonal issues? Was it when you had a thyroid flare? What was going on when all this stuff happened? And those are the important questions because we have to connect the dots to the root cause. So when we ask questions about symptoms that are downstream, we’re actually looking upstream to the root cause that cause the symptoms to manifest. So there’s a different mindset. Most clinicians and doctors are looking at, hey, what medication can we do to cover up that symptom or even what supplement or nutrient or herb can we use? used to cover up that symptom, but we’re actually we may be looking at that too, but we’re also looking upstream as well.

Evan Brand: Yeah, a couple other triggering factors. Divorce is huge. So any issues with marriage whether someone just had a bad marriage and needs to divorce but they haven’t yet they did get a divorce. Like I had a woman last week who developed Hashimoto, she developed thyroid antibodies after her divorce, she had blood work done before she had no antibody, she went through crazy stressful divorce fighting over who gets the kids and all that, and then boom, you look at the labs, and then there’s the antibodies that showed up as sort of a response to the major stress.

Dr. Justin Marchegiani: Yeah, of course. And ideally, when you deal with marital stress, ideally, you’re on top of it and you seeing a counselor to help and it’s always easier to mend it than to walk away some situations you can some you can’t but we always recommend getting some kind of counseling there to help to help on that side of the fence. And then of course, you know, death of a loved one is going to be a big one. Even things like moving and a lot of times moving may be tied to a promotion. Or a good thing. But believe me, it’s very stressful. We look at what’s called the social adjustment questionnaire, moving death of a loved one death of a child’s even more. You know, affairs, divorce anything on the relationship size really big. So those are going to be important things you want to look at from an emotional stress standpoint, because those can be a big thing. And they put stress on the adrenal glands. So hey, we just want to make sure that we’re addressing it, we’re processing it, we’re seeing a counselor, we’re seeing a therapist, someone to work on it. Maybe there’s subconscious stress, maybe we’re working on EFT or NLP or EMDR techniques to deal with PTSD from that trauma. So we have things like that, right. And then, of course, like in your timeline history, we’re also going to be looking at was there a leak in your house? Was there any mold exposure, things like that? Because that’s a big environmental poll. Hey, do you feel better when you leave your house for a week? You know, barring the fact that you may be on vacation and stress is lower. If you just leave your house for a week you feel better. So we like to have Those kinds of timelines, because that can. So I digress. But that can set you up for a whole bunch of gut issues. So when we talk about gut testing, it’s never just the gut myopically. We’re trying to connect the gut to underlying stressors that have been accumulating for years, if not decades, that got you to this position to begin with.

Evan Brand: Yep. Well said Well said, Yeah, the mold piece is huge, you know, because people move so you have the stress of moving, but then you’re moving into a house. It’s moldy. So you and I mean, countless times now we’ve seen people where it’s like, Okay, what happened in the last few years your health went downhill. Well, I moved two years ago. Oh, okay. When you moved into that house, did you get worse? Yes, I did. Okay, let’s test it. Boom, there’s a big smoking gun. And now we know, just with the help of some of these laboratories that look at mycotoxins, they’ll tell you straight up. The papers look at mycophenolic acid, a major mycotoxins it damages the gut barrier. So this is a new cause of leaky gut beyond infections. Also, it promotes the growth of Candida which disrupts your gut and your brain function and efficient moats the growth of Clostridium bacteria, which we often see. So now we have the root cause of the root cause meaning, okay, these people keep treating Candida maybe with the natural path where they do herbs to kill Candida, and then it keeps coming back. Why is it coming back? Well, now I know mycotoxins are one of the big triggers. But let me share my screen. Let’s go into this. I’ve got two different. I’ve got two different ones here that I want to that I want to talk through with you. Let’s do and so two different situations, both of the people had similar symptoms just in terms of mood issues, depression, anxiety, but the one on the right here on my right here, this is the one that’s moving. This one is– 

Dr. Justin Marchegiani: I just want to highlight I want to just highlight one thing here for people. So this first page here, a lot of the path is on the first section bacterial pathogens. These are typically food poisoning type of pathogens, C diff toxin A and B. When you have both is more serious. You can get these from antibiotics, hospital setting primarily Campylobacter and then a lot of the E. coli Whether it’s the endotoxin genic hemorrhagic Coli, or the O 157, or the various Shigella toxins, which are part of the E. coli spectrum, salmonella, cholera, your stinney is kind of like a parasitic bacteria, these are usually going to be food poisoning situations with the exception of C diff more hospital setting, or antibiotic setting. And then, of course, the parasite section is others on page four on this test, but these are some significantly big ones, crypto, and to me, but his political histo for short giardia. And then, of course, some of the viral issues with it, the viral issues with tend to be more self limiting, but the biggest here are going to be parasites and more of the food poisoning or hospital based infections above. All right, go ahead.

Evan Brand: Yeah, and I’m going to make a pretty link which is a link that will redirect you because if you’re listening on audio, this is not going to be as exciting. So if you’re, if you’re listening to my podcast, you can just type in EvanBrand.com and I’m going to make the link MAP. So EvanBrand.com/map, that’s going to take you to Justin’s YouTube channel where you You can view this if you want to kind of follow along. But yeah, so on this on these two particular cases, nothing showed up on on page one. Everything’s below detectable limits. A lot of times we’ll see crypto and Giardia. Though if we’ve got somebody that’s got weight loss or weight gain issues, we’ve got stomach cramping, we’ve got diarrhea. And the interesting thing is to this time of the year when we’re talking towards the end of November, we’ll have a lot of people that will come to us with more acute issues. And when we look at the acute issues, a lot of times the noroviruses will show up and we can give some support but a lot of times those things just have to run their course.

Dr. Justin Marchegiani: Yeah, a lot of times are self limiting. We can do things like high dose silver, so my line will do GI clear tree which is a silver compound or nano silver. We can also do monell Lauren as well to kind of help knock those things down. We can even just do high dose oil of oregano so my lines Yeah, clear fives in emulsified oil of oregano very high dose that can be helpful shakhter threes and nano silver. So a good nano silver a cool little silver can be helpful and a good mana lard which is an extract Coconut, all had great antiviral benefits too.

Evan Brand: Yep, so here’s page two. Now as I mentioned the one on the right here, this person is more sick symptomatically. And we already see one reason why you see the H. pylori at the top of page two here. And this is like an exponential scale. So goes he 345, whereas the person on page two, they’ve just got a lot of stuff going on with their normal Flora being too low, you’ve got some that are showing up too high. But obviously page two here the H pylori is going to be the biggest smoking gun for this person on the right.

Dr. Justin Marchegiani: So let’s kind of hit it one by one. So we have the H. pylori section. So one thing to highlight is the standard deviation, I have a lot of patients that freak out that don’t quite get it. So, you know, unless you take in a stats class or a physics class. It’s weird, right? I wish the lab didn’t use the standard deviation, meaning either the five either the four, whatever. So when you see the reference range, the reference range is either the three. So the average person will look at this and say, Oh, well, the range is greater than one. This is 1.2. That’s only a little bit It not not necessarily, because this is either the three over here to the right, and this is either the five, so to equal it out, you have to move the decimal place to the right three times. So when you move it to the right once now becomes 12, either the four, and then when you move it again now becomes 120, either the three. So now when you look at it, it’s actually 120 times above the normal limit. So that’s important because if it’s 120 verses, only one time above, that tells us the infections probably a lot more serious from an overall load standpoint. Does that makes sense? It does. And people confuse that. And it’s okay. It’s not normal, right? Unless you take in those classes, you know, you’re not going to know it. So if people look at it first time around, it’s just confusing. The lab could do a better job at that, but that’s where we’re at. And then if you look at the virulence factors below, these are cytotoxic proteins that are produced by the infection. So you can see this person on the right and people listening will have The link for these labs so if you want to click on the link and follow along and look at the lab with us, we also have video format. So if you want to see the video version, it walks us walk you through it that way. So you see these virulence factors. So one of the bigger ones is going to be the VAC gay, the gay and the CAG. The most, most research on those two, but these are cytotoxic proteins that are being produced by the infection that give it greater chance of inflammation, ulceration, cancer, etc. So it just it tells us the infection stronger That’s all it is. It’s like oh, this infection has a little bit more muscle or meat behind it so to speak. So you could still have problems without the virulence factors being present. But if we see virulence factors in a strong amount of H. pylori, well then we know that this infections probably a lot more serious, we have to handle it, you know sufficiently But either way, if we see even a borderline number on the H pylori, then we’re still going to address it and make sure we knock it down any comments there.

Evan Brand: I’ve seen multiple people that have had a history of stomach ulcers. And those people with a history of stomach ulcers do tend to show up with some of the virulence factors. And there are some papers on that we’ve got a white paper on this where we can look at the different virulence and see what they’re associated with some is long term inflammation, some is long term infection, some is increased risk of stomach cancers, and the Safageo cancers and all that. So these are very helpful. And if we do see them positive, we always put a huge emphasis on him.

Dr. Justin Marchegiani: 100% Next we have the normal bacteria. And so this is normal, good flora. You know, I should say normal beneficial Flora in the gut. So like when I say that there are two that are probiotic species like you know, well, the ones you think of as probiotics those are going to be your lactobacillus and bifidobacterium species. And there’s a lot of different lactobacillus there’s lactobacillus para kci, acidophilus rotary right. Lot of different kinds of bifidobacteria, long gum, etc. So there’s many different species, bifidobacteria, the lactobacillus kind of lumped all those into one. These are what we consider our probiotics. And everything in this section is a normal bacteria. So when you see achra mantium, you send affiliate high, okay, that’s on the higher side. Is that an infection? Is it a despotic bacteria? Not necessarily. We’re not going to worry about it too much. These things kind of take care of itself. And I’ll go into that. You can see this person has a lactobacillus is low, right. So that’s a beneficial bacteria. So I’m already leaning into the fact this person probably has a dysbiosis, meaning higher amount of bad bacteria in relationship that good bacteria. And so you can see here below, this is the types of bacteria and then the phyla. Think of phyla as family. And there’s two general families of bacteria. There’s the bacteroides family, think bacteroides beautiful, and then from mek kinase think of for mek kinase as fat Now what does that mean? from mek kinase bacteria tend to have the ability to over absorb calories. So when we see higher amounts of mek kinase over absorption of calories, and again, some of the studies on this or week or more MySpace studies, higher levels are for mekinese increase weight gain in mice due to calorie absorption. Think of bacteroides is beautiful, helps, it does the opposite of gaining weight keeps you leaner and healthier, right. So, we don’t judge a lot on these markers, because these could be off if we have a lot of bad bacteria or infections. And I can already see below a little bit, you can see the despotic bacteria section, there are some bacteria that are already off. So because we know that a lot of that normal bacteria may be off so we don’t really worry about it. It’s more of an effect, not necessarily a cause. So we keep it in mind. And as we clean things out and we add prebiotic fibers and we change the diet. A lot of times that stuff by itself will kind of come back into balance itself. We don’t really get too myopic on that.

Evan Brand: Any comments on this overgrowth category as we? Yeah, so let’s move on to the overgrowth category. We talked about how this person on the right is definitely more sick and symptomatic, as the person on the left says my internet connection is unstable. I don’t know if I got choppy on you for a minute. It should be fine now. Good. Okay, so you see the Pseudomonas over here on the right Pseudomonas SBP, Pseudomonas Aeruginosa, you see the staff, little caucus different species of that. You see streptococcus is real high. So even just looking at a numbers perspective, looking at the number of different species of overgrowth bacteria, you could see the one on the right is obviously a bigger problem.

Dr. Justin Marchegiani: Exactly 100%. And then the big thing I like to look at is, look at the standard deviation, I see which ones have the same standard deviation that are positive. So off the bat, you can see the staff is 1.08, but it’s got one standard deviation above so it’s 10 x higher so that’s like an 11. So fives the reference range elevens not bad. Next thing I look Look at this step six are greater than one. So nothing’s like jumping out super high, Bacillus 7.5, either the five, one point and so nothing’s really super high. Now I go over to the patient on the right. Um, let me see if I can what jumps out at me here. So you can look at this was Yeah, Pseudomonas, for instance. Right? That’s 3.468 of the five, the reference range 1.08 of the four. So what’s that? Really? That’s really 34.6? Well, so the Pseudomonas is really high, that’s 34 times above, that’s a big deal, right? So I try to look at and say which ones are are mildly elevated in which ones are significantly elevated, what does significantly mean 10 X or above 10 extra above I considered to be significantly elevated. Now we’re not going to do anything specific to target one bacteria of an over another. We have specific herbal blends that will use to work on knocking these bacteria down. And again, these bacteria can produce methane and hydrogen gases. That can disrupt motility can cause constipation, cause diarrhea. So you want to keep these in mind. Now, a lot of people are like, Well, can this Tell me if I have SIBO? This is a common question. Yes and no. So we know that certain bacteria like Pseudomonas or strep or citro, bakkar, or Prevotella are associated with SIBO. We know that according to the literature, but we can’t specifically say because we don’t know exactly where the bacteria came from, right? So imagine you squeeze some toothpaste out of the toothpaste tube, and you want to know, hey, well, what part of that toothpaste tube was exactly in the middle portion of a two? Well, it’s hard to know once it all came out, right. So, with a SIBO breath test, you can know because when you swallow lactulose, you know, and you blow in the tube every 20 minutes, you know, based on the time it takes for that lactulose to enter the the large intestine, you know, kind of where it is. So it takes about 120 minutes to get into the colon or the large intestine. And once that lactulose breath test is done, so you kind of know if it’s within that hundred and 20 minutes that it’s probably in the small intestine. So we need a breath test to really confirm SIBO overgrowth in general to be exact. Can we say that it’s probably a SIBO overgrowth when we see certain bacteria? Hi, yes. So we tend to use terminology like hey, you have a just a generalized dysbiosis. And we can treat it and address it and retest. We can also do SIBO breath testing so we can be more accurate with lactulose. And know exactly potentially where it could be based on that timing scheme that I mentioned. So with lactulose, you’re blowing into a tube, and then you’re so you’re blowing into a tube, you get a baseline, then you swallow some lactulose and then you’re breathing into every 20 minutes. So you’re going to be able to get about, you know, about six to eight readings before you know it’s in that colon. Does that make sense?

Evan Brand: It does, and we just did a whole show on that. So go look back just a couple episodes ago, we did a whole podcast on SIBO bacterial overgrowth parasite, so check that one out. Now. Here’s what section I want to point out here, which is the fun guy yeast category. You see here that both of these people tested negative or supposedly negative for Candida SBP Alba cans, geo tricon micro spurt, and these are different fun guy. Micro spurious technically considered a parasite, but it’s, it’s confusing. So it’s in the fun guy category. Now, here’s the interesting thing. I don’t have these right in front of me to show you know, these false negative for candy candy is really tough to find in the store. We’d like to measure the organic acids like tartaric acid, and [INAUDIBLE] at all on the urine. So these are false negatives. So people ask about what’s the accuracy? Well, this test is very good, but it does have the issue of missing Candida quite a bit. And I can tell you because I remember these cases, both of these people had major candida overgrowth, it just didn’t show up. So you can’t This is why a lot of people they’ll try to save pennies and only do one test when they’re looking into their functional medicine history. But you can’t you gotta have all the puzzle pieces because all Otherwise, we may only be using antimicrobial herbs and not antifungal herbs and in this case, that would be what would happen we would have only used the bat the antimicrobials and not antifungals. But I can tell you, after looking at the urine of these people, they needed the antifungals. So we got them because we had all the picture. The picture was complete with the urine and stool, not just the stool

Dr. Justin Marchegiani: 100% so just kind of looking above real quick. The gi map can tell us generalize dysbiosis it can give us a pretty good guess that there could be small intestinal bacterial overgrowth SIBO based on the bacteria we see, but it can’t 100% confirm SIBO. So just trying to get people to wrap their head around that. That’s a common question I get. So I’m going to refer my patients to listen to this podcast for more Intel, but to be exact on the SIBO we need that protest. The next is a biopsy. Most people are not going to do a biopsy when there’s less invasive testing like a breath test available. And now adding to your point about the fungal overgrowth. The first thing we look at to assess fungal is clinical symptoms. Do we have any fungal toenails or fingernails? Do we have any dandruff issues in the hair? Do we have any tinea versicolor rashes on the skin? Do we have any history of athlete’s foot or jackets those kind of things. And of course that tells us there could be the gives us a higher chance that there could be fungus in the gut. That’s number one. Number two, we’re going to want to address that either way with specific herbs and obviously we want to hit it topically because sometimes fungus on the body or hair or scalp or skin or growing area or anywhere else still may be a problem and we may have to hit it topically that’s really important to note. And then we also have the [inaudible] which is going to look at fungus from the organic acid perspective and the organic acids a urinary test and that gives us a little bit more of a systemic window into either gut bacteria or yeast. And so that’s another test that we tend to combine with this because I’ve seen a lot of people come back clean on the yeast or fungus the very elevated, that’s important to keep an eye on.

Evan Brand: Yep, all the time. So we’ve seen much, much worse than this page 4 here, there’s a lot of other cases we could have pilfer through but just these are just the to be pulled up today. And according to this, you see that the only thing on the parasite and worm category was the person on the right here had some didn’t to me but fragile list which, according to the lab, they would say this isn’t a normal range. Now, we’ll probably end up killing this just as a byproduct of using the herbs to knock out the other bad guy. So this will probably disappear on a retest. But a lot of times we do see stuff pop up on these pages here blasto and cyclospora and [inaudible] there’s some other bad guys on here that can help drive up these inflammation markers. Now, if you go down to the bottom section here, I told you in the beginning, the person on the right had way more way more symptoms, they were way more sick and look here at the calprotectin level, the inflammation level, you know, we’re well above 400 here. So this is super, super inflamed gut and I’m surprised at that. IGA was as good as it was here the IGA expected to be lower, but it wasn’t. So either way this person needs help major.

Dr. Justin Marchegiani: Exactly. So just recapping, we have the parasites, these are all significant. So please have a parasite that’s close to being positive. So this one, this person here with the D fragilis, at 2.51, either the, either the third, versus the range being 1.08 of the five, I’m not worried about that, because this is essentially, let’s move it over to the left twice. So we’re looking at point o two, five, and then that’s one or greater, so not really worried about that, even though comes back positive, not worried about it, but it’s far below the reference range. If it was maybe 50% below the reference range or greater, you know, 50%, or up meaning point five and up even five same as the reference range, then you know, we’re going to work on treating that for sure. And so we have all these parasites here we of course, we have worms and we have different protocols for worms or for parasites, and we different protocols. If someone has A worm, a parasite, fungus, and bacterial overgrowth together and we may sequence things differently. So there’s a lot of different combinations and how we may hit things depending on what else is coming back. You know, any comments there Evan? 

Evan Brand: No, this is all good. And then what do you want to say about the immune system health here?

Dr. Justin Marchegiani: Yeah, so let’s kind of hit one by one. So sciatica it’s very important if we can’t break down fat that tells me that we have poor biliary output. If we have poor biliary output, there could be stones or sludge in there that could be from estrogen dominance. It could just be from inflammation in the gallbladder. It could be from poor stomach acid levels from gut stress and from CBOE and from infection, so we have to follow the six hours we remove the bad foods we replace the enzymes acids and maybe bile salts, if we have increased levels of sciatica because we have to be able to break down fat. Remember, bile is anti bacterial, right? So if we don’t have enough bile, and we’ve had chronically low bile sciatica will be higher and if sciatica tire that means Biles lower long term Biles antimicrobial So with lower levels of bile for long term that can actually drive bacterial overgrowth, so we want to make sure it’s the adequate adequate. We want to make sure elastase is good if we have low enzyme output, it automatically go to the fact that we probably have low hydrochloric acid too. And we’re going to stop them at HCl and enzyme separately. If we see sciatic right there, we’re going to add an extra biliary support in ox bile as well to help with fat Breakdown.

Evan Brand: Let me mention here what with the H. pylori infection, I’m kind of surprised have two things on this one on the right here that the secret is below detectable limits, because a lot of times we see H. pylori, and hi stay out of crit on the same panel, and then the IGA I’m surprised the IGA is not lower, meaning the gut barrier is less than tech. So maybe that means that the person was doing really good with diet, but I don’t think so with the calprotectin being so high. I don’t know, maybe it’s a relatively new infection. The IGA is better than the physical fast, not there. I don’t know. We don’t have to know every detail of why things show up the way they do. But it was just surprising to see that.

Dr. Justin Marchegiani: Exactly. So I mean, it’s important. So when we see you could have digestive issues and some of these markers couldn’t look, okay. So we have is that there’s an art and a science to what we do. So it’s not just Well, the test says there’s therefore, you know, we’re not going to give you support because we’re not treating a piece of paper, we’re treating a real life human being. So we have to look at the total picture, we have to look at the labs, we have to look at clinical markers, clinical indicators, hair quality, nail quality skin color, we have to look at the whole picture, right? If we see poor nail and skin and hair quality, well, we’re thinking this probably some digestive issues, especially with breaking down fats and protein, even if this test says we’re okay. Yeah, so next thing is we look at beta blocker on a day that tells me there’s probably some bacterial overgrowth, which made it look around and this gets made by bad bacteria. So we like to look at that as well as the other markers for bacterial overgrowth like the actual bacteria themselves. And then of course, that’s going to screw up estrogen metabolism. So we may, if it’s a female or a male, when they were having high amounts of estrogen symptoms, we may give things like calcium to glue great. But a lot of times just fixing the digestion and getting extra sulfur nutrients in there can help a lot of that so we can start breaking down and escorting out those re metabolized hormones, those research questions, we may give extra fiber a vitamin C as well. It just depends but when I seek beta glucuronidase high I’m thinking hormonal issues and I’m thinking also bacterial overgrowth issues too.

Evan Brand: Yeah, just general toxicity because you’re really circulating toxin. So when we see mycotoxins high, if we look at chemical toxins high, we know that person is really circulating all their toxicity. So we really have to prioritize that when we see it high.

Dr. Justin Marchegiani: Exactly. And then the next thing is ocula. Of course, if we see an H pylori infection, you know, we’re thinking Oh, hey, is there an ulcer? Is there any blood in the stool is already redness in the stool? Most of the time, we see That’s going to be in the stool. We’re thinking, hey, maybe there’s just hemorrhoids, right? Those hemorrhoids veins in the in the anus, they get inflamed, but people chronically bearing down. And sometimes a little bit of blood can come out through those veins. And that’s not necessarily as big of a deal as let’s say, an ulcer in the upper gut track, or something in the small intestine like a dwan ulcer So we have to kind of draw a line between ulcerations in the intestinal tract, and maybe a little bit of blood coming out from the hemorrhoids. So of course, if we see any blood, we asked, Is there a history of hemorrhoids? And most of the time, there’s Yes. If we’re not sure, then, you know, we’ll look at Hey, is there any anemic patterns, they’ll be 12, low iron, run a full iron panel as well run it run a full CBC with indices, so we can get a window to make sure it’s not affecting the overall blood and iron levels and hemoglobin levels. Okay, any comments there?

Evan Brand: We’ve seen a really high and these cases it was zero, but we’ve seen it high and it’s a great, very helpful piece of the puzzle.

Dr. Justin Marchegiani: Exactly. And the next thing I would say is the ga levels and again IGA, it’s good to look at we don’t go all in an IGA. If we see extreme high, we’re thinking maybe there’s an active infection and the immune system is going after it. If we see low, we think maybe there’s some chronic stress and that immune mucosal barrier has been weakened due to inflammation from food infections, poor digestion, emotional stress, etc. We don’t go all in though. So it’s not like, Hey, this is low, we have to, you know, go all in and target that. It that’s a, I call these peripheral markers, meaning they’re an effect, not a cause. So the IGA is going to go up because of other things, that’s not going to be a problem in and of itself, we have to look upstream to get to the root issue. So we keep it in mind, but it’s not going to be something we get so myopically focused on.

Evan Brand: Yeah, and it’ll often it’ll often self regulate. So if it’s, if it’s too high, and you fix the bugs, it’ll go back to normal. If it’s too low, and you remove the infections, damaging the mucosal barrier, then it can come back up on its own, and sometimes it does need special care, but a lot of times it does self regulate.

Dr. Justin Marchegiani: Exactly. Exactly. And then again, we have the gluten antibodies. That’s a big deal because if we are gluten sensitive, and we’re consuming foods that are making us weak and jacking up our immune response or weakening our immune response, that’s a problem. So of course, the gluten markers are a big deal and we gotta keep that in mind. And it may not just be cutting out gluten, and you know, avoiding wheat, barley and rye, right, which are gluten grains. Really, that’s basically adding, maybe cutting out all grains because glutens just like brothers and sisters in a family, they may look similar to their aunts, their uncles and their cousins, right, there’s a family resemblance and so our immune system still sees that family resemblance to other types of gluten grains, like rice or oats or corn, or even pseudo grains like quinoa. So we may have to cut out all grains and go 100% grain free. And then of course, the other X Factor is going to restaurants that could be grains or flowers or thickeners and sauces. So if you’re going out to eat and you’re trying to be 100% green Free, you know, stick with steaks stick with things that don’t have sauces on it unless you know exactly what that sauces.

Evan Brand: Yep, well said the calprotectin look at the huge difference here. I mean, despite both of them having bacterial overgrowth, we see calprotectin here at a three, no issue. And then over here we see 400, which is really high. We’ve seen higher but I mean, that’s, that’s a significant problem. And I would say this is more of a, an effect as well, right? I mean, you’re not going to say, Hey, we’re going to submit specifically go after calprotectin however, I often do, I often will throw in, I’ve got one I called gic with two, which is just a straight aloe extract, I often will if it’s this high throw in just a little bit of some aloe or something else to try to hurry up and give down even while we’re working on the bad guys. Yeah.

Dr. Justin Marchegiani: calprotectin is basically c reactive protein, which is a systemic inflammation marker for the blood. It’s a systemic inflammation marker for the gut. calprotectin is produced by the white blood cells in the guts and in and around inflammation. Here’s the thing you You can still have inflammation in your gut in your tummy, and not have high levels of calprotectin. So it’s not a catch all. It’s not perfect. But if we see calprotectin is there we know we keep that in mind, there can be some false positives regarding calprotectin. And of course, there can be false negatives, meaning not that calprotectin is high, but it came back negative, but more like you still have inflammation in your guts. It’s just not coming up coming back with calprotectin. So it’s not the be all end all but if we see it high, it can lead us that there could be some Irritable Bowel Disease like Crohn’s or ulcerative colitis, or microscopic colitis, which is important to know people that have Irritable Bowel Disease, right. Those types of conditions that I just mentioned, they have to be more strict and they have to be more extreme with the diet and like Evan said, we’re going to be adding in more healing and soothing compounds aloe ggl l glutamine. We’re going to be adding a bone broth, things that are soothing for that gut lining to calm down the inflammation of course. That’s that’s an effect not a cause. So we’re still going upstream to all of the things we just talked about earlier.

Evan Brand: Yeah, like that you mentioned here, so this person, you, you’re not going to necessarily get them off the hook just because they’re calprotectin was low as if they’re reporting gut inflammation symptoms, there’s like major bloating or there’s burning, or there’s just stomach pain, we may still use gut healing nutrients, and now with this person, even though they didn’t show up, hi. So I like the point you make that it is kind of an art and a science, because there’s a lot of people that they expect to look at the number and then have a game plan just based on the number but it actually goes deeper than that.

Dr. Justin Marchegiani: Exactly. And I see a lot of people that are doing these tests on their own, and they’re trying to self treat. And it’s a big, big mistake, because you have to look at the clinical picture. I have people that want to reach out to me and just want me to review the test. And I’m like, No, I need to know the whole clinical picture. I need to know everything about that patient, their history where they’re at, and then I connected to the results. So you have to look at everything, and people really make a big mistake. And that’s why you You want to have a good functional medicine doctor that can connect the history to the labs super important.

Evan Brand: Let’s talk about the antibiotic resistance just for a couple minutes and then I gotta run but on the right here, let’s talk about this one because this is the person who did show up with the H. pylori. How would you approach this page if let’s just say that everything we’re positive and they’re going to go to their gastro doc and they’re going to say, hey, gastro, Doc, I’ve got h pylori, but now I’m showing up they don’t but let’s say in this case, because we’ve seen it a lot. amoxicillin shows positive Clarithromycin fluoroquinolones also positive positive positive then what?

Dr. Justin Marchegiani: Yeah, so when we look at when we look at some of the markers here, for instance, these are different families of antibiotics. So for H pylori, there’s what’s called triple therapy that’s come Amoxicillin Clarithromycin Omeprazole, right, amoxicillin, Clarithromycin or antibiotics. So they’re looking at resistance of the H pylori to the antibiotics so obviously nothing came back there. Then you have the floor Quinn alone family which is sometimes us that’s going to be you know, this is has a lot Side effects in the literature with mitochondrial damage. fluoroquinolones are also known to destroy ligaments and tendons, lot of Achilles tendon ruptures associated with these we really want to avoid fluoroquinolones at all costs. So fluoroquinolones will be it will have a Quinn lucquin Cipro, those kind of things got to be careful with those tetracycline as well. It’s not going to be not gonna have the same side effects as the fluoroquinolones and then we have different families of antibiotics, right. So b lactamase is going to be things like they’re going to be penicillin derivatives, that’s going to be cephalosporin etc, typically, penicillin derivatives. So if we see, be lactamase positive, you know, then we want to probably want to avoid if we’re going to go down the antibiotic route, the penicillin derivative antibiotics again, for us, it’s not a big deal because we’re not using antibiotics like a conventional medical doctor would. So it doesn’t really help us a ton, but if people have gotten out of In the past, and we say, Hey, you know, you haven’t gotten better, it’s nice to connect the fact that hey, there may be some genetic resistance.

Evan Brand: So you know, yeah, because we’ll have people that say, hey, look, Dr. J already did triple therapy and then they come to us and guess what they showed positive for all the ones that they did in the triple therapy. So it’s at least nice for us to be able to explain to them why they failed in the past and sometimes that alone just makes people feel better.

Dr. Justin Marchegiani: Exactly. And then we have the macro lives down here, which essentially Clarithromycin up top is a macro slide. So, these are different families, they use these at the top because these are the most common, they call it triple therapy or prep pack is what you said about us, but clarity myosins in the macro lives family, so you have like zero Max Azithromycin, Erythromycin, you have Clarithromycin by x and these are different macro lies and then you have vancomycin by itself. So, these are different anabolic families that are going to be used to address the infection, but we’re not using that but it’s nice To know if there’s resistance and connect it back to the history, or anything else you want to add there, Evan,

Evan Brand: I would just say, the point that you already said, but I’ll say it again is that you can’t just look at this lab and expect someone to review this lab for you and make a protocol. And if they do offer that service, I would be skeptical that service because that’s not how it works. You can’t just look at this and have a full picture. And then hey, I’m going to make a protocol based on these numbers and get you better if you’re just in a vacuum you’ve got you’ve got no history, you’ve got no no information on sleep and diet and stress and relationships and you’ve got no clue what they’ve done that’s helped and no clue of what they’ve done. That hasn’t helped. I mean, I just don’t want people to focus on that by itself. You got to have the full case history you got to have the full review because you just won’t get better if you don’t,

Dr. Justin Marchegiani: history is half labs or the other half. And really important is anyone listening to wants to take the next step. Feel free to reach out to Evan brand at EvanBrand.com you can reach out to Dr. J at JustInHealth.com. We’re available for consultation worldwide if you want to dive in. And if people aren’t ready to take the next step just use this information. It’s totally free get your health better if you have family or friends that could utilize it as well just give us a share Sharing is caring. We appreciate it. Put your comments down below if you’re enjoying it. Let us know what you think. I know Evans gotta run to a patient I do as well. So Evan, wish you the best. It’s Thanksgiving day week. So you have a great Thanksgiving Day with your family and everyone listening have a phenomenal Thanksgiving as well. Everyone, you guys take care. 

Evan Brand: You too. See you later. Bye. 

Dr. Justin Marchegiani: All right. Bye.


References:

https://justinhealth.com/

Audio Podcast:  

http://justinhealth.libsyn.com/the-importance-of-gi-testing-and-the-gi-map-podcast-259

Blood Sugar and Gut Issues – Podcast #183

Listen to today’s podcast as Evan Brand, along with Dr. Justin shares his personal experiences and expert views about the different symptoms and mechanisms of gut and blood sugar issues. Discover how blood sugar levels and health levers, such as gut inflammation, stress, nutrition, eating frequency, weight gain, Insulin sensitivity, etc.

Stay tuned as this duo explains techniques that may apply to you for you to utilize.

Dr. Justin Marchegiani

In this episode, we cover:

01:00   What are Blood Sugar and Gut Issues

06:00   When to Get Concerned with Blood Sugar

15:00   Basic Adrenal Support to Help Stabilize Blood Sugar Levels

18:30   Mwave Mobile Phone App

19:30   Walking Meditation and Massage

Youtube-icon

Dr. Justin Marchegiani: Hey, guys. It’s Dr. J here in the house with Evan Brand. Evan, fabulous little Monday here in Austin, Texas. How are you doing?

Evan Brand: Happy Monday. I’m jealous. I was looking at the US Current Temperature Map. You’re in like the 70’s, and it’s like freaking snowing here again. We just had like 80 degrees on Friday, and now it’s 35 and snowing today.

Dr. Justin Marchegiani: Totally. Yeah. I mean, we had a great weekend here. I have my— my brother and family in town here. And we were on Lake Austin on Friday and Saturday so, we got some great exercising. And, it’s great Monday, man. Looking forward to dropping some good knowledge bombs today..

Evan Brand: Yeah, me too. I did some squats this morning and I can feel it. My legs feel like jello. So, if I fall down during this, that’s why.

Dr. Justin Marchegiani: Totally. Makes sense. Pulled it. So, in general, man, I know we chatted about blood sugar and some fasting stuff. We wanted to talk today about blood sugar, and we kind of want to connect it to a lot of the gut issues that we see with our patients.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ready to dive in?

Evan Brand: Yeah. Let’s do it. Uh— I’ll first share my story, then we’ll get into maybe the mechanism. Uh— When I had H. pylori and Bacterial Overgrowth and Candida problems, my blood sugar was not good. If I went longer than two or maybe two and a half hours, I would start to get a little bit of Anxiety, kind of shaky, kind of stressed, maybe a little bit irritable, kind of…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …moody.

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: That’s not normal. And it wasn’t until I fixed my gut that my blood sugar stabilized. And now, I could basically skip breakfast if I wanted to. I don’t. But if I did skip breakfast, I could pretty much work all day, from like 7:00 AM until 2:00 PM, with no food and feel perfectly stable. And that is unusual for me, ‘cause I had the blood sugar issue for so many years— probably because I had infections for so many years.

Dr. Justin Marchegiani: Yeah. As your adrenals get stronger, they can definitely stabilize blood sugar better. Right? ‘Cause, as your blood sugar drops, your body produces Adrenaline and Cortisol to raise this. So, the more stable your Adrenals are— They have that little bit of extra strength to bring that blood sugar back up. Of course, the more Keto adaptive you are, you’re not gonna have high and low peaks of— of blood sugar, meaning, the faster your blood sugar goes up, the faster your pancreas produces Insulin, the faster your blood sugar drops, the faster your Adrenals produce Adrenaline and Cortisol to bring it back up. So, there’s this like— There’s this like event flow. So, the— the smoother your blood sugar goes up, the smoother it falls, the less your pancreas, and your adrenals are called upon to buffer that out. So, the more Keto adaptive, the more you’re burning fat for fuel, the more metabolic logs that we’re putting on the fire. Think of logs as like Proteins and fats. That’s kind of our metabolic log. And then we have our spectrum of Carbohydrates, non-starchy vegetables, low sugar fruits, higher sugar fruits, higher starchy foods, grains, refined sugar, alcohol, right? There’s a spectrum, lower to higher. And of course, think of Carbohydrates as kindling. We have like, twigs over here, to the more ref— refined Carbohydrates in the middle, which are more like paper. And then, to the end, which we consider Gasoline. So, you know, if we just started a fire with paper and gasoline, that fire goes up and out. You know, if you start a fire with some logs, Protein and fats, and then you get a little bit of kindling in there, then you’re pretty good match to keep that fire burning long and strong.

Evan Brand: Yep. Love that analogy. I was doing pretty good on the fat content. I think it was just the gut was disturbing the blood sugar and adrenals so much that even a perfect diet couldn’t have fixed it. This is what we see too with our clients. I just had a woman before I got on a call with you, who— she has H. pylori. We looked at her Stool Test. She’s got a couple parasites, many species of bacteria overgrowth. Her Candida’s off the charts. Like I  told you before we got on here, she’s literally eating eight times a day. And, I said, “Is that like a snack?” She goes, “No. I’m eating like Steak and veggies, or chicken and veggies, like eight times a day.” she’s eating almost a full meal. I said, “Would an average person think that was a snack Science, or would they think it was meal?” And they would say, they think it’s a meal. So, I told her first of all, “My Lord! That’s a lot of food.” You’re probably not detoxing well if you’re just focused on digestion all day. And, with all the infections, if she goes longer than an hour or two, she’s having Anxiety and Panic attacks. So, I did give her some supplemental, like uh— the PharmaGABA, so that she can kind…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …of chew on those, and gave her some basic Adrenal Support. But, I told her, “My suspicion is that once we resolve the infection, she should be able to go longer without eating.

Dr. Justin Marchegiani: Yeah. I would say, with a lot of people that have blood sugar issues like that, there’s a combination of a couple of things. Number one, there’s typically, a lot of gut inflammation, and inflammation then creates a response of Cortisol. Think of Cortisol as your natural water to put out the fire. Inflammation is the fire — that makes sense. And then, Cortisol’s the— the water to put out the fire. So, if you’re constantly having a fire going, that Cortisol’s constantly being pushed to put out the fire. But Cortisol’s also is gonna have an effect on your blood sugar too. That’s why when you get stressed and you do a Blood Sugar Test— got my little blood sugar meter over here in the corner of my desk. But, if you tested your blood sugar, you would see yo— it on the higher side when you get stressed.

Evan Brand: How much can it fluctuate? Like if, let’s say, during the day, what would you say you’re kind of resting glucose would be maybe like now? Would you say it being like the 70’s or 80’s?

Dr. Justin Marchegiani: I mean, I would say between 80 and 100, but it would depend, you know, when my meal was. But, if I ate like an hour ago, my goal would be to be under 120, closer to 100. I mean, my goal is typically, you know, 140 an hou— after an hour, 120 after two hours,and then back below 100 after three. The more Insulin sensitive you are, you may be able to get that below uhm— 100 within two hours. But, it depends too, ‘cause if you’re doing a lot of stuff and you’re active, it may be okay to have a little bit higher blood sugar because you’re— you’re utilizing that fuel. It’s not like sitting in your bloodstream and being dumped into your muscle to go to Glycogen, or dumped into your liver to— to run De Novo Genesis and make fat out of it. It’s— It’s there as a fuel source and your body’s tapping into it. The concern is that when your blood sugar is— you’re not doing much. You’re not in much physical perceived stress, and that blood sugar is chronically high because in the body has to then go into storage allocation versus burning allocation.  

Evan Brand: Okay. So, when do you get concerned about a blood sugar level?

Dr. Justin Marchegiani: Well— I mean, I would say that, if someone is testing their fasting blood sugar and it’s chronically above 100, not just in the morning. Now, the morning’s important because the morning is when your blood— when your Cortisol goes the highest, right? Your Cortisol rhythm is like this. It— It starts here waking. It pops up in the first 30 minutes, and then goes down during the day. So, i— Some people may have higher blood sugar in the morning ‘cause of that Cortisol spike. And, that’s okay. That’s normal. The question is, how does it look during the day as that Cortisol drops? So, those are the big questions that I always have. So all the patients do a functional Glucose tolerance where they test their fasting. One, two, and three-hour blood sugar, you know, at different intervals during the day, so we can get a window of how that blood sugar fluctuates. So, inflammation’s gonna have a major effect on your blood sugar. Emotional stress will have a major effect on your blood sugar. And a big vector for inflammation is gonna be gut issues.

Evan Brand: Yup.

Dr. Justin Marchegiani: Gut issues.

Evan Brand: And I will—

Dr. Justin Marchegiani: And—

Evan Brand: I forgot to mention too. You’re right. Her— Her Calprotectin, her intestine inflammation marker, it was pretty darn high. It was at— I believe it was at 96, and anything above 50 is flagged high on the test that you and I use.

Dr. Justin Marchegiani: That’s big. Yeah.

Evan Brand: She— She was pretty inflamed and uh— the emotional stress piece was a factor, too. She had just recently gone through a divorce. She’s got three kids that she’s trying to keep up with so uh— that’s a big deal. And, uh— I think the case studies like this are important to share because the data can only take you so far. But when you hear a story like that, it’s like, “Oh my God. This makes sense. And this lady, she’s been burning the candle at both ends, going through divorce for how many y— years— you know, it’s been a year in the making— with three kids in the middle of it. That’s stress.

Dr. Justin Marchegiani: Totally. So, the other big thing is if the gut’s chronically inflamed, that’s creating stress. But, if the gut’s also inflamed, there may be a bottleneck in how she— this patient’s able to digest and get these nutrients into our bloodstream and have a stabilizing effect. So, the big thing I would say with this patient is, we have to make sure— you know, especially at the inflammations that high. She’s really having a hard time. I would make her do a lot of these foods in a crock-pot kind of soup type of manner, where nothing’s raw, everything’s either blended or, you know, pre-digested with the cooking process to make it very easy for the gut to absorb. I would probably be also adding a lot of supplemental free-form Amino acids, Amino acids that are already broken down, so she can just absorb these right into our bloodstream because 50% of the energy by the Protein that you eat goes into the digestive process. So, it’s like, you know, imagine I gave you a dollar. FOr every dollar I give you for you to be able to use it, you really only get 50 cents back.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, that’s kind of what happens with how your body utilizes Protein. So, if we gave you free-form Amino acid, it’s already broken down. So, if I give you a dollar, then you actually have a dollar to spend, but the big thing is, you don’t go through the— the stress of having to process it. So, adding in free-form Amino acids can be helpful in, of curse, getting the Hydrochloric acid and the enzymes dialed in. Now, some people, we try to increase the Calories, which in— you know— We talk about Calories, we’re talking about Calories from whole foods so that means nutrients. Right? We just used the term calorie ‘cause it’s easier to cut, right? We were kind of in this. A lot of the technology that’s out there, right? Whether it’s Chronometer, or MyFitnessPal, or “Lose It!” — There are lot of these things that are calorie-driven. We like Chronometer because it gives us the ability to count the micronutrients, the vitamins, the minerals, etc. So, we can make sure that nutrient density is up. We try to increase the amount they eat so they can last four or five hours. That’s ideal. Some patients, we may not be able to get enough food in there so the can last that long. They may say, “I am blo— so bloated. I’m so stocked,” but then they only can last two to three hours. That’s the issue.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If they can only last two to three hours, but they eat to the point where they feel so satiated and they can’t do anymore, that’s where I recommend more frequent eating at the two to three-hour level. I like to get closer to five ‘cause I want my patients to have a little bit of Ketosis happening, whether tapping in to more of the fat. ‘Cause every time you eat, for the most part, it’s gonna be make— your body’s gonna be paying a little bit of Insulin. So, if we can keep the Insulin down a bit, that helps with a lot of Insulin resistance. And, a lot of people can get Insulin resistant, primarily from the excess Carbohydrates. But, Cortisol can also push that because Cortisol can mobilize extra sugar in your bloodstream that can create that same kind of Insulin resistant mechanism that the excess Carbs will do as well.

Evan Brand: eah. When people hear that, they’re like “Okay. Well, how does that apply to me?” And the answer is, “Well, if you have weight issues, you could be eating a good diet. But if you have a Cortisol problem, you could have weight issues even though you’re eating like a Paleo template. You’re eating real food, meats and veggies. We see it everyday. Where people may have 20/30/40 pounds excess weight, if you fix that Cortisol issue, all the sudden, people just start dropping weight. And I always say it’s a side effect of getting healthy, which is the best part.

Dr. Justin Marchegiani: Exactly. And, you know, just to kind of toot our own horns a bit here, the reason why I think our show is so important is ‘cause we’re talking about real life patient experience. A lot of people talk about theoretical philosophical functional medicine and nutritional concepts. We’re bringing you the live stuff. So, anyone listening, if this applies to you, try to use it. Try to utilize it for yourself. See if it fits. And if you need more customization or sport— or support, make sure you reach out to Evan or I by clicking any of in— information below in the description section.

Evan Brand: Yeah. So, I want to comment on something else you said too, which was about the people who get so bloated after a meal. And  those people, you don’t want to depend on just the Stool Test. You may have to get that Organic Acids, and if you already had Organic Acids but it’s several months old, you may need to get retested ‘cause you could just have a massive Yeast problem. And if you’re throwing Kombucha or something into the gut, and all the sudden you’re bloated and you’re like, “Hey, I don’t have parasites.” Okay, cool, but it may be something else. That was my issue, man. I would get super bloated, and it was ‘cause I had a Candida overgrowth.

Dr. Justin Marchegiani: Yeah. What happens is the digestive system is so stressed that you can’t even get enough nutrition in your gut. So, that food stabilizes you for two to three hours ‘cause you feel so bloated or so nauseous or so just digestively incapacitative. And that’s where you really have to focus on the gut and you have to make the meal smaller, and you really have to utilize tools, like a Crock-pot or an Instant pot or more Bone Broth or more Liquified Nutrition to make it easier on your Digestive System. And, other strategie are just chewing your food up well enough. Uhm— making sure you’re not eating when you’re stressed. Of course, utilizing digestive enzymes and Hydrochloric acid to break that food down. The chewing process increases the surface area and allows the Hydrochloric acid and the enzymes to work better. So, if you’re only chewing your food like 15 or 20 times, try to double the amount of chews. You know, typically, one chew per tooth— 32 teeth. That’s a pretty good rule of thumb— that will help your Digestive system to work better, give more surface area for the enzymes and the Hydrochloric acid to work.

Evan Brand: I’ll tell you, nobody’s doing that. People are like, “Oh my God! Thirty-two chews. I’m doing three and then I swallow, you know, especially if somebody goes to like Chipotle or somewhere where the food is just so soft and mushy. You just shove that mush down and you don’t even chew it. So, yeah. That’s a— That’s a big problem.

Dr. Justin Marchegiani: I mean, like today. I had some really good Collagen peptides, like 20 grams with some grass-fed butter and uh— some MCT Oil. And then after, I’m having, right here, a nice organic Korean drink.

Evan Brand: That’s  good one.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I like that one.

Dr. Justin Marchegiani: It’s a good one and it’s cold-press.

Evan Brand: How much sugar is in that one?

Dr. Justin Marchegiani: Not much at all. I mean, it’s got 9 grams, but that’s the— the lowest you can have with a vegetable drink. I mean, listen…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …to the ingredients, right? Cucumber, Kale, Broccoli and Basil. There’s not anything that’s higher sugar, and there’s not anything that’s fruit-based, right? [crosstalk] You can have…

Evan Brand: Some of those are like 40 grams. Some of those Suja’s, they get crazy with the apple juice.

Dr. Justin Marchegiani: The Suja, yeah. I mean, you can get really screwy because they’ll have like, “Oh! It’s a vegetable juice,” but then it has a carrot in there. Remember, a cup of carrots— cup of carrot juice has more sugar than a Coca-cola.

Evan Brand: That’s hard to believe.

Dr. Justin Marchegiani: I know.

Evan Brand: I know you told me that, but it’s like, “What?!” That’s crazy.

Dr. Justin Marchegiani: And again, There are some good nutrients in there but sugar is sugar, and your liver still has to do what it has to do. And, if it’s Insulin resistance, all these JNK lye enzymes that are really inflammatory get upregulated in the liver to process it all. So, you’re much better off getting the phytonutrients for something like this. And, this is really easy on my gut, right? So—

Evan Brand: Yeah.

Dr. Justin Marchegiani: I had amino acids, some fat. Uhm— I had some MCT Oil, and I have this. So, it’s a really easy kind of digestive breakfast— ton of phytonutrients, seven servings of veggies. Easy peasy, right?

Evan Brand: Yep. I have an idea where I’d like to take the conversation…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …unless you’d like to go somewhere else, and it would be to talk about some of the foundational supplements you could use while you’re working through some of this. So, we won’t get too much into like the gut protocol stuff because that is so different, depending on whether it’s just parasites, whether it’s parasites plus Yeast, whether it’s bacteria plus parasites plus Yeast plus fungus plus [incomprehensible].

Dr. Justin Marchegiani: Totally. Totally.

Evan Brand: That gets crazy. So, maybe we can just chat about kind of our favorites in terms of basic Adrenal support and things that could also help stabilize blood sugar to get somebody through this.

Dr. Justin Marchegiani: Well, I think the first thing is— Let— Let’s start with food, right?

Evan Brand: Okay.

Dr. Justin Marchegiani: Let’s make the nutrition that we’re eating easy to process and easy to digest. So, you can do like a smoothie option with good fats and Proteins blended up. You can do a Crock-pot kind of meal. You can do maybe the butter, MCT, Collagen coffee, and then, you can get some of your micronutrients through a green drink to make it easier on your digestive system. Of course, maximizing Hydrochloric acid, enzymes, and your bile salts, especially if your stools are floating. You can definitely utilize a lot of the free-form amino acids. And then, if your gut’s on fire— you know— we have a lot of uhm— formulas that are gut soothing like my GI Restore. A lot of the healing, soothing nutrients to help that gut line heal. So, those are a couple of really good options to start. Again, we always start with the foundation. You want to build this awesome fancy hotel, you got to start with the floor one. Most people want to go to like. Wha— What’s that floor ten? What’s this cool little thing there? Start low. Start at the bottom, and then, build up to the top.

Evan Brand: Yeah. Make sure you’re addressing your emotional stress too. It’s like all the magic pills we give you for your gut can’t counteract you going through the middle of a divorce. So like, sometimes, you just have to make sure that you’re getting a counselling session. And you know, we kind of are counsellors in a way, but at a certain point we can’t go too deep. We’ll give you recommendations like your emotional freedom technique to tap [crosstalk] on what you love. Uh— That stuff is good too. So, you want to try to make sure you empty the stress bucket. You do your lifestyle stuff, too, like your Epsom Salt baths. Schedule a massage. Maybe you take a Friday off so you can have a three-day weekend. Go out like Justin, and go play out in the water like that…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …stuff is all good, too, and that stuff is just priceless. And then, my recommendation, which I like to mention, would be Schizandra berry. I’ve been feeling really good. So, what I’ve been doing? I’ve been taking my Vitamin C tonic powder, which is a teaspoon a day, 2,500 milligrams Vitamin C, and I mix it with the Soothe tincture, which is the one with Ashwagandha, the Reishi, the Motherwort, the Sisyphus, the Albizia— the one I tell you about…

Dr. Justin Marchegiani: Sisyphus, like—

Evan Brand: ..which I love. I’m growing some, man. So, I just got some. They’re called Jujubes.

Dr. Justin Marchegiani: Oh, yeah.

Evan Brand: It’s actually called Chinese dates, but that’s where they get Sisyphus from. So, it’s the seed that comes in the middle of the Chinese date. That’s where they extract for the [crosstalk] Sisyphus.

Dr. Justin Marchegiani: Jujube. Uh— There was someone talking about this recently. I had a patient…

Evan Brand: Really?

Dr. Justin Marchegiani: ..talking about the Jujube. There’s someone in the podcast realm that’s— that’s— that’s really up on it now.

Evan Brand: Uh— Okay. So, the Jujube seed…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …that’s where you get it, and I’ve got two trees out in the yard that I just…

Dr. Justin Marchegiani: Oh! I know who it was. It was Jimmy Moore and Dr. Will Cole. They were talking about this recently.

Evan Brand: They were telling about Jujube?

Dr. Justin Marchegiani: Yeah, Jujube. Yeah.

Evan Brand: Oh, really? I like the term Sisyphus better— sounds cooler.

Dr. Justin Marchegiani: Sisyphus sounds awesome, man.

Evan Brand: And that’s technically what they’re using. They’re not using Jujube. They’re using the Sisyphus seed, but uh— Sisyphus is the Latin for it.

Dr. Justin Marchegiani: Okay.

Evan Brand: Anyhow— So—

Dr. Justin Marchegiani: But just to just— I want to dovetail…

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: …what you’re saying. So, simple things you can do, right, EFT stuff. Right? Really simple, like three minutes. Just go through— Just think about whatever the problem is. Just— Just go through and tap all the points.

Evan Brand: Do you do affirmations or you just think about the problem?

Dr. Justin Marchegiani: U—

Evan Brand: ‘Cause I like the affirmations.

Dr. Justin Marchegiani: Both. Both. I— I think it depends, right? Like if you’re in a really negative place, it’s hard to go positive and ignore what’s the emotion that’s happening. So, I try to calm the negative down. And then once that’s down below, like a three out of ten, right— ten out of ten’s the worst; one’s nothing; three— The— Then I can go into that positive place. But I try to get— get it down first, and then— and then I’ll do a— affirmation. Number two, is you can do the uh— the Mwave, the new one for the— for the mobile phone…

Evan Brand: Yeah. How does—

Dr. Justin Marchegiani: …out on the year.

Evan Brand: …it work?

Dr. Justin Marchegiani: It basically, you just synchronize your breathing, and you focus on your heart and gratitude while you synchronize the breathing. And then you go into a place of coherence, where the heart and brain are more in sync, so to speak. And that’s…

Evan Brand: I feel helpful.

Dr. Justin Marchegiani: …good.

Evan Brand: I’ve got— I don’t have the mobile one. I’ve got the little…

Dr. Justin Marchegiani: Yeah I have both.

Evan Brand: …pocket one. It’s got way too much blue light though. It’s a blast you in the face. I need a little filter or over something.

Dr. Justin Marchegiani: I think the mobile one’s better, personally.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And uhm— it’s easier to bring with you. You just have this and your phone’s all ready. ‘Cause I don’t bring it with me and it’ll always be dead, and I’m like, “Aw, shoot!”

Evan Brand: Right.

Dr. Justin Marchegiani: So, one more thing to charge.

Evan Brand: [laughs]

Dr. Justin Marchegiani: So, as long as my phone’s good, then that’s good. So, I like that. You know, you can do three to five minutes twice a day. You can just download the Calm Meditation App, and you can do a five-minute, even a three-minute meditation, twice a day is helpful.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just a couple little things like just something that’s not gonna take a big chunk out of your day up that you can justify doing. So, figure out which strategy is best for you and just try one. Even if you do it once for three to five minutes a day, it’s a good starting point to put you in parasympathetics. And the other one is just a good walking meditation. Like, if you do a walking meditation, three to five minutes on appreciation and gratitude, and then three to five minutes on visualizing kind of what it is you want to create or manifest. ‘Cause, you know, appreciation, you go backwards and you— and you thank and you appreciate, and then the visualization is kind of moving forward. So, I think that’s a really good way to do it. And then, you know, like, I get this one from Tony Robbins. It’s a— It’s a— It’s a breathing in. [breathes in multiple times] and then fo— and then four out. And then, what he does is when he breathes, he taps on the acupuncture points on the fingers. So, it’s like in-tap, in-tap, in-tap, in-tap, and then out, back.

Evan Brand: Oh, as your breathing you’re saying?

Dr. Justin Marchegiani: …two, three, four. So, it’s [breathes in and out multiple times in sets of four] So, you’re tapping on these acupuncture points, which are basically EFT points, and you’re doing that while you’re breathing. So, you’re kind of having an EFT session on your fingers, while you’re breathing and walking and then you do a— a kind of a— a gratitude?

Evan Brand: How many reps is he doing? Does he say, specifically, or just whatever?

Dr. Justin Marchegiani:  It’s just basically used about a time thing. So, he does a five…

Evan Brand: Oh.

Dr. Justin Marchegiani: …to fifteen minutes. So, technically, it’s like gratitude for five, visualization for five, and then affirmations for five.

Evan Brand: And that’s all while walking?

Dr. Justin Marchegiani: Corre— Oh, wait. Yeah. You can do a bite. Uh— I like the movement. He does some kind of a movement with it.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: Yeah. So, it’s five visual and five appreciation, five visualization, five affirmation. And you can cut it down to three, three, and three. If you need to do it in ten minutes. And in the affirmations, they’re just affirming what it is you want to create and manifest. Like, everyday and every way, I’m getting healthier and healthier. Everyday [crosstalk] and every way, I’m getting happier and happier. Whatever that is, you’re just affirming it. These are some really good tools and it changes your physiology. And you’ll see, if you— you testing your heart rate variability, you will see it. And then, another simple thing, ready? This is something everyone can do, no matter what. If you’re a programmer, if you’re a teacher, wherever you’re at, just focus on nose breathing. [nose breathing] No breathing from the mouth at all. The Parasympathetic Olfactory nerves tie into the vagus nerve, which is the part of the Parasympathetics, and that really helps relax you So, [breathes deeply] deep nasal breathing— You can do it when you’re having a conversation, when it’s your turn to— to listen. You can do it when you’re watching TV. You can it when you’re typing something up or doing some research. Whatever you’re doing, just like good deep nasal breathing.

Evan Brand: I was doing that just now. I feel so much more relaxed. I think it was because I focused on it. I feel good, like I just calmed down like a notch or two.

Dr. Justin Marchegiani: So, like my thing is what’s the low-hanging fruits. So, if anyone’s like, “Oh my God! I’m so busy. I don’t have time for anything.” Great. You’ve time to breathe, right?

Evan Brand: [laughs]

Dr. Justin Marchegiani: Obviously. So, breathe through your freaking nose, [laughs] right?

Evan Brand: [laugh]

Dr. Justin Marchegiani: Breathe through your nose. Number two, if you have three minutes— three to five minutes, I would just say, if you have a lot of emotional stress or baggage that’s bugging you where you just feel bugged down of whatever that stress is, I think EFT is great. ‘Cause it’s really hard doing a meditation when you got a whole bunch of crap coming through. So, I rather just like lower the emotional stress of whatever that— that, you know, trauma is coming in— whatever that is. Get that down. ‘Cause once your brain’s a little bit quieter, then you can engage in meditation. ‘Cause I find meditation— It’s hard to enjoy it if your brain’s going crazy…

Evan Brand: Agree.

Dr. Justin Marchegiani: …thinking about stuff. So, I much rather get quieter brain by doing some tapping, and then once it’s tapped— Once you kind of tapped out, so to speak, you can go and do a meditation or visualization.

Evan Brand: I would recommend scheduling something, too, whether it’s paying somebody to do an at-home massage or going to get a massage, or—

Dr. Justin Marchegiani: Massage is a game-changer.

Evan Brand: I’m a huge fan of float tanks too because…

Dr. Justin Marchegiani: Yup.

Evan Brand: …there’s something you just can’t get by meditating or taking an Epsom Salt bath, like a physical touch from another human. I mean, we’re in a touch-deficient society due to technology, and I thought that was interesting too. I had Jason Prall in my podcast. He just did this whole Human Longevity Project…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …him travelling the world. And he said, “Man, Americans are so weird when it comes to touch.” Hey. He was like ove in Greece and Italy and Spain,and all sorts of other places. Costa Rica; he goes. Man, everybody hugs and kisses like it’s nothing. He said they were at a restaurant. It was like an Italian restaurant, and all these complete strangers were interlocking their arms together and dancing and singing, and just having so much fun. It’s like, you would never lock arms with a random stranger and dance with him in America, that would be frowned upon and made fun of. So, I think our touch-deficient culture requires more things like a massage, which you got to pay for.

Dr. Justin Marchegiani:  I do think a massage is phenomenal. I just went and took m— my family out for massages. Yesterday was phenomenal. I get massages one time a week. I get a full— full-body kind of foot massage, as well as a Myofascial Release in the upper body, and I think it’s essential.

Evan Brand: Have you visited other places? Have you seen what I’m talking about, this whole cultural issue where people are freaked out to touch a— a stranger or— or hug people and kiss people?

Dr. Justin Marchegiani: Yeah. I definitely that’s— you know— that’s a part of, I think, our culture. I think it depends too. I think different ethnicity is like, you know, an Italian culture I kind of brought up. I was brought up and everyone’s kind of hugging and this and that, and that was kind of part of it. So, I think it just depends, you know, within whatever culture you’re within. Uhm— That can definitely shift, for sure. And I think it’s good to have that. I think it’s great to have it, but if it’s something you don’t feel comfortable with— I mean, obviously, you should feel comfortable with that in your family. I think that great. But maybe a stranger or…

Evan Brand: Right.

Dr. Justin Marchegiani: …maybe someone…

Evan Brand: [laughs]

Dr. Justin Marchegiani: …you’re not really close with, you know, you can use massage as a great way. Especially like a foot massage ‘cause the Somatosensory cortex has lots of receptor sites in the feet. And that really gets the Parasympathetic stimulated, which really gets you into that Rest and Digest mode. So, a good foot massage is amazing on the nervous system. My brother, I took him out, him and his wife, for a massage yesterday, and he got a foot massage and he’s like, “Oh my God! I feel invigorated after that massage.” I’m like, “Yeah. It’s really getting that Parasympathetic branch of the Nervous System dialed in.

Evan Brand: Ain’t that crazy? It wasn’t even a full-body. You can just so the feet. Uh— I don’t know if you’re little baby— Is he— Is he starting to tee— Is he getting teeth in?

Dr. Justin Marchegiani: Yeah. he’s doing great. We were using a homeopathic called Camilia.

Evan Brand: Yeah. [crosstalk] We were using that one too.

Dr. Justin Marchegiani: That one’s phenomenal. Amazing.

Evan Brand: Here’s some— Well, here’s something crazy, So, uh— summer, my daughter, she— She doesn’t have the molars coming in yet, but…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …her— her fourth canine is starting to come in, and we’ve been using the homeopathics and it’s worked somewhat. And then, I came across this literature that was talking about like acupressure points on feet. And supposedly, the tips of the toes, or the places where the canines or the molars can be kind of desynthesized And so, basically, she was really fussy, and II started just massaging her toes, especially the tips of her toes, and she calmed down.

Dr. Justin Marchegiani: Mm—

Evan Brand: I was blown away. So, I mean, maybe it’s random Placebo or maybe there’s something to that. But, I tell you, man, it worked in like 30 seconds of me rubbing her feet.

Dr. Justin Marchegiani: Oh, I think that’s great. I always get my son like a tummy massage. You know, if you’re looking at his— looking at his tummy.

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s a clockwise massage so I start here at the, like for instance, this is gonna be like the descending colon and this would be like the ascending colon going up. And it’s just uh— here, and obviously, there’s like a nice like moisturizer on his tummy and it’s just like this. And I use that thumb to kind of pull everything right down the Sigmoid colon. So it’s at this…

Evan Brand: That’s cool.

Dr. Justin Marchegiani: …and then right down. So, I just use my thumbs, and that helps. That really helps with bowel regularity. ‘Cause their Nervous Systems aren’t quite as dialed in, hence why they aren’t wearing diapers, right? So, that kind of just helps give the— the bowel just a nice gentle assist.

Evan Brand: Yep. That’s cool. So, maybe that advise will help you when he starts getting those uh— canine teeth and it’s brutal—

Dr. Justin Marchegiani: [incomprehensible] to the toes. That’s good. And, u— any of the toes are just like the big toe.

Evan Brand: The big toe worked the best. Yeah.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And she got kind of ticklish with the other ones but the big toe worked the best.

Dr. Justin Marchegiani: [incomprehensible] right at the tip?

Evan Brand: Right at the tip of it, yeah.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I just kind of rubbed it like I had like s— a piece of sand between my fingers. Just kind of rubbed it like this. And I swear— I’m not joking, she went from maybe like a seven out of ten on like the crazy “I’m Crying This Hurt” scale to maybe like three or four.

Dr. Justin Marchegiani: Cool.

Evan Brand: Like, she was still little fussy, and you could tell ‘cause the gums are really swollen, but she was not complaining as much. So— So, there you go people. Go get a foot massage. Go do a float tank. Now, let me mention my shake or my little tonic rather.

Dr. Justin Marchegiani: Yeah. Go ahead.

Evan Brand: So, it’s— it’s the VItamin C powder. It’s about 2,500 milligrams, and then I do two shots of the Soothe, which is the Ashwagandha, Reishi, Motherwort, Sisyphus, Albizia. And then, I do uh— two squirts of herb forms uh— Schizandra. So, we don’t have our Schizandra so that’s one case where I don’t use your brand or my brand. They do have a professional line for practitioners that we use, and I— I do two squirts of that Schizandra. And that addition to the Soothe, I didn’t think it would make a difference but it did. I feel really stable, really solid, blood sugar-wise. If I had a late lunch, I had no issues.

Dr. Justin Marchegiani: That’s awesome, man. Really cool. Very good.

Evan Brand: So, I hope that helps people. So, you mentioned your GI Restore product. So, it’d like kind of your leaky gut support.

Dr. Justin Marchegiani: Yeah.

Evan Brand: [incomprehensible] probiotics. I’ve got some probiotics. We carry several strains. Those could help modulate the inflammation a bit. Maybe just buy it and try it, but maybe work with a practitioner too. ‘Cause we have seen some cases where if you have a bacterial overgrowth or something, the probiotics can kind of— Uh— I don’t know if I’d say “stoked the fire” but for lack of a— for lack of a better term, I’ve had some cases where I don’t do probiotics to the post-infection plan and it works a bit better.

Dr. Justin Marchegiani: Yeah. I mean, I see probiotics being good on step five where you repopulating, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: With that three in the inflammation phase, probiotics can be very anti-inflammatory. It depends how much gut issues or how FODMAP sensitive, how much SIBO is there. Sometimes, probiotics can cause more gas and bloating. So, definitely got to work with the practitioner on that to make sure its individualized.

Evan Brand: Right. And— And you could try and maybe throw stuff at it but I don’t want you guys to build up a supplement graveyard because you’re trying to listen to random things and— and piece it together like— Justin uses a great analogy of like going up Mt. Everest. It’s better to go up Mt. Everest with uh— a Sherpa who’s done it a thousand times— same thing with Justin and same thing with me— rather than just free— you know, freeballing it because [crosstalk] you’re gonna spend—

Dr. Justin Marchegiani: Nice.

Evan Brand: You’re gonna spend more money. You just do.

Dr. Justin Marchegiani: Totally.

Evan Brand: You spend more money in the long run. Like, how many clients do you talk with every week who say, “Justin, I worked with so-and-so practitioner, and they have me on 50 supplements, and none of them worked because they didn’t base it on labs like we do. They just freaking guessed.”

Dr. Justin Marchegiani: Yeah. And also, when you make recommendations for supplements, you want to make sure it’s connected to a system as well.

Evan Brand: Yeah.

Dr. Justin Marchegiani: You want to make sure that yo— you’re supporting an underlying system, not just the symptom. ‘Cause if you’re playing the symptom game with supplements, it’s really easy to kind of whack them all. But if you’re tracing it up to the s— to the underlying systems and you’re also made underlying changes to the stressors— physical, chemical and emotional. You’re gonna be in a much better place; more holistic too, right?

Evan Brand: Yeah. Well, I would like to add another comment to that too, which is— which is, we see that a lot with Naturopathic Medicine and Naturopathic…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …practitioners versus functional medicine. I think there is the distinction there because a lot of Naturopaths, they may say, “Okay. we’re not gonna use Aspirin for the inflammation. We’re not gonna use Turmeric, and that’s it.” [crosstalk] But they don’t get…

Dr. Justin Marchegiani: Or White Willow Bark.

Evan Brand: Oh, yeah. Or White Willow but they don’t get to the root cause of, “Okay. Well, why is the inflammation there in the first place?” Let’s run Labs to figure out the source. So, here you are taking high-dose fish OIl, You’re taking Turmeric. You’re doing White Willow Bark or whatever and you feel better but you didn’t address the root cause. So, you get off the Turmeric and the Fish oil, you still feel like crap. Your joints hurt. You’re fatigued. Your sleeps sucks And you don’t know why. It’s ‘cause you had infections but you never went that deeper level. So, I always told people, “Get to the root cause of the root cause.” Meaning, “Okay. If there’s inflammation, if there’s blood sugar issues, if there’s sleep issues, why?” Okay.

Dr. Justin Marchegiani: Hundred percent. That makes sense.

Evan Brand: And then— And then ask why again, and if you keep asking why? You should have initially get to the answers.

Dr. Justin Marchegiani: I like it. Makes a lot of sense to me. Let’s hit a couple other blood sugar questions. When people talk about being more Insulin sensitive, that means you need less Insulin to fit into the receptor site to pull that Glucose into the cell to utilize it for fuel or store as fat— one of the two, right? Glucose is either gonna be stored or burned. So, the more metabolically active you are, the more of an ectomorph you are, the more Insulin sensitive , the bigger— the more muscles you have, the more you’ll burn it. The more Insulin-resistant, meaning the more Insulin you need to make that receptor site happy to pull that Glucose in, typically the less active you are, the more fat cells you have so, the more your body will store that and not burn it. Not good because fat cells produce a significant amount of Interleukin, which are inflammatory compounds. So by the more fat you have, you’re actually making yourself more inflamed.

Evan Brand: Well, I think you need to slow down and say that one more time ‘cause that’s gonna blow people’s mind.

Dr. Justin Marchegiani: So, [exhales] reg— regarding Insulin. We want to be Insulin sensitive. Insulin sensitive means— Insulin receptor site, Insulin goes in. That allows the door to open so Glucose can go into the cell Once it’s in the cell, it’s either gonna be stored or burned. ‘Kay? So, the more Insulin sensitive you are, you’re tending to burn that Glucose for fuel because there’s less of it there, number one. And you’re gonna be more Keto adaptive, so you gonna be more— be burning more fat for fuel over Glucose, you have less Glucose coming into the cell. So, it’s either gonna be stored in the muscle for exercise or movement, it’s gonna be a small amount will be used by the brain, 20 grams a day, and the rest could be stored as Glycogen in the liver. So, as long as we don’t have— we don’t— we don’t go above what our— what our body can store, then it’s all gonna be is Glycogen or gonna be burnt up in  moment for fuel during an exercise or a movement pattern. Okay? The more Insulin resistant we are, those storage sites are gonna be full. It’s gonna be like you trying to use a sponge to sob upi a mess on the table, but the sponge was never wrung out. So, the more active you are and the more Insulin sensitive you are, it’s like wringing out that sponge. Now that sponge is more absorbent. ‘Cause we know that if you don’t have that sponge wrung out, you’re just pushing around the Glucose. And you’re essentially pushing it into the fat cells, metabolically, in this analogy. So, the more Insulin sensitive, the more we burn fat for fuel, the more any Glucose that comes in. We have storage sites to put it in— liver Glycogen, muscle Glycogen, or using it for fuel. The more Insulin resistant, the more it gets burnt or stored as fat versus allocate it for— for burning.

Evan Brand: Got it.

Dr. Justin Marchegiani: You are primarily a sugar-burner when you are uhm— when you are Insulin resistant because the more Insulin that’s in your blood, the enzymes shift to more storing enzymes than burning enzymes. So, instead of having Lipolytic enzymes being produced— Lipo meaning fat; lytic meaning breaking down or to cut. So, the more Lipolytic means you’re breaking down fat when Insulin is low. The more Lipogenic enzymes are produced when there’s lots of Insulin— Lipo meaning fat; genic meaning store or forming. So, Lipogenic enzymes go high when Insulin’s high. The more Insulin sensitive you are, the more Lipolytic enzymes are produced, the more you’re burning fat for fuel. Does that makes sense?

Evan Brand: It does, and I was gonna take it a step further and say, “This is why people who were Insulin uh— sensitive could probably get away with some fruit versus people who are Insulin resistant. The may have more issues with fruit, and that maybe why we temporarily pull it out if the goal is weight loss. The can’t deal with it. You made a good analogy. It’s like that sponge is full so if you throw in— you know, a bunch of apples or oranges or mangoes or whatever, that Glucose— there’s no room. So, it’s just gonna go straight into the fat, and— and create more body fat and gain weight.

Dr. Justin Marchegiani: Yeah. And the more Lipogenic, the more Lipogenic enzymes are produced, a lot of times that can make you tired, right? Some people, the more Carbohydrate is produced, there’s a propensity to burn that for fuel. So, of course you move it and you burn it. Some people, the more Carbohydrate that’s produced, they actually get more tired, so there’s actually less propensity to burn it, which means it gets stored as fat. So, listen to your body if you start increasing the carbs and you’re not getting energy out of it and you’re not feeling a propensity to move, be careful. Or you just make sure you have good exercise regiment in there. And of course, muscle mass— the more muscle mass you have, it’s like upgrading your sponge size, right? So, that’s the benefit of ecuhm— resistance training. It’s number one, you build a bigger sponge, and number two, you upregulate these little Glut4 receptors, which are like little fingers on top of the— the cell that pull into that Glucose. So, it more efficiently pulls it out of the bloodstream.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s like Glut4 like Tim Ferriss and his book, “The Four-Hour Workweek.” He talks about doing like little air squats or like little mini push-ups before he has a Carbohydrate-rich meal because he’s trying to upregulate the Glut4 receptor sites doing some resistance movement before he consumes the Carbohydrates.

Evan Brand: Yeah. I don’t do anything like that. I just would do Leg day and then have sweet potatoes and it felt so good together. Oh my God! Having a sweet potato after Leg day was like the best. We have a comment here too. The person put, “The longer I’ve been on Keto, uh— if I’m getting uh—” maybe they’re saying Intermittent Fasting. I think that’s what they’re saying— Keto IF. “I’m getting more Insulin sensitive. I’ve noticed I’m getting more resilient to being knocked out of Ketosis. That’s good.

Dr. Justin Marchegiani: Yeah. I mean, I think the— the more Ketogenic you become— because it’s like you starting a fire. With logs in the fire, it’s gonna burn longer. Anyone that’s has to use kindling, here they are feeding that fire all day long. And that fire going up and down also means energy. It also means mood. It also means focus. It also means cog— cognitive. That’s why so many people are getting massive neurological benefits and cognitive benefits becoming fat burners. And a lot of people talk about being Ketogenic. The problem is, what the hell does that mean, number one. And a lot of people confuse it with Ketoacidosis, which is bad thing. So, there’s a lot of dogma with what— what does Keto mean? But just, in your brain, think fat burning.

Evan Brand: Right.

Dr. Justin Marchegiani: Who doesn’t want to be burning fat for fuel, right?

Evan Brand: Agreed. Agreed. Well, let’s wrap this thing up. We had uh— We had one question here from Tim, “Could eating chicken breast without skin while keeping Carbs under 20 grams keep someone out of Ketosis?” It depends on your Protein, right? Justin, ‘cause if you go too high-protein, can’t that kick you out of Ketosis or am I wrong?

Dr. Justin Marchegiani: Yeah. I mean, you can go into Gluconeogenesis and make Glucose out of Protein. The thing is, though, I think a lot of people in the Keto community miss this. Are you gonna make more Glucose from chicken breast or are you gonna get more Glucose from eating like refined sugar?

Evan Brand: So, don’t worry about it basically?

Dr. Justin Marchegiani: No. I think you got to be careful of it. It just depends. Like, you’re gonna need more Protein if you’re more active. So, if you’re lifting more weights, for instance, you may need more Protein. I just think go to a more full-fat source versus a boneless skinless chicken breast. Do a skin on at least, or at least move to a thigh.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Get some full fat in there. But again, I think in Keto, if you’re lifting more and you’re doing more resistance training, you’ll be able to get by with more protein and not have it affect you.

Evan Brand: Agreed. Agreed.

Dr. Justin Marchegiani: But the more sedentary you are, definitely got to lean more in the fat, higher fat percentages and, of course, full-fat meats.

Evan Brand: Yup. Well said. I had some chicken thighs last night. It was delicious. I put the real salt. They have a seasoned salt. Have you had that one?

Dr. Justin Marchegiani: I got it. I got it.

Evan Brand: Aw, man. That’s yummy. That plus Coconut aminos— Summer, she loved it too, man. She ate so much of it. She ate almost as much as us. It’s like, “You’re not even two years old. How do you eat this much?” I can’t believe it. She ate like two full thighs. It was unbelievable.

Dr. Justin Marchegiani: Love it, dude.

Evan Brand: Well, let’s wrap this up. I think— I think I said everything I need to say and want to say on this topic.

Dr. Justin Marchegiani: What a great podcast, man. Hey! We’ll chat real soon. That and you have a phenomenal day. Everyone, if you’re subscribing, give us a thumbs up. Hit the bell and give us a share. Sharing is caring. We appreciate it.

Evan Brand: Mentioned our links so uh— if you guys want to reach out, schedule a consult with Justin. You can do so at his site, justinhealth.com, and if you would like to reach out to me, same thing, evanbrand.com. And, we look forward to helping you all out. Take care.

Dr. Justin Marchegiani: Take care, Evan.


References:

Jimmy Moore and Dr. Will Cole’s Jujube-related Podcast

“Human Longevity Project” by Jason Prall

“The Four-Hour Workweek” by Tim Ferris

www.evanbrand.com

www.justinhealth.com

Dr. Kelly Brogan – A Mind of Your Own – Podcast #165

In today’s video, Dr. Kelly Brogan, an accomplished doctor and author of the New York Times bestselling book “A Mind of Your Own”, joins Dr. Justin Marchegiani as they both discuss the link between gut issues and mental health. Get some useful tips on how to keep your mind clear and active without gut issues hindering it. Get your own mind back with the help of functional medicine. Let’s watch and listen!

Discover some natural ways to be more productive and learn about the different ways to address brain and gut inflammation. Also, stay tuned for some more information about Dr. Kelly’s bestselling book, “A Mind of Your Own” and viral articles.

In this episode, we cover:Dr. Kelly Brogan - A Mind of Your Own - Podcast #165

02:41   Depression: Illness of Modern Civilization,

Not a Chemical Imbalance 

04:53   Animal Model of Depression

08:20   Multiple Different Lifestyle Pillars

12:00   Meditation and Productivity

16:42   Supplemental Ways to Address Brain Inflammation

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Dr. Justin Marchegiani: Hey there. It’s Dr. Justin Marchegiani. Today’s podcast, we have a great guest.  Dr. Kelly Brogan in the house. Kelly is wicked smart. I’ll bring up my Boston ex. You went to MIT Undergrad in Cornell from Medical School. So, it’s a privilege to have her here. She has a New York Times bestselling book, “A Mind of Your Own.” Did I say it correctly?

Dr. Kelly Brogan: That’s right? [crosstalk] You got it.

Dr. Justin Marchegiani: A Mind of Your Own, really looking at natural solutions to get your brain back on track and move back on track. And one of the things about Dr. Kelly that I love so much is she looks at how mood is connected with the gut. Because most people, they just want to throw a medication to fix the brain. They fix the symptoms but not actually get to the root cause, which can be in the gut. So, Dr. Kelly, welcome to the show.

Dr. Kelly Brogan: Thank you. Total pleasure to be here.

Dr. Justin Marchegiani: Excellent. Well, tell us a little bit more about your self, ‘cause you went down this conventional medical rabbit hole, right? MIT, Cornell– You’re diving in deep– you do your residency, uhm– and you’re kind of learning all these conventional treatments for Mood disorders, etc. How did you come out of that alive? And how did you get your training to get to the real root cause and the functional medicine side here.

Dr. Kelly Brogan: Yeah. So, you know, I come from a very conventional mindset, and I was raised by uhm– an immigrant mom. And anyone who has immigrant parents knows that, basically, you follow the rules; you become a doctor, a lawyer and you’re supposed to be making a lot of money.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: And that was essentially, you know– My effort uhm– was to become a doctor. I thought, you know– I figured out through my work on a suicide hotline, actually, at MIT, that we’ve cracked the code of human behaviour. We know that these are genetic illnesses that are reflected as chemical imbalances that require pills for lifelong management. Cool! You know, I’m gonna participate in that model. And so, it really wasn’t into my own, sort of uhm– health journey, which is what you’ll all hear from any turncoat doctor. We had a personal experience where we bumped up against the ceiling of what conventional medicine has to offer. And we learned a broader version of the truth. And uh– you know, I’ve always been a Science Nut. I’m very comfortable on pubmed.com, and I went and researched for myself, you know– the truth about everything I learned in medical school and residency and fellowship. Uh– and what I learned was pretty jaw-dropping. I was ready to hear it though because I had already had my own uh– experience of putting an autoimmune disorder into remission through nutrition. And so, you know– what I learned is that depression, for example– Let’s just talk about depression because it’s a– It’s a emblematic of these more systemic issues in our medical system. But, uhm– it’s not a thing. It’s not a disease in a way we were told it was. And, you know, what I– what I learned through my review of the medical literature is that in six decades, you know– we’ve been trying to validate this idea that depression is a chemical imbalance. The science just isn’t there. I was shocked because I can’t tell you how many hundreds of patients I’ve sat with and I said, “You know, you have a chemical imbalance. It has something to do with Serotonin or Dopamine or Epinephrine, and you know– you need to manage it. And the sooner you accept that, you know– the easier your life is gonna be.” So patronizing. You know, I’ve said that to countless patients. And when I looked to the Science, it just wasn’t there. But, what is there, interestingly, is a science that frames depression as uhm– an illness of modern civilization, right? So, it’s a response on the part of the body, mind and spirit, uh– you know, to the kinds of stressors, exposures, triggers, toxicants that we are encountering today, that we just haven’t evolved to accommodate. And perhaps, we never will. Perhaps we’re not even meant to, right? Because…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …of– of wrong living today, and– and the way that the natural world will ultimately ask us to get back in line. And– and one of the ways that– that asking happens, that– that invitation’s delivered is through symptoms. So, uh– you know, I found  that there are actually a lot of reversible causes of what we are calling depression.

Dr. Justin Marchegiani: Interesting. Very good. And I see a lot of patients, clinically, right? ‘Cause I’m working with patients making diet changes or cutting out gluten, grains, refined sugar, a lot of the inflammatory foods, or cutting out a lot of the bacteria in the gut that has this compound called LPS or lipopolysaccharide. And, you’ve talked about that kind of getting into the bloodstream and making its way to the brain, and creating mood issues there. Can you elaborate more on that?

Dr. Kelly Brogan: Yeah. So, you know, I think it’s fairly intuitive for most people– you know, that the gut and the brain are connected, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: You felt nervous about giving a speech and maybe you lost your appetite or you have diarrhea, or something like that. And that makes intuitive sense. But, the other direction– you know, the gut to brain direction, is really something we’re just beginning to develop scientific comfort with. Although it’s been actually several decades since it’s emerged in the literature. When it comes to depression, it’s interesting because the animal model of depression– There is such a thing. In the animal model of depression, the way that they induce it is to inject– Systemically, right?– in these rodents, LPS, as you mentioned. So this– this compound in a grand– grand negative bacterial balls. And the deal is that it’s not meant to be sort of circulating around. So, once it’s breached that gut-brain uh– Sorry– that gut barrier..

Dr. Justin Marchegiani: Yes.

Dr. Kelly Brogan: …then it can alert the immune system to the need of greater inflammatory response at the gut level. It’s all by design. Everything that the body does makes sense if only we have the mindset and framework to, you know, receive that uh– information. So, you know, through this lens, uhm– the inflammatory response that ultimately results in the symptoms of depression, which are what? Sleep disturbance, social avoidance, changes in appetite, for example, changes in  motivation, fixation on very specific thoughts, uhm– you know, the– the– the driver of that perhaps could be reduced to a gut insult. So, where do gut insults come from? Most of the time, through what we put in our mouth…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …right? So that means that we are empowered to make changes to our brain behavior and cognition through diet, you know. And of course, now we have science that shows that within seventy-two hours of changing your diet, you change that ecology in your gut, your microbiome. Uh– and so, I totally agree, you know, that there are certain foods that really moved the needle quickly. They also happen to be foods that are very addictive in nature, right? You know, things like, wheat, dairy, sugar, alcohol. I actually stored coffee in that mix. I know that’s little controversial.

Dr. Justin Marchegiani: Hm– Mmhmn.

Dr. Kelly Brogan: Uh– but, you know, so– so, not only are you seeing what you look like without these addictive foods, but you’re also engaging in a pretty deep exercise of changing your gut ecology. And, you know, we could talk about the role perhaps of certain kind of starches in, you know, feeding gut bacteria, ‘cause that’s, you know, part of my approaches to restrict those for the first month.

Dr. Justin Marchegiani: Got it. Interesting. And what’s your experience treating patients ‘cause, clinically, I treat– well, fifty patients a week in my virtual clinic here in Austin. And I’m running Stool test–  sometimes, even multiple Stool tests on different patients, and I’m saying, you know, obviously, “Your SIBO type of overgrowth.” “You’re Methane and you’re Hydrogen overgrowth”. And then, I’m seeing infections like, Blasto, Giardia, and Cryptosporidium, E. histo and H. pylori. What are you seeing in your patients? Are you kind of seeing a similar imbalance of those creatures.

Dr. Kelly Brogan: It’s interesting because I– you know, when I departed conventional medicine, my first deep dive was into functional medicine.

Dr. Justin Marchegiani: Mmhmn.

Dr. Kelly Brogan: Uhm– and that’s, you know, uh– I was certified through ADIHM, and I was very interested ‘cause this is how my mind works…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in quantifying every aspect of my patients’ existence, right? So, I wanted blood and saliva. I wanted hormone testing. I wanted Urine analysis and I wanted Stool analysis. And I did that for several years– yeah, almost a decade, into this work. Uhm– until I came upon uhm– a deep desire to bring this opportunity to more and more people. Perhaps you couldn’t necessarily afford all that testing, or for whom it was just overwhelming, right? And so, somehow, I arrived at the point today, where my approach is actually quite simplified. Such that, I actually come to believe that if you recruit the synergy of multiple different lifestyle pillars. And they’re pretty basic, right? Pretty familiar, too, obviously. So, detoxification…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …looking at daily contemplative practice. Of course, I’m– have my specific opinion on what I believe is one of the more powerful types. I’m Kundalini Yoga uhm– Instructor.

Dr. Justin Marchegiani: Nice.

Dr. Kelly Brogan: And, also the role of a strict commitment to a therapeutic diet for the space of the month. So, in working with these pillars, even without testing at all– So, in my online program, we don’t do any labs. The outcomes that I have gotten actually more rapid and more robust than when I was mired in the weeds of testing. But when I was, I actually found that there are some common uh– reversible drivers of diagnosis of anxiety, of depression, even OCD, panic attacks, ADHD, Chronic Fatigue– In my practice, the one of the most common ones was blood sugar imbalance, so…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …big one, right? Uhm– so you could test for that. You can diagnose reactive hypoglycemia, or you know you can just do a dietary intervention for ten days and see if that was part of the deal for you, right? So, another big one is wheat and dairy indigenousity. So again, you can test for that or you can just take it out and see how you do. Another big, big, big– big one, probably upwards of 80 percent of my patients have a diagnosis of Hashimoto’s, often…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …perhaps driven by mimicry like you’re talking about e– Epstein-Barr, uhm– for example, uh– you know, infection. Uhm– Hashimoto’s, Graves, Postpartum Thyroiditis are big– what I call, psychiatric pretenders, right? If you do not know that you have this going on, you could land your self on Zoloft and Lithium, or more. And that’s why this kinds of testing– unless you’re really committed and you just know, you’re not gonna go the medication route– you know, this kind of testing can really– potentially even, you know, save your life. I’ll be that dramatic about it. Uhm– and, you know, and then, of course, I’d become very passionate about the untold side effects of other common medications, right? So, as drivers of psychiatric illness, so things like birth control pills and acid blockers, statins, antibiotics. Uhm– so, you know, sometimes it– it– it needs to be looked at through the eyes of an expert like yourself. Uhm– but sometimes it’s really simple. You know, and– and engaging in this kind of uhm– you know, pillar approach can– can be really all you need.

Dr. Justin Marchegiani: Very cool. Just curious. Can you give us like uh– a day in the life of Dr. Kelly. What does your diet look like, Breakfast, lunch, dinner?

Dr. Kelly Brogan: Yeah. So that’s the interesting uhm– part about this kind of like holistic medicine, if you want to call it that, is the power of your potential to influence and heal patients, I believe, is in direct proportion to your ability to walk the walk, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So, you know, you transmit something to the people you are looking to help, simply because you’re living that life. So, I– you know, I walk the walk completely, you know. I asked many of my patients to do coffee enemas, for example, which I learned from my mentor, Nick Gonzalez. And you know, if II didn’t do them, how would I ever convince someone else that it’s effective? And this is why meditation is a tough one for me because I follow the literature on meditation for many years and I never did it. I was too busy. Meditation was for other people. And everytime I sat down to do it, I hated it. I hated the experience of just being with myself and being with my crazy mind, right? So, until i broke through that barrier and actually committed to a daily practice– Now I have a pretty strong 45-minute daily practice…

Dr. Justin Marchegiani: It’s great.

Dr. Kelly Brogan: …predawn. But, you know, until I did that, I didn’t– I don’t think I convinced a single patient to meditate. You know, we both sort of thought it was a good idea. They weren’t doing it. I wasn’t doing it. So, you know, the real game changer for me, personally, ‘cause I heal my Hashimoto’s mostly just through dietary change uhm– in almost eight years ago now. Uhm– and my life really changed. I’ve really rewired my nervous system and my productivity performance and aligned it with my flow, changed dramatically when I started meditating every single day. And, specifically, when I started meditating before sunrise, uhm– everything changed. You know, I used to be up until 2 in the morning, working. I’m a total workaholic.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I wake up everyday dying into this work. I love this work. I– I would do it for free, forever. You know, this is what I’m here to do. But, I would work ‘til two in the morning regularly. And you know, in New York, that’s– it’s the culture here.

Dr. Justin Marchegiani: Totally. [crosstalk] Hustle and bustle.

Dr. Kelly Brogan: Totally. Exactly. Totally sanctioned. So, you know, I uhm– When I started meditating at 5:30 in the morning everyday, which I started after in the setting of grief uhm– you know, after my mentor died. It’s the hardest thing I’ve ever dealt with…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …in my life.

Dr. Justin Marchegiani: Roger that.

Dr. Kelly Brogan: I was desperate.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. I was totally desperate, and I did it. The nest day, I woke up and I have never missed a day since. Uhm– but, if you’re waking at 5:30, you can’t go to bed at 2:00 AM, right?

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Or you’re gonna be in trouble [inaudible]

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: So now, I go to bed at nine. Do you know how revolutionary that is for a New Yorker…

Dr. Justin Marchegiani: It’s amazing.

Dr. Kelly Brogan: ….to go at bed at 9:00 PM? And–  and you would think, “Oh, I’m missing– you know, what is that?– five hours of productivity.”

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Like, how do I even keep my business afloat. Uhm– but my performance– and again, sort of alignment with– just things unfolding, everything happens exactly, you know, the moment I need to. I don’t need to drive this ship. You know, that’s one of the sort of secret pearls in self-care that you wouldn’t otherwise believe unless you’ve had the experience. So, i’m a big believer in foregrounding self-care as being really my only responsibility. All I have to do every single day is make sure that I have committed, again, to taking care of my self. And the rest is gonna. Is gonna be exactly how it needs to be.

Dr. Justin Marchegiani: Very cool. So, I think I missed it. What was breakfast again, typically, for you?

Dr. Kelly Brogan: So, I have this uhm– smoothie often. It’s so funny because sometimes I’ll write a blog that I, you know, spend weeks and weeks and weeks researching. It’s like, you know, ten, 15, 20, 30…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: …represent it. And like four people will read it, right?  

Dr. Justin Marchegiani: Mhmmn.

Dr. Kelly Brogan: And then, one day, I just decided to write uh– the ingredients of the smoothie that I put uh– together. Okay, it’s like egg yolks, coconut oil, uh– plus/minus coconut oil. Uhm– nut butter, frozen organic cherries. It’s collagen powder, uhm– coconut water.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Just, yeah. Basic– basic stuff, but it’s not a green smoothie, right? Uhm– it’s not a ton of Kale and Spinach or anything like that. And it was– It’s like, to this day, the most viral thing I’ve ever written. [laughs] It’s just breakfast, [crosstalk] right?

Dr. Justin Marchegiani: Love it.

Dr. Kelly Brogan: Because if you struggle with blood sugar stuff, like I did, uhm– like many of the people I work with do, It’s like, within the day resolution. Like within one day, you can turn that around. You’ll feel what it is to put, you know– It’s two tablespoons of ghee. Put that much fat into your body for breakfast is an unusual thing uhm– for most people, and it tastes delicious and you actually feel full for some times, double-triple the amount you would have otherwise. So, that’s why I’m actually big– I’m glad you asked– big believer in just beginning with changing your breakfast. Like if you are not ready for the rest of it, just start with there. And see…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …how different you can feel.

Dr. Justin Marchegiani: I love it.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: ‘Cause stabilizing that blood sugar is so important. ‘Cause when your blood sugar goes on highs and lows, you get the Hyperinsulinism, which is gonna create all kinds of problems in your hormones. If you’re a woman, it will turn you into a man, uh– by getting the PCOS stuff going, and if you’re a man, it will turn you into a woman by upregulating aromatase. So, you have that side of the fence. And the blood sugar swings. When they go low, you’re gonna get a lot of Cortisol and Adrenaline, which can create mood issues and create that anxiety and that may be the reason why you’re on the Xanax. [crosstalk] So the other moods stabilizes, right?

Dr. Kelly Brogan: Exactly. [crosstalk] You said it so I don’t have to. That’s exactly it. It’s powerful. I mean, I have patients who’d have six panic attacks a day. They’ve had three medications heading to Electroconvulsive Therapy. And all that was going on was Dysglycemia.

Dr. Justin Marchegiani: Huge. [crosstalk] Huge. Now we have these cells in our brain, also called the glial cells, and a great portion of the cells in our brain are actually immune cells, which is interesting. And once these cells get activated from stress or inflammation– it’s like  positive feedback loop. It just gets more and more and more. Uhm– what do you do to help decrease brain inflammation? I think you’ll talk about the gut, but is there anything you do supplementally to help decrease that brain inflammation?

Dr. Kelly Brogan: Yeah. So that’s where I am a big believer in this multi-pronged approach, right?

Dr. Justin Marchegiani: Hmmn.

Dr. Kelly Brogan: Because, if we’re– if we’re looking at an anti-inflammatory diet, the typical template of a diet I recommend is not gonna be any major surprise uhm– to anyone– but, the Vegans probably, because it’s uh– you know, a classical sort of ancestral diet. You know…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: It was animal food. You know, the nuts and seeds– all vegetables…

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I restrict resistant starch for the first month. Uhm–

Dr. Justin Marchegiani: like a Paleo template, basically.

Dr. Kelly Brogan: It’s a Paleo template, basically. Includes, uhm– some starchy vegetables, but not uh– white potatoes. So, just to restricting…

Dr. Justin Marchegiani: Nitrates.

Dr. Kelly Brogan: …they always– Nitrates are included, so tomatoes are fine. Eggplants are fine. You know, mushrooms are…

Dr. Justin Marchegiani: Just the potatoes, okay.

Dr. Kelly Brogan: Just the white potatoes. And uhm– and you know, otherwise, my patients do always reintroduce things like white rice, gluten-free grains, uh– legumes. So, it’s not a long-term Paleo diet. It’s just restricted for that first month. Uhm– so that we can understand what resistant starch does to your microbiome, basically, because when you reintroduce potatoes– Do you have gas and bloating? You know, Are you super tired after you eat white rice? We just want to know that, right, for these potent starches. Otherwise it’s not that uhm– dramatic, but it is– just have this anti-inflammatory effect, ecologically rebouncing at the gut level. And then the meditation components, I just think, as one of the meditations I often recommend is called Kirtan Kriya Carer or _____[18:13]. It’s been studied in  randomized trials, actually, for changes in brain level profusion. Uhm– and the subjective outcomes in terms of resolution of cognitive impairment and Dementia patients, who we have nothing to offer, you know, on a pharmaceutical level. So, literally, all they did was 11 minutes of this meditation every single day.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: So, i’m a big believer in the potential of this ancient  technologies to send that signal of safety at the brain level. And then, of course, you know, when you’re engaging in detoxification– even if it’s as simple as taking the pesticides out of your diet.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Uh– You know, we’re fundamentally changing the way the immune system is being triggered. And as you said, you know, we have evidence that from a gut level, and also from a psychosocial stress level, we could mobilize the immune system in the– in the systemic circulation. That then tracks back to the brain. And like you said, kicks off that alarm. You know, when i was in med school, we don’t even know that the brain had an immune system. We thought that it was a privilege region.

Dr. Justin Marchegiani: It’s crazy.

Dr. Kelly Brogan: We didn’t know that what’s inside of the brain. You know, we’re just discovering basic anatomy, still, at this point. So, it’s important to work with the tools that do the least harm.

Dr. Justin Marchegiani: Very good. Now, I’ve seen you write this, and I may be off in a little bit. I’ll just throw it out there and you can correct me.

Dr. Kelly Brogan: [nods]

Dr. Justin Marchegiani: You know, you’ve talked about the brain-gut connection with mood. Now, being a functional medicine physician, I’m addressing everything: diet, lifestyle, blood sugar, [crosstalk] all the body system, hormone, detox. So, we’re never ever putting in on one magic pill.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: But as we fix things, I do see certain amino acid nutrients with certain nutrients, like B6, and certain B vitamins. I have seen that significantly helped a lot of people on the mood side, not every time. So, I know the SSRIs and some of these medications, we think they work by just blocking reuptake of some of these chemicals but that may not be the case. So, what’s your take on the amino acids? I do see benefits, but I know, you–you’ve talked differently about that.

Dr. Kelly Brogan: Yeah.

Dr. Justin Marchegiani: Things like 5-HTP, tyrosine, ___[20:09], L-dopa; those kind of things.

Dr. Kelly Brogan: Exactly.

Dr. Justin Marchegiani: Yeah [inaudible].

Dr. Kelly Brogan: Yeah. You know, listen. I am a passionate supporter of natural medicine. You know, and there are many, many, many, many different approaches. Uh– I mean I had patients who’d come– not patients. I know of people who come up of psychiatric medications using flower remedies. So…

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: …you know, i know that there is not one path here. And that’s the beautiful thing. Uh– but, in my approach, I use no supplements at all for the first month.

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: Uhm– when– I don’t begin medications taper, for the first month either. So, in a context of medication taper, then I actually do use amino acids. Uhm–

Dr. Justin Marchegiani: Uhmn.

Dr. Kelly Brogan: I use things uh– you know, the ones you’ve mentioned in particular as a compliment to the purported mechanism of the given medication, and I aIways use a general mix of amino acids. And I find them to facilitate the process. Uhm– I don’t use any supplements as a replacement for medication because it’s not the contraces we’re going for, right? We’re going for uhm— you know, trusting the body, trusting it’s uhm– responses, curiosity about what the body is meaning to tell you. And then also working through a lot of uhm– sort of indoctrinated fear around emotions like, you know, deep sadness, rage, grief– You know, this kind of pain that we are uhm– not, in any way, making space for. You know, to– to investigate with any degree of curiosity because, you know– one of the greatest uh– most meaningful lessons I’ve learned is that on the other side of that process of personal encounter with your deepest, darkest uhm– experience of your mind and body, is a kind of expansive, you know, exposure to these exalted emotions: gratitude, joy…

Dr. Justin Marchegiani: Huge.

Dr. Kelly Brogan: …even bliss. You know, that becomes available to you when you have the courage to sort of walk through that dark night. So that is a big part of my uh– approach.

Dr. Justin Marchegiani: So, some free-form amino acids which is great. What do you do with adaptogenic herbs? I mean, I use Ashwagandha a lot. I find that really help modulate Cortisol, which can thus help along with anxiety and even sleep. What’s your take on adaptogens, and what are your top three favorites?

Dr. Kelly Brogan: Uhm– I would say, I have a top one favorite. [laughs]

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: Because I’m a big Rhodiola fan.

Dr. Justin Marchegiani: Uhh– love it.

Dr. Kelly Brogan: And had been for many years. And it’s one of my first introductions to the power of herbal– you know, herbal approaches and herbal medicine, personally. And, You know, I find that it’s a really powerful compliment, not only to support in cognition at the time when many of my patients have been injured by medications on the cognitive front, uhh– but also that inevitable, you know, exposure to stress. I think it’s a really magical plant to dance with. So, I’m a  big fan of it.

Dr. Justin Marchegiani: What about nutrients? And I say, BC– uh– B6, or P5P, Pyridoxal-5-Phospate, really essential for helping these neurotransmitters activate. What’s your take on the most important nutrients for you that you see makes the biggest bank for your back and also a B6, too.

Dr. Kelly Brogan: Mm– I– I would– In my experience, the most profound single nutrient– because, you know, most of us do offer that as uh– you know, sort of a compliment…

Dr. Justin Marchegiani: Uhmn–

Dr. Kelly Brogan: Uhm– in– in the entire birth.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: But the one that I had the most miraculous outcomes with is actually B12.

Dr. Justin Marchegiani: Yes. Huge.

Dr. Kelly Brogan: And, you know, through my work with Nick Gonzalez, I’ve had a better ability to contextualize why– that is, in the patients that I work with. They are what he would call parasympathetic dominance, and so they respond especially well to animal-based nutrients, particularly white B12. You know there are cases in the literature of one woman, in particular, who was diagnosed as uhm– having psychotic depression. She was given Electrocompulsive Therapy…

Dr. Justin Marchegiani:  Totally.

Dr. Kelly Brogan: …and uh– multiple medications, and all that she was going on was a B12 deficiency. So, I actually used– have my patients inject themselves uhm– with something like a Hydroxyvaline in a pretty generous dose. Sometimes like 5mg, sometimes several times a week uh– initially, which is obviously considered to be rather aggressive. But uh– it seems to be, you know, quite effective in a short period of time, particularly for uh– you know, cognitive and energy-related impairments.

Dr. Justin Marchegiani: You know, Dr. Brownstein’s also a big form of the hydroxyl form. Why do you like the hydroxyls so much– let’s say, over the methyl or the adenosyl?

Dr. Kelly Brogan: Uhm– I had– I started with a Methocarbamol form.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan:  I just had a couple patients who uh– felt overly activated by it. You know, like whose are wired by it. And– and again, I’m using large doses, so it could have just been that. Uhm– so I– the hydroxyl form is just a– a way to thread the needle, you know, for those patients who might be susceptible to the– the methyl as [inaudible].

Dr. Justin Marchegiani: And then, do you have any opinion on GABA as well? You know, some people say the molecule’s too big to cross the blood-brain barrier. Others are coming out with liposomal forms. What’s your take on GABA?

Dr. Kelly Brogan: Yeah. I have gone very comfortable using a form called PharmaGABA. [crosstalk] It’s a–

Dr. Justin Marchegiani: PharmaGABA, yeah.

Dr. Kelly Brogan: Yeah. Fermented…

Dr. Justin Marchegiani: The science got it.

Dr. Kelly Brogan: …form

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: Yeah. And, you know, it’s uh– when it works, it works. And who knows if that’s, you know, Placebo. Otherwise, I don’t really care, because if it’s as benign as it is, I’ll apply that Placebo Effect all day long. But I, It’s a fan favorite– you know, of my patients, uh– particularly during the process of moving through a medication taper. It’s a very important uhm– tool.  

Dr. Justin Marchegiani: And then, when you’re dealing with people that are on these medications, whether they’re Benzos or SSRIs, or even Lithium and such. How are you dealing, like– Does every– Can everyone have the ability to get of those medications at some point, and who are the patients you don’t want to like take them off. Where it’s really you got to be super, super slow.

Dr. Kelly Brogan: Mm– Well, it’s my passionate belief that every single person should be offered the opportunity to come up with psychiatric medications.

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: I’ll even go farther to say all medications, period. What the most critical ingredient is uhm– is the mindset, right?

Dr. Justin Marchegiani: Yeah.

Dr. Kelly Brogan: So, believe that it’s possible. It’s the readiness to commit uh– to lifestyle, medicine and to self-care. Uhm– which, of course confers the type of empowerment that’s very necessary to move you out of the dependent and helpless position that you are put in as a psychiatric patient. Uhm– but I had taken patients off of– you know I have videos of my website to prove this, so to speak. I’m publishing cases in the purity of literature. Uh– taking patients of up to medications they’ve been on for 25 years. Uhm– I have patients with histories of Schizophrenia, psychotic mania, suicidal depression. And over and over and over again, they’re shedding their diagnosis and they’re completely and totally off medication. I have yet to fail. Uhm– and I don’t expect to. But, I always screen my patients. I have a very skew population, because of these two criteria– the mindset and the belief.

Dr. Justin Marchegiani: Totally. And then, we’ll put a disclaimer. We don’t want anyone getting after uhm– psychiatric medication on their own. We want them to go back to the Prescribing Physician. But on average– just in general, are you typically tapering off about one to two-month timeframe? Is that generally, where you’re at?

Dr. Kelly Brogan: Oh, wow. No. It can be years.

Dr. Justin Marchegiani: So, years or so?

Dr. Kelly Brogan: I’m glad you asked, because…

Dr. Justin Marchegiani: Good.

Dr. Kelly Brogan: I think I forget sometimes that that’s not uhm– you know, uh– an assumption. So, I don’t touch uh– medication until my patients, in my online program– until they have gone through this month-long commitment.

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: Meditation, detox and diet. Literally, I won’t touch it. It’s a total requirement. Because I used to do it before I require that, and it was kind of a nice idea. We’ll start looking at your diet now. It’s non-negotiable. Okay? So, that happens first, and then the taper is around 10 to 20 percent of the total dose per month is a typical pace. So, it depends on…

Dr. Justin Marchegiani: Got it.

Dr. Kelly Brogan: …what you’re taking. It’s one medication at a time. The process can take years. And, you know what? If you want it to last, and you want it to be a permanently chaptered for you, you have a right with that. You know, because it’s an investment in this being, not just a revolving door where you’re back on meds in a couple of months. Uh– but I– I absolutely do not recommend that anyone consider coming off medications, particularly until they have uh– initiated this kind of self-care and physical healing regiment. And you know, in my program, I have an entire module dedicated to tapering, because it’s not a science, unfortunately. Uhm– and there are very few practitioners who know how to do it. And that’s why patients actually become more educated. Then their provided about how to do it. Uhm– it’s a bit of the wild west at this point.

Dr. Justin Marchegiani: And, is that course over at kellybroganmd.com?

Dr. Kelly Brogan: Yes! We– It’s called, Vital Mind Reset.

Dr. Justin Marchegiani: Vital Mind Reset. We’ll put all the links below. We’ll put the links to the Amazon Book as well, “A Mind of Your Own.” So, everyone that’s listening and finding value. Go support Dr. Kelly by getting that book. That’s great. Now, one last thing here before I let you go, Dr. Kelly. Uh– when I use certain amino acid with patients, even some of the free-forms, I’ll start to notice the patient is starting to have some of the– the side effects, as if the drug’s too much. Do you see that at all? And then, do you start to gradually taper if those higher side effects from the amino acids are making the drug work better? Do you notice that at all?

Dr. Kelly Brogan: That uhm– is possible. I don’t often encounter that for whatever reason, uh– but  that’s absolutely possible. And in fact there’s a proprietary formula called uhm– EMPowerplus by TrueHope. It may [inaudible]

Dr. Justin Marchegiani: Yes. TrueHope, yeah.

Dr. Kelly Brogan: Yeah. And, you know, they counsel about that– you know, that it’s very possible that in the setting of uh– nutrient repletion, that medication could become actually almost quasi-toxic uh– so that you would need to begin to ramp down on the dose of medication at that point. So, it’s– it’s highly possible and that’s an incredible reminder. You know, that nutrients are– are very powerful uhm– tools to be used with strategy.

Dr. Justin Marchegiani: Awesome, Dr. kelly. I think you’re changing the world. I appreciate you coming on the show. Last question for you, “If you’re on a desert island and you can only bring one nutrient, one supplement, one herb– whatever it is, what would that be for you?

Dr. Kelly Brogan: Oh, turmeric, of course. [laughs]

Dr. Justin Marchegiani: Turmeric. Okay. Got it. [crosstalk] Crucumin?

Dr. Kelly Brogan: Yeah, Crucumin.

Dr. Justin Marchegiani: Can [inaudible] can the anti-inflammatory on?

Dr. Kelly Brogan: It’s everything. You know, it’s like a miracle. It’s a miracle herb, and you know the research on it, of course had– had my skeptical mind convinced. You know, with the catalog research on Crucumin, which is one isolate of this…

Dr. Justin Marchegiani: Totally.

Dr. Kelly Brogan: …very complex herb, is astounding. You know, head to head against medications like Cox-2 Inhibitors, antidepressants. It’s extraordinary. So, I think of it as a, you know, the– the power performer, for sure.

Dr. Justin Marchegiani: I love it. Now, is there anything else you want to let the listeners to know? Any new books, products, online things coming out for you that people should be aware of?

Dr. Kelly Brogan: No. Just you know that we’re here to support your journey. If any of these is resident, it is one hundred percent possible for you. I see it every single day. And so, just to make sure that I plant that seed of potential. And oh, you know, we’re here to support. We have tons of free information on this site, and of course, greater uhm– complex products if needed.

Dr. Justin Marchegiani: And let’s hear those links one more time. kellybroganmd.com– the second one was?

Dr. Kelly Brogan: That’s it. You know…

Dr. Justin Marchegiani: Okay.

Dr. Kelly Brogan: …all the information’s there. So let’s just keep it simple.

Dr. Justin Marchegiani: And then the book– if you guys love it, go get that book on Amazon. Dr. Kelly, we really appreciate you coming on the show.

Dr. Kelly Brogan: Thank you so much.

Dr. Justin Marchegiani: Awesome. Take care.

 


References:

www.kellybroganmd.com  

“Vital Mind Reset Program,” by Dr. Kelly Brogan

New York Times bestselling book, “A Mind of Your Own” by Dr. Kelly Brogan

https://www.amazon.com/Mind-Your-Own-Depression-Reclaim/dp/0062405578

“Increase your Brain Health by Changing Your Breakfast: The KB Smoothie” by Dr. Kelly Brogan

https://www.truehope.com/effectiveness/ingredients EMPowerplus by TrueHope

 

Natural solutions to combat stress – Podcast #122

Dr. Justin Marchegiani and Evan Brand talk all about stress, its effects on our health and variety of natural ways on how we can beat it. They discuss into detail the parts of the brain and hormones affected when we deal with stress and how these hormones are related to health issues like gut inflammation, ADHD, decreased libido, weight gain, depression and memory problems.Natural solutions to combat stress

Find out some of the sources of stress that we engage in consciously and unconsciously. Learn about the process and cycle of stress, develop awareness and apply some valuable tactics on how to combat stress in our life, which in turn improve our health.

In this episode, topics include:

1:46   Forest Bathing and its benefits

4:48   Cortisol levels and its effects on our body

9:19   Different sources of stress and  ways to deal with it

21:13   How the amygdala and hippocampi reacts to stress

26:09   Different approaches on how to beat stress

itune

 

 

youtuve

 

 

Dr. Justin Marchegiani: Hey there, it’s Dr. Dr. Justin Marchegiani here with Evan Brand. Really excited here, we got the video going today. So hopefully, we’ll have the face-to-face connection here for everyone at home. Evan Brand, how are you doing today, man?

Evan Brand: Pretty well. It’s sunny and cold but I’ll take it over cloudy and cold so I can’t complain.

Dr. Justin Marchegiani: Absolutely man, I love it. I know we talked about talking about stress. Speaking of stress, how you are you dealing with stress up there? I know you have winter and you got cold weather up there in Louisville. How is that going?

Evan Brand: I mean it’s not too bad to be honest. I love living here in Kentucky so much that I turned a blind eye. I think I put my rose colored glasses on despite the winter and it was like mid-20°F so cold. But I- actually, I put together a weight bench in the garage yesterday so I’m gonna be beginning some outdoor primal exercise. I joked with my wife I was like “Babe, there’s nowhere to put the weight bench. Let me put it down in our daughter’s room” and she was like, “ No” and she said, “our primal ancestors wouldn’t have needed to work out indoors” and I was like “Fine, I’ll put it outside”. So I’m gonna be getting some, some- I guess we’ll call it cold, cold exposure training and lifting weights at the same time.

Dr. Justin Marchegiani: I love it, I love it. That’s excellent. I can picture your wife using that excuse to send you to the store to run errands. Well normally, normally in the hunter gatherer society, the husband will be out for weeks trying to get food for his family. You should go to the store for at least the next hour or two for us.

Evan Brand: Exactly.

Dr. Justin Marchegiani: That’s smart. Very cool. Well yeah, here in Austin, it’s a great, great weather. It’s 56° on the colder side. I guess a little warmer up in the weekends but we talked about stress here pre-show. One of the big things I’ve been doing and I know you’ve done podcast of this in the past. I think you’re in bulletproof radio talking about this, is forest bathing.

Evan Brand: Yes, absolutely.

Dr. Justin Marchegiani: I found this awesome little nature trail behind my house there in Austin and I have taken my dog, Butter, and my wife and I now we go for a great walk down there and it is awesome. Really enjoying myself. We go for a couple of hours. I got my Fitbit on, I’m racking a couple of 10,000 steps days over there and then it’s great.

Evan Brand: I know, you feel so much better. For me, anytime that I’m stressed it’s usually due to a deficiency of nature. Obviously there are other causes at play which we can talk about some of those causes and effects-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -but you were designed as a human to be outdoors and if you separate yourself from the outdoor environment, you’re gonna have build up of stress. It’s just that simple.

Dr. Justin Marchegiani: Absolutely. And I know the research on forest bathing is pretty, it’s pretty- its quite compelling. Uhm the effects of lowering cortisol, lowering that stress hormone and the cortisol is this hormone that’s really interesting and today’s podcast is gonna be just on stress in general and natural things we can do. We’re gonna try to take a different nuance approach for it. But just getting outside and walking around not just on your street but if you can go on to a wooded trail, it’s actually great. The effects on lowering cortisol, if you just google forest bathing, a lot of really good effects with that. Can you go more into the detail? I know you’ve got more podcast on this topic.

Evan Brand: Yes, so basically a lot of the research is coming out of Japan who came up with the term “shinrin-yoku” and it makes perfect sense.

Dr. Justin Marchegiani: Totally.

Evan Brand: Of course we’re gonna have a reduction in stress compared to the control group in the research where they take salivary cortisol samples of people walking on the side walk walking on urban area. They actually see increase in stress hormone cortisol but adrenaline too and you see decreases in adrenaline not only DC reduction in cortisol but you also see increase in heart rate variability and the higher your HRV score is, the healthier your nervous system is. Meaning you’re more in parasympathetic, less in sympathetic. And for us in the modern world we’re constantly reacting to things that our ancient wiring system wants to put us in sympathetic like a bad email or a bad text message –

Dr. Justin Marchegiani: Yeah.

Evan Brand: – that can put us in fight or flight. We think our survival is at risk but it’s not.

Dr. Justin Marchegiani: Totally.

Evan Brand:  And forest bathing also there’s some cool research if you type in rumination in the forest, you can read that some of the bloodflow to the prefrontal cortex which is the newest part of the brain. The blood flow actually decreases and the more reptilian part of the brain in the back increases the blood flow back there meaning, you’re less likely to start overthinking and beating yourself up and being self-conscious and you know, people are hard on themselves. And I’ve been guilty being hard on myself too and a lot of times it’s just that front part of your brain is overactive and due to the modern world and technology, social media, I mean there’s a lot of bad influence that contribute.

Dr. Justin Marchegiani: And what’s that part of the brain that causes the rumination effect?

Evan Brand: Pre frontal cortex-

Dr. Justin Marchegiani: Okay. The prefrontal cortex, the neocortex, the high functioning part of the brain.

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Yup.

Dr. Justin Marchegiani: Excelllent. And also we know cortisol. Higher cortisol and lower cortisol are both detrimental, right? Higher cortisol is that tire but wire, you keep on going, you’re energized, but maybe you’re more anxious, maybe you have the heart palpitations, maybe you have excessive sweating and body odor. And these are the high cortisol. And again typically people that are higher cortisol, they least have the energy and the propulsion. It’s like the engine’s redlining but it still flying down the street versus, “hey, now the car’s going, it’s pot, pot and pot along”. But now your kinda in that low cortisol statement. Again, high cortisol, what it will do is rip up the gut lining, right. Coz it will rip up the IGA and it’ll tear up the gut lining. High cortisol also tear up muscle. So you start getting skinny fat. So maybe you look skinny but your muscles don’t really have much tone to it or contour. Or you start gaining weight because now you’re ripping up so much protein, you’re actually increasing blood sugar from the protein from the gluconeogenesis happening. So, now your blood sugars going up from the stress response as well. So you have- you can get insulin resistant, you can get sarcopenia, meaning the kind of the flabby muscle. And then you can also tear up the gut lining and tear up other tissues in the body, too. Hair, skin, nail, etc.

Evan Brand: I’m glad you brought up the IGA because I’ve been looking a lot. And I’m sure you have been too on the G.I. map at the bottom. Seeing how the link between people with adrenal issues their gonna have low IGA levels, but their also gonna have more infections, too.

Dr. Justin Marchegiani: 100%.

Evan Brand:  So not only are you tearing apart your tight junctions contributing to leaky gut, which can contribute to autoimmune disease. All stemmed from you being on social media too much, for example, you can also contribute to yeast overgrowth, bacterial overgrowth, SIBO infections because now your bulletproof vest, which is your IGA, your first line of defense, that’s now reduced. And I had a guy last week-

Dr. Justin Marchegiani: Yes.

Evan Brand: He’s in his mid-20s. His IGA level was, was one of the lowest I’ve seen. Like 2, maybe 200 and the scale is, you know, 500 to 2000 at least on the GI map that you and I use.

Dr. Justin Marchegiani: Yes.

Evan Brand: And yet, I’ll see a 75-year-old woman you would suspect would have lower IGA just to distress and aging. And her IGA could be perfect. It could be 700-800. So just because you’re young and overall you, you hit the gym, and you wear cool yoga pants, and all of that- that doesn’t mean you’re any healthier.

Dr. Justin Marchegiani: I totally get it, man. And here’s the thing, too, right- Is you can be making all these great changes to your diet to your lifestyle, and how you perceive stress- Let me just take a side out here, I’m gonna digress for a second. But Dr. Robert Sapolsky, the PhD stress researcher out of Standford, wrote a book I think in the mid-to-late 90s called, “Why zebras don’t get ulcers?” and his basic philosophy was that, a zebra, right- when chased by a lion, they have to run and they basically either live or they die. That’s pretty much it. And you’ll see a liberal, uh zebra that survives a tiger attack, or lion attack. I think it’s lion attack with a whole tank of flesh missing from its back and it’s out there- eating and drinking the water like nothing even happened. So this zebra that is basically close to death, is totally turning the stress response on and off like it’s a light switch. The problem with us is that our stress which keeps on flickering on and off all daylong is we cannot turn it off because that stress becomes a micro-stress. And it’s constantly being turned on we’re driving a conversation with our wife or partner, dealing with kids, poor sleep, you know, politics, this that, friendship drama, finance issues, that’s constantly flickering on and off. It’s like you have a- a light show going on in your house. That’s what kind of stress is happening. Even though you get this zebra, who basically almost died, totally relaxing and in drinking water and eating grass over there by the stream.

Evan Brand: Well, that’s the problem. We got too smart. Because if you look at- you and I- I know people heard the stories of car crash accidents where the adults may die in the crash but the children expect depending on what age they are the real young infant, you know, 2,3,4,5 years old. The kids will survive because they didn’t go into fight or flight. They had no anticipation. They didn’t tense up. They didn’t flex all the muscles and argh, before it- before the crash happens. And so they’re fine and the adults who anticipated it, they set off the fight or flight flexed all the neck muscles, got tight, tense. Boom, they broke their neck. They’re dead. So, I guess what we’re trying to convey in this podcast today is so many people are looking to the food and fitness gurus and they’re frustrated because they’re doing Paleo and it’s, “Oh, I’m doing AIP so well. I do paleo so well, but I’m still not getting results” and it’s like, “well, we could look at your circadian rhythm, I mean, are you using your iPad at night?” “Oh, I’m wearing blue blocking glasses” “Okay but your skin receptors still can pick up light, there’s light receptors on your skin”

Dr. Justin Marchegiani: Right.

Evan Brand: So you’re just bathing in an extremely bright bathroom plucking your eyebrows at 11 PM before you go to bed. This is the other factor.

Dr. Justin Marchegiani: I knew your eyebrows are looking good today.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Ha ha

Evan Brand: Thanks.

Dr. Justin Marchegiani: I hundred percent agree with you, by the way. I think that’s a really important point, is that we’re just chronically under all the stress. My biggest thing is this, when dealing with patients is, try not to look at like- It’s so easy get stressed out over the diet and all the things that you have to do now. My goal is always a look at things from a perspective of, what can we exchange, what can we substitute or switch versus what do I have to remove and cut out, right. Because when you going to this cutout mode, “ I had to do this now”,  “Oh my gosh, I’m missing this”. The key is going to an exchange mode coz the exchange mode is kinda like a barter in your brain. It’s like, you want this result, that result is better mood, better energy, better libido, less brain fog. So for that, you’re gonna barter. What you gonna give up, what are you gonna exchange with, you know, uhm- let’s just call it your functional medicine doctor- us, right. What are you gonna exchange to Dr. J and Evan. What are you gonna do based on what they’re telling you to do, based on their experience and results to get to that goal that you want. So it’s kind of we’re having this barter. We’re  having an exchange of what, what habits can be put in your place, substitute in, for what your- what you were doing that’s not getting you the results you want. So, we can look at it as an exchange in a barter and negotiation versus like you have and give up all the stuff. I find patients have a much better mindset and they’re not getting stressed out by their mindset, making all these healthy changes.

Evan Brand: Agreed. The other thing too that’s really helpful if you’re stressing out about all the- minutiae. Coz that’s where the success really comes into me, is dialing in the minutiae. So getting the shower filter, getting the water filter, making sure that the butter is good. All of these minutiae things that tend to overwhelm people- you want to put those things on autopilot. So once that’s programmed on autopilot, for you it’s not a struggle to do AIP anymore. Maybe at first you’re like “Oh, I’m gonna miss this”, “I’m gonna miss that”.  But now it’s on autopilot, so it takes almost zero effort to maintain. And that’s the goal, is to get as much stuff and autopilot as you can that we don’t have to think about diet. You don’t have to think about exercise. And now all you’re focused on, is how my managing stress. So stressful situation comes at me, I know, okay- I’m to be more susceptible to go eat some sugar.  Because I’m stressed, I need a quick glucose to think better. That’s what your body’s gonna tell you to do coz that’s what you’re primed to do. Get a quick burst of glucose so you can think. And then the stress is gone.

Dr. Justin Marchegiani: Totally.

Evan Brand: But if you can catch yourself  and you’re on autopilot, then you could just- maybe you do EFT, may be due a round of EFT. I’m about to make a really bad decision.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m gonna tap this out.

Dr. Justin Marchegiani: All tapping points. Exactly. I think that’s great. I have my push up bar here. So between patients, I’ll be doing some push ups. Also, one of the best things I got- I haven’t told anyone, my patients probably hear it in the background- I’ve a walking treadmill now. So it’s lies underneath my desk and I stand about three quarters and half a day and I’m walking about 10 to 12 miles over 20 to 30,000 steps a day. Last week I walked 75 miles while seeing patients.

Evan Brand: Sheesh.

Dr. Justin Marchegiani: Isn’t that amazing?

Evan Brand: Are you wearing shoes? Or are you going barefoot?

Dr. Justin Marchegiani: I’m actually wearing sandals.

Evan Brand: Cool.

Dr. Justin Marchegiani: I wear sandals. I used to wear shoes, but they were just too loud.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they’re too loud when they hit and I went barefoot and after about 5000 steps I started getting blisters.

Evan Brand: I’m sure.

Dr. Justin Marchegiani:  I feel like this is kind of a good compromise but any of my patients that hear the uh-you know, little me walking in the background,I apologize but I’m giving you 100% of my attention. I can walk and chew gum at the same time. Uhm, but yeah, I’m really pumped because I’m getting 20,000 30,000 steps a day. And that’s actually helping to lower my cortisol.

Evan Brand: That is excellent.

Dr. Justin Marchegiani: It’s keeping the stressed down. And just to kind of reiterate one thing, is you talked about the habits. Like once you have your water filter dialed in, once you have like the sea salt by your water when you fill up, once you have like the stuff in your fridge to make meals, it’s all easy. Coz when I go to the- use the water, the filter’s already there. When I go to grab the cupboard on the fridge, the food’s already there. So I always say preparation is the biggest first step. Once you actually go through the inertia preparing and everything is there, it’s so easy to capitalize it, so easy to focus. It’s like, I’m a big Tom Brady fan, I know, haters are out there, but the Patriots are in Super Bowl this week. I’m really excited about that. And you know, you got to talk about the game time, right. When the game happens, so much of that game is one in the preparation leading up to that game, right. So, so much of the preparation in our health is one leading up to us making decisions every day. We can get ourselves prepared, if we can batch cook, if we can have the water and the minerals in the right place, we can have supplements in a really easy setup place, if we can have a good routine were our gym time is scheduled or we have a little set up at home to work out, like you do outside, that’s gonna let us be successful. But it’s gonna lower that stresses coz it’s gonna put these tasks in the random access memory the RAM versus havin’ a- havin’ a startin’up from the hard drive, so to speak.

Evan Brand: Right. Yeah, instead of having to retrieve and start fresh. I agree. I mean to retrieve and start fresh. I agree. You know I think what we’re saying in so many words is the lifestyle component to me is the most important aspect.

Dr. Justin Marchegiani: Huge.

Evan Brand: There’s so many sick people that have a great diet and they exercise 2,3,4,5 times a week. Maybe they’re doing hot yoga and Pilates and bar and all of these great things. And they eat at the hippest restaurants and they were the coolest leather boots. But at the end of the day, if you’re a stress case because you’re beating yourself up mentally, because there’s unmanaged emotional stress, or there’s a bad relationship that you’re not gonna cut out, I don’t care how organic your diet is. You’re not gonna be able to out supplement, you’re not gonna be  able to outkill it, you’re not gonna e able to out smoothie it. You’re toast unless you address the lifestyle. So you and I always talk about numbers, it’s tough to say because based on the context, our numbers might shift. But for this conversation, I could say 80% of the issue is lifestyle and 20% is combined diet and fitness. And lifestyle could include your circadian rhythm. So that can include getting bright light exposure-

Dr. Justin Marchegiani: Totally.

Evan Brand: – a bright environment. This could include grounding yourself, this could include swimming, this can include walking with your dog and your wife like you’re doing, this can include you drumming, listening to music, dancing.

Dr. Justin Marchegiani: Yup.

Evan Brand: I told you, I went to my grandparents house and played cards- huge stress relief. I mean that it’s so fun.

Dr. Justin Marchegiani: Yeah, absolutely.

Evan Brand: I mean it’s so basic but yet, the exchange that you’re making in a small lifestyle investment can be far more than a simple diet tweak or beating yourself up because you had an extra piece of chocolate. I think honestly, the biggest battle that people face is themselves.

Dr. Justin Marchegiani: Yup, I agree. It’s self-

Evan Brand: It’s self-inflicted wounds whether it’s physical because they’re under moving or over moving, or emotional. They’re beating themselves up for no good reason. They’re guilty about something because everywhere you go, there’s an article about how bad this is for you or how bad this is for you. There is no deficiency of information that anybody listening to this show has. Its not the deficiency of information. It’s preventing people from getting what they want. To me, it’s dialing in what, what does it take for you to be happy, what roadblocks are in your way there preventing you-

Dr. Justin Marchegiani: Yeah.

Evan Brand:- from making the action steps you need to make.

Dr. Justin Marchegiani: I agree.

Evan Brand: If you got a constant battle going on with a spouse but yet, you’re trying to kick the sugar habit at the same time, I can’t tell you that you’re going to succeed by just trying to go cold turkey on sugar. You’re gonna have to take care the emotional stuff, too. It’s not one or the other, right. It’s not like you can- a perfect diet’s can gonna fix all these other aspects. I guess that’s what I’m saying. But I’m just been very long-winded about it.

Dr. Justin Marchegiani: No. You’re right on point. I always tell people about the patients that we kinda get into care. There’s four phases which most people go through during any difficult skill after trying to undertake or learn. And I, I call being healthy a skill. And also one thing to add on, too. It takes no more effort to get what you want than what it does to get what you don’t want. Meaning you develop habits in your life that are running in the background subconsciously, that are constantly making you sick and unhealthy. Now, we can create new programs and new habits that are running that are getting you to be healthy. So no more effort to get what you want than it does to get what you don’t want- same thing. So the four phases that people go through, typically in their health at this. They’re unconsciously incompetent. They don’t know what they don’t know. They think their grains are healthy. They think saturated fats- bad. They’re drinking their soda. They’re using aspartame and Splenda. They are clueless and in fact, they are thinking that what they’re doing is actually helpful to them even though it’s not. That’s the first step. Now, the second step is they’re consciously incompetent. Now they’re starting to know that they don’t know. Because now they’re starting to get sick, they’re starting to not feel well they’ve gone to the conventional doctor, they’ve said “Hey, you know we can’t help you” or they give him a whole bunch of diagnoses that involve some drugs that don’t fix the underlying issue. The drugs cause more problems, more symptoms. Maybe they keep on going back. Now they’re given antidepressant and a psychiatric referral and they’re like something’s wrong. They’re consciously- they’re like, “ I know something’s wrong, but I don’t know what it is”. Now that’s the point phase 2 with a reach out to someone like us, right. Now phase 3 is kinda where we intervene. This is the hard part going from phase 2 to phase 3 is the hardest. That’s where they are consciously competent. Dr. Jay and Evan have educated the patient. they know the kind of water. They know the minerals. They know the food. But it’s hard and it’s tough. And when they mess up, they beat themselves up. And they don’t quite know what the best exchanges are. They don’t- they haven’t made it a habit yet. They are not batch cooking. They’re not doing things. They are not prepping the house in a way that makes it easy for them to succeed. So they’re consciously competent but it’s taking all of the RAM in their database.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Me and you, Evan. We operate in unconscious competence. We don’t even have to think to do the habits that we wanna do. We just, “hey, I got my walking treadmill. I walk 10-12 miles a day. I got a gym. I got kettle bells on the corner. I pop out push-ups. You do this. You go out in your gym. You go for walk with your wife. You walk your dog. You’ve all these habits. You are getting vitamin D. You’re hydrating and you’re not even thinking about it. And there’s zero bandwidth being taken up. And that’s where we’re trying to transition our patients to. And I think any patient that’s listening, they have to understand the really big binds in that first one to two months while we get you from consciously competent to unconsciously competent, it’s autopilot.

Evan Brand: Yup. That was well said. That was excellent. I had a thought, too. And then I lost it. It was about how the lifestyle component is brought up. People say manage stress but they don’t know how to manage stress. So let me out one piece assigned to this.

Dr. Justin Marchegiani: Yes.

Evan Brand: Because rational brains are like-okay, you guys are getting into airy fairy land. What is this actually doing to me?

Evan Brand: So you have this –

Dr. Justin Marchegiani: Yes.

Evan Brand: – part of the brain called the amygdala.

Dr. Justin Marchegiani: Uh-hmm. Uh-hmm.

Evan Brand: And the amygdala is your- I call it your Rolodex, if you will. It kind of cycles through all of these thoughts, all of these things that come into the brain. And it determines whether it should trigger a fight or flight reaction, or is everything okay and we’re gonna press the green button instead. And with chronic stress- so if you are beating yourself up, You’re in this transition phase, you’re trying to remove bad habits, integrate new habits and your cell phone goes off. “Ding” that notification sound. Here you are trying to have a relaxing lunch, “Ding”, the cell phone goes off . Now you gotta go look at it. “Oh my God, it’s a text message from so-and-so”.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is the last thing you wanted to read. The amygdala, that part of the brain, is gonna go, “poof”, red button fight or flight. And the more that that red button gets hit, that becomes a hair- hair trigger. Just like a really sensitive firearm, that trigger is so sensitive you better be careful unless you’re ready to use it, don’t even get close. Because, “ding”, that notification goes off again, “poof”, red button gets hit. Fight or flight system goes, stomach acid becomes a luxury.

Dr. Justin Marchegiani: Yup.

Evan Brand: So there goes good digestion out the window. Blood flow’s now shunted away from the central part of the body and blood flow is basically going to design- be, be working to get you to run.

Dr. Justin Marchegiani: That’s it.

Evan Brand: And our goal is, you don’t want to press that red button. Leave that red button alone. Put a glass case over it. So it’s a lot more difficult to hit that red button. And this takes practice. You and I talk about this. There’s things that can still stress us out and still get to us but the goal is, with the combination of bringing in this functional medicine approach. So this is where the adapted genic herbs come in.

Dr. Justin Marchegiani: Yup.

Evan Brand: So like Rhodiola. You can look at a research study Rhodiola,  200 mg was used in about 1200 patients. And after just three days, it was- I believe it was above 90% of all of these patients experienced “a massive reduction in life stress”. So in this case, the adapted gene could be putting this glass case over this red button in the amygdala so no longer is as fight or flight system immediately, “ump” We’re not gonna hit the red button anymore. We’re building up the resilience so you can be a warrior. So next time that text message comes in, you can- maybe you shouldn’t have your phone by your table on the first place, but that’s fine. Let’s say you have it there, now you look at that bad text message and you can process it first. So instead of immediately, “ump”,  automatically hitting the red button. You can look at it, “okay not a big deal, I’ll take care of this . I’m gonna finish my meal first because I know Justin told me that if I skip meals, my blood sugars gonna crash coz I have adrenal stress right now. And if I skip a meal, have anxiety. And I’m trying to get off the Xanax that the doctor prescribed.

Dr. Justin Marchegiani: Yes.

Evan Brand:  Because I don’t want to be on it anymore and I want to get rid of this anxiety. So what I’m gonna do is I’m gonna put this phone aside. I’m not gonna hit the red button. I’m gonna put the phone aside, finished chewing my meal, take in my enzymes.

Dr. Justin Marchegiani: There you go.

Evan Brand: I’m gonna press the green button. Everything’s okay. There is not a situation I need to fight or flee from right now.

Dr. Justin Marchegiani: Yup.

Evan Brand: And let’s get back to life. And the more that you can hit the green button with the amygdala, and the less you can hit the red button, overall the better you’re gonna be. Because you are not designed to be in fight or flight 99% of the time like we are in the modern world.

Dr. Justin Marchegiani: 110%. I love it. So let’s just kinda recap. We talked about stress, how it affects our gut lining, how it affects and burns through neurotransmitters that’s why the more stress you are, you burn through dopamine you burn through serotonin and you start getting depressed. You start getting OCD, you start getting ADHD. So all these different things happen. It starts burning up the brain tissue and affects the area called the amygdala in the brain, which is right around the hypo, hypothalamic area. And that affects memory, the hippocampi, too.

Evan Brand: We didn’t even-

Dr. Justin Marchegiani: Yes.

Evan Brand: We didn’t even talk on the hippocampi. So you can- you can look at-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -with MRIs, the hippocampi you have one on each side. It gets marinated in cortisol and it begins to make these memory centers all look like Swiss cheese. So people as they get older, it’s happening younger and younger. But people joke about being forgetful that’s not funny. That’s a sign that something is going on. So, yeah. There’s tissue destruction, there’s the leaky gut aspect. Keep rollin’-

Dr. Justin Marchegiani: Yeah, a 100%. So you’re rippin’ up the hippocampus. With that affects memory and learning. So if you’ve any job like, let’s say me and you, Evan, we’re havin’ a problem solvin’, think all day long, you’re an attorney, you’re a doctor, you’re a nurse, you’re a teacher __, you-you’re a mom having to deal with your, kids you’re homeschooling you’re dealing with activities, you’re multitasking, people are calling. You need that higher brain function to perform at the higher end. Man, I’ve so many patients are reaching out to me, they’re like, I’m just- I’m a shadow of my former self.

Evan Brand: Yup.

Dr. Justin Marchegiani: Right. They have that inner kind of feeling like that is not quite where they used to be. They’ve aged 20 years in the last year too, right. So we’re trying to develop all these tactics to help. So number one: the diet’s in place. Paleo template, autoimmune template, whatever works for you in that realm. Number two: gets some habits that you can do with your family that will help decrease stress. I like the forest bathing whether its just walking outside or doing a little nature hike. Love it. Number three:

Do push-ups or some air squats, or get a desk treadmill that you can walk at while you’re at work or in between whatever you’re doing. Just get a little bit of movement in. One of the biggest things that CEOs do is they exercise to not work with their body, but to help their brain coz they feel exercise helps with their brain and their ability to function and deal with work stress. So the exercise piece is not necessarily an aesthetic thing or physical thing, it’s actually more of a mental, emotional thing. Number four:  Make sure you have the lifestyle habits of clean water, a good sleep, good sleep habits, and hygienes. And your food- your fridge’s stock of really good food. And once you have all that piece left, then we can talk about supplements. Then we can have magnesium for stress. We can add Valerian or L Theanine. We can add our Adaptogens, our Rhodiola, our Ginseng, our Ashwaganda, our Lutarol, our Maca for female hormones, our chaste tree. We can add extra B vitamins, we can add even adrenal glandular and support. We wanted to find out that more based on adrenal test. And then next piece is we dig more into the functional medicine with the gut and the detox and other specific more nuanced nutritional deficiencies. Anything you want to add to that, Evan?

Evan Brand:  Well, I love how you’ve laid out 1,2,3,4,5 like that because the gut infections, although massively important, that’s so much later down the road. You put so many other foundations and placed first. A lot of people that come straight from what is called conventional and want to go straight to detox. Or, “hey, I took this detox tea” or “this detox Paleo  shake” or “I went straight into some gut protocol”. If all that other stuff is not addressed- Yes, it’s very important to remove Candida. This candida problem, definitely is impairing brain fog.

Dr. Justin Marchegiani: Huge.

Evan Brand: If you look back at- If you look back at my organic acid test from a few years ago, I had Candida problems and it perfectly explain why I was mixing up my words.

Dr. Justin Marchegiani: Totally.

Evan Brand: I was putting words in different order. When I had to address that to get the brain better; however, if I just slept better, I noticed 20,30, 40, 50% improvement in brain function there. So yes, it may be Candida, yes it may be the infection, yes it may be the mitochondrial function problems that we’re gonna have to fix, but also could be that you’re staying up until 2 AM and then you’re getting up at 6 or 7. And you say, “well I can just function better on 5 hours of sleep”. Well you probably just running on adrenaline which will give you that temporary heightened sense of cognitive function, but that’s because your body thinks that you’re running from a bear because why else would you be light sleeping tossing and turning all night. There must be a bear around. We’re gonna have to run from that in the morning. So you’re gonna get that burst, but in the long run, your brain function is going to be sacrificed and your memories can be sacrificed, your sex drive is a luxury. So why ovulate, women can lose their period.

Dr. Justin Marchegiani: Totally.

Evan Brand: Why have a sex drive for men if you’re running from a bear? That’s – Let’s do that tomorrow. We gotta-

Dr. Justin Marchegiani: Yeah.

Evan Brand: We gotta live.

Dr. Justin Marchegiani: Exactly. Yeah, 100%. And one of the things I’m gonna put it out there, so everyone can hold me accountable as well. But the biggest thing I find, too- for myself and a lot of people I talked to, is mobile devices, iPads, phones, Facebook stuff late at night.

Evan Brand: It’s not good.

Dr. Justin Marchegiani: Yeah, I mean, I think I like to go on Netflix or Amazon prime or Hulu and I like to wind down. Find a nice show that kinda entertain me, I can laugh, I can enjoy. But I’m finding, and my wife’s it too, is pullin’ out the iPad or the phone, checking this checking that, checking my email, checking a text, checking Facebook, all this thread. And it’s like, my brain just constantly go, go, go, go, go. The thing I’m trying to do now is, I’m putting my phone in airplane mode. I’m having a little moon on my iPhone so, no notifications come up and I’m putting my phone in my room, already plugged in and ready to go so I can go to sleep.

Evan Brand: You know many family members are mad at me because my phone is on airplane mode like 24-7. You’re like one of the only people that I text because I’m so  anti-phone.

Dr. Justin Marchegiani: I feel fortunate.

Evan Brand: Yeah, haha.

Dr. Justin Marchegiani: I’m taking you out of your Zen date now everytime I text you.

Evan Brand: No, you’re not. You’re fine, man. You’re fine. It’s always good to chat with you. But seriously, though. And apparently something happened to my voicemail, where now my voicemail doesn’t work. So you just get this voicemail has not been set up. I’m not even gonna fix it.

Dr. Justin Marchegiani: Oh, man.

Evan Brand:  I’m not even gonna fix it because that’s just one more thing, right. We’re always pulled away and I want to cut all the strings on things that are pulling me away. And checking voicemail is just one more thing. You how it goes, you get  2,3,4,6 voicemails piling up. I can’t do it.

Dr. Justin Marchegiani: I totally agree. And the big thing I’m challenging you and everyone else, else anyone else out there, have you cut off for your phone, right. Whether it’s 8 or 9 or 9:30. Have that cut off, it in airplane mode. Hit the moon or whatever that equivalent is on the android. What’s the equivalent on the android for zero notifications?

Evan Brand: I think it’s do not disturb mode, something like that.

Dr. Justin Marchegiani: Perfect. Do not disturb. Do not disturb mode, moon mode, sleep mode and then put your phone away. Put in your bedroom wherever that charging place it belongs for the rest of the night. And be present with your wife, or your partner, your child  or whatever that night on time is that you guys do special whatever that routine is. Be fully present with that. That’s the thing that I’m trying to do. Also, I’m gonna be on I think- I think a staycation next week. And I think I’m gonna uninstall Facebook for the week.

Evan Brand: Ooh, I’m proud of you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So one other thing that for me has been massive is completely getting rid of Wi-Fi in the house. I completely disabled it. And so now, I’m hardwired. And so for me to use my phone, you may think it’s funny, but I have an ethernet cord that plugs into a u, an ethernet to USBC, adapter.

Dr. Justin Marchegiani: Oh my God.

Evan Brand: And so-

Dr. Justin Marchegiani: Really?

Evan Brand: Yes. So listen- So this is how much work it takes me to get on my phone to use social media. I have to get- I have to disconnect the adapter for my computer, unplug the adapter, plug up the new adapter, ethernet to USBC, then run with the cable wherever I’m going to use the phone. Plug up to the phone in then use the internet access. So for me, putting that many barriers in place, my phone is completely hands-off. If  I’m not on calls, my phone does not exist to me. And that has been so massive for my productivity because you get in the social media loophole. You gotta check this, you gotta reply on this, you gotta upload new data to this, you gotta post an article here, you gotta put the podcast there. It’s too much. So now, actually a guy from the minimalist, I’m not sure that I chatted with him, was an email something, something with the conversation of the minimalist guy- it was Josh, he said that he completely got rid of Internet in his home. Now for us, we can’t do that. That’s not practical. But for him as a writer, he completely got rid of internet access from his home; therefore he was only able to write on like Word document applications and then when he would go to a coffee shop or something. Then he would have the ability to get online and do email and Facebook and blah, blah blah. So for as a writer, I think that totally valid. It wouldn’t work for us, but like I said, I’ve still for many- many, many reasons disabled the Wi-Fi completely. And it’s enabled me to- I have to be grounded in a set location before I’m gonna use the Internet as opposed to me just mindlessly walking around the house checking this, checking that on my phone.

Dr. Justin Marchegiani: Yeah, I agree. I think we’re hitting it two different ways. You know, I just try to put it in airplane mode and- and sleep mode. And then also the big thing is, you should’ve took this first, but either way, Christmas tree timer plugged into my router and modem. And the Christmas tree timer- that Wi-Fi and Wi-Fi is gone at 11 PM.

Evan Brand: I had that-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I had a power strip and a timer. I would- if we were not home, then I would I would use the timer. I would just let- because the fish tank was on the timer, too. But when we were home, I would just “poof” I would turn off the power strip. But for me, there’s a lot of cool, a lot of cool data coming out from Deborah Davis and some of these other-

Dr. Justin Marchegiani Oh, yeah. Yeah.

Evan Brand: EMF Wi-Fi experts that are showing like the different spectrums and babies. And in all of that- in showing that nature basically drops off around the 2000 MHz range. And that’s exactly where 2.4, 2.4 GHz

Dr. Justin Marchegiani: Gigahertz.

Evan Brand: – and router. That’s where they pick up. So basically, they have this natural, nonexistent field in the spectrums.

Dr. Justin Marchegiani: Yup.

Evan Brand: And that’s where Wi-Fi plugs in. So for me, I don’t want to touch that spectrum, especially with the baby around. I feel much better. To me, it’s- we don’t have to prove it’s dangerous. For me, we can’t prove that it’s safe.

Dr. Justin Marchegiani: Right.

Evan Brand: So for me, it’s not a huge deal to just do the hardwired Internet thing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And I chatted with Bing Greenfield, too. And apparently, he did that. He- in previous conversations he told me he was just turning Wi-Fi off at night. And last time I spoke with him,  he said, “nope, I’m doing completely hardwired. So I’m not the only one going- going so old-school. I don’t have dial-up.

Dr. Justin Marchegiani: Yeah, I think it’s good. I think it’s good but if you’re not ready to go that full length which I’m not because the TVs that I use, I have no cable- No cable TV. So my TV’s all Internet-based. And it’s- I don’t have router. I don’t have access to plug-in up there. So we keep it going just for the TVs at least. But if not, you can always put your router on a Christmas tree timer and just- There’s even one that will be like you can change the hours. So Saturday will go longer or Sunday longer, in case you’re up longer in the weekends. And you can adjust it. But I try to make it so that router is off for about eight hours a night. So that way, I can at least sleep without any Wi-Fi nearby.

Evan Brand: Agreed. Yeah, I think that’s- at the end of the day, the sleep time is most important. Some people goes as far as turning the breaker off in the room. I’ve not done that yet. Maybe when I get a new place-

Dr. Justin Marchegiani: Oh, that’s inconvenient.

Evan Brand: Yeah. You can put a kill switch on the wall but we’ll save that conversation for another day.

Dr. Justin Marchegiani: Oh that’s cool, I like that. Awesome. Part two coming up soon. Awesome, Evan. Hey man, great chat. I think we’re on video. This could be a really good one if we get this whole podcast issue fix, we get the video going, man.

Evan Brand: Go check out Justin’s YouTube channel. Type in justinhealth. You’ll see the videos. You’ve got what- twenty- 20,000+ subscribers there that are checking out your content.

Dr. Justin Marchegiani: Yeah. Over 25,000. Really fun, plus you get to see our ugly mugs here, too.

Evan Brand: Oh, yeah. Don’t say that.

Dr. Justin Marchegiani: Of course. All tongue-in-cheek, man. Alright, brother. Good chatting with you. You have an awesome day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.


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