Functional Medicine Steps to Reversing Depression and Mood Disorders | Podcast #382
In this video, Dr. Justin and Evan talk about depression. Depression is a common mental disorder characterized by persistent sadness and hopelessness. Treatment options include anti-depressant medication and mental health practices such as therapy. Recent research suggests that factors such as amino acids and gut health may also play a role in the development of depression.
Another approach to treating depression and mood disorders is Functional Medicine, which focuses on identifying and addressing the condition’s underlying causes. This approach may include addressing nutrient deficiencies, addressing gut health issues, and identifying and addressing any underlying chronic health conditions contributing to depression or mood disorders.
Dr. Justin Marchegiani
In this episode, we cover:
00:26 – Depression
03:12 – Amino Acids
10:14 – Gut
28:17 – Key Takeaways
Dr. Marchegiani: Hey guys it’s Dr. Justin Marchegiani, today we are here with Evan Brand. Excited to have a nice conversation with you, man! How’s it been? It’s been a little bit! What’s cooking, brother?
Evan Brand: Yeah, not too much is cooking. I figured that over the weekend, I was looking at statistics, and I thought, okay I wonder if things have changed since a year ago or five years ago, or 10 years ago when I really got interested in the topic of depression.
Turns out nope nothing’s changed, depression is still the number one leading cause of disability in the United States. That’s shocking! and…
Dr. Marchegiani: Isn’t that crazy?
Evan Brand: This affects everything! This affects your marriage, the way you treat your kids, the way you treat your co-workers if you’re an employer, the way that you’re treating everyone. And so our job today would be to provide Solutions and maybe some testing strategies that someone who’s suffering from depression or other mood issues. What could they do at home from the functional medicine perspective, and how could you actually reverse it? Is it actually possible to reverse it?
And I would say yes, it is because we see it all the time and I’ve suffered tremendously but I’ve made massive strides in my mood over the years by slowly and systematically fixing little pieces of things that have been wrong with me from parasites and gut infections and mold and lyme and tick-borne issues, all of these add up it’s not just “Oh he’s in a bad mood!”, There are literally underlying causes you can fix so let me just jump into that first and say that from the Psychiatry model of depression, let’s talk, what about your childhood?
Well, what’s your relationship and how do you feel, and how does that make you feel? And it generally stops there. Maybe there’s a prescription given but they don’t ask “Hey when’s the last time your basement flooded?”, “Oh, I saw you had mold growing around your window trim let’s talk about that.” They don’t go into that. They don’t go into your environment, or how your environment may be contributing to it from a biochemical biotoxin perspective and that’s a huge missing piece of the mental health puzzle.
Dr. Marchegiani: Oh I agree! I mean, you know, there’s a study that just came out last year we talked about it, I think, in a previous podcast that looked at antidepressants, and they’re essentially not being effective right? And kind of that whole Serotonin model as being kind of an antiquated model. Right, so a lot of these older medications, they block these reuptake ports where Serotonin would come back into that presynaptic neuron and essentially go back into the neuron and be used up again.
And so essentially, that model of causing the Serotonin to accumulate in between the synapses, so we have a neuron, that’s the presynaptic neuron, this is the postsynaptic neuron, Serotonin would hang out in this area called the Synaptic Cleft. And essentially, the Serotonin will then go back up into the presynaptic neuron, and the medications would block that, it would block that port, so then it would accumulate more in the Synaptic Cleft. And so they’re kind of saying this model is kind of more antiquated. It’s not quite necessary that’s what’s happening.
And that’s interesting because this is the kind of drugs that have been talked about and used in this area, and this mechanism for, you know, 20 to 30 years and so, there’s also some nutrients that you use that are similar. We talk about, kind of 5- HTP, and some of the cofactor nutrients that we use on the amino acid side may plug into that model or maybe it’ll be a little bit different than that. Can we kind of talk a little bit more about the amino acids?
Evan Brand: Yeah, well, first what we do is we look at the urine. And you can measure the metabolites of your neurotransmitter, so Dopamine, Serotonin, Endorphin, you can measure these metabolites. Think of it, the analogy I’ve been using lately is to prove that there was a bonfire, you look for the ashes. So we kind of look at those ashes, and we’re like okay, look at the evidence here, there was a fire burning, so we measure the urine in the same way where we look at these breakdown products of those brain chemicals, and we can infer what the level of brain chemistry may look like.
And we often see low Serotonin in people that are anxious, depressed, irritable, they have trouble sleeping, and so we will plug into that amino acid pathway with things like Tryptophan, or Five Hydroxytryptophan, we’ll combine that with B6 which is a necessary cofactor for Serotonin and then for Melatonin and people feel better. So I think it’s crazy to think about how many hundreds of millions of dollars and hundreds and millions of prescriptions were given out if truly those drugs don’t work! I mean are people going to go ask for a refund now? I mean that’s crazy!
Dr. Marchegiani: I know, right
Evan Brand: Like, what a disappointment really that model was the model, and what we’re seeing is totally the opposite. We’re seeing massive success with amino acids you and I’ve talked about free-form amino acids, these certain blends where if there’s low Serotonin and low Dopamine, we may sprinkle some Tyrosine in there, or DL-Phenylalanine and these people can make a recovery within just a few weeks.
We’re talking if you’re on a scale of one to ten, your depression is a 10-max like you don’t want to live. You could knock that down by half, I’d say, in as little as a month if you’re doing all the right steps.
Dr. Marchegiani: Yeah, I think part of the reason why we see clinical benefit using some of these amino acids or nutrients, so number one, the medications are working differently. They’re not actually adding building blocks, they’re blocking the reuptake of that. The problem with when you block the reuptake of these neurochemicals into the presynaptic neuron is you increase the recycling, right?
It’s kind of like these neurotransmitters go back into that synaptic neuron to kind of hide out from the cold or from the harsh weather, if you will because the longer they’re outside the more they get depleted and so the whole goal of these medications is they block that reuptake but then they end up depleting and impacting a lot of the Serotonin long term. That’s part of the reason why doses have to be increased over time. So there is that mechanism that’s part of the reason why we see side effects with these drugs.
Number two is we’re actually adding building blocks, and we’re also adding the important cofactors that are needed for synthesis. B6 needed for synthesis, we’re providing the amino acids. Also, we never see a patient that has mood issues and we just say “Hey, here’s B6 and 5HCP.” We’re making changes with their diets. We’re reducing inflammation, we’re managing Dysglycemia that means preventing these high and low blood sugar swings.
We’re maximizing protein, we’re making sure we’re breaking down our protein, we’re making sure the fats are good that’s important because every single cell in your body has a healthy lipid bilayer and these lipids if they’re rancid, junky, Omega-6 processed vegetable oils that have been oxidized, that’s going to create stress within your cells and so if we’re using good healthy fats that are Omega-3, fish oil, good healthy saturated fats from pasture-fed eggs, grass-fed meats, you know, wild game organ meats or grass-fed butter or tallow.
These fats are going to make healthier cell membranes, less oxidative stress, and so we’re fixing the Glycemia, we’re fixing the nutrient density, we’re fixing the healthy fats, we’re fixing the digestion, we’re adding in cofactors and so then when we add in different amino acids whether it’s 5-HTP, Tyrosine, different cofactors, Calcium, B6, Folate, B12, these are important cofactors as well so we’re never just giving one nutrient in isolation.
Another problem with a lot of the studies, they’re going to be like “Hey this amino acid without making any changes in this person’s health, didn’t really create that therapeutic effect.” And we’re like “Yeah, well, we never would just do that anyway.” So that may be true that’s why science and functional medicine is hard because science wants to deduce all the variables and just do one thing at a time but we just control 20 different variables right there by getting their diet right, they’re water right, their sleep right, their supplements right, their environment-mold right.
So you know all these things that’s like 20 variables, and so that’s kind of where medicine and functional medicine have a hard time because there’s too many variables that can’t be isolated when we see patients.
Evan Brand: Yeah it’s really not fair too because you’ll see this one headline, this amino acid or natural medicine for depression is BS, it’s snake oil, it’s pseudoscience it’s like okay, well, take Johnny, who loves his wife, loves his kids go for a hike every morning, gets plenty of sunshine, clean house, eats great, no gluten, no Dairy, and he takes it and he does amazing and then you have Betty over here she starts her morning with donuts and she watches negative news, and she sits in the dark she gets no natural bright light in the morning and she takes it and she hates her life, and she hates her kids, and she’s divorced and lonely and smokes a pack of cigarettes and she takes the 5-HTP and it doesn’t work and therefore it’s BS.
So yeah, I agree with you it is hard because what we’re doing is 20 to 30 variables all at once and then we’re not even addressing the part that we talk about too, which is trying to get the Limbic System dialed in because if you’ve been stuck in a chronic state of fight or flight because of your depression, you want to get out of this hole, you feel trapped in this home, you’re trapped in this job, I mean this could be a three-hour mega podcast but the long story short of it is all these other variables those change, how your brain processes, stress, fear, and that all can lead to more depression too. So we’re always trying to implement some sort of mental health practice.
I love doing meditations. It used to sound crazy to me. I used to hate to sit there for five minutes and be quiet but now I look forward to it. Now I’m like “Oh! I’m turning back into the real me!”, versus this busy version of me is different so I think you have to be miserable enough to listen to us when I say and I know that our friend and Mentor Kayla has said this for years something like if you don’t have an hour to meditate you need two and I was guilty of that because I was like I’m too busy. I’m too busy to slow down, I’m too busy to relax and think and now I’m like no I need that time so that I am clear-headed and not depressed during the day because I’m less overwhelmed because I’m more clear-headed.
Dr. Marchegiani: Yes, so when we talk about a lot of things here different factors, just take it with a grain of salt you can find studies you can find people that have had benefits or not, the issue is we’re not going to ever just take and do one variable at a time. There’s going to be a lot of things, and the more leverage you move and the more you set that foundation of health up, the more a supplement or a nutrient or an herb or a Botanical or a hormone could potentially provide a therapeutic effect even though data out there isn’t supported because we’re setting a foundation and moving a lot more variables than these studies are. It’s important to note.
Evan Brand: Yeah, we hit the organic acid test also, if you are having mood issues at all. You need to look into your gut as you and I know there’s a huge correlation between gut infections and mood disorders, whether that’s anxiety, bipolar, depression even panic attacks, this could be coming from the toxins released by the overgrowth of the microbes in your gut so to me a stool test would be a critical component of a mental health workup.
Dr. Marchegiani: Yeah, so in general that’s super important because 80%, 90% of all the neurotransmitters come from the gut now. Some of the data says hey these neurotransmitters don’t cross the blood-brain barrier but either way the amino acids that we take in those do have to get through the gut into the bloodstream and then those would then either get converted in the gut or go past the blood-brain barrier the astrocytes in the brain and they would get converted in the brain so the whole idea of like 5-HTP is those can actually cross the blood-brain barrier and go to the brain but we need to have good health, good healthy gut function to be able to break down and absorb these things and then also the newer model of depression looks at the brain’s inflammation.
They’re saying, hey a lot of the inflammation in the brain could be what’s causing problems. The problem is we know a lot of conventional medicine’s way of addressing inflammation tends to have side effects. We know NSAIDs kill about 20 000 people a year with gut and liver issues. We know Vioxx from the early 2000s killed 60 000 people with strokes and cardiovascular issues. So when you start to inhibit and stop these uh Cyclooxygenase the Cox Pathways. Cox-1, Cox-2, Cox-3 they can have impacts on reducing inflammation but those enzymes are also really important for rebuilding other tissues so you’re kind of robbing Peter to pay Paul.
And so conventional medicine, they have a lot of tools that may have a lot of side effects and so we know this new model of brain inflammation and mood is real and I think that’s why we can move the needle so much when we fix the gut because so much of the inflammation is in the gut. Whether it’s from food dysbiosis, endotoxin from bacteria, mycotoxin from fungus, or colonized yeast or mold, H. Pylori, parasites, just not breaking down foods and having larger food molecules of of dairy, Casein, wheat right grains and so all of this inflammation in the gut can be easily driving inflammation in the brain.
Evan Brand: Do you think you can eat your way out of this because that’s a common thing that just spreads on social media like wildfire is this idea like if you just get your diet perfect, all your problems go away and I already have my answer but I want to hear it from you because 90 plus percent of people that come to us are already doing something to improve their diet and they still have these issues.
Dr. Marchegiani: The more chronic the problem is no because I give an example of a patient, right? If you’re driving down the street and you get a flat tire right and now your car is not driving well, if I change that flat tire that day, do all my problems with my car go away? Yes because it just happened that day. But if I were to drive around on that flat tire for years and then be like well the root cause was that flat tire if I just change the flat tire I’m addressing the root cause the car should go back to normal like it drove three years ago well now you have collateral damage because you drove the car now aligned for years now the front end, the axle the suspension the shocks, the steering, everything’s jacked up and so just because you fixed the underlying root cause collateral damage happen in other places in the body.
And so then now you have to come in there and fix all the other collateral damages that occurred.
Evan Brand: Yeah that’s a great analogy. I mean the sound bite makes it difficult for us because then we have to explain that to people because people say oh well I heard from so and so if I just eat this, if I do kefir, if I do grass-fed Meats I’ll just be fine. That’ll fix my SIBO, that’ll fix my infections, that’ll fix my health issues and if you could eat your way out of this, if everyone could eat their way out of this then you and I wouldn’t be having this conversation right now.
Dr. Marchegiani: Yeah and a good history is really what tells you because usually with a good history, you can kind of see where the first shoe to fall was right. you’re like going to the person’s history their diet was good their lifestyle was good they had a mold issue in their basement because of a flood that wasn’t addressed and it’s like oh okay that screams to me this is an environmental thing or you can go back and see there was emotional stress and then there was some diet issues and then antibiotics you’re like okay.
So the history kind of can tell you you know how things started to unfold just like if I told you my history about my car and I told you three years ago I got a flat tire, you could say Okay, I see how that kind of unfolded. So this is where a good history you know really makes a lot of sense and then you want to also go into it not thinking it’s just one thing. It’s just the mold, It’s just you’re the gluten, it’s like no no. So when you have people that are like just dietitians, the problem is all they have is food. So all they’re looking at is food as being the underlying issue and that’s the problem.
You have to have a broader tool belt because then you’re like okay, food definitely is blood sugar, definitely is. But then other things could be as well and you want to combine everything.
Evan Brand: It may be a little harder for us to explain that and we’ve done this for a decade plus now which is that we have to be generalists and specialists at the same time like if you go to just the diet guru he’s going to convince you everything that you do diet wise is going to fix all of your problems and then you and I go wait a second you take 20 depressed people that come to us there’s going to be 20 different clinical outcomes and 20 different clinical protocols for this people here.
Dr. Marchegiani: And diets too!
Evan Brand: It could be this lady here, it was the death of her husband, it was an illness, it was moving out, it was Trauma from her children and it was mold exposure and dysbiosis and she was on XYZ medication versus over here lady just had thyroid issues. Okay easy fix that depression, this lady here gut infections, fixed that, that depression is gone. So the problem with the mental health space is it’s like okay depression and everyone thinks they have the same flavor of depression. You can have 20 different flavors or 20 different little small rivers that all end up at the same symptom depression but not everyone is getting there the same way the same path.
Dr. Marchegiani: Bingo! 100 percent! And even with diets right, I see some patients and they’re super sensitive to vegetables. They can’t even handle vegetables; some have to be on an elemental or even a carnivore diet. Some are just okay with the Paleo template, some need some level of variation between an autoimmune or an SCD or low oxalate or so there’s always a different variation depending on what’s going on.
So food always is important, so when we look at food, we’re looking at nutrient density, anti-inflammatory, low Toxin and we’ve got to make sure that you can break the foods down that’s super important and then the next part on top of food is that we don’t have enzymes acids in bile support, dial then and you can’t break that food down that food’s going to be a stressor inside of your body. And then, of course, all those nutrients to run our brain chemicals and pathways have to come from that food so if we don’t break them down and absorb it then that’s a problem too.
Evan Brand: So let’s make that visual for people so this is a 52-year-old woman, she’s had digestive issues for 20 years and she has depression. She was told if she does go autoimmune or she does go animal-based, she’s going to be fine. She does it, now she has diarrhea, she doesn’t know what to do, she’s confused. How do we approach that and break that down?
Dr. Marchegiani: Yeah, so I mean, the first thing is we have to look at her gut because even a healthy diet and healthy enzymes and acids there could be infections and stuff inside the intestinal tract that could be creating stress and inflammation so we’re going to work on the enzymes, we’re going to work on the acids, we’re going to make sure she’s breaking down her fats, we’re going to make sure the food is dialed into to whatever degree we think we need to based on how severe the issues are and then we’re going to be testing, we’re going to be looking at what’s going on with her microbiome and her and dysbiotic bacteria and yeast and bacteria and potentially colonized mold. This colonized mold from the living arrangement for where you live could be impacting things as well so we’ve got to look at everything.
Evan Brand: Yep, Candida could be in the puzzle too so people blame the food and they’ll say oh well I don’t feel good with meat like I’ve tried that I don’t feel good I’ve tried to increase fats I don’t feel good and then they may give up and we’re like okay it’s not the food that’s the problem it’s everything else that’s in your bucket that’s making that a problem. You should tolerate this, you should feel fine with it, it’s just a matter of getting your nervous system calmed down.
Someone in the comments has a vagus nerve yeah I mean your nervous system is a piece of it, we were talking about the limbic system. You know if you’re stuck in fight or flight all the time that you know that’s going to impair your ability to digest your food I mean how many times have you been in an argument at the dinner table you get done with the meal and you don’t even remember you’re still hungry. You’re like did I even eat? Like that’s what we’re talking about here.
Dr. Marchegiani: Yeah, when you’re activating your amygdala and or your limbic system, this is kind of your fight or flight response, that’s going to go up the vagus nerve or your parasympathetics go down it’s not a seesaw. So as the limbic, amygdala, brain stem right that’s the back part of the brain these are all primordial reflexes for fight or flight and survival okay. So very very important and the problem with that is if this is over activated the parasympathetics which are really that’s the vagus nerve, that’s this whole entire nerve cascade that helps with rest digest, activates the frontal cortex so you can make decision making, you can see the outcome of poor decisions and actions and then you can stop acting in a bad way right.
Most crimes and people doing bad things it’s because they’re thinking from their amygdala brain stem and not their frontal cortex, and so the more stressed you are that can create problems. I also saw, I read an article one time where a lot of things like road rage and like serious crime done like impulsively, was done from people that were hypoglycemic, so very low blood sugar. Because the low blood sugar kind of creates a stress response, and that activates the frontal cortex I mean, everyone can have that response of like dealing with their spouse and they haven’t eaten all day, and they’re just like, “Oh my God! I just need to eat like I’m just, I’m angry!” right.
So things like nutrition and blood sugar could easily impact that kind of brainstem response now outside of that there are different programs and things you can do, like you mentioned earlier in meditation or there’s different programs like DNRS or the Gupta program or NLP or EFT or EMDR. These are different programs that help get at the subconscious, limbic system, brain stem response kind of calm down which then brings up the parasympathetics and brings up the vagus nerve.
Evan Brand: Yeah and this was a critical step for me I mean I didn’t realize I was stuck in fight or flight until I downshifted from it and then I’m like, “Oh wait a second, man I was running running running like a little rat on a wheel”, and then finally I kind of snapped out of it, and I was almost running on autopilot I’m like wait a second I need to be more conscious with what I’m doing my actions and all of that.
So sometimes you have to say no to be able to say yes and what I mean by that is if you’re a people pleaser, you may end up as a depressed, anxious person because you’re constantly trying to satisfy everyone’s needs. This could be for your children or your spouse or whoever. If you’re a people pleaser we find this a lot. Those people are the ones that end up more burnt out, more anxious, more depressed, whether it’s a caretaker role as any sick family member or a sick parent or aging parent or just trying to please people in society.
So it’s okay to say no if you’re too booked up, if you’re too tapped out, you can say no to someone. Get your mind right, sit down, get your functional medicine labs done, get your work up done, so you can see what you’re up against. When you’re so stuck in fight or flight, you’re dealing with blood sugar crises, you’ve got toxins, you’re worried about your house, you got to get the plumber over to fix the leak, you got to separate from all that if you need to go sit out on the front porch and watch the birds fly for a minute to get your mind right that’s what I would do.
Dr. Marchegiani: Yeah you kind of mentioned the people pleasers. I grew up with some of those and it’s interesting right? Because you think people pleasing comes from a place of like, you know this is good, I want to help all these people around me. The problem is there’s also on the other side of the people-pleasing spectrum is a lot of resentment, because people pleasers will do a lot for this person XYZ, family, friends, kids, etc.
But then there’s this unspoken kind of goal or agreement that they’re kind of making that person is also going to make them a priority at some point and help them and if they don’t, it’s totally unspoken, this is where the resentment comes in. “Hey, you didn’t do this for me but I did this for you.” It’s like “Well, wait a minute. I didn’t realize I had to pay you back on that. I didn’t realize that was something I had to like to be indebted to you. I thought you were just doing that out of kindness.”
So it’s really important that you know, one, that you make yourself a priority that’s important because only you know what you need. Only you know the rest you need, the self-care you need, the things that you love, the hobbies, the time that you need right? Only you can put food in your mouth and get to bed on time. I can’t ever force you to do that.
And then you’re kind coming from a place of abundance where your cup is filling over and then, the spilling over is what you give away to friends and family and obviously, this is different if you have young kids right because they can’t take care of themselves but as kids get older and family gets older right it’s kind of more of that cup running over and that’s a much better mindset than having a low cup where you just give away and then your cup super low to begin with.
So just kind of make sure that you’re making deposits into yourself and then using the abundance to help others around you after the fact.
Evan Brand: Yeah and this could be something simple, this doesn’t necessarily have to be a supplement, this could be you taking a hot bath, you could be scheduling a massage, you’d just leave the house, go take a little drive, if you got to get away hopefully your spouse is supportive. If you say “Hey, gotta get my mind right. Gotta reset, go for a drive honey.” Perfect! These are the small steps that allow us to think clearly about our next action step but if you haven’t looked at your underlying issues, it’s time to look.
If you’ve done the diet, you’ve done the lifestyle, get the data because if you’re not testing, you’re guessing.
Dr. Marchegiani: Yep and anyone that has young kids, you have three kids, I have two young kids. We know kids, their needs are insatiable and they will never fully be satiated where like, you go do this activity, you do this, you give them this treat, you have this meal, you have this experience, the kids will never say “Mom and Dad thank you so much for this great day. You go take care of you now.” That never happened, it’s like “Now we’re on to this! And now we’re on to that!” right? There will never be that closure of like, “Great job Dad, thanks!” It’s like “Now what’s next? Now what’s next? Now what’s next?”
So you have to have that like all right, “Now it’s Mom and Dad’s time.” We’re gonna get a sitter, we’re gonna have a date night, we’re gonna have, I’m gonna schedule a time to go for a drive or go for a walk or meditate or exercise right so you have to kind of have that boundary within yourself and know that no one’s gonna just probably pat you on the back and say “All right, you go do you now,” probably not going to happen.
Evan Brand: Yeah and that’s not really a sexy advertisement that’s going to come from the media or anywhere else. There are benefits to society being caught up in this Loop and when you can step back from that it really helps change your perspective and even just that perspective change alone can help improve your mood so this topic is all about depression but as you see there’s a million different little spider webs. Yeah little inputs here and I think this is a totally reversible condition, yes there are genetics involved, yes there are environmental pieces, biochemical pieces, nutrition, lifestyle, digestive, all of it adds up but you really have to just plug and fix each little hole in this happiness bucket.
If you think you’re happy I think of it almost visually this bucket of happiness, default that’s what it is like my baby she’s default happy but as you age you get inflamed, you get infections, you get nutrient deficiencies because the soil’s depleted. Even if you eat an organic orange, you gotta eat 20 of them to equal the orange of 1920’s,
Dr. Marchegiani: Exactly
Evan Brand: Well, that’s a hole in the bucket. And then it’s, you’re overworked, okay that’s a hole in the bucket. This is why tribal societies, you ask them, they rarely have a word for depression because all the inputs they’re getting are keeping that happiness bucket full or set another way, they don’t have as many holes in their bucket that we in the modern world do so try to plug those holes, fill that bucket and you can totally reverse from this to where your life is something you look forward to, rather than you dreading your life and wishing it away.
Dr. Marchegiani: I love it! I love it! And so outside of that, if you have like previous trauma, whether it’s sexual abuse or issue with marriage or kids, get the support you need on the counseling side, behavioral therapy or if it’s like some kind of a subconscious trauma that’s there from the past, you know, EFT, EMDR, NLP, these are techniques that really work on that kind of subconscious stress, just make sure you have support for that if that is a thing or not and then everything else that we’re going to recommend is going to be customized because I could have a patient with really really high cortisol and all these nutrient deficiencies, we got to get that cortisol in check because that’s going to be causing limbic system problems.
And if I see these neurotransmitters off or important cofactors like Folate, B12, and B6 off, that could be a bigger deal for someone that maybe have normal markers for that. And so a lot of the rec like, these are things that could be wrong, but then we like to have that individualized approach so we’re not guessing, we’re assessing. So this is where we’re going to do organic acids and nutrient tests, this is where we’re going to look at the hormones so what we’re going to look at blood sugar and diet.
Just causing dysglycemia issues can cause massive problems so you can go get like a Freestyle Libre Three, put it on your shoulder, connect it to your phone, and test your blood sugar for two weeks, see how you do, see how you feel, monitor that, creating awareness, check, track your sleep, track your HRV, see how you’re doing in regards to your recovery and your parasympathetic response. These are some cool kinds of devices that you can do to kind of monitor and bring awareness to what’s happening.
Evan Brand: Yeah absolutely and I would say for someone that is on the verge of giving up and they have no hope, have hope, just reach out to someone, talk to someone. If you are obviously suicidal, you know call The Suicide Hotline. Don’t kill yourself over this, it’s not worth it. There’s too many people ending their lives that they could have been fixed. I mean just a famous recent case of suicide was, it was the either president or there was someone high up in Texas Roadhouse. It was a, there’s a restaurant chain that was headquartered in Kentucky where I’m from, and the guy, post virus, had tinnitus, and of course he got depressed from that and ended his life.
It’s like, well, there’s a million things we could do to help with tinnitus, like if he could have had a functional workup, he might have been able to fix that and would have ended his life. So there’s so many different situations that lead to someone doing that but I’ve even had clients where in the beginning they feel like they’re at the end of the rope and by the end, they think, “Why did I ever think that?” “I’m totally out of that mindset now.”
Dr. Marchegiani: Yeah, the last thing you want is a permanent solution to a temporary problem, right, that’s what suicide is. It’s a permanent solution to a temporary problem. We gotta have that solution-based mindset, okay? And again, the healthier you are, the more adaptable to stress you become, right, the more you’re going to think with that frontal cortex, the more you’re going to be able to problem-solve and get to the root.
So I think we have some good things here, that we kind of laid out. Again a lot of this will be individualized again if you guys want to dive in deeper, head over to evanbrand.com. Evan has research and resources for y’all, sees patients worldwide, and you also can head over to justinhealtstg.wpengine.com as well. We do functional medicine support worldwide, so you can reach out to either of us. We’ll put some links down below of different supplements that we like, different labs that we, like highly recommend work with a practitioner so you can have a guided approach.
Again it’s not just if I gave you a recipe right and I said, hey these things are, this is what you need for the recipe, but I didn’t give you the right order, and I didn’t customize it for you you’re gonna have a bunch of slop because if you put the eggs in after you baked it right it’s just not going to taste good and so the order of operations and that customization approach is so important that’s how we get patients better so just kind of FYI on that. Anything else Evan you want to leave a listen with?
Evan Brand: Yeah, I appreciate the website and we are some of the best guys out there. We don’t say that just to toot our own horns, we say it because we’ve been through our own struggles, and we’ve helped thousands of people worldwide.
I’ve confirmed with the labs that we work with that we are in the top 10 worldwide of practitioners running the most labs, and from that, we see a ton of data, and with that data, we can help people the average person has been to 5, 10, or even 15 different practitioners specialist, other functional medicine people, naturopaths, conventional doctors, neurologists, cardiologists, and then somehow they wind up with us, and we give them good results so if you do decide to work with us we’re going to take great care of you, as he mentioned, Dr. J at justinhealtstg.wpengine.com that’s justinhealtstg.wpengine.com or me Evan Brand at evanbrand.com.
We’re happy to be there for you guys, and we’re always willing to look someplace that someone else hasn’t looked at, that’s why we don’t give up. We’re just ruthless for the pursuit of health and happiness, so thank you all, and take good care.
Dr. Marchegiani: Excellent! If you guys found value in this, please give us a share with friends or family, write us a review, put a comment, give us that five star on iTunes we really appreciate it. Thanks, guys! Have an awesome day!
International DSL GI Map Genetic Stool Test
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How to Deal with Stress and Feeling Overwhelmed – Functional Medicine Approach | Podcast #380
Let’s get real: there are times when you’re going to feel overwhelmed. Whether with work, school, social obligations or just life, we all feel anxious, overwhelmed, or stressed at some point. In this podcast, Dr. J and Evan discuss that giving yourself grace and patience when you have these feelings is essential as well as your gut health.
Different coping mechanisms work for each person. The following suggestions can help. If one doesn’t work for you, consider trying a different one. The most important thing is to check your diet since what you eat can significantly affect your overall function.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:28 – Foundational Physiology
12:51 – Mold and Fight and Flight Response
28:35 – Takeaways
Dr. Justin Marchegiani: Hey guys. It’s Dr. Justin Marchegiani. I’m with Evan Brand today. We are so excited to be back at you with a live podcast. We’re going to be chatting about stress and overwhelm, and how to deal with it. What’s the functional medicine approach? Evan what’s cooking, man? How have you been?
Evan Brand: Oh, really good man. The first thing. Let me make sure my camera looks good. The first thing is like people run to alcohol in modern society, it’s socially acceptable to run to the liquor store, even as a soccer mom, and go buy enough alcohol to just kill your whole family and nobody bats an eye. And that’s like our.Coping mechanism not just as Americans, but other societies too. So I’m hoping today everything people have been through. Overwhelm is huge, man. A lot of people are burned out. A lot of people are frazzled. The stress response is broken. Their fuses are short. They’re nervous systems are stuck in fight or flight. So I was like, man, let’s hit this as a topic because, let me tell you, the pharmaceutical route is nasty too. It’s Gabba like products, but it’s Xanax and lorazepam and all these benzos, which are benzos terrible. They’re addicting.
Dr. Justin Marchegiani: That could be hard to get off. You start at a, you know, 0.25 to 0.5 milligram dose, and then you keep on ratcheting up and then it’s hard to come off it once you start getting really high.
Evan Brand: Now if you saw a VAT of adaptogenic herbs that you and I have consumed in the last decade between us it would be a large VAT of adaptogenic herbs, but that’s what allows us to work hard with sick people and raise children and keep up with animals and wives and houses and all of that. And so for me, that’s my first thing for someone. If I could take someone as a conventional American on the street going to drink alcohol tonight because they’re stressed or overwhelmed. I’m gonna say, hey, instead of reaching for that bottle, reach for the bottle of water or maybe some herbal tea like chamomile if you want. But then let’s hit some adaptogens. Let’s go for maybe some Relora. Let’s hit the passion flower. Let’s hit Rhodiola, let’s hit something that we can do to change the stress response. There’s tons of studies but today’s more free flowing conversation. But if you type in Rhodiola stress, there’s many, many studies done on this and how it literally alleviates the feeling of stress meaning, you and I can’t magically make the stress and overwhelm disappear from someone’s plate. But what we can do is provide their body nutrients so that their brain, their nervous system, doesn’t think that plate is as full as it really is. And that’s the cool thing about these.
Dr. Justin Marchegiani: 100%. So when I look at any type of stress, I always look at the foundational Physiology because if you take someone’s Physiology and you throw it off kilter like for instance the easiest stressor to put someone under acute is acutely is just don’t sleep for a night and then let me just kind of, you know, see you in the morning and list out all my problems and complaints and stressors that you have to then deal with. Well, you’re gonna have problems being able to take that information in and be able to execute. So we have to look at the foundational Physiology. So the first thing is sleep means if you can just get 8 to 10, eight hours of sleep and get to bed on the other side at midnight. That sets your Physiology up in regards to recycling your neurotransmitters having a good healthy cortisol awakening response. That circadian rhythm or cortisol is higher in the morning and lower at night. So then you have this inverse melatonin-Cortisol ratio. Where your cortisol drops at night, your melatonin goes up and then of course, you know, making sure the food is nutrient dense, good proteins as fascinate meal and we’re not overdoing the carbs, what our body needs and it’s anti-inflammatory and we’re stabilizing that blood sugar because people forget one of the biggest stressors on our hormones is that blood sugar fluctuation throughout the day the more this glycemia we have, the more our blood sugar goes up and down, like a roller coaster. We have to make stress hormones to bring it up and then insulin to bring it down, which then causes us to be in a fat storing mode. And so if we can manage your blood sugar, prevent these disc glycemic swings, we can make sure we have good proteins and fats. Stay away from the junkie process, fats, and we manage that blood sugar reading every maybe five hours or so and getting to bed on time. That sets the foundational Physiology and then we can come in there and biohack and add other nutrients and stuff as well.
Evan Brand: Meaning if you’re a vegan, living on date bars and drinking yourself to sleep with wine. Yeah, you gotta stop.
Dr. Justin Marchegiani: Right. Yeah, yeah. I mean, again, like with alcohol, like every now and then is having a little bit of alcohol to kind of distress. Is it OK? Sure. Choose clean organic alcohol, do it after a meal, maybe have some activated charcoal or or some NAC. But that’s like at the end you really want to have the foundational food, the foundational nutrients. Again, if supplementally, the easiest things I’m going to add and I like to stick to nutrients first, so I’m gonna do magnesium. That’s a very kind of sedating, calming, supporting herb. I mean nutrients and minerals. It’s going to have 300 enzymatic roles in the body, anywhere from blood sugar to relaxation, to relaxation in the heart, to vasodilation, to sleep. Very anti-inflammatory in the brain so I love magnesium. You can even do it with a magnesium salt Epsom salt foot bath which is great too. If you have gut issues that help with the absorption you could be doing theanine which is an amino acid that helps upregulate and support healthy GABA levels you can even add-in pharma GABA, maybe a sublingual GABA tablet, that’s excellent as well. So a magnesium, GABA theanine, these are excellent things out of the gate from a nutrient standpoint. Anything else nutritionally you want to highlight?
Evan Brand: Well, I told you, I was texting you over the weekend. I got hit with something luckily I’m back in action. But my resting heart rate was pretty fast, so my nervous system was just kind of boom, boom, pumping, responding to whatever type of sickness I had. And so that kept me up. So I took some motherwort as you know, motherwort is one of my favorite herbs, because it’s great for the heart. We use it for A-fib, we use it for atrial flutter or any kind of heart palpitation type symptoms. It’s amazing, it’s calming that, but it’s great it’s calming emotional stress too. So if you’re overwhelmed, if you’re frazzled, if you’re even getting to the point where you’re like.I’m going to have a mental breakdown. I’m gonna have a panic attack. Somebody put me on some kind of drug. A lot of times psychiatrists will prescribe antipsychotic medications, which are not the answer. They’re not the root cause at all, but motherwort can really calm you. So it’s an emotional support and it’s a heart nervous system support and it’s great if you wake up in the middle of the night and you can’t get back to sleep. Take a little squirt, go lay back down. It’s amazing. Doesn’t taste great, but it works amazing. So I would rate that as more potent than something like theanine.
Dr. Justin Marchegiani: Yep. And then also um ashwagandha I find to be very helpful as well. I’ll take that before bed if I need to, I’ll typically do a magnesium before bed. Ashwagandha can be really good, especially if you’re stressed because that’s going to help modulate the high cortisol, but also can help bring up any of the low cortisol as well, so ashwagandha is excellent. You can easily combine that with the Rhodiola. Two things like ginseng tend to be a little more stimulating so things like ashwagandha are going to be great and even phosphorylated serine. Serine can be very common. What serine does? It sensitizes the receptor sites on the hypothalamus to cortisol. So there’s this natural feedback loop of cortisol circulating in the body. It binds to receptor sites in the brain and the brain is like, whoa, this is a little bit high, let, let’s kind of calm down that cortisol secretion so it helps regulate that cortisol from getting too high, so phosphorylated serines are excellent. PhosphatidylSerine is kind of 1 electron. It’s one step in the enzymatic process backwards. So phosphorylated it’s better because it’s a little bit more activated and activated state. So that’s excellent.
Evan Brand: Man, I’ve been looking at some papers on mold toxicity and melatonin. So mold actually does a couple things. That’s crazy. If you type in mycotoxins, dopamine, you can find papers saying that mycotoxins damage the part of the brain that makes dopamine, so then you’re less likely to have energy and focus and concentration. So I’m sure that brain fog increases your stress and overwhelms you because you feel like you’re less capable of being a parent, being a boss, whatever you got to do at work. So, that’s one impact of mycotoxins and then also it’s reducing melatonin. So, I know when I was out of my house, we were staying in a hotel for like six weeks with the kids. It was crazy, but I didn’t sleep. I mean, it took me 3 different hotel rooms to find one where I could sleep and I just, I’m assuming now it was a mycotoxin issue, screwing up my sleep. I’m sure I was stressed from being out of my house. I mean that was years ago now. But I look back at that time and I go, Oh my God, anytime I’m exposed to mold, like in a hotel, I just don’t sleep. And then the research proves that. So my advice is if someone is dependent upon medication and herbs, a supplement for sleeping. If you are sleep deprived, the first thing you mentioned is the foundation. If you are sleep deprived and that’s creating stress, well, what’s your environment look like? Do you have good air purification? Do you have dehumidifiers? Do you have a mold problem? Do you have water leaks? Are you living in a moldy apt, a condo or townhome? It has water damage because if so even the most perfect supplement protocol can’t counteract us, so you may need to take steps to investigate your air quality, like some Petri dishes. And maybe there’s something there. Maybe when you get out of there, you sleep better. That’s a good clue that you’re onto something.
Dr. Justin Marchegiani: Yeah. The problem is most people, they have issues and they take action, but they’re still kind of anxious about what’s going on. So it’s really important. Action should help with the anxiety. Like the reason why anxiety is there from an evolutionary standpoint is to get you to take action to avoid, I don’t know if there’s someone gotten that woods. Last month they got eaten by a bear. Well, yeah, when you get near that woods you should be anxious because your body’s hardwired and make you more alert so you don’t get eaten by that bear. So you have to understand where the anxiety is coming from and as long as you’re taking actions. And you’re closing the loop, so to speak, on what that anxiety is coming from. You should feel better about it. And so I always say whatever the anxieties are, just try to have one or two solutions for each one of those. Then your brain knows, hey, I’m doing something about it, I can turn down that stress response because action are already being taken. So think about that as well. And then also like you mentioned, hey, if I have, if I’m uncertain about my environment, let’s get that mole test. If the mold test is positive, let’s do at least one thing to make sure that the environment gets better. Are there active leaks? Do I see water stains on the ceiling? Is there a chronic high level of humidity? Let’s work on that.If not, we can always just get in some good air filtration. We can work on fog in that area, make sure there’s no active leaks coming in. Then we’re, you know, getting a dehumidifier in there. We’re taking active steps. So you shouldn’t feel as anxious about that environment because you’re starting to make it healthier.
Evan Brand: And people say, what the heck are they talking about molds for on a podcast about stress and overwhelm? Well, here’s the mechanism. Your immune system responds to the mold as a threat, and it is a subconscious threat, meaning you Evan, or you Justin sitting here, you might think, OK, I’m not very stressed right now, like, I’m having a good time, this is great. But your nervous system subconsciously is running all these programs that are saying, hey, look, there’s actually a toxin in this room I’m responding to. And so you’re amygdala, your fighter flight system, part of your limbic system sends out an alert. Danger, danger, danger. And you may not even know it. So you could be sitting here on your couch, anxious for no reason. And it’s your limbic system. And many, many people report when they improve their air quality. They can settle down. So that’s the mechanism. I want people to understand when you think overwhelm you think just emotions in your head. But no, these external factors, these external toxins and variables can impact you. I mean, what about a bad neighbor? What about every time you see your neighbor’s car pull up, you’re like, Oh my God, there’s John again. And John stresses you out every time he pulls in the driveway because you guys got in an argument, so, you have to.Integrate some four of, I would say trauma release into all of this too. So you and I are big fans of tapping. So I would say if you’re catching yourself in these loops, you mentioned closing, closing the loop, which I think is smart but if you’re stuck in a loop well maybe you could integrate some tapping to pull you out of that. So tapping is basically acupuncture, but without the needles. You tap these points and then you say an affirmation. You know, I’ve done that many, many times here.
Dr. Justin Marchegiani: I think it’s very good. Kind of helps calm down the nervous system response. There’s different programs out there. I’ll put some links down below like there’s DNRS or the Gupta program. These are excellent programs that involve visualization, maybe some aspects of NLP. You really work on controlling the thoughts and the images in your brain, whether you do tapping or eye movement like EM DRI movement, desensitization, response techniques, these things help calm down that fight or flight response and then you kind of allow you to be using more of your frontal brain because the data is when you’re in this chronic stressed out state, the amygdala right that. That forebrain or that hindbrain is kind of more active, that’s the prehistoric brain that is involved in fight flight and that fear response. And so most people are all working from this reptilian brain versus that frontal cortex that involves thinking and looking at your options and coming up with solutions and problem solving and predicting outcomes based on where you’re at, right. We need that frontal brain. But if we’re using our reptilian brain right, then that’s gonna be activated with a lot of these stressors. And so one study right here, I’m looking at, I’ll pull it up here and we can talk about it. I think that kind of supports what you’re saying regarding mold and this fight or flight response, being a big deal. So this one study here was looking at mold inhalation causes an innate immune activation, neural cognitive and emotional dysfunction. And they were talking about intranasally administering different, you know, this is black mold Stachybotrys. And they were looking at, you know, innate immune activation, toxic mold and how it affects your emotions. And of course it’s going to impact inflammation. It’s going to cause joint pain. It’s gonna cause sleep issues. You mentioned earlier, it also has a major effect on dopamine. Can you highlight that again?
Evan Brand: Yeah. Dual control F is dopamine in that paper. It might be a different paper. See if you can find it.
Dr. Justin Marchegiani: Yeah, here you go. So exposing drosophila to 0.5 mil part per million of this chemical causes significant loss of dopamine neurons. So decreased dopamine levels and initiated onset of Parkinson’s, suggesting that exposure to mold produces the chemical that may be another environmental risk factor for Parkinson’s disease. So dopamine is really important for feeling good, for focusing, for dealing with stress. It’s that neurotransmitter that gives you that kind of connection that makes you feel loved, so really, really important and it talks about long term inflammation following mold exposure and autoimmune changes in the brain. So that’s that’s powerful.
Evan Brand: Yeah, this is huge. Uh, trying to get Dale Bredesen on the podcast, he wrote a book called the End of Alzheimer’s. And now he’s really hitting the mold angle as an Alzheimer’s link. I think it’s a huge piece of the puzzle. That and heavy metals but many people may hear this and they may just glaze over what we’re seeing. We’re literally saying that your environment could be contributing to a neurodegenerative disease where your neurologist is not going to have a clue. They’re not going to be testing you for this stuff. They’re not going to ask you about your water leak under your kitchen sink. They’re not going to be running mycotoxins in the urine, they’re not gonna look at the Great Plains or organic acids test. So in terms of. We’ll talk about testing in a second, but I think we should describe to people, how do you know if you’re in a state of overwhelm? Because many people are so used to living in fight or flight that they don’t really know how to downshift. So maybe we should go through symptoms, I will say inability to make decisions or analysis paralysis, like, if you’re struggling just to decide what to make for dinner, or you’re struggling just to decide what to do tomorrow, that’s that’s a huge problem. You can’t comprehend simple decision making, I would say loss of libido, loss of energy, motivation, sleep disturbance, maybe some sugar cravings, brain fog, anxiety, I would say distractibility or escapism, meaning you’re always jumping from like social media app to social media app. Like you just don’t want to live in your reality because you’re in a state of overwhelmed, that’s like escapism. What else would you add to the list?
Dr. Justin Marchegiani: Like, well, I would say it just depends where someone’s at, right? If someones going into an acute exposure or an acute stressor and they have a good foundation. That’s a good, that’s good because a good foundation you know allows you to deal with and adapt to stress. So I always look at it’s always good to model healthy people. So you work on the water, you work on the food, the blood sugar, the good fats, the good proteins, the sleep before midnight, getting enough movement so you feel energized but not tired. That’s a foundation. And then if the stressor comes into your world like mold, right? In this study, they talk about not just mold, but pesticide exposure, smoking. Right. So basically I’m looking at air and living quality. So the first thing I’m going to do is I’m going to just cross things off my list. I’m gonna get a mold test from my house, whether it’s a plate test or an army test. I’m going to make sure I have good quality air filtration because even at my home there is no mold. You’re going to still have some off gassing of some furniture or paint or carpet or hardwoods or professional grade vinyl. There’s something in your air that’s gonna be more stressful and so you want to make sure you have a good quality air filter. Whether it’s an Austin air or an air doctor, you’re going to want to make sure your water is filtered and clean, and then you want to make sure if you’re in a human environment, you know, get a dehumidifier for your home and keep the humidity below 50%. I think that’s really key out of the gate.
Evan Brand: Yeah, yeah. What other symptoms do you think somebody would experience if they were in a state of overwhelm? Well, it depends. I mean, chronic overwhelm can just happen by having a lot of open loops on someone’s plate, a lot of stressors that are in your environment, emotional stressors, and you’re not taking action on them and now you have 2, 3, 4, 5. And so your body is going to cause you to get really anxious, really stressed and really overwhelmed because you’re not closing the loops. And so I just look at what are the top three things that are stressing you out from an emotional stress thing you haven’t taken action on. Just pull out your phone or paper and just write down what they are and write down A&B options for each one. And then say OK, good, I got them down and I’m gonna execute it when the time’s right, but I can at least put that to bed. And so that’s a really important thing. It’s kind of like that. Just trying to think of one situation. We had a, you know, mold issue in my home and it was like, OK, took action on it, got the remediation person out, got the air filtration, did it the right way, did in a negative air containment. Make sure we test it like.I just, I took action. But, you know, when I knew this problem, this environmental stressor was there, it was stressing me out because of all the unknown, right? And so I just said, I’m going to take action. I’m going to handle it the best way possible. I’m going to make sure we test, I’m going to make sure we clean it out. And I felt a lot better about it. But the more you leave these things open, it just kind of gnaws at you quite a bit.
Evan Brand: Yeah, I mean, this applies to the debt too, right? A bill here, a medical debt here, a debt here on the car and then the car is going back like, so those things, you got to try to chip away at those too, I mean, this is in the financial podcast, but I would tell people try to knock out your smallest debts. Because if you’ve got like this bill and this card and that card and that debt, like that really weighs you down emotionally. And I see it all the time with people. It’s a huge piece of the stress. So like if you’ve got a credit card. Let’s say you’ve got an Amazon or Target credit card with 500 bucks. Like knock that one out first and then go to your $5000. One, like you have to chip away at these things.
Dr. Justin Marchegiani: Yeah, I mean, I think biggest thing out of the gate, I mean you can look at some of the Dave Ramsey stuff on that, but if you use a credit card or not, like I use credit cards because they get 2% back on everything, right? So it’s like, OK, I’m gonna get paid 2% for using it. Sure, I’ll use it. The difference is I pay my credit card off every day. And the reason why I do that is running a business and doing all these things. There’s lots of expenses and one if I have hundreds of transactions at the end of the week.What if there’s fraud? What if there’s issues? At least I can see it every day and then I can also monitor it. I can have my pulse on what’s where money’s going in and out. And so it makes me feel on top of it. And I would say just from a stress standpoint, financially, you know, three to six months of living expenses, I think is a good one to have in savings at all times. So if any issues happen, you have that to lean back on too many people. I think you don’t have that three to six month buffer. I think that can be a big stressful thing. That’s just kind of in the background for sure.
Evan Brand: Yeah so even some of I think it was Shaq or someone I saw it’s been some, I think it was Shaq or someone I saw recently an interview, some extremely high level millionaire was saying that every day they still look at the numbers, they still check their numbers, the bills, where the moneys going, where the credit is, where the debt is, they still look at it even though they could buy anything in the world, they still take a look. So if you’re just out of the loop on, that’s a big problem.
Dr. Justin Marchegiani: And with phone apps, you know you can jump on it and you can finalize it and look at it in about one or two minutes. The more you kind of have your pulse on things, the better. I think it’s really good and then you know you could talk about all the inflation that’s happening. That’s a whole different strategy in regards to investment and such like that that you know we do a lot of things on the investing side as well. But I think the biggest thing is to have about three to six months and just be on top of income coming in and expenses going out. So you have your pulse on it.That allows you to pivot and make changes.
Evan Brand: Yep. So that’s the financial piece, to try to get that buffer. The environmental piece, try to have a good clean Oasis where you can properly sleep, your nervous system can calm down.
Dr. Justin Marchegiani: I think a couple of good air filters. Couple of good air filters. Get your home tested. Even if you just get a couple of the plates and you just wait five or seven days and count the spores and make sure the spores are under five or so, that’s fine. You can avoid setting it to the lab that is more than five, then we definitely want to send it to the lab. Um, you know, take a look at your ceilings. Go walk around, make sure you don’t see any spots on your ceiling. You know, go hire someone to come out once a year and just do a roof inspection. Just make sure your roof looks good. Go take a peek in your attic right, get a moisture meter and just kind of test the walls out a little bit and make sure everything looks good there. You know, those are all good simple things you can do out of the gates.
Evan Brand: Keep the exhaust fan on if you’re gonna take a hot shower. I’ve seen many, many people have issues with that just because of that hot steam of 2020 minutes or however long the shower you’re taking, all that steams.Gotta go somewhere. So if you’re not sucking it out with an exhaust vent, it’s gonna have to soak into that drywall so that paper backing on that drywall can get real moist. We see that as a huge problem area.
Dr. Justin Marchegiani: Yep. Or even just get a dehumidifier for your bath or even just a portable one. That’s a big one. If you don’t have an exhaust fan and you get a portable dehumidifier and just keep it on to at least pull that moisture out of the air and think that’s important.
Evan Brand: Yeah, absolutely.
Dr. Justin Marchegiani: And then I would say, I would say message. Get body work done, whether it’s chiropractic, that very coming on your nervous system, having your spine adjusted, that’s where your central nervous system flows from your brain down the spine, making sure your spine and your vertebrae are moving. Make sure soft tissue is doing well, those good pliability in that soft tissue. Making sure that fascia is being manipulated. Myofascial release different things to help that fashion that connective tissue stay soft and supple like a tenderloin versus harden and flame like beef jerky. Chiropractic, I think it’s powerful as well just to make sure all the joints in your hips are moving your upper cervical spine. Really important that that’s all kind of dialed in as well. All these are all really important things that can calm down that nervous system and inhibit the IML, the intermedial, I think it’s the intermedial cell column that kind of stimulates that fight or flight nervous system.
Evan Brand: Turn your screen share off. That way I can see your figure. Yeah, the message is huge. I went to get a massage a couple weeks ago and the ladies like, yeah, we’re all fragrance free. And I went in there and my God, I left smelling like a dryer sheet. Like my wife is ready to kick me out of the car on the way home. She’s like, you reek. And so I guess they’re, they’re sheets at the massage studio just had driver seats on them or something. So that was a stressor for me because here I am going to do something good like call my system and then I leave smelling like a dryer sheet. So double check the head.
Dr. Justin Marchegiani: The best thing you can do, and I told you about it too, the best thing you can do is the cheapest thing is to get washed soda, which is basically baking soda for your washing machine. And then what you do is you do your wash and then you put like a 30 minute soak on there. Or one hour or soak you could do 30 minutes, right? Put a cup of the wash soda in there so you know it’ll sit for 30 minutes. The baking soda absorbs any smell, any stink. I had a little lemon shirt that was moldy. It was so bad because it got washed and then it sat there for a couple of days and it got moldy and the washer, I couldn’t get it out. I washed it like a dozen times. My mom comes into town, she’s like, oh, here, it’s just, it’s an Italian trick here and she will put the arm and hammer in there, do an hour soak, and it literally kills it. It felt brand new and I had washed it dozens of times wiith all these essential oils and anti mold uh, shampoos couldn’t touch the smell. So wash soda, especially if you’re sensitive. Use that to suck all the smell out of what’s in your detergent or anything else. And I’ll use just like the free and clear, no sense. I’m like Evan. I’m very, very sensitive to smell. Just really. It’s really ready to shop there for me, man.
Evan Brand: It was my skin though. My skin ripped. I had to take like 2-3 showers. I still smell. Maybe I should, like, scrub myself with baking soda. It was nice. It was like impregnated into my skin, man.
Dr. Justin Marchegiani: I don’t know what it is, but there’s like a I think it’s like I’m not sure if it’s younger woman today, but it’s like it’s like my parents generation that group wore at least the females a lot of perfume. Like you could literally be 15 feet away from someone and you could smell their perfume, it’s definitely changed. Like my wife’s generation, right, women in their 30s and 40s, there’s a less perfume smell. I think people are using more essential oils and natural things, but it’s funny how generations change how much perfume to last more and but I’m super sensitive to perfumes. We try to keep zero in our home and if we do anything, it’s like an essential oil or like a lavender or like a little bit of cedar or kind of rose. Those kinds of things keep it simple.
Evan Brand: We could hit the smells for a minute too. That is a stress to the system. It’s a big stressor, yeah, especially if you’re burning it. So, like candles, throw them away. If they’re not essential oil based, it’s just garbage.
Dr. Justin Marchegiani: Dryer sheets. Throw dryer sheets away. If you want to get the benefit of dryer sheets, you can get one of those static balls. Just put it in there.It’s like a little ball that knocks the static down. That’s the purpose of dryer sheets mostly, right? But then you don’t have all that scent and smell, so that’s a good way to kind of mitigate the stress from that.
Evan Brand: Yeah, we hit the blood sugar, the sleep, the environment, the smells, the finances, I mean, those are a lot of pieces of overwhelm, really. What else are we missing?
Dr. Justin Marchegiani: Yeah, I mean, I just think, you know, close those loops. Look at what’s on your plate for stressors, what’s bugging you out, what pops into your head. Be on top of that. Also monitor that self talk. Most people, if you look at how you talk to yourself, that inner voice. right? Behind your head that you hear. Most people would not be friends with a person that spoke the same way as their inner voice. So make sure you really upgrade the quality of your inner voice. Having that inner voice really gives you guidance, intuition. But also don’t beat yourself up. I think it’s super important. There was no Anthony Robbins quote that was really important as well. It’s like, you’re going to do so many things right in the day, so many things you’re gonna do right and well. And you gotta give yourself a pat on the back. Because if you’re not watching yourself succeeding and then giving yourself that congratulations to that PAT in the back and you’re looking for your kids or your spouse or your friend to do it all the time, they’re not going to see enough of it. So really make sure you’re catching yourself doing a lot of the good things and pat yourself on the back for it. And you know, take your wins whenever you can take your wins.
Evan Brand: Yeah, no, that’s great advice. The rumination, right this negative self-talk, ruminating about your problems, thinking about your past, the things you did wrong, living with regret. Those are big problems. So someone told me years ago,
Dr. Justin Marchegiani: I want to hit that. It’s really important. So the rumination, I find serotonin and acetylcysteine plays major major role that sulfur and serotonin for me I used to be a little more OCD and ruminating and getting my NAC up and getting my serotonin levels up five HTP and B6 really help rumination. It allowed me to kind of like OK that that’s the issue and then allowed me to disconnect from it and and then just kind of focus on what the next thing is and not have to be playing the loop on repeat all the time, which is very stressful.
Evan Brand: Oh yeah, it’s huge. So people don’t understand that. They think once again negative self-talk, they think rumination they think .We’re talking about these emotional things, but no, we’re actually talking biochemistry. We’re talking neurotransmitters also. So what I was going to say is someone told me years ago, if you want to get out of your head to get into your body. So that’s what I do a lot of. If the weather is decent enough, I’m out there on the mountain bike, I’m out in the woods, I’m hiking, I’m biking and moving among the water. I’m doing something to get out of the head by getting in my body. So do that, and then the testing. Let’s talk about that, because you brought up serotonin and then overwhelmed.
Dr. Justin Marchegiani: Oh, go. Go ahead, go ahead. Hit that part. One more thing that you brought up, I wanna hit it too.
Evan Brand: OK, don’t forget. So if you’re overwhelmed, I would say do the following. Get the urine test, urine done at home. You can order it through our office. If you need help, reach out to Doctor J at justinhealth.com or Evan Brand on evanbrand.com. Let us help you order these at home from the Functional Medicine Lab so we can investigate the cause of this overwhelmed because there could be internal toxins. There could be pesticides, mycotoxins, bacterial overgrowth, parasites, worms, H. pylori, gut inflammation, brain inflammation, low neurotransmitters, nutrient deficiencies, all combining to create these emotional issues. So get the oh, we may want to look at stool, we may want to look at chemicals. But reach out and then we can help you develop a plan to figure this out.
Dr. Justin Marchegiani: Really important one last thing I wanted to highlight too is appreciation. Because most of the time when you’re overwhelmed, you’re thinking about what’s missing in your life or you’re thinking about this problem that you have to address and you’re like, I don’t know what, do I have time to do this? So you’re thinking about this expense that you’re thinking about things that you’re you’re missing or things that you have to expand or you have to lose, but when you appreciate your focusing on all the things that you have and you’re really trying to create context for that and really feeling that sense of gratitude and appreciation and appreciate essentially like if your finances appreciated, if your investments appreciate, they get greater, they get bigger. So you’re taking everything in your life and you’re feeling that sense of gratitude, making everything bigger in your life in regards to how you feel about it and how appreciative you are and having a perspective of, you know, if you live in the United States like you’re, you’re a one percenter just living in the United States, right? I mean I think it’s if you make $19,000 a year, right, which is poverty in this country. You’re 1% in the world. It’s like, whoa. That’s like, that’s perspective, right? Perspective also gives you appreciation.
Evan Brand: Yeah, I mean, I can have dark humor with my grandparents. Like my grandma called me the other day. Apparently my grandpa hit a curb and busted a tire. They were without their car, then the tires on backorder. Nobody has that size in stock. And I was like, well, it’s better than being dead and she’s like, you’re right, you’re right. I’m gonna enjoy this. This is fun. We’re gonna get a rental car. It’s no problem. And so I just tell her all the time, you know, if there’s a complaint, like, at least you’re not dead because, you know, her relatives have disappeared. And you know, she’s one of the last women standing elf, that generation, you know, from the 40s. So I’m like grandma, like, enjoy it, you’re alive. This is amazing. And usually it kind of snaps her out of the funk.
Dr. Justin Marchegiani: Yeah, appreciation is important, right? Because usually you’re just focused on all the things that are going wrong and you’re just flipping that switch. And if you look at NLP and kind of the work of Richard Bandler, he is a really interesting guy, but he would always take a look at successful people and he talked to them. He’d want to know what’s the image in your head when you’re in this peak state and you’re succeeding and you’re doing well, what are the images in your brain look like at the time? Meaning like, what are you thinking of? What’s the picture real in your brain look like when you’re achieving and doing these things? And almost always it’s in the positive, almost always it’s showing in visualizing the outcome and you’re already seeing it happen multiple times already before you actually do it. And versus it’s the negative, it’s the worst case scenario. So really be aware of the picture screen on your brain almost like go within, pretend like you’re in a movie theater and you’re literally seeing the picture screen, which is what you’re seeing through your eyes. And then you’re really changing that screen. Like you’re the director directing that movie screen while you’re seeing it in the movie theater through your eyes. Does that make sense?
Evan Brand: It does. It does to me because I do it all the time. I’m always trying to visualize the outcome. This has already happened. The person I want to say yes, already said yes. What I needed? It’s already here. Even though I don’t have it yet, I’ve already got it. And that goes a long way.
Dr. Justin Marchegiani: And then also pretend like if you’re there in that movie theater inside your brain, remember you have control over that. If it’s in a bad space and you’re just all negative and you’re just looking at everything the wrong way, you can just put a new movie in, right? You’re not a victim, you’re not sitting there chained down like Clockwork Orange, right where they peeled the guys eyes open, right? It’s like you have control over what you’re watching, so put a different film in there.
Evan Brand: Yeah, the last thing I would say is just take a nap. Like if you’re just so overwhelmed the middle of the day hits, you’ve got fatigue that can also be overwhelming because you’re so tired. You have so many obligations you’re trying to do, but you’re so fatigued. Number one, get the labs run so we could figure out why you’re so damn tired on paper will,
Dr. Justin Marchegiani: Your adrenals looked at, yeah. See how stressed out there do you have that chronic low DHEA? Are your neurotransmitters VMA, HVA, 5-hydroxy, indoleacetic? Are they all depleted and down? Because this could take a while to get this thing repleted.
Evan Brand: Yeah. So if you’re feeling that, get the data then. If you gotta close your eyes for a minute, close your eyes, lay there and take a nap. If you can do it, if your lifestyle allows you to take a nap, escape from the kids, whatever you gotta do, do it. And hopefully you’ll come back a little more refreshed, a little more in control when you’re not so exhausted.
Dr. Justin Marchegiani: And when your neurochemistry is depleted, it’s really hard to willpower out, willpower that. And so sometimes, yeah, they get the food and the supplements on track and then it’s like then the willpower and then the energy and then the ability to now start doing the things you need to do is start to become easier, there’s less resistant to get this downhill kind of momentum, so that’s very important. And again, looking at the adrenals, looking at the neurotransmitters, looking at your DHEA sulfate, looking at your circadian rhythm, right, that circadian rhythm should should go up in the morning and down at night, and the more dysregulated that is if it’s reversed or flat, that tells me that stress feedback loop is disrupted and you’re probably using that amygdala in that brain stem. You’re operating more from that fight or flight state all the time.
Evan Brand: Yeah, that makes sense if you need help, reach out. You can reach Doctor J at justinhealth.com worldwide consult meaning labs can be sent to your door. Wherever you are. You get the results. Look at them, make a protocol, get yourself better. So justinhealth.com for Doctor J and myself Evan at evanbrand.com. We look forward to helping you guys, and hopefully this content was helpful. Share it with your friends, your family. If we can get somebody else out of the whole, that’s what we love. I mean, it just takes one person that could totally transform your life. This is your husband you’re trying to get out of, overwhelm your wife. Have them listen to this so we can help lift them up because it’s gonna make your life way better.
Dr. Justin Marchegiani: Yeah, just pick one thing. If you’re overwhelmed already and you’re like, crap, he just said 15 things, just pick one, like what’s the easiest thing that you can do? And then once you get some momentum, then we’re gonna go to two and then we’re gonna go to three. So just start kind of stacking and get that momentum and then you get that downward momentum going. Then it starts to be easier to add new modalities to the mix.
Evan Brand: Yep, Amen.
Dr. Justin Marchegiani: Excellent. Alright man, great chatting with you Evan and hope everyone listening enjoyed it. Feel free to share with friends or family. We’ll put a link down below where you can review us. We really appreciate a review on both our iTunes channels. Super helpful. It’s the word out there and you guys have a phenomenal day.Take care of y’all.
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The Root Causes of Anxiety – A Functional Medicine Approach | Podcast #370
Conventional medicine labels anxiety as a neurotransmitter imbalance and relies on pharmaceutical drugs to dampen the symptoms. Although, prescription medications can be a helpful and even necessary tool in periods of overwhelming anxiety. But we have so many more tools at our disposal than just medications!
Dr. J and Evan explain that they recognize that anxiety is often the proverbial “tip of the iceberg” in functional medicine. It’s the clear and present warning that something is going on below the surface that needs our attention. Our current circumstances may have been the breaking point, but the anxiety manifests in underlying issues. That’s why rectifying these issues is necessary to make anxiety more manageable or even eliminate it!
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:06 – Acute and Chronic Stress
4:06 – Amino Acids and Herbs
11:24 – Gut Issues
16:26 – Functional Medicine Approach
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the root causes of anxiety, a functional medicine approach, and how to get to the root cause. Really excited about this topic. We see many functional medicine patients with these exact issues and we always want to get to the root cause of why that is so. Evan, how are we doing man?
Evan Brand: I’m doing good. You know the anxiety story for you and I talking about anxiety goes back literally eight years. It would have been late 2014 when I was in my luxury apartment in Austin and I was calling you and I was saying, “dude, I can’t stop this”. My heart is pounding. I’m freaking out. What the heck is going on and you said, “man, if you go to the emergency room, all they’re gonna do is they’re gonna give you some sort of anxiety medication. So why don’t you go and take about a gram of magnesium and see what happens.” And so, that’s what I did. I think I might have had some pharma GABA or some other tools on hand, maybe some passion flower and luckily, I calmed it down but little did I know back then that I had some of the big root causes of anxiety that were unresolved which included mold toxicity, Lyme, Bartonella, some of these tick-borne infections that drive up the nervous system, unfortunately. Now, knock on wood, anxiety’s been a minimal to non-existent part of my life and It’s incredibly freeing because anxiety can be so debilitating that people become housebound or they become afraid to travel, they become afraid to go on planes. They become afraid to seek the raise at their job. They just want to live in this little cocoon because they’re so afraid and anxiety is also very debilitating for children too. It affects their confidence and their self-esteem and their motivation for school and how they get bullied and so, I mean, we could do an hour on this but think just to open this thing up with a bang, I would say that infections are a big driver of anxiety so whatever that is a tick-borne infection like a Bartonella, Babesia, Lyme situation or gut infections like we’ve talked about a thousand times in the last 10 years together which is parasites, bacterial overgrowth, worms, Candida, anything that’s gonna release a toxin or aggravate the immune system.
Dr. Justin Marchegiani: Yeah. 100%. So anytime you look at anxiety, you always have to get to the root cause, right? Obviously, if it’s unresolved emotional stress, your body is designed to create anxiety for a certain situation, like if you, I don’t know, if you have lived in a forest across the street and there are bears, there should be a healthy amount of anxiety so you know, don’t leave food out and you’re just a little bit more careful with your habits so you don’t get attacked by a bear, right? There’s a healthy bit of anxiety there which is good to kind of keep you on edge so you are alert and you make good decisions. We’re talking about things that are, you know, unhealthy amounts of anxiety where you don’t have those types of emotional stressors, right? Obviously, if those emotional stressors are there, kind of take inventory of them and figure out what that corrective action is you need to kind of close the anxiety loop. I always say close the anxiety loop. What is that action? You have to take that allows you to feel confident that you are not ignoring the reason why there is anxiety there. If you did that, great, awesome. Check that off your list. The next thing is like you mentioned, obviously, any type of chronic stress or acute stress can create anxiety, right? And so, chronic and acute stressors do different things to your body. They’re going to cause B vitamins to get recycled and used up at a higher rate. They’re gonna cause magnesium to get used up at a higher rate. They’re gonna put you in a fight or flight position, where your body goes into fight or flight and then that’s gonna cause increases of cortisol, increases of adrenaline and it’s gonna cause your brain to get hyperactive and obviously at the same time it’s gonna affect digestion too when you’re in fight or flight. It’s gonna decrease your body’s ability to make stomach acid and enzymes and it makes it harder for you to break down your food. And so, and then of course, the more stressed you are, now you’re gonna start craving more processed foods that increase dopamine and increase a lot of those, uh, feel-good brain chemicals to buffer that but so, I always look at like what’s the constructive vehicle to fix this, what’s the destructive vehicle. Destructive vehicle feels good at the moment but creates problems down the road. Constructive helps at the moment. May not, maybe not quite as fast but then actually gets to the root cause over time. And so, some of our constructive vehicles like you already mentioned, magnesium, right? Theanine, right? B6, B5, right? And I always look at nutrients first, like nutrients are in the hierarchy before herbs so nutrients first and then, in the hierarchy coming down would be herbs, Ashwagandha, passion flower, Valerian. Those things are nice herbs that kind of activate and stimulate GABA. So, GABA is an inhibitory neurotransmitter. So, it’s the brake pedal on the nervous system. So, think of the gas pedal as adrenaline, as cortisol. That’s the fight or flight nervous system response and the gas pedal is gonna be GABA and the things that are gonna help with GABA are gonna be Taurine, Theanine, GABA in and of itself. And then on the herbal side, things like Ashwagandha have multi-adaptogenic effects. They can increase cortisol and increase stimulation when things are too low but they can also tamp it down when it’s too high. I like my wife. She was really stressed the other day. We are getting our kids out for an easter party and she’s like, “you have something to give me? I am so stressed.” And I’m like, “here you go”. And I gave her a bunch of GABA, Taurine, and Theanine and magnesium, some B5 and vitamin C and some Ashwagandha and she looked at me like two hours later, she’s like, “what the heck did you give me. I’m on cloud 9.” I’m like, yeah, you know that, the better living through chemistry right there.
Evan Brand: That’s great. Yeah, and motherwort. I love motherwort too. It’s great for the anxiety when you’re having, like, heart palpitations, blood pressure type issues as well.
Dr. Justin Marchegiani: Hyperthyroid too. They use it on hyperthyroid, as well.
Evan Brand: Yeah. That makes sense.
Dr. Justin Marchegiani: Too high thyroid, it can also be. It can help dampen that down, as well, which is nice.
Evan Brand: It’s great for grief too so like the cool thing about certain herbs is they can be an emotionally calming tool but they can be a nervous system calming tool too. So, like, as you mentioned, there could be an emotional thing like a bad boss, a bad spouse, a bully. You know that type of emotional anxiety driver but it could be a chemical driver too, meaning like a toxin driving the nervous system to be ramped up. Also, we should talk about blood sugar. I know we’ve done podcasts on this before but you know there’s a big impact on issues with blood sugar. Thank the Lord, my blood sugar is so good now, I could eat dinner at five and not eat till 1pm the next day and I’m stable, like, I can fast for extended periods of time as needed and I don’t have any issue but however when my gut was a wreck which I want people to pay special attention to, if your digestive system is compromised, you’re not gonna be tolerating fasting that well because you’re already so likely nutrient deprived because of the malabsorption due to the infection. So, years ago when I tried doing this type of fast, I would have major anxiety and that’s low hanging fruit so do what you got to do but you got to get your gut tested and then fix the infection first.
Dr. Justin Marchegiani: 100%. So, just kind of looking at a bunch of different things. So, on the emotional side, right? If it’s unresolved emotional trauma that’s creating anxiety, you know, someone wrote about DNRS, that’s great. You know, this NLP, where you kind of visualize a stop sign or something to kind of do a pattern interrupt. That’s excellent. EFT, EMDR with eye movement or different tapping on meridian points to kind of dampen down that sympathetic nervous system response. And again, these are gonna be good, you know, uh, more chronic issues. Yeah. If it is an acute issue, you know, a lot of times, just get to the root underlying issue where that issue is acute.
Evan Brand: I was on a plane one time and the turbulence was so bad and I started tapping on the plane. That really helped. I’m like okay. Even though it feels like this plane is about to crash, I love and accept myself and I’m like okay that’s fine.
Dr. Justin Marchegiani: Yeah. Especially things like that. You don’t have control, right? There’s nothing you can do outside of just sitting there and getting through it. And so, it’s better when those things are kind of the case but you know, it’s kind of like, I’m just trying to think of you know an example, it’s kind of like, you go upstairs and don’t turn the alarm on for the house or like maybe did I leave the front door unlocked, right? And so, there’s a natural bit of anxiety. You start going down to bed and that little bit of anxiety kind of creeps in, you’re like, I’m not gonna be able to get to sleep fast if I don’t at least just check on the front door, right? So, let me make, oh good, it’s locked. Oh good, the alarm is on. Good. Now, that anxiety can go down because it’s there for a reason, right? So, if there’s a root cause, act on it, right? If there’s isn’t a root cause, right, but it’s more emotional, you can do some of the tapping and you can work with a practitioner to get to the root cause on that and then of course having better biochemistry will get will make every bit of anxiety better because you’ll be able to adapt to it and deal with it better. And so, of course, like we already talked about with cortisol, chronically high levels of cortisol and adrenaline are gonna be big so you have to get to the reason, the root cause why. And again, foods could be a reason why like gluten, too much processed sugar that can drive up that anxiety. Again, you already mentioned blood sugar fluctuations. If you’re on this reactive hypoglycemia roller coaster ride where blood sugar goes up because you ate too much processed carbohydrate, refined foods, junkie, vegetable oil, omega-6 fats. Blood sugars up and then it can crash right back down. The crashing is where you tend to get a lot of adrenaline cortisol stimulation and on the way up, you get lots of insulin so you get this insulin-cortisol-adrenaline kind of tug of war happening and that can be very stressful on the body. And then, of course, if your blood sugar is chronically high and you’re making tons of insulin that can also be a problem too. High levels of insulin can cause all kinds of problems with hormones, especially in women, it can cause issues with ovarian cysts and testosterone problems. And then, high levels of blood sugar deplete a lot of your B vitamins and magnesium. And so, if we have poor levels of B vitamin and B6 and B5 and B1 and B2 and B3 and folate and B12 and magnesium is depleted, that’s gonna cause more stress and more cortisol issues and it’ll be harder for you to deal with and adapt to that.
Evan Brand: And I would say, if you have anxiety longer than the week, I would almost consider that chronic. I mean, it’s crazy to me, how many people you have and I’ve talked to over the years who’ve had anxiety for a decade or longer and sometimes as one person commented that anxiety and OCD together is terrible. A lot of times OCD does come hand in hand with anxiety. We’ve done podcasts specifically about amino acid therapy and we use amino acid therapy in our clinics but if you have OCD, anxiety, low self-esteem, worry, negativity, depression, disturbed sleep, those are all symptoms of low serotonin. So, what you need to do is to get an organic acid test so we can measure this and look at the brain chemistry because if you’re not testing, you’re guessing. So, when you’re listening to this conversation about anxiety, I swear to you, you’re never gonna find a psychiatrist that’s gonna say, “hey, maybe we need to run an organic acids test, maybe you have low brain chemistry because you have bacterial overgrowth. So, we’re also gonna run a stool test. If they’re out there, send them our way, we’ll do a podcast with them but I doubt your psychiatrist is ever gonna consider running functional medicine testing on you to investigate this. I don’t care if you do lorazepam or the klonopin or whatever. It’s not the root cause and it’s gonna dig you.
Dr. Justin Marchegiani: Any benzo
Evan Brand: Yeah. Any benzo is gonna dig you further in the hole because now you’ve got this dependency issue and now you’ve got his issue of withdrawal and I don’t know if you’ve read some of the stories on this but my God if people try to acutely stop those benzodiazepines, there’s major major major side effects. So, it’s just not around
Dr. Justin Marchegiani: Especially, if you’re on doses, you know, above one milligram or so on a benzo, it can be harder to get off and sometimes the taper can be, you know, six months to a year coming off of it. If you’ve been on it for a while or been on a higher dose. Yeah, you need to kind of do a slower type of taper for sure.
Evan Brand: And there’s so much, I mean, just think of how many millions. I didn’t look at the numbers here but how many millions of people are on prescription anxiety medication and they never ever get to the root cause. It’s so sad to think about someone that’s been on like a Lorazepam or another benzo for 20 years and they’ve never once asked about the gut. The question came in, how does dysbiosis cause anxiety. What are the mechanisms? Well, I think, one, right out of the gates is gut inflammation. Number two would be nutrient malabsorption because as you mentioned, a lot of these B vitamins are necessary for many processes in the body including energy production so sometimes you have anxiety and chronic fatigue and that sucks too because now you’re too tired but you’re anxious so that’s not a fun recipe either. What else would you say about the gut anxiety connection?
Dr. Justin Marchegiani: Well, so anytime you have chronic gut inflammation whether it’s from food, whether it’s antibiotics. Antibiotics are creating rebound yeast or bacterial overgrowth. We could put H. pylori in that category, and other infections, as well. That’s a one you and I already mentioned, creates malabsorption just from indigestion, right? Not enough enzymes, not enough acids, not absorbing things well. Two, you’re gonna have exogenous production of lipopolysaccharides which in and of itself are a toxin, right? They’re produced, they’re part of the gram-negative bacteria in the gut and they’re stressful on the liver and there’s also can go to the blood-brain barrier. And when they’re in the brain, they can create mood and anxiety issues as well. So yeah, lipopolysaccharides, you could have acetaldehyde and mycotoxins from fungus. You could have issues with the parasites producing their own type of internal toxins for sure. Of course, your body also produces through healthy gut bacteria, a fermentation process to make its own B vitamins, vitamin K. Those kinds of things. So, if we have dysbiosis, we typically are gonna have low levels of beneficial bacteria so we don’t have that good endogenous production behind it. And then, of course, that’s gonna over activate our immune system. So now, we have all these toxins kind of slipping through our bloodstream. We have undigested food particles, getting through our bloodstream. Now, our immune system starts becoming hyperactive and that can suck up energy. That can suck up resources. So, there’s studies on for instance H. pylori creating mental health issues, mental, emotional issues, depression and anxiety partly because of the lipopolysaccharides and endotoxins are the same thing by the way. LPS or endotoxins and obviously nutrient absorption problems too.
Evan Brand: Man, when I had H. pylori, I was super anxious. I don’t know if I was depressed as much but I was definitely anxious and you remember how skinny I got, I mean, I lost so much weight too. So, a lot of people, you know, they look at anxiety on the surface right. And everyone looks anxiety is just like this mental thing and you just need to watch some hoorah motivational video and just get over your fears and that I was like no anxiety goes way deeper than that. You just eloquently illustrated this, the aldehydes from the yeast and the fungus toxins and the bacterial toxins and the parasitic toxins and the mycotoxins. You guys, this anxiety is not in your freaking head. It’s not. It may manifest in your head but the root cause is not in your head unless you’re describing like, this toxin getting across the blood-brain-barrier but beyond that, the gut I would say is the biggest driver of anxiety. I’d say, if I had to pick one place to look, it would be the gut.
Dr. Justin Marchegiani: Yeah. So, when we look at this, what’s kind of the hierarchy of addressing this? So, of course, you fix the foods, right? Because the foods are one. You’re gonna decrease inflammation from the foods. And the inflammation in the foods is gonna cause gut permeability so you cut out the gluten, the dairy, the processed refined sugars and flours, the junky omega-6. You focus on good high-quality animal-based fats, good healthy proteins, you know, more carbohydrate from fruit and starch, especially if there’s blood sugar issues and then from there, then you work on digesting it. So, make sure enzymes and acids and good digestion are there. Get your gut looked at especially if there’s any type of chronic bloating or motility issues or indigestion, unadjusted food in your stool, diarrhea, then you get your gut looked at and of course if this issue is more chronic, you want to look at your stress handling system so the interplay sympathetic and parasympathetic nervous system in your body and your nervous system is your adrenals and so you can get your adrenals looked at cortisol rhythm wise, you can do a cortisol panel. Look at your cortisol in the morning and throughout the day. Make sure it’s not too high or it’s reversed. On a good organic acid test, we can look at neurotransmitters like Vanilmandelate which looks at adrenaline. We can get Homovanillate which looks at dopamine, right? We can get the DOPA which looks at dopamine. We could also get 5-hydroxyindoleacytate to look at serotonin and then of course we can look at B6 like a kind of urenate or xanthurenate, right? We can look at brain inflammation markers like picolinate and quinolinate so there’s inflammation in the brain that gives us more indications. We can look at oxidative stress markers like 8-hydroxy-2-deoxyguanosine. There are good markers out there to look at these different things to give us a window of what’s happening so you know, we work on the food, work on the lifestyle, sleep. Make sure we’re digesting and breaking things down. Look at the nutrient deficiencies, look at the gut, look at the infection, look at the digestion and then of course, you know, we can always branch out and look at mold or mycotoxins or heavy metals or more toxic burdens down the road. That’s the foundation first and then I would say on top of that, if there’s any type of chronic pattern where there’s an emotional trauma involved that’s more unresolved definitely bring in a good practitioner, you know with some tools in their tool bag of NLP or EFT or EMDR or hypnosis. Anything that you want techniques to get into the subconscious but again the healthier you are the better the emotional stuff is to resolve so if you’re doing EMDR and EFT and NLP and you’re eating processed food and crap, it can still work, but it’s gonna be better when your brain chemistry is healthier.
Evan Brand: Oh, yeah. Amen. Well, think about all the people that are in talk therapy and then they go and they go eat a subway sandwich for lunch, thinking that they’re doing themselves a good favor by eating turkey on wheat bread with processed cheese and then they get mayonnaise or sweet and sour sauce on it or whatever the heck they’re doing and then they feel like crap, I mean.
Dr. Justin Marchegiani: Yeah. I’m not a big fan of talk therapy in the long term. I think, talk therapy is good did you kind of just consciously process something like how did this happen maybe you’re learning some tools to enter into your life from a habit standpoint to fix whatever that issue was but then most of that trauma sits in the subconscious area of the brain which is where 90% of all your thoughts are subconscious and so that’s where you want some of these techniques like we talked about but I think talk therapy is good to acutely process what you’ve observed whatever your experiences are and then talk about, hey what can you do, you know, as a person today as an adult today, um, you know, from a habit standpoint to address it but then after that then you gotta, you know, if you’re in talk therapy months and months later and you’re still just ruminating over the same thing then it’s a subconscious thing you got to work on next.
Evan Brand: Yeah, and look, don’t let me talk people out of doing it. I’m not trying to do that but what I’m saying is I’ve had people that said, “oh yeah, I’ve been with this therapist for 3 years and I meet with them every week or every other week”. And I’m like, “okay and what do you do with this therapist?” “We talked.”, “Okay and what else do you do?” That’s it. It’s talk therapy and I go, okay, you’ve been doing talk therapy every week or every two weeks for 3 years and you still have anxiety that’s this bad. We got to dig deeper. So, like I said, there’s a role for that but it’s not gonna get you out of the woods. The person who commented about the dysbiosis and anxiety question, they also commented in here said they did have a stool test that showed H. pylori. They have extremely high Morganella which is one of those bacteria we’ve talked about and calprotectin which is gut inflammation over a thousand. Fatigue and anxiety were the main symptoms. We see this everyday all day.
Dr. Justin Marchegiani: Yep. Exactly. I’m familiar with that case for sure. And inflammation in the gut can definitely create those types of issues and get to the root cause of it too. And then, someone writes in, about Accutane too, I mean, this is super common if you get into the dermatology world. I mean, dermatologists, they either cut something. They burn it off with a laser. They freeze it off or they use some type of antibiotic, topical or internal or they use some kind of like, synthetic vitamin A. That’s it. That’s the dermatology world you know in a nutshell and they tend to not get to the root, you know, we’re talking like more chronic acne, chronic skin stuff. They tend to not ever get to the root cause of how or why that’s even there. Diet, sugars, junky, omega-6, poor digestion, poor fats, poor proteins. They don’t really get to the root cause of what that is and so, they recommend synthetic vitamin A, which is Accutane, which again, will decrease the amount of oil produced by your sebaceous glands which can be helpful in the short run if they’re producing too much oil but they can create chronic skin and eye dryness in the long term and they’re not even getting to the reason why your skin’s producing too much oil to begin with. Usually, it’s too much insulin. Insulin is a huge driving factor of excess oil and then of course, you have different food allergens, gluten, dairy, too much sugar. That can also cause a lot of problems with the skin cells.
Evan Brand: And not to mention, the connection between people that have anxiety and acne. Guess what, they’re both linked to the gut. So, if you have acne and anxiety, you gotta investigate your gut. Please. Please. Please.
Dr. Justin Marchegiani: Yep. 100%. And again, you know, outside of that, you know, we look at different toxins down the road. If we look at heavy metals, there’s different tests. We can look at, to do a challenge test on your metals with a DMPS or some kind of a challenge agent. We can definitely look at mold if there’s mold in the environment that’s important to look at. And again, if you’re in an environment where you feel better leaving that environment then there could be some mold in there, especially, if a history of water damage that was unresolved, definitely want to get your mold looked at or just your home looked at too, especially if it’s something that the whole family is dealing with just get the home looked at to start. It’s usually cheaper and more effective out of the gates.
Evan Brand: Yeah. well said. And, heavy metals too. I’m glad you brought that up. You know, mercury and other heavy metals that can stimulate the nervous system and cause issues. So, if you have a bunch of silver fillings in your mouth, you’ve got to consider that. May not be your number one smoking gun, sometimes it is but heavy metals are a big problem and even detox too can make people feel too sick. I mean, you and I have seen this many times. Other practitioners that have handled people before they come to us or they’ve done something too aggressively with chelation or other detox methods and then they’ve ended up worse. So, there’s like a tight rope and that’s where the art of medicine comes in. Everything is not just like cookie cutters. So, too much is a problem. Too little is a problem and that depends on gut and detox and beta glucuronidase and liver and all of it. So, like if your friend got better and you tried what your friend did and you didn’t do well, that might not be your right protocol.
Dr. Justin Marchegiani: Yeah. Exactly. And then, just to kind of highlight the nutrients in, compared to talk therapy, Julia Ross is out there. She’s like a family therapist person but she’s done a lot of books on amino acids and diet and she had different clients that she used to use talk therapy for years and years and years and said, “hey, let me just try adding in some amino acid therapy to their protocol and let’s see how they do with their talk therapy when we add in the amino acids”. She started to do that and then these patients would come the next week and they’d be like, “Yeah, just, I’m just good. I just don’t even feel the need to talk about it. I’m over it”. And it’s like wow so it’s like it gives people the equipment to kind of, like, process these issues and again I think talk therapy acutely may be fine. It’s just when you’re talking about the same thing for years and years and years, you’re probably not getting to the root cause, right? This is probably just covering up something else, you know. Now, I think it’s better than being on a drug, right? So, if it’s helpful and you don’t need a drug that’s great but, in the end, you know, if you can do some of these nutritional things along with it, you may find that you can just deal with the issues better you know I, the analogy I get patients is, try dealing with difficult problems around the home and not having slept for a couple nights. You’re gonna lose your patience with your wife with your kids. You’re not gonna be able to think right, you’ll be foggy, get some good night sleep and then wake up and deal with the problem. It’s like you’re gonna be way more equipped to deal with it. I think that’s kind of how brain chemistry works when you’re dealing with these stressors.
Evan Brand: Yeah. Absolutely. Well, I remember in that book too, talking about how, like, amino acids were administered, right? At the beginning of a session and then the people would just immediately like, smile or loosen up or relax and so it’s amazing no matter how much you talk. Long story short, I know we’ve beat the drum on this for a minute but last thing, no matter how much you talk. It’s never gonna change your levels of serotonin just by talking it out. If you have a gut problem that’s affecting your nutrient absorption which is affecting the tryptophan and the conversion with the B6 over to 5HTP and then over to serotonin and then to melatonin so sleep issues too. So skin, sleep, anxiety, they’re all connected depression. We’ve already talked about that. This person here’s putting a bunch of question marks like they’re mad at us. What is the connection between Accutane and depression?
Dr. Justin Marchegiani: It’s just a side effect. It’s a side effect of the drug.
Evan Brand: It could be a side effect. Yeah.
Dr. Justin Marchegiani: Yeah. Just the side effects of the drug. That’s all it is. Yeah. So certain drugs, you know, are gonna have side effects. Ibuprofen can cause ulcers and liver issues, right? Just a drug side effect.
Evan Brand: Yeah. Well, we got to wrap this thing up. But if you need help clinically, you can feel free to reach out. We work with people around the world. We send these functional medicine labs to your door. We have an incredible logistical team on both sides where it’s incredible. We can help people in literally every part of the globe where people like us don’t exist or maybe they do but we’re better. So, if you need help, you can reach out directly to Dr. J, that’s Dr. Justin Marchegiani at justinhealth.com for consults or me, Evan Brand at evanbrand.com. We’re happy to help. You guys, don’t give up. We’ve been through it. We are warriors ourselves and we’ve worked on our health for years and we love what we do and we love helping people and there’s so much possibility when you can beat an issue like anxiety. So, like I said in the beginning, whether it’s seeking that raise, that new promotion, that new job, that new spouse, you know, that partner, that relationship that you want to grow but you can’t because you’re held back by anxiety. This is a huge huge problem and you can overcome this. So please don’t give up.
Dr. Justin Marchegiani: Yeah. If you guys enjoyed it too, look down below, you’ll see a little link where you can write us a review. We appreciate the review and if, also, it’s benefiting you, feel free to share with family and friends and there’ll be links where you can reach out to us directly to get that extra bit of help. All right guys, have a phenomenal day. Take care. Bye everyone.
Evan Brand: Bye-bye.
Dr. Justin Marchegiani: Bye.
The Gut Connection With Urinary Tract infections (UTI) and Yeast Infections | Podcast #367
Urinary tract infections (UTIs) are a common medical problem affecting millions of people worldwide. The primary source for UTIs is presumed to be the gut. That’s why in this video, Dr. J and Evan talk about how gut bacteria can contaminate the urethral opening, eventually propagate themselves in the bladder, and cause symptoms of a UTI and possible yeast infection.
They also added that women are significantly more likely to get UTIs than men. It is due to anatomical differences that make it easier for disease-causing bacteria to travel to the urinary bladder after accidental transfer from the bowels. They also discuss the other clinical and evidence-based factors with helpful tests to find the root cause of these issues.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:53 – Urinary System
10:54 – Antimicrobials and probiotics
18:55 – UTI and Yeast Infection
Dr. Justin Marchegiani: Excited to be here with Evan Brand. Today, we are gonna be chatting all about the gut connection with urinary tract issues, UTIs and yeast infections. Really excited to dive into this topic. This is the common female topic that we deal with. I mean, men deal with UTIs as well but men have a longer urethra area so it’s harder for men to have UTIs with them. Women have a much shorter urethra so bacteria can make its way up to the urinary tract and blood much faster and easier and so probably more of a female issue but we’re gonna dive in. The physiology is similar between the two so men listening will still get something of it as well. Evan, how are we doing today?
Evan Brand: Hey, doing really well. And so, looks like about 90% of infection in the bladder, 90% of these cases of these infections of bladder, urethra and kidneys, it’s all related to E. coli, which of course E. coli are in your poop and can generally just take route up that way and they can migrate and populate within the urinary tract and so women obviously know these symptoms if they’ve had it but it’s you have to urinate more frequently, it’s painful urination. It could be pressure in the pubic area. It could be fatigue. It could go more severe into kidney injury but most women are usually so miserable before they get to that point that they end up doing some sort of conventional treatment. So, why don’t we just talk about the conventional approach because I think it’s great to highlight what people are doing and then what we’re doing differently that we may argue is a far more sustainable solution without the side effects. Antibiotics are gonna be huge and we’ve got some statistics on this. Antibiotics are prescribed for 33% of women to combat a UTI before the age of 24 but of course these synthetic antimicrobials are not without short- and long-term consequences.
Dr. Justin Marchegiani: I’m gonna just share one thing here on screen just so everyone can see. So, you can see the female anatomy, right here is the urethra, here’s the bladder so you can see a very short distance from the urethra to the bladder. You can see here in the male anatomy, right at a much longer distance to get up here. Obviously in the urinary tract, you’re just typically with the UTI, it’s the bacteria that’s making its way up here, okay, into the urinary tract that’s causing the infection like Evan already mentioned that’s mostly gonna be bacteria, right? Usually on the UTI side, it’s gonna be E. coli there, can be some Pseudomonas, it’s mostly E. coli. And so, it’s really easy for women to get bladder infection because you can see it goes up faster. Again, things like birth control pills we’ll talk about and antibiotics really shift the urinary pH and the intestinal pH which has a major effect on the bladder and the urinary tract and it makes it easier for bacteria to grow that tends to be why women are a little bit more susceptible than that for bladder infection obviously but in general you’re gonna see that with birth control pills because how estrogen affects the pH and then also women when they menstruate, right, just that whole vaginal area right there, sloughing off that endometrial lining. All that blood flow does shift that whole entire are to be way more alkaline because bloods around 7.3 pH so it does shift that whole vaginal tract to be more pH higher on the pH side which can increase other bacterial infections more on the vaginal side but hopefully that helps. Any comments on that, Evan?
Evan Brand: Yeah. It’s totally interesting and this is stuff that maybe you didn’t pay attention to in school and biology class but now in adulthood it’s a lot more important and I think people just don’t even understand the anatomy of it and this is something that according to the research here, 25% of people treated for UTI, they will experience a recurrence 6 – 12 months later. So, I mean, that’s a quarter of these people that now have another UTI and they just go on this merry-go-round. And of course, every time you go on these antibiotics, you’re damaging the mitochondria, you’re damaging your gut microbiome in total, so it’s not just this one thing that you’re doing, it’s the sum to your system and it can really add up.
Dr. Justin Marchegiani: Yeah, when we deal with urinary tract issues, I kind of look at, okay, you have yeast issues over here. They’re kind of, they intermingle right and how the different things happen. You have bacterial issues over here, right? So, your UTI issues are primarily bacterial, right, affecting the urinary tract. You can have BV, bacterial vaginosis, that’s another bacterial issue. Usually, Gardnerella bacteria is one that’s affecting the vaginal canal. So, a little bit different, right? Different, you know, same general area, different anatomy per se. You’re gonna have similar sequelae of tissues affecting it, right? The big difference with the BV issue is you’re gonna get the potassium hydroxide odor which is, that’s kind of the fish smell. That’s what the bacteria in the vaginal canal does, it creates that potassium hydroxide that’s the fish odor. You’re not gonna quite get the odor with the UTI but you will have the burning during peeing. So, that’s gonna be the big differentiating factor. Sometimes, more odor on the BV but sometimes you can have none and then of course more pain during urination on the urinary tract issue and then if that continues to be left up that bacteria will eventually continue to go north and eventually hit the bladder as you can see that anatomy pretty short on video here. But, one of the big common issues is I would say like the big three, anytime I look at this problem, they tend to be the same. It’s gonna be a combination of antibiotic use so we’re wiping out a lot of the good flora in our intestinal tract which also affects the vaginal or urinary microbiome and then that affects the beneficial probiotics that actually make hydrogen peroxide like probiotics usually make hydrogen peroxide which is antibacterial. They’ll make different acids, glucuronic acid, they’ll make acidic acid. Different acid acids that actually help keep the microbes in check. They make hydrogen peroxide H202 and it keeps a lot of the bad bugs down. So, the first thing is we have a wiping out of the beneficial flora that also drive yeast overgrowth too so the same thing where it wipes out the good stuff, the beneficial probioflora, the probiotics the Bifidobacter, the Lactobacillus. The different species within the Bifidobacter and Lactobacillus, right? There’s Rudaea, casei, plantarum, lactis, these are all beneficial species, okay, that keeps the bacteria in check but also when you knock down a lot of the good stuff that can also causes this rebound overgrowth and yeast and that’s a lot of doctors today even on the conventional side tend to give an antifungal after an antibiotic in a lot of these female patients because they see a lot of these symptoms happen frequently.
Evan Brand: Wow. And, you’re mentioning the antibiotic that starts this whole cascade and that’s not necessarily the antibiotic to treat an existing UTI and then we’re talking about these recurring UTIs. We’re talking antibiotics for something simple like, I’ve heard of some women going in for a dental cleaning or something just that seems benign and then boom the antibiotic just really had forced them to take another fork in the road with their gut health and of course the vaginal health is affected.
Dr. Justin Marchegiani: Exactly. Now, with urinary tract issues, I mean they’re simple things, right? Sometimes, just after intercourse, after sex, just not peeing. Sometimes that sperm and the semen being up there can kind of create some issues with bacteria so urinating after sex can be very helpful. You’ll see it with younger kids just wiping the wrong direction, right, essentially wiping back to front bringing some of the bacteria in the stool into that urinary vaginal area can be a problem. Sometimes different contraceptive methods like that involve, like a spermicidal intravaginally can sometimes mess up the milieu of flora in the vaginal tract. Having bladder stones or kidney issues can sometimes have problems, going in for a surgical procedure where they put in some of a catheter, you know, those are, you know, gonna be way unlikely but you know just kind of given the gamut of those across the board. And then of course, you know, the antibiotic exposure and I would even say just too much sugar, too much carbohydrate, a lot of bacteria like acellular easy to digest refined processed carbs. So, more carbohydrates, more sugar, more grains, more flours are definitely gonna work, you know, increase those microbes’ kind of having a feeding frenzy if you will.
Evan Brand: And, how can you find this out? Well, there’s an easy to do at home test that you can buy for less than 10 bucks. You can do these test strips at home. These urinary test strips and if generally, you see a dark purple, you’ve got a big issue and so it’s something that people should have on hand if you’ve suffered for a while. I know a lot of women; they just hate having to go to the doctor’s office and get tested and then they leave with another antibiotic and then they’re on this merry-go-round. So, we talked about the conventional approach, they really as far as it goes antibiotics
Dr. Justin Marchegiani: So, with the test strips, I think most of them are primarily looking at either immune cell in the urinary tract. I think, a lot of times with yeast or bacteria. They’re looking for, like leukocytes or leukocyte esterase, they’re looking for bacteria or I’m sorry immune cells in there. I know, some of the yeast ones are looking at pH so they’re looking at a more alkaline type of pH. The more alkaline the pH moves from six to seven to neutral, right, neutral is around 7. Into the 7-ish range, that tends to say that okay we have more yeast issues or we’re starting to move back in the direction of bacteria if we’re starting to see some of these leukocytes moving into the urinary tract.
Evan Brand: Yes. It’s kind of an indirect marker, right? You’re looking at those leukocytes and that’s what you would be seeing in terms of like, the light purple, dark purple, extreme purple on the test strips.
Dr. Justin Marchegiani: Yeah. So, they’re looking at the immune system starting to come in there and obviously with a BV issue, bacterial vaginosis. They probably need a swab to see what’s going on there, see if it’s like a Gardnerella or a Pseudomonas or Klebsiella, you know, what the bacterial species is. Now, typically with yeast issues in the urinary tract, I’m sorry with, uh, yeast infections primarily gonna be Candida or Candida subspecies. With BV, it’s primarily Gardnerella and with UTI’s it’s gonna be E. coli, typically.
Evan Brand: Now here is the cool part. Are you ready to talk about some of the transitions you hit on the diet piece of a bit of sugar process things? Maybe we should hit this first and then we’ll talk about, like, the functional strategies that kind of thing. You and I were talking about this before we hit the record that so many people, they want the solution to an issue like this but they haven’t even got the foundation styled in, in regards to their sleep, in regards to stress, proper hydration, nutrient density, lack of antibiotics if possible. Just those foundational pieces, a lot of times, are gonna keep women in a place where they’re not gonna end up with this problem so if you’re just tuning in, somehow you found us and you’ve not been listening for a while and you’re just now hearing us and you’re looking for this magic remedy, you got to make sure you get the foundations in order first because in theory, this should not happen if you’ve got the foundation style then.
Dr. Justin Marchegiani: Correct and so first thing out of the gates is just foundational things like hydrating enough because if you have a UTI issue just having constant good water flow and also you know with some electrolytes in the water that can be very helpful kind of having an antibacterial effect. And just keeping that good water flowing, the solution to pollution is dilution so that can really kind of keeping things flushed down. Obviously, being very careful if you’re having antibiotics. Why did you have the antibiotics? Was it for routine preventative things? Was your diet off and your immune system’s weak and you got sick and you needed it? Why, right? So, you want to look at that and if you had chronic antibiotic use, you know, what does the bacteria in your gut look like because odds are, if your bacteria or yeast imbalances are present in the vaginal tract or the urinary tract, you probably, also have issues in the digestive tract. You may have SIBO, you may have bloating, you may have gas, you may have poor digestion, low enzymes, low acids, H. pylori, parasite infection, you may have to look deeper in the intestinal tract and actually work on knocking down some of those microbes fixing the gut and then really work on repopulating some of the good bacteria after the fact to really work on fixing the gut because you start to fix the gut pH and the gut bacterial milieu that does help improve IgA levels and that does help with the immune system in the vaginal area as well.
Evan Brand: Yeah. Well said. So, if you’re coming in with the UTI, most of the time, there’s gonna be more than just a UTI present. There could be as you mentioned a number of, we have someone coming in and UTI or recurrent UTI is one of their complaints, I can tell you, you and I are gonna wanna run the stool panel and we’re gonna run organic acids because we’re gonna want to look at the whole microbiome and certain things may get missed on the stool and the urine should feel in the gaps like we might find Candida in the urine and it got missed in the stool. So, stool and urine, there are things that your typical doctor and your lab locally is not gonna run. They might run a urine panel but this is not the same urine panel as an organic acid, we’re talking something far more advanced, far more comprehensive whereas the urine panel, locally, is primarily just gonna look for bacteria or maybe leukocytes as you mentioned you might get a positive or a trace or something like that but it’s not a detailed description of what’s going on you mentioned several bacteria too, like Klebsiella and Prevotella, we can identify this on a stool panel. So, that’s why it’s so important to get the data and could we just throw a woman on an herbal UT formula, we could but you know, we want to do our due diligence, we want to do a good work-up on these people too to make sure that we’re not just cut straight to the chase and we skip something huge that we would find on these tests.
Dr. Justin Marchegiani: Right. I mean a lot of the antibiotics they’re gonna be using are gonna be like Bactrim or any of these kinds of, um, Mors, Augmentin’s a big one. Bactrim and Augmentin, those are a couple definitely be very wary of any of the fluoroquinolone families because they have significant side effects regarding tensing tendons and ligaments and mitochondria so be really careful of using fluoroquinolones. Of course, when we work these patients up, we’re doing a really good history so we understand how everything came to fruition regarding the UTI, yeast infection or bacterial vaginosis. We’re trying to understand it, right? Obviously, with certain things like yeast infections, BV, like making sure things are dry in that area. If you’re in a very moist environment keeping things dry helps because yeast and mold love a very moist environment. So, keeping things dry tends to be very helpful. Soaping up some of those areas you’d be very helpful too that you can use a really nice, um, as long as the mucosa is not like really, um, irritable, you can really use a really nice sulfur soap especially in the outside air if there’s anything yeasty on the outside are, anything internally. There are definitely internal things that we can do. So, on the internal side, just getting water in there, maybe helpful using raw cranberry juice, not anything with added sugar but raw organic cranberries, you know, 4 ounces at a time diluted some water is pretty good. You can drink that. That’s gonna have a nice low pH in it, which helps prevent the bacteria from growing. It also helps with some D-mannose in the cranberries. Can also internally do things like different berberines, can be very helpful, that’s excellent boric acids, another excellent compound. You gotta be careful with these by, enlarged by itself because they can be a little bit irritating so you want some nice things that provide some moisture whether it’s aloe or shea butter. There’s different, like moisture compounds that can provide the moisture so you don’t dry out that tissue as well.
Evan Brand: You know, how about some of the suppositories. Have you used those before? I’ve seen some of these like pH suppositories, those have been helpful, also I think it’s integrative, I know Aviva Romm did a talk or an article on it one time. There was a specific probiotic that we had used, I think, it was called pro-flora that we had used, uh, that was supposed to be inserted vaginally and that was like a game changer for BV and some other related issues. So, not only taking oral probiotics but vaginal probiotics as well. That has been a game changer for many women. It’s not something we have to go to a lot but it is a good tool if someone just in bad shape and the conventional strategies failed them or made them worse then something like these vaginal probiotics are helpful. So just to be clear, there’s some strains specifically for vaginal health that are taken orally but then there’s also other blends that you can insert vaginally and the women have reported great success with those.
Dr. Justin Marchegiani: Yeah. You want to make sure the hydration is there, whether it’s aloe or beeswax or shea butter or coconut oil, some of those can be helpful. Again, the antimicrobials that we may use would be the boric acid, some of the neem, some of the different berberines. And again, we may want to also add probiotics in and around there that can be very helpful. In regards to, like yeast issues or, um, UTI issues, you got to be very careful because when you women menstruate, well more with yeast and more bacterial vaginosis because that’s affecting the vaginal canal more. When women menstruate, that blood is like 7.3, right? So, that’s very neutral to alkaline. So, when you’re menstruating, you’re taking that acidic pH in the vaginal tract and you’re moving it backup to a more neutral pH when you menstruate so that’s gonna actually make it easier for bacteria and potential yeast to grow and you could have a BV issue or yeast issue that can happen due to your menstruation. So, when you’re already more susceptible in that vaginal area, you know, you gotta, you may actually wanna do a suppository in and around your period too, because that pH is gonna move up and that can start to cause microbes to grow. Some women have to be more careful with that, you know, if they have a chronic yeast or bacterial issue just to make sure it doesn’t come back.
Evan Brand: I want to hit a few more herbs and then I want you to riff on the birth control conversation because I think that’s huge. So, you mentioned berberine and some of the other related herbs. Also, we’ll use the antifungals at the same time. So, you and I have our own custom blends that we use and so we may use something like Pau D’arco, French tarragon, horse tail, olive leaf, things that have antifungal and antimicrobial properties. So, that’s the cool thing about what we do is as you mentioned Backstrom or some of these other conventional strategies. It’s just a big sledgehammer, right? It’s not a targeted tool. It’s one sledgehammer. We don’t know exactly what we’re gonna kill but it’s an antibiotic, were just gonna drop the nuclear bomb into your gut and we’re gonna disturb not only your gut microbiome, we’re gonna negatively affect the production of your nutrients in your gut. We’re gonna negatively affect your mitochondria. We may knock out the UTI but as you saw in the papers, 25% of those UTIs are gonna come back within 6 months to a year and so when we’re coming in with these antimicrobial herbs, also, throwing in antifungal herbs, that’s where the magic really happens because there could be a combination as we talked about. It’s rare to see just UTI, it could be a combination issue meaning there’s some Candida, there’s some bacterial problems, maybe there’s parasites in the gut too. Maybe there’s H. pylori like you mentioned. And so, that’s the fun part is when you take a blend and you’re working people through this protocol. You’re now knocking 4,5,6 issues out all at once in one fell swoop when they originally just came in with the complaint of UTI. When you do the labs, you wanna uncover so much more and that’s where the beauty is.
Dr. Justin Marchegiani: 100%. Here’s one study here looking at the perceptions using contraception birth control pills. So, usually this is like a synthetic estrogen mostly, right, an ethanol, estradiol. I’m looking at the influence on the vaginal microbiota and so really the take home here inside of the gate, the vaginal state was significantly modified hormone administration apparently corrected the alterations uh, but has the potential of being an accurate tool. Where is it? Right here, um, there it is, I’m sorry. Statistically significant association between, this is, um, this is contraception and normal microbiota was observed after three months when the vaginal microbiome was modified at 6 months inflammatory reaction was detected in almost half of the women. So, only seven women but you can, it created an inflammatory state in the vaginal microbiota and then also yeast colonization was increased and it created an inflammatory reaction in three out of seven women and it altered some of the beneficial bacteria in the vaginal area. Now, small study but you can see, you know, three out of seven, it affected this and this is what we see clinically with a lot of our female patients is some of these things can be affected because it’s affecting: one, it’s creation; two, it’s causing yeast to grow impacting some of the good bacteria and how does it do this, it does it mostly via LDH. If you alter someone’s digestive pH, right, let’s say you give them a proton pump inhibitor, you’re gonna have all kinds of digestive issues and maybe even nutrient deficiencies that can affect things long term. Obviously, with birth control pills, there’s other things they do, they can create issues with nutrient absorption or they can cause nutrient deficiencies in areas of B vitamins, folate and also calcium and magnesium. So, we see a lot of women that do birth control pills have a lot of those nutrient problems. So, if you’re on a birth control pill, ideally, it’s better to use something that’s more barrier based or if you want to set it and forget it method, you know, potentially looking at the ParaGard which is a copper IUD, you just have to make sure you can handle the copper. I find if you want to set it or forget that the copper tends to be better than the hormones but ideally, you know, a barrier method it’s not internal all the time. It’s probably better so that just kind of gives you a couple options there.
Evan Brand: Yeah. I’ve heard some stories, some horror stories about the copper ones too. So, like you said it cold be a problem but
Dr. Justin Marchegiani: Not everyone has problems with it. I mean, women that like tend to cramp a lot, they could have, because that cramping, IUD being in that uterus sometimes that can cause pain but it just depends kind of where women are, you know. Some parents may be pushing kids to have a method because they don’t want their kid getting pregnant and maybe they feel like they aren’t responsible enough at maybe 18 or 19 and they set it and forget it method. If you want that, I would recommend doing the ParaGard before you go to a hormonal method.
Evan Brand: Yeah, for sure. And, not to mention too we’re already in a society of so much estrogen dominance and you and I have done podcasts about the impact of gut imbalances in issues with the glucuronidation pathway which is then causing further issues. So, we could see this estrogen problem in a woman who’s not on birth control. You could still see that manifest in this way and so that’s why you’re getting off of the xenoestrogen, you’re cleaning up your makeup. You’re getting rid of plastics. You’re fixing your gut. You’re improving detoxification. All these other functional medicine strategies are directly impacting your ability to beat this situation. So, we know, we always want people to look at the big picture. Don’t just look for the magic, uh, like, berberine, Pau D’ Arco remedy. And there’s a question here in the chat, ‘how many Pau d’ Arco capsules is needed for someone who has Candida in their gut?’. I have no clue because we rarely use it in isolation. We’re always gonna use it in a blend. And I doubt you have just Candida. You’ve probably got other issues too.
Dr. Justin Marchegiani: Yeah. Somewhere when they come in, they could have a combination of a little bit of a bacterial, a yeast issue, UTI thing. That could be a kind of combination of 2 or 3 different things happening. This one may be more predominant. So, we never wanna just go all in on one thing. Again, if someone’s having vaginal issues specifically, there’s gonna be things that we insert intravaginally like some of the boric acid, like some of the neem or the berberines and we’ll probably interchange in some probiotics because part of the big problem is you have to get the bacteria flora in the vaginal area, back up to where it should be because it’s the good bacteria that will help keep the other bad bugs in check through their natural acid and hydrogen peroxide production.
Evan Brand: Well said.
And so, the point I was making is that I don’t want people listening and going okay just give me the freaking remedy. What’s the natural urinary tract remedy? That’s what I’m here for. And we’ve talked about some of those, you know, the mannose, the cranberry, the berberines, the Pau d’ Arcos, the French Tarragon, this whole blend, you know, that may be the solution but what got you here is important. Have you fixed the other issues that have gotten you here. And so, I hope people see the big picture. Sometimes, you and I are happy to just go boom, hit the oregano oil and were happy to just throw out just this natural solution but like you said before we hit the record, you don’t want people skipping out on the low hanging fruit.
Dr. Justin Marchegiani: Exactly. And so, it’s always good to do history. I find the big issue is antibiotics can be a big factor. I also find just some of the low-hanging fruit like the intercourse and hydration can also be a big factor as well. You’ll be surprised. And so, my wife comes to me, she’s like, ‘my friend has this issue, what should I recommend?’. Well, it’s hard, I can’t really recommend a lot of things because I don’t know much about them if eating like crap and they’re not hydrating and they’re drinking lots of soda and they’ve been on lots of antibiotics, you know, I may say, hey, all right, do this [24:34] but that’s gonna be palliative and not fix the whole lead up and how everything went down. And so, the lead up and I call it the timeline history of how we get to this point matters so much because, you know, if not, you were just becoming naturopathic doctors that are using nutrients and herbs like MDs use drugs. Now, again, I think that’s better because a lot of these things are natural, have less side effects but still we want to be holistic and still root cause.
Evan Brand: Yeah. Well said. That’s the problem. There’s a difference between naturopathic approach to this issue and functional medicine approach to this issue. So, I think you made that clear, which is, you go to the naturopath, it’s hey, here’s the oversee, functional medicine is gonna come in and say, ‘okay, well, how did you get to the UTI?’. Oh, you took antibiotics, you’re on birth control for 20 years, you had a sexual partner who had extremely poor microbiome health, maybe there was some issue there, maybe you had multiple partners, maybe one of them had H. pylori. You have low stomach acid. You ended up with dysbiosis, then you got Candida overgrowth, then you drank too much alcohol, you loved to do wine in the evenings. You ate a little too much chocolate, you know, it’s like, that’s the more investigative route and that’s where people need to be thinking. We’ve got friends that are naturopaths, good people, but you just got to go deeper most of the time.
Dr. Justin Marchegiani: Yeah, and a lot of times too, if I’m, if someone has chronic issues, I wanna know more about their gut because the microbiome has such an impact especially with IgA and with the overall immune system. So, if there’s chronic issues in the vaginal area, you have to look up to the intestinal tract. Very important.
Evan Brand: Yeah, and you would say there’s gotta be some link between the low secretory IgA that you and I are seeing on the stool test and what’s going on with the vaginal microbiome too, right? You would assume that’s a system-wide defense shield that’s gonna be affected.
Dr. Justin Marchegiani: Yeah. It’s part of the mucous membrane barrier. So, mucous membranes in the eyes, the mouth, the intestinal tract, the urinary tract, the vaginal canal. So, if we see low IgA issues in the intestinal tract, that barrier is a little bit weaker. Think of the force field, you know, you see star trek, they put, like their force field up, right, so they, so when the Klingons go to shoot them, it kind of bounces off, right? Think of the force field we have in our intestinal tract and our vaginal canal and our urinary canal that kind of protects and so probiotics can help, obviously getting rid of the dysbiotic microbes can help, avoiding a lot of things that create the imbalances to begin with, which would be a lot of the antibiotics or maybe pesticides or GMO foods that produce a lot of antimicrobial compounds too. All those help avoiding those things too.
Evan Brand: You know, what’s happening even in the functional medicine world, is that everything’s becoming isolated. Are you noticing that? Like people are focusing on just the gut. So, it’s like this leaky gut formula, this leaky gut protocol and they’re ignoring the fact that you just mentioned this IgA, this mucosal barrier is kind of a system-wide problem. So, there could be oral, vaginal, gut all at the same time, all related to the same dysfunction of these force fields being down. I think it’s just marketing, right? People just want to market that they’re the gut guy, they’re the parasite guy, they’re the Candida guy. I think that’s just a marketing probe but hopefully people are seeing this and of course if they’ve been listening to us for months or years, they’re seeing that this is a system-wide problem, it’s just manifesting in this way.
Dr. Justin Marchegiani: Yeah. In the functional medicine world, a lot of people market to niche areas and symptoms which is fine because a lot of people when they get focused on something, they think they have these issues, they’re going into google or they’re typing that issue. So, for you to be relevant and for that person that has health issues to find you, you do kind of have to market to a symptom but then when you find that person and you talk to them, you wanna make sure that their approach is globally where they look at things holistically and you’re not seeing the gut person that only deals with the gut and they’re not looking at your thyroid or your anemia or your low glutathione. They’re not connecting the dots. So, you got to make sure they’re still able to connect the dots but multiple systems and they’re not just focused on one issue. So, it’s okay for doctors to market to that, you just have to make sure that their philosophy is a holistic philosophy that encompasses everything in there.
Evan Brand: Yeah and holistic spelled w-h-o-l-e a wholistic, the whole thing, the whole body, the whole person, not just holistic as in natural, it’s gonna be the whole piece and I think that’s where I suffered for a long time because I focused on my gut for so long but I was ignoring toxicity issues, I was ignoring dental issues, I was ignoring tick bite infections. So now, oh crap, I see the whole picture and I would miss that if I just dialed in the gut so and that’s what you and I do. We’ve done this over with clients worldwide, we look at the whole picture. If you’re suffering, if you’ve been through the conventional rabbit hole or maybe you’ve been fortunate to avoid the conventional rabbit hole, you don’t want to go down it but you need help, feel free to reach out. Dr. J and I work with people around the world. We can send these labs that we’re talking about stool and urine. These are at home, these are non-invasive. It’s rare that we need to do invasive testing but most of the time it’s at home functional medicine tests can be sent to your door, you do them, you send them back to the lab. We get the results. We jump on a call. We run you through them. We interpret those. We make a protocol for you and get you better and get you off the merry-go-round. So, if you need help, feel free to reach out, Dr. J is at justinhealth.com and me, evanbrand.com and you can reach out, book a call with us, we’d love to talk with you, help you, find and fix the root causes if you just have UTIs and you think that’s all it is, maybe you’re right but maybe not, either way, we’re gonna help you get to the bottom of it.
Dr. Justin Marchegiani: Very good. Excellent. So, for women that are listening and kind of want to recap here, first thing, make sure your diet is right, keep in the process refined sugar, grains, flours out, makes a huge difference. Omega-6, seed oils, in general, should be reduced as well. Hydration, make sure hydration is good, clean and filtered water, um, you know, good mineral water, especially if you have more health issues, more minerals in there is gonna be better. Next thing out of the gate, you know, urinate after intercourse, those kinds of foundational things. If you have chronic gut issues, definitely, get your gut looked at. If you’re on hormone, if you’re on birth control pills, definitely get your hormones looked at and figure out why you’re on them. Most women aren’t even on hormone or birth control pills for birth prevention. They’re on it for off-label issues like acne or headaches or lots of PMS and so most women could totally get off it because they’re not even using birth control pills for the original intention. They’re for off-label use and so that would require looking deeper at the hormones. Next, you can get tested, you can do either a, um, a MONISTAT test to look for yeast, you can get those at the drugstore, you can do one of the strip tests to look for leukocyte esterase or I think it’s nitrites in the urine for more of the UTI issues and of course, if you have a lot more of the odor-like, uh, issues, you can get a vaginal swab from your OB or your primary to rule out any of the BV issues as well, again, similar solutions, you know, some maybe more internal in regards to what we recommend, some maybe more internal like with swallowing pills so maybe internally, intravaginally and of course the more chronic the issue is, the more we have to really support the vaginal microbiome with the right beneficial bacteria getting in there internally as well. And then, of course, just keeping up with a lot of the menstruation because that can really affect a lot of the, um, the bacterial issues and yeast issues in the vaginal canal because it’s gonna shift that pH from very acidic to more neutral to alkaline at that time of the month when you menstruate. So, hopefully, that’s a good kind of crash course, out of the gates and kind of you guys understand kind of our spitball kind of philosophy and how we look at the whole history and really connect the dots and we have our little toolbox of all these things but we just got to make sure it’s catered to the history.
Evan Brand: And alcohol too, I think, we briefly mentioned it but alcohols got to go. It’s just, it’s not gonna help you. It’s going to promote all sorts of issues. It’s gonna aggravate the immune system. It’s gonna affect your IgA levels. It may promote dysbiosis and it may promote more yeast problems and so I’ve heard many stories where a woman’s like, oh yeah we went to Napa Valley and we drank wine and ate chocolate and salami and cheese all weekend and now I had a flare up. It’s like, well, yeah, duh, I mean, that’s incredibly damaging. Everything that you’ve done, you binged on wine all weekend so I think wine kind of gets like this people think that they’re not drinking alcohol. Somehow, they think they’re getting off the hook. Oh, it’s just wine, like, it’s so socially cool, it’s like coffee. It’s like coffee and wine, like wine is so accepted into the culture but it can be a big problem, I tell you. Some of those California women, the ones in San Francisco, like, it’s part of the culture here. I had one woman argue with me that she didn’t want to get off alcohol. I said, well, what if it’s gonna help your gut. She’s like, well maybe I’ll consider it. So, sometimes as practitioners, we’re having to bargain with people and try to make trades and make healthy swaps, we’ll swap it for this and try this and what if you do a binder afterwards. So, sometimes, you gotta work with people, they’re not just in a vacuum. We got to work with them and help educate them so that they’re more dedicated to the lifestyle changes but I just want to mention alcohol because I think a lot of people, don’t even consider the impact it has on the gut but then on this flora.
Dr. Justin Marchegiani: Yeah. A couple things with alcohol, number one it’s diuretic so it will increase the frequent urination and kind of make you more dehydrated so good hydration helps prevent a lot of that bacteria from growing. Number two, out of the gates, you know, it may be necessary out of the gates for the first month so as you get things under wrap. There’re also healthier versions of alcohol. I mean, you can always get, like a Cosmo martini that has the fresh lime juice in there and cranberry juice. Just make sure it’s, like not the cranberry with sugar or the lime with sugar. Make sure, it’s fresh lime or actual juice cranberries with, like a nice Tito’s vodka, I mean, Tito’s vodka is, um, it is charcoal filter, right? So, it’s gonna be really clean and you can get some nice cranberry and lime in there that should be almost be beneficial in a way, obviously, you know, keep it, you know, a drink or two maybe once or twice a week max but once you better that maybe a good option to add things back in and just stay away from a lot of the sugary stuff and of course the glutinous drinks and you’ll be in a lot better position.
Evan Brand: Yeah. It’s a funny thing you have to mention. There’s got to be real cranberries because most of the time you go to a bar, it’s like that. It’s garbage. The heart or it’s the high fructose corn syrup concentrate.
Dr. Justin Marchegiani: Yeah. So, worst case, you can always just do a fresh lime squeezed in there and see if they have anything that’s just a pure, you know, extract and that’s a much way to do it. Of course, dry or white wines and you know just a good Tito’s vodka is always great with just the lime in and of itself. That’s an easy way to do it and keep the sugar and junk down but also keep a nice acidic pH there which is helpful for the vaginal area.
Evan Brand: Yeah. We’ll hope, as you mentioned, no I think we covered It so if you need help, we mentioned the links here Dr. J, that’s Justin at justinhealth.com. You can reach out for consult worldwide. Me at evanbrand.com, either way, we’re here to help you guys. We love what we do. We have a blast and it’s fun to educate people. It’s fun to empower people and take back your health and it’s possible. Whatever you’re dealing with it’s possible to make progress so just keep your head up. Stay motivated. Don’t always run straight to that antibiotic if there’s another way. You may try another solution. If you’ve been doing this for a decade now and you’re still battling it, you’re not out of the woods yet, it’s time to look deeper.
Dr. Justin Marchegiani: Excellent. Great chat, Evan. Everyone, have an awesome week. We’ll talk soon. Take care of you all.
Evan Brand: Take care, now.
Dr. Justin Marchegiani: Bye now. Peace.
Evan Brand: Bye-bye
Genova Organix® Dysbiosis Profile
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
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.
What are the Natural Anti-Inflammatory Agents for Pain Relief
In general, we have our COX pathways. Now, Arachidonic acid can feed those pathways. A lot of excess, junky, refined Omega-6 from animal products can definitely feed those pathways. That sets the table like gas in the kitchen where a little spark can take it off.
Click here to consult with a functional medicine doctor for recommendations on natural pain relievers.
Where to find anti-inflammatory agents:
- Natural herbs like ginger can help with COX-1.
- Fish oil is excellent for COX-2 at high doses. If you do high doses of fish oil, you can increase what’s called lipid peroxidation because fish oil is a polyunsaturated fatty acid. It’s more unstable. It’s got more double bonds in it. Omega-3 means three double bonds. The more double bonds that are they are, the more unstable the fatty acid is to heat things like that and the more, let’s say it can be oxidized. So, having extra vitamin C or extra vitamin D on board when you’re taking extra fish oil just to make sure you don’t have oxidation is great, and we already talked about things like systemic enzymes.
- There is also curcumin but liposomal curcumin is better due to the absorption or something with black pepper in it helps with absorption, too.
- Frankincense or Boswellia.
- White willow bark which is kind of how aspirin is naturally made though aspirin works more on COX-1. So, aspirin can be your other natural source and you can do white willow bark which is the natural form of aspirin.
- There are things like Tylenol but Tylenol works more on the central nervous system perception. So, it decreases the nervous systems’ perception of pain. Note: We have to be careful of Tylenol as it can actually chronically reduce glutathione. So, if you’re taking Tylenol longer-term, you definitely want to take it with NAC and/or some glutathione, just to be on the safe side.
- At the extreme example, we have opiates which block pain receptors in the brain, the opiate perception of the brain. It’s not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive.
- We can block some of these natural pain perceptions with CBD oil. So, CBD is another great way to reduce the perception of pain.
In general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation.
If you have osteoarthritis, rheumatoid arthritis, sports injury, or you’re just trying to heal maybe postoperation, these things may be something to implement and then obviously work in all the other root causes, too. You are not just what you eat. You are what you digest from what you eat.
So, if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair or falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place.
If you need to reach out to talk about your pain and inflammation issues, click this link to schedule a chat with me!
Vitamin D Benefits You Should Know
Vitamin D has a couple of different benefits. Let’s go over some of the benefits. We’ve talked about the natural antibiotic that’s being produced by vitamin D, which is called cathelicidin, a kind of antibacterial enzyme. It is super helpful at being able to knock down bacteria. It also has antiviral mechanisms, as well as antimicrobial peptides and antiviral mechanisms.
Click here to consult with a functional medicine doctor to learn about proper Vitamin D supplementation.
Part of that is it stimulates and it can modulate the Th1 immune response in the Th1 immune system where you’re making a lot of your natural killer cells and your helper cells. Good helper cells can also help your antigen-presenting cell and it can help make antibodies more efficiently. So, you’re also going to have a better Th2 immune response. You’re going to make antibodies to whatever that infection is. Those tend to come a little bit later in the game, but good signaling to make your antibodies is super helpful as well.
There is a couple of other studies here that are talking about different things. We have a reduction in our MMP-9 concentrations. We have a reduction in bradykinin storms and reduction in our cytokine storm. So, basically we have a lot of inflammatory molecules that get produced such as bradykinin, cytokines, interleukins MMP-9. These are inflammatory types of chemical messengers. Vitamin D can help modulate that and prevent that from being overproduced. The more we overproduce those, the more our immune system responds. So, we can create more cytokine storm issues because our immune system will be on this positive feedback loop, responding and creating more issues with the cytokines. When there are less cytokines, there’s less chance of a cytokine storm, which is basically our immune system responding.
Imagine a fight between two people where one person yells out first and the other person yells back. Then they’re pushing, shoving, and hitting and the violence escalates. That’s what happens with the cytokine storm with your immune system and all the different cytokines and immune chemical signal. So, we can keep that modulated a bit which is very helpful. Vitamin D plays a really important role in that.
Get vitamin D supplementation from Thanksgiving to spring. At least, make that investment. If you want to come off the rest of the year, as long as you’re getting some sunlight, it’s fine. At least do that vitamin D supplementation to give you a good bump and the fat-soluble nutrients you’ll get over those four or five months will hang around months afterward because it takes a while for that vitamin D level to build up.
If you want to learn more about Vitamin D, click this link where you can schedule a chat with me!
The Top 5 Reasons Why Your Estrogen Levels are High – Men & Women!
Let’s talk about the top 5 reasons why your estrogen levels are high. We’re going to break them down today.
WHAT ARE ESTROGENS?
First, let’s look at the 3 major kinds of estrogens: E1 or estrone, E2 or estradiol, and E3 or estriol. In a woman’s regular cycle, it’s usually estradiol we’re talking about. When you start shifting to more menopausal and the ovary stops working, you start getting more estriol. The adrenals help in kick in a lot of DHEA and you make more estriol. Estradiol is more of the growth factor type of estrogen and estriol is a weaker estrogen.
Click here if you need to consult with a functional medicine doctor to learn more about estrogen and your hormones.
WHERE CAN WE FIND ESTROGENS?
- PLASTICS. You’ll get it when the plastic is warm like in a microwave or out of a plastic water bottle especially if it’s in the car and the sun is hitting it or it’s outside. That’s why you want a good stainless steel or glass water bottle if you’re going to go outside or leaving it in the sun. The microwave heat and the radiation is going to cause a big release of plastic chemicals there, the xenoestrogens. One of the big ones are the phthalates but also BPA. There are other types of BPAs that are new which are supposedly safe but there are still estrogen-like compounds there as well. These plastics can affect women and men as well. Men are actually going to be more affected by them because men aren’t used to having estrogen in their environment and getting a whole bunch is going to be a problem.
- PESTICIDES. These tend to have an estrogenic quality to them and if you’re eating foods that are not organic, you’re definitely going to be getting organochlorines and various pesticides in your environment.
- PHYTOESTROGENS. These are found in soy. For example, I had a vegan-vegetarian patient. We ran a Dutch sex hormone panel on her and her estradiol was through the roof and really high. Phytoestrogens can be a big one, so soy may be a problem. With vegan-vegetarian, there’s a lot of phony protein consumption like fake meat kind of stuff such as the Beyond burger where there are a lot of soy and estrogen-like compounds in there. There are also hormones in meat. You have to make sure you get antibiotic-free, hormone-free, and ideally organic and pasture-fed or if you’re on the Whole Foods scale, step 4 or step 5 is ideal. Step 2 is at least pretty good. Organic means no pesticides, no hormones, and also the food they’re eating has no pesticides or hormones, too.
- HIGH LEVELS OF INSULIN. Too much carbs drive high levels of insulin because insulin responds to a high level of blood sugar. The blood sugars in your bloodstream go up and your pancreas comes in. The beta cells make a bunch of insulin to bring it down and bring it into the cellar and converted to fat. So, high levels of insulin upregulate an enzyme in men called aromatase that converts testosterone, the male hormones, to estrogen which becomes a problem. Now, in women, a similar thing happens but it’s the exact opposite or the big switch. Their estrogen is converted to testosterone. So, women can actually get more androgen-like issues which results in weight gain, acne, hair growth, and sometimes you can see some libido enhancements on that. So, that’s the difference between men and women.
- POOR GUT HEALTH. In the gut, we make healthy good bacteria in our gut that help us absorb a lot of nutrients. A good healthy gut function helps us break down protein for good HDL levels and good enzyme levels. We need these to break down protein into amino acids which are really important for helping us to detoxify. So, detoxification helps us to excrete estrogens that we’re getting exposed to in our environments such as the pesticides, plastic, or something that you don’t even know you’re getting exposed to. Good healthy detoxification will help your body eliminate that, so that’s a good backup plan.Also, if we have a lot of dysbiosis, SIBO and bacterial overgrowth, we can make a lot of what’s called beta-glucuronidase. This is an enzyme that’s made by bad bacteria and it makes it harder to detoxify estrogen. The beta-glucuronidase takes conjugated estrogens and binds it to a protein that helps us excrete it out the body. It takes that protein and it pulls it apart. It takes the handcuffs off that protein, so that allows that estrogen that’s been deconjugated to go back into the body in the general circulation. So, if we have gut issues, that could be a major concern.
HOW DO WE ADDRESS THE PROBLEM?
We need things like cysteine, glycine, glutamine, sulfur amino acids, and things that help us methylate like B12, B6, and folate. So, these nutrients we have to get them in our diet via a good diet. We need to be able to break down and absorb those nutrients, so we need good digestion to get those things in there.
So, in general, we’ve got to make sure we have a good gut bacteria balance. Even fungal overgrowth can cause problems and H. pylori that can lower stomach acid and make it harder to break down nutrition on one side and then it can create this bacterial overgrowth enzyme that makes it hard to detoxify estrogen. These are really important components. If you have any issues with estrogen, you’ve got to look there.
Now, we may want to do things to help detoxify like make lifestyle changes, food changes, pesticide changes, make the changes in regards to plastics, and make in in regards to your diet, your glycemic load, and your gut. That’s a good first step to get to the bottom. There are also different things we may do to help upregulate detoxification to help get that estrogen. It may be activated charcoal or various soluble fibers. It could be things like bentonite clay. We could use things like DIM or Calcium D-Glucarate or glutathione, sulfur amino acids, and vitamin C. They’re all helpful in different situations. We would recommend them based on what’s happening but at least make the diet and lifestyle changes out of the gates.
If you want to find out the root cause of what’s happening, click this link where you can schedule a chat with me!
The Top 5 Causes of Chronic Headaches
Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.
Click here for a consultation with a functional medicine doctor if you are experiencing chronic headaches!
So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.
1. Food Allergens
Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain. Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.
2. Food Additives.
These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.
3. Blood Sugar Fluctuation.
We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings. This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.
4. Gut Infections.
Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.
5. Hormonal Issue.
A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues. That low level of oxygen may also cause some headache issues as well. Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.
If you have any questions about headaches, please reach out to a functional medicine doctor to find a way to fix your issue.
Oils That Cause Gut Inflammation
There are various top-causes for gut inflammation but a big one is an oil. The oil you use to cook or bake into foods could be a major culprit to your very uncomfortable gut inflammation. Let’s look at the good and stable oils vs. the unhealthy oils.
Click here for a consultation with a functional medicine doctor if you have questions about what oils to use for cooking!
If you look at the standard American diet, just even a hundred years ago, your grandparents or your great grandparents, they did not have access to these type of oils. They were cooking with traditional fats. They did a lot of lard and maybe some beef tallow.
If I asked my grandfather, “What did your grandmother cook you and what did she cook it with?” She was not using soybean oil. She was not using corn oils. She was not using rapeseed oil, which is canola. She was not using peanut oil. If they did something fried, it was going to be fried in 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.
When it comes down to fats, most plant fats are not going to be the best unless they are cold extracted or unless they are minimally processed to extract the fats. Partly because of the processes of extracting, it tends to damage 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 at a natural state.
So the best plant fats are:
- Coconut oil because it’s a saturated fat and it’s more temperature-stable.
- Cold-press olive oil and good-quality avocado oil, which is primarily a monosaturated fat.
- Palm oil, which is more in a kind of saturated state.
There are some nut-based and some seed-based oils, but then you start ramping up the Omega-6 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 we’ll give it supplementally and that’s coming from great sources that are going to be in capsules that won’t be oxidized and such.
Bad fats are going to create a lot of oxidative stress and they are going to deplete a lot of your antioxidant reserves because if those fats are oxidized, your body is going to need a lot of vitamin C and vitamin E to help with the oxidative stress that those fats may cause your body.
Now what it you find a good fish with gluten-free breading so it’s not covered in wheat with 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’ve 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 bread it, you bread it yourself?
There’s a product that we like of sweet potato fries that my wife will do for my son because it’s really easy, but they have a little bit of canola oil in there. 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 easy saturated fat or my easy fat for cooking that’s plant-based would be avocado. I like 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 avocado for cooking. If you have control over it, you always choose the better fat over the junky fat if you can.
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, meaning like traditional people were probably not doing it because you’ve got to have some heavy-duty equipment to extract the oil, but coconut oil would be super traditional. I mean, this would be something that has historical use.
Your big fats that are going to be plant-based would probably be primarily coconut. But your biggest ones that I think are going to be used more long-term from generation to generation will be your tallows, your bacon fat, your duck fat, and those kinds of things because saturated fats don’t go bad. They stay good for a long time because the carbon is saturated with 4 hydrogen bonds between them, which makes the fat really, really, really temperature-stable.
Take note of oils are that bad for your gut because they cause inflammation and oxidative stress.
If you have any questions about what the best oils to use for cooking, please reach out to a functional medicine doctor to learn more.