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

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

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 

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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

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

Recommended products:

Enzyme Synergy

TRUCOLLAGEN

Liver Supreme

Digest Synergy

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Genova NutErval

What are the Natural Anti-Inflammatory Agents for Pain Relief

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

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

Where to find anti-inflammatory agents:

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

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

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

  4. Frankincense or Boswellia.

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

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

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

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

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

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

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

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

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.

Recommendation

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?

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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:

  1. Coconut oil because it’s a saturated fat and it’s more temperature-stable.
  2. Cold-press olive oil and good-quality avocado oil, which is primarily a monosaturated fat.
  3. 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.

 

Symptoms and Dangers of Low Potassium

Symptoms and Dangers of Low Potassium

Do you know how much potassium you’re getting? I was looking at some recent research including a national survey which indicated that approximately 98% of Americans are not meeting the recommended potassium intake.

We all know the Standard American Diet is not good–but it’s not just the American diet that favors processed foods over whole plant foods, such as fruits, vegetables, beans, and nuts. This is the standard European diet. This is the standard Australian diet. Most developed first-world countries are primarily consuming processed, potassium-devoid food.

Let’s tie that directly into the research I mentioned at the beginning. A study done by a Chinese hospital and Chinese medical university in Wenzhou, Zhejiang Province, China on hypokalemia and clinical implications in patients with coronavirus. The researchers found that people that had severe hypokalemia–the technical term for potassium deficiency–and took potassium supplements were inclined to recovery. While the study results don’t directy say a potassium deficiency means you’ll get sick, it does indicate that because of the ACE-2 enzyme and the whole relationship to the virus, that one contributing factor may be low potassium levels.  And if you already have low potassium to begin with, then you may have a higher risk of fatality.

Click here for a consultation with a functional medicine doctor to learn about the symptoms of potassium deficiency!

Sodium and Potassium Pump

Why Does Potassium Matter?

Potassium is a key part of the sodium-potassium pump. A cell has sodium inside the cell and potassium outside of the cell, and the sodium-potassium pump uses active transport to move molecules from a high concentration to a low concentration by moving sodium ions out of and potassium ions into the cell

The enzyme that’s involved in making this happen is an ATP enzyme. You can identify enzymes because of the suffix “-ase” at the end: ATPase. ATP is important because it is the energy generated by your mitochondria.

Side effects of a potassium deficiency include:

  • Muscle or nerve problems
  • Mood issues
  • Adrenal dysfunction
  • Energy issues
  • Digestive issues
  • Heart palpitations
  • Achy muscles, muscle breakdown
  • Feeling tired and stiff
  • Tingling and numbness issues

Symptoms and Dangers of Low Potassium

One of the big side effects of a potassium deficiency is muscle or nerve issues, because potassium and sodium are very important for the muscles and nerves to work

There is also a potential for mood issues because sodium and potassium play an intricate role with the adrenal glands. Part of the reason why people’s potassium gets low–outside of a poor diet–is going to be because of adrenal function. Typically with the adrenals, aldosterone starts to go low.  Aldosterone is a mineralocorticoid that exists in the cortex of the adrenals. As aldosterone starts going low, sodium can start to drop too. As your sodium drops, sometimes your potassium can look like it’s not too bad. It can look actually a little bit high, but you could still actually have potassium issues because of the fact that your adrenals are weak and you’re peeing out a lot of your minerals. 

If you have sodium-potassium pump issues, you probably have energy issues too. Healthy mitochondrial function is needed to make ATP for the sodium-potassium pump to work.

Cramping is another potential side effect of being potassium-deficient, because the muscles need the fluid wiring, sodium and potassium, and minerals.

Your bowel movements and your motility starts becoming slower when your potassium drops. We need healthy levels of potassium so we have good bowel movements; otherwise there can be digestive and elimination problems.

Heart palpitations are another potential effect of low potassium, since we need potassium and magnesium for our heart to pump. Our heart is a muscle as well. So if your heart is skipping beats or beating harder or faster, that’s a sign of palpitations, which could be from low potassium.

And other symptoms include tingling, numbness, achy muscles, muscle breakdown, feeling tired and stiff. The breakdown of muscle is known as rhabdomyolysis and that breakdown is going to be very much helped with good potassium levels. You’re going to have less muscle breakdown with potassium levels being adequate.

If you have any symptoms of a potassium deficiency, please reach out to a qualified professional to test your levels and determine your next steps.

Top 7 Nutrients to Heal Your Gut | Podcast #294

Our gut is a group of organs that needs to be in good condition in order for our body to function properly. There are a lot of ways to take care of our gut. For today’s episode, Dr. Justin and Evan Brand talk about Top 7 nutrients to heal our gut, and also the root causes. Read more of the podcast below.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover: 

1:21    Downside of OTC Medications

9:18    Healing Nutrients for the Gut

19:11  Gut Irritating Symptoms

31:57  Probiotics

32:47  Mold

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Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan Brand. We are really excited to chat about the top seven nutrients to help heal your gut. We’re going to talk about the root causes of why your gut may be inflamed and irritated to begin with, and how we as functional medicine practitioners, help the body heal faster while addressing the root cause. Evan, how are we doing today, man?

Evan Brand: I’m really good. Feels good to be back in the saddle. And excited to dive in with you here today. We’re in a gut disease epidemic. Maybe I should try to pull up some statistics here on like, IBS, your typical idiopathic chronic inflamed, you know, inflammatory gi issue. Let’s see what the numbers are. According to the CDC real quick, but this issue is huge. It’s I know it’s in the millions. So CDC, I it’s got to be bigger than this. This seems this seems low. Okay, well, these are people diagnosed with autoimmune gut disease. diseases. So Crohn’s disease or ulcerative colitis, back in 2015 was 3 million people. But those are people diagnosed and you’re talking the most extreme manifestation, Crohn’s and ulcerative colitis. So if we’re talking IBS, completely different from IBD, the numbers, I’m going to say probably in the double digits of millions for sure.

Dr. Justin Marchegiani: Oh, I mean, I mean, if you just go look at the top medications by sale, you’re going to see I’m almost positive, you’re going to see omeprazole or some kind of a Nexium or acid blocker in that top five or top 10 for sure, I know and pass It’s been three or four. It’s been common. I mean, you know, it just really depends on what you market, right? A lot of times when these medications go over the counter, it becomes a little bit less of a deal because everyone has access to it. No companies in the market it quite as much right? True. But in the past, it’s always been a big, big top selling medication. And when you’re on medications like that, you can actually create more damage and more inflammation, partly because you’re not breaking down your foods, partly because you need acidity to prevent bad microbes from growing. So number one, you start having indigestion issues because you’re not breaking down your food all the way. Number two, you don’t have that good acid so other bacteria and critters can grow. Number three, yeah, it could potentially block some of the irritation in the gut. If you’re not making enough acid, a lot of times your food rots and creates organic acids from the rotting process. That’s, you know, that’s real. Now the problem is having enough acid though, can also help break down that food and prevent that acid rotting from forming as well. So it’s a double edged sword. The question is, is the gut mucosa in the stomach? Is there enough integrity to handle the acid? That’s the question. Sometimes there is sometimes there isn’t. The people where there is these are the ones that merely start getting better with some apple cider vinegar or some betaine HCl, the ones who feel a little bit worse. These are the tricky ones, right? These are the ones that have a whole bunch of back pain, right, but have a sunburn so they can’t really get a massage because there’s their skin on the outside is so irritated where the inside support that is needed right from those deep muscles and tendons can’t receive it because of the inflammation. Think of that as a gut lining, right? That’s irritated from all of the ads or inflammatory foods or a lack of stomach acid. All of that can be driving that for sure.

Evan Brand: Let’s go into like story mode. Because people love this. I mean, lecture lecture mode is fun, but people love story mode. So let’s go into story mode for a few minutes. I just want to tell a story and if you’ve got one to share, to have gut issues, you know, so I guess I have to me personally, you know, my gut issues were that I had major weight loss. I had depression, I had anxiety I was having panic attacks. I was having sleep issues, skin issues, just bad bad acne. I had burping I had bloating, I mean pretty much across the board. That’s Something people don’t think about is that it’s not just your gut that’s affected when you when your guts affected it’s your brain and a lot of cases too. And long story short, I had many infections and I do believe even back then I didn’t know this, but I do believe that mold was part of my journey and detoxing, it has improved my gut because mold can cause diarrhea. And so I had a lot of issues with my bowels that have gotten way better after doing binders. But the story that I was going to mention was a teenager who I saw within the last few months who was around 16 17 I think it just turned 17 and the GI doctors basically gave him a prescription pad he was diagnosed with pain colitis, which is where it was the entire colon, not just the the later section of it that was inflamed, and they gave him I don’t remember the name of the drug but some sort of immune modulating drug and send him on his way. And we ran a stool test on this kid. His inflammation level was above 1000 on calprotectin, which is crazy. We don’t like to ever see it even post that correct. And we just got him on some of the gut healing nutrients. So you and I always use and we’re going to dive into what those are later. But within six weeks we retested his stool just because it was an urgent situation. Typically, we don’t retest that soon. And we had already got the inflammation down into triple digits. So I mean, within six weeks, hundreds and hundreds of points of calprotectin had dropped, I think we got it down to maybe a 200. So from a it was over 1000, I think was 1200, down to a 200 in about six weeks.

Dr. Justin Marchegiani: So unprotect is like the equivalent of C reactive protein for your blood, right? Calprotectin is produced by the immune cells in the gut. So when you have a lot of interleukins are cytokines or nuclear factor Kappa beta, these are all like these inflammatory signaling molecules, your white blood cells and immune cells will produce calprotectin as a end result. So it’s a good way of monitoring it like you’re going to see it very high, you know, greater than 500 and a lot of irritable bowel diseases, colitis, ulcerative colitis, Crohn’s, those kind of things, right.

Evan Brand: Yeah, we don’t see it that often though. I mean, maybe I mean, more than the average person more than the average practitioner, probably because the people that we’re seeing have already struck out with conventional doctors. But I would say out of a given month, I probably only see calprotectin above 500, maybe five to 10 times.

Dr. Justin Marchegiani: Yeah, me above 500. It’s a lot. I’ll see it typically above 50. You know, 50 is kind of my functional range. And hundreds, I’ll see that quite frequently. And it just depends, right, we see a lot of patients that have already gotten very educated from us on the podcast. So they’re already making a lot of first line changes. And that’s kind of the benefit of the podcast, patients already come in with a lot of momentum and wind at their back because they’re following a lot of these first line kind of low hanging fruit therapies. So they’re making some diet changes, they’re doing some simple things, and that provides a much better foundation so we see less inflammation coming in. So for sure, now, root cause what are some of the well we’re going to talk about some of our favorite nutrients in a minute, but root cause you know, food allergens are going to be a big root cause grains, dairy, right booms, anti nutrients and plants. Some can be big deal. Not enough stomach acid, not enough enzymes, right? A lot of chronic stress, people don’t realize but over exercise is actually known to create gut permeability. A lot of studies on post marathoners and lots of aerobic exercise, actually increasing gut permeability. People were like thinking about their gut and their leaky guts, which can create a lot of immune stress or thinking about inflammatory foods and infections and enzyme and acid deficiency. But guess what overexercise can also aid in that permeability.

Evan Brand: Yeah, so you mean you could think you’re doing great and oh, I eat keto and 90 bulletproof coffee, but then you go run five miles every day. That’s just not gonna be good.

Dr. Justin Marchegiani: Maybe a stressor? Yeah, stressor was a big article. I think it was like last month in a golf magazine. Tiger Woods blamed all of his back in the surgeries on on chronic cardio. He was doing lots of running, which, you know, anyone that’s in the athletic industry would know that, that doesn’t really translate to the golf field that well, right. You need very specific types of movements and training modalities to allow That to transfer and chronic long distance cardio guess what it really only transfers to chronic long distance cardio sports. If you’re not doing a chronic long distance cardio sports, most people are going to do better with a better targeted resistance training and or circuit training or Burst Training kind of workout. But that’s neither here nor there. But it connects back to the gut permeability, which could be causing a lot of your digestive issues if you’re over exercising.

Evan Brand: Yeah, I had a I had a girl who was in college, I want to say maybe sophomore junior in college, and she was running three to five miles per day, at least five days a week. So you’re talking 15, sometimes 20 miles a week, Her skin was a wreck, and her gut was a wreck. The only protocol for the first six weeks after we got the labs back was samana microbial herbs to address all the infections. And then we did some omegas we did some enzymes. And and then the piece that I think was most important was I told her Hey, only do two runs a week above a mile. So like a mile, you know, twice a week and then the other days you know, do something else do yoga, do stretching, do weightlifting. And that alone was enough to to significantly change her her story and she’s like, Oh my god, I didn’t realize how tired I was. I was beating myself into the ground. And these athletes, they get addicted to the endorphins from the running.

Dr. Justin Marchegiani: Yeah, there is the big endorphin rush. So kind of moral of the story here is do the low hanging fruit have the right foundational things, you may need to see a really good functional medicine practitioner to kind of get these things dialed up and lined up. Now our first healing nutrient, let’s plug it in right now would be zinc. Zinc is a very powerful nutrient in my gi restore. I have a zinc in there a zinc carnosine, which is a very absorbable zinc in the in the gut, which is great. That has been shown to decrease inflammation in the stomach. It’s also shown to be very helpful on the gut permeability side. And in some studies that’s actually been shown to decrease gut permeability induced by excessive cardio exercise. So keep that in the back of your head. back of your head there, zinc is gonna be one of those nutrients you’d want to be adding in. Very important, and it’s going to be foundational and zinc is also very high and a lot of paleo foods, right. And a lot of your high quality meats and seafood products you’re gonna get a lot of zinc will typically do, you know, anywhere between, you know, 10 to 30 milligrams of zinc in a day to really help on the gut permeability.

Evan Brand: Yeah, there’s a really good study on this American Journal of Clinical Nutrition 2016 zinc carnosine works with bovine colostrum and truncating heavy exercise induced increase in gut permeability in healthy volunteers. So, yeah, long story short, and we like colostrum too. So we will use that some people can’t tolerate it, but most people can. So take, you know, zinc alone or colostrum with I wasn’t on our original list of nutrients, but hey, it’s done really, really well for me and many people too. So why don’t I go ahead and throw colostrum into the mix as well.

Dr. Justin Marchegiani: Yeah, we’re gonna put our links to some of the products that we personally formulated and recommend for our patients and have been doing for years. We’ll put them down below. Evans gonna have his, what’s the name of your GI product?

Evan Brand: Mine’s called GI Sooth. So you do powder and I do capsules, they’re both great. You can’t go wrong with either one.

Dr. Justin Marchegian: Exactly. Mine is GI Revive is the designs for health product. Yours is the GI Sooth the mine is the GI Restore. And I’ve been using that one for about two, three years. That’s a phenomenal product. And then the thing with yours is you don’t have any additives or flavors in it. Neither does mine. The problem with the designs product has a little bit of additives and flavor in the powder form. And I’ve seen patients really react to some of these added flavors and sweeteners and gums. So you got to be very, very careful with that. You either want a powder that does not have a lot of sweeteners in there, or you want a capsule one that’s very important. So there’s some brands out there that are really good and clean, like I just mentioned, but have some of those binders in there. That could be a potential problem. So you really got to look at some of those binders.

Evan Brand: Yeah, we love them. But when you throw in natural flavors and then you’re throwing in tapioca dextran. I mean, a lot of people complain to me that if they’ve tried that one before with other practitioners that it would mess up their blood sugar too, because that tapioca, I don’t know the body recognizes them, you know, sort of as a blood sugar spike or so. So we, so we don’t use that one clinically, but a lot of people have used that one previously, if you’re working with like a naturopath, they may have brought that tool out on you, and it’s probably still going to do more good than than bad, but that’s not what we use.

Dr. Justin Marchegiani: I think another low hanging fruit, a lot of people use this and a lot of people may even go do it to it as a first line therapy would be glutamine. Now, glutamine is excellent because it’s a primary fuel source by the parasites in the gut, which is awesome. So these are like the gut cells that make up the gut lining. These these cells are going to require a lot of glutamine. So glutamine is very, very important for providing that fuel source. It really helps provide good integrity kind of like collagen and glycine. glycine is also really good for the gut lining collagen provides Good integrity for hair, skin and nails. Think about glutamine is providing really good integrity for the gut lining. And the problem is, why does the gut become permeable when there’s lots of exercise? You know, Evan?

Evan Brand: I mean, cortisol is going to be my main my main thing.

Dr. Justin Marchegiani: Catabolic physiology right and catabolic physiology. What does it primarily attack it attacks protein and amino acids, right? That’s why chronic cardio people that have a certain physique, right, they’re much more leaner, more emaciated looking, definitely less muscle tone than a sprinter. Just Google sprinter versus marathon runner, you’ll see an instantaneous side by side and what the difference is and part of it is because runners are going to engage in more catabolic physiology more cortisol, right. And sprinters are going to engage in more anabolic physiology testosterone growth hormone, right, and that’s going to cause muscles to grow. So l glutamine is going to help balance out that catabolic physiology now that catabolic physiology could be from overexercise. It could be from inflammation in the gut from gluten. Right? It could be from all those different things. It could be from potential infections. Now, we could use glutamine in a way that’s just symptomatic, right? Like we’re not getting to the root cause, meaning I have an infection. I have poor diet, but I take this, that’s okay. But we’re always trying to get to the root cause. So if we add in L glutamine, we’re gonna add it in with a lot of these other things as well and ensuring the root causes dialed into.

Evan Brand: Yeah, so you could say glutamine is basically anti catabolic. So looking at that zinc study, it was talking about how the intestinal permeability went up by what they say here three fold. So the intestinal gut permeability went up three fold after exercise the zinc or colostrum, basically truncated the rise by 70%. So if you threw in something like glutamine, which actually, you know, there are some kind of pre workout nutrients that we could use blends of amino acids that may have glutamine in there, and I’m sure with a good Grass Fed Whey protein, we We use some of those, you’re going to get some glutamine there too. And so to me, it’s, it’s the great, you know, maybe pre or kind of post workout nutrient as well.

Dr. Justin Marchegiani: Correct. I’d also say the synergistic nutrients that work with glutamine, I would say are also gags, which are like coastal amino glycans. You know, being a chiropractor for a while I work with a lot of disk patients. I don’t do this anymore. But a lot of the disk material, the raw material in that disk is made out of these guys like also amino glycans. And these can be severely impaired with lots of insulin and oxidative stress. And of course, if we’d have had digestion, we may not get enough of it through our diet, right? So we may add in an acetal Glucosamine, which is a form of a glyco glycosaminoglycans a gag for short, so very, very helpful and helping connective tissue helping the gut lining lots of anti inflammatory benefits and they kind of work in conjunction with the glutamine because they tend to be connected, and then we’ll connect in there the glycine right glycine is very high in collagen. So, collagen is also very high in glutamine, so glutamine, glycine and EDIS and an acetal glucosamine or the gags that the glycosaminoglycans are going to be very helpful at building blocks for the gut lining, and they’ll be a really good buffer for catabolic physiology when cortisol and stress is present. And that tissue starts to get broken down.

Evan Brand: Well, here’s another cool thing about glucosamine that came up in the research was that it helps to reduce biofilm with different pathogens like E. coli. So, you know, you and I, we talked so many times about using anti microbials. And we’ll come in and use our gut healing nutrients. What if there were some biofilm left behind? And by accident you and I were actually eradicating the biofilms therefore keeping people in good shape as opposed to allowing them a relapse if you didn’t do a gut healing phase is kind of just gives us a little more credit and ego boost for doing the gut healing phase. Because if you just came in and kill, kill, kill, maybe there was something left like a biofilm of ecola then comes back but this paper on the NSE two glucosamine it talks about, you know, reducing that biofilm formation so that’s pretty awesome.

Dr. Justin Marchegiani: Exactly and any of my patients that are listening biofilms are important. That’s why I recommend a specific ginger tea protocol. And the ginger tea I recommend is going to have one high dose ginger in it that’s juice ginger. Ginger is a very powerful biofilm Buster you can go into PubMed and just type in ginger and biofilms you’ll see dozens of studies. It’s also anti inflammatory, it’s very safe as well. It’s a natural blood thinner too. So it prevents a lot of the cells from getting stuck and sticky. And then also I typically recommend a little bit of the Manuka honey in there and Manuka honey really helps biofilms and has an antibacterial effect. But just dovetailing on what you were talking about regarding the gags the anesthetic glucosamine or the the glycosaminoglycans. They also have immuno inflammatory modulating effects, right. So we have different cytokines which are signaling molecules that are produced from the inflammation So these are like TNF alpha, this is nuclear factor Kappa beta, interleukin six different interleukin molecules, it helps modulate those and kind of dampen those down a little bit, which is helpful. So it’s kind of like the fire is going, and I’ll just kind of put that fire out. Now it may not be a root cause of the fire. But if you’re working with a good functional medicine doctor, they’re gonna make sure we use things that modulate the firewall at the same time we get to the root cause of the fire.

Evan Brand: Yeah, let’s talk about that real quick. There’s been a couple cases where we’ve had people in such bad shape that will actually come in and bring some of these gut healing gut soothing nutrients right away in the very beginning. I mean, if I’ve got somebody that’s so miserable, let’s say they’ve got major Cold Blood that’s showing up they’re bleeding every time they poop, I mean, their guts in bad shape. We may come in knowing it’s not root cause it’s palliative care, but we’ll come in and use gut soothers in the beginning, maybe even before we get to the end of microbial phase, I mean, if their guts just so so hurting we might not be able to come in and kill the parasites are whatever is at the root of this thing. Have you done that before? Have you come in and said, Oh my God, this person, they’re not even ready to go to the phase one we got to go phase like point five here.

Dr. Justin Marchegiani: Patients have typical gut irritating symptoms in the top three to five complaints on their chief complaint list. And then we’ll add in some of these healing and soothing nutrients off the bat, I find a lot of my patients, I don’t really need to use them off the bat, if I get their diet and digestion working better, and I get enzymes and acids and food and maybe even, you know, some simple bone broth or some ginger tea in there. A lot of times I won’t need it. But anyone where it’s in that top five, will kind of come in there and use it for a couple of months just to really accelerate the healing, partly because I want to get people ready to deal with the gut killing part of the face. And if someone’s guts too raw, sometimes those herbs, they’re not going to tolerate them well. And the herbs right in my analogy of someone having a sunburn but needing a really good massage or a chiropractic adjustment because of their Their lower back, but at their skins really burned, they may not be able to receive that right? Same thing on the gut killing, we may need to come in there with some really powerful gut killing herbs. But patient is to run the mucosa. And they can’t handle the herbs, or they can’t even handle any stomach acid, right? So then we have to, that’s where it’s really important to get these things in on the front side.

Evan Brand: Yeah, and your average person listening who just wants to improve their health and their gut health, you may not be in that category where you have to go to gut healers, we’re talking to people that have been a gastro doc for 5-10 years, they’re really suffering or maybe they’ve just been undiagnosed this whole time, but they’re in really bad shape. That’s where we’re going to bring that out in the beginning. So your average person listening that may not apply.

Dr. Justin Marchegiani: But you know, I think low hanging fruit for anyone is going to be collagen, we can always add in the collagen, which is going to have a lot of the glycine in there. And it’s also going to have some of the glutamine in there, right. And so that’s at least a good first line step because no one’s getting enough connective tissue in their diet unless they’re doing lots of bone broth soups. That’d be the only exception. So if you’re not doing a lot of bone broth, soups and things like that, You probably need some extra collagen in there. Yep, yep. So favorite brand. So I mean Evan has his gi su died my gi restore, but I also have my true collagen, which is a product that I formulated. And with that product, a lot of collagen or actually they add sulfuric acid into the collagen. with mine we were able to do proteolytic enzymes, why does that matter? It matters because your tummy doesn’t really have to do much of a breakdown process because the enzymes already make the the collagen so absorbable there’s very little digestion that has to happen to take in those nutrients. And when the guts really inflamed, you want a lot of these things pre digested so it’s easy for me to handle. We’ll put our links down below in the description below. 

Evan Brand: Beautiful, beautiful. So speaking of sunburn, let’s go on to the next one. Let’s talk about aloe. I love aloe, and actually have one I’ve got one called GI Sooth 2, which is just a straight aloe extract just because, you know there’s some cases where I don’t feel like we need the full shebang with the glutamine and all that. So we’ll just say well, let’s try out By itself, and there’s a paper here, some kind of pharmacology therapy paper, randomized, double blind placebo of oral and this is just aloe vera gel. This is not even the concentrated extract that we’re using, we’re talking just straight aloe vera gel for ulcerative colitis. And even just in four weeks, it was a clinically significant benefit for colitis. And so we’re talking people in major autoimmune gut issue and in four weeks, they’re in really, really good shape with it. That’s not going to happen with drugs, I’m sorry, the pharmaceuticals are not going to have that fast of an outcome. And it’s probably going to be a hell of a lot more expensive for for the drugs. And once again, it’s not really gonna, I don’t know it’s just not root cause for me aloes, more root cause it’s going to soothe the gut, it’s going to reduce the inflammation. It’s not just going to try to modulate some enzyme or modulate this. It’s just, I like it.

Dr. Justin Marchegiani: Aloes, also has some anti inflammatory effects, right? There’s a so we talked about C reactive protein and nuclear factor Kappa beta and interleukins and cytokines. There’s another answer. There’s another inflammatory marker called MPO, or Milo peroxidase. And aloe helps modulate Milo peroxidase. And it’s also shown to have a lot of antispasmodic effects. So a lot of people that have IBS, for instance, a lot of times they have a lot of spasms. I know Evan, when you were diagnosed with IBS, at what, 10 years ago, they recommended a lot of antispasmodic drugs and it’s too bad yeah, you didn’t have that functional medicine knowledge. You know, you could have been taken out of the get go to help with that.

Evan Brand: I did. I didn’t do the drugs but yeah, they recommended them. And so luckily though, the the stats The funny thing about it, the spasms it wasn’t what I’ve learned our spasms clinically it was more just Hey, urgent, boom, gotta run to the bathroom. versus some people it’s they’re just sitting there at their chair trying to type on their computer and Boom, they’ve got these spasms happening. So for me, luckily, it wasn’t as miserable as it could have been. At the time, though, you know, even though I didn’t know what I know, now, I still was doing some of the enteric coated peppermint oil. And that was very, very helpful. I don’t mean of course, it wasn’t root cause it didn’t magically erase my infections, but the entire code of peppermint did do some good for me.

Dr. Justin Marchegiani: That’s good. That’s excellent.

Evan Brand: And that wasn’t on our list, but why not throw it to the list? It’s gonna end up being like 12 nutrients for your gut, but we had to have some kind of buzz, you know, Buzz worthy title. So we said seven but peppermint, I think could also be considered.

Dr. Justin Marchegiani: Yeah, we’re gonna provide overvalue here. I would say next is gonna be sulfur compounds. So one of my favorite sulfur compounds is MSM, which is methyl sulfur on methane, so powerful organic sulfur compound. Again, first mechanism, what’s the underlying root cause mechanism for you science junkies out here? It’s going to be modulating your B cells, it’s gonna be modulating nuclear factor Kappa beta, it’s gonna be not not modulating TNF alpha, interleukin one, interleukin three Looking sick, these are all chemical signaling molecules from inflammation, it’s going to be decreasing Milo peroxidase, like the aloe, a lot of studies showing that MSM and these sulfur rich compounds are going to have a lot of powerful antioxidant compounds in there, really helping to suit providing a lot of, let’s say neutralization of the oxidative stress. Why is the oxidation there? Well, because of the inflammation, inflammation, cause oxidation. Oxidation is when you lose electrons. When cells lose electrons, they become very unstable, and that can create DNA damage. And so we need antioxidants, things that have extra electrons that can donate them. And that helps prevent the oxidation thus preventing the DNA damage. So the sulfur rich compounds, they reduce inflammation, interleukin cytokines, and they have antioxidant properties to help stabilize the cells in your gut. Very good.

Evan Brand: Well, how about the How about the Cox 2 pathway too because that’s going to change Increase inflammation and the MSM back can also down regulate Cox 2. So, I mean, you can’t say that it’s gonna act in the same way like is aspirin but I mean it can definitely help with some of the gut pain I would say associated with some of these infections.

Dr. Justin Marchegiani: Well yeah also, you know, we know we need so the Cox two enzyme also is going to be modulated by, if you remember back in the early 2000s to drug Vioxx, that was a big drug also NSAID’s modulate that Cox two, right? Cox stands for cyclooxygenase. Two. The problem is if you do too good of a job blocking that enzyme, we need that enzyme to build up our gut lining build up our heart and stuff. That’s why we saw lots of strokes and even potential ulcerations from those kinds of medications because they do too good of a job. That’s the problem with drugs is they create lots of side effects herbs and they tend to have more of a modulating kind of use where they kind of bump it and move it in the right direction but not So far where it causes the side effects where drugs go way too far, and then you have a lot of side effects, right? Like it was a journal article in the New York, New England Journal of Medicine 1998 by Wolf at all talking about ibuprofen, killing 19,000 people a year taken appropriately. So the nice thing about these natural supports, if you’re not gonna have to worry about those kind of side effects, which is great.

Evan Brand: Wow, what was I mean, not to get too off subject, but what’s the mechanism on that? It’s just the intestinal bleeding that happened or-

Dr. Justin Marchegiani: -bleeding, which then affects the liver, which also can affect the alterations in the stomach. And that can also affect the heart. It’s so yeah, it’s that Cox enzyme is to to dampen and torque to good on it. And then that enzyme is needed to do other things that are important in the body. Wow It’s kind of like, imagine if like you had a high ashwagandha or high levels of cortisol and you took some ashwagandha demodulate it well, if it not cortisol all the way down. to the ground, you’d be in a state of Addison’s disease. Right? And yeah, like that you kind of trade one thing. It’s not all the time, right? And if people that are using it chronically, those are the ones that really have to worry about it. So if we’re going to use something more longer term, we want it to be more natural, because it’s gonna have a safer profile to it.

Evan Brand: Yeah. So if you’re out there and you’re on daily dose of ibuprofen, because you got a headache because you’re still eating gluten, you know, consider that your warning get off gluten, get rid of the headache. 

Dr. Justin Marchegiani: 100% 100%. All right, what else do you want to chat about? How are we going to licorice?

Evan Brand: Love licorice. So let’s talk about the difference real quick, because you and I love licorice for many reasons. I mean, it’s one of those nutrients that can be used for different body systems. So we’re often going to use more of an active licorice for adrenals. So where you have the glycerin, the active component that can help extend the half life of cortisol. I use the analogy of plugging up your smartphone to one of those little battery packs where you’re going to get a little extra juice out of your phone. That’s what we use it for regarding adrenals if we’re working on that, but if you take the glycerin out, and you remove it, and then it becomes called dgl, where it doesn’t have the, the active component anymore, so it’s not necessarily going to affect cortisol now, now it turns into like a gut healing nutrient. So dgl is in both of our blends, and you and I’ve used it, I don’t know thousands of times by this point, and it makes things taste good to dgl. Like if you have it in some bitter herbs, it can, it can kind of blunt that nasty taste a bit

Dr. Justin Marchegiani: 100%. So DGL is excellent, you already talked about it. Regular licorice is going to have an effect that increases cortisol, which can then also increase your mineral corticoids, which hold on to water and sodium, which on the adrenal side may be a good thing if we need it, and we have a test showing low cortisol. But if we don’t have a test and we want to make sure we don’t over increase cortisol or our blood pressure, that’s why we use the test. dgl licorice though I think you kind of highlighted that dgl is is very powerful because you have the anti inflammatory benefits without the cortisol increasing blood pressure increasing sodium fluid retention effects.

Evan Brand: Yeah, I had a study here I was trying to see exactly what it said it was called integrative treatment of reflux and dyspepsia in children. Of course, all the good stuff licorice was on there gingers on the list here of botanicals. talked a little bit about sleep hygiene. Anyway, I was trying to just get a number right now in terms of how beneficial it was. It just talked about they didn’t say a number they just said here that compared to placebo licorice extract showed a significant decrease in the total symptom scores of the gut issues. So of course, they always put this in there, although more evidence is needed. DGL can help people wean off acid drugs acid blocking medication.

Dr. Justin Marchegiani: Yep, that’s powerful. I think we hit seven already, which is great. So let’s kind of go into a bonus round here off the bat, I would just say probiotics can be very helpful. A lot of times we don’t add probiotics in on the front side. But we’ll add them in after on the back side just because there’s a lot of things we can do on the front side, but probiotics, bifidobacterium, lactobacillus, acidophilus, etc. These have been shown to have anti inflammatory effects on the gut. And now the timing is everything because there’s a lot of things that you can do. The question is, at what time and the thing is, Evan and I have seen thousands of patients we have a lot of experience in the timing of things. So a lot of times we’ll use probiotics on the backside are really help. One, help gut permeability help IGA levels help crowd out a lot of these bad bugs which can them them in their own right, create inflammation. So if we crowd them out a little bit in a gentle way that can also reduce inflammation and then just naturally helping to modulate a lot of these interleukins and cytokines and all these compounds are very powerful.

Evan Brand: Yeah, I’ve been a bigger fan of probiotics. Lately just because of dealing with mold and trying to detox that out of my system and helping people deal with mold, there’s this pathway that happens. Basically, you can convert more toxic molds into less toxic molds using probiotics it basically, I don’t want to say it conjugates them because that’s not the mechanism but for lack of a better word, it’s sort of maybe de granulate. The mold toxin, makes it less toxic, and then you can excrete it out and the remaining toxin does less damage because now you’ve converted it. I don’t have it in front of me, but those are just charred of okra toxin, with the help of probiotics being converted into maybe alpha okra toxin or something. It’s kind of downstream tablet, and then downstream again, and then the toxicity drops with the help of probiotics. So long story short, I use probiotics all the time, and they work great.

Dr. Justin Marchegiani: Love it. Also, let’s do a little bonus round people. Let’s talk about mold. This could be well, so we have gut infection that could also be big things that are holding people back. I don’t think we have to go into this in depth. We’ve done podcasts On this, but a lot of people forget about the mold aspect. Because mold has various mycotoxins, which can increase gut permeability. We’ve done a podcast where we go more into how we deal with this clinically, but can you just go over that concept, Evan?

Evan Brand: Yeah, the main thing is, you know, after interviewing a guy, Dr. Nathan, he’s a medical doctor been working on mold for 2025 years, he told me, he said, You can’t fully heal your gut unless you get rid of the mycotoxins and I thought, well, how is that true? Because, you know, I’ve been working with people for a while now. And I’ve had many people who their gut symptoms are so much better so that I just get lucky that those people did not have mold. Was I missing the mold? Or, or what? How could How could you say something so strongly, you can’t heal your gut without it. And then I started looking back at some of these cases where people would be in really good shape for a few months where you eradicate the infections, you come in with some gut healing nutrients, and then a few months later, they’d say, you know what, I’m kind of, I’ve got Candida coming back or my tongue is white again, or I’m having sugar cravings again, and now I’m Going kind of circling back to those people and testing them for mold, and I’m finding that they’re positive, they’ve got it, they’ve got toxic levels. So now we just throw it into the mix. It’s not that I’m saying it’s the end all be all biomarker, it’s the end all be all catalysts for leaky gut at all. But if you’re somebody who’s gone down the rabbit hole of addressing H, pylori parasites, bacterial overgrowth, and all that, and your integrative natural functional, whoever practitioner didn’t look at this piece, I would consider it because it’s also the mechanism of weakening the immune system. So it’s not just the direct damage on the gut barrier, but I would assume that weakening the immunity has a role in this too. I mean, if you look at <INAUDIBLE> acid, something we test for, they give that to people when they’re doing organ transplants, so that it’ll kill the immune system so much that their body won’t reject the new organ. I mean, that’s how they use any conventional medicine. So this stuff is potent, potent, potent, and then you’ve got things like glio toxin, which affects the gut and the brain. So It’s a game changer. I mean, I feel like we talk about it so much now, but it’s really transformed my life and in our clinical lives too, because this is the epidemic. We used to not build houses with drywall. And now we do. So when you look at your great, great grandpa, he didn’t have a problem because this house was built with plaster. And now the house is built with drywall with paper backing. So it’s it’s a new epidemic, but I do believe it’s the number one cause of chronic fatigue that we’re seeing out there based on Dr. Brewer study, you know, 95 plus percent of his patients with chronic fatigue tested positive for mold, and all those chronic fatigue patients, they often have gut symptoms. So a lot of people have diarrhea, and they’re tired. Is it the diarrhea causing the fatigue? Maybe, but it also could be the mold. So that’s my rant on that.

Dr. Justin Marchegiani: Yeah, the only comment, I would say it just really depends, right? Because I’ve seen a lot of patients that are in a moldy environment or could be in a moldy environment. I have seen a lot of benefit and a lot of improvement, with a lot of the foundational changes that we do without even talking mold. So it just depends upon how chronic and how much is there. And then also genetically how sensitive you are to mold. There are some genetic types, they can just handle a lot of mold, and some not. So I don’t think it’s a be all end all. But I think it’s definitely an important factor that should be on our checklist, and we should be aware of it. And anytime we see a chronic health issue, we should be testing for mold in the home as an easy low hanging fruit. Because if you have high levels of mold in the home, you know, that can affect everyone in the house, right, which is great. You don’t have to test everyone’s urine individually. But then once we see high levels in the home, then we can go and start being more specific on what that individual person’s load is. And then, you know, my biggest thing is, Hey, if you’re out of the home for a week or two, how do you feel? Do you feel better, and I’ve seen a lot of patients they’re out for a week or two, they come back and it’s like, boom, now we got to be careful if you’re out of the home because you’re on vacation and you’re hanging out relaxing all week or two, and then you come back to a stressful environment. That could be a factor too. So you got to keep stress under under that control, so to speak. So you’re comparing apples to apples.

Evan Brand: True, true. But yeah, I mean, Dr. Nathan, when he’s talking about he can’t heal the gut unless you get rid of mold. Yeah, maybe in the 25% of the population who doesn’t genetically detox mold. But you and I have seen so many cases of probably the 75% of people who they can detox mold, so it wasn’t an issue. And that’s why we we were like you mentioned able to get them such good progress and results in success without even addressing them all, because they were probably genetically gifted. He seen the genetically gifted like me, who built the mold toxin up and then it had some downstream effects.

Dr. Justin Marchegiani: Yeah. And also, if you get tested for mold, and you’re gonna test your urine, make sure you challenge it with a lucify on for at least a couple of days to a week ahead of time, I typically recommend one gram of solidify on a day, you know, for three to seven days ahead of time, too many people I see come in, they’re like, Oh, my molds, fine. And I’m like, did you do a challenge ahead of time? They’re like, nope. So you got to make sure you’re really challenging the urinary mold levels ahead of time. Can you speak to that?

Evan Brand: Yeah, that’s very helpful. And if you’re you might not need a gram. If you’re doing that. Like a better quality if it’s like bizarre more maybe a seagull you may get away with, you know, a few hundred milligrams to half a gram. You know that less? Yeah,

Dr. Justin Marchegiani: yeah, it was almost probably 500 milligrams to a gram would be fine if it’s SSE or one of the other types that we like, then you get a couple hundred milligrams, it’s probably fine.

Evan Brand: Yeah, but the sawn has been helpful too. I’ve had some people just as an experiment, right? You and I are we’re experimenters. We’re in the trenches. So I’ll have people you know, I’ll have you know, Jane Doe I’ll have her do five days glue to fine and then I’ll tell her on the morning of when you wake up hold up, jump right in the sauna 2030 minutes then collected Whoa, it’s crazy how much more you see coming out. So and we know that we know that heating up the body helps mobilize toxins of all kinds. So if we’re going to do like a combo urine, organic acid, Miko chemical profile, man, we really do get a better read on people. My analogy is it kind of squeezes the orange, you know, in the cup of tea shows up just more accurate.

Yep, totally. Yeah, that makes a lot of sense. Totally. Makes a lot of sense. Well, let’s wrap it up if you’re ready for the highlight today. 

No, I’m done. You want to wrap this thing up? 

Dr. Justin Marchegiani: I think so. I think we’re on the right track with everything. So anyone want to reach out to myself JustinHealth.com available worldwide for console Evan at EvanBrand.com. So if you guys want to dive in deeper and get to the root of what’s happening here, we are happy to help you. We do a lot of these testing all over the world. So if you’re coming in, we test them all. We’ll test the gut, we’ll do all these things. We have kind of have the right algorithm, the right formula to kind of get people on that healing journey. Anything else? Anything you want to highlight around?

Evan Brand: I would just say that the issues we talked about are worldwide. You know, this is not just an American problem. You know, we’ve got clients in Australia, we’ve got clients in Canada, we’ve got clients in Europe. I mean, this is this is something happening around the world and it’s amazing how many people don’t get the proper help that they need from the conventional doctors. It’s really really sad. I was looking at my podcast reviews this morning. And of course, you know, I and you were in the alternative health category and I thought you know what we need to stay in this alternative. Category until this becomes the mainstream, you know, and that and people have made that argument before that what we’re doing. This is the original medicine. This is what people were doing thousands of years before the quote, conventional medicine existed before the vaccines and the drugs and the prescriptions and the acid blockers. Allah was around before all of that. So this is not really alternative or, or new age at all. This is just legit.

Dr. Justin Marchegiani: 100%, appreciate it. We’ll put the recommended products that we love. Evan has GI Sooth, I have my GI Restore, we’ll put the links down below so if you guys wanna support us, we appreciate that. And you guys have a fabulous day. Take care ya’ll.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.


References:

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/top-7-nutrients-to-heal-your-gut-podcast-294


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