The Gut Anxiety Connection | Podcast #352

How do your emotions get affected by your gut state? In this video, Dr. J and Evan talk about anxiety and stress as an example and how we can manage them based on evidence-based practice. Excessive worry and stress can worsen GI problems, and studies show that treatments and good food templates will help people cope with their GI symptoms.

Dr. J and Evan clarify that the brain immediately affects the gut. For example, the thought of eating can stimulate the release of the stomach’s juices before food gets there and vice versa. A sick intestine can alert the brain, just as a troubled brain can alert the stomach and intestines. Therefore, a person’s intestine and stomach distress may cause or be the product of stress, anxiety, or depression. It’s because the gastrointestinal (GI) system and the brain are intimately connected.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 –   Introduction
2:21 –  The Importance of Gut Microbiome
4:21 –  The Gut Microbiota’s Effect on Mental Health
8:43 –  Strategies on how to Approach Adverse Reactions to Probiotics
15:13 – Potential Neural Marker in Anxiety Disorders

Dr. Justin Marchegiani: For the podcast, really excited. Evan and I are gonna be chatting about the gut-anxiety connection. A lot of people have mood issues, uh, mental, emotional issues and they’re connected to the gut. And most people unless you have bloating gas, diarrhea, constipation, acid reflux, they’re not really connecting any gut issues to their mood especially anxiety. So, we’re gonna try to connect the dots for everyone here today. Evan, how are we going today man? 

Evan Brand: I’m doing really well, you know, I’ll start out by saying if you were to go to a conventional doctor and the referral for anxiety or depression to a psychiatrist, they’re never gonna consider the gut. They’re never gonna run a stool test or an organic acids test or a mold toxin test. There’s a study done on mice and mice that were exposed to various mold toxins. They have lower levels of dopamine and we know people with lower dopamine, they could be more apathetic, they could be more depressed, they could just be less excited for the world and although the organic acids doesn’t measure GABA, we can tell just based on symptoms, like easily stressed, hard to relax, you need alcohol to calm yourself down or maybe you need chocolate to self-medicate. We know these people probably have low GABA and GABA is the breaks of the brain. At least, that’s how I refer to it. Think of the GABA as being able to inhibit or slow down the sympathetic overdrive and GABA is going to calm that and increase that parasympathetic reaction. Now, the connection is to gut, well, we know, there’s a paper here we pull up just because we like to have a couple studies, there’s one titled, “Gut Microbiota’s Effect on Mental Health: The Gut-Brain Axis”. Long story short, the study backs up, what we’ve already known and you and I have been doing clinically for a long time, which is that we’re fixing dysbiosis because we’re finding that when you increase levels of lactobacillus, this is key in producing GABA and so that’s pretty interesting and the study goes on to talk about the different inflammatory pathways and how dysbiosis creating inflammatory proteins in the gut. That’s gonna also affect anxiety. So, dysbiosis alone that’s sounds crazy to some, maybe to mental health physicians but if you have gut overgrowth problems, that could be the biggest single smoking gun for you mood issues.

Dr. Justin Marchegiani: 100% because the gut microbiome very important. It helps modulate the immune system. So god healthy levels of beneficial bacteria, Bifidolactobacterium, Lactobacillus beneficial flora. They’re gonna actually, help modulate the immune system, they’re gonna help with permeability, keeping gut permeability down. They’re gonna help with inflammation reduction. They’re gonna keep the inflammation down. They also help, um, take mold toxins that you may get exposed to and make them less virulent, less strong, less inflammatory as well and then also beneficial bacteria are gonna synthesize nutrients based on the food coming in, so it’s gonna take your poop and it’s gonna take poop and convert it to nutrition versus dysbiotic bacteria is gonna take you poop and make things take your nutrients and make you more toxic, right? So, we wanna really get high levels of nutrition and you’re gonna get endogenous production through health gut bacteria, like vitamin K, different B vitamins, you’re gonna get some fermentation acids that actually make it harder for a lot of bad stuff to grow. So, this is kind of important starting place and if you look at some of the medications that are coming out for more mood stuff, some of the mechanisms seem to be more of an anti-inflammatory on the brain. That’s very interesting because we know, the mechanisms in the past have been kind of SSRI or tricyclics in the 80s and 90s or SNRI, right. These different kinds of medications of course, you have benzodiazepines that work on GABA and the different GABA agonist, right. So, now, we’re working on inflammation and we gotta be careful because we had some inflammatories natural, not natural but anti-inflammatories in the early 2000s, they called, that was called Vioxx that killed 60,000 people. So, we gotta be careful because when you, uh, use a lot of pharmaceuticals anti-inflammatories there could be side effects and I imagine if it’s on mood and the brain, you could see strokes and things like that. So, we gotta be careful. So, we try to use as many natural components foundationally with diet and supplements. First, because of the least likelihood to cause problems. 

Evan Brand: Wow. That’s insane. Well, you and I talked about the impact of exercise on anxiety before, we’ve covered that. We know that exercise is a super potent antidepressant. Here’s something cool about the gut in this particular paper. I put it in the chat for you if you wanted it, but it talks about how Lactobacillus strains upregulated BDNF, which is the brain derived neurotrophic factor and that resulted in increased regulation of the HPA axis. Let me just read the last part again because that’s pretty nuts. Supplemental Lactobacillus increase the regulation of the HPA axis, so here we are working with people using adaptogenic herbs but let it, but the cool thing is we’re actually fixing the adrenals by fixing the gut too, which is amazing and then it goes on further to talk about supplementing with Bifidobacteria and how the patients in the study rated an overall happier mood using six dimension of mood including: energetic, uh, composed versus anxious, elated versus depressed, clearheaded versus muddled, confident versus unsure, and agreeable versus angry. So, long story short, this actually improved the HPA axis functionality, as well as diazepam, or there’s another one here citalopram, that’s an anti-depressant, that’s an SSRI so long story short, this is pretty nuts. Probiotic therapy reduces the depressive symptoms and improve the HPA axis as well as an SSRI. So, there you freaking go. And here’s one more thing, Bifido infantis increases tryptophan, a serotonin precursor. So, we always talk about, okay get tryptophan in the diet but simply the good bacteria can actually make tryptophan, which then makes serotonin and GABA. This stuff is just amazing. 

Dr. Justin Marchegiani: I put the study up on screen. So, anyone watching this video here could take a look at it again. If you are listening to audio, we put the video link down below. If you guys want to look, this in the journal clinical practice 2017: Gut Microbiota’s Effect on Mental Health. And I’ll just gonna read that conclusion again. Dysbiosis and inflammation of the gut have been linked to causing several mental illnesses including anxiety and depression, which are prevalent in society today. Probiotics have the ability to restore normal microbial balance, therefore, have a potential role in the treatment and prevention of anxiety and depression. It gets really powerful there. And again, that’s only one of many things. Now, um, just to comment, I see a lot of people that get their mood worse when they have some of these things too. So, what’s the deal? Well, probiotics can be high in histamine and they be high in FODMAP. So, if you have a lot, if your immune system is so wound up, the histamine from these probiotics may cause problems, also the fermentable nature of these probiotics may cause problems, if you have SIBO. So, if you have massive bacterial overgrowth or your immune system is so wound up, when you can’t process histamine or you’re sensitive to histamine then you have to be careful with these things. So, even though we say, this is good, it doesn’t mean it’s good for everyone. So, we’re just trying to lay out, hey, it maybe good for you but if it’s not, here’s maybe the reason why and we just have to dig in deeper and so there’s really no just magic solution. There’s a lot of tools that we kind of line out and we go in sequential order and work them through with our patients to get the best results possible. 

Evan Brand: I’m so glad, you went that direction with the conversation because me listening to myself as a third person, I’m thinking, oh my God, I need to go out and buy probiotics right now and I’m gonna just feel happier and less anxious and all that. And that certainly was not the case for me when I had gut infections and I tried probiotics, it made me worse, it made my skin worse, it made mood worse, I got more anxious, and what the hell is going on. Well, as you mentioned, there’s a sequential order so I love that and this is why it’s important for you to do, and for I to do what I do because you and I are seeing these things clinically and the trenches is totally different versus somebody with a health podcast. They could look at this study and they could do a whole podcast about this, and then they could trick people not on purpose but just not having the clinical background, they could look at this and go, oh my God, probiotics are gonna be the miracle cure and then people are gonna listen to the podcast, they’re gonna do it and then they’re not gonna have a good reaction like me and they’re not gonna know what to do. So, I’m so glad that you’re integrating the clinical approach to this thing which is wait a second, yes, this is all true but there’s an asterisk next to this study and the asterisk as you mentioned is what if there’s bacterial overgrowth and the histamine bucket’s already so full or what if a mold or a mast cell has problem and the histamine bucket is already so full, so you can’t tolerate these probiotics. So, maybe walk us through what you’re doing, what do you suggest people do if they’ve had a reaction like that to probiotics, maybe they didn’t do it at the right order, or how should they approach this?  

Dr. Justin Marchegiani: Well, the first thing we have to really do is just calm down the immune system and the biggest factors that we have to do that is the food that’s coming into our body. So really, choosing a good anti-inflammatory, nutrient-dense whole foods and, and if we know that there’s a lot of digestive issues, bloating gas, we may have to restrict FODMAPs and fermentables out of the gate to kind of decrease the dysbiosis.  Because when we address like gut microbiome issues, we hit in three ways, right, we starve it, we kill it, we crowd it out. So, starve, kill, crowd, starve, kill, crowd. And so, the first aspect of that is shifting the foods to starve some of these microbiomes that maybe bad and then again it’s gonna be short-lived, we’re not gonna, we don’t wanna go low FODMAP forever, right, because there’s a lot of good foods that have FODMAPs in it and even histamine in it. So, there’s no reason, we’d want to do that but, in the beginning, if we can shift the immune system, calm it down, if we can shift some of the microbes down and then as we start adding different things in supporting our ability to break down food, start adding in adrenal support because when our nervous system is just stuck and our vagus nerve and our parasympathetics are low and our ‘fight or flight’ is high, our immune system is gonna be, it’s gonna be overly sensitive, okay. It’s gonna be overly sensitive and we’re also gonna have poor digestion and when we have more poor digestion, we’re gonna have gut permeabilty issues, we’re gonna break down our food and we’re gonna  have more of these foods in our gut get into the bloodstream and stimulate the immune system in a negative way. And so, if can calm down that immune response through decreasing our sympathetic nervous system whether it’s breathing techniques just good diet and lifestyle, good food, managing blood sugar throughout the day, not over under exercising, good hydration. All of those things are kind of, you know, the foundational marks, that we put as we work up a patient. So, we have that foundation there. 

Evan Brand: Here’s the question that came in from Keith, he said, “what are your thoughts in taking colostrum for gut health? We use colostrum but as you mentioned in that in immune situation, we might not want to use colostrum. I’ve had some people, where their immune system is so just haywire that colostrum does affect them. It’s not super common but there are some cases where we can’t use it and so in that case, we may be coming in with more herbal based leaky gut supports DGL, glutamine, zinc, carnosine, more amino acids  

Dr. Justin Marchegiani: amino acids, nutrients. Yeah, I mean colostrum, because it comes from a cow, right? It’s gonna be, more dairy based. Supposedly, colostrum is dairy free meaning, you’re not gonna get the casein and the lactose. So, it depends on how sensitive, you are. Some people, they may be sensitive were they still in a problem. Some may, it may be okey. I tend to just avoid colostrum, just because my patients are very hypoallergenic and so I tend to use more of the more hypoallergenic compounds like the zinc and the glutamine and the DGL and just things like that. Not saying, it’s not beneficial and I’ve had my patients take it and do well with it. So, I’m on the fence with it for sure, I have a little bit of colostrum in my true keto collagen and patients do really well with that. And so, it’s a tool that we put in our tool belt, but for our sensitive patients, I tend to not be the first thing that I jump on for sure. I think we’re on the same page with that.   

Evan Brand: Yeah. Uh, here’s a person here, “what about a probiotic that has both Lactobacillus and Bifido, will they cancel each other out?” No, we used those together all the time and some of the most high-quality professional formulas we make. We have combinations because you get different nutritional benefits in the gut from different species. There are some cases, where I have done straight Lacto or I’ve done straight Bifido, just to see how people do? But those are like the one percent sensitive people. The average person, we’re working on, they can tolerate a combination and then obviously, if we’re working on mold or Candida or some other problem, we’re often throwing in Saccharomyces boulardii in there too. So, then now you’re doing Bifido, Lacto and you’re doing Saccharomyces. That triple combo which technically Saccharomyces boulardii, even though it’s marketed and sold as a probiotic technically a yeast will often work that into the protocol and it does so much better.   

Dr. Justin Marchegiani: Yeah, 100%. Evan, what’s your experience using spore-based probiotics?  

Evan Brand: You know, they give me just terrible gas. My God. It just hurts my tummy; I’ve tried them and I went on them and I went off of them. I went low dose. I went high dose. I mean, we even manufactured some too and I’m like, God, I just don’t feel that good with them, I’ve had some people that are like, hey, this thing is a miracle cure, this is the best I’ve ever felt and good for them. But for me, it just did not go well, so I feel much much better with a low histamine, more I guess, you would just call it living probiotics as opposed to the spores. What about you? 

Dr. Justin Marchegiani: Yeah. I mean, It just depends, I think patients that don’t do well with your Lactobacillus, Bifidobacter, I definitely have a good bunch that do better with the spore based probiotics. So, depending on the level of SIBO that’s going on, some patients do really great with it. I have no problem myself with higher dose Bifidobacter, Lactobacillus infantis species, so I don’t have with it. But some patients, I know with significant SIBO history just do well on, if they just do much better and supposedly that the spore-based probiotics really help potentiate the growth of these other beneficial flora. So, it does help a lot of the other beneficial flora and they do hang out a lot longer too.  

Evan Brand: Yeah. And I’ve tried a couple of different professional brands. I mean there’s two big brands out there. I tried both. The one I did actually feel pretty good on, a couple others I didn’t feel so good on. So, I think it could be a brand difference too.  There was another question here, “when is the best time to take probiotics with fiber or empty GI?” I don’t know the whole wheat fiber deal. I’ve never heard of that before. I personally take them on an empty stomach and I’ll do them first thing in the morning like before breakfast. I’ll just pop all my supplements or I’ll take them before bed. Unless, I’m taking a binder then I won’t. My thought on it is to try the bacteria in there especially because some of the professional manufacturers, you and I use, we’re using an acid resistant capsule. So, it’s gonna actually bypass the stomach acid and deliver the beneficial microbes to the gut so in that case, that’s why I like it to be there. Just because, there’s not as much competition with the food could just be theory, I don’t have any proof that it works better but that’s how I approach it. 

Dr. Justin Marchegiani: Yeah, that makes sense. I mean you can definitely have some beneficial effects with some fiber, with some probiotics because the fiber does act as prebiotics and it can help kind of provide the fertilizer for the seed, the seed being the probiotics to grow. I do like it. A lot of your conventional probiotics tend to do better on an empty stomach but I mean taking them with food has some beneficial effects as well with digestion and such and so I say. Try to take most of those with food. I think that’s good. I just wanted to pull one study up here, I think this is interesting, um. Let me pull this up here. So, just kind of support we’re talking about right. This study is looking at neuroinflammation association alterations of the brain is a potential neural marker in anxiety disorders, so we’re just trying to build up the case that we’re talking about here. Preliminary evidence suggests anxiety disorders are also associated with increased inflammation. Systemic inflammation can access the brain and enhance pro-inflammatory cytokine levels that have been shown to precipitate direct and indirect neurotoxic effects. Prefrontal and limbic structures, these are parts of the brain that have to do with higher thinking, uh, emotions, memory are widely reported be influenced by neuroinflammatory conditions in concord with these findings various imaging studies on panic disorders, agoraphobia, generalized anxiety have been reported alterations in the structure and the function and the connectivity of our prefrontal and limbic structures so what they’re saying is inflammations affecting the parts of you brain that are involved. They’re higher thinking, higher function memory cognition anticipating, you know, cause and effect based on your actions, right. Prefrontal cortex is it’s the part of the brain that allows you to anticipate, to think, to plan, um, most of people from our you know from evolution we’ve been more, um, midbrain kind of reptilian brain type of you know, kind of knee jerk reaction kind of response and the frontal cortex gives us the ability to think and certain nutrients have allowed that part of the brain to grow. High quality cholesterol, Omega-3, free fatty acids, amino acids help that brain to grow. But if we’re driving inflammation in that’s gonna have a negative impact. Now what are the things that are gonna be driving inflammation in our diet? Well, Omega-6, refined processed vegetable oils, trans fats, refined sugar, too much carbohydrates, too much sugar, these are all gonna drive brain inflammation. And of course, inflammation in the gut can cause inflammation in the brain. Inflammation in the gut is bidirectional, it is a two-way highway. Inflammation in the body whether it’s like getting exposed to round up or mold toxins can cause gut inflammation. Inflammation in the gut through dysbiosis and food allergens can also cause leaky gut and cause inflammation from the gut to go outward up to the brain and it can activate the microglial cells in the brain which can create fogginess and more immune response that can make us feel worse and more, um, more anxious or depressed based on what’s happening in the gut. 

Evan Brand: I just sent you one, other paper too, which kind of interesting, talking about antibiotics and how antibiotics are gonna drive up depression and anxiety and talked about treatment with just a single course of antibiotics was associated with a high risk for depression and then also anxiety. So, I’m not saying don’t take them, I mean if you need them to save your life. But I will just say, that’s there’s so many people that have been put on these different medications that affect the gut and so when we’re trying to paint the picture here of what went wrong, why did someone become anxious, it could have been that they went in for a routine dental procedure and they were taking the antibiotics, they screwed up their gut, now they have dysbiosis as you mentioned, this big inflammatory link to the brain. Now, they’ve got this bacterial overgrowth, they simply were using something as preventative medicine, these antibiotics and then boom, now they’ve got this overgrowth. And then as you mentioned these bacteria are pooping poop and then that’s going to make you more anxious, so there was a question that came in about, well, “how much time do probiotics take to work for anxiety?” I mean, that’s a really tough question to answer because what else is going on, are there gut inflammation issues, are there bacterial overgrowth issues. What about Candida problems, I mean, there’s other things we have to factor in, so I wish it were just so easy to say hey take this probiotic in three weeks, you’re gonna be less anxious. I wish that were the case but, I think the answer is it depends.  

Dr. Justin Marchegiani: Totally. One study here, I’m putting the study up on screen, so you guys can see, Anxiety exposure and the risk for depression, anxiety or psychosis, journal of psychiatry 2015. So, you guys can see the abstract and the conclusion down below. Take a look at this study, all right. All right, where is it. Systematic Administration of Curcumin Affect Anxiety-Related Behavior in a rat model. So, it’s interesting. So, what we’re trying to look at here is results suggest that curcumin has anxiety-lytic like effect on biochemicals and behavior. Uh, it may be useful agent to alleviate or treat psychiatric disorders similar to those observed in patients with PTSD. So, what are they saying here? They’re saying in this rat study, giving curcumin actually resolved and significantly had a benefit on anxiety. Now, why is this? Well, because it has natural anti-inflammatory benefits and the postulate is that by reducing inflammation in the brain and in the body that also helps the mood and anxiety. Now, we don’t wanna just rely on the supplement. So, people that are watching this right now, don’t just say hey, I’m saying to fix your anxiety get curcumin. Fix all the foundational things that set the table, that drive inflammation and then once you have the foundation then you can go dig deeper and using specific supplements to reduce inflammation like curcumin, like Boswellia, or frankincense. You can also, there’s systemic enzymes that can be taken away from food. There’s a lot of good higher dose fish oil, ginkgo. These are excellent nutrients that can help drive down inflammation. A lot of the bioflavonoids and some of our lower sugar fruit like berries and quercetin, those kinds of things. And other studies on a handful of blueberries a day can reduce inflammation in the brain to. And we talked about that in the past, so inflammation plays a major role and get the foundation right. Because if you have a lot of dysbiosis but you’re trying to take curcumin to cover up the inflammation, fix the gut stuff first, fix the adrenals and the sympathetic overload first, fix the food and the blood sugar and then you can dive in deeper with extra functional medicine nutritional, uh, tools.  

Evan Brand: Yeah. Yeah. Good point. And I’ll just say it in another way, which is that you could take all the generic stuff meaning generic natural stuff as you mentioned Boswellia, curcumin, potentially high dose fish oil to reduce inflammation. Maybe you’re gonna lower the anxiety some but you’re still not getting to big root of it which for me was gut infections. I had parasites, I had H. pylori, I had major bacterial overgrowth, I had Candida problems, I had mold problems. All those things were affecting my gut which were affecting my brain so I was having just out of the  blue, anxiety, I mean some points, I was panicking, I thought I was dying in some situations. My blood pressure was going crazy for a while, I mean it was all related to these toxin issues and so I encourage people to get some of the labs run so you can figure out what the heck’s going on. The first place to start obviously is gonna be a stool test. So, we run a DNA stool test that you can do at home and you get that back to the lab and then you can get a really work up on what type of infections do you have. Is it just bacteria or do you have parasite? What about your gut inflammation? Have you measured that? Because if you’re anxious and we see high gut inflammation, we gonna go ding ding ding look at the connection there. And then, we mentioned on the Oak test, there’s not GABA but we can do trial runs. I manufacture a chewable version of GABA that we use, it’s pharmaGABA, which is fermented and bioavailable. So, we use that. And if people have a good response to that, then we assumed that they had a low GABA situation. If they take one or two of those and then they feel better then hey we’re pretty happy. 

Dr. Justin Marchegiani: Also, let me just. That’s very good and so, if you wanna support the show, some of the supplements that we’re gonna recommend we’ll put it down below in the notes section you know recommended supplements. So, Evan has a chewable GABA. I also have a liposomal curcumin. When you’re taking curcumin, you wanna make sure it’s liposomal. So, it has maximal absorption, only about 15% get absorbed,uh, it’s also better absorbed with black pepper as well, but people that have night shade sensitivity that may be problematic. So, if you want curcumin supreme is a liposomal version, we’ll put down below. Put Evan’s recommended products too. Now, interesting study here, when I look at inflammation in the same rat study. When they looked at the administration of curcumin, they actually saw a decrease in cortisol. So, this is serum cortisol here and as they increase the curcumin, you can see the drop in cortisol. And it makes sense because cortisol is an anti-inflammatory, so, the more your inflammation your body has, the more you’re gonna surge cortisol to help reduce the inflammation. The problem is cortisol is catabolic. It’ll break down tissue and so in the long run, you don’t want cortisol out of the balance because it will start breaking up tissue. So, in interesting enough to see that the reduction in cortisol followed by the increase in the amount of curcumin given to the rats. And the increase in, um, improved mode, the decrease in anxiety. So, that’s powerful. So, we wanna look at everything from a root cause. We wanna have all of our foundational tools and our palliative functional medicine, nutritional tools to plug in. And its good data to back it up, so we, you know, we can see, yeah, these things make sense because I always tell patients I’m talking to, what’s the mechanism, what’s the root cause, are we getting to the root cause and are there anything else we can do palliatively to support the healing of the root cause. 

Evan Brand: Yeah. Meaning, okay we could do some chewable GABA, we could do some curcumin, or whatever else to try to calm things down, while behind the scenes, we’re working on getting the mold out, fixing the bacterial balance, integrating probiotics, restoring gut flora, bringing in Saccharomyces boulardii to address Candida. All thes things are, I mean, that’s the art of it, right? That’s the fun and the beauty of what we do and it’s just a blast. Let’s hit this question here from Sarah before we wrap it up. She said, “Are there any thoughts on raw milk to help heal the gut if tolerated, ok? There are mixed thoughts with this.” I’ll rant on it really quick. My thought is because I had a lot of issues with dairy, I personally just do butter and I feel best with that. And I would argue that to help heal the gut, we can use all these clinically shown ingredients that don’t use dairy proteins like the zinc, carnosine, the glutamine, the chamomile, the DGL. So, my bias is to go for that. But, what do you think? 

Dr. Justin Marchegiani: I have the same as well, um. I don’t do great with raw milk. I get massive diarrhea, massive bloating issues even raw. Now, the benefit of raw milk is, you have all the cream right the homogenization tends to like kind of damage a lot of the globules and then of course pasteurization destroys all the enzymes that help you handle casein and lactose, which is the sugar in the milk better, the caseins, the protein. And so, there’s that right? And so, you tend to had. If you have problems with dairy, you have a better chance of being able to tolerate it with raw milk. Now, even with raw milk, I don’t do it as well, but I do, I don’t tolerate as well but I do tolerate butter and ghee wonderfully because it’s cut out the casein, it’s cut out also the lactose as well. So in general, if you’re more hypoallergenic probably stay away from it, wait till you’re healthy or try it, um, if you’re relatively healthy and you wanna give it a try, sure, but in general, if you’re having immune issues or chronic inflammation issues, probably stay away from it until you get things under the control and then you have a better baseline and then when you try to add it in, then you’ll really be able to know, if you can handle or not because you’ll, you’ll go from feeling good to not and It’ll be quite clear.  

Evan Brand: Yeah. Question from Ty, “what’s the first diagnostic tool we can use to determine the state of your microbiome?” uh, typically two things were gonna do, the stool test, the DNA stool test we use at home and something that Justin and I run clinically on pretty much everyone and then the organic acids test is helpful too because we’ll certain bacteria pop up that maybe the stool test missed or vice versa. So, stool and urine at home, those are thing that we can run and they’re incredible valuable tools, so valuable that I almost don’t even want to work with somebody without those data points because at that point you’re just guessing and we prefer to test not guess. 

Dr. Justin Marchegiani: Totally, now on those tests, we may look at commensal bacteria like Bacteroides and Firmicutes, uh, Bacteroides and Firmicutes, you want essentially, you know good levels of Bacteroides or Firmicutes. If people have high levels of Firmicutes in relation to Bacteroides that could be a problem but that usually is never the problem in and of itself. Usually, there’s dysbiotic bacteria, Citrobacter, Klebsiella, Pseudomonas, um, Morganella, right? These are all dysbiotic type of flora that are overgrown, that can throw off a lot of the commensal stuff. So, ideally if we see commensal bacteria off. We want to address the dysbiosis first and then we can use different fibers and prebiotics and probiotics down the road. Once we’ve kind of fixed a lot of the dysbiosis and that kind of help get it back in the balance. 

Evan Brand: Man, I tell you half an hour flies but we gotta run and this is something we could do a part two part three on but the big smoking gun for people with anxiety might in my opinion based on suffering for years and years and years of with different issues, it’s the gut, the smoking gun for anxiety, mood issues, depression, fatigue. A lot of this is coming from the gut. You and I have hit upon how B vitamins are made in the gut too, you did a really eloquent explanation on previous podcast about how you’re making the nutrients that fuel the mitochondria, we went pretty deep into that before so that’s an exciting mechanism that I think most people are not talking about they’re putting people on Adderall or other things to try to boost up their mental energy. You gotta look at the gut so I encourage people to get tested. And if you need help, you can reach out clinically. We have a question from, uh, where’d it go, Pelona, “how can I contact you or have an appointment?” So, uh, Dr. Justin Dr. J, he’s available worldwide, so am I. If you want to reach out to him, it’s at justinhealth.com. You can reach out worldwide, phone, facetime, skype, whatever and then for me Evan, evanbrand.com. We’re available for consults and we can send labs to your door, we run those, we get them back to the lab, jump on a follow-up call, review the results and then make you a protocol, get you feeling better as quick as we can.     

Dr. Justin Marchegiani: Excellent. I’ll put a list of recommended products and recommended, uh, resources for today’s podcast to kind of back up what we’re saying. Also, you can watch the video on screen where we pull up some of the studies and if you guys enjoyed it. Gives us a thumbs up. Put your comments down below. Let us know what you like and what you wanna see improvement on and recommended topics coming up all right. Evan, thanks for everything. evanbrand.com, justinhealth,com We are here to help you guys. Have an awesome day. 

Evan Brand: Take care though. 

Dr. Justin Marchegiani: Take care. Bye.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-gut-anxiety-connection-podcast-352

Recommended Products:

Genetic Stool Test

International DSL GI Map Genetic Stool Test

Curcumin Supreme

TruKeto Collagen

TRUCOLLAGEN (Grassfed)

Brain Replete

Genova Organix Dysbiosis Profile

Genova NutriVal FMV

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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

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

Recommended products:

Enzyme Synergy

TRUCOLLAGEN

Liver Supreme

Digest Synergy

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Genova NutErval

The Gut Lung Connection – Your Gut Health Can Affect Your Breathing | Podcast #348

In this podcast, Dr. J and Evan talk about the connection between the gut and respiratory system. You might not immediately associate gastrointestinal problems with lung disease, but the two frequently coexist. The tissue and glands in your lungs and intestines are the same and react to the same triggers.

At first look, the operations of your digestive and respiratory systems appear to be somewhat dissimilar. Though, the systems are connected in a variety of ways. The digestive tract can function because of the outcomes of respiratory action and vice versa. In addition, the systems collaborate to deliver energy to the body’s cells.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

3:08:   Key factors of lung inflammation

7:48:   Probiotics as regulator of immune response

11:56:  Foods major role in gut-breathing connection

20:17:  Available Testing and Herbs

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 gut, lung connection. This is really important. Lung health today, it is very important. We have to get good oxygenation. We have to make sure that inflammation from different microbes in the environment, whether it’s allergen or infections, we have to make sure that we’re able to still breath and transfer oxygen even with those stressors in the environment. We’re gonna talk about how the gut is connected to that, how inflammation in the gut can be bi-directional and can affect the lungs as well. So, let’s dive in. Evan, how are we doing today man?  

Evan Brand: Hey. Doing really well. Starting this thing off, I was looking at some papers this morning. I told you this was just too important for us not to cover so in the journal of immunology from this year 2021, I’m just gonna read you one, really, really big thing here which is the fact that intestinal dysbiosis is associated with increased mortality in respiratory infections due to an exacerbated inflammation and decreased regulatory or anti-inflammatory mechanisms in the lungs and the gut and they say here, pointing to this important relationship. So, this was actually the first time I’ve heard. You and I have been talking about stuff for years, I mean, we’ve done between us both close to, you know, thousand podcasts and we’ve been talking about gut-brain axis, we’ve talked about the gut-thyroid axis, we’ve talked about the gut-skin axis but I don’t think we’ve ever hit on the gut-lung axis and so this paper is just really reviewing the literature on this and it’s absolutely incredible because guess what, the beneficial bacteria helps respiratory infections and there’s 30 pages, if not more, I haven’t even had a chance to review all the papers on this but there are countless, countless papers now and pages of papers showing that the probiotics actually can reduce the inflammation in the lungs, however, if you’re in the hospital or if you were in the unfortunate situation of being in a critical care unit, an ICU, you’re gonna be getting antibiotics more than likely and you’re not gonna be getting probiotics. And, we could go into the mechanisms but I think the mechanisms will probably bore people but long story short, there’s an increase natural killer cells and obviously decreases in inflammatory cytokines and there’s many, many other mechanisms but long story short, probiotics are absolutely amazing and we know that the antibiotics that you’re gonna get in these situations are gonna do the exact opposite.  

Dr. Justin Marchegiani: Absolutely. Here’s a great study here. I know, we’re kind of referring to some of it. I’m going to share my screen here with the audience so everyone can see it, all right. Let me know if you guys can see this here. I’m gonna pull this up here so you guys can see it. All right. Can you see my screen there? All right. Awesome. All right. So, off the bat right, one of the key driving factors of lung inflammation is gonna be dysbiosis, right? Why is this? A lot of this has to do with the fact that bacteria, 80% of the immune system is in the intestinal tract, right? You have some in the GALT, which is gonna be the gastric associated lymphoid tissue, that’s in the stomach, right here. And then, you have the MALT, which is the mucosal associated lymphoid tissue. So, the mucosal, uh, that’d be the intestine. So, the small intestines in the middle here and then the peripheral on the outside is the large intestine. And so, a couple of the big things that you’re gonna see is when the immune system is overactive. One of the first things the immune system does is when it’s overactive, it actually creates inflammation, right? Part of inflammation is vasodilation so it can bring the immune system, the immune cells there to help fight it off. Think if you get bumped in the eye. What happens to the eye? It gets swollen, right? And so, you create this low-grade inflammation which is part of how the immune system works. The problem is, you know, most that inflammation that we’re seeing in people, it’s not an oops, I broke my elbow, it’s gone in a day or two, it’s a chronic low-grade inflammation and so you can see, um, when we add in things like probiotics over here, right, probiotics do a bunch of different things, they regulate the Th1, the Th2 immune cells, right? So, Th1, Th2, right, so that’s gonna be the natural killer cells on the Th1 side versus the antibodies on the other side and so, we have this balance between helper natural killer on the one and we have the antibodies on the two. So, we have this good balance and if they have it out of killer, like, let’s say we have higher Th2, you may see more allergies and things like that which can obviously stress out the lungs and obviously if we have some kind of infection in the lungs, we want good Th1 modulation because if the Th2 is really high, the Th1, those natural killer cells are gonna be lower. And so, you can see, obviously, it’s gonna express several viral defense genes. It inhibits various cytokines and chemokines so the chance of you having, um, what’s that, what’s the expression they call it here, it’s the inflammation after a virus kind of comes in and ravages the lungs 

Evan Brand: Like the cytokine storm

Dr. Justin Marchegiani: Yeah. Cytokine storm and so this really helps modulate the imbalance in cytokines after the fact, right? And obviously, it’s gonna modulate immunoglobulins, that’s your antibodies, your IgG, IgA, IgM, IgG and then to modulate your innate and adaptive immune system and obviously it’s gonna help with the allergenic anti-allergenic property, so that’s gonna be a Th2 stimulator. So, you can see, it’s gonna really help modulate this here. And again, this article doesn’t even really address it but if we don’t have good gut absorption of let’s say of vitamin A or vitamin C or vitamin D, right, if we don’t have good absorption in the gut then obviously all those nutrients play a major role in modulating the immune system too. Any comments on that, Evan?

Evan Brand: Yeah. Well said. So, I’ll take it a step further. We see all sorts of dysbiosis, bacterial overgrowth, Candida, parasites, worms, gut inflammation coming from the diet. You alluded to the malabsorption. So, let’s say, you’re giving someone X amount of zinc, let’s say you’re giving someone X amount of quercetin and vitamin D and vitamin C and you’re thinking that you’ve got a good protocol, well, we talk about this all the time. It’s not really about what you eat or what you take, it’s about what do you actually digest, what do you absorb and what do you assimilate from that so the problem is I have first-hand experience now with some really, really intense medical cases, we’ll just leave it at that for now. And, this particular person has been getting vitamin C in a crushed-up tablet form where in reality, we should be getting IV vitamin C. So, it’s not just about what you get, it’s how you get it, it’s how much you get it, it’s how much what you get from what you’re taking. And, there’s a lot of issues and if you say you’re getting 2 grams orally in a crushed-up low-quality form, we know that Vitamin C. In general, we see it low all the time on organic acids testing. Maybe, you’re getting a tenth of that so you’re really just gonna get the therapeutic amount so a lot of people I find are either being fairy dusted or fairy dusting themselves because they’re putting so much hope into the products they’re taking and they’re just not getting much from that due to these underlying issues with the gut. And, you and I have beat the drum on the gut for freaking 10 plus years and we’re still having to beat the drum on the gut but I hope that you feel as good as I do about all the work we’ve done because we know that everything, we’re doing with the gut is improving people’s responses so that if they do get exposed to something, they gonna have a much, much healthier, better response to it. 

Dr. Justin Marchegiani: 100%. I want to show one more article up here if you don’t mind. We’re trying to incorporate some of these new systems here so people can kind of see what’s happening with some of the articles that we’re looking at while we go live. I think it should be helpful. All right, there’s one thing I wanted to post here. So, we’re looking at different infectious stress on the lungs and what’s happening but look at what’s happening with probiotics, right? Probiotics are having an effect on modulating TNF alpha, Interleukin-6, it’s having also effects on modulating over here, your CD4 cells, these are your natural helper cells. Probiotics, actually, have a major role in modulating this whole immune response and so, you know, I think one of the best things you can do if you have poor gut health out of the gates here is potentially adding in some probiotics, uh, maybe adding in some fermented foods as long as you are getting bloated or gassy. Now, some people that have SIBO, these things may make it worse and so if you’re one of those people that probably won’t be the best thing but if you’re trying to be more in preventative mode, we probably want to get some of this dysbiosis under control and work on building up good bacteria after the fact, kind of my general analogy is you get your car washed before you get it waxed. You go and throw down seeds only after you’ve done the weeding in your lawn. Anything else you wanna add, Evan?

Evan Brand: Yeah. Except for like in acute situation, you might have to change the order of operations, you might have to go hardcore in it maybe some bloating, some burping, some gas, some kind of reaction, you know, you gotta make a pros and a cons list, right? There’s always a risk benefit analysis and those short-term effects from a probiotic if it were in the wrong order per se are not gonna be a huge deal, long-term.  

Dr. Justin Marchegiani: Yeah. Absolutely. Let me just kind of, all right, good, so I think that’s really good. So, first thing I wanted to add on top of that is we know gut permeability is a major stress on the immune system because you’re allowing undigested food particulate potentially or potentially like endotoxins which are like the outer shell of the bad bacteria, potentially even mycotoxins from fungus or mold, right? These things affect gut permeability. When the gut is more permeable, that allows more foreign antigens, think of antigens as like foreign proteins, right, so you could put bacteria, viruses, food, all in that kind of anagen category. It exposes more things to the immune system and the more you expose bigger chunks of things to the immune system, the more responsive the immune system will be. And so, ideally, we don’t want to poke the bear, right? Think of it like, gut permeability is poking that sleeping bear and we don’t want to over stimulate that and create immune responses unless we really need to.

Evan Brand: Yeah. You know, what’s crazy too, this, I mean, we’ve seen so many things with obesity and you know worse outcomes and diseases and you know. I went to the restaurant yesterday, I got some delicious chicken wings, some grilled chicken wings and I look around and everyone, this is on a Sunday, everyone’s drinking mimosas and bloody Mary’s and whatever else and the majority of the people are obese and they’re getting pretzels and nacho cheese and then they get donut holes delivered to their table and then they get a sandwich with like six pieces of bread and the cheese is going off the sandwich and then they go and get chocolate cake afterwards. It’s like, my goodness, just imagine how much better we could be if people just had chicken wings like me for lunch. I didn’t have donuts, I didn’t have queso, I didn’t have freaking pretzel, I didn’t have bloody Mary, like, come on. People, it’s like, they don’t care about their health until they are forced to care about their health but by the time you get to that point it’s already too late so I guess my little rant here is just, I really want people to start taking their health seriously now. Stop waiting until you’re at rock bottom before you decide you wanna change things. Use this information that Dr. J and I are providing and implement it now, like, people listen, listen, listen and then the implementation is just not there. I really hope people implement the stuff you and I talked about. 

Dr. Justin Marchegiani:100%. So, I mean, out of the gate, I mean, of course, you know, you have caught people on a bad day, maybe they’re 90%, you know good and 10% off and you caught them on their cheat day, right? But odds are that’s probably not the case but we have patients who are really good and may have a bad day every now and then. And so, hey fine, if you’re doing great and you’re on point and you’re in great health and you want to cheat every now and then, I always recommend trying to choose the least damaging cheat possible, right? That probably isn’t the best example of that but in general, food plays a major role, right? Because food’s gonna have nutrients to run your immune system, right? Our fat-soluble vitamins, our antioxidants, you know zinc, magnesium, selenium, all play major roles with the immune system. Our antibodies are made from proteins so if you’re not getting and digesting good protein, you’re not gonna be able to make good antibodies for your Th2 immune response and then obviously, if you’re eating inflammatory food, the more omega-6, the more you stimulate your prostaglandin E2, that’s more the side inflammatory side, the more you’re gonna have unprovoked immune responses and you’re just gonna be chronically inflamed and then you may have this cytokine storm we talked about because you don’t have good balance to your immune system and so, also, on top of that, right, we know how much carbohydrates, especially refined processed carbohydrate. It feeds a lot of bad bugs. So, if you have a lot of fungus overgrowth, yeast overgrowth, bacterial overgrowth, these bugs prefer refined processed foods, right? It’s gonna just be easier to digest, easier to feed them and so you’re gonna create overgrowths like that. And these bad bugs, obviously, produce other types of toxins in your body, right? Bad bugs eat your nutrients and poop. And then, instead, versus eating your poop and producing nutrients, right? Bad bugs take the nutrients you’re eating and they’ll produce more toxins and endotoxins and different metabolites, lithocholic acid, etc., versus producing B vitamins, producing vitamin K, producing different beneficial acids that prevent the colon from overgrowing, right? Probiotics, acidophilus, literally, translates to acid loving and so good probiotics actually produce and lower the pH in the intestinal tract which actually makes it harder for bad bugs to grow, right? Bugs tend to prefer an alkaline type of environment to actually grow in the lower intestines.     

Evan Brand: That’s a great point. I don’t think many people know that about acidophilus. I’m glad you broke that simply for people that you actually want lower pH environment because that’s not really a place for these pathogens to thrive versus when you’re on proton pump inhibitors, for example, acid blocking medications or if you’ve got an H. pylori infection, you’re gonna have that higher pH, you’re gonna have that more alkaline gut and then that’s where things really get into trouble, I mean you and I, I think we’ve done a whole podcast on this but the brief spark notes are lower stomach acid, age, stress, not chewing your food, that’s gonna increase malabsorption and feed the bugs too. So, this once again goes back to the same thing and we’ve said 100 times you get your gut tested. Figure out if you’ve got this overgrowth going on. Don’t wait until you’re in a critical situation. We got to get your gut fix now. Think of working on your gut as preventative medicine. How revolutionary is that?  

Dr. Justin Marchegiani: Absolutely. And then also, when you consume too much carbohydrate, we talked about how you’re gonna feed the bad bug. We talked about what the bad bugs do in regards to impeding nutrients, adding more toxins, pooping poop, right? There was one more thing I wanted to kind of highlight on that realm, we talked about the gut permeability and the overstimulating immune system. Also, high levels of carbohydrates, glucose looks very similar molecularly to vitamin C and so you have these macrophages, little Pac men and Pac women that go along in the lymphatic system and in your bloodstream. They gobble up bacteria, gobble up viruses, gobble up crud. 

Dr. Justin Marchegiani: Also, high levels of carbohydrates, glucose look very similar molecularly to vitamin C, and so you have these macrophages. These little pacmen and pacwomen that go along in the lymphatic system and in your bloodstream. They gobble up bacteria, gobble up viruses, gobble up crud. Vitamin C kind of docks on that macrophage and and kind of supercharges the macrophage so it can gobble things up more. Guess what glucose can actually come in there, and docks on that macrophage, and it can decrease the macrophages’ ability to gobble things up. Now in literature, the literature logs to make things confusing, so there’s kind of like two sets of language. There’s like the lay language right where we’re kind of communicating it in a way that everyone gets it. In the literature, they’ll call it the phagocyte index, right P-H-A-G-O-C-Y-T-E-S, so phagocyte with a P-H, right? So go on PubMed, type in phagocyte index and you’ll see, that’s the macrophage. The ability to gobble critters and bacteria up, and so if we decrease the phagocyte index, it’s going to be just they’re not going to be able to gobble things up as much, and so this is really important and so high levels of glucose, high levels of insulin, which, again, glucose and fructose stimulate insulin production, right? And so, you’re going to have. Less gobbling of your pacman and pacwomen in your bloodstream to be able to control these critters.

Evan Brand: That’s crazy. Ok, so you’re saying if I’m in the hospital and the nurse or whoever brings me my lunch, which I saw when my grandmother was in the hospital couple years ago for heart issues. You know what they brought her for lunch? It was this little like packet of peanut butter which was corn syrup and like peanuts. And then I think it was probably a piece or two of bread and then it was a little Jelly packet. And guess what that was? Corn syrup and like fake artificial flavor and purple dye and whatever else. So, you’re saying that’s not the optimal diet for good macrophage. I guess you would call it bug eating per southeast.

Dr. Justin Marchegiani: No. One, it’s going to feed a lot of despotic bacteria. Two, it’s going to decrease the phagocyte index, so your body’s ability to gobble up the bacteria and such. And then I would say on top of that, the more insulin resistance you have, ’cause, how, how It works is right? You take in glucose, you take in fructose, right? When there’s fiber attached to it, it actually decreases; glucose and fructose is damage. I.e. like if I consume some fructose from blueberries 1, there’s a bunch of antioxidants with the blueberries. Bunch of different course. It ends and bioflavonoids and vitamin C on that. There’s also fiber so fiber kind of blunts the effects that you may get from fructose when you consume things like blueberries or strawberries. But when you consume fructose without the fiber, i.e., high fructose corn syrup, right or table sugar, which is sucrose to gross is fructose and glucose. High fructose corn. Syrup is just like 55-45 fructose to glucose. Where table sugars, half and half right? When you consume it without the fiber and out the nutrients. What happens is the body says ok, we gotta go store it in the liver. So, in the 1st place it goes to to dump that fructose is stored In the liver. Once the the fructose sources are done. There can’t store it anymore. It starts to convert it. With that, and then once the liver starts getting fatty, all this fructose just hangs around in the bloodstream and it’s creating all this oxidative stress. It’s like putting a barbecue sauce right on your chicken before you barbecue it. It creates this browning effect. And so when you have all this high level to fructose in your bloodstream because your liver saturated, your liver is now fatty. It can’t store anywhere else. You have high levels of insulin now you start browning all the arteries. And then what does that do? It creates inflammation and makes your platelets and your blood cells just more sticky. So you have increased chances of clotting. What’s going to happen when you have clotting in the lungs? It’s going to create a whole bunch of lung stress, right? Obviously hard issues if it’s in the heart. Brain issue is in the brain. And so if we can get the fructose and the high levels of insulin down, one, that’s going to help blood flow. It’s gonna decrease your oxidative stress reserves and so when you have high levels of oxidative stress, what does that? Due to your needs of vitamin E and vitamin A and vitamin C? It increases it, because your body is having to put out these fires and think of these antioxidants is like the fire extinguisher. So, it’s wanting to use all these antioxidants. And of course the fuel that feeds a lot of this stuff is going to be high sugar and crap that also feeds the bacteria, which then makes the immune response worse so you can see all these things, they kind of compound on each other one after another.

Evan Brand: Yeah, yeah, that was a great way to put it out so I was kind of picture in my head. This snowball effect that gifts. You and it gets nasty quickly.

Dr. Justin Marchegiani: It does. It really gets nasty.

Evan Brand: And then if you’re really, really bad and then you’re on the feeding tube, I mean we’ve seen, and I know you’ve talked about this before with your some of your work in the medical industry years ago. I mean, you’ve talked about some of this stuff they feed people. It’s it’s bad. These feeding type solutions. I mean, I’m pretty sure it’s just straight garbage. I don’t have an ingredient list in front of me, but I know it is not good.

Dr. Justin Marchegiani: Yeah, 100% and uhm… You know sugar is used, it hits that opiate receptor, right? It’s, it’s people use it to kind of modulate pain, modulate all the bad stuff that’s happening so it’s you know it’s very addicting. You know, once you’re stuck on it. We had a question come in, “How do you test for some of these things with the bacterial overgrowth?” So you can do a SIBO breath test Lactulose breath test. We can do one of the different organic acid tests that we’ll look at some of the bad bacteria metabolites like benzoate, hiparate 2, fat 2 3 phenylacetate, Indicam; These are different organic acid or bile acid markers that we can look at. Will also run good, comprehensive DNA stool tests that will look at some of these bacteria, and if they’re overgrown right, some of the common bacteria will see, or Klebsiella, citrobacter, prevotella, morganella, Pseudomonas, right? There are some of the common ones that we’ll see, and there will be elevated way outside the reference range when this happening.

Evan Brand: Yeah, you’ve got strep. You’ve got staff. We’ll look at Candida on the stool, even though it’s not as accurate as the urine will look at. The parasites too. What about like blasto and crypto and Giardia? What about H. Pylori infections? All these things add up against you, so our goal is really trying to get everything on paper and figure out what all you’re up against and the. Cool thing is. A lot of times, you and I are knocking out infections that maybe we didn’t even know were there because we can’t test for everything like we have really, really good testing. But I’m sure there are still different pathogens that we don’t even know, but the cool thing is with these herbs and with these synergistic formulas that we’re using clinically with people is that you may have some antiviral, antifungal, antimicrobial antiparasitic properties all to these same compounds. So you may knockout 4 different infections with the same nutrient as opposed to, let’s say a specific drug designed to target a specific pathogen, like an anti-giardia antiparasitic medication. Whereas herbs we may come in and knockout, giardia plus crypto, you know. Plus the H. Pylori all in one fell swoop, so that’s the benefit and not to mention. Let’s say it’s berberine, that we’re using for antimicrobial support. We may help support glucose there. We may, with some of these.

Dr. Justin Marchegiani: Yeah, yeah, there’s some of that.

Evan Brand: We may. We may lower inflammation at the same time as we’re eradicating the infection, so that’s just really beauty. Once you get the data, the beauty is that you can work on multiple mechanisms at the same time getting someone to the finish line fast.

Dr. Justin Marchegiani: Yeah, and also when you take some of these herbs, these herbs are going to have antioxidants in it so the oxidative stress that you kind of create with the killing of these microbes. These herbs are going to have some antioxidants present in them just due to their their phyto signature. Obviously when you take in an antibiotic, right, you’re not going to have a lot of nutrients or antioxidants present with that. They actually they can create more oxidative stress. Just going to PubMed type in antibiotics and oxidative stress or antibiotics and mitochondrial stress. There is a study supporting this, so the part of the benefits with the herbs is that you’re going to get some antioxidant nutritive properties ’cause based on their phyto signature and again, this is all going to be dependent upon. These herbs being higher quality right, not cheap ones, and if they’re grown in soils that have high levels of lead or mercury then that could obviously be a negative impact. So we want to make sure we’re sourcing out high quality herbs. That’s why we want to have a professional grade where we have third party testing on them to make sure they’re adequate. The next thing on top of that is there’s synergy between some of these herbs. So, for instance, you talked about berberine’s right very helpful. Barbarians also help modulate lipids, right, triglycerides, cholesterol, right. They also help with blood sugar and guess what? Berberine’s combined with warm wood our shown actually have antiviral qualities which is very helpful. So if you have any kind of lingering viral stress that can also be very helpful. I see people when we do gut killing, they, they may start to flare their herpes because their immune systems going after it. Sometimes that can happen too. Or there may be very helpful with their EBV or something else going on in their bodies. So we gotta keep an eye on all those things.

Evan Brand: That’s cool. Yeah, that’s really fascinating. Oregano 2, right? We love oregano will use that as a broad spectrum too. That has a lot of cool different antiviral into microbe properties olive leaf is another great one. That we use and…

Dr. Justin Marchegiani: Yep, olive liters of antiviral properties to anti inflammatory for sure.

Evan Brand: Sure, and it’s gentle. You know some of these things are just so gentle that even in young children that were seeing with these issues, I mean, I know with you and. I you know. I’ve actually had couple clients, they they’ve really tooted you and eyes horn. They say you know that you and doctor J or kind of the only guys out there with young kids that actually are doing functional medicine because so many people are doing like, functional medicine theory you know? Or maybe they’re clinician and they’re older. Maybe they don’t have kids, so I wanted to pass that feedback on to you that are our clients. They they really love that about us that we’ve got young kids, ’cause we’re implementing this stuff with our kids too. I know you and I have both done antimicrobial nutrients and other supportive stuff for our children, and it’s been really great because there’s so much fear and I, I guess you would just call it misinformation when it comes to to kids. Kids are so resilient, but they do sometimes need help and you know, you’ll often get the recommendation or the the comment that, Oh well, the pediatrician doesn’t know anything about that. For the kids, I will tell you, personally herbs are great for kids and we use protocols and kids all the time. There’s so much to be done with kids.

Dr. Justin Marchegiani: 100%. So, just kind of out of here just if we kind of re summarize what we’re trying to, you know, make sure you. Guys extract from here. Is number 1, beneficial bacteria is going to help modulate the immune system, decreased permeability, immune permeability, which or gut barrier permeability, which takes stress off the immune system. it’s going to modulate the cytokines the interleukins. So, when your immune system comes in there you’re not going to create more damage from the immune system, so it’s kind of like the firefight is coming in and you have a small fire and instead of putting it out with one of those portable little fire extinguishers they bring the whole big ladder and truck in there and spray so much water they knock down all your walls. It’s kind of like, well, that’s kind of an inappropriate response to that kind of fire. Same thing with your immune system. We don’t want your immune system to be creating stress and inflammation because the response is inappropriate, right? We could see this with other stress infection. We see it with allergies, right? And so we want to make sure we have good immune stress. We want to make sure that your gut is healthy where it’s extracting all of the nutrients we’re putting foods in there that aren’t feeding the bad bugs, but also providing lots of good beneficial healthy fiber and healthy full spectrum antioxidants and nutrients that help the gut in the immune system as well. Any comments on that Evan?

Evan Brand: Well, you know that just kind of spurred the five and we could do a whole Part 2 on this, but I mean there is a role of some leaky gut support outside of probiotics. During this, you and I have our own custom professional formulas that we use with various nutrients like Aloan, Muk and cama meal and other things that you can use to actually support the gut lining. So this would be another great thing to. Implement if you’re in these situations, maybe you’re unable to get testing because you know it takes. You know, couple weeks, turn around time or a little more, depending on what you’re doing. So if you’re kind of in a more acute situation, I think not knowing what you’re up against, you still could bring in some of these leaky gut supports now. And then if you’re in a situation like I’m telling you to wait before you hit rock bottom, wait before you know, don’t wait before you hit rock bottom. Don’t wait before you have to go. To the hospital work on your gut now. If we have all the data we can work you through these steps here and then we may have already gotten you to the gut healing point to where you’re not coming into this infection with a leaky gut. I would much rather someone come in with a healthy gut. We know we’re gonna, they’re gonna do far better and with this discussion you and I talked about today of the gut-lung axis, now is the time to focus on your gut, so you don’t have to focus on your lungs.

Dr. Justin Marchegiani: 100% and it gets great. Makes a lot of sense. So you guys listening to you enjoy today’s content here, we’ll put a list of some of the products that we use. Some of the probiotics that we that we specifically like in use with our patients. I’ll put some of the the immuno-nutrients that we’d like to kind of modulate the breathing pathways- quercetin stinging nettle-all excellent. I love ginger tea as well, we’ll put that in the links down below those are all excellent things. And of course some of the herbs that we like as well will put some of the clearing herbs that we like for the dysbiosis and such in the comments or in the comments, ah description below. And if you want to support us, you can purchase some of those things there. If you also want to reach out, we’re available for functional medicine consultation support all around the world. Will put that link down below as well; evanbrand.com to reach out with Evan. Doctor J, justinhealth.com to reach out with myself. Thanks so much. Evan, any last things you want to highlight?

Evan Brand: No. That’s it. If people need help, feel free to reach out. We’re here for you. We’d love to help you do, do an overhaul. You know what I mean?  If we got to look at your system, let’s look at your system. Please reach out if you need help. Doctor J at justinhealth.com me, Evan, evanbrand.com. Would love to help you and we’re here for you.

Dr. Justin Marchegiani: Awesome! Alright. Have a good one everyone! Take care. Bye now.

Evan Brand: Take care. Bye, bye.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-gut-lung-connection-your-gut-health-can-affect-your-breathing-podcast-348

Recommended products:

Genova SIBO Breath Test

Genova NutrEval® FMV

Probio Flora

Immuno Supreme

Antioxidant Supreme 60 caps

Vitamin C Synergy

Dopa Replete Plus 60 caps

Aller Clear 120 caps

GI Clear 1

GI Clear 2

GI Clear 4

GI Clear 5

GI Clear 6

The Top 5 Nutrients to Address Gut Inflammation and Leaky Gut | Podcast #339

Whenever you are worried about your gut health and having inflammation, Dr. J and Evan are here to share five essentials that may help you.

Lessen your intake of highly processed foods, refined carbs, sugar, artificial sweeteners, and alcohol. Opt instead for anti-inflammatory foods like fruits, vegetables, spices, and healthy fats but, if you suspect that several foods are triggering inflammation in your gut, it might be worth giving an elimination diet a try.

It may require removing foods from your diet that you suspect are connected to your gut problems for roughly two to three weeks at a time. Inflammation in your gut may cause a host of harmful health symptoms, from fatigue to irregular periods and chronic constipation. However, a few changes to your diet and lifestyle might be vital to helping you control these symptoms and improve your gut health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:48   Looking into the Gut Deeper

3:53   Good Foundations

6:26   Chewing is Important

8:22   Mushrooms as Anti-Inflammatory Properties

16:00  Probiotics

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Hey, you’re doing really well. And you know, we always come up with a title. And then we over deliver on that title. So we’re calling this something along the lines of top five nutrients to help your gut or to heal your gut or support intestinal permeability, but maybe we end up going over five. So I’m just gonna go straight to my favorite because it’s so easy. It’s so broad spectrum in its use. And it’s so safe for people across the board to use it, whether it’s kids, adults, the elderly population, even people that don’t have testing, you know, our philosophy is test don’t guess we want to have the data, we want to have good stool testing, and good organic acids testing to look into the gut deeper and figure out what’s going on under the hood. But there is usually a three, sometimes four week timeline between talking with a client or a new patient and then getting the test results. So what do we do to help these people in that in between time before we can do the real work based on the data, I’d say my favorite is probably aloe, and specifically you and I use an aloe extract. It’s a 200 to one, so it’s 200 pounds of gel converted to one pound of extract, and then that’s encapsulated. We had a young boy, not super young, maybe 16 17. But he was diagnosed with autoimmune gut issues, Crohn’s all sort of colitis, actually pan colitis where the whole digestive tract was affected major bleeding in the store. We got him on simply a 200 to one extract of aloe. And within three weeks, we did a new gi map stool test, and we dropped his calprotectin levels, which is his gut inflammation by 1000 points, just by aloe alone.

Dr. Justin Marchegiani: Unbelievable. Yeah, it’s powerful what nutrients can do now I always tell patients, if you’re trying to come in and make some changes out of the gates, I mean, your best bang for your buck would be fixing the food, because the food is constantly getting your body getting your gut in flames. So the first thing we can do is look at the the the inflammatory food that could be coming in this could be gluten or other technically gluten free grains like corn, oat, rice, those kinds of things. So you want to really get the grains out, you want to really get a lot of the poly polyunsaturated omega six vegetable oils. And again, the reason why vegetable oils tend to be more, let’s say poor is because they’re highly processed to extract the fat. And the processing actually damages the fat and creates free radical stress within those fats. Because the more you take in damaged fats, your body has to utilize antioxidants to stabilize the fats. So they don’t create free radicals. And so it depletes a lot of your antioxidants. And then those fast take on and become part of your cell membrane. And to have healthy cells you have to have good membrane. Because the membrane essentially is the brain of your cell. It provides a lot of good cellular communication happens with the membrane. So if you have junky fats, whether it’s omega six junky fats, or trans fats like hydrogenated soybean oil, right, those kinds of things, canola, you know, safflower, those are going to be more junky omega six, and they’re going to really not make the healthiest cell membranes, they’re going to deplete your antioxidant reserves. And if they’re on the trans fat side, they’ll make your cell membranes very inflexible too.

Evan Brand: Yeah, good point. And I apologize for skipping over the diet piece, you know, you think of the typical American person, they think, just give me the pill. Give me the magic remedy. So we’ll talk about some of those remedies. But yeah, you make a great point, you can’t go out to Pizza Hut for dinner, and then just take an aloe capsule, and everything’s going to be okay. Correct.

Dr. Justin Marchegiani: Yeah. So that’s it’s good to look at the foundation out of the gates. I’d also say like, I’ll just kind of put this next category into a broad category and just say, amino acids. And these amino acids could be things like an acetylglucosamine, NaG that could be things like glycine, which are going to be very high in collagen or bone broth. And they could also be things like glutamine, so I kind of put these in the amino acid bucket, when they tend to be very good support for the entire sites of the gut lining, that can be used as fuel for the gut lining, they also can help with gut permeability. And, and glycine is a really good backbone for connective tissue. So it can be very helpful for that lot of that connective tissue healing out of the gates.

Evan Brand: So how about enzymes? When you hear nutrients to heal the gut or support the gut, you don’t necessarily think about enzymes, you think of more like you mentioned, the glutamine, Aloe, the kind of calming, soothing things, but I would argue enzymes have a role in helping with reducing gut inflammation simply by improving digestion and reducing the putrifying and fermenting of foods because I know my gut was Super inflamed. If I look back at some of my original stool tests, when I had gut infections, yes, I was doing things to soothe my gut, but simply just treated, the infections alone got the inflammation down. And part of that process of treating the infections was using enzymes, because my digestion was so terrible, I would get exhausted after a meal. And that was a sign that I had low stomach acid. So I would say the enzyme should be on our list here, because so many people do to age due to stress. Maybe you’re eating in a loud restaurant, like you’re on your lunch break for work, and you’re listening to us or there’s music, boom, boom, boom in the background, and you’re sympathetically stressed while you’re eating enzymes, to me would be a good insurance policy to help break down your foods and then therefore reduce inflammation.

Dr. Justin Marchegiani: Yeah, foods are not broken down properly, they’re going to sit, they’re going to ferment, they’re going to purify, they’re going to read certify also, those foods are more likely to create hydrogen and methane gases because they’re fermenting, and those gases can throw off your motility, motility and how you move the bowels. And if the bowels are one too short, or should take too fast on the diarrhea side, you may not absorb those nutrients well. And if they’re too long, on the conservation side, you may reabsorb fecal toxins. And so you know, long or short on the bowel motility can definitely affect absorption or create more toxins in the body. So I think that’s a big one. And then just kind of connecting the enzymes and we could throw HCl in there too, because HCl helps activate enzymes, I would say chewing, chewing and and really just the mastication and healthy eating habits because chewing your food up really fine, allows more surface area for those enzymes and acids to work. So you can have a good amount of enzymes or acids, you only have a couple of chews. you swallow your food, those enzymes and acids aren’t gonna work as good as you really chew it up, you know, 30 to choose one chew per tooth, you know, ideally like an oatmeal like consistencies and allow those enzymes and acids to work better.

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Evan Brand: It’s hard. I’ve tried to do that I’ve tried to do that many choose, oh man, my jaw gets tired. So and that’s the that’s the problem too, that we have with our food is like you go to Chipotle, a for example. Everything’s really soft. Like if you get rice if you get like carnitas. Or if you get the chicken, you barely have to chew it. It’s almost like mush. So I try to personally seek out occasionally I will seek out whether it’s like beef jerky, or no bison jerky or even just a steak, you know, I try to really get something that works my job because I just feel like in America, our food is so soft and easily digestible, that we don’t have to really chew anymore.

Dr. Justin Marchegiani: Yeah, so if you have a nice steak or a nice whole chicken, just make sure you chew it up. Same thing goes with over hydrating, you know, try to get your first thing I do is and I get to go eat a meal, I kind of go to the reverse osmosis filter, get a nice big glass of water to add some minerals, one, two, and then I get my meal going that way it gives me 10 15 minutes or so for everything to absorb. And of course the colder the water you got to take a little bit longer because your body holds that water in your stomach, heats it up to about room temperature and then passes it through. So the colder that water is, the longer you should wait in between the meal

About mushrooms. This is something that you know, just doing a little bit of research before we hit record, that this is something that I don’t necessarily go to right out of the gate but I’ve been using mushrooms for a long time. I know you and I personally have been taking mushrooms for a long time. And it turns out that for example, Lion’s Mane mushroom has some really, I would say probably just as impressive as some of the other herbs you’re mentioning, whether it’s like dgl, licorice or marshmallow kind of the conventional gut healing ones. Lion’s Mane has some really awesome anti inflammatory properties. There were two papers that we had found here on Lion’s Mane mushroom being shown to protect from and shrink gastric ulcers. Also, Lion’s Mane was shown to significantly improve symptoms of two major inflammatory disorders of the digestive system. And so that’s cool, because normally we’re using Lion’s Mane for cognitive problems. I know for me, my brain is much more clear. I’ve got Lion’s Mane mushroom in my system right now. I took two capsules this morning, and I certainly feel it mentally. But I did not even think that I was feeling it in my gut. So that’s cool.

Totally. Yeah, that gets really important. Again, a lot of gut issues, the immune system can be a big player at it. And so of course, if you’re able to modulate the immune system with the medicinal mushrooms, or immunogenic compounds that are going to be in those mushrooms, whether it’s beta one, three, D glucan, whatever that is, it could have an effect on gut permeability and improving digestion. I think all that’s very, very important. Also, just kind of one pet peeve of mine. Someone in the comments was chatting about this. A lot of people when they talk about leaky gut, they talk about leaky gut like like it’s the cause of Problem. leaky gut is the effects of on what’s happening with the gut. So the more inflamed you are, the more you’re not breaking down your food. The more crappy The food is, the more inflammatory The food is, the more dysbiosis we have, the the lack of certain nutrients we have, the more stress we are right. All that then creates and increases the chance of gut permeability. Gut permeability isn’t the cause unto itself. It’s the effects of a lot of other issues happening. So when people talk about Oh, you gotta fix the leaky gut. It’s like, not necessarily, you know, it’s like, it’s like saying, Oh, we have to fix. Imagine you have a leak in your roof and the waters pulling on the carpet below you. So we got to fix that water on the floor. It’s like, No, no, you fix the hole in the roof. And again, it may be semantics, but we got to call a spade a spade. If the water’s coming into the roof, you talk to them, we got to fix the hole in the roof. You don’t say we fixed the the water on the ground, right? So I just want everyone I want to train everyone to kind of get thinking about things from a root cause standpoint, versus labeling the damage at the end result conventional medicines really good at labeling damage down here and not talking about the effects of top that should the cause up top there labeling the effects down here. So we want to go root cause?

Yeah, that’s great. And I’m sure we could come up with other analogies on it. But that makes a lot of sense. It’s kind of like, okay, we need to come in with the towel. Oh, no. Now we have this super absorbent towel, this towel is going to absorb 1000 times more water on your floor than any other towel. And then yes, this, this carpet is mold resistant. So if you use this carpet, that water in your carpet won’t create mold, but you’re still missing the frickin hole in the roof roof.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

Well, let’s call it out. Let’s call out why that happens, though. It’s simply money. And it’s the supplement industry. There’s a lot of money. Yeah, it’s marketing. There’s a lot of money made on leaky gut this and this leaky gut book and this leaky gut protocol and this leaky gut practitioner. The problem is you could take all these leaky gut support for a decade and never treat the infections like if you just went and did like you mentioned glutamine, and we hit the zinc carnosine and the dgl. And we did the aloe, like we talked about in the beginning, none of those are going to erase a blastocyst is hominis, parasite infection, none of those are going to get rid of Giardia. None of those are going to treat the H pylori, they may help. But they’re definitely not going to eradicate the issue causing the leaky gut in the first place. So that’s just marketing. It’s money involved in this. And, you know, as practitioners, I think it’s really smart of you to call it out like that, because it’s, it is frustrating for us because we’ll look on a new client or new patients intake form. And they’ll be taking all these quote leaky gut supplements. Yeah, I found this leaky gut protocol online, and I still have all these digestive problems. And it’s like, well, yeah, look at your stool test, you have all these issues. And you could do that for 20 years and never fix it. So I could rant on that all day.

Yeah, other thing I would just say out of the gates is it’s okay to palliative Li support the leaky gut, we just have to make sure when you’re palliative Li supporting something we’re also root cause supporting it as well root cause fixing it. Palliative support, totally fine, right. Nothing wrong with that we just got to call a spade a spade and and not pretend the palliative leaky gut support is root cause support. Yeah, long as we can do that, then I think we’re pretty good. Next thing I would highlight out of the gates and you see this herb being listed as being very helpful for the gut permeability, but it’s also very helpful on the adrenal. So that’s licorice. And so when we use licorice is a lot of licorice being used in leaky gut supports. That’s that’s d glycerides. And this is the glycerides component of the licorice is pulled out. And the glycerides component of a licorice is is the component that slows the breakdown of cortisol, I think it’s the 11 beta hydroxy steroid dehydrogenase to enzyme. The licorice inhibits that enzyme. That’s the enzyme that helps break down cortisol. So we know cortisol too low, we need healthy levels of cortisol to actually build up the gut lining. It helps with building up the gut lining. Of course, if our cortisol levels are too high, and we’re chronically stressed, right, that can also break down the gut lining. We know that with people that are chronically stressed getting ulcers, right, we know that as well. And so when we look at licorice, it really helps with cortisol improvement. So if we do a cortisol test, and we see chronically low cortisol, that can actually help with the gut lining with the mucosa with the stomach with the duodenum. And that can actually help with the cortisol bringing that back up. And that can help build back up that gut lining. And so we like licorice, that’s non diglycerides for the gut and Nanda glycerides licorice, we give it typically orally sublingually, to our patients, that will eventually trickle downstream to the gut as well. And so licorice can be a powerful thing. You just have to be careful if you’re giving a non diglycerides version that people that have already higher level of cortisol, that may make things worse. So we just got to make sure we’re testing that to know what kind of pattern we’re seeing.

Yeah, that’s a good point. So we could do a whole part two on that. If you want. Give us some feedback. Like maybe the gut hormone connection. And we could hit that in detail. But yeah, you highlighted a very important point, which is that cortisol is involved with this whole process. And it really is a Goldilocks zone. If you have too little cortisol, you’re exhausted. And you’re probably going to be dependent on stimulants and caffeine and sugar and things that are going to damage your gut. But then simply, you don’t have enough to build up the gut. And then if you have too much, now you’re catabolic, you’re breaking down your muscle tissue, and you’re breaking down your gut barrier. That’s probably part of the reason that I lost a lot of weight and a lot of muscle. When I first moved to Texas, I had gut infections, and I was incredibly stressed, just moving and leaving my family behind, you know, emotional stuff, homesickness gut infections, I had the perfect storm to tear up my gut. So I can tell you firsthand that adrenal supports did help. And that was probably because it was helping regulate the cortisol levels, which then in turn, took the load off my gut, so to speak.

100% Yeah, I like that. And so it’s good to really make sure that’s under control. 

Evan Brand: How about probiotics? I think it’s worth mentioning. These are totally valuable tools that can help regulate histamine. Yeah, and regulate bacteria with it. So let’s dive into that.

Dr. Justin Marchegiani: Yeah, so you have to you I said you have three to four big families. Okay. So you typically have your lactobacillus and bifidobacterium, which are typically come together and usually a good high quality broad spectrum probiotic. So my line we have one called profile, Florida doesn’t have a lot of the different lactobacillus whether it’s kci acidophilus Bulgaria’s brevis, rhamnosus. And then of course, you have a lot of the bifidobacterium whether it’s bifidobacterium, bifidum, longum, brevis, right. So those are your broad spectrum lactobacillus or bifidobacterium. Probiotics, lots of good data, lots of good research anywhere from food poisoning for inflammation reduction, gut permeability reduction. nutrient absorption is all kinds of different studies connecting the dots on those so that’s kind of the bifidobacteria, lactobacillus Of course, we have more of our spore based or soil based probiotics. These are going to be a lot of your bacillus strains, right, whether it’s bacillus, subtlest class ei coagulans, like Informix, right. These are the bacillus strains. These are really good if you are very much cebo sensitive, fodmap sensitive, we may use some of these over a bifido lactobacillus species. And then of course, I’m a big fan of the probiotic that’s kind of more of a beneficial yeast called Saccharomyces boulardii in my lammie, one called sacral flora, again, we’ll put the links below for for all y’all so if you want to see it, we’ll put the links below sacral Flora Saccharomyces boulardii is very helpful a lot of studies on it, helping to improve immunity in the gut IGA IGA levels going to get low and just gut inflammation or gut stress. Of course, it’s going to help with food poisoning a lot of studies on it helping with H. pylori, C. diff, Clostridium difficile, blastocystis hominess. It also helps crowd out yeast and Candida so there’s a lot of excellent benefits with saccharomyces we love it and it’s usually going to be a core part of my probiotic, my fifth r which is repopulation re inoculation on the good healthy probiotics, once the fourth hour is done right fourth hours and to be removing the gut bugs removing the gut infections. Fifth hour, we come in repopulate re inoculate with good bacteria. Most people kind of sweet they want to start probiotics sooner, and that may not be the best step. Not saying it may not help. But some people have just found one that’s just a lot of pills. And two, if they have a lot of bad bugs in there. It’s like going and getting a whole bunch of good fresh grass seeds throw down on a lawn full of weeds, right? You got to get the weeds done before we throw down the seeds right got to get the car washed or we get waxed.

Evan Brand: Kind of like that. Yeah, we had a lot of good feedback on the podcast we did remember we were talking about probiotics and how a lot of new research is showing probiotics are being used to help with getting out mycotoxins and we know that mold toxins damage the gut. So yes, so I have been I’ve honestly been working in probiotics into the protocol sooner and most people do well. There are some like you said that just don’t you got to pull the weeds before you throw the seeds. But there are a lot of people doing really good with throwing probiotics and sooner in the protocols now. So like you said, if they can handle the amount of pills, maybe we try to sneak one or two in or we could do like powdered versions, typically, it’s like a quarter teaspoon, we could throw in a blend like that sack be you could you could do powder and maybe throw it in a smoothie or something. So we are trying to integrate those a lot. And I’ve had amazing success personally with probiotics. So I think it’s interesting, there’s still a lot of people that poopoo probiotic probiotics I know you and I we kind of get, you know, so caught up in the clinical trenches that we may miss some things, but I do get a couple of emails, you know, here and there from from people, clients sending them like, hey, this guy like says probiotics are a waste of money, and you know, that they don’t work. And I would just say that’s not true. We have so much clinical data personally.

Dr. Justin Marchegiani: It’s all about context, right? It’s like if someone comes in, they have chronic gut issues, and they’re just taking a probiotic thinking that that’s going to be the answer to their gut problems. It’s probably not right, and that’s where we’re trying to have a comprehensive functional medicine plan. That’s root cause and not just trying to Pro supplements at the wall thinking that that’s going to fix it. So yeah, I understand if that you know where that person is coming up with that, that bias that biases from not having a comprehensive root cause plan with a functional medicine practitioner, they’re just trying to throw stuff at them instead it hoping it will fix the symptoms, not fix the root cause.

Well, here’s Yeah, good, good point. Here’s the other thing, too, it’s even some probiotic companies will say that about other companies, it’s more of a marketing thing like, hey, their probiotic is crap, or it doesn’t work because of X, Y, or Z. But I will just say with what you and I use, clinically, we’re using professional supplement manufacturers exclusive only to health care providers. And a lot of the stuff we use, we have extended release technology. So when arguments like probiotics are going to die in the stomach, they’re not even going to make it to where they need to. But a lot of the new technology we use, they’re not even going to break open, they’re going to be resistant to the stomach acid. So that’s another problem too, when you hear these little like, super sometimes buzzworthy type articles. It’s not taking into consideration the quality, the quantity, the purity, the potency, the technology involved, it’s like probiotics, they get the label, and then that’s it. And that’s just not a fair classification.

Correct. And then also consumer reports that a study on probiotics a couple years back maybe 5 10 years ago. And what they found is most probiotics that they put a number on the outside of the bottle, hey, this is how many colony forming units. And what a lot of the cheap companies do is they say, Okay, this is how many should have been in this probiotic at manufacturing of this product. Let’s say it’s 20 billion. Now, what the professional companies do is, right, when you’re buying high quality, professional ingredients, they’re gonna say this is how many colony forming units should be in this capsule at expiration. And so you’re looking at something like two to three times the amount of those that species that CFU on the bottle colony forming units, is going to be typically in there. So when you see like, in my probiotic, I think it’s 40 billion per two capsules, right? That’s going to be what’s in there two years from now at expiration, right? And so obviously, it’s going to be two to three times the amount of that before. And so you want to use professional companies. So what you see on the label is always worst case, scenario, number one, and then also how products are stored by professional companies is very important. So like, where we have our warehouses, like everything is stored in an air conditioned or a refrigerated environment for a lot of our probiotics, some don’t necessarily need that. But which we value, the the scenario and how that store because that really increases potency, too.

Evan Brand: Yeah. And the funny thing is, too, we’ve seen some papers on supposedly expiration dates, you know, this is something that you and I are forced to do with the professional companies we work with. But you know, we’ve seen some research on supplements from 2030 years ago, still being viable, meaning they still had some potency and purity to them. And obviously, they still had a biological effect. So to me, I would if I had to pick like a consumer shelf bought probiotic, or a suppose that expired professional product, I’m going to go for the supposedly expired product, I’d go for a five year old professional probiotic, then, you know, on the shelf today consumer level.

Dr. Justin Marchegiani: Yeah, exactly. And also a lot of the probiotics or supplements that require refrigeration on the warehousing side, a lot of times you’re just not going to get that on Amazon, you’re not going to get that level of specificity just because that’s not how their warehouses are set up. And so with ours, we make sure that that refrigeration components is there because we’re working with patients and we need we need that potency, because we’re trying to get clinical outcomes, right. We’re trying to sell and provide a clinical outcome for the patient. And if we’re just providing products that aren’t meeting that standard, we’re not going to win. And of course, we want to be successful on that front.

Evan Brand: Yeah, yeah. Well say Well, I think we covered a lot of it. So the mushrooms are beneficial Lion’s Mane the mushroom is amazing for the brain, but for the gut also Chaga mushroom would be great reishi mushroom could also deserve a good mention, you hit upon the amino acids. So the glutamine or the various types of glucose amines involved. We love amino acids, we use those all the time you mentioned like collagen also being you know, part of that makeup, we hit on some of the herbs like the the licorice, or the dgl version of it, the marshmallow, we like to use a lot, we hit upon the aloe, and then we hit the probiotics, I think those are the big categories. And then the enzymes we hit that too.

Dr. Justin Marchegiani: I think we did a really good job hitting a couple and I just I really want to plug in concepts, right? Like a lot of people, they just try to throw information at people and and try to memorize that. I think that’s not beneficial. But if you can just understand concepts, right? A concept is just something that sticks. You either get it or you don’t. And so we try to use a lot of analogies and understand we try to plug in a lot of the concepts of root cause versus palliative cause. We try to get you to think about, hey, if this helps, why does it help? is it just an anti inflammatory? is it helping just improve better digestion? is it helping your immune system? is it helping your adrenals and helping you that your body’s natural process to build back up that gut lining? What’s the underlying mechanisms if you understand that, then you see how it plugs into the greater matrix of healing.

Evan Brand: Yeah, I mean, I agree 1,000%. So, I think the big concept of today is Yes, here are some things here are some nutrients you can use. However, we really want to make sure you’re testing, not guessing. So if you do need the aloe to calm the gut for now, you need the enzymes to help improve digestion. For now, you notice that HCl is helping with your heartburn or you notice that the enzymes are reducing your bloating, or your burping or your gas. Great, but what led to all that in the first place? What led you to need the aloe because you had gut inflammation, what led you to need the enzymes, that’s where somebody like us can come in and help you figure that out and plot it on paper. And, you know, we’ve been through the trenches personally. And clinically, we’re always improving upon herself. You know, I work on my children, I know you work on your children, we’re giving our kids things to help their guts, I mean, so this is like a, there’s no finish line, I don’t want people to think, Hey, I just do this aloe for a month, and then I’m done. You know, there’s not a finish line with the gut, we’re constantly being exposed to new toxins and new pathogens. We’ve even seen with the virus that’s been going around a lot of issues with the gut there, we’ve seen a lot of issue with tissue destruction in the intestinal tract. So who knows? Right now with the 5 10 year outlook of the GI health in the US is right now, our guts are notoriously bad, due to glyphosate and other things, damaging them. So just a quick note, you kind of started with the diet all and with the diet 100% organic is important, if you’re going to go buy all these probiotics, but yet, you’re going to eat strawberries with an average of 22 pesticides on them. If they’re not organic, you’re wasting your frickin time and your money because we know all those pesticides are just killing the beneficial bacteria in your gut that you’re trying to re inoculate or repopulate with. So please go organic, you know, before you spend money on probiotics.

Dr. Justin Marchegiani: Exactly. And then also how long do these probiotic strains last in your gut, I mean, a lot of times, you’re going to see the data show in about one month or so. So that they don’t stay forever. So when you take a probiotic, it’s not like it’s there forever. So it’ll it’ll hang around typically for a month, it’ll help with a nutrient synthesis, it’ll help with nutrient absorption, it’ll help with inflammation, modulating the immune system, there’s some data that maybe the spore based probiotics hang around a little bit longer, and they may help proliferate the growth of other beneficial species. So just think when you take a probiotic, it’s not forever. Now the goal is that we’re getting some level of fermentable foods in your diet, whether it’s from sauerkraut, or low sugar kombucha, or some kind of fermented pickle or something, or, you know, cultured coconut milk or potentially high quality raw milk if you can tolerate it. So you know, that’s typically how we’re getting exposed to probiotics more on a day in weekend kind of situation. If you’re someone that can’t get that level of exposure with fermented oils from food, then you probably want to be on a probiotic a little bit more frequently, if you’re not getting those fermentable. So we just got to plug and play where we’re at. I think our ancestors probably did more fermentable foods, which is ideal. But if we can’t we plug in a good quality probiotic, or at least throw in something every couple of months, just to kind of fill in the gap to make sure we’re getting exposed to those good for mandibles.

Evan Brand: Yeah, great point, I just want to highlight what you said too, which is like your gut bacteria are actually going to help you with your health in other ways. So once gut bacteria optimize your healing the gut, you’re making neurotransmitters the way you should you’re making serotonin, you’re making things to improve yourself, you’re making B vitamins to help your energy and your mitochondria. So this is why I really the gut, I mean, we just we can’t stop talking about it because it literally is the foundation.

Dr. Justin Marchegiani: Exactly. So just kind of want to make sure that is understood. And that makes sense for everyone. We’ll put a list of recommended products down below. So you guys have access to those you want to support us support the show, we appreciate it put those down below. Also, if you guys want to reach out to Evan brand, head over to EvanBrand.com, Evan is there for you guys worldwide. And again, I’m there for you as well, justinhealth.com, Dr. J myself, there’ll be a little link button, you guys can click and reach out to us we are available worldwide to help you guys help you help support y’all. We want to make sure they have the support you need. And you have a good comprehensive plan to get what’s going in the right direction if you’re not having success. And then also just try to apply one thing today as well. If you’re having if you’re overwhelmed, and you’re having a sticking point great to reach out, if not just try applying this information, we want to really help as many people as possible. And we know we’re going to help many more people than we actually see in person with this information. So just make sure you’re applying it. And if you are enjoying it, share it with family and friends that could also benefit put your comments down below. Let me know the best part that you liked about this what resonate with you the most. And give us a like and share as well. We appreciate it.

Evan Brand: Yeah, and if you’re on the apple listening, if you’re on your Apple podcast app or Stitcher or wherever else, give us some stars, let us know what you think the show deserves between us both we have I lost count, but it was somewhere over 705 star reviews for our podcast in between our various feeds. So please give us some stars. Give us some sentences give us a blurb on whether you still call it iTunes or Apple podcast. We’d love to beat out people that are not clinically oriented. There’s still like top health podcast out there that it’s just theory theory theory theory. And then we have to like recalibrate people’s theories because they’re not clinically based. So we would love to beat those people. How do we beat those Before we go higher in the charts, how do we do that? With your reviews! So we have a some stars. 

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take careDr. Justin Marchegiani  

Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Hey, you’re doing really well. And you know, we always come up with a title. And then we over deliver on that title. So we’re calling this something along the lines of top five nutrients to help your gut or to heal your gut or support intestinal permeability, but maybe we end up going over five. So I’m just gonna go straight to my favorite because it’s so easy. It’s so broad spectrum in its use. And it’s so safe for people across the board to use it, whether it’s kids, adults, the elderly population, even people that don’t have testing, you know, our philosophy is test don’t guess we want to have the data, we want to have good stool testing, and good organic acids testing to look into the gut deeper and figure out what’s going on under the hood. But there is usually a three, sometimes four week timeline between talking with a client or a new patient and then getting the test results. So what do we do to help these people in that in between time before we can do the real work based on the data, I’d say my favorite is probably aloe, and specifically you and I use an aloe extract. It’s a 200 to one, so it’s 200 pounds of gel converted to one pound of extract, and then that’s encapsulated. We had a young boy, not super young, maybe 16 17. But he was diagnosed with autoimmune gut issues, Crohn’s all sort of colitis, actually pan colitis where the whole digestive tract was affected major bleeding in the store. We got him on simply a 200 to one extract of aloe. And within three weeks, we did a new gi map stool test, and we dropped his calprotectin levels, which is his gut inflammation by 1000 points, just by aloe alone.

Dr. Justin Marchegiani: Unbelievable. Yeah, it’s powerful what nutrients can do now I always tell patients, if you’re trying to come in and make some changes out of the gates, I mean, your best bang for your buck would be fixing the food, because the food is constantly getting your body getting your gut in flames. So the first thing we can do is look at the the the inflammatory food that could be coming in this could be gluten or other technically gluten free grains like corn, oat, rice, those kinds of things. So you want to really get the grains out, you want to really get a lot of the poly polyunsaturated omega six vegetable oils. And again, the reason why vegetable oils tend to be more, let’s say poor is because they’re highly processed to extract the fat. And the processing actually damages the fat and creates free radical stress within those fats. Because the more you take in damaged fats, your body has to utilize antioxidants to stabilize the fats. So they don’t create free radicals. And so it depletes a lot of your antioxidants. And then those fast take on and become part of your cell membrane. And to have healthy cells you have to have good membrane. Because the membrane essentially is the brain of your cell. It provides a lot of good cellular communication happens with the membrane. So if you have junky fats, whether it’s omega six junky fats, or trans fats like hydrogenated soybean oil, right, those kinds of things, canola, you know, safflower, those are going to be more junky omega six, and they’re going to really not make the healthiest cell membranes, they’re going to deplete your antioxidant reserves. And if they’re on the trans fat side, they’ll make your cell membranes very inflexible too.

Evan Brand: Yeah, good point. And I apologize for skipping over the diet piece, you know, you think of the typical American person, they think, just give me the pill. Give me the magic remedy. So we’ll talk about some of those remedies. But yeah, you make a great point, you can’t go out to Pizza Hut for dinner, and then just take an aloe capsule, and everything’s going to be okay. Correct.

Dr. Justin Marchegiani: Yeah. So that’s it’s good to look at the foundation out of the gates. I’d also say like, I’ll just kind of put this next category into a broad category and just say, amino acids. And these amino acids could be things like an acetylglucosamine, NaG that could be things like glycine, which are going to be very high in collagen or bone broth. And they could also be things like glutamine, so I kind of put these in the amino acid bucket, when they tend to be very good support for the entire sites of the gut lining, that can be used as fuel for the gut lining, they also can help with gut permeability. And, and glycine is a really good backbone for connective tissue. So it can be very helpful for that lot of that connective tissue healing out of the gates.

Evan Brand: So how about enzymes? When you hear nutrients to heal the gut or support the gut, you don’t necessarily think about enzymes, you think of more like you mentioned, the glutamine, Aloe, the kind of calming, soothing things, but I would argue enzymes have a role in helping with reducing gut inflammation simply by improving digestion and reducing the putrifying and fermenting of foods because I know my gut was Super inflamed. If I look back at some of my original stool tests, when I had gut infections, yes, I was doing things to soothe my gut, but simply just treated, the infections alone got the inflammation down. And part of that process of treating the infections was using enzymes, because my digestion was so terrible, I would get exhausted after a meal. And that was a sign that I had low stomach acid. So I would say the enzyme should be on our list here, because so many people do to age due to stress. Maybe you’re eating in a loud restaurant, like you’re on your lunch break for work, and you’re listening to us or there’s music, boom, boom, boom in the background, and you’re sympathetically stressed while you’re eating enzymes, to me would be a good insurance policy to help break down your foods and then therefore reduce inflammation.

Dr. Justin Marchegiani: Yeah, foods are not broken down properly, they’re going to sit, they’re going to ferment, they’re going to purify, they’re going to read certify also, those foods are more likely to create hydrogen and methane gases because they’re fermenting, and those gases can throw off your motility, motility and how you move the bowels. And if the bowels are one too short, or should take too fast on the diarrhea side, you may not absorb those nutrients well. And if they’re too long, on the conservation side, you may reabsorb fecal toxins. And so you know, long or short on the bowel motility can definitely affect absorption or create more toxins in the body. So I think that’s a big one. And then just kind of connecting the enzymes and we could throw HCl in there too, because HCl helps activate enzymes, I would say chewing, chewing and and really just the mastication and healthy eating habits because chewing your food up really fine, allows more surface area for those enzymes and acids to work. So you can have a good amount of enzymes or acids, you only have a couple of chews. you swallow your food, those enzymes and acids aren’t gonna work as good as you really chew it up, you know, 30 to choose one chew per tooth, you know, ideally like an oatmeal like consistencies and allow those enzymes and acids to work better.

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Evan Brand: It’s hard. I’ve tried to do that I’ve tried to do that many choose, oh man, my jaw gets tired. So and that’s the that’s the problem too, that we have with our food is like you go to Chipotle, a for example. Everything’s really soft. Like if you get rice if you get like carnitas. Or if you get the chicken, you barely have to chew it. It’s almost like mush. So I try to personally seek out occasionally I will seek out whether it’s like beef jerky, or no bison jerky or even just a steak, you know, I try to really get something that works my job because I just feel like in America, our food is so soft and easily digestible, that we don’t have to really chew anymore.

Dr. Justin Marchegiani: Yeah, so if you have a nice steak or a nice whole chicken, just make sure you chew it up. Same thing goes with over hydrating, you know, try to get your first thing I do is and I get to go eat a meal, I kind of go to the reverse osmosis filter, get a nice big glass of water to add some minerals, one, two, and then I get my meal going that way it gives me 10 15 minutes or so for everything to absorb. And of course the colder the water you got to take a little bit longer because your body holds that water in your stomach, heats it up to about room temperature and then passes it through. So the colder that water is, the longer you should wait in between the meal

About mushrooms. This is something that you know, just doing a little bit of research before we hit record, that this is something that I don’t necessarily go to right out of the gate but I’ve been using mushrooms for a long time. I know you and I personally have been taking mushrooms for a long time. And it turns out that for example, Lion’s Mane mushroom has some really, I would say probably just as impressive as some of the other herbs you’re mentioning, whether it’s like dgl, licorice or marshmallow kind of the conventional gut healing ones. Lion’s Mane has some really awesome anti inflammatory properties. There were two papers that we had found here on Lion’s Mane mushroom being shown to protect from and shrink gastric ulcers. Also, Lion’s Mane was shown to significantly improve symptoms of two major inflammatory disorders of the digestive system. And so that’s cool, because normally we’re using Lion’s Mane for cognitive problems. I know for me, my brain is much more clear. I’ve got Lion’s Mane mushroom in my system right now. I took two capsules this morning, and I certainly feel it mentally. But I did not even think that I was feeling it in my gut. So that’s cool.

Totally. Yeah, that gets really important. Again, a lot of gut issues, the immune system can be a big player at it. And so of course, if you’re able to modulate the immune system with the medicinal mushrooms, or immunogenic compounds that are going to be in those mushrooms, whether it’s beta one, three, D glucan, whatever that is, it could have an effect on gut permeability and improving digestion. I think all that’s very, very important. Also, just kind of one pet peeve of mine. Someone in the comments was chatting about this. A lot of people when they talk about leaky gut, they talk about leaky gut like like it’s the cause of Problem. leaky gut is the effects of on what’s happening with the gut. So the more inflamed you are, the more you’re not breaking down your food. The more crappy The food is, the more inflammatory The food is, the more dysbiosis we have, the the lack of certain nutrients we have, the more stress we are right. All that then creates and increases the chance of gut permeability. Gut permeability isn’t the cause unto itself. It’s the effects of a lot of other issues happening. So when people talk about Oh, you gotta fix the leaky gut. It’s like, not necessarily, you know, it’s like, it’s like saying, Oh, we have to fix. Imagine you have a leak in your roof and the waters pulling on the carpet below you. So we got to fix that water on the floor. It’s like, No, no, you fix the hole in the roof. And again, it may be semantics, but we got to call a spade a spade. If the water’s coming into the roof, you talk to them, we got to fix the hole in the roof. You don’t say we fixed the the water on the ground, right? So I just want everyone I want to train everyone to kind of get thinking about things from a root cause standpoint, versus labeling the damage at the end result conventional medicines really good at labeling damage down here and not talking about the effects of top that should the cause up top there labeling the effects down here. So we want to go root cause?

Yeah, that’s great. And I’m sure we could come up with other analogies on it. But that makes a lot of sense. It’s kind of like, okay, we need to come in with the towel. Oh, no. Now we have this super absorbent towel, this towel is going to absorb 1000 times more water on your floor than any other towel. And then yes, this, this carpet is mold resistant. So if you use this carpet, that water in your carpet won’t create mold, but you’re still missing the frickin hole in the roof roof.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

Well, let’s call it out. Let’s call out why that happens, though. It’s simply money. And it’s the supplement industry. There’s a lot of money. Yeah, it’s marketing. There’s a lot of money made on leaky gut this and this leaky gut book and this leaky gut protocol and this leaky gut practitioner. The problem is you could take all these leaky gut support for a decade and never treat the infections like if you just went and did like you mentioned glutamine, and we hit the zinc carnosine and the dgl. And we did the aloe, like we talked about in the beginning, none of those are going to erase a blastocyst is hominis, parasite infection, none of those are going to get rid of Giardia. None of those are going to treat the H pylori, they may help. But they’re definitely not going to eradicate the issue causing the leaky gut in the first place. So that’s just marketing. It’s money involved in this. And, you know, as practitioners, I think it’s really smart of you to call it out like that, because it’s, it is frustrating for us because we’ll look on a new client or new patients intake form. And they’ll be taking all these quote leaky gut supplements. Yeah, I found this leaky gut protocol online, and I still have all these digestive problems. And it’s like, well, yeah, look at your stool test, you have all these issues. And you could do that for 20 years and never fix it. So I could rant on that all day.

Yeah, other thing I would just say out of the gates is it’s okay to palliative Li support the leaky gut, we just have to make sure when you’re palliative Li supporting something we’re also root cause supporting it as well root cause fixing it. Palliative support, totally fine, right. Nothing wrong with that we just got to call a spade a spade and and not pretend the palliative leaky gut support is root cause support. Yeah, long as we can do that, then I think we’re pretty good. Next thing I would highlight out of the gates and you see this herb being listed as being very helpful for the gut permeability, but it’s also very helpful on the adrenal. So that’s licorice. And so when we use licorice is a lot of licorice being used in leaky gut supports. That’s that’s d glycerides. And this is the glycerides component of the licorice is pulled out. And the glycerides component of a licorice is is the component that slows the breakdown of cortisol, I think it’s the 11 beta hydroxy steroid dehydrogenase to enzyme. The licorice inhibits that enzyme. That’s the enzyme that helps break down cortisol. So we know cortisol too low, we need healthy levels of cortisol to actually build up the gut lining. It helps with building up the gut lining. Of course, if our cortisol levels are too high, and we’re chronically stressed, right, that can also break down the gut lining. We know that with people that are chronically stressed getting ulcers, right, we know that as well. And so when we look at licorice, it really helps with cortisol improvement. So if we do a cortisol test, and we see chronically low cortisol, that can actually help with the gut lining with the mucosa with the stomach with the duodenum. And that can actually help with the cortisol bringing that back up. And that can help build back up that gut lining. And so we like licorice, that’s non diglycerides for the gut and Nanda glycerides licorice, we give it typically orally sublingually, to our patients, that will eventually trickle downstream to the gut as well. And so licorice can be a powerful thing. You just have to be careful if you’re giving a non diglycerides version that people that have already higher level of cortisol, that may make things worse. So we just got to make sure we’re testing that to know what kind of pattern we’re seeing.

Yeah, that’s a good point. So we could do a whole part two on that. If you want. Give us some feedback. Like maybe the gut hormone connection. And we could hit that in detail. But yeah, you highlighted a very important point, which is that cortisol is involved with this whole process. And it really is a Goldilocks zone. If you have too little cortisol, you’re exhausted. And you’re probably going to be dependent on stimulants and caffeine and sugar and things that are going to damage your gut. But then simply, you don’t have enough to build up the gut. And then if you have too much, now you’re catabolic, you’re breaking down your muscle tissue, and you’re breaking down your gut barrier. That’s probably part of the reason that I lost a lot of weight and a lot of muscle. When I first moved to Texas, I had gut infections, and I was incredibly stressed, just moving and leaving my family behind, you know, emotional stuff, homesickness gut infections, I had the perfect storm to tear up my gut. So I can tell you firsthand that adrenal supports did help. And that was probably because it was helping regulate the cortisol levels, which then in turn, took the load off my gut, so to speak.

100% Yeah, I like that. And so it’s good to really make sure that’s under control. 

Evan Brand: How about probiotics? I think it’s worth mentioning. These are totally valuable tools that can help regulate histamine. Yeah, and regulate bacteria with it. So let’s dive into that.

Dr. Justin Marchegiani: Yeah, so you have to you I said you have three to four big families. Okay. So you typically have your lactobacillus and bifidobacterium, which are typically come together and usually a good high quality broad spectrum probiotic. So my line we have one called profile, Florida doesn’t have a lot of the different lactobacillus whether it’s kci acidophilus Bulgaria’s brevis, rhamnosus. And then of course, you have a lot of the bifidobacterium whether it’s bifidobacterium, bifidum, longum, brevis, right. So those are your broad spectrum lactobacillus or bifidobacterium. Probiotics, lots of good data, lots of good research anywhere from food poisoning for inflammation reduction, gut permeability reduction. nutrient absorption is all kinds of different studies connecting the dots on those so that’s kind of the bifidobacteria, lactobacillus Of course, we have more of our spore based or soil based probiotics. These are going to be a lot of your bacillus strains, right, whether it’s bacillus, subtlest class ei coagulans, like Informix, right. These are the bacillus strains. These are really good if you are very much cebo sensitive, fodmap sensitive, we may use some of these over a bifido lactobacillus species. And then of course, I’m a big fan of the probiotic that’s kind of more of a beneficial yeast called Saccharomyces boulardii in my lammie, one called sacral flora, again, we’ll put the links below for for all y’all so if you want to see it, we’ll put the links below sacral Flora Saccharomyces boulardii is very helpful a lot of studies on it, helping to improve immunity in the gut IGA IGA levels going to get low and just gut inflammation or gut stress. Of course, it’s going to help with food poisoning a lot of studies on it helping with H. pylori, C. diff, Clostridium difficile, blastocystis hominess. It also helps crowd out yeast and Candida so there’s a lot of excellent benefits with saccharomyces we love it and it’s usually going to be a core part of my probiotic, my fifth r which is repopulation re inoculation on the good healthy probiotics, once the fourth hour is done right fourth hours and to be removing the gut bugs removing the gut infections. Fifth hour, we come in repopulate re inoculate with good bacteria. Most people kind of sweet they want to start probiotics sooner, and that may not be the best step. Not saying it may not help. But some people have just found one that’s just a lot of pills. And two, if they have a lot of bad bugs in there. It’s like going and getting a whole bunch of good fresh grass seeds throw down on a lawn full of weeds, right? You got to get the weeds done before we throw down the seeds right got to get the car washed or we get waxed.

Evan Brand: Kind of like that. Yeah, we had a lot of good feedback on the podcast we did remember we were talking about probiotics and how a lot of new research is showing probiotics are being used to help with getting out mycotoxins and we know that mold toxins damage the gut. So yes, so I have been I’ve honestly been working in probiotics into the protocol sooner and most people do well. There are some like you said that just don’t you got to pull the weeds before you throw the seeds. But there are a lot of people doing really good with throwing probiotics and sooner in the protocols now. So like you said, if they can handle the amount of pills, maybe we try to sneak one or two in or we could do like powdered versions, typically, it’s like a quarter teaspoon, we could throw in a blend like that sack be you could you could do powder and maybe throw it in a smoothie or something. So we are trying to integrate those a lot. And I’ve had amazing success personally with probiotics. So I think it’s interesting, there’s still a lot of people that poopoo probiotic probiotics I know you and I we kind of get, you know, so caught up in the clinical trenches that we may miss some things, but I do get a couple of emails, you know, here and there from from people, clients sending them like, hey, this guy like says probiotics are a waste of money, and you know, that they don’t work. And I would just say that’s not true. We have so much clinical data personally.

Dr. Justin Marchegiani: It’s all about context, right? It’s like if someone comes in, they have chronic gut issues, and they’re just taking a probiotic thinking that that’s going to be the answer to their gut problems. It’s probably not right, and that’s where we’re trying to have a comprehensive functional medicine plan. That’s root cause and not just trying to Pro supplements at the wall thinking that that’s going to fix it. So yeah, I understand if that you know where that person is coming up with that, that bias that biases from not having a comprehensive root cause plan with a functional medicine practitioner, they’re just trying to throw stuff at them instead it hoping it will fix the symptoms, not fix the root cause.

Well, here’s Yeah, good, good point. Here’s the other thing, too, it’s even some probiotic companies will say that about other companies, it’s more of a marketing thing like, hey, their probiotic is crap, or it doesn’t work because of X, Y, or Z. But I will just say with what you and I use, clinically, we’re using professional supplement manufacturers exclusive only to health care providers. And a lot of the stuff we use, we have extended release technology. So when arguments like probiotics are going to die in the stomach, they’re not even going to make it to where they need to. But a lot of the new technology we use, they’re not even going to break open, they’re going to be resistant to the stomach acid. So that’s another problem too, when you hear these little like, super sometimes buzzworthy type articles. It’s not taking into consideration the quality, the quantity, the purity, the potency, the technology involved, it’s like probiotics, they get the label, and then that’s it. And that’s just not a fair classification.

Correct. And then also consumer reports that a study on probiotics a couple years back maybe 5 10 years ago. And what they found is most probiotics that they put a number on the outside of the bottle, hey, this is how many colony forming units. And what a lot of the cheap companies do is they say, Okay, this is how many should have been in this probiotic at manufacturing of this product. Let’s say it’s 20 billion. Now, what the professional companies do is, right, when you’re buying high quality, professional ingredients, they’re gonna say this is how many colony forming units should be in this capsule at expiration. And so you’re looking at something like two to three times the amount of those that species that CFU on the bottle colony forming units, is going to be typically in there. So when you see like, in my probiotic, I think it’s 40 billion per two capsules, right? That’s going to be what’s in there two years from now at expiration, right? And so obviously, it’s going to be two to three times the amount of that before. And so you want to use professional companies. So what you see on the label is always worst case, scenario, number one, and then also how products are stored by professional companies is very important. So like, where we have our warehouses, like everything is stored in an air conditioned or a refrigerated environment for a lot of our probiotics, some don’t necessarily need that. But which we value, the the scenario and how that store because that really increases potency, too.

Evan Brand: Yeah. And the funny thing is, too, we’ve seen some papers on supposedly expiration dates, you know, this is something that you and I are forced to do with the professional companies we work with. But you know, we’ve seen some research on supplements from 2030 years ago, still being viable, meaning they still had some potency and purity to them. And obviously, they still had a biological effect. So to me, I would if I had to pick like a consumer shelf bought probiotic, or a suppose that expired professional product, I’m going to go for the supposedly expired product, I’d go for a five year old professional probiotic, then, you know, on the shelf today consumer level.

Dr. Justin Marchegiani: Yeah, exactly. And also a lot of the probiotics or supplements that require refrigeration on the warehousing side, a lot of times you’re just not going to get that on Amazon, you’re not going to get that level of specificity just because that’s not how their warehouses are set up. And so with ours, we make sure that that refrigeration components is there because we’re working with patients and we need we need that potency, because we’re trying to get clinical outcomes, right. We’re trying to sell and provide a clinical outcome for the patient. And if we’re just providing products that aren’t meeting that standard, we’re not going to win. And of course, we want to be successful on that front.

Evan Brand: Yeah, yeah. Well say Well, I think we covered a lot of it. So the mushrooms are beneficial Lion’s Mane the mushroom is amazing for the brain, but for the gut also Chaga mushroom would be great reishi mushroom could also deserve a good mention, you hit upon the amino acids. So the glutamine or the various types of glucose amines involved. We love amino acids, we use those all the time you mentioned like collagen also being you know, part of that makeup, we hit on some of the herbs like the the licorice, or the dgl version of it, the marshmallow, we like to use a lot, we hit upon the aloe, and then we hit the probiotics, I think those are the big categories. And then the enzymes we hit that too.

Dr. Justin Marchegiani: I think we did a really good job hitting a couple and I just I really want to plug in concepts, right? Like a lot of people, they just try to throw information at people and and try to memorize that. I think that’s not beneficial. But if you can just understand concepts, right? A concept is just something that sticks. You either get it or you don’t. And so we try to use a lot of analogies and understand we try to plug in a lot of the concepts of root cause versus palliative cause. We try to get you to think about, hey, if this helps, why does it help? is it just an anti inflammatory? is it helping just improve better digestion? is it helping your immune system? is it helping your adrenals and helping you that your body’s natural process to build back up that gut lining? What’s the underlying mechanisms if you understand that, then you see how it plugs into the greater matrix of healing.

Evan Brand: Yeah, I mean, I agree 1,000%. So, I think the big concept of today is Yes, here are some things here are some nutrients you can use. However, we really want to make sure you’re testing, not guessing. So if you do need the aloe to calm the gut for now, you need the enzymes to help improve digestion. For now, you notice that HCl is helping with your heartburn or you notice that the enzymes are reducing your bloating, or your burping or your gas. Great, but what led to all that in the first place? What led you to need the aloe because you had gut inflammation, what led you to need the enzymes, that’s where somebody like us can come in and help you figure that out and plot it on paper. And, you know, we’ve been through the trenches personally. And clinically, we’re always improving upon herself. You know, I work on my children, I know you work on your children, we’re giving our kids things to help their guts, I mean, so this is like a, there’s no finish line, I don’t want people to think, Hey, I just do this aloe for a month, and then I’m done. You know, there’s not a finish line with the gut, we’re constantly being exposed to new toxins and new pathogens. We’ve even seen with the virus that’s been going around a lot of issues with the gut there, we’ve seen a lot of issue with tissue destruction in the intestinal tract. So who knows? Right now with the 5 10 year outlook of the GI health in the US is right now, our guts are notoriously bad, due to glyphosate and other things, damaging them. So just a quick note, you kind of started with the diet all and with the diet 100% organic is important, if you’re going to go buy all these probiotics, but yet, you’re going to eat strawberries with an average of 22 pesticides on them. If they’re not organic, you’re wasting your frickin time and your money because we know all those pesticides are just killing the beneficial bacteria in your gut that you’re trying to re inoculate or repopulate with. So please go organic, you know, before you spend money on probiotics.

Dr. Justin Marchegiani: Exactly. And then also how long do these probiotic strains last in your gut, I mean, a lot of times, you’re going to see the data show in about one month or so. So that they don’t stay forever. So when you take a probiotic, it’s not like it’s there forever. So it’ll it’ll hang around typically for a month, it’ll help with a nutrient synthesis, it’ll help with nutrient absorption, it’ll help with inflammation, modulating the immune system, there’s some data that maybe the spore based probiotics hang around a little bit longer, and they may help proliferate the growth of other beneficial species. So just think when you take a probiotic, it’s not forever. Now the goal is that we’re getting some level of fermentable foods in your diet, whether it’s from sauerkraut, or low sugar kombucha, or some kind of fermented pickle or something, or, you know, cultured coconut milk or potentially high quality raw milk if you can tolerate it. So you know, that’s typically how we’re getting exposed to probiotics more on a day in weekend kind of situation. If you’re someone that can’t get that level of exposure with fermented oils from food, then you probably want to be on a probiotic a little bit more frequently, if you’re not getting those fermentable. So we just got to plug and play where we’re at. I think our ancestors probably did more fermentable foods, which is ideal. But if we can’t we plug in a good quality probiotic, or at least throw in something every couple of months, just to kind of fill in the gap to make sure we’re getting exposed to those good for mandibles.

Evan Brand: Yeah, great point, I just want to highlight what you said too, which is like your gut bacteria are actually going to help you with your health in other ways. So once gut bacteria optimize your healing the gut, you’re making neurotransmitters the way you should you’re making serotonin, you’re making things to improve yourself, you’re making B vitamins to help your energy and your mitochondria. So this is why I really the gut, I mean, we just we can’t stop talking about it because it literally is the foundation.

Dr. Justin Marchegiani: Exactly. So just kind of want to make sure that is understood. And that makes sense for everyone. We’ll put a list of recommended products down below. So you guys have access to those you want to support us support the show, we appreciate it put those down below. Also, if you guys want to reach out to Evan brand, head over to EvanBrand.com, Evan is there for you guys worldwide. And again, I’m there for you as well, justinhealth.com, Dr. J myself, there’ll be a little link button, you guys can click and reach out to us we are available worldwide to help you guys help you help support y’all. We want to make sure they have the support you need. And you have a good comprehensive plan to get what’s going in the right direction if you’re not having success. And then also just try to apply one thing today as well. If you’re having if you’re overwhelmed, and you’re having a sticking point great to reach out, if not just try applying this information, we want to really help as many people as possible. And we know we’re going to help many more people than we actually see in person with this information. So just make sure you’re applying it. And if you are enjoying it, share it with family and friends that could also benefit put your comments down below. Let me know the best part that you liked about this what resonate with you the most. And give us a like and share as well. We appreciate it.

Evan Brand: Yeah, and if you’re on the apple listening, if you’re on your Apple podcast app or Stitcher or wherever else, give us some stars, let us know what you think the show deserves between us both we have I lost count, but it was somewhere over 705 star reviews for our podcast in between our various feeds. So please give us some stars. Give us some sentences give us a blurb on whether you still call it iTunes or Apple podcast. We’d love to beat out people that are not clinically oriented. There’s still like top health podcast out there that it’s just theory theory theory theory. And then we have to like recalibrate people’s theories because they’re not clinically based. So we would love to beat those people. How do we beat those Before we go higher in the charts, how do we do that? With your reviews! So we have a some stars. 

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take care.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-top-5-nutrients-to-address-gut-inflammation-and-leaky-gut-podcast-339

Recommended products:

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Betaine HCL Supreme

Genova NutErval

 

The Root Causes of Constipation & Slow Motility | Podcast #331

Wouldn’t it be easy if you could blame your constipation on one thing? While that typically isn’t the case, your irregularity could be pointing to either one or multiple causes. Let’s watch and listen to Dr. J and Evan here, helping you learn what your gut may be trying to tell you, and what you can do about it. 

Dr. J and Evan emphasized to make a few changes to your lifestyle and see if they result in any positive bowel changes. Such as more high-fiber foods in your meals: fruits, vegetables, whole grains.  These steps will help you observe health changes – what works and what’s not via tests results as well.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:56       Slow Motility, Bowel Motility

8:06       Detoxification

15:57     Food for Detox

22:00     Vegan Honeymoon

27:40     System Approach, Solutions

30:51     Conventional Side

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan Brand. Today we are going to be having a podcast all about constipation and bowel motility issues. This is a topic that we deal with all the time with our patients, especially when we’re dealing with and addressing potential infections. This can be a common side effects. So we’re going to dive into the underlying mechanisms and what you can do what we do about it with patients. Evan, what’s going on, man? How we doing?

Evan Brand: Doing really well. If someone listening is still embarrassed to talk about their poop, then I would encourage you to shed that shit shed the shame or embarrassment. We talk about poop all day. We love it, we enjoy it. This is part of being a human number one being a healthy human number two, because if you’re not pooping, you’re reabsorbing toxins, whether that’s xeno estrogens from environmental exposure or pesticide and herbicide or mold toxins, I mean, how we get rid of our toxic waste and chemicals and things we’re making internally and that we’re exposed to is peeing and pooping. And so when you look at someone who feels bad, they have dark circles under their eyes, they have skin issues, they’re irritable, they’re fatigued, they have headaches, a lot of times constipation is one of the underlying issues with those people. And if we can just get them pooping properly good amount in good shape, good size, good consistency, good frequency, we can really increase their productivity, their energy, their mental cognition, we can get rid of sugar cravings. I mean, there’s a lot that can happen when you just regulate the bowels. So we’re going to dive in today on some of the big root causes root triggers, I’m going to go straight to number one for me, which is going to be gut infections. Now, you and I were just talking before we hit record about different gut bugs and how some people with IBS, they’ll end up IBS constipation, others end up IBS D diarrhea. And so depending on what type of infections you have, your bowels may become dysregulated.

Dr. Justin Marchegiani: 100%. And so, when you have different gut stressors, slow motility can easily be a result. So you can easily see on the on the fast side, motility is too fast. Our body doesn’t have the ability to reabsorb water and electrolytes in time, because usually electrolytes and water kind of follow each other. So as the colon kind of pulls out the electrolytes, usually the water comes out with it. And so when we have slower bowel movements, right, they’re usually harder, more compact kind of stools. So if we look at like, for instance, the Bristol stool chart, I’ll pull that up on screen. So anyone that’s watching the podcast can take a look at it. The Bristol stool chart, the chart that’s used by gastroenterologist and such, but it’s just a way of kind of assessing where you’re still fit. So the typical number four is like the poopy policeman. And that’s like just a really good solid looking snake, like not overly hard not overly soft stool. That’s number one. If you go to the actual number one on the Bristol stool chart that’s like kind of the rabbit poop, right, the rabbit pellets really hard, hard to move. And then number seven is just pure liquid. So four is kind of right in the middle, and in between. So let me just show you what I’m talking about here. So you guys can visualize if you’re watching the podcast video along with it. So here is the Bristol stool charts that you guys can see. Okay, so number one, right separate heart clubs, nuts hard to pass. This is like the rabbit poop, right? That’s type one. And then it gently progresses back to two and three, right? where it starts to get more sausage shaped like it says except it gets more smoother, and that as it goes to three. And then step type four is the perfect poopy policeman kind of more of a sausage like more smooth, not overly cracked or not overly soft. And then you can see as you go to five and six, it becomes more liquid and then seven and just entirely liquid watery, no solid. And so that gives us a pretty good window. And so we usually when we have when the guts really inflamed, and we have usually a lot of toxicity in the gut, we can usually see it go to number seven where it’s pure liquid. And that’s because the body is just trying to flush things out. And when things go a little bit slower, you could still have inflammation and have type one right so you could have h pylori, that’s lowering stomach acid, you could have a lot of cebo that is meth that’s producing a lot of methane based back gases. And how do you know it’s methane is you have a lot of foul smelling gas or flatulence that’s a sign that there’s a lot of methane present. And methane can easily screw up that migrating motor complex and make the bowels go more on the slow side. But you can have the same level of infections like h pylori, or maybe histo or Giardia. And that could also cause it to go on the diarrhea side. So it just kind of depends. Everyone’s a little bit different. But we always you could have cebo you could have h pylori, you could have low enzyme and low acid levels that can easily be causing type one. But for someone else, those same infections could easily be driving steps type seven, right where it’s pure liquid. So you got to look at everyone as an individual on that. And really, you know, come up with the right plan.

Evan Brand: Yeah, and it can Alternate to write. I mean, that was my situation when I first had gut issues and I was losing weight uncontrollably when I had H. pylori and parasites and bacterial overgrowth and Candida the whole nine yards. You know, there’d be some days the gut was good. And most days the gut was not good. Luckily, I’m over that now. But man, I’ll tell you, I have a lot of empathy for people that, you know, you never know what you’re going to get, you kind of wake up and it’s like, Is today a good day or not a good day. And now that I’ve learned so much, you and I, both over the past few years about mold toxicity, that’s a big trigger for gut issues, too. So I’m get constipated, but a lot of diarrhea. And I think that’s the body’s way of trying to get rid of the toxin, but also the gut is so irritated. And you can have leaky gut from mycotoxin exposure, that that can be a factor too. So eventually, we’ll get into the gut healing phase of our conversation. I think that’s critical to healing constipation.

Dr. Justin Marchegiani: 100%. And so on the constipation side, there could be issues with obviously, the bowel motility has to be slow. So what’s constipation. So if you’re not having a BM, you’re not passing about 12 inches of stool in about a 24 hour period. That’s typically constipation. And there are millions of people in this country that aren’t able to have a BM every day. Now, once you start going 2 3 4 5 6 7, I see some patients that go up to seven days about a BM, that’s a problem because half of your stool is going to be bacteria. The other half is going to be you know, fiber and such. And within that stool, some of that bacteria and toxins needs to leave your body. If you’re not having that pass through your intestinal tract into the toilet, your chance of reabsorbing a lot of those toxins goes up really high. That’s definitely not good. Because those toxins get reabsorbed into your body. There could be xeno estrogens, there could be mold toxins, there could be a whole bunch of junk in there that you could be reabsorbing, and that could be really stressing out your body. So the first thing we talked about with detoxification is people talk about Detox Detox Detox, right? Well, if you’re not pooping every day, and that’s because of a gut infection or not chewing your food well enough or having insufficient hydrochloric acid or enzyme levels, or having some kind of a h pylori or SIBO issue. All of those things can easily affect your detoxification people are really focused on detox. Just by getting your digestion and your motility better. That makes a huge difference on your liver, and all your detoxification pathways, your lymphatics, your immune everything.

Evan Brand: Yeah, it’s funny, you’ll see women on Instagram, they’re all done up their hair and their makeup and their lipstick, and they’re like marketing, hashtag add hashtag detox hashtag tea. And they’ve got these like, I don’t know, you know how it is like, these ridiculous products that they’re marketing and they’re not talking about poop. To me, that’s the best way to detox is get poop out. I’m not going to buy detox tea, maybe like a little bit of dandelion or some who knows milk thistle, blend it in. Yeah, I mean that that’s part of it. But unfortunately, detox has kind of gotten co opted by the marketing industry. And so most people don’t even focus on that, though. You know, they’ll poop once a week, but then they take a detox tea and they think they’re doing it correctly.

Dr. Justin Marchegiani: Yeah, I mean, my whole take on detoxification out of the gates is very simple. Okay, first, get enough good clean water in your system, to make sure you’re digesting your amino acids and all your nutrients. Well, remember, sulfur based amino acids run the majority of your detoxification pathways, along with B vitamins, right. So we need good B vitamins, good antioxidants, good sulfur amino acids. So if we’re breaking down those nutrients, well, there’s not a bottleneck with HDL levels or enzyme levels. We’re getting enough good clean water. And we’re not overly stressing our sympathetic nervous system because remember, the more we overly overly stress the adrenals the sympathetic nervous system decreases that migrating motor complex, which are the wave like contractions that move stool through your intestinal tract just like you kind of roll up the to pace roll at night, I get that toupees moving through to get your toothpaste out to brush your teeth. your intestines do the same thing. So if you can do those top three things, right, you’re on the right track. Now there may be extra things where we need extra sulfur or extra antioxidants or compounds or binders to help with mold or heavy metals. That’s true and that that would be addressed down the road but a lot of toxic patients detoxification happens hepatobiliary liver gallbladder back into the intestines and then out the intestinal tract. So we need to have really good motility and really good absorption of nutrients and a lot of good clean water to help fuel that.

Evan Brand: Yeah, good point. Good point. Yeah, so we both manufacture our own custom blends of supplements that are professional grade, and we both have a liver support that has some gallbladder nutrients built into it. That can be really helpful because, as you mentioned, with sluggish bowels, a lot of times there’s also sluggish bile production. So just helping to thin the bile, whether it’s using supplemental ox bile or muthoni, taurine, beet powder, whatever else we could do to increase bile flow that’s going to be helping and then why don’t we hit on the diet piece. I mean, I think this is the low hanging fruit that you’re having. American is still really really blowing it on, which is just the fact that they’re not doing enough good meats, good fats, good veggies, you know, your average, American might wake up and I don’t know, do a piece of toast and maybe in 2020, or 2021, it’s an avocado toast. But still, you know, that’s not the optimal thing for good poops.

Dr. Justin Marchegiani: Yes, so inflammation in the diet can easily mess up the intestinal tract, inflammation in the diet can easily create inflammation in the gut. And that could either move the body more to diarrhea or more constipation. Now, for the sake of this podcast, if we start moving more to constipation, not good. And of course, you know, these foods can stress out the intestinal tract. And then when we start creating inflammation in the intestinal tract, and then we already have indigestion, and we don’t have adequate enzymes and acids, so we’re kind of burping a lot after our meals, food sits longer in our tummy, right, and we’re not in a lot of gases are produced because the foods are not being broken down properly, that’s a problem. So we got to really make sure we’re masticating and chewing our food very, very, very well, we got to make sure that increases surface area for enzymes and acids to work, we also have to make sure we’re not overly hydrating with our meals. So hydrate 10 minutes or more before meal. And then if you’re consuming a little bit of liquid with a meal, just do it to kind of help with swallowing pills, don’t do it for hydration purposes. Because water has got a pH of seven, your intestinal tracts a pH of 1.5, or two. So if you start adding a whole bunch of seven, Ph to a to a pH of two, you’re going to move that pH more in the alkaline direction away from the acid at direction. And we need good acidity to help activate our enzymes and our acid levels very important. So that’s low hanging fruit is chew your food up well. Second, is make sure you’re not overly hydrating with the food do all your hydration two minutes before.

Evan Brand: I’ve got my grandfather so many times till this drink liquid with almost every bite of his food, held his Drink, drink drink, like take a bite of food and wash it down with liquid. I’m like no, like you’re literally just pouring water on your digestive fire don’t do that. So yeah, it’s it’s easy. And it actually does make a difference. I mean, you know, I’ve probably talked about that before. But it does make a difference. Like if I, I’ve got a mason jar here, my goal, if I sit at the dinner table, I will try to not have it more than like two ounces of liquid. You know, if I have a full cup, I’m more I’m liable to drink it. If I’ve just got a little bit I know, hey, this is the only liquid I have if I need a little help with the meal. Otherwise it just food, no liquid with the meal. 

Dr. Justin Marchegiani: Yeah, for me, as soon as I know, like a meal is coming, I’m gonna go just maybe take two mason jars, add some sea salt to it, I’m going to down them and then I’m good. And then you know, 510 minutes later, I can start the eating process and I chew my food out very well. So then that gets the digestive juices rolling as well. So on top of that another low hanging fruit is let’s say you eat good quality proteins or fats, and that makes you constipated. That’s almost a surefire sign. You’re not making enough enzymes or acids. So some people they really do poor with enzymes, and acids, and it reveals itself through animal products. Now, a lot of people when that happens, guess what their natural tendency is, unfortunately, either going to go vegetarian or yeah, oh, it’s the meat that’s so bad for my gods, the meat that’s in my intestinal tract for days and days. It’s rotting in there, you know, yeah, documentaries, I have to cut out the animal products. Well, it’s just a sign that your enzymes and your acids are really poor. And the meat is revealing that now what’s the solution? Now in the meantime, you may want to drop down some of the meat that you’re doing, or some of the protein or fat you’re doing, just to kind of lessen some of the stress off the intestinal tract. But the first thing we’ll do before that is we’ll add in some HCl and some enzymes, maybe even some bile salts, we’ll see how much that starts to correct it. And then if we need then we can drop the animal protein and fat down a little bit if we need. Now, if your intestinal tracts really messed up, you may have to do an elemental or a bone broth faster, or something more liquid based to make it easier on your intestine. So everyone’s a little bit different. And we have a lot of clinical experience about being able to meet someone where they’re at so we can get optimal results.

Evan Brand: Yeah, and it’s sad that the meat gets the blame, you know, and like you said, all these documentaries that will pop up on Netflix, they’re all like, majority, you know, anti meat vegetarian vegan documentaries, and then you kind of have to help clients because sometimes we’ll get clients that have not listened to enough of us where the we haven’t convinced them to get back on me actually had a vegan or ex vegan client come to me last week. She said she was vegan for six years. And she got back on me with the help of listening to our podcasts. And she says she feels better than she ever has, which is amazing. She was able to transition back onto me without necessarily a bunch of supplemental enzymes, but in most cases, yeah, we’re going to come in due to and people may say why why do I need the supplement? Well, we don’t live in a world where you’re sitting on the edge of a cliff overlooking a river valley with no stress. And you know, hunter gatherer average work 18 hours a week. We’re not doing that anymore. We’re working 40 60 hour work weeks. We’ve got kids, we’ve got technology we’ve got Got smartphones taking our attention away, we’re scrolling in Bowling at chipotle looking at our phone while we’re eating, or we’re stressed from bills and mortgages and obligations and whatever and age, by the time you’re age 40 50 60, you’re not making hardly any enzymes and acids compared to when you were younger. So all those factors add up that is the answer of why why do you need enzymes to support you? And how do enzymes help you poop? Well, because when that food is digesting better, your body’s going to be able to get rid of what it doesn’t need. And if you have a lot of malabsorption problems, you know, you may see on digested food in the stool. And over time, I’ve noticed people just adding in a handful of berries a day was all we needed to really clear up their their issues. Once we got all the gut infections enzymes in, you know, infections resolved, enzymes put in if they still needed help, we’ll go into a couple other things you want to get into. But handful of blueberries, I mean, that does a lot.

Dr. Justin Marchegiani: So it just kind of going back to some of the the vegan stuff. So I always tell my patients will in general, ie more non starchy vegetables, most paleo people eat more non starchy vegetables than vegans do. Most vegans I find have lots of processed carbohydrate, they have lots of grains, lots of lentils, or legumes and they don’t typically eat tons of non starchy vegetables, it’s it’s difficult. On the vegan side, most don’t do it right now, if you’re going to be a vegan, you need to do lots of good fats from avocado and coconuts. And you probably need some kind of an amino acid supplement from rice or pea protein or some kind of some kind of an algae kind of protein source because most aren’t doing it right if you’re going to do it that way. But number two is sometimes the vegetables can jack you up to especially if they’re raw, because a lot of that fiber or if the vegetables are higher in fermentable, carbohydrates, some can be like garlic and onions and, and broccoli and asparagus, they can be higher and fodmaps. And fodmaps can be fertilizer for a lot of the SIBO base bacteria. So if you have a lot of bad bacteria that’s producing maybe more methane, and some of those vegetables start to feed some of that methane producing bacteria that may make you more constipated too. So I’ve seen some patients do better more with the meats than with a lot of the plants. So I’ve seen it go both ways. And you know, it’s hard because if you’re let’s say you’re one person, and you had an experience where you went vegan, and you felt great, well guess what, you only have your experience, I see patients that have gone carnivore and felt great. And so because we have this perspective, where we’ve seen dozens of people do great from different things, that allows us to form a unbiased clinical recommendation on what we think is best for the patient, because we’ve seen successes work from both sides. And the question is, we don’t have a dogmatic belief in Oh, well, this is what does it well, this is why it would do it for this person. And this is maybe why it doesn’t for you. And we’re going to we’re going to move the levers around because the goal isn’t to do this thing is to get you the result. So it’s really important that if you’re working with someone, you know, kind of talking to patients that are out there, you want someone you want to work with someone that’s results driven, not process driven, meaning, hey, this, you have to do this diet, this is the most important thing, this should get you the results versus Hey, no, I want to get you these results, we’re going to try pulling some of these levers and see what happens as a result. And then we’ll we’ll go backwards from there. So just really important. You want to make sure you’re working with someone that’s results driven, not necessarily, you know, dogma driven, if you will.

Evan Brand: That’s another great soundbite. You’re just rolling out these things. I love it. This is exactly the point that we needed to hit on. Because in this day and age, unfortunately, everything is kind of a soundbite. So you go to the lectin guy, you’re going to get the lectin diet, you go to the carnivore guy, you get the carnivore diet, you go to the vegan guy, you get the vegan, and you and I don’t really have any labels for us, we’d like you said we were results driven. And so we’re able to be more flexible. I love that we’re not in a box, like these people, because once you write the carnivore book or the lectin book, you’re kind of that guy, and then you’re stuck in that box. And it’s like, oh, wait a second, I’ve got all these other people doing really good with some cooked lightly steamed veggies and blueberries over here. But you told me I need to be carnivore. So what the heck, and then it just blows your credibility. So I yeah, I don’t want to be in a box.

Dr. Justin Marchegiani: Now I tend to lean more on the Paleo template, but I use the word template, not diet, so I can have flexibility. And there’s some patients that I’ve seen that haven’t been able to tolerate any meat, we’ve had to just lean on free form amino acids, with some good vegetables or starches that are easy to handle. And I’ve had to go to that extreme with some patients. And if my dogma was no, you must eat animal products all the time. While I may not have been able to help that Paris person so we try to have the levers that we work with. We kind of have like a foundational bias, but it’s a bias that is flexible and that we can adjust according to the patient.

Evan Brand: Yeah. And eventually I would argue that that person you’re referring to could probably get back in and they may have been able to get back here forever later.

Dr. Justin Marchegiani: Not the case, not a forever thing. It’s kind of a starting point where, hey, you break your ankle, you probably may have to be in a wheelchair out of the gates. And then we progress you to, you know, some crutches and they put you on a boot and then you just maybe Walk slowly, you don’t run and now you start jogging and majesty, right, there’s a progression and how you how certain things heal? Well, it’s the same thing, the four year digestive system that’s not quite as outward, it’s inward, right and how it looks and performs. But you can feel it just the same as an outward injury to your foot or hand.

Evan Brand: Yeah, I’m gonna keep this thing going a little more philosophical than action based for a minute, just to to further this conversation, which is that let’s say someone goes to the bookstore. It’s funny, everything’s changing with society, isn’t it now it’s the Amazon bookstore, the Kindle bookstore, it used to be the real physical brick and mortar, there’s still a need that exists out there. I know there are some. So you go into the store, right, and you go to the diet section, and then someone picks up like, the, like I said, the Paleo book, The lectin book, The carnivore book, they do that, and then they get different or weird results. And then they kind of just give up, and that’s why they get so opposed to the word diet, or they get so opposed to the idea of changing the way they eat to change their symptoms. But the problem is, all these people writing these books are missing all the other root causes. So just because Jane didn’t do well, with a lot of meats, she might give up on meats, like you said, or she saw the documentary and give up on meats, but she never worked with somebody like us. So when we have these clinical tools that we have, where we’re going to be measuring the stool measuring the urine and looking at different infections. If we could just resolve those for Jane, get some of the enzymes back in clear the infections, guess what now she does great with the meat. So it’s sad, because there’s so many people that may have tried stuff like this, but they got so turned off with the non amazing results that they thought it was the diet to blame. But it wasn’t it was just the root causes. And like you said, the indicator is it sort of for us, it’s a clue Oh, that happens when you do meets, that doesn’t mean give it up. That means let’s figure out why. And the H Pylori could be the big one.

Dr. Justin Marchegiani: It’s true. And I call it the vegetarian or vegan honeymoon. A lot of people that do go vegan, they can feel great their first year, it all depends where they’ve come from if they ate a lot of processed food or crappy food. And they’re eating lots of organic vegetables, and maybe some good healthy or plant fats like olives, or avocado or coconut oil. And they’re just getting a lot of organic food in their system, they may feel a lot better now over time is essential fatty acids and amino acids start moving more in the deficient side. And a lot of those fat soluble vitamins like a d k start moving downward, they’ll start having more problems over time. And that’s kind of I call it the vegan honeymoon where they’re kind of chasing that honeymoon. They’re like, I don’t feel as good as I did last year. And they kind of get stuck. And usually it’s a protein, fatty acid kind of issue, or maybe even a carbohydrate issue too much carbs. And then you got to look deeper. So getting back to the constipation part right, we have the six hours that I used to work with my patients. And we kind of start with that as a framework, removing the bad foods, or placing the enzymes and acids to the first two hours. And we adjust the diet accordingly. So it could be cutting out cutting down a lot of the fiber or a lot more cooking or going lower fodmap. or cutting out salicylates or females or going on to a moon, it could be a combination of all of that could be an elemental diet, of course, adding in enzymes and acids. And bio, especially if the stools are floating more, that’s a sign that we’re not breaking down fat, so we may adjust those first two hours. And if we’re having bowel movement issues, I may add in things like ginger, or bitters or D lime any, we may have to even add in some natural things like trifle or magnesium to really get the bowels moving. It just depends. I don’t like to add in bow movers unless I really can’t move the bowels with those first two hours, right. If I can’t move the bowels with those first two hours changing the diet and changing enzymes, acids and bile support, then we may lean on things to kind of get the ball moving. But I always want to see how the body responds before we have to add those things in first.

Evan Brand: Well, you make a great point. And even clinically, the things you would recommend to be used directly for moving the bowels those things are still a hell of a lot safer and more effective than some of the conventional stuff you’re going to get. So I mean, if you go to your conventional doc and they refer you to the GI doc and you’re diagnosed with let’s say IBS, C constipation, IBS type issue, there’s going to be some type of a pharmaceutical involved and there’s likely going to be side effects with that. And once again, it’s not the root cause so in your case like you mentioned clinically, you may not go straight to the magnesium hydroxide to help move the bowels by adding water to the bowels However, there’s so many people deficient in magnesium anyway that you could be actually fixing simultaneously fixing an underlying mineral deficiency plus helping to move the bowels. So the cool thing about what we do, is there a positive side effect so we can kill multiple birds with the same stone?

Dr. Justin Marchegiani: Yes, I’d much rather use a nutrient than like an abrasive herb like Cena or Cascara Sagrada, right? No one has a deficiency of that, but they may have some deficiencies in some of these magnesium so that can be helpful. Now if I get bowels moving out of the gates, usually one or two months in, I’m going to try pulling back on some of these compounds to see if the bowels can move on its own. So it just depends, right? We’re getting the body hydrated, we’re chewing better. We’re working on eating and a non stressful environment, we’re getting enzymes and acids better. We’re cutting out the inflammation. And we may be changing some of the format, the building and the food. So all of those things are moving so many levers. So when I work with patients, patients are like, want to know like, what’s the solution for this? What’s the solution for that? It’s like, I don’t know, I’m going to just give you what I’ve seen to work. And we’re going to do eight or nine or 10 things out of the gates. And we’re going to see what works. But in general, to know exactly which one it is, it’s really hard because you’d have to like make one change, wait a couple of weeks, make one change, wait a couple of weeks. And it would take patients years to get better versus weeks and months. And so we make a whole bunch of changes at once. And then we monitor and we check in on those changes.

Evan Brand: Yeah, good point. So just to give a little more clarity, somebody who’s listening, like what does that even mean? Eight or nine changes. Oh, my God, that’s overwhelming. No, I mean, it could be Hey, look, we’re going to give a little more enzymes and acids, we’re going to pull this food out, we’re going to get you to do a little bit more water and a cleaner water source, we may throw in a little bit of this extra mineral, or maybe a little extra vitamin C, you’re going to do a handful extra of some blueberries, you’re going to make sure you’re getting enough adequate movement because you’re a sedentary job. So we’re going to get you a standing desk. And now you can stand up and move around, we’re going to get you to do a 10 minute walk a day, we’re going to get you to you know, take a couple deep breaths, we’re going to get you to chew your food better, we’re going to make sure that you’re not sitting in, I don’t know a crazy loud restaurant with like, you know, speakers blasting, you know, techno music in the background, we want you to just settle down, we want you to go to bed on time. I mean, yeah, those things give you 5 10 15%. And then by the time you add it all up, you’ve got really good success.

Dr. Justin Marchegiani: Yeah, you’re not chewing your food. I’m sorry, you’re not hydrating when you’re eating right? All these things matter. And maybe getting a little bit more sunlight, right? All these things matter. And so that’s why it’s so hard to be like, well, what’s the solution? for this? It’s like, well, there’s a lot of things that can be a contributing factor, it could be 10%, for this 5% for that 20%. For that it’s very rare that this one thing is at 90 100%. Sometimes you get big, like you just make one simple change. And you the next week you check in with the patient. They’re like, well, I’m 80 or 90% better, it’s like whoa, that’s a home run, that can happen too. But we don’t count on it. And that’s why we do things kind of in a systematic fashion of what’s going to be the low hanging fruit and then we kind of move up from there, right? You got to build up the foundation of the house once the foundation solid, now you can you can build up, the foundation is not solid, then you have a whole bunch of problems that have happened with with the building of the house as you start going up.

Evan Brand: Good point. Good point. And this is the whole reason that we do a workup and we run people through a sort of a system. You call it a system approach. Because if you come in and you go to the doc, hey, I’ve got constipation. Pharmaceutical laxative, see you later. If you come to us constipation, it’s like, Huh, Interesting. Interesting. Okay, let’s figure out why. And if you ask why enough and you do the proper testing, you’re going to get to that why. So I just want to make sure we’re always comparing and contrasting because you ask, you know, Bobby, who hasn’t pooped all week what he’s going to do for his constipation, he might go to Walgreens, he’s going to go to the laxative section. Oh, I found this laxative. This one looks good. Let me drink some of this stuff. Oh, yeah, I poked Problem solved. It’s like, huh, yeah, you solve the constipation problem, but you didn’t solve why that’s happening in the first place. So I just, it shouldn’t have to be revolutionary to think root cause, but it still is not the mainstream. So until it’s the mainstream, our job is not done.

Dr. Justin Marchegiani: Yeah. And so when for most conventional, like gastro people, for instance, they’re just like, hey, motility support, here you go laxative support, here you go. It’s very rare, you may get one that say, hey, let’s do a Siebel breath test, maybe that, and then what after that, maybe they’re gonna just recommend, hey, you know, do this quick little diet thing, because a lot of the conventional fodmap diet still have a lot of grains and other crap in there. So you may not change the inflammation. And they may throw some Rifaximin or neomycin at you, boom. And then now maybe you have a fungal overgrowth or something on the backside, because they don’t do or address the gut bacteria, right? And then that can create other rebound overgrowth down the road. So let’s say you have a very progressive kind of forward thinking gastro Doc, maybe that’s what happens that I just mentioned, but most that’s going to be hey, here’s your motility enhancer. And you know, you got to just learn to relax and meditate and hey, maybe taking antidepressant a lot of time. That’s it. So you’re kind of stuck. And that’s just the insurance space model. When you have three to five minutes with a doc, that’s typically all they’re going to recommend for you. They don’t have enough time to really dive in deeper. And that model doesn’t give them the ability to dive in deeper. So you really need to see a functional medicine doctor to really have the ability to go deeper and get to the root cause.

Evan Brand: Yeah, I get so frustrated with that term, integrative it just makes me angry because I’ve had so many people and I know you have to hundreds and hundreds and hundreds of clients and patients that have said I’ve worked with this angle. Right of guy, Mike Oh, integrative What did he do? And you know, they kind of market it as it’s like so forward thinking, but like you said, it may be the Rifaximin at most. And then guess what a lot of these people they have antibiotic resistant infection. So we’ll test them and guess what the SIBO situation is still going on. Maybe they have parasites or like you said, there’s a fungal overgrowth component to it as well, their guts leaky, their guts inflamed. Now they’ve got all sorts of other problems as a side effect of hitting this Rifaximin. In some cases, it can help maybe play whack a mole a little, it may knock some things down, but they still have enough problem when they come to us that we need further work. So I get frustrated with this integrative idea. Because and I know there’s good intention behind it. But as you mentioned, with that model, the way the model exists, it doesn’t doesn’t allow enough time and there’s not enough advanced testing, like we’re doing to to fully get to the bottom of it

Dr. Justin Marchegiani: Correct. And once you kind of talk to your conventional medical doctor, and you say, hey, walk me through your thinking on what you think the root cause of this could be. Usually it kind of reveals their that they really don’t know. Because if you’re just providing a drug to treat the symptoms, well, obviously, they’re not worried about the root cause because it’s Band Aid down below, right? So we kind of look at everything in my line, kind of as the SSS approach, right? You have the underlying stressors here, could be physical stress, chemical stress, emotional stress, food allergies, bacterial overgrowth, sibo, right, all of these stressors, increase our stress bucket, and then the body systems start to dysfunction, hormones, digestion, immune detoxification, as the system starts to dysfunction, then you have all this, the symptoms happen down below. And so conventional medicine just band aids, these symptoms down below, they don’t ever go upstream. So you got to have conversations with your doctors that talk more about the upstream issues. And so we try to nullify all of the underlying stressors, make sure foods good chewings, good, hydrations. Good. And then we’re going to do tests that look at the function of the systems. So it’s a lot different of approach. So if you’re working with someone, you know, you want to be able to ask the right questions, what do you think the underlying root causes are, and as a patient, make sure you walk into it with an open mind that there’s probably not one underlying issue, it’s probably a bunch of things that are spread out, that are part of the underlying cause, from a stress standpoint, and the body system standpoint that are emanating the symptoms downstream?

Evan Brand: Yeah, well said Well said, that’s a great, great visualization, and you have permission to have 4 5 6 7 8 9 10 things going on.

Dr. Justin Marchegiani: That’s the key, that’s that that’s the missing assumption, you could have a lot of different things. And then as you walk through with the clinician, and you’re making changes, you need to not go into it as Oh, I made this diet change and the supplement, I don’t feel better yet. It’s okay. There’s always a plan B, a Plan C, a plan D, a plan E. And if the answers down here, and E and F and you, you quit and get discouraged that B and C, then you never get a chance to kind of go deeper. So just as patients are listening here, always make sure you have that ability to kind of just like, have a good attitude and keep on progressing down the line.

Evan Brand: Yeah, and you can’t blame them on me. This is the way that people have been conditioned over decades and decades of conventional medicine, but it still does frustrate me when someone will approach us whether it’s a friend or a family member or something and they’ll say, Hey, you know, I’ve got autoimmune. I’ve got sjogrens or I’ve got alopecia or I’ve got, you know, diabetes type two. What’s wrong with me? Like, why did this happen? Where did this come from? It’s like, Where do I even start? You stay up till 1am? You posted a picture the other day on your Facebook page? Have you eating an ice cream Sunday? Yeah, never get exercise. I know what you do. You sit all day, you don’t get outside and you’ve never had a tan in your life. So you’re afraid of the sun. If you do go outside, you lather yourself in sunscreen chemicals. You don’t eat organic, you’re super stressed. I mean, you know, so when people ask, well, what’s wrong? Why is this happening? It’s almost like, Oh, are you ready for this? Because I’m about to open up Pandora’s box here. And I’m going to tell you 20 things of what’s happening, I’m gonna tell you 30 things of why this has happened to you. So it’s just a reeducation really, of telling people look, it’s there’s not a one smoking gun, rarely to you and I find one smoking gun.

Dr. Justin Marchegiani: Yep, I 100% agree. It’s nice every now and then where you kind of get a home run and functional medicine, when you kind of make a couple of changes. And it’s like boom, and you blast it out of the park. It’s always a good luck little ego check. Because you know, you work with a lot of difficult patients over over time. And so it’s nice to get a couple of home runs every now and then. But if you work with a good clinician that has the right algorithm and kind of goes through the things goes to the options that give you the greatest chance of success out of the gates, and then work to the things that give you the less success at the end, then you have the greatest chance of success as a patient early on. And you set the foundation for greater healing over time. So I think that’s really the most important mindset is clinically go with the high percenter options.

Evan Brand: Yeah, and I’m not being a bully here. And I’m not making First of these people, I’m just saying, we really need to re education. You know, you you people eventually come out of the woodwork at at you when you and I do what we do and they’re not ready for the red pill. They’re not you know, they’ll ask what’s wrong me? Why do I have diabetes? Or why do I have this headache? It’s like, ah, are you ready? Are you ready? Because there’s there’s a lot to uncover. There’s a lot to unpack.

Dr. Justin Marchegiani: Yeah, I think most people once they’ve kind of gone through the conventional medicine model, and they’ve kind of said, Hey, all right, well, I just don’t want to be relying on laxatives or enemas my whole life. What’s next? Usually, once there’s, they kind of have this level of like, okay, these are the only options I have from conventional medicine. There’s a level of openness that occurs from that, where they’re like, Alright, what’s next? What’s next? I’d see functional medicine and nutrition is helping people all the time, what’s next outside of this because they just kind of have this yearning that there’s got to be something more. And I think that’s creates a level of openness and readiness to. 

Evan Brand: Good point. Good point. Yeah. I often say people have to hit rock bottom or they have to be miserable enough to listen, I mean, you and I’ve heard countless stories of husbands and wives that are stubborn and they want to eat the pizza while the other spouse has to eat the grass fed steak and sweet potato that grass fed steak sweet potato tastes better anyway. So I don’t know what they’re doing. But But anyway, they’ve got to have their own issue right? And then finally, once the other person once they get miserable enough, then finally they’re they’re willing and you don’t have to drag them into this whole thing as much.

Dr. Justin Marchegiani: No, I totally agree. Well, if you guys are listening, and you enjoy the podcast here, put your comments down below. Really appreciate the thumbs up and a share. We also reviews are great JustinHealth.com/iTunes, EvanBrand.com/iTunes. It’s great. If you feel free to head over to EvanBrand.com you can schedule an appointment with Evan anywhere in the world. Vice versa with myself Dr. J at JustinHealth.com. We’re here to help y’all. And I appreciate you guys listening and just feel free to share this content with some friends or family that can benefit. Again, we’re clinicians that have had 10s of thousands of patients experience kind of combined, and we want to provide actionable information with y’all so you can take action and get your health back in your hands. So we really appreciate you guys being listeners and attending. 

Evan Brand: Take great care yourself. We’ll be back next week. 

Dr. Justin Marchegiani: Thanks.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-root-causes-of-constipation-slow-motility-podcast-331

The Gut Skin Connection – How Your Gut Health Can Impact Your Skin | Podcast #330

The gut and skin enjoy a constant dialogue via what has become known as gut-skin axis. In this video, Dr. J and Evan are discussing that while symptoms of gut health issues can be incredibly varied, the skin is often a great barometer for what’s going on inside the gut.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:51    Different Skin Aspects

5:37    Getting Good Skin

13:12   How Gut affects Skin Health

20:28  Collagen Benefits

28:52  Tips to Remember

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

https://www.youtube.com/watch?v=VizOZ1ZMo6g

Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here today we’re going to be talking about the gut skin connection, how your gut health can impact your skin. This is a, you know, quite a big topic of discussion. A lot of my patients have gut health hormone health. And part of that whole sequelae of symptoms is going to be skin issues. And it’s important right skin kind of is your first representation to the world of who you are and your health. And if you’re healthy, you want good skin as a byproduct. So we’re going to dive into that and talk about, you know, things you can do to improve your skin and your gut health. If it’s not at an optimal level, Evan, how are we doing today, my friend? 

Evan Brand: Doing really well. And you’re right, when you see someone your initial gut reaction, you know, they say, Don’t judge a book by its cover. 

Dr. Justin Marchegiani: Pun intended.

Evan Brand: Exactly. When you look at somebody, you go, oh, wow, they don’t look healthy, or they look pale, or they look frail. Or they look weak. I mean, we make a lot of quick judgments on people. So you know, for the people listening that are like, well, I don’t really care about my vanity, you know, that’s so vain or whatever. It’s like, Well, do you want a good paying job? Do you want a good spouse? You know, you might not even get to the second date. If the person looks at you and goes, Oh, wow, you know, this person looks unhealthy. They look sickly. So I think it’s, it’s important to try to go beyond feeling vain about it and know that as you mentioned, your skin is it’s it’s a picture of your health picture. And my skin was a really good barometer. For me going through some of my detox protocols, my wife would look at me and say, Honey, you look pale, and I would go take a binder and then all of a sudden my skin tone would get better. It was almost like I was recirculating toxins. And then when I took my liver detox or binder support, my skin looked better. So for me, I kind of personally use it as a barometer. Or if I eat dairy as a treat, I may see acne pop up and I’m like, Oh, look at that. Look what I did. Here’s the effect of that dairy.

Dr. Justin Marchegiani: Yeah, totally. Yeah. And the pre show, we were trying to figure out effect versus a fact. Right? And so effect is the end result. A fact is, is the verb so we’re trying to wrap our heads around that the English language is quite the the crazy thing. So yeah, absolutely. So skin is very important. So there’s a lot of different aspects of skin right? Its first aspect is, you know, just keeping acne and skin rashes under control, whether it’s psoriasis, or eczema, or just general acne, there’s different food allergens that can have effect on that. There’s different enzyme and acid and just indigestion with foods, not breaking them down, that can have a big effect on that. And there can also be things like hormones. So whether it’s elevations in testosterone with women, whether it’s, you know, testosterone, androgens, that can have a major impact on women’s skin. Also just inflammation in general food allergens, in general, high levels of insulin can create more oil from that sebaceous gland. And that sebaceous gland, that oil can feed a lot of the bacteria on the skin, which can create, obviously the acne vulgaris bacteria feeding and creating acne. So there’s a lot of different mechanisms, right. So when you look at skin health or anything, is a lot of different components. And so food allergies are one component in digestion, not enough acid and enzymes, a component and of course, things like H. pylori, and bacterial overgrowth and fungal overgrowth, and parasitic infections can all impact that. And then of course, female hormones can play a big role. estrogen dominance is a big thing. Insulin resistance is a big thing. Insulin resistance can feed excess androgens and women, that’s a big thing. And then of course, increase aromatization. And estrogen in men can also feed skin issues as well. So there’s a lot of different connections here that play a big role. And of course, certain nutrients, if you’re deficient in zinc or vitamin A, can also play a big role in skin health as well. And then, of course, poor detoxification, because your skin is the integumentary system. And it plays a major role in detoxifying. So the biggest organ of detoxification in the body. So there’s a lot of different mechanisms here. And we’ll kind of dive through them one by one.

Evan Brand: Imagine how much profit we could reduce from the makeup industry. If Well, I guess it would be a multifactorial process, right. And number one, you’d have to convince women that natural skin is beautiful, and that you don’t need the six inch long eyelashes and all that. But imagine how much of a hit we could put into the makeup industry if we were to improve people’s skin because you have so many women that they’ll say oh, well, I wake up with bags under my eyes. It’s like, well, it’s not the bags that are the problem that needs to be covered up by makeup. Those bags under the eyes are the clue that maybe there’s some lymphatic issues or there’s some detoxification issues. And so many women, yeah, food allergies. You’re right. I mean, I have so many women that report that just by working through some of the protocols that you and I use that they need less makeup, and of course their husbands are always wanting women to look more natural anyway, at least my wife, I look at her and I’m like wow, she’s naturally pretty, I don’t think you need or should be putting stuff on. So and of course, there’s the mental brainwashing of society and the psychology behind makeup and all that that we don’t have to get into. But I think from a biochemical perspective, women should embrace the way they look and use that as a motivating factor. to work on these underlying issues that we’re talking about, meaning don’t just go for the foundation or whatever, it’s called to cover up the bags, let’s fix the bags.

Dr. Justin Marchegiani: Yeah, and ideally you get healthier so if you want like a natural healthy makeup option, there’s some decent ones out there, you need less of it to kind of get the job done. You know, because some women it’s, it’s, it’s part of who they are is they’ve been doing it for so long. So let’s just try to reduce it and try to use healthier ones that are going to be less toxic, right?

Evan Brand: Yeah, and the Environmental Working Group will just get that out of the way now the Environmental Working Group has done a great job of their skin deep database you and I’ve covered that I know you’ve mentioned some of the micelle products and some of these others that that are that are helpful.

Dr. Justin Marchegiani: Yeah, I like the Marie Veronique has a couple other good companies from a skincare standpoint. So the first rule of thumb when you’re supporting your skin is do with food. Right? Don’t put toxins and food allergies, fix your gut. Use good nutrient dense foods right your skin needs high quality fats. It needs high quality amino acids. It needs collagen in each vitamin A it needs zinc. It needs a lot of good nutrient dense foods to support it. We also want to decrease inflammation right? A lot of the junky omega six fatty acids, trans fats, foods that are refined processed grains lots of sugar that drives insulin. Insulin feeds the sebaceous glands to make oil oil can feed bacteria on the skin and create acne. And then of course, food allergens can also drive eczema can also drive psoriasis, sub harangued dermatitis right, a lot of these things that are fungal or bacterial or autoimmune base can be driven by a lot of these things. So foods really important. And again, there’s a big disconnect in the dermatology community, like you go to a lot of conventional dermatology offices, they’ll say in some of the pamphlets like food does not influence your skin. And that’s an absolute crock of crap. Right. And part of the reason why that’s the case is because dermatologists aren’t educated in nutrition. They’re not doctors in medical school, conventional allopathic doctors have very little education and nutrition. And when they do, it’s primarily from the aspect of disease, vitamin connection, right? scurvy, but low vitamin C very, very low B one, right? A lot of these diseases that are connected to low nutrient levels. But we know health is not about diseases, it’s about a health is on a continuum. And so the extreme end is a disease but there’s a lot of stuff in between, that we’re looking at. And part of that could be skin issues. And so certain nutrients play a big role. And I can tell you having seen 1000s of patients and hundreds who have skin issues, and I’ve been able to have you know 95 99% resolution with these issues, partly because of the fact that diet plays a major influence. So foods, keeping carbohydrates in check reducing insulin, insulin and women drives lots of androgens, androgens will create more cystic acne, inflammation, even dairy like even sometimes butter in really healthy people could be a problem. So I always say anytime you have any acne issues, we’re cutting out 100% dairy, even carry gold grass fed butter out of the gates. And that’ll be one of the first things we try to add back in as the skin gets clear to see if it’s kryptonite or not. But that plays a very important role. I’m trying to get more zinc in your diet, whether it’s like pumpkin seeds or oysters or just high quality grass fed beef zincs very important can always throw in some extra zinc in your molti or in a zinc lozenges things are very important for the skin vitamin A very important some studies back in the 1920s on to dermatologists called Pillsbury and Stokes and they found that probiotics and called Never Oil were very important for skin health. This is 100 years ago. So the fact that dermatologists aren’t up on this literature is just ridiculous. It’s because they aren’t interested in a nutritional intervention. When you have retinae and clindamycin and Accutane and tetracycline and, and different, and you chrissa and you know, all these different medications that are used for skin, right, that’s what their go to is and that’s what they’re educated on. And it doesn’t fix any of the problems anyway, it’s it covers it up. And so a lot of other things that can be done and have been done for a very long time.

Evan Brand: It’s funny that you and I are not dermatologists, but that we have, in most cases, better results than dermatology offices. And at least if it were a comparable success rate, like with their drugs, that’s palliative care. And what we’re doing is root cause care. So maybe if you took Joe Blow and Jane Doe over here, and let’s say they work through you and I and our protocols and testing, and then they go to the dermatology office and just get the Accutane or whatever, maybe in terms of look, maybe you’d make the person look similar because those drugs do work. But then you get off of them and things go backward. But man, all I’m saying is I think we’re better at skin now. I don’t know how to recognize melanoma. My grandfather’s had it and he’s got it cut out. So in those skin cases, yeah, go to your dermatology office. But if it’s more of these chronic issues, these more functional scan issues. I tell you, we’re gonna have much, much better results and somebody listening may hear what you said and go oh my god, he said 95 to 99% success rate. You’re not you’re not inflating those numbers. at all, I can tell you with confidence those numbers are legit that you’re saying because I’ve seen the same thing, even within just six weeks of Gut protocol, sometimes we’ve had 80 to 90% improvement in skin symptoms.

Dr. Justin Marchegiani: Yeah, I think dermatologists do a really good job at handling skin cancers. You know, I think that can be very helpful picking up melanomas. There’s also a lot of the autoimmune stuff that they recognize, it’s typically you know, they’re just going to recommend corticosteroids or some kind of, you know, immunosuppressant like Ella dal or you chrissa. They’ve done a lot of options, or they’re just throwing a lot of antibiotics on the skin, which can screw up your skin microbiome as well, your skin has its own microbiome. So some of these things acutely may be fine. If you have a teenage kid that has an acne flare, and you want to decrease the chance of scarring, right? That makes sense. But you know, what’s the long term solution, right, you need a long term solution outside of that, and they may not have those options for you. So it’s good to have someone in your back pocket know where they’re good know whether or not there’s getting to be more holistic ones out there that understand diet plays a big, big role. And that’s good to know. I mean, I think, you know, if, if your kid eats like crap, and your dermatologist says it doesn’t matter, and then that keeps your kids acne flaring. Well, that’s not going to fix any problems. And plus, we know skin requires nutrition, amino acids, fat soluble vitamins. So just kind of from like a foundational level, you need to consume good building blocks. So your body can repair and turn over and use those good building blocks to help your body becomes stronger, right. Food and calories that you consume and nutrients you consume. They’re not just for energy, they’re actual building blocks so your skin can turn over. So very important there. I think also with sunlight and things like that getting some sunlight don’t burn, right, minimal urothelial dose, if you’re going to go outside, make sure you’re using you know, for a long periods of time where you would burn make sure you’re doing a full spectrum sunscreen that’s in a block out UVA and UVB for a long time, we’ve only blocked out UVB light, and we let a lot of UVA come in and people will damage their skin because the collagen will get destroyed. If you’re chronically allowing a lot of UVA exposure, the UVB that gives you the burn is kind of the it tells you whether or not you’re out there too long. But if you block the B and allow the A in, you’re basically allowing yourself to potentially destroy collagen. So if you’re going to be out in the sun, use a full spectrum, UVA UVB maybe even a UVC to make sure you have coverage if you would get burned, and then try to get yourself some sunlight. And then for me topically, I’m going to be using some natural retinol not a lot of the retina the retina has a lot of side effects can create redness and irritation, don’t love it. But I’ll use some of the retinol with some vitamin C and glue to fire and in some of the skincare products that I use, I use a really excellent prebiotic probiotic miss that have good bacteria for my skin. Because I want to really support my skin microbiome. Those are really important things for me on the skincare side. And then of course, like keeping the food allergies down. Now, for some people coming out that have a lot of acne, we’re going to come out of the gates with some autoimmune stuff out of the gates because I’ve seen eggs and nuts and seeds, dairy and butter be problem. So we’re going to be a little bit more strict out of the gates. We’re going to make sure we’re digesting our foods really well indigestion is a problem. We’re going to look at the gut, the gut can play a major, major role. And I’ll pause there and you can you can kind of dive a little bit. 

Evan Brand: Sure. Yeah, I’ll take it further. So the gut, to me, the big mechanism is h pylori. Now parasites are big. I mean, you saw my skin was six, maybe I can’t keep up with yours, maybe six or seven years ago, my skin was messed up. And it was because I had various gut infections. I do believe parasites are a big contributor. But really, it’s hard to pick a smoking gun for the gut, because Candida bacterial overgrowth, parasites, they all contribute to the same thing, which is an issue with nutrient absorption, they create this malabsorption problem. But I think h polarize is one of the big ones for people because of what it’s doing with the parietal cells and reducing your stomach acid because then what’s really happening is you have this domino effect of the H pylori, then allowing the purification of your food which then creates the overgrowth of even more pathogenic bacteria, which then may allow parasites to thrive because now there’s not enough stomach acid to kill them off. So I really do think that h pylori was one of my big variables for my skin. And I can tell you with confidence that I’ve seen it in countless countless teenagers and people in their 20s that are still dealing with acne. If we get rid of H. pylori alone, we may have 60 to 75% improvement in the skin just based on that. And then the question is, well, can you bring in enzymes to help reduce some of the malabsorption and 99% of the cases? Yes, rarely is there too much inflammation or gutter rotation where we don’t do enzymes and acids out of the gate. But really, if I were a dermatologist running a brick and mortar practice, you know what I’d have on my shelf, I’d have digestive enzymes, and every client that comes in with skin problems, here’s your enzymes, and that would fix it. 

Enzymes and HCl as long as there’s not so much gastritis or gut irritation, definitely a combination of the two for sure. I 100%. Agree and then a good elimination diet plays a big role. These you know, if you have bags under your eyes, that’s called allergic shiners and allergic shiners. They’re basically a pool of the lymph under the iron because there’s a lot of lymph in this area. And so lymphatic increase lymphatic fluid increase is going to happen with inflammation. Think about if you bump your head or get in a fight and get a black guy, what happens there’s inflammation and pulling, while you’re doing that at a at a micro level when you have inflammation from food, and you’re going to see it in the eye area, because that’s where there’s a lot of lymph. So if you’re having allergic shiners, right, don’t carve it up with makeup, try to cut out the foods out of the gates, that’s gonna be a big one out of the gates. Make sure you’re consuming enough water, people that have chronically dry skin, it’s not a hydration issue. Remember, fats provide a lot of the moisture to your skin to be moist and not overly dry. So if you’re having a lot of chronic dry skin, you know, eat consume good water, right, but also really make sure your fats are up and make sure you’re digesting those fats that’s really important. And if you want to topically add some shea butter or some coconut oil to your skin, if it’s the winter and you’re in a really, really low humidity environment, you know, you may need to topically add a little bit of that to during the winter months if it when it’s drier out. So you may want to topically hit it. But you don’t want to get into the habit of only doing the topicals because you got to support your skin inside and out.

You know what’s amazing now that you mentioned it like that. When my wife and I first got together, it will be 11 years ago, our diet was not like it is today. And every winner her and I both we would get really itchy our skin would get red, we get really dry skin. I’m telling you, man, I did not put lotion on but maybe once this entire winter. And I used to have to do that all the time. How funny is that? We could put the lotion industry out of business with this advice too.

Dr. Justin Marchegiani: Yeah, I mean, you may topically need to add a little bit but you’ll be able to reduce the 80 to 90%. I remember when I was first trying to get healthy 15 20 years ago, 15 years ago, I was trying to low fat thing. I’m the gates and I remember one winner, my skin was so itchy and dry. And I remember I came across an article and I started adding in coconut oil and an olive oil. And I was just doing a tablespoon of a day and I remember being like Wow, my skin the dryness just it reduced at 90% with just internally adding fats, because I’m thinking like oh dryness, that just means more water, right, you need more water, but you need to be able to carry that water to the skin. And the fats provide that kind of support, the fats help bring that hydration to the skin. And so fats for me played a huge role. And I’ve seen that as well. And of course with all this fat phobia, the more dry your skin gets. That means the more inflamed is going to get the more inflamed the more redness and and and potential for other issues are going to happen. So if you don’t have enough fats on your skin that can create this cascade of a lot of other skin issues.

Evan Brand: Well, you know what else is I’ve noticed too, you know, Irish descent, at least some Irish some German. And years ago, I would never be able to get tan, I would just straight burn. And I rarely wear sunscreen, maybe you advise me different. But I typically just wear like a big sun hat in the summer. If it’s like 95 degrees and it’s frickin hot. I might do some zinc oxide if I’m out all day, but if I’m just out like half an hour plane in the garden, and then I’m gonna head back in and cook lunch or something I’m not putting sunscreen on I’m just out there with no shirt. And I used to just burn so bad even from that dose. Now, I don’t burn. The fats are helping me not burn now. Maybe it’s the meats to the collagen. I mean, there’s something changing where I just, I can I can bronze now, which is pretty interesting, especially for an Irish guy.

Dr. Justin Marchegiani: Yeah, the fats definitely play a big role and helping to bring calcium to the skin that can be I’ve seen that be something also having a lot more of the bioflavonoids whether it’s Grapeseed, or a lot of the antioxidants, those can go to the skin and also have an SPF kind of factor. I know Grapeseed extract plays a big role. A lot of these oligomeric proanthocyanidins, which are like these antioxidants, and in fruits and vegetables can play a big role. The fats, like I mentioned, the omega threes play a big role.

Evan Brand: Oh, you make a good point. Yeah, sorry, I forgot to I forgot to mention that. Yeah, I mean, I do a ton of blueberries like come spring, early summer, I’m doing a ton of blueberries, I think you’re right, there’s probably some antioxidant factor too.

Dr. Justin Marchegiani: Antioxidant factor, there’s a good fat factor, the fast to play a big role with bringing calcium up to the skin, which I know helps. And then obviously having enough zinc plays a big role because we typically, the more natural skincare is going to use like zinc oxide or titanium dioxide for kind of natural sun scare sun skincare. And so of course that that has a deflective aspect to it. And I imagine that the zinc that you consume orally is also going to play a big role. So like in summer months, you know, I’ll bang down six to eight oysters in a week. And you’re getting you know, eight milligrams of zinc per oyster. So if you bang down eight or nine oysters, I mean you’re getting 70 or 80 milligrams of zinc and you know the daily requirements only like 10 so you can get like a week’s worth of your zinc in one oyster session.

Evan Brand: Wow, that’s impressive.

Dr. Justin Marchegiani: Yeah, so it’s really good and you can also get some extra from pumpkin seeds too as long as you tolerate the seeds.

Evan Brand: Yeah, I actually had some pumpkin seeds yesterday they were good just some I got some sprouted ones supposedly those are easier to digest so if someone reacts, maybe tried to sprout it I personally don’t have an issue either way. So some one thing to consider Alright, so we hit the gut infection piece. You did great hitting on some of the nutrients Stephen some of the good nutrients that would be in a multi which you and I make some really professional multis.

Dr. Justin Marchegiani: Alright guys, you’re gonna have 20 or 30 milligrams of zinc in there. So that kind of gives you a good whack and then if you’re adding in, you know, mushrooms or grass fed beef, right or any some of the healthier nuts and seeds that are out there, that and obviously, that’s gonna play a big role and then collagen, collagen really helps because we’re just not getting a lot of collagen based amino acids, right, we’re getting a lot of muscle meat, we’re not getting a lot of skin or joint. So having the skin on your chicken or chicken thighs very helpful, right having soups or bone broth helps. And you can also really take an excellent collagen amino acid support. I know mine, we use collagen from grass fed cows and we also use proteolytic enzymes to help break down those amino acids to make it easy and you can mix them in your water you can mix them in your tea or your soup or your coffee. So it’s just a great way to get extra building blocks for your skin. And it also helps your hair and your nails and your joints.

Evan Brand: I was speaking to college and let me do a little rant here and an anti plug. So the bulletproof collagen bars I used to eat those. Dave Asprey is bulletproof company, who he was the CEO of and then he stepped down couple years ago and now the ex or current CEO of hostess who makes like ding dongs now he’s the CEO in charge of bulletproof product. Anyway, I was at Whole Foods a couple weeks ago, I used to love eating those collagen, like the collagen bars, you know, it’s like a hydrolyzed collagen with like a little bit of stevia or monk fruit in there with some organic cashews. And I go in there, and there’s a new box, and it’s like new and improved recipe and I’m like, Yes, this is gonna be delicious. And I didn’t even read it because I just thought, okay, it’s gonna be awesome, right, you know, and I get home and I start to eat it. And it’s like real slimy. And it used to be kind of crumbly. I’m like, What’s weird wise, it’s slimy. Maybe I got a bad batch or something. And I flip it around, I look at the label. And it’s no longer organic cashews. Now it’s just regular cashews. And then now there’s safflower oil, which Dave was extremely anti bad oils. So now there’s safflower oil in there. And there was one other thing that tripped me out. But yeah, so safflower oil from organic to non organic nuts. And then there was one other thing. So luckily, I was able to return them and get a refund. But that used to be my go to thing that I’d recommend for people to get a good easy source of collagen as a snack, and I can no longer recommend that product.

Dr. Justin Marchegiani: Interesting. Yeah, I had an experience to where I bought a mainstream collagen brand at Whole Foods, I have my own called Tru collagen, but I ran out. And I needed something right away, because I typically put it in my coffee or tea in the morning. And I grabbed the you know, good one, or named a brand that everyone will recommend put it in my coffee and my coffee tasted sour as heck. And I’m like, this is unflavored what’s going on. And basically, there’s two ways you can manufacture collegen. Of course, like you buy the best raw material you can, but then you got to break that cut, you know that collagen into peptides, right. And so there’s two ways you can do it. You can do it with sulfuric acid, or you can do it with enzymes. And so mine we do it with enzymes, which gives it a very, very neutral taste. So when you mix it and stuff, there’s not an extra taste. But this brand, I guess had used sulfuric acid because that’s the major side effect is you get that little bit of sourness or a little bit of a bitter aftertaste when you mix it and things. Now it’s like, oh, okay, got it, even though it’s unflavored. And you don’t see anything in the ingredients. You know, how you extract those, how you extract those amino acids matters, and it can really affect the taste.

Evan Brand: Wow. So I’d love to put them on blast. But if you don’t want to, that’s fine. And we’ll just tell people that storebought is not the best. And there’s a reason that Justin and I have professional healthcare manufacturers. And there’s a reason that what we have is considered a practitioner grade, you know, I get kind of annoyed when, when people will market supplements as like pharmaceutical grade because pharmaceuticals are crap. They’re filled with corn and fillers and all kinds of garbage. So when I see like, you know, pharmaceutical grade, like vitamin C, it’s like, ah, get out of here with that crap. So I would just prefer that we use the term professional, professional quality. And that’s not bs marketing. That truly is a difference.

Dr. Justin Marchegiani: Yeah, when people say pharmaceutical grade, because there can still be a lot of crap and pharmaceuticals, it’s more like the cleanliness of the factory or the manufacturing facility is very clean. But you could still add a whole bunch of crap into the supplement that’s not clean. But because the the manufacturing process is clean. It’s it’s pharmaceutical grade, right? And so yeah, so it’s professional grade, because we’re also cutting out all of the extra crap that we know isn’t going to be as good fillers, dyes, corn, you know, potential glutens all those different things that aren’t not going to be as good so for sure we keep all that in consideration and then We also do testing, right? I mean, we, I tested bunches of ashwagandha from major, you know, manufacturing people that we get it in and we test it and it’s got lead in it, we’re like nope, see later, you know, because we need to have the highest quality of product because we’re working with patients and we need to, we need to have a clinical outcome. It’s not just selling something and making some money, I need a clinical outcome, I need the highest quality because that matters, the outcome really matters. So you’re 100% right on that professional grade, so where to go. So we talked about collagen, I think low hanging fruit anyone, you could always do tablespoon of cod liver oil a day, tablespoon or two across the world, the vitamin A, and there’s excellent central fatty acids really good at eating high quality animal products is obviously going to be great. If you’re not doing high quality animal products, we’ll fix your digestion. But you could always do some seafood. If you can do that, you could always do some egg yolks, you could do that. You could also do some nuts and seeds, as long as you can tolerate them, especially the pumpkin seeds can be really good or chia seeds can be really good, or at least some algae on that side of the fence can be great. And then I would say make sure you’re pooping every day, make sure your bowels are regular. If you’re not going every day, you can be reabsorbing a lot of toxins in your gut. And if you have a lot of bacterial overgrowth, what happens? The bad bacteria Creek creates an enzyme called beta glucuronidation, this enzyme de conjugates metabolize estrogen. So what happens is you bind these proteins to estrogen. And these proteins are that you’re basically conjugating you’re binding this protein, and that allows you to excrete these hormones. And this enzyme comes in their ad conjugates. It breaks the handcuffs and allows those hormones to go back into general circulation. And so it’s possible that bad bacteria can really create hormonal imbalances. And if you’re a female, and you have potential estrogen dominance, that can be part of what’s going on. And so estrogen dominance can drive hyperpigmentation and skin issues as well. So you got to be on top of that. And of course, if you’re taking the birth control pill, you can almost guarantee that you’re going to be in that estrogen dominant state as well, because you have all this synthetic typically ethanol estradiol in your bloodstream as well.

Evan Brand: Yeah, well said. So we technically could have called this something like the SIBO hormone skin connection or something, but it is all connected. And we do find that when you get gut infections resolve skin’s better. And also, when like you mentioned, you’re knocking out the gut infections, you’re able to lower the beta glucuronidation. And now that pathway, the glucuronidation pathway works more efficiently. And then you get other toxins out to like mold toxin. So you can have skin issues with mold toxin, I certainly did. And that’s because we know that mold toxin can affect the gut barrier, mold can create leaky gut. So if you are treating the infections, you don’t get that toxin out to you’re not fully out of the woods. And in regards to testing, let’s mention that real quick. And then we can wrap up. So if you’re working with somebody like Dr. Justin and I what we’re going to be doing is a GI map stool test or similar, we’re going to be using organic acids testing, maybe some hormone profiles, and maybe some other toxin profiles. So with urine and stool, we can get so much information into this. And your dermatologist is never going to run a stool test. They’re never going to run an organic acids test and find that you have clusters and Candida and strep and klebsiella, Giardia and H pylori and give you herbals to kill it herbal antibiotics antifungals. That’s never the protocol. So I’m not saying don’t go to them. I’m just saying if you want root cause solutions. These are the types of tests and solutions you need to implement. Not a topical steroids, which is exactly what my wife got prescribed when she had a lot of issues. They did a good job with testing, but it was a patch test. And they found that she was reacting to some parabens and all the garbage that was in her conventional skincare products at the time. So they at least did a good job of testing that. But they never tested the actual body. They just tested the chemicals. They didn’t go and say hey, what are the deeper underlying issues? Oh, you’ve got poor methylation poor detox function. You’re not pooping. You’re pooping once every three days. They don’t go into that.

Dr. Justin Marchegiani: Yeah, 100% you know, so we got to try to get to the root underlying issue. The problem is when you do steroids, you also weaken your connective tissue, you weaken the skin, and then it sets you up for more dependency. And then it also weakens the immune system and it could also create more blood sugar imbalances, especially if you’re having to use a lot of steroids. And that blood sugar, guess what, that can increase insulin and increase insulin increases what more sebum oil production, potentially more acne. So a lot of times these medicine medications can create a vicious cycle. So you got to be very, very careful with that. So out of the gates, kind of what’s the Reader’s Digest version, work on the diet, work on your carbohydrates, work on certain nutrients, fat soluble vitamins work on digesting your protein, adding college and adding vitamin A and zinc. Get your gut looked at work with a good functional practitioner. If the low hanging fruit things aren’t working? Right, it’s okay to you know, stop guessing and assess what is going on. Also, put your comments down below. Let us know things that have already helped you in the past. I’m curious to know, let us know your successes. Also feel free and share this information with friends or family that are suffering or dealing with issues and want to dive into the next step or want to do deeper testing into it. Give us a thumbs up, I really appreciate it. And we’ll put our links down below you want to reach out to Evan EvanBrand.com, great place to go. You can schedule with Evan worldwide, as well as myself, Dr. J JustinHealth.com. As well, we’ll put links underneath as well where you guys can review our podcast, we appreciate your feedback. This helps us to help more people. So if you’re enjoying this information right now, give us a quick review just a sentence or two, let us know if we’re doing good. And if we’re not give us some feedback, we always want to do better, Evan, anything else you want to highlight?

Evan Brand: Yeah, if people are just sitting there like maybe they’re like halfway awake, or they’re daydreaming, snap back into reality, review us, we will love you forever. We really do need the reviews, it helps us beat out other people. You know, we don’t do ads on this show. Maybe one day I’ll go back to doing some if I have a good partner that we work with again, but for now, this is a non ad show. And so many other shows are just filled with it. You just have to put up with the spam, we try to give you guys all killer, no filler. So I hope you recognize that. Take the two seconds go on your your app. for iPhone users, it’s probably the easiest. That’s the best place to review us on your Apple podcast app, see the show, click write a review. Boom, give us the stars you think we deserve? Give us a few comments. It really helps motivate us, you know this kind of a thankless job, you’ll get hundreds of thousands of downloads and then maybe two people are like, yeah, that was a good episode. So we really want to hear it. And we really appreciate it. It’s what keeps us fueled up and just mentioned the links, don’t hesitate to reach out. We’re going to save you more time and more money. Yes, you got to pay to play, so to speak to get labs and console’s done, but I tell you if I knew what I know now, man, I could have saved myself years of suffering with my skin issues throughout high school. I mean, I just had, it wasn’t the worst that wasn’t the pizza face, kid. But I certainly have my my issues with acne. And man, if I would have been able to get it dialed in now like we do for some of our kids and teenagers that you and I work with. Wow. And we’re literally changing the trajectory of their entire life. It doesn’t go this is like I said the beginning. This is beyond the vanity. I mean, I had a kid in California who’s 17 and now that his skin is so much better he’s so much more confident he got a promotion at work so he’s making more money. He’s feeling better he’s got a new partner so he’s you know, he’s he’s with a female now and he was previously too like embarrassed to to want to date anyone. So I mean this this could affect everything. Career finances, this is not just how you look in the mirror. So I want people to go beyond that and think about how much more could you achieve if your skin was better? And I think the sky’s the limit.

Dr. Justin Marchegiani: Yep, also scanning god are intimately connected. If you have skin issues, you may not be breaking things down. You may be gassy. You may be bloated. So look within right above below inside out. Alright guys, hope you enjoyed today’s podcast. Really appreciate it. Share, care, thumbs up review links below.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-gut-skin-connection-how-your-gut-health-can-impact-your-skin

Recommended products:

TruKeto Collagen

TRUCOLLAGEN (Grassfed)

La Roche-Posay Lipikar Cream

Mother of all cream

Winter Skin Care Tips: Get Rid of Dry Skin | Podcast #320

Winter can wreak havoc on your skin — making it dry, itchy, and irritated. And it can feel like there’s no escape: Cold, blustery conditions outside can leave your skin feeling raw, while indoor heat zaps moisture from the air and from your skin.

In this podcast, Dr. J and Dr. Evan are talking about skin problems that you might encounter during this season. There are many simple ways to combat the causes of dry winter skin and help keep your skin feeling moist and supple all season long, including some easy changes to your everyday routine. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:23    Skin Issues

4:43    Detox Pathways

13:24  Infections

22:00  Humidity Issues

24:07  Proper Digestion

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan Brand. Evan, hope you had a great new year great holiday season so far. Today we’re going to be diving into skin issues dealing with skin issues coming the wintertime, all the different things that may happen due to dryness, cold. Lots of sweets from the holidays in the New Year’s all that stuff. Let’s dive in man. How you doing? 

Evan Brand: Doing well. Happy New Year to you. Happy New Year to everybody. This is the first podcast of 2021 Hooray, we need to like clap for a minute. Yeah, exciting. 2021 All right. So skin issues. While I was telling you about my daughter, Jenna, my little 1- 19 month old, she was having some really dry skin on the back of her arms and legs. And so we’ve done a couple of things to help her which is pretty cool. So I’ll share that right off the bat and then we’ll dive into some more root cause stuff. So we really upped up her fish oil we were giving her about it was two squirts of a liquid and it was a professional version so I don’t remember the milligrams but we just doubled their dose so we just kind of doubled her doubled the normal dose of omegas and that seems to help especially if we think what’s happening is like a keratosis Polaris, which is a common situation. And then secondly, we did a babo botanicals brand and it was called a colloidal oatmeal lotion and it was fragrance free. And it’s mainly just like shea butter. We tried coconut oil topically that’s always kind of my first go to for skin issues, but it didn’t touch it. It didn’t help it at all. But when we got this Colloidal Oatmeal Babo Botanical product, it was a game changer. And no This podcast is not sponsored by them. But hey, if you want to sponsor us reach out to great product above to share it with more people.

Dr. Justin Marchegiani: Very cool. Very cool. So we have the keratosis Polaris, which is where the [inaudible] and kind of just accumulates in the pores and, and you can get this bumpy chicken skin feeling usually like on the back of the arms on the button stuff, right? Is that what you’re referring to? 

Evan Brand: Yeah, that’s right. 

Dr. Justin Marchegiani: Yeah, you’re saying that the omega threes really helped that omega threes really make a difference and help improve the extra keratin deposits in the pores?

Evan Brand: Yeah, my wife had it too real bad when we first started dating and we’ve got around like, two to four grams a day of omegas and her back her arms feel perfectly smooth now. I mean, of course we got her gut better, we got her diet better, but I honestly think the biggest factor the biggest variable was the omegas.

Dr. Justin Marchegiani: Yeah, the extra omega threes can make a big difference. Also good zinc, extra zinc too can also help. That’s really good to know. So we also talk about skin diet plays a big role. So we have to kind of rule out things like gluten extra refined sugar can feed yeast and bacteria and these things can produce, you know various mycotoxins or endotoxins that can put stress on the liver in the body and you may see the skin reacting as a means to that you may see skin issues and breakouts as a means of that. Also, large amounts of sugar can cause insulin which can cause insulin surges, which can cause extra sebum and sebum, can cause can feed bacteria on the skin which can create more acne and more skin inflammation. Also, things like gluten can potentially drive autoimmune reactions like eczema, psoriasis, potentially even rosacea issues. So you got to look at dairy you got to look at gluten, you got to look at refined sugar that could be driving a lot of that insulin that could be feeding a lot of the microbe was the fungal the yeast, the bacterial overgrowth, which can obviously affect the skin too.

Evan Brand: Yeah, yeah. So what about eggs? I think that’s important to mention, too. I personally feel that pulling out eggs is a good strategy for people if they’re unsure of what’s happening with their diet and reactions, that eggs may be a culprit. And then also, conventional dairy. I know that was a big culprit for me. I would like to cheat on it a little bit and do like some grass fed cheese every once in a while but then even that sometimes I’ll notice a skin reaction to it.

Dr. Justin Marchegiani: Yeah, so eggs could definitely be a role. So for unknown I’d probably want to go autoimmune out of the gates, no grains, legumes, dairy, nuts, seeds, nightshades or eggs and keep the sugar down just so we’re not overfeeding bacteria and yeast which could be causing skin issues like I mentioned earlier. So that kind of be a first step. I always want to look at omega threes, right? Because that can help to KP the keratosis Polaris that can also just help inflammation. Your skin needs really good healthy fats. So if you’re a female and a lot of your skin issues tend to be more based around your cycle. I tend to like fats like borage or black currant seed oil, which are GLA omega six fats, a good omega six, but it can these kind of omega six like GLA fats can really help decrease a lot of the sebum and a lot of the stuff that may clog the pores of the skin. So I do like a lot of the black currant seed oil can be very, very helpful for women’s skin issues. That’s excellent out of the gates. Usually women tend to help it more but if you’re a guy and you’d have more of the KP or the bumps, that’s where really up in the omega threes can make a big, big difference.

Evan Brand: Yeah, awesome. How about detox pathways? Maybe we should mention that I think just supporting the liver I’ve seen personally, especially with kids, when we see skin issues will come in with some liver support. If it’s a kid who can’t take pills, we’ll give them some kind of a liquid liver support tincture and I’ve noticed a big difference especially under the eyes, you know, if we’re talking scan, we’re not just talking like bumps on the arms. We’re not just talking acne, we’re talking possibly like dark circles under the eyes. That’s often at least in Chinese medicine, they say dark circles under the eyes, his liver, and I’ve actually noticed that correlate quite well. When we bring up liver support dark circles under the eyes go away. So if you’re a woman, every morning, you’re doing your makeup. And here you are doing your powder foundation or whatever the heck you’re putting on under your eyes. You might not have to do that if you just support your liver. It’s funny how women, they can just cover stuff up with makeup, but man, we’re not going to cover up it. So we’re going to see the dark circles, we need to treat it root cause we’re not just going to, you know, put some powder on it.

Dr. Justin Marchegiani: Oh, yeah. And so with the we call allergic shiners, so what you see is a lot of lymphatic pooling, so you have a lot of lymph in the face area. And a lot of times what you see is the pooling of the lymph right under the eyes. And a lot of times that’s going to be food allergies, just go on Google type in allergic shiners, okay. And that’s a lot of times because of it’s not like an aging thing. It’s a lot of lymphatic stress because of certain foods. So like I mentioned, cut a lot of those big foods out, see how much that helps decrease the lymphatic pool. And you can also do things to support the lip, right? You can do rebounding, you can do whole body vibration, you can drink ginger, or burdock tea or essiac tea, things that naturally bright clover tea, red roots, etc. Things are naturally support the limp that can be helpful. But if you’re doing that, and you’re still eating foods that are inflammatory, that may still kind of counteract it. So ideally, you know, support the limp and cut out some of those commonly offending foods that may really help decrease that pooling underneath the eyes.

Evan Brand: That’s smart. I didn’t know the the food connection there with the allergies. So what about the darkness? Do you think that’s tied into any kind of toxicity? Or do you think just with the lymph in general, it’s just going to appear dark just because it’s stagnant no matter what.

Dr. Justin Marchegiani: Yeah, I mean, a lot of that just has to do with the length. I mean, we’ll pull up a couple pictures here in a minute. But anytime you really increase an immune response, you’re going to just get more lymphatic pooling, and you’re going to see it underneath kids eyes, or Yeah, it’s interesting on kids, and you also see it in, in adults too. But you know, it’s people put they go to the spa, you put a cucumber over it. Why? Because the cucumber telling tends to help disperse a lot of that lymphatic fluid. That’s the reason why. And let me pull up a Google image here so you guys can see.

Evan Brand: And sometimes it’s dark. And then sometimes it’s bags too. Oh, yeah. Yes. You look at the one to the left, though with the little girl. That one. No, go to the second one there. That’s what I’m used to seeing with people. Yeah, just that kind of darkness.

Dr. Justin Marchegiani: Yeah, I mean, it just has to do with the increased blood flow and lymphatic pooling. It’s really what it is. Wow. And just cutting that out can make a big, big, big, big difference.

Evan Brand: Yep. I wonder if there’s, there’s got to be a histamine connection to this too. 

Dr. Justin Marchegiani: Yeah, I mean, anytime you have a food allergy response, part of a allergenic response is going to be histamine at so-

Evan Brand: Oh go back up, go back up on the top there on that screen. The very top of there, it said, Oh, this is interesting. So it was talking about indoor allergens. So mold could be a trigger of the allergic shiners, too. I never even thought about that.

Dr. Justin Marchegiani: Yeah, I mean, anytime you breathe stuff into that sinus cavity, right? Whether it’s outdoor allergens, like dander or cedar or things like that, grass pollens, right of course, those can be a big role. But you know, you can see right here what causes it, right. So what happens is the the tissues and the blood vessels in the nose become swollen and a lot of excess fluid happens. People don’t understand when you have a histamine reaction. And a lot of times that causes things to vasal dilate. So these blood vessels get swollen, so you get a lot more blood, you get a lot more lymphatic flow, you get a lot more immune reaction. And that’s why all that stuff sends a pool right there because all that the sinus cavity kind of coming together right in this T zone here.

Evan Brand: There you go. Look at that pollution and perfume and other irritants. So women if there’s any left listening to the podcast, it’s still wear perfume. Stop doing that. That’s so bad. Do essential oils if you want to smell.

Dr. Justin Marchegiani: Exactly. If you want a nice scent do a good really good essential oil, do a lavender do a.. see trying to think of a bunch of other feminine herbs or feminine essential oils if you’re a guy do rosewood or do cedar keep it really simple. You know there’s a couple of really good blends that are out there that I like Frankincense is a pretty good neutral one. You know, I just tend to rely on my nice essential oil based deodorant tends to be really clean and, and works well. But yeah, so you want to not put in, rub toxins on your skin, toxins on the fragrances, all of that can affect bags under the eyes. All of that can affect your skin too, because it’s going to just create more toxicity, more stress on your liver in your body. Now getting back to the hormone stress, if we have more, let’s say detoxification problems that could create issues because if we have estrogen dominance, right, well we have high levels of androgens as a female, right high levels of estrogen estrogen dominance, and it can be low estrogen, but it’s just higher relatively speaking than progesterone, right? That ratio is off that 20 to 25 to one progesterone, estrogen often maybe it’s 10 to one or 15 to one That ratio starts to skew that could put more stress on the liver. And if you have estrogen issues that can be a problem. A lot of women when they consume too much refined carbohydrates and inflammatory foods, they tend to convert more of their estrogens to androgens, testosterone, right stauss rounds and androgen, it’s in the androgen umbrella, right. And those can cause like I mentioned a lot more sebum and more skin issues and more acne that way, and then having prostaglandin imbalances prostaglandin two, which is more inflammatory. Having them one in three supported with a lot of those good fats, like I mentioned, are going to be helpful. So you’re going to really help a lot of the inflammatory pathways with good fish oils, you’re also going to help prostaglandin one and three, which are going to help with the skin with the black currant seed and the borage oil. So those can be very helpful too.

Evan Brand: Good Good call. Also, when we’re coming in with detox support, you mentioned estrogen we’re going to come in with like some phase two detoxification support anyway, so we may come in with something to help with glucuronidation, maybe some calcium D glucose rates, so you wouldn’t think of it like your average person, maybe even a naturopath or a functional Doc’s probably not even going to think calcium D glue, great for skin issues. But if you think that the mechanism of helping with estrogen dominance, it may be a game changer. And then let’s go into the infections a bit. I–

Dr. Justin Marchegiani: Also calcium lucre could help with some mold too, because it was any mold exposure that could also help by enough to mold too.

Evan Brand: Totally, yeah, binders plus a little calcium D glue. Great. I think you’re on your way. Let’s Let’s hit on infections. I’m surprised you and I haven’t brought this up here we are this far. And we haven’t thought about infections. I mean, that was a big one for me. I think my face was already better. But I was still suffering quite a bit when you and I first became friends my skin was still not very good because of all my gut infection history.

Dr. Justin Marchegiani: I think you were also still consuming some higher quality dairy that may have been a problem. So some people that are doing a lot of cheese or like milk even if it’s raw. Right and good quality, you may still have a problem with that even if it’s really good clean dairy. Usually butter or ghee tends to be okay because there’s less casein less lactose in there almost none. But if you’re doing other stuff, it could be a problem. Was that an issue? Evan? Do you remember the dairy being a problem? 

Evan Brand: Man, you remember Central Market and all their amazing cheeses I would do some of those grass fed organic cheeses. It wasn’t often though I’ll be honest, it would maybe be like a chunk of cheese every few days or so. But I think even that was too much for me. 

Dr. Justin Marchegiani: Yeah, and you know, I tell you I can do well with butter or ghee, but I do not do well with milk or cheese as well. What happened is gassy, tend to get loose stools and then skin issues will tend to manifest shortly after for sure. So even high quality dairy not that good. Now the fat based dairy, right? Butter and ghee tends to be different because it’s primarily 99% fat. There’s very little casein, very little lactose, which is the sugar in dairy. And so of course, gese even cleaner than butter because there’s virtually zero casein versus virtually zero. lactose in there. So I tend to be a lot better.

Evan Brand: I mean, it’s curious. How do you do with whey protein? Are you okay with it?

Dr. Justin Marchegiani: Yeah, I do. Okay, with wakers weighs 99% casein and lactose free? Mm hmm. Yeah. tends to be a lot better. Yeah, I do okay with it. My favorite is gonna be collagen, you know, high quality grass fed collagen peptides. So I do my true collagen blend, which works great. Because there’s really it’s it’s in a peptide form. So there’s no other larger proteins in there. It’s really clean and well broken down. So that tends to do my powder standpoint does really well.

Evan Brand: Awesome. All right. Well, let’s just talk a couple minutes about infections. I think this is an important part to consider if you have skin issues, I’ve worked with countless small children and teenagers and we always are going to look at the potential for infections. There’s nothing in particular, I’m not going to say hey, it’s got to be blasto. Or it’s got to be this or that. I would just say in general, any type of dysbiosis bacterial overgrowth SIBO Candida H. pylori, the whole party that usually happens together is going to be a potential. And I think the one of the big mechanisms here is just to reduce stomach acid by the H. pylori. So I think enzymes to fix the skin are also another important strategy we’re going to implement.

Dr. Justin Marchegiani: Anytime we have indigestion and our protein and our fat and carbohydrate molecules of the food that we’re eating are larger and are broken down. You’re going to have intolerances, foods not going to be broken down all the way. And those large globules, proteins, fats, etc, can get into the bloodstream create more immune reaction, also, there’s going to be a fermentation that happens when those food molecules are not broken down all the way and that can create bacterial overgrowth. And we know hydrochloric acid does have a way of being disinfected in a way it really decreases. bacteria and yeast flow to the intestines. And if we have low levels of acid, it’s kind of like missing the natural disinfectant on your table. Right? That you know that can help clean things up in your body so that that’s definitely a real thing there. And the other component i would say is being because we were kind of talking about the holidays and Christmas is it can get very dry in the wintertime and a lot of places in this country. And so having a really clean moisturizer can be helpful. Now it depends So we’re just talking about, you know, person with dry skin, we may just choose a really, really good clean shea butter, or coconut oil or just a really clean, moisturizing product from a high quality company. And you can use skin deep cosmetic database Environmental Working Group database to look at healthy skin products that have really good ingredients in there. I like to use the Marie Veronique products. I like their lipid barrier complex and their barrier restore serum. They work amazing. I use that on my skin. And I had one child that had eczema, he’s kind of gotten over it, he’s done really well. We’ve kind of cleaned out the his diet and his mom’s diet too. So things like salicylates could be a potential problem outside of just your autoimmune foods. And then we use a really clean, hypoallergenic moisturizer called Vannapply. Again, it’s not anything like nutritious for the skin. But sometimes when the skin’s inflamed, immunologically, from an autoimmune skin issue, sometimes the skin just needs moisture and not things that could potentially stimulate the immune system. So sometimes a clean thing like that can be very helpful. So that applies very good. There’s another product called La Roche-Posay, I’ll pull it up, it’s a French brand of a moisturizer. And that works very good, as well as providing just really good moisture. And then sometimes we may have to change the environment, sometimes it gets very, very dry, you know, 20, to 20%. And humidity, we may have to add a humidifier into the kid’s room or into the adults room to get a little bit more humidity in the room. The big X Factor is don’t just leave it on non stop, because you can actually create mold it with a humidifier if it’s unchecked, unchecked Uncharted. So you have to make sure that if you’re adding humidity to the room, it’s for a season, it’s for a reason it’s for a short period of time. And you may want to have a humidity detector in the room just to make sure you don’t get above you know, 50% where mold could grow.

Evan Brand: Yeah, you know what I was thinking I’ve never seen it, maybe it exists, it’d be cool to have a humidifier that actually has an hygro hygrometer built in. So like you could set your for you know, 40% and then you’re pumping humidity in and then it hits 40 and shuts off. That’d be super cool.

Dr. Justin Marchegiani: I 100% agree. Yep.

Evan Brand: So I think the x layer would be good too for just to implement this as a tangent, not related to skin. But the xylitol spray for the sinuses are is awesome too, because that can help moisturize it. And the next layer is kind of a good, natural antimicrobial, if you will, it can help a little bit with the sinus cavity. But yeah, back to the skin. So how we’re going to investigate this was peoples, we’re going to start with diet, we’re going to come in and say, probably remove the eggs, definitely get off the dairy, get off the gluten. And then we’re going to come in and do stool testing, we’re going to do urine organic acids. So we can look at all the different bacteria that may not show up. You see, sometimes what happens I had to happen last week, we had a guy who, on the organic acids, he looked pretty good. There wasn’t any kind of bacterial overgrowth evidence, but when we got to his stool test, he had Prevotella and klebsiella, and all sorts of bacteria off the chart. And so if someone’s on an extreme budget, maybe one test would be sufficient. But in most cases, we’re going to try to get the full picture because it’s hard to make a puzzle complete if you don’t have all the pieces. And so that’s really why we’re gonna want to look at multiple things. And then as you mentioned environment, we’re going to factor that into, and then potentially improving the indoor air quality. So what if you are having some sort of an allergic reaction to your environment, whether it’s mold or dander, pollen, or whatever, something like a really good charcoal filled air filter, it’s going to be a game changer, possibly putting charcoal in your body, you know, supplementing with binders, and then addressing any infections we see supporting the liver bumping up omegas. I think stress has a factor. We talked about hormones, we talked about the estrogen we talked about glucuronidation. I think those are really the main variables. Do you think we’re missing anything else?

Dr. Justin Marchegiani: No, I think we hit it pretty well. My only other component is if you have eczema or psoriasis, and your skin’s overly dry and you’re trying to get the dryness down while you’re fixing the root issue. I mentioned the vanapply vanicream product being good. And the other one was the La Roche-Posay, and it’s the lipikar balm is a nice one. It’s just a lot of moisture, which can decrease a lot of the dryness and then when the dryness is decreased, that decreases the itching and when the aging is decreased, that can help decrease a lot of the inflammation. But you have to make sure a lot of people when the eczema psoriasis kind of Facebook groups because I follow a lot of them just to read what they’re doing. They want a magic solution. They want something to rub on their skin and have it all go away. But that’s never how it is. So you typically have to get to the underlying issue with foods and guts stuff too. So make sure if you do something that’s a lotion that’s topical, make sure you’re not ignoring the internal stuff.

Evan Brand: Well that one sounds so fancy. It’s got to be good just based on the way you pronounce the name of it.

Dr. Justin Marchegiani: I know like a nice little long French name there with the Amazon links in the description so you guys can access it. And then you mentioned the other one that had the oatmeal in there. That was really clean. What was the product?

Evan Brand: Yeah, I’ll give it the link to it it’s like a there’s like a kid’s, like fragrance free version. It’s like a colloidal oatmeal product.

Dr. Justin Marchegiani: It began with a B right?

Evan Brand: Yeah Babo. Yeah let me look I’ve got it here. I was like colloidal oatmeal lotion and this stuff is awesome I tell him my wife’s like honey this look at look at her skin and I was feeling these areas on our little girl’s skin like man it’s it’s crazy and yeah here it is nine bucks can’t beat it. So it’s called Babo Sensitive Hydra lotion, Chamomile Calendula. And then like I said, it’s got the colloidal oatmeal, I’ll put you the link in the I’ll put it in your chat here if you want to look at it.

Dr. Justin Marchegiani: And is there any worries at all with that due to gluten sensitivity in the oats?

Evan Brand: I don’t think so. We haven’t seen any type of issue. I know there’s a possibility. You’ve got that Avena Sativa Kernel Flour. So it does have the oat flour in there. I mean, if I thought that was some autoimmune possibility, we may stay away with it. But it’s a pretty rare situation. I’ve only seen a few people where we thought that they were going to be sensitive enough to it, you know that we should pull it out or find something without oats I’m not doing like oatmeal bass or anything like that, you know, this is just like the the spot of maybe a quarter at most on the areas and that’s like maybe once a day, if that issues- 

Dr. Justin Marchegiani: -any kind of here and there to kind of knock it down. It’s not like a staple. 

Evan Brand: No, no, no, we’re not lathering her in it or anything. It’s just like a spa treat is is all we’re using it for. I know some people get crazy with lotions or lathering the whole thing. Now I think I’d probably stay away in that case, but for spa treats, probably. Okay,

Dr. Justin Marchegiani: That’s smart. Excellent. I think we hit a lot of good skin stuff. Today we talked about some of the hormone stuff with female hormones. We talked about some of the androgen component and how that can tie into insulin. Don’t forget guys, high levels of insulin can drive excess estrogens in guys. And that can cause other issues too, and put stress on the liver. We talked about some mold stuff. We talked about allergen issues, food allergies and stuff and some of the eye stuff. We talked about the humidity issues in the winter, where it gets drier, maybe get a humidifier really monitor the percent humidity if you can get one that has engaged that test the environment and let’s say it doesn’t go above 40% or 35%. That’s better, because that way you kind of have a limiter on there. It doesn’t go over the top. We at one point had the humidifier on too much. This was years ago, and we noticed a little bit of mold in the in the carpet nearby. And we never made that mistake again. So if you use a humidifier, like put a timer on it, like an hour or two, boom, have it go off. Don’t leave it on all the time. Be smart about it.

Evan Brand: Yeah, that’s interesting. When you think about a humidifier, right tip tip, typically, people are going to just sit it on like a wood, night nightstand or something and then that wood is probably just absorbing all that moisture. It sounds like a recipe for disaster if you overuse it for sure.

Dr. Justin Marchegiani: Exactly. So you may be like if you can, if your kid has some humidity issues, skin issues, maybe put it on for an hour or two at night, put a timer on it done. Yeah, and that way, it’s not going to go the whole night. But we’ll provide a little bit of relief and and help the mucous membranes that may be a little bit overly dry.

Evan Brand: And then also, you know, don’t overbake don’t over with your soaps or shampoos or conditioners make sure everything’s clean there. Don’t over soap yourself. I mean, you’re not you don’t need to lather your whole body and soap. I think that’s an easy one. Regarding hand soaps, I mean, I know a lot of the conventional ones are gonna dry out hands and skin. So we got to mention that also water filters are key. That’s why you and I both have whole house water filters, because the chlorine and the trihalomethanes and all the irritants in the tap water can irritate your skin in the shower.

Dr. Justin Marchegiani: That’s a big one. Yeah. So if you have a lot of chlorine and a lot of chemicals in the water that can be very irritating on your skin. So we really want to make sure that that is addressed with a high quality filter. And that will take stress off your skin a ton really well.

Evan Brand: I don’t travel with it. I even bring like the Berkey or a comparable shower filter. Like when we went to Florida last winter, I brought a portable shower filter with us man, it was a game changer because, you know, we wanted to fill up the bathtub for the kids because the chlorine was so strong. So luckily, we just filled the tub with the showerhead filter. And it was awesome. So we didn’t take the kids and they weren’t just breathing in chlorine.

Dr. Justin Marchegiani: That’s good. That’s really good. And the only other thing I would just say beyond that is just making sure you’re digesting your fats and proteins well. So people think oh, I’m gonna just drink a whole bunch of water that’ll get moisture to my skin, it’s like well, you need a good fat carrier to bring that hydration to the skin. A lot of times the skin and the you know, these are that layer there’s a hydrophobic layer in the skin so it does not like water. So you need fat to kind of bring that moisture to that skin. So if you don’t have enough fat you will get very dry skin and dry skin can get more irritated, you tend to scratch that dry skin more and then that scratching creates inflammation and that inflammation just it’s a kind of a self defeating cycle. So you really want to make sure you have good healthy fats in there and at least half those fats should be saturated fats coconut oil, it should be high quality grass fed animal products. It should be pork, pork fat lard and if you want to do any plant fats Keep it to high quality olive oil, avocado oil, maybe some palm, obviously coconut is going to be a great fact that it’s saturated and it’s plant. So those are a couple of good things to do just to make sure you have good fats. And of course, if you don’t have good digestion, you know, at least get into enzymes and some HCl In the meantime, while you work on fixing your stress or fixing your gut In the meantime, for better absorption and digestion.

Evan Brand: You know, the way I look at it, it’s rarely going to be just a skin issue, there’s going to be possibly bloating, gas, burping, some type of food sensitivities, food reactions, right skin issues are rarely going to occur in isolation. So I think of it as a clue, right? You and I talk about clues in functional medicine, the skin is really just a clue. And then we think Oh, interesting what’s going on under the hood. So that’s where we come in, and do the testing. And if you need help clinically, please reach out. We would love to help we work with people worldwide, via phone, FaceTime, Skype, etc. We’re very blessed to be able to provide lab testing to people across the globe, and to provide solutions to healthcare that other practitioners and doctors have failed before. So if you need to reach out clinically, you can reach Dr. J at JustinHealth.com. You can reach me Evan Brand at EvanBrand.com and we look forward to 2021 together so let’s have some fun. Give us some comments and questions if you’re on watching listening on Dr. J’s YouTube channel. Put some potential topic ideas in there. We’re always open to new topics. We talk about stuff we think’s important, but if you have some issues or concerns, you know, we’re happy to do kind of like some q&a stuff too. So please give us some feedback.

Dr. Justin Marchegiani: Absolutely. If you guys want to reach out and dive in deeper it could be a good issue could be a hormone issue. EvanBrand.com for Evan, JustinHealth.com for myself, we are here to help worldwide. Thank you guys, and I hope you guys are having a great start to 2021 and we’ll be here you guys take care. Bye now.

Evan Brand: Take care.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/skin-care-tips-to-improve-dry-skin-podcast-320

Recommended Products:

GPL Mycotox
Omega Supreme
La Roche-Posay Lipikar Cream
Mother Of All Cream
Babo Botanicals Sensitive Skin Hydra Therapy Lotion
Air Doctor Air Purifier
Whole House Dehumidifier
Water Filtration Device
Whole House Water Filter
Clearly Filtered
Pelican Water
Organic Grass Fed Meat

 

Autoimmune Protocol – The Paleo Way | Podcast #312

The AIP diet is an elimination and reintroduction protocol which aims to reduce inflammation in the gut, heal the gastrointestinal tract and in turn, reduce overall systemic inflammation. It is a diet targeted specifically at autoimmune diseases. We have Dr. J and Evan chatting about the benefits of this diet and how it can bring our body to a healthier state.

One of the biggest benefits of the AIP diet is its ability to alleviate inflammation, which is key to reducing symptoms of autoimmune conditions and promoting better health. Eliminating a few specific foods from the diet and filling up on nutrient-dense whole foods instead can have a powerful effect when it comes to inflammation.

Check out the podcast below for more info!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:42       What is Autoimmune Paleo

8:14       How is it Beneficial

21:18     How to’s in Food Sensitivity Issues

26:22     How Paleo Helps in AIP

31:03     Goal of Decreasing Immune Stress

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

Dr. Justin Marchegiani: We are live. It’s Dr. J in the house. Evan, how you doing today man? 

Evan Brand: Doing well, let’s dive in. Let’s have some fun. We’re going to talk all about autoimmune paleo, which is the template that we push a lot of people towards, not because we’re some dogmatic attached to our cards kind of people, but because we like results. We like clinical success. We like people to get better. We like people to reverse their health issues. We like people to take back their health, we like people to get off their medications when their doctor allows them to. And autoimmune paleo is by far the best template you and I’ve ever implemented clinically, which has given us those various types of success. So where should we start? 

Dr. Justin Marchegiani: Yeah, so off the bat, what is autoimmune paleo, so it’s a good starting point. It may not be good for everyone out of the gates, it just for me, it depends, right? I see a lot of patients that are sick and then have done a lot of things. And this is like the next logical step. If people were coming in to see me and they already have, let’s just say have a really kind of crappy kind of standard American diet. I may just start out with a Paleo Diet out of the gate. So we have paleo right that’s like no grains, legumes, dairy and then like kind of butter maybe like acceptable within that range that and then obviously no legumes, grains, so no grains, legumes or dairy, butter, acceptable meat, acceptable vegetables, non starchy veggies, and then of course, good healthy fats, right, not seeds, dairy based fats, animal fats are all acceptable. Okay, and then we have paleo I call it paleo 2.0, which is the equivalent to an autoimmune paleo template. And you notice how we use the word diets not. We use the word template, not diet. I don’t like the word diet, because diet is it’s very inflexible. This is what you eat, where a template gives you the ability to adjust things. So I like the flexibility within the description template. So an autoimmune template versus the Paleo template. paleo is no grains and legumes, no dairy. autoimmune is no nuts, seeds, nightshades nightshades, being tomatoes, potatoes, eggplants, peppers, and eggs. And so within that, that template, we’re still going to be having healthy proteins, healthy fats from animal products, fats that are not seated dairy free, but healthy animal products, other fats like olive avocado, and palm and coconut are all great. And then carbohydrates, from fruits from vegetables, minus the tomatoes, potatoes, eggplants, peppers, and we can adjust the macros accordingly, proteins, fats, and carbs. So that’s kind of a good first step out of the gate. So paleo, and then paleo 2.0, which is going to be on one and paleo and these are all paleo template, autoimmune template out of the gates. 

Evan Brand: Yeah. And people don’t necessarily need to get stuck on the 2.0 the AIP forever. Okay, so this is not a podcast to say, look, everybody needs to do this. As Justin mentioned earlier, you know, we’re working with a lot of people clinically who’ve been to 510 20 practitioners before us, they’ve been on every diet under the sun, they’ve done every treatment under the sun, whether it’s natural pathi, homeopathy, functional medicine, doctors, conventional doctors, they’ve already been through the wringer. So in our patient population, it’s a bit more skewed towards the autoimmune because of the type of people we’re seeing. Now occasionally, we’ll get people in that are just Healthy People that want to feel better, or athletes and those people are not as compromised. And so for those, maybe we’re just standard paleo, and there’s a lot more flexibility. So just want to make that distinction because I don’t want your average person who doesn’t really have any major concerns thinking they need to go, you know, stick with AIP for life.

Dr. Justin Marchegiani: 100%. Now, what if you don’t have an autoimmune diet? What if you don’t have an autoimmune disease? Should you do an autoimmune template? Well, here’s the deal, autoimmune template, really, the goal is you’re cutting out any food that has a higher chance of being hyper allergenic, right, there’s a lot of data on these different studies with nuts or seeds, that they can they have one anti nutrients in them, right oxalates phytase, either they affect protein digestion, mineral absorption, and they can be irritating on the gut lining. So there’s a lot of hyper allergenicity increased immune activity. So the and then they also have maybe potentially more omega six fatty acids that can drive down more of the pro inflammatory pathway. So the goal is that we’re trying to reduce some of these anti nutrients that have a negative impact on the gut lining. And the number two, we’re trying to increase nutrient density. Alright, so we’re choosing foods that are higher and better fats, right? fats that are polyunsaturated fats that are more polyunsaturated, they can be damaged and they can be oxidized, right so animal fats, coconut oil, saturated fats, not so much. And and then just the just the gut permeability aspect. So we see nuts and seeds fit that criteria. Eggs potentially even though eggs are awesome and so nutrient dense with a good vitamin A and fat soluble vitamins and cholesterol in the yolk, especially, they’re amazing. So sometimes those compounds can be a little bit more allergenic. So can the nightshades with the alpha solonian compound and they’re in the saponins. They can be a little bit More irritating on the guts get into the joints create inflammation. So it depends. The goal is really that it’s just a nutrient dense, anti inflammatory and then low in toxins, but more importantly, plant toxins, anti nutrients. 

Evan Brand: Yeah, well said and the reason you’re bringing up the lectins. And some of these other compounds of these foods are because they’re going to contribute to increased intestinal permeability. So when you’re talking with anyone, whether it’s rheumatoid arthritis or some other autoimmune disease, there’s always a domino that has to fall which is that the gut is leaky, this increased intestinal permeability has to take place. Now we’ve gone into the details of why that can happen from the infection perspective, low stomach acid, food fermenting in the gut, bacterial overgrowth, parasites, emotional stress, overtraining, we’ve tried to hit a lot of these different variables that can go into the leaky gut. But you can also have all the lifestyle infection piece dialed in, but if you’re eating, let’s just say, you’re doing salsa on your, you know, cassava flour, tortillas and your grass fed ground beef, but you’re just doing, I don’t know corn chips and salsa all the time with it, it’s possible that a lot of those lectins like you may get from your nightshades like your tomatoes and peppers. Those can irritate the gut lining contribute to that leaky gut and then that’s going to increase your autoimmune risk. Or if you’re already autoimmune, it may potentially flare you up depending on what’s going on. 

Dr. Justin Marchegiani: Absolutely, there’s one study that came out looking at people that have potential autoimmune genetics, they have the likelihood to make 10 times more IGA antibodies against certain foods than healthier foods. And in this one study, it’s called food intolerance and patients with a manifest autoimmunity with manifest autoimmunity observational study, in the Journal of autoimmune review, they talk about that the IGG level for specific foods were higher in the patient control group and the control group. So if these people that had autoimmunity they had more antibodies, and what they found was they saw a significant increase level and IGG. That’s a type of antibody that’s produced. And most doctors only look at IGE, which is anaphylaxis type of allergy response, immune response. And that’s like you need the epi pen for that right and so this is kind of IGG there are other types of responses that aren’t even in that IGG IGA, IGM IGE category, and so IGG isn’t the be all end all by the way. But they found that casein cow’s milk weekly and wider the eggs, rice, even some nuts and what and walnuts and almonds tend to have more of a allergenic idg response. They found no antibody reaction with vegetables and fish and meat products. They seem to be very immunoglobulin neutral. Guess what we do with an autoimmune template or a paleo template, we’re cutting most of those foods out. Obviously, with autoimmune, we’re focusing cutting the eggs out and the nuts and the seeds out to that’s it’s about decreasing the immune response. People that have a lot of autoimmunity, their immune system is sucking up lots of energy and lots of resources, because it’s responding to all this food in a negative way. And so the goal is we’re just trying to calm down the immune system. And then those foods aren’t there. We don’t have the gut permeability. Therefore the the body can use those resources better versus having the immune system hyper responding.

Evan Brand: Yeah, well said. Now, one other point to why would this be beneficial to do or to go down this rabbit hole and as I mentioned, maybe not forever, right? Maybe temporarily, we pull out eggs for me, I pulled out eggs for a long time when I had gut bugs. I had an Louise on the podcast and we talked all about gallbladder and eggs and how there’s a big factor there where eggs can irritate the gut, you know, just based on the gallbladder issues. And so I pulled them out and now I can tolerate eggs, no problem duck eggs, I tried experimenting with those for a while some argue duck eggs are a little easier. quail eggs I played with those a little bit. You know, I can’t say that I’ve noticed a huge difference among the different types of eggs. But I think it’s a cool experiment when you try to get into the reintroduction phase where you’re going back to paleo 1.0 and adding eggs and things back in nuts. For me, same thing, I used to get really, really bad headaches from walnuts, so I cut those out for a while. If I do a little bit of those, I’m okay. So the good news is your body can calm down. And that’s one thing that this diet will help you do is it’ll help you to identify your trigger foods. Because if you’re just eating a bunch of different stuff, and your diet is too varied, and if you’re not tracking it, you don’t have a clue. If you go and you have a salad, where you’ve got walnuts and pecans and cranberries, and tomatoes and whatever on your salad, you’re not going to have a clue what’s irritating you but if you go AIP for a bit, now you’re going to know hey, you know what, as soon as I add it back in those tomatoes, boom, my joints hurt. And then you’ll have a much, much more clear path. So if anything else, it’s more helpful to use the journal plus reintroduce foods and it can be amazing. That’s how you really figure out what you tolerate what you don’t. 

Dr. Justin Marchegiani: Yeah, I tell patients you don’t really know how dirty you get until you get really clean. Right, once you’re really clean, and then you get dirty, you’re like, Okay, I get it. I’m dirty right now, right? What does that mean? We want a clean baseline. So what’s the clean baseline? In my analogy, the clean showers the baseline. And in regards to the food, that’s the autoimmune diet, the autoimmune diet is the clean shower, it’s getting really clean. So then when we start to one, maximize the diet, usually people are going to see benefit within a within a couple of weeks, and or a month, and I always like patients to kind of plateau, some or plateau within three, four weeks, where they may see a lot of improvement and joint pain or energy or brain fog. And then it’s like, Okay, good. Now they’re kind of like running out of steam in regards to their initial jump and improvement. So I want patients to typically be on the diet for four weeks and the plateau for at least one week before they do any reintroduction, some autoimmune patients, they continue to see significant improvement week after week, and it may last a couple of months. So patients that are like that, I’m a little bit more strict on what they’re under reintroduction. Now, it’s usually not that big of a deal. Because if you get those kind of results, those results speak for themselves, and they really motivate you a ton. So it’s not like twisting an arm to get someone to follow that diet longer, because the results are guiding us that we’re on the right track. So I tell my patients, if you’re gambling and you’re on a streak playing poker, or blackjack, I’m not going to pull you off the table. Right? I’m going to let that streak roll a little bit. Same thing with the diet. So if you have a lot of success coming out of the gates, I’m gonna let it roll. I’m gonna let you plateau. And then we have a specific reintroduction protocol, and how we add foods back and I’ll go into that in a minute. 

Evan Brand: Yeah, well said and, you know, there’s not a lot of money involved with this, meaning you can’t really make money just by getting people to eat meats and veggies. So the problem is, there’s not too many studies. Now I don’t know if you want to pull it up, but I just sent you one in the chat. For those watching on video, they may be able to see this. It’s a PubMed study here. It was in the inflammatory bowel disease journal 2017. As I mentioned, there’s not much money in this right. So it’s probably going to be few and far between clinical trials on autoimmune diets because there’s no drug involved and Big Pharma isn’t going to pay some random guy to do a diet trial. Right. But anyway, this was a study on patients with Irritable Bowel Disease. And they did it for six weeks, followed by five week maintenance. And it just goes into the results here it talks about significantly improving people with ulcerative colitis, and significantly improving Crohn’s disease. C reactive protein, they said didn’t change much. But the calprotectin, which is a marker we measure on the stool panel, it improved from 471, which is high was to 112 at week 11. And also Wow, those that did drop. I mean, that’s a lot. I mean, you’re talking hundreds of points, just put died alone. And then it says here among those with follow up endoscopy at week 11. improvements were also noted in a simple endoscopic score for Crohn’s disease and a Mayo endoscopy sub score. So we’re not obviously running that we’re not doing scopes on people, we’re running stool panels. But I’ve seen the same thing. I had a guy who had calprotectin above 1000, it was insane. He had pan colitis where it was the whole colon and you know, pretty much the whole intestinal tract was involved. It was pretty sad. But just with now, technically, in his case, we didn’t do just diet, we did a lot of really, really potent aloe extract. But I mean, we were able to get calprotectin down hundreds and hundreds of points within a few weeks. So there’s the proof.

Dr. Justin Marchegiani: 100% those are all excellent points. So a couple people in the chat here Andrew Hill wrote in that we got to be careful with tapioca because it’s a similar cassava similar to latex and yeah, if you’re a sensitive person, we may want to even cut that out for a few weeks before we add that in. Technically that may be allowed, right cassava yuca, tapioca. And that same kind of family. I think it’s the same thing. There’s different names, but that may be something we want to work on excluding others may just be some of the spices, you know, like pepper, some of the nuts or seeds or spices that are something that you don’t eat, but it’s more of a topical kind of thing on the food. Got to be careful over that if you’re really sensitive, usually foods going to have a dose dependency. So the more of that food you eat, the more the immune reaction will be exacerbated due to its we keep an eye on those things for sure. Riley wrote in that we know basically one of the no take on the food sensitivity test, when does a food sensitivity test become beneficial? So my issue with food sensitivity tests, is most of them come back with some level of autoimmune foods on there for people. Okay, that’s number one. So I always look at test, does it change the treatment? So most are going to have some of these foods on there, number one, number two, if it doesn’t have those foods on there, would a patient still benefit from cutting those foods out? That’s the important question, because your immune system may be responding in a way outside of a typical IGA G or IGA test. There are other tests out there that look at like the MRT or the Alliance akt look at other type of T cell intermediary responses, which could be it. But I still know people that run these tests and they have patients that test perfect for gluten. And then now you’re in this conundrum is do you allow your patient to eat gluten now because the test says gluten is fine, because we know there may be an immune response happening in the body outside of what’s being tested. So that’s why I don’t like it because you can give a lot of false sense of security that you can eat gluten or other grains. Number two, I’ve seen benefits cutting those foods out, even when it says it’s fine. So for me, it doesn’t change what I’m doing enough for the value for the cost. And I’d rather use that money on another lab or a stool test or supplementation that’s going to be more root cause supportive. 

Evan Brand: Well said, I’m going to take that as my soundbite. So anytime somebody says, Evan, why won’t you run a food sensitivity test dummy? I’m going to say, Well, my good friend, Dr. Justin said it better than me, and then I’m going to play them your little soundbite you just did because it was it was so good. But I agree. And that’s exactly what what I do is I just tell them, Look, save your money. Let’s go AIP. And then let’s do reintroductions plus you journal. And we find that that’s going to be far better. I mean, when you look at gluten, for example, I have seen people where it does show up as that it’s going to be okay. However, they know when they eat it, they don’t feel as good. They feel a little brain fog, they feel bloated. And that didn’t show up on paper. So then they’re confused. And then the husband goes, See, I told you you’re crazy, eat a pizza, and then you just get yourself in trouble again. 

Dr. Justin Marchegiani: So yes, now where food allergy tests may be helpful. It doesn’t quite fit into the patients that I see is if a parent is trying to help a child and or a family member who is totally on is totally uncompliant and resistant to doing anything. And if we can get some lab data saying to avoid these foods, that may help with leverage, but most people are coming to see us they’re they’re investing a lot to work with us. So they’re pretty darn compliant. If we say don’t do that, let’s save you some money. They just typically listen to us. Yeah, well, number two is if you’re already at a great, great super high level of health, and you want to see if there’s any maybe weird foods there, then that may be helpful to look and see if any other foods that are there. The problem is if it says don’t eat raspberries, and then you eat blueberries, what’s the chance that blueberries and now on the list next month? Right? That’s where it becomes this like whack a mole where you’re like, wow, like one and the other one pops up over here. And you’re like, crap. 

Evan Brand: That’s a very good point. Yeah, the compliance and the leverage. I mean, that’s the reason that we do some of the testing in regards to the infections too, because somebody will say, Hey, I feel like I’ve got this, I want you to just give me a parasite protocol. I think I’ve got parasites with you know, you and I’ve covered this before people come in, and they have this idea of what they think’s wrong with them. And we, they just want us to pursue that rabbit hole with them. So we’ll come in and we’ll use the data first look on the paper. You know what, actually, no, we think this is a bigger priority over here. And then we circle back. So yeah, that’s that’s a great point.

Dr. Justin Marchegiani: Absolutely. So I think it’s, uh, you know, we want to always look at you know, the root cause why you’re sensitive to these foods, of course, you want to be fixing the gut that’s gonna be ideal. Whether it’s SIBO or H. pylori of bacterial issues, you want to work to the six hours because patients have a chance of having increased risk of food allergens when the food’s not broken down properly. So adequate levels of enzymes and acids chewing your food masticating your food Well, not overly hydrating when you eat adequate enzymes, adequate acids are all very helpful at being able to break down the food again, if you love it, rotate it. If you’re eating beef every single day over and over again, your chances of a beef allergy goes up right but you saw the study I just mentioned earlier, that study showed much less chance of animal products and vegetables causing an allergen right so that we cut out the big foods that are going to be the highest risk. Now. Outside of that there’s a reintroduction plan that I infuse with my patients when it’s time. So we add each food back in over a two to three day period. So we’ll start with egg yolks before eggs ghee before butter, one not one seed one Nightshade at a time. And typically a very small amount of food on day one, a little bit more on day two. And if we have no negative symptoms, then usually we’re good we can go to the next food if we’re on the fence, we can have a day three where we eat a larger amount of food because the response tends to be dose dependent small amount of bad food for you. Small amount of symptoms, larger amount of food, larger amount of symptoms and then if you stair step the dose up usually the symptoms go up as well. So if you’re on the fence, it gives you that ability to be confident that you’re sensitive or not. And we go right down the list. 

Evan Brand: Yeah, so give me a little bit of concrete like view how would that look? So today’s Monday when we’re recording so let’s say you want to add back in almonds for me you’re gonna have me do what have you? 

Dr. Justin Marchegiani: Yeah, so let’s just start in the right order. So egg yolks before eggs, so I may go and I may poach one egg, poach it, it comes up. I’m keeping the yolk a little bit soft. Why I don’t want to oxidize it. I trim away the egg white egg white tends to be more allergenic, feed it to my dog, have the yolk How do I feel? That’s a good if I do. Okay, let’s do two yolks tomorrow. Trimming away. Good. Excellent, great. Awesome. Very good. Next day we’re going to add in the full egg. Now we’re going to do a little omelet, right, but we’re not going to overly, we’re not going to overly cook up the egg yolk, the egg white, I’m sorry, we’ll keep it so it’s, you know, the whole eggs blended but it’s going to be a little bit more wet because we don’t want to overly oxidize the cholesterol on the proteins that are in there. Right? oxidized cholesterol and protein tend to be more hyper allergenic higher immune response. And then if we’re good there, then we go to gi waggy. Keys, clarified butter, less lactose, less casein, right? The casein and lactose have the biggest problem. If you can tolerate ghee Great, now we go to butter The next day, same kind of stairstep so my sensitive patients can handle ghee can’t handle butter. So we always want to start with the least allergenic to the most. So if we can handle one egg yolk but not the egg, guess what we at least have an egg yolk in our diet. If we handle the egg, the GI but not the butter we at least have some of that good butterfat clarified gi back in our diet. So we always go least to most, where if we did it the other way around. You wouldn’t have been able to add the food back in. 

Evan Brand: Yeah, that’s great. Okay, and then when do you bring in some of the nuts, the seeds? How do you do those any particular order you found better or worse. 

Dr. Justin Marchegiani: So I would just start with like, if you’re gonna do almonds, you could just do one or two almonds, right? And IDN sprouted is a little bit better, right where it’s soaked, and that can deactivate some of the anti nutrients, the lectins, the phytates, right, the oxalates. So you can do a couple of almonds, maybe one teaspoon or tablespoon almond butter. And the next day you can double or triple that dose. See how you feel if you’re okay, that’s a good sign. But of course, deactivating some of the anti nutrients can be helpful too. And then the next day, let’s say pecans are in your routine. Try pecans, try pistachios or walnuts. And again, if if you’re not eating those foods on the reg, it’s not that big of a deal, right? Just try to choose the nuts or seeds that are more on the regular things that you’re doing more on a daily routine. 

Evan Brand: And of course we want to make sure these are organic. We want to make sure these are fresh. I advise keeping your nuts in the freezer like I keep my pecans in the freezer. And they taste so good frozen to like I’ll take pecans out of the freezer do a little bit of maple syrup. Oh my god, you talk about delicious. 

Dr. Justin Marchegiani: Oh totally. Yep. 100%. Now here’s the other deal too. So then we have let’s say you’re able to get nuts or seeds or nightshades or eggs back in right you get everything back in. Do we ever allow grains now I always just tell patient it depends on how significant a patient is. If we know someone has diagnosed autoimmune condition I always try to stay more on the grain free side I hate the word gluten free because you can be gluten free and eat lots of process rights and oats and corn and that could be a problem right? Because the problem means are are the umbrella the problem? You know umbrella gluten is one prolamin under that umbrella, right? The most common one is the wheat, barley and rye that gliadin prolamin. Then you have horizen in which is rice, you have a vignette which is oh right you have seen what you have seen which is corn. So these are still like brothers and sisters of the Glee and protein. So just like someone you may see someone, a brother or sibling, and you may be like, Oh, you must be so and so you look just like him as a family resemblance. Well, your immune system has that same kind of resemblance with other proteins that are cousins and brothers and sisters of gliadin. And so your immune response can be triggered. Also, there’s a lot of data in the non celiac gluten sensitivity research that grains, even if you’re not allergenic to them can still increased gut permeability. And the more you increase gut permeability, the greater chance you have of creating more inflammation or triggering autoimmunity. Now, what does that mean? Does that mean never eat grains? It just means my general recommendation is always try to be grain free if you can have a substitute. If you’re relatively healthy, good health and you have no autoimmunity. Could you eat some grains that have gluten here, they’re probably you could probably get away with it, you know, and it probably wouldn’t be that big of a deal. I wouldn’t recommend it being a staple because those foods, they’re still inflammatory. They still have a lot of nutrient blockers in there. And they still aren’t nutrient dense. So I still much rather, I’d much rather see someone have some white potato over a bunch of wheat, right potato is actually pretty nutrient dense and has a lot of potassium in there and a lot of good minerals. I rather have someone do that over over gluten. Complete gluten full, if you will, grains, but it all depends where you’re at, the healthier you are, the more versatility and adaptation you have, the more unhealthy you have or the more diagnostic autoimmunity you have, you really want to be careful. A lot of times it’s just not worth it. Some people they eat some gluten, they’re inflamed for a week, it takes them days to get back on the wagon. So it depends upon how long it takes you to get back on the wagon. And if you have a known thyroid issue, there’s some data saying that autoimmune response can last for weeks and even months so it’s just not worth it depending on the damage that may occur. Dude after the fact. 

Evan Brand: Yep. Well said and yeah, he’s talking about like the gluten cross reactivity issue. So like, for a while, you know, I had a lot of people doing corn because they thought, Okay, I’m gonna, I’m gonna be okay. But turns out they weren’t. Okay. So in a lot of cases, yeah, we do remove the corn if I do a much rather see 

Dr. Justin Marchegiani: much rather see cassava or you could chips over anything with corn or anything else like that. So that’s much better like this yet they brands pretty darn good. Or just a really good white potato chip like the boulders make a good one with avocado or coconut oil that’s really good fat. On the potato side.

Evan Brand: I’ve noticed the same thing. Yeah, potato for some reason, even though it’s still potentially cross reactive. I’ve noticed it is better tolerated than corn for most people. So that’s good. Maybe it’s just a lower count or maybe a slightly different compound in there. 

Dr. Justin Marchegiani: Exactly. And I use a lot of root vegetable chips. So I’ll do like a lot of turnips, rutabaga, or sweet potato, like a lot of root vegetable, like grain free type of stuff. And that tends to be pretty good. But the nice thing is, once you kind of work through that autoimmune template, you should get a lot of confidence in what you can or can’t handle. And then once you’re at a high level, if you’re if you’re going off the reservation too much, you’ll start to feel it. And that usually gives you a pretty good idea that you’re probably doing too much for you. So our goal is to get you feel really clean. And then once you’re really clean, it’s kind of easy to notice when you’re getting dirty. 

Evan Brand: Yep, yep, well said. And the whole point of this is what well, it’s to give you relief is to get you to feel better is to get your brain to work better your joints to feel better your sleep to be better your food reactions, your gut, your, your everything. I mean, the skin, the brain, I mean, this literally can affect every body system here. So we really want to focus on what’s the end goal. It’s not just tweaking this just to tweak it make this like an obsessive OCD type thing because it can get a little crazy. No, it’s to get you to feel better. And then while we get you to feel better, we’re working behind the scenes on these other root causes. Because it’s very unlikely that someone became sensitive to all these foods just out of nowhere, right? There’s something that triggered it. And Okay, so we’re getting you simmering, okay, we got your diet, just you Okay, we got that pillar of the house in now, while that’s sitting there, simmering. Let’s work back here. We’re going to work on this, this this over here, and then boom, now we go back to this diet. Good job, you’ve been holding steady. Okay, now let’s bring normal quote normal things back in and then people tolerate him. So that’s kind of the whole rationale. That’s kind of our mindset behind this whole thing. When we’re working clinically. It’s not just the dietician, approach. Here’s the diet have a good life? It’s okay, well, why did you have to go to this level of specificity in the first place? And that’s the real question. 

Dr. Justin Marchegiani: Exactly. And also, people want to start having more grains on the regular, I would say make sure your health is really great and stable. And I’d also say if you wanted to be more certain, run an HLA dq test for gluten sensitivity, if you have to or ate on there, you definitely want to avoid the gluten, one or three is going to be a little bit less. And then I think four is the only true genotype that is not gluten sensitive, you could still have other problems with the anti nutrients that are in there, or the higher amounts of fermentable carbohydrate, but that’d be my one test that would say just to really know that make sure there’s not a genetic issue. If you’re going to put it in there and more in the regular for me, my big cheats are going to happen. If I go out for sushi, I may have a couple of rolls. But usually I like the Alaskan roll that has like a lot of salmon, and a lot of avocado, and then there’ll be a little bit of white rice. So when I typically cheat, it’s going to be getting some white rice for sushi. And but I typically use coconut aminos and a soy free soy sauce and MCT oil and I’ll typically do extra enzymes and extra charcoal during those meals to mitigate the inflammatory response. So it’s a kind of couple of little tricks that I kind of do. If not for me, I just I just feel too good. I don’t want to have a setback. So there’s enough substitutes for me where I can engage in that substitute still feel really good and not have a problem? 

Evan Brand: Yep, they are. Well said. 

Dr. Justin Marchegiani: Anything else you want to add Evans? Oh, one more thing. I wanted to say. What if autoimmune paleo is not enough? What does that mean? So some patients they may have to do carnivore, they may have to do a variation of an autoimmune paleo, low fodmap SCD template where we’re cutting out fermentable, carbohydrates, even some of these really good fermented foods. Or we may have to be cutting out foods that are high in salicylates and females, that may have a little bit higher amount of anti nutrients that, you know, things that could be on the vegetable side, right, or fodmaps, like broccoli, and let’s say onions and garlic, things that are have good benefits, we may have to cut out other foods. And again, we see a lot of patients that come in that have done a lot and that are very sick or have a lot of gut inflammation, we may have to go to that extreme. We may even have to do an elemental diet or a carnivore diet. So everyone’s a little bit different and they come in from different places. But if an autoimmune diet does not work for you, there’s other things that we need to work on it. You’d really want to work with that practitioner at that point, because your health issues are a lot more nuanced. 

Evan Brand: Yeah. And hopefully you’re not hopefully you’re not to that level. But just know that if you’ve done this and you’re still suffering The number one, there’s probably underlying triggers you haven’t identified yet things that are really aggravating your immune system or the gut. So we need to try to find those triggers. And then number two, you can tweak this thing even more to get you stable, the whole thing, the whole goal is to get you stable. So we can work on root causes here. So it’s not just diet and done, just remember that.

Dr. Justin Marchegiani: 100%. And also, what’s the goal of this diet, right, I always tell patients, what’s the goal is that we don’t have like a goal in mind. Most people, when they make a diet change, they kind of just go to this place in their hand, like it’s forever. And they kind of have like a little mini funeral, like how I miss my potatoes, my, or my seeds, they kind of have this really this kind of state of mourning, where it’s really sad and they’re depressed, I always tell my patients, the goal is to one first, increase your nutrient density in your diet, number two, to decrease inflammation overall, right, and then three, to decrease a lot of the toxins, whether those toxins or plant based toxins, whether those toxins are you’re not eating organic, and you’re getting pesticides, and chemical toxins, all those things are valid. And the goal of that is that now decreases the immune system stress, and that the immune system stress starts to go down. There’s less autoimmunity, there’s less inflammation in the body. And that kind of starts creating this snowball effect where your body can start to heal as we start addressing infections, supporting the adrenals addressing nutrient deficiencies, calming down the immune response by addressing infections and using probiotics and other nutrients on that side of the fence. 

Evan Brand: Yeah, you made a great point, which is the emotional piece. So we could do a whole part two podcast on this if people want. We’re going into the whole rationale scientific part of that. But if you’ve got a woman who is addicted to her cookies, you’ve got to work through the emotional stuff, too, right? So we could come in with all these rational, very scientific studies and things you have gone into, right? It sounds really attractive and really scientific. But then you got the emotional bubbles popping up. And people are going Oh, no, but what about this? And what about Thanksgiving? And what about this and my family and I love to do go eat the popcorn at the movies, you know? And so then the emotional piece is hard. So you have to work through that with people. And we do we have those conversations. So on the face of it, it sounds all easy, right? It’s like, okay, just boom, boom, boom, boom, boom, you’re great. But then, once you actually sit down at the plate, and you’ve got that fork there, then the emotional stuff comes up. It’s the the husband or wife making fun of you for your choices. I mean, that’s a common one. It’s if there’s a divorced family, it’s the child going to the other part of the family, where the other family member doesn’t believe in this and say, This is all quackery. And then they come home after eating pizza all weekend, and then they’re in an autoimmune flare, or you go over to the parents house. And, you know, they think it’s a joke. So they still try to serve you bread and butter, you know. So there are some things you have to work through on the family emotional side, but you know, it’s definitely something that’s, that’s possible. Everybody can do it. 

Dr. Justin Marchegiani: Yeah, where I see it a lot, you know, well, meaning grandparents that feed their kids cookies, their grandkids, cookies, you know, or like, they want to spoil them a little bit. That can be really tough, too. But yeah, you got to get everyone on the same page. And in general, you got to have a plan. And if you’re having a lot of cravings, most of those cravings, a lot of the protein orphans, which are like opiate like compounds in grains and dairy hit that same opiate receptors. So those foods can have a lot of addictive qualities to it. And a lot of people they’re used to operating on a blood sugar rollercoaster, so their blood sugar goes up and down, up and down. Because not enough good protein or fat in the meal or they’re not, they’re going too long between meals. So really working out the blood sugar. A lot of times if someone switches from a standard American diet to an autoimmune diet, the two big mistakes they make is one, they’re not getting enough calories from their autoimmune diet, therefore, they’re chronically hungry, which creates cravings. So you have to make sure you’re getting enough calories or nutrients. The second thing is they may go to low carb for them. So if someone’s needs a little bit more carbs, and they’re at a relatively more healthy way, they may come in go really to low carb, and that may cause more cravings too. So you may have to just add in some good, healthy, safe starches to fill that carb void if those carbs are a good place for you. My default set is always lower carb, higher fat, and then kind of work through that over time, because most people have more insulin resistance and going lower carb out of the gates helps resolve a lot of that. 

Evan Brand: Good points. Good point. Yeah. And the gluteal morphin stew. I don’t know if you said I think it said the other thing that 

Dr. Justin Marchegiani: Yeah, the protein orphans are gluteal morphemes. These are like the opiate like products like that are in gluten or the KCM orphans in the dairy. 

Evan Brand: Yeah. So when people say oh my god, I’m addicted to my whatever, they’re not joking. You literally are and there can be some sort of a withdrawal from it. And then also from the neuro transmitter perspective, that’s something we’re going to look at on organic acids testing. So if we see for example, whether it’s low endorphins, low dopamine, low serotonin, we may come in with specific amino acids to try to repair and rebuild. And that can be a good let’s call it a nutritional support band aid for the brain chemistry, which is causing the underlying craving in the first place. So rather than say, hey, go from the gluten cookie to the grain free cookie, it’s okay. Yeah, maybe you do that. But we’re also going to give you a little bit of some DLP a or trip the fan or something to help the brain because the brain is involved with this too. This is not just the gut, the brains involved too. So we’re, we’re thinking about all these variables as we go. It’s kind of a moving, it’s like, I don’t know, maybe a good NASCAR analogy, you know, it’s like the, the guys are coming on and changing all the tires and we’re doing that in every category. So it’s the brain, it’s the gut, it’s the immunity it’s the adrenals we’re we’re simultaneously working on all of these pieces and then boom, you succeed you feel better. So I think we should wrap it up if you’re ready too.

Dr. Justin Marchegiani: I think we can’t man that we did a great job kind of outlining everything this will be a good reference for my patients as well that you know, just kind of want more intel on the autoimmune side. If you’re listening to this and you want to dive in deeper and you’re feeling a little bit overwhelmed with some of the diet changes out of the gates definitely reach out to myself for Evan, EvanBrand.comand there’s a little link there where you can click the schedule or myself Dr. J. At JustinHealth.com we’re happy to help you. We have experienced doing this for over a decade with thousands of patients. And if you’re ready to take that next step, we’re here to help you all if not just utilize all this free information and just kind of execute on it and make yourself healthier. We really appreciate it. 

Evan Brand: Yeah, if you’re a do it yourselfer, that’s fine. But for me, and you and many others, it’s better to have a guide, it’s better to have the data test don’t guess get the information, know what you’re up against. So you can figure out and when we say test, don’t guess we’re talking the root cause stuff. We may not run a food panel out of the gate, but we’re gonna run a gut panel out of the gate figure out what infections could be causing these issues in the first place. So thanks for tuning in. We appreciate you guys and we’ll be in touch. 

Dr. Justin Marchegiani: Put your comments down below. Let me know your success on an autoimmune diet. Really want to know and thanks for sharing. You guys. Have a good one. Take care of y’all.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/autoimmune-protocol-the-paleo-way-podcast-312

Fatigue, Tiredness, and Lethargy: Link to Gut Infection | Podcast #311

Tiredness is not a symptom that defines any one particular disease. Rather, tiredness can be a symptom of many different diseases and conditions. Causes of tiredness range from lack of sleep and over exercise to medical and surgical treatments. The lack of energy (lethargy) associated with tiredness can sometimes cause difficulty with normal daily activities, leading to attentiveness and concentration problems. 

Dr. J suggested considering to support protein breakdown by extra amino acids and enzymes. Dr. Evan also added that if you have issues, always reach your conventional Dr. or functional Dr., be tested, find the root cause and guide to fix possible infections that cause you to feel tired before you reach a crisis level.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:10      Mechanisms to Gut Infection

4:05      Where Gut Stressors Come From

12:12     Infections that causes Fatigue

17:41     Probiotics and Beneficial Bacteria

22:32     Supplements to Gut Infection

24:18     Immune Issues

This image has an empty alt attribute; its file name is itune-1.png

Youtube-icon

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about your gut infections may be making you tired. Many people don’t think about how their gut maybe having an impact on your energy, your mood, your emotions, but it’s totally true. Most people think, oh, if I have a gut issue, I’m just gonna have bloating or diarrhea or constipation or acid reflux. Oh contraire. We’re gonna dive into that today, Evan, how are we doing today, man? 

Evan Brand: Doing really well. How about should I just go straight into my story, then? I mean, I suffered with this thing firsthand, as you know.

Dr. Justin Marchegiani: Yep. Let’s do it. 

Evan Brand: So when I was down in Austin, I was losing weight. And I didn’t know why I was losing weight. And turns out and I was exhausted. That was that was the main thing. I mean, I was drained, like, it was really tough for me to get through the day. I mean, I was to the point where, at some point, it’s kind of embarrassing. I mean, I was like, okay, am I do I have enough energy to cook a meal at night, you know, for dinner, like, the workday just drained me. And so fortunately, after I got the gut infections resolved, I mean, the story is not much longer than that my energy came back online. So I mean, we can say clinically, and personally, that this is a big, big smoking gun for anybody who’s been dealing with chronic fatigue.

Dr. Justin Marchegiani: Oh, totally 100%. Now, let’s talk about some of the mechanisms why like, you could have constipation, you could have diarrhea, you could have all these digestive issues, that’s fine. And it makes sense why some of these issues may be causing problems. Because if you’re going to digest a lot of the nutrients that energize you, right, B vitamins, your amino acids, your essential fatty acids to burn them in the mitochondria for fuel, all of these things require optimal absorption, right? So if we don’t have adequate enzyme, or acid level or biliary level to break down fats, proteins, and carbohydrates, we’re going to have a problem with those nutrients getting into our bloodstream and making their way to ourselves and our mitochondria to be burned for fuel. So that’s one big mechanism. And the other big mechanism out of the gates, and we’ll kind of expound deeper into each one is the fact that your immune system sucks up lots and lots of resources. So think back to when you maybe got the flu or had some kind of illness. Were you energized? Are you tired? Most people were very tired. Now, why is that? It’s because your immune system allocates lots and lots of resources when it’s stressed. And it will make you tired, because it’ll pull some of those energy resources to put it towards fighting an infection. All right. So if your immune system is caught chronically in that state of trying to fight something, whether it’s a gut infection, cebo, or parasite, or just gut permeability issues that are upregulated, due to bad foods, and food allergens, you’re going to be really over stimulating and over allocating resources to deal with whatever’s happening with the immune system, aka the gut. Don’t forget 80% of your immune system is located in the gut, people forget that so important. So if you’re over stressing your immune system, you’re gonna have problems. 

Evan Brand: Yeah. And so for me, I was taking some immune support, but it was all just kind of a bandaid, right? Because I wasn’t focused on the underlying infection. So this time of the year, we’re, we’re talking in the fall here coming up on winter, you have a lot of people that will say, Well, you know, I really just want to strengthen my immune system. So they’ll go and do maybe some extra vitamin C, maybe some medicinal mushrooms, or maybe some other herbs, astragalus, things like that. But it doesn’t matter if you do all those if you don’t address the infection. So if someone’s like, tired and they feel weak, they feel depleted. They feel like they’re possibly immunocompromised. Sure, you could do some of the tools, like we talked about those herbs, but really, you got to test first of all, figure out what kind of infections you have. And then step two, is you come in and make a protocol to fix those infections. And not to mention, you know, like h pylori is super contagious. So, I mean, you and I’ve seen hundreds and hundreds of cases where, you know, husband and wife have reinfected each other. And so we’re not doing this to try to make more money. We’re doing this to help the family when we say, Hey, what about your husband? What about your wife when we try to get them on board? It’s because we know about this potential, you know, cross contamination.

Dr. Justin Marchegiani: 100%. So we kind of look at the gut, and we’re like, Alright, where are the gut stressors coming from? So the first stressor we look at are food allergens, because if your immune system is kind of responding negatively to food, that could be a big a big issue, right? And what happens is, when food allergens kind of come in, whether it’s gluten or dairy, or just you know, processed grains, or sugars, or even things like nuts, or seeds, or just more allergenic foods, soy those kind of things. Your immune system is upregulated dealing with those foods, and that’s going to suck away resources. And also, these foods if you have an allergen to them, if your body’s hyper allergenic, meaning your immune system is over responsive. There may be some gut permeability. And gut permeability is like these little tight junctions in the epithelium in the small intestines. They’re like this. So imagine you’re putting your hands together like you’re saying a prayer now, start pulling your fingers apart a little bit, you see the little gaps that happen that’s happening at a microscopic level with the tight junction cells in the small intestine. So the more you’re stressing your gut lining, these tight junctions open up, like I mentioned, the fingers come further apart. And then food particular we call it antigens, right? These foods aren’t supposed to be in the bloodstream at the size they’re in. Now you start having these antigens go into the bloodstream at a larger level, and now the immune system’s going to start going after it with full force. And that’s gonna start sucking up a lot more of your resources. So the first thing when we’re working with patients worldwide, we’re trying to cut down the food allergenicity we’re trying to decrease the immune response by helping the foods not become so bad or stressful on the immune system. So some people coming in on a standard American diet, a paleo template, maybe enough. Some people that are really have an autoimmune issue or Irritable Bowel Disease, we have to go to a paleo template where we’re cutting out extra allergenic foods, some we have to even go to a carnivore or some kind of an STD low lower fodmap diet because the bacteria is overgrown, and it’s reacting to even fodmap foods like broccoli and onions and garlic like healthy foods, were reacting to it. And so it this whole thing becomes a little bit more nuanced with food, the more unhealthy you become, or the longer your conditions progress. So as a practitioner, right, we’re trying to meet people where they’re at some people come in at a really easy phase, they’re just diets crap. And we can just make a simple change with the Paleo some we have to get a lot more nuanced. 

Evan Brand: So let me ask you, you brought up garlic. I had a woman last week, actually. And she was complaining that garlic was a big issue for her. So we’ve already cleared out gut infections, and we’ve done a great job. We’ve retested we’ve confirmed that we got rid of all the gut infections, we are doing some leaky gut support, but she says every time I eat garlic, I get really bloated. What would you What would you do? What would you say to that garlic person? 

Dr. Justin Marchegiani: Well, it could be a SIBO thing. So I’d want to test other fodmap foods. So if there’s some kind of a gut issue or like a bloat or a motility issue, or a diary or a constipation issue, we’re going to be cutting out fodmaps fermentable carbohydrates, fructose, oligo, disaccharide, mono and polyols. And we’re going to do that and then we’ll eventually do a reintroduction. And when we reintroduce foods, we’re going to start with moderate fodmaps first and then go to higher fodmaps. Last, so those foods are higher fodmap. So the question will be How did she do adding in the moderate ones? First, I want to know how she did incrementally adding things in.

Evan Brand: So like apples, she does fine, which was interesting, because to me, I’ve had a lot more people have issues with apples than I have with garlic. So I thought Hmm, you know, is it really a bacterial overgrowth thing? The stool test didn’t really show much in the in the bacterial category. So it’s kind of like, well-

Dr. Justin Marchegiani: when people like that, I just want to see is it a one off? Is it just garlic? Or is it other foods like onions and broccoli and avocado, which is a moderate or sweet potato, which is a matar, I want to test more of the moderate fodmaps? Maybe add in some fermented foods like a kombucha or a sauerkraut? Did it happen with those two, if it’s just a one off, then it could be some die off, it could just be she’s having an issue with that food. So if it’s a one off, I don’t really worry about one offs, I look for patterns, like patterns or like part of being a good functional medicine doctor, it’s pattern recognition, you’re looking for patterns, like some patient that can be Well, last week I had this happen or that like, we got to look at bigger picture, we got to have enough data points. So we can look at patterns. Anything can happen one off due to stress or a poor night’s sleep, or you got exposure to some bad foods. And now your guts a little bit rocky for a few days. So we got to look at longer trends and really have a lot of good pattern recognition. Part of what we do, we’re kind of CSI detectives, and we got to look for things repeating itself, because anything can happen one off, we don’t want to change what we’re doing, or the programs that people are on, off of just a one off issue.

Evan Brand: And that’s what it was, it was a one off and it was kind of, you know, frustrating for me because I’m thinking well, crap, you know, everything else, she’s tolerating good and any other problematic foods, I’d kind of put in that same category that we thought would be a problem. They’re not a problem. So I’m sitting here thinking, Okay, well, what kind of explanation Can I give her? Because she wants some kind of good functional medicine answer for me, right? And so that’s what I told her. I’m like, well, this sounds like just Oh, to be honest, kind of like a food sensitivity, particularly to the garlic. You know, I don’t looking at the testing. I told her I didn’t really see anything that was compelling to indicate any other sort of issue and all the other foods were tolerated. So I kind of just gave it like a political answer. It was like, wow, hmm. You know. 

Dr. Justin Marchegiani: Yeah, well, we’ll come it’s possible there could be just a, her immune response is just a little bit more sensitive to if we don’t see extra data points correlating to it, then I just tell patients, hey, let’s just we’ll come back. We’ll work on probiotics. We’ll work on good re inoculation of good healthy bacteria while adding some prebiotic fibers every month. We can try testing it again. But as long as there’s no yeah, as long as there’s no, let’s just say, family of other foods that are interacting like this, then we’re not going to really worry about it too much. But you can always retest, make sure that gut’s doing good, but it’s possible you have one off allergen issue that’s possible. But every month, we can always retest it and see.

Evan Brand: Yeah, good point, I did end up throwing in a high dose, multi strain probiotic. So we’re with a high amount of bifido. So we’re gonna see what happens. 

Dr. Justin Marchegiani: Yeah, and this person could tolerate fermentable carbohydrates, like sauerkraut and, and maybe a little bit of kombucha it’s probably not a fodmap issue, because those things are very, very high in fodmaps. It could be she’s killing some stuff off. It could just be she sensitive to garlic. It’s possible. Yeah. And so I mean, I just tell patients, hey, you know, that’s an artifact, we just kind of make a note on it. When we follow it down the road later on. If things kind of connect back to it down the road. That’s nice. But if not, things that are one offs. You don’t want to you don’t want to one off to derail your whole investigation. 

Evan Brand: Yes. Yes. That’s a great point. You know, it’s like you’re, you’re you’re like, you know, investigating a crime scene, and you have his weird piece of evidence. That does not make sense. 

Dr. Justin Marchegiani: Yeah. Right. Okay. Well, we’ll make a note on that. And we’ll come back to it if there’s any patterns that they point back to it down the road.

Evan Brand: Yep. Yep. Great. So so small tangent, but really helpful. I think it’s, it’s helpful for people to see how do you have to think when you’re approaching these issues, it’s not always black and white, you know, we try to refer back to clinical experience, we kind of sprinkle in some of the data sprinkled in some previous case studies that we’ve done with people. So it’s really fun. But back to the fatigue piece. 

Dr. Justin Marchegiani: So I just wanted to highlight one component, because while you’re on it, is when we are talking about these things, because we’re clinicians, and we see thousands of patients, we’re operating more off of clinical concepts than like rote memorization of like, a fax. And so when people listen to our podcasts, we really want them to understand the overarching concepts of health. If you understand a concept, you don’t really have to memorize it, if you’re trying to memorize random facts and randomness, and that becomes a little bit convoluted and a little bit stressful. So just try to get the overarching concepts that we’re talking about here. Once you get the concept, you never have to worry about memorizing, and it’s just there. 

Evan Brand: Yeah, yeah, good. So I just wanted to go back to the to the fatigue piece, because for certain people, there may be multiple layers of infections that are causing your fatigue. So for me it was H. pylori, and then once I got rid of the H pylori, then it was the parasites that were still causing me to be tired. And once I got rid of that, then I did have some Candida that I had to address. So what I want people to know is that if you double down or triple down on something, you know, the guy tells you it’s parasites, or the girl tells you it’s this, and you pursue that, and you’re not better, it’s possible that you’ve, you’ve missed something. And so I just want people to wrap their head around you, like you say, you have permission to have multiple things wrong at the same time. So you could have a bacterial issue, a parasite issue, a Candida problem, all at the same time. And so you got to make sure you get all the data if you just run a stool test. Candida rarely shows up on the stool test, you and I’ve talked about this many times. So the urine test will often fill in the blank. So if you had one test done, or your doctor ran this or that, and you feel like you’re missing something you probably are so keep, keep digging. 

Dr. Justin Marchegiani: You also there’s one study here just looking at h pylori and mitochondrial function, I’ll put it up on my screen. But this is important, right? And the reason why it’s important, I’m going to just I’m going to do a share here. So if you guys are listening to the podcast on YouTube, you’ll be able to watch the video. If you’re on iTunes, you know, you have to just click the YouTube link, and you’ll be able to see what we’re talking about. If not, I’ll try to describe it pretty well. But you can see my screen you see my screen. 

Evan Brand: Yep. h pylori affects the mitochondrial function. 

Dr. Justin Marchegiani: So this is important right here. So mitochondria are the powerhouse of the cells. This is really important and the powerhouse of your cell generates ATP for energy. Now, if you look here at the bottom they talked about, they wanted to investigate whether there’s an increased mutational load and mitochondrial genome and what they found was there believe that the there’s a downregulation in the mitochondrial DNA repair pathway? What does that mean? It means how your mitochondria are repaired and regenerated. It’s going to be down regulated, so you’re not going to be able to repair your your mitochondria as fast. It’s believed to be involved in mitochondrial base excision repair. Our results suggest that these genes A p one and y b one, just know that their DNA is that are involved in mitochondrial DNA repair. They’re they’re demonstrated to be involved and they’re demonstrated to be down regulated when there’s an H pylori infection. So it just means that your body’s ability to generate ATP which has decreased respiration coupled aptr. So you’re not able to generate as much ATP and repair your mitochondria as well when you have an H pylori infection. And this is something that we think is there with a lot of gut infections. It affects your mitochondria. Your ability to repair it, which then affects your ATP synthesis. 

Evan Brand: That is pretty crazy. I mean, especially if we’re talking about an athlete who wants to perform right you’ll have all these big celebrity personal trainers and stuff and they’ll just get people on different diet changes or no, you need to do this exercise or this exercise and they missed the boat. They don’t have a clue about H. pylori being the root cause of the of the fatigue or the exercise performance. So yeah, it’s just crazy. 

Dr. Justin Marchegiani: And then also, there’s a lot of right here, right here one study, I’ve already looked at it before, if people are having gut issues, and they go to their conventional gastroenterologist, what are they typically prescribing? Well, a lot of times they’re prescribing antibiotics, right, and there’s a lot of data, bacterial Seidel, antibiotics induce mitochondrial dysfunction and oxidative damage. And so we know this is something that’s actually present, where there’s damage to the mitochondria with antibiotics. 

Evan Brand: Well, and and, and to be clear, for H pylori, it’s not just one antibiotic, it’s three or even four, they have what they call quadruple therapy now, which just the name of it scares me, it’s literally four antibiotics at the same time. And you and I have both seen patients that have had triple or quadruple therapy done and guess what we retest them, and unfortunately, due to antibiotic resistant bacteria, the infections are still there. So now we have to come in, repair all the mitochondria that were damaged, plus use herbs, which are much, much safer, and in my experience, just as if not more effective, and then we actually get rid of the bugs. 

Dr. Justin Marchegiani: Yeah, she’s a summary of your mitochondria dysfunction and oxygen damage induced by bacterial Seidel antibiotics, which is interesting, because bacteria, all antibiotics are bacterial Seidel, so interesting. They use that description. It’s mammalian cells. I’m not sure which mammals they use. But they talked about that it’s alleviated by antioxidants. Well, guess what, when we use a lot of the clearing herbs that we use, guess what they’re rich in, I mean, tons of antioxidants, polyphenols. And that’s the benefit, a lot of the herbs that we use, they have a lot of antioxidants in them to help buffer the oxidative stress. Because remember, oxidative stress is part of what happens with the antibiotics. And we have a similar effect with herbs. But the herbs have a lot of antioxidants, which is helpful. Any comments on that? 

Evan Brand: Well, what you’re saying makes us look really good, because not only are we giving nutrients that can effectively get rid of the infections, but we’re also protecting the system or even replenishing antioxidants, because in general, and the oxidants are going to be reduced because of all the oxidative stress from the infection in the first place. So it’s literally like a win win, for us and for the person under the protocol. 

Dr. Justin Marchegiani: Yep. And there’s lots of different studies here as well on probiotics and beneficial bacteria, correcting mitochondrial dysfunction with probiotics. There’s there’s definitely studies on this as well. And again, you know, these are things that we’ve seen in our practice, like when you see someone get better. So protection of hepatocyte mitochondrial function by blueberry juice probiotics. So there’s lots of studies on this, because when you see patients get better with certain beneficial bacteria, after you do an elimination, you’re like, why does that work? And so what happens is you see a clinical outcome, patient getting better when you do something. And then you’re like, Huh, what could the mechanism B and then you chase it down online? And you’re like, oh, maybe that’s it? You know, maybe it has to do with the fact that it’s helping the mitochondria and people’s feel better afterwards? Maybe that’s the mechanism. It’s possible, right? 

Evan Brand: Yeah. 

Dr. Justin Marchegiani: We have to comment on that. 

Evan Brand: Well, it’s a lot of good things happening. And then you mentioned the probiotic piece. So that’s going to help even more. So after we get someone on a killing protocol, there’s going to be good benefits there, your energy is probably going to get better just based on doing that. And then when you go to the next phase, if we’re going to come into the gut healing phase, you’re going to get even better than so it’s it’s really fun for us to kind of paint the picture here of just how how is someone going up, up up up better, better, better? And you’ve just outlined how so pretty I talked about it right here. 

Dr. Justin Marchegiani: They talked about a collusion the studies show this is BP stands for blueberry juice and probiotic exhibit a synergistic effect preventing the development of a and that’s non alcoholic fatty liver disease by protecting mitochondrial function, suppressing the damage of mitochondrial ultrastructure by reducing mitochondrial swelling, right. So mitochondrial damage by antibiotics, as well as we could do the same thing when we search, let’s say pesticides, or heavy metals or mold toxins, so we know that gut plays a big role and one helping to absorb those nutrients. But number two, also helping to have beneficial bacteria that modulate these, this inflammation and mitochondrial damage as well. 

Evan Brand: Yeah, yeah. Well said. Excellent. 

Dr. Justin Marchegiani: Well, it’s good that just a couple of studies. I mean, when we look at like we look at research a lot differently, so just kind of everyone there. We look at clinical outcomes in patients. And then we chase them back to what the literature says. The problem is a lot of people who are clinicians, they’ll look at the literature, and then they’ll try to then come up with a clinical like decision based on the literature. And that’s sometimes it’s really hard to do, because a lot of the PhDs and a lot of the research out there isn’t necessarily clinically driven, and maybe driven because someone has a PhD in this area. And they’re just they’re just studying that topic, because or maybe it’s an NIH funded study. Who knows, right? So we’re looking at things that are clinically driven, not research driven, because someone has decided to dedicate their life to this topic. And this is the study they’re choosing right? 

Evan Brand: Now. It’s good that we can kind of pull out some studies to help backup what we’re saying. But it’s not like we go into PubMed to try to figure out exactly what we’re going to do the clinical stuff is really that’s where all the magic happens. 

Dr. Justin Marchegiani: Yeah. And some may say we have a confirmation bias and how we look for these things. But we’re not looking for out of the blue we’re looking for, because we’ve seen clinical outcomes support something is happening in that direction. And then we use the data, the research to say what could be if positive things are happening in this direction? A to B, what could be the mechanism of why that is? And so we kind of chase it backwards. versus the other way around? 

Evan Brand: Yeah, yeah. And it’s just it’s a blast. It is fun for you to pull that stuff up. Right? Because, you know, we get we get used to our our methods, we get used to our results. But when you get to see in the literature like that antibiotics, causing mitochondrial damage is like, Oh, yeah, I forgot. That’s why we do this. It’s Yeah, we’re Exactly. We don’t want people to get damaged. 

Dr. Justin Marchegiani: And you get confident when you see things repeat itself. Clinically, you’re like, Okay, something’s happening here. Now what? So you’re going at it with a lot more confidence versus like, Hey, I think maybe, you know, I’ve heard this, it’s a hearsay kind of thing. No, you’ve seen it, you’ve seen it clinically? Well, here’s the confidence.

Evan Brand: Here’s the thing that’s always fun for me is when we’re on the topic of fatigue and gut infections. And so when you have a case where you do the follow up, and someone is reporting that they have significantly more energy, and you didn’t give them any energy supplements, you just fix their gut, you just gave them some liver, maybe some enzyme support, some gallbladder support, and then you killed the infections and all the sudden, boom, I’m 20% more energetic. I always smile and laugh simultaneously. Because it’s like, This is so fun. We have 20% more energy. And we did zero energy supplements. That’s just super cool. 

Dr. Justin Marchegiani: Yeah, it’s powerful. Now, if people start feeling a little bit worse, then we got to be very careful. So when people start feeling worse, I’m like, all right, we got to spend more time building up the adrenals, we got to make sure the diets clean, because if someone’s got his or, like, if you’re putting lots of bad foods in and you’re inflaming the gut, then your immune system and also your adrenals may be making more resources to deal with the inflammation in your gut. So we have to decrease the inflammation in our gut and support the adrenals by calming it down. Now, the adrenals have more resources. And of course, we always like supporting the adrenals ahead of time. So then you have natural, your more of your natural anti inflammatories, because conventional medicine when there’s serious gut issues, they’re going to give prednisone cortisol, well, let’s just support your body’s ability to make that naturally. And then when we go into a gut clearing phase, then we have more of those resources on board. And then patients are sensitive. I’m titrating the herbs in there slowly so we’re not overwhelming the system by killing more, you know bacterial toxins, LPs endotoxins, mycotoxins, we’re not overwhelming the lymphatic system that a toxification immune system. So we’re going to kind of really titrate things in a little bit slower if you’re more sensitive. And we may even add things like binders and glutathione too. 

Evan Brand: Yeah, yeah, the glutathione is good for me. I had to take a break from it for a little while. It was just too strong. It does mobilize toxins to so this is all case by case basis. But yeah, I love glutathione when it works. But when you take too much, that’s no good. There’s always a right dose. 

Dr. Justin Marchegiani: Yeah, if you’re slow, if you’re like more sensitive, always start low, work your way up. And then if you’re sensitive, you can always start with just a gentle binder first, as long as you’re not getting constipated. That’s a good first step on increasing things. 

Evan Brand: Yeah, that’s great. So let’s see here. 

Dr. Justin Marchegiani: Um, the other component, I would say is people that have got issues tend to also have immune issues. We already talked about why 80% of your immune systems in the Galt, that’s the gastric associated lymphoid tissue that’s in the stomach. And then also the model that’s the mucosal associated lymphoid tissue, lymphoid meaning like lymphocytes, white blood cells, and that’s in the small intestine. And so if you have a lot of gut permeability issues, if your guts over responding well, what’s the most common autoimmune condition that affects people and mostly women, five times more women is autoimmune thyroid. And so if you have an autoimmune thyroid, that could also be affecting your energy because you know your thyroid gland is being attacked and your body is ability to generate thyroid hormone may be decreased. And it’s possible that your conventional doctors overlook that. And so knowing that there’s an autoimmune thyroid could be affecting your energy too. And if you have an attack, you could feel hyper where you’re like anxious, can’t sleep irritable, sweating, right? first and then you go into a hypo where you’re like tired, fatigued, depressed, right? So you could easily be going hyper and hypo swings based on autoimmune tax of the thyroid. 

Evan Brand: Yeah, and once again, the hashimotos could be a side effect of something else. So even if you go to the endocrinologist, let’s say they were a more advanced endocrinologist, for example, hopefully they’re running thyroid antibodies TPO, TG maybe TSI. And they’re looking at that and maybe they’re treating your thyroid giving you desiccated glandulars, or nature thyroid, or just Synthroid or side ml. Even then you see how people can fall between the cracks and not get better. Because yeah, you’ve kind of cranked up the thyroid that was hypo due to autoimmunity. But you still never got to the gut infection that started at all.

Dr. Justin Marchegiani: BINGO, BINGO, BINGO, BINGO 100%. That’s what we got to look at always the root cause. So anything else you wanted to talk about here on the gut and fatigue I did, we hit the thyroid, of course, I alluded to the adrenals earlier, because they play a huge role in regulating inflammation. And we know acute gut issues, they may be, they may be given a corticosteroid to calm down the gut inflammation, that’s possible too. So we want to support your body’s ability to do it naturally. I would also say supporting protein breakdown. So with maybe adding in free form amino acids, because protein can be very hard on the body to break down. So of course, dialing in enzymes and acids and maybe giving extra free form amino acids. So it’s taking stress off the digestive system to be able to access those amino acids as well. 

Evan Brand: I think I think you’ve hit it all. I mean, I would just say, kind of where do you go next is you really have to get the data. I mean, we’ve talked about a lot, right. But if you don’t have the data, you don’t know what you’re up against. You don’t know what you’re doing. So, you know, I think the best advice I could give is if you’re dealing with these issues, test, don’t guess. And so, you know, feel free to reach out to Dr. J. Justin at JustinHealth.com. And he can run labs on you anywhere in the world and send them to your door and jump on a call and discuss it make a great protocol to help you to get better. Same thing for me my website, EvanBrand.com. And we’re available we love helping you all we’re grateful to be in this position. So you know, sure you know a lot of you listening or kind of do it yourselfers. That’s what led you to be smart and find a podcast anyway. Because you want to kind of educate yourself, but there’s a certain point where it’s okay to reach out. And I tried to fix myself for a long time. And you spend more money and you spend more time doing that. So you know, feel free to reach out and get a guide.

Dr. Justin Marchegiani: 100% and then you’re available at EvanBrand.com worldwide. We’re available worldwide and we’re clinicians, we have our sleeves rolled up and we’re in the trenches every day, dealing with patients. Also, if you’re listening to this don’t just kind of glom on to one thing. So we see lots of people they’re like, they come in like Oh, I know what’s h pylori or I know it’s Candida or I know it SIBO keep an open mind on what’s happening because you have the right to have more than one issue going on at the same time. And for instance, Evans original story was Evan had not could have it wrong if you had h pylori, Giardia and crypto. That’s correct. Yeah, yeah, h pylori, giardia crypto, those are some serious infections. Any one of those infections is serious and could could have created the symptoms Evan was having yet he had all three at the same time. So if Evan was like, Oh, it’s only H. pylori, you know, he may have missed the fact that grd and crypto were involved too. So go into with an open mind and you have the right to have more than one infection happening at same time. Sad but true. But either way there are solutions to work on it and fix it. 

Evan Brand: I was tired. Man, I was tired. Now that was a that was a that was a level of exhaustion that just doesn’t even seem real. I mean, that’s how you know something’s wrong when you’re that tire. But you know, hopefully, with this education we’re providing people can reach out and work on this before it gets to that crisis level because it’s much easier to pull you out if you’re not that deep. 

Dr. Justin Marchegiani: Now Evan can you go to your conventional medical doctor or a gastroenterologist and typically get these infections picked up on? 

Evan Brand: No, definitely not the testing is just so outdated, you know, it’s not sensitive, like the DNA stuff we’re using. So that’s the downside is if you go to the gastro doc down the road, say, Hey, I think I’ve got Giardia, I heard these two guys on the internet talk about it. They’ll probably just laugh in your face and say, Well, you didn’t travel to any third world countries. So you don’t have it. But if you if you really want to Sally, I’ll test you on they’ll run the outdated test and then everything comes back negative and then we’ll say see, I told you it was all in your head, just, you know, take an acid blocker. 

Dr. Justin Marchegiani: So yes, my opinion is very similar. So the more acute you are, especially with typical gastrointestinal symptoms, the greater chance they’ll pick you up, especially if you came back from like Mexico or some kind of a country like Bali where infections are probable, right? But now what do you do? If your infections aren’t really gut based symptoms, they’re the fatigue or the brain fog, well, then how does that get picked up, you’re typically never going to get picked up for that you’re more than likely to, to get a psych referral for an antidepressant, right, then to get a gut test, and Evan already alluded to some of the technology they have isn’t going to be as up to par. So we have a little bit you know, more access to the DNA technology a little bit more sensitive. And then also like H. pylori testing that they may run a breath test, right? Urea breath test and look for elevated levels of co2, it’s possible, but that may miss an infection. And if it’s more subclinical, you may need a more sensitive test to pick it up. So if you’re listening, and you’re like, Hey, I’m gonna go to my MD that may not be the solution, I may not get you the answers you want. And if you don’t have the typical gut symptoms, diarrhea, bloating, gas, a lot of stomach discomfort, and irritability, you may not even they may not even want to run a test, because those symptoms don’t match with what they think the problem could be. 

Evan Brand: Yeah, yeah. And you know, it sounds like we’re like picking on him. Right? And we sort of are and that’s fine. I love picking on them, because they’re failing people. And it makes me sad. Because I was there I was sitting in the doctor’s office trying to get help. And I was told that I just needed an acid blocking medication. I told the doc, no, I feel better when I take it. enzymes that actually increased my stomach acid, I think you’re wrong. She said, That’s not possible. You’re gonna hurt yourself, you need to stop taking supplements stop all dietary supplement, the FDA, blah, blah, blah, blah, blah. And and that was it. And that’s when I signed off and said, No, I’m done. 

Dr. Justin Marchegiani: Yeah, and I do recommend, and I think you’re in the same way, I do recommend patients that have chronic issues, or acute issues, at least go see your conventional medical doctor just to get checked off that there’s nothing glaring that’s going on. And that that way, if you work for someone like myself, for you, and then they’ve kind of already been looked at, and they’ve kind of already know, okay, conventional medicine is kind of done all they can do. And, you know, functional medicine is the next best option at that point. 

Evan Brand: Yeah, I’m not saying we’re the all knowing at all, if you’re bleeding out of your butt, you need to go confirm you don’t have some type of a bleeding ulcer or colon cancer or you have some type of a polyp issue or diverticulitis and you need colon surgery. I mean, there are certain things that we can’t help with. But for these more functional, non pathological issues, we’re definitely going to be able to help. 

Dr. Justin Marchegiani: And we can help with all those issues. Once they’re stable. If they’re unstable, though, conventional medicine does a really good job on stabilizing very sensitive issues. But once they’re stable, now what because for the most part, it’s going to be just symptom drug management for the rest of your life. Right? If you look at what they talked about, it’s, hey, we’re managing your gut issue versus let’s actually get to the root underlying issue. And sometimes management’s good when things are acute and flared. But now when they’re stable now what we want to go beyond just who wants to just manage their diarrhea for the rest of their life? That’s crazy, right? 

Evan Brand: Oh, God. Well, that happens every day, doesn’t it? It’s happening today while we’re doing this call somebody is in the doctor’s office right now about to get an antispasmodic drug for their diarrhea. 

Dr. Justin Marchegiani: Yeah, and that may be fine acutely, but then what’s next? So get your health issues under control from a you know, stable standpoint, and then work on the next step with a good functional medicine doctor. Well, everyone was excellent chatting with y’all anything you want to leave us with Evan? 

Evan Brand: No, that’s it. We’re just ranting at this point. So if you need help, please reach out. JustinHealth.com, EvanBrand.com. Take great care yourself. We’ll be back. Have a good one, y’all. 

Dr. Justin Marchegiani: Take care. Bye now. 

Evan Brand: Bye.


References:

https://www.evanbrand.com/

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/fatigue-tiredness-and-link-to-gut-infections-podcast-311

Hashimotos Root Cause Solutions With Inna Topiler | Podcast #237

Hashimotos is an autoimmune disorder in which antibodies directed against the thyroid lead to chronic inflammation. Also known as chronic lymphocytic thyroiditis, Hashimotos is the most common cause of Hypothyroidism in the United States.

Get a wider picture on Hashimotos’ root causes, symptoms, and solutions, and how can other issues with thyroid or gut affect your overall body health. Find out what Dr. Justin and Inna Toppiler talked about here.Inna Topiler

Inna Topiler – MS, CNS

In this episode, we cover: 

0:50 Eczema patient, oxalate issues

05:31 Moderate or high oxalate foods

10:19 Inflammation bucket

14:57 Hashimotos Symptoms

30:41 Solutions

Youtube-icon

Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani, welcome back to beyond wellness radio. I have clinical nutritionist, Inna Topiler in the house, you know, as part of my thyroid reset summit, which was excellent. Make sure you get access to that, but you know, welcome to the podcast. How are you doing?

Inna Topiler: I’m good. Thank you so much for having me. I’m excited to be here.

Dr. Justin Marchegiani: Well thank you. It’s great. We’re doing it via video. So if you guys are listening to the podcast, make sure you subscribe to the Youtube Channel justinhealth.com/youtube hit the bell, hit the subscribe button so you can get access to these awesome podcasts and video as well. So what’s going on with you, and I know you’re a clinical nutritionist, you’re kind of in the trenches every week with patients. Just is there a memorable patient or case that kind of comes to mind the last week or two we can kind of break down for the listeners?

Inna Topiler: Absolutely. So I am typically, I’m seeing, you know, probably about 1520 people a week. And then I do research and I do my podcasts. And working on the summit the other days. And so people usually come to me after it, probably similar to you after seeing two, three, four, sometimes even 10 different practitioners. So I’m kind of their health detective and I’m solving a lot of mysteries. So, um, lots of cases come to mind, but actually I’d like to tell you about one. Uh, she, um, is 30 years old and she was having a lot of Eczema and a lot of rashes and she’s been to numerous dermatologists and have taken, I can’t even tell you how many rounds of steroids and um, antibiotics, topical creams, you name it. And you know, it’s a very frustrating thing when your skin’s always itchy and red and uncomfortable. And a lot of it was on her face too, which I mean, that’s how you present to the world. So it’s, um, you know, it was great in a lot of issues for her and she’s tried everything and she, but essentially came to see me, she’s already gluten free. She was dairy free, you know, she was doing a Paleo type diet. So she was doing in her mind everything she was taking probiotics. She was paying, you know, $50 for this like very special probiotic yogurt. I mean she was doing it but yet unfortunately her symptoms were not any better. Um, and so we did some testing, we did an organic acid test, we looked at foods and what was very interesting for her, the issue actually wasn’t that she was sensitive to a food. She was actually sensitive to compounds in food. So as she was trying to be healthier, she was eating a lot of leafy greens. As you know, we all hear Kale, it’s good for us. And um, cauliflower and spinach. Um, and she was eating because she’s changed to more of a Paleo template. She was eating things made of almond flour and she was having a lot of sweet potatoes cause she wasn’t eating starches. And when we looked at it, we said, okay, well she actually had high sulfate on her organic acid tests and she was living a lot of sulfur, but she was also consuming a lot of foods that had, um, oxalates in them. Um, and oxalates are, they’re almost like these crystal x structures and they can really affect our body negatively. She also had elevated Billy Rubin. And what’s interesting is Billy Rubin has to go through this one specific pathway in the liver to get metabolized. And that same pathway is also what conjugates the oxalates and also a lot of carcinogens and estrogens, estrogens from the environment.

Inna Topiler: So not to make it too complex, but basically, if you guys can think of a, uh, you know, let’s say a drain, right? And we have the faucet that’s on. So if the drain is open, the water goes through where everything goes down. But if the drain is clogged, you have the faucet on, it backs up, and eventually the sink overflows. And that’s what was happening with her. So, even though she was doing all this sort of right things and you know, she did the Paleo, she was taking probiotics, she looked at all that and it really wasn’t her issue. So once we actually changed her diet and um, believe it or not, I had her removed green juices even though I know we hear that it is so beneficial for us, but it was too much Solfa for her. She was using tons of Kale and spinach is for sharing. It was too much sulfur. She was also eating spinach almost every day in a salad. And while spinach has a lot of benefits, it is very high in oxides. A Cup of spinach has 300 milligrams of oxalates, which is a really high amount. And so, and just so you guys know, if someone has issues with oxalates and if you have that sort of club drain and things aren’t going through, it’s recommended that you eat less than a hundred milligrams of oxalates per day.

Dr. Justin Marchegiani: Oh three times. That would just the spinach exposure alone. Right?

Inna Topiler: Exactly.

Dr. Justin Marchegiani: I’m just con– So, it’s a couple of questions here is off the bat it was the issue with the sulfur, was it more the oxide? It sounds like it was more of an oxalate issue.

Inna Topiler: It was more of an oxalate issue, but the sulfur kind of tends to go hand in hand. It seems like she was dumping sulfur in the urine and she didn’t actually have enough in her body. So we had to make sure that she wasn’t overdoing it. But sulfur is found in so many different foods and we can’t remove all sulfur. So, you know, they were kind of intertwined, so we had to make sure that she wasn’t overdoing it, but still getting some and then making sure that we’re working on the liver pathways to process that.

Dr. Justin Marchegiani: Totally now, a lot of the organic acid tests sometimes correlate a lot of the oxalates with yeast or fungal overgrowth. Did you see a yeast or fungal overgrowth with this patient’s [inaudible]?

Inna Topiler: Such a great question. Yes we did. It wasn’t that bad, but it was there. Um, and actually, um, to let you know, but that when we started to address her diet, we didn’t even get to the yeast yet. We just started changing the Diet. We took out almond, we replaced it with other nuts. We took out the spinach, her rashes disappeared.

Dr. Justin Marchegiani: So basically you kind of pulled out maybe like a list here of all your moderate and higher oxalate foods and you used, did you just focus on cutting the high ones or even the moderate ones?

Inna Topiler: I just focused on the high. Um, so many foods have oxalates and she was already so restricted. I didn’t want to overwhelm her too much. So we kind of spinach, we cut out almonds and we lowered potatoes —

Dr. Justin Marchegiani: and almonds and what are good replacements for those?

Inna Topiler: Um, so, um, you can do, um, I mean all of the — See, the problem is that with leafy Greens, uh, some of them are not gonna have as many oxides, but they’re going to have a lot of sulfur. So then we don’t overdo that. So I had her do more things like Romaine lettuce and then we ate other vegetables, asparagus, green beans, Zucchini. It’s okay not to always have leafy greens. I think that her body just needed a break from those. So we really focused on other vegetables.

Dr. Justin Marchegiani: What about Kale, does Kale works? Kale. I mean I think it’s obviously higher sulfur, but it’s a lower oxalate one, right?

Inna Topiler: It is.

Dr. Justin Marchegiani: Just cut the nuts out. And you were kind of not alternative–

Inna Topiler: We did coconut. Um, we also looked at other nuts like walnuts that are not as high in Oxalates. And then she wasn’t actually necessarily sensitive to the grains, at least not from what we figured out. So she was doing Paleo because she thought that it was healthier, but it wasn’t really helping. So we actually put in a little bit of a millet. Millet is really low in lectins. So a lot of people that don’t do well with grades can tolerate that. And then we put in a little bit of rice and she was okay with that. Of course, obviously everyone is different. So it doesn’t mean that everyone can do that. But in her case, it was better to have a little bit of the grain, um, and lower the amount of potatoes that she was doing because otherwise it was all potato or almond flour based stuff. Another thing we did was cassava flour. I’m a big fan of cassava and again, I mean you want to do it in moderation because if you have a lot of it that can be higher glycemic. But we did use it in some baking and she was doing cassava flour tortillas and that worked well too. And that’s grain-free.

Dr. Justin Marchegiani: Awesome. I know the oxalates can kind of get in the joints too and kind of crystallize and um, and create pain and inflammation. Was this patient presented with any of those symptoms at all?

Inna Topiler: No. So for her it was more the skin issue and I think that, yeah, I do have another person who was having that issue with their joints. Um, she was in her mid forties and she was feeling very arthritic and she said to me, I’m not that old. What’s happening here? And she went to see a rheumatologists and they tested for rheumatoid arthritis. He did all the testing that came out negative and she also was eating spinach, pretty much every day we cut that with for her. All we did was cut spinach and her [inaudible] went away. Another thing I want to mention is related to that is people sometimes don’t realize, and again I’m not trying to bang up on Kale or spinach. I mean obviously there’s benefits. I’m not saying it’s bad for everyone, but sometimes people also don’t realize that a lot of leafy greens, even though they do a fiber, they can back us up a little bit. So if you’re eating a lot of Greens and a lot of cruciferous vegetables and you’ve, if you have constipation, just be mindful of that. Especially if you have thyroid issues because you know there’s a correlation with that. Um, you may want to lower that and that can help.

Dr. Justin Marchegiani: Can cooking foods also help one, break down some of that fiber, but also help lower the oxalates a little bit. You look at strategies and trying to take some of those raw oxalates and maybe cook them down a little bit to help decrease the amount.

Inna Topiler: Yeah, that definitely helps. But I think initially it does help to try to cut more of it out. Um, plus you know, it helps with the rotation because people get into a rut, as you probably know. And you know, they have spinach and okay, this is good for you. I’m gonna eat it every day. Okay. They’re still, yeah, let’s get from an eat it everyday. So it’s nice to rotate. So I think, yeah, if you’re eating a lot of something, it’s good to give your body a break and then we’ll add back slowly. And the cooked versions are definitely going to be better.

Dr. Justin Marchegiani: Yeah. If you love it, rotate it. That’s a good edge. I like that. And what happened to her skin? So how did that progress? Did you have to go deeper and, and do, you know, work through the digestive system and you find the gut infections? How did her skin progress over the, you know, a bit of time here.

Inna Topiler: So what’s really great is that all of the rashes went away as soon as we changed the foods. And I mean, as you can imagine, she was just ecstatic because she’s been dealing with it for so long.

Dr. Justin Marchegiani: When you say rashes, you mean the Eczema, right?

Inna Topiler: Well, it was Eczema and rashes, so it was kind of a combination. So it was like rashy itchy bumps and then the dry scaly spots that —

Dr. Justin Marchegiani: Did you see any connection at all with histamine with her.

Inna Topiler: Yes. Um, and I think, I don’t know if you agree, but I feel that the histamine is just a temporary reaction because everything else is flared up. I don’t think that she would have that problem longterm, but a lot of the foods that have oxalates like the spinach is going to have histamine as well. Um, and we did lower some Kombucha and some yogurts that she was doing.

Dr. Justin Marchegiani: Yeah. I find the same thing. Like you have your stress bucket or your inflammation bucket. I did a podcast, they on allergies and we talked about, you know, here’s your bucket and we have all these different antigens in there. And when you’re already topped off and off, sometimes just those simple histamines could be an issue, but if your bucket was lowered, it wouldn’t be a problem. And a lot of those foods are still really nutrient dense and who doesn’t like Bacon and Kombucha. Right. So I totally get where you’re coming from on that.

Inna Topiler: Yeah, exactly. Exactly. Um, I think also, um, when you look at the histamine reaction, a lot of what goes on in the gut is going to affect that. So if you’re got some mass and if there’s dysbiosis and overgrowth and Sibo and everything else, you’re going to be more likely to react to them. So it’s kind of like same analogy as you’re get in with the bucket, but in addition to the food intolerances, there is all this infection that’s in there too.

Dr. Justin Marchegiani: 100%. And how much better is her skin now? She half is you almost a hundred percent gone.

Inna Topiler: It’s 100%.

Dr. Justin Marchegiani: Oh Wow. That’s awesome. Anything else you have to do with the skin stuff?

Inna Topiler: Um, well we are starting to address, um, there some SIBO, the yeast, we’re working on that, but the skin cleared up just from the food and it’s not always the case. I mean obviously everyone is different so sometimes you have to look at everything until you see improvement. But in her case, um, she was lucky and it was really nice that just the food alone clear it up. Now that doesn’t mean we’re done. There’s obviously still stuff going on and she was experiencing some bloating and some discomfort that’s still there, which made sense. She was a little bit upset about that at first cause she said, okay, my skin’s better, but why is this still there? So I had to tell her, well, we just started, we still have a lot more work to do. So one thing at a time.

Dr. Justin Marchegiani: Yeah. It’s always interesting when you work with patients because as a clinician, I mean, you know, there’s a bunch of levers you’re going to be pulling, right? Diet, stress, hydration, exercise, looking at the gut, looking at the hormones, right? And you may not know one of those levers make may get you 90% of the way there while the other couple don’t move the .. lot. And it’s hard to know which one it is because you have so many experiences where summits evenly spread out some, it’s just that one lever and everything is right. You notice that too.

Inna Topiler: Mhmm. Definitely, definitely.

Dr. Justin Marchegiani: And its always a surprise.

Inna Topiler: It is. And sometimes when I talk to someone I could Kinda tell like, all right, I don’t know if it’s my intuition or just looking at the test could be my logical brain, but I’m like, ah, I think it’s going to be over here. Sometimes I’m right, sometimes not. But yeah.

Dr. Justin Marchegiani: And what is your Mr average patient look like as she is? Is it female 35 40? What’s the Avatar right in there? What other, what other major issues are you seeing the patient’s coming in outside of just the skin issues? Is there another type of pattern that just, it’s constantly knocking on your office door.

Inna Topiler: A lot of fatigue. I see a ton of autoimmunity and you know what they say, you attract what you yourself have or had or I’ve dealt with. And so I’ve, uh, I have Hashimoto’s, which I’ve been able to successfully reverse. I still have some antibodies, but they’re a lot better than where they were —

Dr. Justin Marchegiani: Saying you’re a man. I’m in the same booth as you. What was your most recent thyroid test? You remember your personal results?

Inna Topiler: I do. I test mine every, you know, probably two months or so. Um, so just to give everyone a little bit of a history, my antibodies, when I first tested them, and this was back when I’d probably go in 20 years, when I was in my early twenties, they were in the seven hundreds, which is very high. And that’s when I was like, okay. And then over the years just with doing detox and working on my gut, working on metals, they’ve shut up to as high as 6,000. So that was my ultimate high. I’ve gotten them. Yeah. So I’ve gotten them, uh, to the 200 mark now. That’s the lowest they’ve ever been. Um, and interestingly enough, and I want to touch on this because I think this is an important piece. I’ve done everything. Literally like all the cleanses, um, took, took out all the metals that all the nutrients, um, worked on my gut and basically I was as perfectly as I could be and my antibodies were around 450 and they stayed there for awhile. They flared up postpartum after I had my son and then they went back to the 450 mark and I kinda thought, okay, this is just my baseline and you know, it’s better than 6,000. But then I started meditating and I got a lot more into the mind, body aspect and just seeing the importance of all of that. And without changing anything else, I was still doing the same diet, the same nutrients. My antibodies dropped under the 200 points. So that’s what got me to the 250 mark.

Dr. Justin Marchegiani: Wow. How about your thyroglobulin? Where are those coming back positive at all?

Inna Topiler: Mildly. So were added, vary anywhere between like 30 and 80. They never really got above a hundred.

Dr. Justin Marchegiani: Okay. Got It. I’ll go over mine with everyone. Just to be transparent. Are you, do you need thyroid hormone? You know?

Inna Topiler: I do. So I take a very small amount. And that’s another thing I wanted to mention really quick. As a nutritionist, I always try to do things naturally. And for the longest time I was very against taking thyroid medication. My TSH was always borderline. It was always in like the waterline normal lab, you know, optimal range. It was not borderline, it was out. I was in like the 4.5 um, range and by T4 was a little bit on the lower end. MIT three was always low, was in the 70s but I always said, you know what, this is my job. I need to do things naturally and I’m going to do that for myself. And finally, I mean years later I talked to someone and you know, cause every practitioner needs their own practitioner, right? We can’t take care of ourselves. We need someone to help us as well. And I decided to do a little bit of supplementation and it was so life changing. I can’t even tell you my hair started growing, my energy improved that I wasn’t feeling bad, but I just felt so much better. And I take, I do a compound it two 43 and I have 52 T4 and 13 micrograms of t three so really like not a very large dose, but what an amazing effect that has.

Dr. Justin Marchegiani: That’s great. That’s awesome. Yeah. I ran my blood tests here two weeks ago. My TSH, I don’t, I do not need thyroid support because of my labs. We’ll go over it. TSH was 1.81 so it was below two below two and a half. T 4 free was 1.4 which is good. A T4 total was 8.7 which is good. We want between six and 10 ish. If you, you know, Well if you don’t agree and let me know too, she had three total was 103 and T3 free was 3.5.

Inna Topiler: Those are great numbers!

Dr. Justin Marchegiani: Yeah, they’re pretty good. TPO antibodies. I’m, I’m keeping them below 16, 15 ish. So those were in the sixties or seventies. A couple of years back. Thyroglobulin has popped up to 74 though. So that’s a little bit on the higher side for me. When these labs were done, um, I ate a little bit of a gluten free dessert the night before, so my glucose was a little bit high in the morning, 105 and my insulin was a little bit high at 11. So right now I’m tightening up the gluten free dessert stuff and, or any dairy in my diet and I’m trying to go a little bit lower carb. I’m going to be testing my insulin and all my antibodies next month. So, you know, as clinicians we like to monitor our own stuff and kind of benchmark our own stuff too. So that’s just for transparency’s sake. That’s where I’m at.

Inna Topiler: Thanks for sharing.

Dr. Justin Marchegiani: Yeah. Cool. But it’s good though. I think it’s great as a clinician that you have your own challenges because it causes you to really look deep. It causes your patients, I think to know that you’re trying to practice what you preach as well. And I think it’s tough too because like I’m in a place where I’m like, I don’t want to take thyroid hormone, but I also understand, you know there’s probably a delineation of when you do, obviously you crossed that. Can you walk us through, what’s that threshold? Is it, are you looking at TSH? Are you looking at a T3 threshold? What are you looking at the say, hey, I need thyroid hormone.

Inna Topiler: So for me I looked at both of those. So while TSH of course is important, if you know with Hashimoto’s that can sometimes fluctuate and if my T4 and T3 was normal, I wouldn’t have done it. But I had the very textbook pattern. My TSH was elevated slightly, my T4 was slightly low a, my TSH was 4.5 so it was out of the optimal range. My total T4 was five point. I mean that, we’re going back years now, but it was under six, it was like 5.8 and my T3 was 70.

Dr. Justin Marchegiani: All is your T3 free.

Inna Topiler: Uh, like 2.7. I mean it wasn’t terrible but–

Dr. Justin Marchegiani: It was under this lower side for sure. Yeah.

Inna Topiler: Yeah. Um, you know, and because of the pattern that if it was just one of the numbers, then I would think, okay, maybe I’ll just wait and see. And I’ve tried a lot of natural stuff and I’ve tested it in the numbers were always showing up that way. So it wasn’t just, you know, cause the TSH will fluctuate. Things can happen from day to day. This was consistent month after month. And knowing that we need thyroid hormone for every cell in our body. And this is something that people may sometimes not realize because we think, okay, thyroid is important for our metabolism. It’s important for temperature control. But there’s just so much more than that. We need it for our brain, we need it for our feet. I mean we need it for our gut, for everything. And I actually realized, wait a minute, I’m being so hardheaded here, like I’m going to do things naturally. I’m not going to go on this. Meanwhile, I’m actually harming my body. If I don’t have enough thyroid hormone, then my guts not going to heal the way that it’s supposed to and other things are not going to work. And I’ve tried a lot of natural stuff. Now here’s the thing, I’m not saying anything against natural stuff. That’s always my first resort with everyone. Um, it’s just that because of fresh tomatoes for awhile and my thyroid was damaged due to it, I need it. Not everyone does, but you know, it’s just looking at everything and weighing it out. And I think it’s important because sometimes people can, you know, go too much one way and then kind of forget about everything else on the other side.

Dr. Justin Marchegiani: Yeah. A lot of people come into this thyroid game and they’ve kind of caught their thyroid or their immune system beating up their thyroid like 10 years into this relationship. And it’s like, okay, you’ve been beaten me up for like 10 years and there may be some functional tissue that’s not quite producing that hormone like it was, you know, a decade ago. So that’s where you kind of have to replace things. But a lot of times, you know, you may be able to replace some of that functional tissue by doing all the things that we’ve talked about. We’d be all in the thyroid summit that we talked about, but gluten and the leaky gut and supporting some of these nutrients, but sometimes there’s just kind of the gap, right? And that’s kind of where you have to really be real. Look at the TSH, the look, how much is the brain talking, and then look at the actual hormones and say, Hey, are we at least getting to mid range or so? And if we’re not, then we got to look at a bumping that up, especially if we have low thyroid symptoms, like your cold hands or cold feet, maybe thinning eyebrows, mood issues, motility. What kind of, what were your low thyroid stuff?

Inna Topiler: Uh, cold hands and feet. Yup. Um, hair loss but not so much loss where like, you know, it was falling out. It was just really thin and brittle. Yeah. And you know, it was interesting too, it never grew past my shoulders. It was just like the end when I was younger. It did and then it just stopped like it would get here and that’s it. And since then, you know, my hair swell, I’ve cut it recently but it’s way past my shoulders now. So that was kind of an interesting thing. I did have a little bit of the eyebrow thinning fatigue, irregular cycles, issues with motility. I mean, not terrible, but just, you know, things are just, we’re not 100% and when I optimize that, it all just completely aligned.

Dr. Justin Marchegiani: And was there like as you went through kind of like adding various things in and dressing various systems? Where’s there a couple of things that was like, oh, this really accelerated this or this really accelerated that?

Inna Topiler: Um, how many before doing thermos and I did a lot of stuff to really balance my body, still cleansing out the yeast. I had a lot of Candida, a lot of mercury in a lot of copper. Yeah. Clearing the Candida was huge. I mean I had a lot of IBS symptoms which got so much better than motility stuff was still a little bit off, which the thyroid helped with. But overall the dissension against the bloating in that, that way better with the candida. I had to tell a cop on a ton of mercury and that was not an easy road. I mean it was probably a year or two year and a half process, probably even more two years of detoxing that and I did a combination of some culation um, along with some other methods. Um, so that really helped a lot too.

Dr. Justin Marchegiani: That’s great. Excellent. And what made you want to go compounded with your thyroid versus like an armor or Nature-Throid or WP?

Inna Topiler: So that’s a really good question. And um, what happened to me was interesting. I actually went on West steroid. That was the first one I went on and I, uh, I still like kinesiologist back in the day and he muscle tested me and he’s like, oh, this is great cause I was back then I was like, okay, I’ll just do armor because that’s what everyone was doing. And he said, no, no, the WPS can be better for you. So I’m like, okay. I did that. And um, and I felt really good. That’s when my hair started to grow back and my energy was good, I felt great. But then I tested my antibodies and you know, before starting that there were in the four or five hundreds they went up to 3000.

Dr. Justin Marchegiani: Woah! Holy smokes.

Inna Topiler: And I thought, hmm, okay, that’s kind of weird. And I thought maybe it’s a fluke. I waited another six to eight weeks, retested 3,500. I’m like, okay. Did another couple of months where he tested above 5,000 the lab didn’t quantify when it was above 5,000 so I’m like, okay, well obviously something changed here. And I’ve talked to a bunch of different practitioners and colleagues and I knew that there was something in the WP that was affecting in, even though there’s not a ton of research and even though people say you can take it, it’s fine, you know, there are um, you know, studies that show and I think, you know, anecdotally like in my case as well, they, because it is a natural substance. If your body attacks your on fire and he can then attack the armor of the WP. And of course it doesn’t happen to every person. Not saying everyone Hashimoto’s can’t take it, but I was the one or 2% that it happened to.

Dr. Justin Marchegiani: Yeah, it’s rare. I have not seen the patient like that, that bumped that high because of it. I’ve heard from other colleagues though, I always retest because I’m always looking for it. You know, it’s like a, it’s like the, the, the, the metaphorical Unicorn you hear of it and I’m always looking, but it’s great that, you know, you actually went through that and you saw it and did you go right to compound or did you notice you had the same effect with armor and P or nature throid too.

Inna Topiler: Um, so what I did, and interestingly enough also I talked to a few colleagues and what they were saying is, well, if you feel good then don’t worry about it. And I just did not really agree with that and I guess I feel good, but there’s inflammation going on. So I wanted to, once I realized that it must be that I wanted to get off right away. I–

Dr. Justin Marchegiani: How did you feel though? I’m just curious. What happened to your thyroid symptoms?

Inna Topiler: Gone. I felt great. Hmm. Yeah, I felt great. No issues at all, but I just knew that these numbers don’t look right and if the inflammation is silent, but it’s there. So I, if I had more time, I was also trying to get pregnant at the time and I just didn’t want to kind of mess around with stuff. If I had more time I probably would have tried Armour just to see if it was different, you know, if there was something in the WP versus the armor. But I said, you know what, let me not waste time here. Let me just go to a synthetic. And I didn’t want to do Synthroid and Cytomel just because there’s some other additives in there. And my doctor that I was working with worked with a pharmacy that was nearby the [inaudible] Compound and it was very easy. I know sometimes it could be difficult if your doctor’s not open to it, but I had someone that already had a great pharmacy, um, that they worked with. And so I did the compounded synthetic T4 T3 and I have to tell you, and this is, I know it sounds weird because you’re like, how can this happen this fast? My antibodies dropped from above 5,000 to a thousand and then they went to 400 within two months.

Dr. Justin Marchegiani: Wow. Did you try the, the tyrosint for the synthetic T4 that’s clean?

Inna Topiler: I didn’t, I just went right to the compounds. Okay. Because with the tire scene I’d still need the T3 and —

Dr. Justin Marchegiani: Then you would really want to put it together.

Inna Topiler: Yeah, exactly. And it’s all in one pill so it’s easier.

Dr. Justin Marchegiani: Are you open or are you curious to try adding it back in and see what happens?

Inna Topiler: Not really. Only because you know, I mean, and I, I definitely play Guinea pig a lot and I try stuff, but I got my antibodies down. I really don’t want to take any chances, have them going back, ever–

Dr. Justin Marchegiani: Do it. That’d be an amazing blog post to, to do it. Cause this is really good because you mean as a clinician you hear about these patients but sometimes you don’t really see them or sometimes you know, a lot of doctors don’t retest. I always retest after someone’s given a thyroid hormone support and that’s amazing because that’s a huge jump. I’m blown away right now. It’s amazing learning experience for everyone though. Awesome. Yeah.

Inna Topiler: It really is. And again, I mean I, for everyone watching, I don’t want you guys to think that that’s going to happen to you. I mean there’s a small percentage of people. It’s not everyone who has Hashimoto’s, but it’s worth looking at because it is possible and it’s amazing how quickly that happens too.

Dr. Justin Marchegiani: What other strategies can the listeners kind of utilize or apply regarding reducing their antibodies outside of just changing thyroid support? Cause most people we’ve kind of recognized that may not be helpful. There’s a lot of data actually showing that things like WP or thyroid glandular can lower antibodies. In your case it was the opposite. But what other strategies have you done or you’ve seen work with patients?

Inna Topiler: Well, I think that when we look at antibodies, we want to look at the immune system, right? Because that’s the immune system being confused. Um, you know, it’s not your thyroid’s fault. It’s the immune system that’s producing those antibodies. So we really want to look at the triggers and everyone’s going to have different triggers. But we all want to look at different infections. So whether it’s Epstein borrows, recommend that people test that and see to make sure it’s not reactivated or that you don’t have a lot of past antibodies and you can test for that by doing VCA, igm, VCA, Igg, um, and the EBNA. And, um, so look at that cause that’s just such a common infection. Yeah.

Dr. Justin Marchegiani: You’re saying run the viral capsid antigen, the nuclear antigen. Would you also run the early Antigen for the EBV Epstein?

Inna Topiler: Well, the early one, I guess if you’re feeling sick, um, if you’re not yeah, to activate, if you’re not feeling sick, you could just run the other ones to see. And um, you know, there are things that you can do, um, specific antioxidant, zinc, selenium and Acetyl cystine lysine to help your body to fight that. Um, you know, also look at toxins and I’m sure you guys probably talk a lot about this on the podcast, but you know, things we’re putting into our body everyday. So, of course our food, but also what we’re putting on our skin, what we’re drinking, our water from, the type of water that we’re drinking. That’s all really important. Um, and um, you know, with food, obviously making sure that you’re not eating anything that you’re sensitive to and that can change. You might be sensitive to certain things at certain times of your life and others at others. So doing food sensitivity testing, looking at things like food compounds, like oxalates are so far. And then the other big thing is stress, um, and the adrenal glands. And I think that we all talk about stress and we all know, okay, we need to stress less, but a lot of us aren’t really doing anything about it. And we kind of just blame it and say, okay, well let’s just stress. But you know what? Yes, it’s just stress, but we still have to support it. And so I think there’s so many techniques. Meditation has been really, really life changing for me. And, um, I learned it from Emily Fletcher with this Eva. Um, really, really liked that technique because she talks about that you actually don’t have to quiet your mind. And that was so interesting for me because I’m a perfectionist, and so every time I try to meditate, I’ve tried not to think, and by trying not to think, I would think more. Yeah. Right. So then I felt like I was failing and I’m like, why can’t do this? Why would I do something that I fail at every day? I mean, any intelligent person is going to have that thought. Right. And so she teaches that the job of meditation isn’t to quiet your mind. Um, it’s kind of like she says, you know, you tell, you can’t tell your heart not to beat, so you can’t tell your brain not to think. Um, the, you know, so she kind of does it with a mantra and she has this technique of doing it that I found to be way easier than anything else I’ve tried, which is why it’s been so successful for me. And that’s changed so much for me in my health.

Dr. Justin Marchegiani: Can you walk me through what that looks like? So, okay. You sit down. Can you just kinda just walk me through your flow?

Inna Topiler: Sure. So, um, you know, and again, it’s not a meditation teacher, so there’s, there’s more to it than that–

Dr. Justin Marchegiani: But people I think value it coming from just an everyday person that’s done it but also gotten great results. I’m really intrigued with the antibody immune response you had by doing it. That’s amazing.

Inna Topiler: Yeah. And I think with that, and I’ll walk you through the technique in just a second. I just want to tell you what the antibodies, I think what was happening to me is whenever I would see my antibodies high or I don’t feel well, sometimes I feel achy or just off, I would call it my sort of quote unquote autoimmune symptoms. I would right away start to obviously get nervous and then think, okay, what do I do? Which supplement do I take? What food do I cut out? I need to do this, this, and this. So it was a lot of doing and while doing is good, I didn’t want to say anything negative about that. I was almost like getting in my own way, if you will. So I would be doing so much that I actually wouldn’t allow my body to rest. And I really needed to remember that the body does know how to heal. We just have to get out of our way and give it a chance. And because I was always doing and so active, I was actually elevating my cortisol by freaking out, so to speak about all of the stuff that was happening. So what meditation did, and what I do now is if I start to not feel well, and Emily actually talks about this in her course. So if you feel like you’re getting sick, the first thing you do is go get your buns in the chair. So then you could take that 15 minutes and actually get out of your own way, not thinking about every supplement to take. And again, you still have to do that, but allow your body that 15 minutes so that it could do what it needs to do and then go take the supplements and the other things that you need to do. So it’s a combination. And so with the technique, she walks people through a little bit of mindfulness for the first, um, minute or so where you just tune into your body so you listen to what you’re hearing. You can see what you’re seeing with your eyes closed. You can smell your surroundings, you can taste to see what the taste in your mouth is. That just brings you more into your body. Um, and then the way that she teaches is to do with a mantra and everyone actually gets a personal mantra, um, through her course. Um, but if we just take a word, let’s say, um, like we could use ohm for example. And so what people would do is it would close their eyes and then in their mind they would just say the word ohm and they would just repeat that with their eyes closed over and over again. Um, and it’s something that shouldn’t be super loud. It could just be like maybe slight whisper or just, you know, you can hear yourself saying it or, um, you can just kind of repeat it like very, very softly in your mind. And what’s nice about that is it gives you something to concentrate on. Um, and then if you go into some type of a daydream and you don’t realize, that’s okay. But if you realize that you’re not saying your mantra, then you want to go back to it. And that’s kind of the difference between if you don’t realize you’re still meditating, if you realize and you choose to stay off, then you’re off and you want to bring yourself back. I mean, obviously there’s more to it. Like I said, I’m not a meditation teacher. This is just her technique that I’m using. There’s more to which is a book and a course that people can learn from. And I don’t get paid for this. I just like her work. So I mentioned it again. Um, but it’s really, really helpful. Um, another thing that I also found very helpful in the mind body front is, um, uh, one mentor of mine, his name is Dr Mario Martinez. He has a book called the Mind Body Code, and he also has a workbook that’s an audio called the mind body code. I highly, highly recommend that. Um, what he talks about is that oftentimes a lot of our emotions can be stored physically in the body. And we all have different wounds that we can be wounded by, you know, our parents or society when we’re younger. And, um, some of the wounds that are really common are shame, abandonment and betrayal. And most of us are gonna have at least one, but probably all three at some point in our life. And you know, with portrayal doesn’t have to be something really, really major, but even minor betrayal can count. And then shame is something that, you know, we’re exposed to since childhood. I mean, even as toddlers, you know, if our parents says, don’t do that, um, you’ve been a bad girl or you’ve been a bad boy, that shaming. But of course it could happen to a higher degree as we get older. And shame can really affect the thyroid and autoimmunity because, um, you know, our thyroid is in our throat. That’s our fifth shocker. That’s our expression. And so when you feel shamed, um, that can really suppress that voice. And so there’s a big correlation there. So I did some of that work, um, with him. And you know, people can also, if they’re interested in that they can get the audio book and the workbook. Um, it’s very inexpensive and there’s a lot of great information with that.

Dr. Justin Marchegiani: I think we really touched upon some really excellent concepts. He really connected the dots here. Great clinical experience or feedback with the antibody increase with the glandular support. Is there anything else you know, that you want to highlight here for the listeners that you think is extra valuable you want to add?

Inna Topiler: You know, I think what I would want to add is, you know, for people that are watching, listening to this, that have health issues, you really want to make sure that you have the right mindset. Um, because when we look at people that get better, those that have a positive outlook and a mindset that they can figure out the answers and then they can heal, do better than people that are unsure. And of course for a lot of people it has been a long road and you guys may have dealt with a lot of stuff and may have gone to many doctors that perhaps were not helpful. And sometimes it is hard to keep the face if you’ve hit a lot of roadblocks and walls along the way. But if there is a way to just really believe that you can, um, because the answers are out there and there is hope, um, you know, we just have to have that notion that it is possible because it is, you know, usually if you’re experiencing a health issue, there is some type of a reason behind it. Like, things don’t just happen out of nowhere. Sometimes we don’t know what it is and we have to test and dig. Um, but if you can have that knowing that the answers are out there because they are, it’s gonna help you in healing.

Dr. Justin Marchegiani: I 100% agree when you’re in pain, right? Pay attention inside. Now that’s the acronym. So it’s always, instead of looking out, look in. So that’s really good feedback, you know, where can the listeners find more about you and what you do and the information that you produce and provide?

Inna Topiler: Absolutely. So I actually just recently launched a podcast. It’s Health Mystery Solves, and we had a great interview that went live a couple of weeks ago. So that’s a, you can subscribe on iTunes or it’s healthmysterysolve.com. Um, I also have a virtual practice, complete nutritional wellness.com. I have lots of blogs, but I think probably the main thing is going to be the podcast because there’s new content every week.

Dr. Justin Marchegiani: That’s awesome. Yeah, I’m on the podcast, so everyone go over and listen to our interview was really great and thanks for this awesome information. Look forward to connecting with you again. So, you know, thanks so much.

Inna Topiler: Absolutely. You’re welcome. Bye Bye. Have a great day. Bye.


References:

https://justinhealth.com/

https://completenutritionandwellness.com/

http://healthmysteriessolved.com/

Audio Podcast:

http://justinhealth.libsyn.com/hashimotos-root-cause-solutions-with-inna-topiler-podcast-237


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