Addressing Reoccurring H. Pylori Infection | Podcast #238

H. Pylori is a bacterial infection. This kind of infection is something that we always see in our patients with gut issues or poor digestion, or mood and energy issues. H. Pylori is anywhere between 20 to 50 percent of the population that could have this infection.

Know more about more symptoms that could lead to H. Pylori infections, advanced tests and medications, added symptoms, and a lot more.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

00:57 What is H. Pylori Infections

02:49 Antibiotic Resistance

03:19 H. Pylori Medications, Tests

08:13 H. Pylori Symptoms

14:31 Other H. Pylori complications



Dr. Justin Marchegiani: Hey there it’s Dr. We are live. Evan, how are we doing today? 

Evan Brand: Hey man I’m doing good. Happy Monday to you. 

Dr. Justin Marchegiani: Very good. Happy Monday to you as well. Well we talked about today we’re going to be chatting about H pylori and H pylori infections. The topic that we see weekly in our office of patients coming in with gut issues or poor digestion and even patients that don’t even have gut or digestive issues that have just strictly mood and energy issues. H pylori is anywhere between 20 to 50 percent of the population could have this infection and I see it a lot in my clinic.

Evan Brand: Yeah I would rate this is one of the top five roadblocks to achieving optimal health. You know you and I will zoom in and focus on maybe smaller more nuanced topics. But to me this is like one of the biggest roadblocks there is, mainly because of the mechanism that H pylori is doing on the body which is reducing your ability to produce stomach acid.

Dr. Justin Marchegiani: 100 percent. So H pylori is a bacterial infection. H stands for helico so it’s like a helix shape and they can kind of like burrow and turn and twist into that gut lining it can create inflammation and there are virulence factors that we look at the big ones are gonna be [inaudible]. These are cytotoxic proteins that are being produced by H pylori by the bacterial infection and they can create more inflammation. It’s a good sign that the H pylori stronger. It’s a big player to be creating a lot more problems. I do see patients still have issues that don’t have these various factors but if we see them it’s a good idea that we want to clear them out by knocking out the infection. And it’s.. for me it just kind of like puts the infection at a higher level in priority in the treatment protocol.

Evan Brand: Worst case scenario with H pylori and those virulence factors you can develop gastric ulcers, you can develop gastric cancer, you can have major damage to your esophagus, so this stuff can get pretty nasty. And we’ve seen cases like that where someone comes to us where they’ve already had an ulcer diagnosis by doing like a barium x ray where you drink a terrible chalky drink they do an x ray on you and they can visualize the ulcers and then the gastro doc in that case generally they’re just gonna put you on acid blocking medication. So I think maybe we should spend just a minute here talking about conventional treatment for this stuff. It’s not very pretty. Triple or quadruple therapy is often used which is three or four antibiotics used at the same time. Now we know that that doesn’t work. Number one, because the CDC admitted that antibiotic resistance is happening. But number two, you and I measure antibiotic resistance on our stool testing and we find a lot of positives which would indicate, hey if you take this antibiotic, you throw it down the hatch you try to treat the H. Pylori with it. It won’t work. 

Dr. Justin Marchegiani: Yeah I see that a lot as well. I also see a lot of the antibiotic resistance even clear after herbal treatments. Do you see that at all?

Evan Brand: I do too and I’ve always been interested in that. And people asked me and I don’t ever have a good answer to why 

Dr. Justin Marchegiani: Yeah I’ll have to call the lab about that and figure out why that is. But I think —

Evan Brand: I think I know the answer yes. So if we clear the H. Pylori, maybe they can’t test the resistance of the antibiotic towards it because the actual bacteria that showed positive flow.

Dr. Justin Marchegiani: And that very well could be maybe you need enough of that bacteria there to actually test the resistance against other antibiotics. Now that it’s low enough we don’t have enough of that sample, it’s possible. I think that’s a possible theory. But we see H pylori frequently. Now we’ve been testing the DNA. And that’s a good way to test the PCR, the polymerase chain reaction testing is the newer DNA technology to assess the infection. It’s about two to three thousand times more sensitive than the previous gold standard which was the antigen testing. So antigen means it’s the foreign. It’s a piece of the H Pylori. They use a specific stain and they visualize it under a microscope. That was kind of the old type of testing.

Evan Brand: Or remember about five years ago, you and I were just starting to get into the DNA PCR testing but we were still using the old antigen testing where it took three days of stool samples. Remember that?

Dr. Justin Marchegiani: Yeah I remember that.

Evan Brand: So we it would test negative and then we’d have the DNA and we’d see positive and then we’d look at symptoms and we’d say Wow. So now, I mean you tell me if you if you’re doing it differently but I believe you and I both have ditched doing the antigen based testing pretty much completely because we used to run both because we were not sure which one was more accurate. Now we know the DNA is much better.

Dr. Justin Marchegiani: Yes, exactly, so the DNA is great. I will still every now and then if someone is, I think to have an H pylori infection but they’re not coming back up every now and then I will order a blood test where we’ll look at IGG IGA IGM to get a window into acute infections or chronic infections. Right. IGA IGM is more acute, IGG is more chronic. It’s possible that you had exposure to H Pylori. It’s cleared and the IGG still positive. You don’t ever want to treat based off of the IGG blood test for the H Pylori anyway. And then there are breath test, so breath test essentially work by testing and elevation in CO2. So essentially you have and they think they also may assess urea as well. So you have ammonia or you have protein in your tummy and that protein breaks down into urea. And when you have the ureae that’s elevated from H Pylori that urea is can cause that you re to break down into ammonia and CO2. And so you’re getting a lot of that CO2 that’s coming back positive as an indirect indication that H Pylori is active in the gut. So it’s that increase in CO2 that’s giving you that indirect measurement that H Pylori is there.

Evan Brand: Yeah. So one of the questions that we get from people is well, hey I tested positive on this stool test now you gave me this horrible protocol to address this infection. Can we just do a breath test because it’s cheaper or my doctor is going to run the breath test for me. Can’t we just do that to prove that we got rid of it. 

Dr. Justin Marchegiani: Right. So typically you always want to compare apples to apples so if we ran let’s say a genetic stool test and we came back with H Pylori we’d always want to compare apples to apples. We want to compare it to the other tests to assess the, to assess the veracity. So you came back with the G.I. map positive. We want to retest on the G.I. map.

Evan Brand: Now you could throw in the breath on top of it if you want to but I wouldn’t try to replace breath or blood. You know I wouldn’t try to use those to replace a stool panel. We still find the stool is most accurate and also too, you know when you’re looking at somebody who’s got it’s very rare to see H. Pylori by itself. Why don’t we discuss that? I mean, if we look at right now it’s on page two of the stool test. That’s where we see all these H Pylori markers we’ll look at the beneficial bacteria which are often low. But that’s not all. I mean usually there’s a handful of other things like Candida overgrowth that happens as kind of a, I would consider maybe a secondary issue that happened due to the primary H Pylori infection.

Dr. Justin Marchegiani: Oh totally, 100 percent. So just kind of looking at the breath test they are assessing urea but the big thing that does come up is carbon dioxide does come as a byproduct. So just to be clear they are looking at a lot of the urea and that’s a lot of the protein breakdown because H pylori does have that enzyme urea. So just kind of giving you an update of kind of what that breath test is looking at. So we have we have our genetic stool test that we like and they can also assess and look at the virulence factors, and they can also look at the antibiotic resistance. The big antibiotics are typically going to be a combination of triple or quadruple therapy usually it’s in to be Clarithromycin, Amoxicillin Prilosec or PPI and or Bismuth. And sometimes they’ll throw in Tetracycline or Doxycycline to pull those other antibiotics out. So that’s kind of the general triple slash quadruple therapy. And then on the IRB as we may use other things like or goldenseal or CLO or mastic gum or higher dose of oil oregano or even probiotic species can be very helpful at knocking down H Pylori. So there’s a lot of things that we may use to help knock down that H Pylori.

Evan Brand: I want to talk more about like confections that come with this. Yeah. So bacterial overgrowth you know we’ll talk about gut inflammation permeation of the gut barrier. But first why don’t we talk about symptoms because people may be hearing H Pylori all this talk and the like. OK well how the heck do you know besides testing that you have it. You mentioned some people may not show any symptoms at all but they still have a very high level of it. But most people that come to us they’re symptomatic right. They’re not just reaching out just for fun. They’re reaching out because they’re symptomatic. So I would see I would say weight loss or weight gain. In my case, I lost a bunch of weight with H Pylori where I just wasn’t digesting my proteins very well and so I lost muscle mass. I would say bloating, heartburn, gas burping, bad breath is pretty common your breath gets bad because your food’s rotting in petrifying in the gut, your nails my nails develop vertical ridges like my nails became more weak and at ridges because of my malabsorption. What else would you say symptom wise?

Dr. Justin Marchegiani: Can you talk a little closer to the mic? 

Evan Brand: Yes. So your audio right there. Your audio did the same thing it sounded like you were really far away but you weren’t I think then something. 

Dr. Justin Marchegiani: Okay. All right guys we’ll just keep it really close. Perfect. All right. So in general yes. So the low hanging fruit with H Pylori is gonna be getting enough stomach acid.  acid, super super important when it comes to H Pylori. Now it’s a double edged sword with H pylori because with H pylori your gut lining could be a lot thinner. It could be a lot more inflamed due.. due to its inflammation. So hydrochloric acid is like it’s like trying to get a massage for your back pain or an adjustment for your back pain when you have a sunburn like you may need it. It may be the right thing but it may be too much for the amount of inflammation that’s present in your body. So we it’s really important that you work with a clinician to have this kind of dialed in. So we may come in with very low dose on hydrochloric acid or maybe even not maybe just use some gentle bitters or enzymes to support the digestive process and then assess how much inflammation, make sure there’s no bleeding, make sure we add in things to kind of cool off the gap before we do anything on the acidic side. And everyone’s a little bit different. So it just depends I’m always airing on the side of talking to the general public in doing things that aren’t going to set you up for more pain or more inflammation and then work with a clinician that can help individualize things as you start to stabilize.

Evan Brand: Nausea is another symptom I forgot to mention. What about you? Do you have any other symptoms I mentioned the gas bloating burping– 

Dr. Justin Marchegiani: Your gas, your bloating, your constipation, your diarrhea, anytime enzymes or acids are affected motility can be affected. And then of course you have, there’s a couple of studies out there saying, hey look at these symptoms of H Pylori. They have nothing to do with digestive symptoms. These are mood issues, depression, anxiety, cognitive issues so you can have a lot of issues that aren’t H pylori driven, and they can be mood in emotional and cognitive stuff and this is hard because people are kind of like indoctrinated to think, oh I have to have acid burning, I have to have stomach pain, I have to have an ulcer for H pylori to be a problem, and you may not have no symptoms at all connected to digestion.

Evan Brand: Yeah absolutely. I had depression, I had anxiety, I had panic episodes. I mean I was a wreck when I had H Pylori. So I can agree and attest to the fact that yes there probably are some cognitive, psycho, emotional stuff involved and you know, your, your counselor is not going to tell you to go get a stool test for your depression.

Dr. Justin Marchegiani: Exactly yes. And that’s an important part. And why does this happen? What’s the mechanism? The mechanism is pretty simple. I think if we don’t have enough hydrochloric acid if we don’t have enough digestive support, we have to break down these amino acids, right? So think of like a necklace you’re wearing. Think of that as protein, right. If we go to break each pearl off of that necklace. Those are amino acids, and essentially digestive was we have to break those little pearls up so we can utilize, assimilate, and absorb them. And then of course in our body they get converted into a lot of our neuro chemicals, serotonin is going to be tryptophan, or five HDP, tyrosine will get converted to dopamine and adrenaline and norepinephrine and then you’re going to have some of these amino acids convert to GABA which will help you relax and wind down. So we have to essentially take this necklace and break each individual off so we can digest it absorbing assimilate.

Evan Brand: Yep. Well said. All right, so let’s go back to the point I mentioned earlier. So the Coinfections like what else happens with H Pylori, we often see Candida overgrowth happening. We often see bacterial overgrowth happening, so at that point maybe more GI symptoms will come on board, and it may not be the H Pylori directly. It may be know pseudomonas or streptococcus or Klebsiella. Some of these other bad guys. And then we know too that all this undigested food has collateral damage on the gut barrier, right? So we’re going to see the secretory IGA go low and then we know someone has a leaky gut situation. Now what about  Do you test Zonulin? I don’t because I just haven’t found it worth the extra expense for people. But some people this beg and plead that they want on when tested.

Dr. Justin Marchegiani: Yeah there is some data on it. I mean most of the data is kind of circular it comes from Alessio Fasano over at Harvard but there’s some good data that that’s good. That’s the number one protein forgot permeability so if I see a lot of auto immune people I will definitely run it just to assess how permeable the gut is. So Zonulin, this protein when it’s elevated it means the tight junctions are kind of getting unzipped in your gut and the epithelial lining, and then the more permeable your gut is, the more bacteria and infectious debris and or foods that aren’t broken down fully can get into your bloodstream, and create an immune response and create more inflammation, because your immune system not used to seeing all these foods not broken down in the bloodstream. So that creates a lot of immune stress. So it’s nice to have that. I’ll look at it more patients that are have a lot of autoimmune stuff going on just to assess if treatment brings it down. But again it’s not causation for me that’s more correlation. How does this improve as we do these things over here to get rid of inflammation or digest foods or get rid of other infections, so it’s kind of a corollary marker for me.

Evan Brand: Makes sense. I mean I just generally look at the low secretory IGA. I’d say based on that hey you know probably a leaky gut situation. 

Dr. Justin Marchegiani: Yeah, 100 percent. So looking at the H Pylori right today’s podcast is on H Pylori. It’s going to be affecting the digestion of protein. It’s going to affect the lowering of that PH in the got that nice low PH does three things, it, one it makes it harder for bacteria to grow think of nice low PH as like bleach on a dirty picnic table. It kind of cleans things up and sterilize those things bacteria hates acidic environments to grow and likes actual the alkaline environments. Number two, it gets enzymes activated. So those nice active enzymes are PH sensitive so we drop down that nice PH. These enzymes perhaps energy and turns the peps in. We get these nice protein like enzymes going and then all that food that’s all kind of mushed up. That’s called kyme. All right that gets emptied into the small intestine and that nice low PH triggers a whole bunch of Bicarbonate from the pancreas, a whole bunch of enzymes, proteolytic enzymes, light ballistic enzymes that means protein and fat digesting enzymes. And it’s also gonna trigger that gallbladder to bruise a whole bunch of bile which will help you digest fat as well. So three things, right, it’s creating an environment that’s harder for bad critters to grow, it’s activating enzymes, right? And it’s activating a lot of our proteolytic portions and as well as getting the pancreas and the gallbladder involved so really important.

Evan Brand: Yeah, the whole domino effect has to happen with enough HCL which you can’t make if you have that infection, and we find 80 plus percent of partners share H Pylori too, so this is why sometimes we have to get the husband or the wife or even the kids involved too, because if someone gets better and then two to three months later, symptoms come back or issues return then we know it’s probably just a case of reinfection.

Dr. Justin Marchegiani: 100 percent. So if H Pylori is one of these predators that you know typically a lot of parasites the more fecal oral so we usually have to be a higher level of intimacy for that infection to pass back and forth outside of the fact maybe someone did wash their hands and they cook a meal for the family. That could happen every now and then. But the bigger thing with H Pylori that can be spread with saliva. So just you know a kiss between a mom and her son easily spread that, or sharing silverware or sharing a drink in a household– pretty common among family members so that could easily be spread. So, definitely if we see a husband or wife come in, I definitely want at least those two treated. And then we may look at what’s going on with the kids that have any issues that are kind of abnormal on the radar. Meanwhile a little bit deeper right.

Evan Brand: Yeah. Well said well I don’t think there’s anything else we need to cover on this subject. I’m sure we could, we could pick and add more things to the picture. I would you say if you don’t have gut symptoms that doesn’t mean that you’re clear. 

Dr. Justin Marchegiani: Correct. I think it’s good to look at that. And then if you have cognitive issues or let’s say you have mood issues and you’re on an SSRI, maybe a medication that may not be getting to the root cause, it’s stabilizing. Right. But let’s get to the root cause. And then, once we address that then you can go back to your prescribing doctor and look at tapering off that correctly but we always want to get to the root cause. 

Evan Brand: Absolutely. 

Dr. Justin Marchegiani: Now don’t find one thing here I’m just kind of highlight it is gluten is a big deal. I find the more inflamed we keep the gut it’s harder for H Pylori to be eradicated. So, in other words, if people don’t change their diets even with really good herbs it can be harder to knock out the infection. So the more we can keep inflammation down, the better the patient responds to a lot of these natural herbal treatments that.. you notice that too?

Evan Brand: Yeah. Well most of the people that come to us they’ve already changed their diet. So it’s rare that we have to have that, hey you need to be off gluten and dairy conversation. But yeah it does act as a roadblock, especially when we see teenagers that are going out and eating pizza and stuff like that. I don’t get as much success as quickly with them.

Dr. Justin Marchegiani: I agree I think it has to do with getting the inflammation in the gut and the digestive tract drops, but also I think it has a major effect on the immune system. I think if your immune system is continuing to be pounded with the entire course, eventually that performance would drop. 

Evan Brand: Good call. I didn’t think of the mechanism. What do you mean system that makes perfect sense. With the dairy piece especially, I could think of kids that are saying oh my skin is still bad you know cause skin issues can result from H Pylori too. Right. Because that rotting food will create some acne. OK. Well what are you eating and they say well I go out and eat pizza twice a week. Well there you go.

Dr. Justin Marchegiani: Exactly. Find the big thing in a lot of the skin issues are what happens because poor digestion is going to be a skin issue. That’s why you see, lots of people talking about improving. You know when they start adding apple cider vinegar into their diet because you’re asking. To see the gas and that’s helping to break down proteins and therefore you see improvement. Yes. That’s another mechanism. Why skin improves with better gut out, better acid and digestion, less putrefaction to the patient and the skin is always going to be used as a means to detoxify. So if you have stress and we can’t get it out giving you to deliver, the skins into the next organ system that’s going to be leaned upon to help with the thoughts of the patient.

Evan Brand: Yeah if I start to break out of my face, I start to think, OK what’s going on. Am I not doing something right. Is my gut? Is it my diet? Is it my liver? Like what’s going on.

Dr. Justin Marchegiani: Exactly. Good point. All right. So just kind of recapping the if someone’s struggling with issues that digestive side or even mood side and muscle look at that. That’s the H pylori infection connection. Make sure you click down below. Reach out to Evan at or Dr. Justin Marchegiani. Myself at  Links down below. We also have transcriptions available if you guys want to look at or read transcriptions there’s a great option for you. Make sure you click and subscribe as well so you get new great content that is coming out of your way. Right. Anything else you want to say here?

Evan Brand: No that’s it. I would just say get yourself tested. You never know until you test.

Dr. Justin Marchegiani: I totally agree. You’re not testing,  if you’re not testing, your guessing. Right. We want you to assess and getting that correct data so we can make the right.

Evan Brand: My daughter showed up with H Pylori. She had loose stool, and so we tested her around age 2 and she had H Pylori. So we gave her some liquid herbs. We retested her H Pylori, now gone. So I mean this doesn’t discriminate no matter how old or young. I mean, you could be two years old with this infection and that could lead into potentially issues with growth and development and all that. If you’re just not digesting, her gut inflammation was high with that as well. So I’m glad that we were able to catch it early and take care of it.

Dr. Justin Marchegiani: Awesome. Pretty cool. Well great podcast today. We’ll be back next week. You guys have a phenomenal day. Thanks guys. 

Evan Brand: Take care. Bye

Dr. Justin Marchegiani: Bye.


Audio Podcast:

The truth about H. pylori infections and functional medicine – Podcast #90

Dr. Justin Marchegiani and Evan Brand go in depth about H. pylori infections and the conventional medical treatment using antibiotics versus the natural solutions. Learn what it is all about and how it can be treated when you listen to this podcast.

H. pylori infectionsThey talk about the different studies made and publications that will help us understand what H. pylori is all about and how to effectively get rid of it. Find out what the testing methods are to check if you have certain infections. Also discover the mechanisms of how H. pylori can be spread so you can avoid getting infected.

In this episode, topics include:

00:52   About H. pylori

06:48   Mainstream care/conventional treatment

07:40   Conventional medical treatment vs natural treatment

14:45   Gut killing protocol and supporting affected body systems

19:30   Testing methods









Dr. Justin Marchegiani:  Evan, it’s Dr. J. What’s going on? It’s Monday.

Evan Brand:  Yes, sir! Back in the trenches, looking at some more lab results, and we got an email that requested this topic that we were probably gonna get to anyway which is on H. pylori, something that is honestly, once again, I feel like I say it—sounding like a broken record—but honestly more common that I though, so Mil, she sent in an email saying that she loved the podcast and she loves to actually hear our case studies and that she’s working with clients, too, and she’s seeing a lot of infections and she wanted to hear a podcast on H. pylori. So here we are. Thanks Mil from Melbourne, Australia.

Dr. Justin Marchegiani:  Love it. Well, what do you think about H. pylori? I mean, that’s quite an—it’s an infection that I see probably over a dozen times a week in my clinic. I’d say at least 50 times a month, no problem. That’s pretty easy. It’s pretty common. What’s your take off the bat? Before I go on my little rant.

Evan Brand:  Well, it’s something that you have to rule in or rule out because what I was talking with you about off air is a guy that I was working with, for some reason we haven’t run a stool test right out of the gate, so we just started with adrenal treatment and we sort of hit a wall. Some of the anxiety was reduced. Some of the depressive symptoms were reduced. The energy was increased. But we were still hitting this wall with some of the GI symptoms, some of the tinnitus, etc. and so I figured, okay, well, it’s time we need to circle back and run the stool test and that’s when we found Klebsiella and H. pylori. So for me, it’s something that you really have to rule in or rule out, and if you’re just hitting a wall or you’re not getting results with your program, this could be an underlying factor that—that many people don’t even have on their radar.

Dr. Justin Marchegiani:  Yeah, I totally agree. I find H. pylori, it’s an opportunistic bug meaning if you’re under stress especially if you’re eating gluten and grains. If you have other type of toxic stress going in by eating, say pro-inflammatory foods, any type of body system stress is going to decrease your body’s ability to secrete hydrochloric acid because you’re lowering your parasympathetic nervous system which is like that vagus nerve that really helps you rest and digest, and that kinda opens us up. It lowers that force field to bugs that we may get in contact with like H. pylori and one of the mechanisms that H. pylori has is we have kinda like the gastric fluid in our tummy and then we have this mucous layer. And this mucous layer that kind of like provides this buffer protection against our epithelial cells. These are the cells that line—that really make up our stomach lining and the H. pylori comes in there, does a couple of things. It takes urea and it converts it to CO2 and ammonia via the enzyme urease. So H. pylori secretes this enzyme called urease that then takes increased ammonia and increased CO2 from the urea. Urea is a byproduct of protein metabolism. So we know how important the stomach is for breaking down protein. So imagine we have this set of dominos. I give this analogy to my patients all the time because it just—it’s what clicks with me the best. The first domino that has to knock over for healthy digestion is in the stomach and that’s gonna be low stomach acid. Low stomach acid activates an enzyme called pepsin. It turn pepsinogen into pepsin which helps break down protein. And again, stomach acid, the HCl is pH driven. So HCl, hydrochloric acid, drives pH down but when we eat protein, we have this urea that spits off it and if we have H. pylori in there, that’s gonna take that urea, turn it into—I’m sorry, take the urea via urease and turn it into ammonia and CO2. Ammonia’s got a pH of 11 that raises the pH, that low pH that—I’m sorry—that—that pH now that’s now raised up, it’s more alkaline, that’s gonna affect us from activating our digestive enzymes and the inflammation by the H. pylori starts to wear away that mucous layer and—and we have all the cytotoxins and the ammonia that’s now there, starts to damage those mucosal cells.

Evan Brand:  Yeah, so I wanna go through some of the symptoms here that people notice. Basically long story short, what you’re saying here, we’re gonna have a severe compromise of the whole digestive process in general. So when I asked this male client, take a look at your fingernails, so he had the vertical ridging, which is something I also had, too. But we knew that there was some sort of protein malabsorption going on. So that’s one of the symptoms right there, is that some of these people they may even—I’m sure you’ve seen in some of the vegetarian and—and vegan clients as well. They may have just an intolerance for meat. But it’s an H. pylori infection. It’s not that they need to be a vet—a—a vegan or they’re built for a vegetarianism, they may—may have this infection that’s causing them to not do well with protein in general. So some of the symptoms here, you know we have the weakness, the tiredness, lightheadedness, irregular heartbeat, cold hands, cold feet, depression, easily bruising, stomach upset, weight loss, diarrhea or constipation and on and on. So a lot of the nutrients that you’re not gonna be absorbing from your food, that’s gonna show up when your fatigued. So that’s why if you go think about all these people out in society, going on acid blockers and energy drinks for their symptoms, they need to just look and see that there may be an H. pylori infection.

Dr. Justin Marchegiani:  I 100% agree and H. pylori on one extreme it can cause deeper issues, right? We know like the mainstream type of issues it can cause is like increases in gastric cancer, gastric lymphoma and also ulcerations—that’s like one extreme. The problem is a lot of people that have H. pylori may not be at that level of extreme. They may have brain fog. They may have fatigue. They may have joint pain. They have migraine headaches. They may just be moody because remember when you affect digestion of proteins and, the ionizations of minerals, that means being able to take minerals into your bloodstream, lots of other symptoms can happen not just at the pathological extreme. So conventional medicine looks at things from the extremes. Functional medicine looks at things basically everything in between. And we know that if we have digestive issue, that’s gonna affect absorption. We know if we have gut inflammation, that’s gonna affect leaky gut and create bottlenecks for us getting us these important nutrients to have healthy metabolism and mood and performance from getting into our system.

Evan Brand:  Yeah, so the problem is once again with the mainstream care here, is that you’re going to come across antibiotics and antibiotics are not going to be best option because some of the time you can have a rebound effect, right? So someone may go on an antibiotic, think that they’re better and then they’re actually not gonna get rid of the infection. So a lot of times you got for the conventional treatment here, you may get antibiotics and acid blockers at the same time, instead we like to look at the botanical alternatives, that honestly are just as effective if not more without not even 1% of the amount of side-effects that you’re gonna have with this conventional medical treatment. Do you wanna elaborate on that?

Dr. Justin Marchegiani:  Right. So you’re talking about the conventional medical treatment versus kind of the—the natural and some of the side-effects with them all? Is that kind of–

Evan Brand:  Right.

Dr. Justin Marchegiani:  What the angle? So the conventional medical treatment is something known as the Prevpac or triple therapy. It typically is a combination of clarithromycin, amoxicillin, some type of proton pump inhibitor like omeprazole or Prevacid and sometimes they—they’ll sub in like bismuth instead of the proton pump inhibitors. So those are like the triple therapies. Now we run some genetic stool test that will actually see a lot of patients have resistance to clarithromycin, which is interesting that mean—that’s like kind of the big killer in this triple therapy for 2 weeks. They’ll give these three combination drugs together and I see a lot of patients that have these types of issues where they’re resistant to the antibiotic. Now that’s a problem because is the therapy gonna work? Probably not. And then also are we addressing the underlying issues that cause the compromised immunity to fall prey to the H. pylori to begin with? No. Are we fixing the collateral inflammation to the mucosal cells that were damaged? No. Are we fixing the underlying digestive issues from the low stomach acid and the low enzymes? No. Are we looking at the other co-infections that may be involved like Giardia or maybe a small intestinal bacterial overgrowth or yeast overgrowth or maybe a deeper parasite infection? No. So you can see all these other issues, it may just not be that simple of looking at one infection. And some people do get better on the triple therapy, but I’d say the majority of patients that I see have already been treated for H. pylori that have it, and they did not get resolution and a lot of times the antibiotics made them worse because they probably have this detoxification issue that was backed up because remember, detoxification pathways primarily run from B vitamins and sulfur amino acids and if our digestion’s impaired, well, there goes the protein, right? To—to run our phase 2 pathways. And if we have issues with gut bacteria being out of balance, well, the gut bacteria helps produce B vitamins, so you can see all these mechanisms kind of get knocked down and—and just treating the H. pylori with an antibiotic may not be the underlying—may not be the best way to go about it. It may cause more symptoms than—than actually fixing the issue in a functional medicine way that’s more linear like we talked about in our last podcast about our—the right path to healing.


Evan Brand:  Right. So another piece, too, that I wanna mention is if you are going this conventional route, you’re never gonna get told to change your diet. You’re never even gonna get told that what you eat has a relationship to how you’re feeling with this H. pylori. So if you’re just doing supplements, even if you are going the natural route, but you haven’t adjusted the diet, your results are gonna be limited there.

Dr. Justin Marchegiani:  Absolutely and let’s not forget, right? The same cells that make stomach acid, the parietal cells in the stomach, they’re also the same cells that produce intrinsic factor. Intrinsic factor is this binding protein that binds to B12 in the food, in the stomach, and then our tummy then—or I should say our intestinal tract reabsorbs it at the end of our small intestine in the area called the ileum. So we bind it up to this stuff, we basically tag it with this intrinsic factor in the stomach and then we re-absorb it at the end of our small intestine in an area called the ileum. Now this is interesting because we need stomach acid to liberate B12 from our food, and this is actually coming from Harvard School of Public Health’s website and they actually talk about the fact that it’s estimated that 10-30% of adults over the age of 50 are low in stomach acid.

Evan Brand:  I’d say it’s like 90%. What do you think?

Dr. Justin Marchegiani:  Yeah, I was just about to—to go into that. So like the big thing is, right? They’re looking at everything from like a pathological extreme.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So, you mean just because you’re at pathological cut-off, what if you’re knocking up against it, you know? How many years do you have to knock up against it before they consider you, you know, very, very low in stomach acid? So I would say it’s much higher than that. I would—I’m 100% on your—on your level here. But the thing is, a talk about how stomach acid is require to liberate B12 from the food. Now why is B12 so important? We need B12 for healthy nervous system. If we don’t have enough B12, we’ll get something called subacute combined system disease or posterolateral scleros—sclerosis where the myelin sheath in the nerves will actually get worn away from lack of B vitamins, B12 in particular and we also need B12 to mature our red blood cells. Immature big goofy red blood cells have a hard time carrying oxygen and nutrition. So low B12 equals bigger red blood cells that aren’t mature, right? Red blood cells actually get smaller as they get more mature. As they are immature, they are bigger. It’s kinda like the opposite. Imagine like babies being born like 10-foot adults and they get more mature as they get older, it—it’s—that’s kinda how it is with the blood cells. So we see these big goofy cells that can’t do their job and that means lack of nutrition, lack of oxygen and basically overall lack of neurological health and methylation which is so important, too.

Evan Brand:  That’s scary. So it really is—this is one of the biggest pillars that could collapse someone’s health journey if they go undiagnosed and untreated with this issue.

Dr. Justin Marchegiani:  Absolutely and then H. pylori, like if you look at H. pylori, it’s got wo little walls. It’s a gram-negative bacteria, so how I kinda draw the analogy because I—I use analogies a lot because you don’t ever have to remember a story. People can hear stories and they—and they get it, right? People could think of maybe a story that their grandfather or grandmother told them when they were younger, and they heard it once and they still got it. So if we kinda teach in stories, we just say it once and they got it. But imagine H. pylori, it’s got like two cell walls, that’s a gram-negative bacteria. So imagine like anyone that watches Game of Thrones, right? We’ll use the castle analogy here. So imagine you got this like moat around the castle, that’s like the first wall of defense that H. pylori has. And then we have like the actual castle wall as like the second wall of defense. So we have two walls, right? We have the moat and then we have the castle wall. So it’s harder to kill these bacteria that have two walls obviously because it’s harder to get across the moat and then have the energy to climb up the wall. So imagine that’s kinda like H. pylori. Now in the outside before you get into the moat, imagine all of these traps, all these land mines, right? That’s what’s called LPS. They’re these little things that sit on the outer second wall that are basically toxic. LPS stands for lipopolysaccharide. It also stands for endotoxins. So it literally is a toxin. So imagine with H. pylori, we got the—we got the moat. We also have the big castle wall. That’s layer one and two. And then outside of the moat we have all these land mines. And that’s why H. pylori is so hard because the land mines are essentially a toxic stress on our body because as we kill the H. pylori, it can create more symptoms because our liver and our detox pathways have to process those land mines or those LPS/endotoxins.

Evan Brand:  So what you’re saying here, it’s not gonna be just a gut-killing protocol when we come into treatment. It’s gonna have to be a multi-pronged approach here where we’re supporting the actual body systems that are getting affected by this dump essentially, which is the same thing that can happen with like parasitic infections, too, right?

Dr. Justin Marchegiani:  Yeah, so we may use things like ginger because ginger is a biofilm type of buster. So biofilms are like imagine the—you know, on those outer two walls, we have these protective agents that make it harder for you to disable those land mines or harder for you to—to scale the moat or scale the wall. So the biofilm agents allow us to kind of attack those two walls easier so we can use things like ginger, as a really simple or easy one. A lot of the herbs we’ll use, we’ll have biofilm busters already in it. We may give extra enzymes to provide biofilm busters. We may give things like diatomaceous earth to help break down biofilms as well. And then we may—may even give extra binders like citrus pectin of various vegetable fiber pectins to basically put straightjackets around these crazy endotoxins. So imagine someone’s in a bar, they’re getting all rowdy, right? The bouncer comes in and puts their arm around their back and escorts them out. That’s what some of the fibers do. That’s what the charcoal also does as well. Diatomaceous earth can also help with that. So we have a lot of our different binding agents that we use in conjunction with some of the herbs. And again, you really wanna do this in—in sequence, so we always wanna work on body system one before body system two. Body system one being the hormones, two being the gut and infections, and three being detox. And then even before that, that sets the foundation is always the diet and lifestyle stuff. So you always wanna make sure if you have an infection, you’re better off working with a functional medicine doctor or practitioner because I’ve seen patients get far worse and far sicker doing these protocols on their own because what happens is you start feeling like crap and then you don’t know what to do. Because you only have one data point and because you’re getting sick and this is the first time you—you’ve felt it then you kind of go into freak out mode. So it’s always good to have someone that’s done it, in my case, a couple thousand times and—and I know you—you’re right up there, too, with your experience. So you want that experience because it gives you the confidence that you know you’re on the right track. Like if I’m going to Mt. Everest next summer to hike, you know, Everest, right? I want to go with one of those trail guys that have been all the way to the top. I don’t want to go on that journey alone because, man, it’d be pretty scary when it starts getting windy and stuff, and you don’t know what to do.

Evan Brand:  Yeah. So something that’s cool that you just said, I’m glad you brought up the adrenals, you know, body system one here. I’m looking at a study, it was from 2012, and it was titled Effects of Alpha Tocopherol and Ascorbic Acid on H. pylori. Long story short, the H. pylori intensity was decreased by increasing the ascorbic acid concentration in the body. So a lot of times, you and I are using vitamin C anyway with adrenal support, hormone programs, and so that’s something that I usually keep in place is the vitamin C supplementation during H. pylori because we’re gonna be able to up the speed or up the—what they call here—eradication rate. It says by impairing the microenvironment created by the bacteria and facilitating the diffusion of antibiotics, which may be that’s herbal antibiotics and in our case, into gastric mucosa. So that’s a pretty cool finding there that we can actually see vitamins that we’re using for other protocols for this protocol, too.


Dr. Justin Marchegiani:  Yeah, and also there’s a study here from the Journal of Psychosomatic Medicine, they talk about mucosal wound healing being impaired via stress. So they–

Evan Brand:  I believe it.

Dr. Justin Marchegiani:  They talk about that the data suggest here that something, you know, transient predictable, even relati—relatively benign can significantly affect the consequence of wound healing. Now it talks about mucosal wound healing. So now if we extract—extrapolate that to our gastrointestinal mucosa, we could see how supporting someone’s adrenals would then help balance and modulate cortisol levels, and if we know cortisol is important for that musical healing, you can see how us addressing body system one before we go into body system two being incredibly instrumental at setting the table for that nice immune mucosal wound healing environment.

Evan Brand:  Definitely. Stress is a killer. I mean, it comes up in every conversation we have, I think.

Dr. Justin Marchegiani:  I 100% agree. And so we know like the conventional H. pylori symptoms, a lot of people don’t have those, right? So then you gotta know well, just because you go to your primary care doctor and they say that you don’t have it, or maybe they do a breath test, and remember what I said, right? Urea gets metabolized to CO2 and ammonia, the ammonia is what screws up the stomach acid but the CO2 is what they’re measuring on the breath test. So the typical testing methods are CO2 via the breath test.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We have blood via the IgG, IgM, IgA, which is an indirect immune response looked at via the blood. We also have a villous or a gastric mucosal sample because we’re looking at trying to clip away a piece of that maybe H. pylori in the stomach or first part of the small intestine, but you know, if we don’t get it, that could be like putting a bucket in our—in our lake and pulling it up and saying, “Oh, it’s just water. That means there’s no fish in the lake.” So we don’t wanna just also have that same mindset and say, “Well, look, there’s no sample there. Well, the doctor may have missed it.” It’s very possible that that could have happened. We also have—we also have your stool antigen test which is a great test to look at. We like Biohealth stool antigen, and then we also have genetic test like PCR, polymerase chain reaction. We use a handful of labs like GI-MAP or Diagnostic Resource Group, and they’re—they do really good work and anyone that wants to get access to those labs, check out either Evan’s site or my site for access to those labs so you can get fully looked at, but again, we wanna look at it in conjunction with body system one as well. Just don’t make the mistake of just going after body system two. I’ve seen hundreds of patients get sicker doing that and they end up having to come back anyway and do it all over again and they waste a few months of their time and money.

Evan Brand:  Oh, gosh. Spend—spend a couple minutes here, what happens to these people that ignore the order of operations?

Dr. Justin Marchegiani:  Well, symptoms get worse, and again like I said, LPS is a toxin, so if you’re in the camp of having detox pathways impaired, right? And we could see that on organic acid test. We may see things like hippurate or you know, many of the different organic acid markers out of range—sulfate, pyroglutamate, right? These are all markers that bends the weight. These are markers that correlate to detoxification that could mean our phase 1 and phase 2 cytochrome P450 oxidative pathways are backed up and it may be hard for us to escort toxins out of our body.

Evan Brand:  Yup, that makes sense.

Dr. Justin Marchegiani:  So triple therapy is the conventional treatment. We use some different herbs in our clinic. We mentioned some of the biofilm agents, some of the binders. We use a bunch of various gut-killing herbs like clove or wild indigo, berberine herbs, mastica, oil of oregano, wormwood. We do different things like the ginger and again, it’s gonna be in the right dose, in the right amount. And the big thing—here’s the X factor, the X factor is do you have a co-infection along with the H. pylori. I have 3 patients this last week that not only had H. pylori, they had Giardia and they had Blasto.

Evan Brand:  Oh, man.

Dr. Justin Marchegiani:  Now what would happen if we just went after H. pylori alone or they just did the triple therapy for H. pylori alone?

Evan Brand:  Yeah, it’s not gonna work. You’re still gonna have symptoms, that’s for sure.

Dr. Justin Marchegiani:  Yeah, I mean let’s say you went the conventional route and let’s say, you added metronidazole or Flagyl in to kill Giardia. Well, great. I mean, the research only says that works a third of the time. Awesome. So now you—you roll in the dice. You have a 66% chance that none of that’s fixed and most doctors would never come, you know, even look for the Giardia anyway. So then you’re really set up for a world of hurt. So we wanna sequence things the right way. Typically, one infection at a time; sometimes we’ll do two if people have a stronger constitution, we’ll add in two. But you can see that we talked about the test. Some people may have to get all 6 tests done to evaluate whether or not they have H. pylori. I had one person recently took 4 times to get rid of the H. pylori. Most of the time it’s one or two, but sometimes it can take 3 or 4 and then we also know it can be spread pretty darn easily. In a lot of third world countries for instance, one of the main mechanisms is actually flies, because people are defecating in the streets. It’s like—I know like a lot of countries like India, I think 300 million people in India are still defecating the street. It’s crazy to think that because you know, that’s a third of the population in India I think. And if a fly goes in there and lands on someone’s stool that has H. pylori and then let’s say flies into your house and flies on your meal, you could easily get H. pylori vector that way.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  They also talk about here—and we’ll put all these studies into the transcription so everyone can go look at it later but they also talk about vaginal secretions, being a mechanism for H. pylori so intercourse, husband and wife, that’s gonna be very common, and even saliva. So non-sexual relationships that may be intimate like you know, kissing your—your son or daughter, right? That—there’s still a saliva interaction or even just sharing silverware or—or food or glasses. There could still be a connection there because we know saliva is a mechanism and we know vaginal secretions are also a mechanism, too.

Evan Brand:  I was trying to find a world map here, but it does show that in—this is just on PubMed talking about the evolution of H. pylori resistance to antibacterial agents that in Asia greater than or equal to 80% of the H. pylori cases are already resistant to the antibiotics in the first place.

Dr. Justin Marchegiani:  Right, right. They are resistant to it and that’s what we see a lot on the—on the DRG and the GI-MAP test. We’ll see a resistance to that clarithromycin which is that typical—typical antibiotic used to treat it.

Evan Brand:  Yup, and they have here talking about the metro—how do you say that one? Metronidazole?

Dr. Justin Marchegiani:  Yeah, that’s Flagyl basically.

Evan Brand:  Yeah, resistance to that one, too. The resistance isn’t as common in—well, it’s you know, greater than or equal to 20% in the USA and other developed countries, but that’s—that’s still massive.

Dr. Justin Marchegiani:  Right, and just so you know, there’s not a ton of research on H. pylori being transmitted via vaginal secretions, but this paper here in sexually transmitted infections in 2000 is putting that out as a hypothesis. We’d have to look at more—more recent papers, but they talked about that it’s being a potential reservoir especially with the right environmental conditions, and they also talked about potential reservoirs for H. pylori or feces, the cheek—the cheeks, right? The kissing. Think food, saliva and dental plaque. So because these are potential reservoirs according to the research, it’s also a potential for it to be spread. Now we can’t say, is it a one to one? Right? When you kiss someone with H. pylori, do you get it? No. Because we have something known as IgA which is our local immune membrane killer that lives in our mucosal system in our mouth, in our gut, and vaginal canal or urinary canal, gut tracts, that can knock it down. So if you have good constitution and good IgA levels, you can beat it out. That’s why we talked about H. pylori being opportunistic, where there’s more stress, low stomach acid, lower IgA. Think of your defense systems being down. Think of the, you know, the old Star Trek film where the force fields are down. The Klingons can attack and their lasers hit a lot harder when the force field’s down than when it’s up,

Evan Brand:  Yup, makes perfect sense.

Dr. Justin Marchegiani:  Any other feedback you wanna give, Evan?

Evan Brand:  I think that’s it. I think that was really good coverage. I was glad that we were able to zoom in, zoom out, and sort of paint a good picture here.

Dr. Justin Marchegiani:  So I just wanna say to any potential patients listening. The diet piece is gonna be important. Cut the grains and the gluten and the refined sugar, and the junk out of it. Get the sleep and the blood sugar timing stuff down. But then if you’re still having some of these symptoms, the next step would be to evaluate body system one and two and three, maybe not all at the same time, but at least body system one and two to start, and get on a comprehensive program so you can move through the mountains or the woods, or that your healing journey confidently and not feel like you’re grasping for straws when there’s a—a setback that—that can happen from time to time.

Evan Brand:  Right, so once again, here’s another piece that we’ve uncovered of why the diet and fitness industry has such a horrible success rate. Here you go.

Dr. Justin Marchegiani:  Awesome. Well, hope everyone enjoys this podcast here. This is such a big issue that I see in my clinic, and I see it day in and day out. I see about 50 H. pylori cases a month and about, I’d say 30-50% of the population have this infection, but if you’re having symptoms at all or you  just want to be—have optimal health, you should get the H. pylori eradicated and be infection-free. Everyone has the right to be infection-free.

Evan Brand:  Definitely.

Dr. Justin Marchegiani:  Alright, Evan. Great show.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Take care! Bye!

Evan Brand:  Bye!



What Causes H. Pylori Infection…The Most Insidious Infection Around?

By Dr. Justin Marchegiani

What causes H. pylori infection? Did you know that over 50% of the population has an H. pylori infection (1)? Dr. Marshall, the scientist who discovered H. pylori, won the Nobel Prize in medicine in 2005 for his discovery. His initial research was done on himself, as he infected himself to prove the bacteria’s causal connection with gastritis (inflammation of the stomach).

H. pylori is an opportunistic infection that spreads more rapidly in people that have a compromised immune system. This is why there are higher rates of all parasite infections in Third World countries. In the United States, we are seeing an increase in chronic stress and poor eating habits, which compromises our immune function and makes us open for an attack.

How Do You Get an H. pylori Infection?

H. pylori, unlike other parasitic infections, can be spread very easily via saliva and doesn’t require sexual intimacy per se. This is why it’s very common to see an entire family test positive for an H. pylori infection. Things like sharing a drink or silverware can be enough to spread the infection in a compromised individual.

What does H. pylori do to our body?

One of the biggest problems with H. pylori is its production of a specific enzyme called urease, which essentially neutralizes hydrochloric acid due to its increased production of ammonia. Hydrochloric acid is needed to help digest protein, ionize minerals, and create an acidic environment in the guts to stimulate bile release from the gallbladder, which aids in fat digestion in the small intestine.


h. pylori infection

If we can’t ionize our minerals properly, this will lead to a whole host of issues, including osteoporosis, immune problems, thyroid problems, and anemia. Lack of hydrochloric acid will also lead to indigestion, malabsorption, gas, bloating, and a catabolic physiology (your body breaking down faster than it can build up).

A large percentage of H. pylori infected patients will not present with any symptoms, so it’s possible you could be feeling great and still have an infection. This is also why my recommendation for anyone with an H. pylori infection is to supplement with hydrochloric acid and enzymes to ensure optimal digestion, even if no digestive symptoms are present.

It’s important to note that the enzymes and hydrochloric acid by themselves will not be enough to eradicate the infection. A proper assessment should be made by your functional-medicine doctor regarding your primary physical, chemical, and emotional stressors to ensure long-term eradication of the infection.

Click here to eradicate your H pylori infection!

h pylori and inflammation

H. pylori also irritates the stomach lining, hence its connections with gastric ulcers. This essentially creates silent inflammation, and now your adrenal glands have to come to the rescue to put out the smoldering fire in your gut. Your body uses cortisol from the adrenal glands to help put out the fire. But as your adrenals become more fatigued, cortisol will lose its capability of keeping the fire under control. This is the point where you will start to see the exacerbation of your symptoms. Many people can have this infection for a long period of time and not necessarily have any symptoms until their adrenals drop into stage III adrenal fatigue.

What Makes H. pylori Different?

H. pylori is a gram-negative bacteria. What this means is that H. pylori has two cell walls while most bacteria (gram positive) only have one cell wall (see picture below). When there are two cell walls, it makes it harder for antimicrobial medicines and herbs to eradicate the infection. This is analogous to a castle with stone walls for protection also being surrounded by a moat, which makes it more difficult for any intruders to invade.

Efflux Pumps and Antibiotics

In between the first and second cell wall, there is something known as efflux pumps. These pumps have the ability to disperse the antibiotic medicines that were given to the patient back outside into the gastrointestinal tract. These efflux pumps are believed to significantly contribute to antibiotic resistance, which is so prolific today (2).

When the antibiotics are pumped back into the gastrointestinal tract, patients can experience more die-off reactions. These reactions can include fatigue, nausea, bloating, flu-like symptoms, and diarrhea. H. pylori has obviously adapted in a way that has made it more resistant to antibiotics. This is one of the main reasons why I’m such a fan of herbal medicines, as they can be used for longer periods of time and don’t seem to have the same side effects as antibiotics.

The other major issue with gram-negative bacteria is that the outside of the bacteria is toxic. This toxin is known as lipopolysaccharide (LPS), or endotoxin, which is actually toxic to the liver. The more H. pylori becomes eradicated from your body, the more your detoxification pathways become stressed from the toxic debris! This is why I find removing the infection over a longer period of time and using additional herbs to help with drainage and detoxification can be beneficial in reducing those die-off reactions.


gram negative bacteria

The most common or conventional symptoms of H. pylori infection:

  • Abdominal pain
  • Bloating and fullness
  • Dyspepsia or indigestion
  • Feeling very hungry one to three hours after eating
  • Mild nausea (may be relieved by vomiting)

Less common symptoms of H. pylori infection:

  • Neurological pain
  • Anemia (B12 or iron)
  • Leaky gut (gastrointestinal permeability)
  • Depression and anxiety: All of the neurotransmitters in our body are made from proteins and amino acids.
  • Constipation and diarrhea: Inflammation can disrupt motility in the GI tract.
  • Crohn’s, ulcerative colitis, or any other digestive disorder
  • Explainable weight gain.
  • Fatigue or thyroid disorder: H. pylori is linked to autoimmune thyroid disease (6).

gut healthExams and Tests for H. pylori

  1. Blood tests: These tests are indirect and assess the specific immune responses to the H. pylori infection. The immune responses that are measured are H. pylori and IgA, IgG, and IgM antibodies. If you test positive for IgA or IgM, you can be confident that you have an active H. pylori infection. Research has shown that test results in patients that are positive for IgG antibodies tend to drop within six months of H. pylori removal (5).
  2. H. pylori breath test: This test measures increased levels of CO2, which is the by-product of urease and nitrogen. H. pylori breath tests tend to only show acute infections.
  3. Stool testH. pylori stool tests are the gold standard and are the only tests that look for the actual particles of the H. pylori bacteria.
  4. Endoscopy: This test is the most invasive and tends to be the least reliable, especially if you have no overt symptoms. This test can be good at assessing cancer as well as damage to the stomach, duodenum, and esophagus. For most individuals this test is unnecessary and is only recommended for high-risk patients.

Conventional Treatment Options and the Prevpac

Patients who have H. pylori and also have an ulcer are most likely to benefit from being treated. The treatment does not work in all patients.

Treatment must be taken for 10 to 14 days. Medications may include the Prevpac, which is a combination of three antibiotics.

  1. Clarithromycin (Biaxin)
  2. Amoxicillin, tetracycline, or metronidazole (Flagyl)
  3. Proton-pump inhibitors, such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
  4. Optional: Bismuth subsalicylate (Pepto-Bismol), in some cases

Natural Treatment Options

  1. Mastica (3)
  2. Burberines (4)
  3. Oil of oregano
  4. Wormwood
  5. Neem
  6. Olive leaf
  7. Black walnut hulls
  8. Burdock
  9. Probiotics (4)
  10. Vitamin C (4)

It’s very important the right combination of herbs as well as the right dosage of herbs are used. I strongly recommend a customized program by a functional-medicine doctor specific to your needs. This will give you the best chance of removing the infection the first time without terrible die-off reactions. If you have any of the symptoms mentioned in this article, click here to schedule a complimentary consult.


1. Yale J Biol Med. 1998, Helicobacter pylori: the Middle East scenario.

2. Biochemical Pharmacology 2000, Antibiotic Efflux Pumps Francoise Van Bambeke et al.  

3. Phytomedicine. 2010, The effect of mastic gum on Helicobacter pylori: a randomized pilot study.

4. Alernative medicine review 2001, Alan Gaby M.D, Helicobacter pylori Eradication: Are there alternative to antibiotics?

5.  J Clin Microbiol. 2001, Short-Term Follow-Up by Serology of Patients Given Antibiotic Treatment for Helicobacter pylori Infection.

6. Acta Med Iran. 2013 May, The association of Helicobacter pylori infection with Hashimoto’s thyroiditis.


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.