The Top 5 Reasons Why Your Estrogen Levels are High – Men & Women!

Let’s talk about the top 5 reasons why your estrogen levels are high. We’re going to break them down today.


First, let’s look at the 3 major kinds of estrogens: E1 or estrone, E2 or estradiol, and E3 or estriol. In a woman’s regular cycle, it’s usually estradiol we’re talking about. When you start shifting to more menopausal and the ovary stops working, you start getting more estriol. The adrenals help in kick in a lot of DHEA and you make more estriol. Estradiol is more of the growth factor type of estrogen and estriol is a weaker estrogen.

Click here if you need to consult with a functional medicine doctor to learn more about estrogen and your hormones.


  1. PLASTICS. You’ll get it when the plastic is warm like in a microwave or out of a plastic water bottle especially if it’s in the car and the sun is hitting it or it’s outside. That’s why you want a good stainless steel or glass water bottle if you’re going to go outside or leaving it in the sun. The microwave heat and the radiation is going to cause a big release of plastic chemicals there, the xenoestrogens. One of the big ones are the phthalates but also BPA. There are other types of BPAs that are new which are supposedly safe but there are still estrogen-like compounds there as well. These plastics can affect women and men as well. Men are actually going to be more affected by them because men aren’t used to having estrogen in their environment and getting a whole bunch is going to be a problem.
  2. PESTICIDES. These tend to have an estrogenic quality to them and if you’re eating foods that are not organic, you’re definitely going to be getting organochlorines and various pesticides in your environment.
  3. PHYTOESTROGENS. These are found in soy. For example, I had a vegan-vegetarian patient. We ran a Dutch sex hormone panel on her and her estradiol was through the roof and really high. Phytoestrogens can be a big one, so soy may be a problem. With vegan-vegetarian, there’s a lot of phony protein consumption like fake meat kind of stuff such as the Beyond burger where there are a lot of soy and estrogen-like compounds in there. There are also hormones in meat. You have to make sure you get antibiotic-free, hormone-free, and ideally organic and pasture-fed or if you’re on the Whole Foods scale, step 4 or step 5 is ideal. Step 2 is at least pretty good. Organic means no pesticides, no hormones, and also the food they’re eating has no pesticides or hormones, too.
  4. HIGH LEVELS OF INSULIN. Too much carbs drive high levels of insulin because insulin responds to a high level of blood sugar. The blood sugars in your bloodstream go up and your pancreas comes in. The beta cells make a bunch of insulin to bring it down and bring it into the cellar and converted to fat. So, high levels of insulin upregulate an enzyme in men called aromatase that converts testosterone, the male hormones, to estrogen which becomes a problem. Now, in women, a similar thing happens but it’s the exact opposite or the big switch. Their estrogen is converted to testosterone. So, women can actually get more androgen-like issues which results in weight gain, acne, hair growth, and sometimes you can see some libido enhancements on that. So, that’s the difference between men and women.
  5. POOR GUT HEALTH. In the gut, we make healthy good bacteria in our gut that help us absorb a lot of nutrients. A good healthy gut function helps us break down protein for good HDL levels and good enzyme levels. We need these to break down protein into amino acids which are really important for helping us to detoxify. So, detoxification helps us to excrete estrogens that we’re getting exposed to in our environments such as the pesticides, plastic, or something that you don’t even know you’re getting exposed to. Good healthy detoxification will help your body eliminate that, so that’s a good backup plan.Also, if we have a lot of dysbiosis, SIBO and bacterial overgrowth, we can make a lot of what’s called beta-glucuronidase. This is an enzyme that’s made by bad bacteria and it makes it harder to detoxify estrogen. The beta-glucuronidase takes conjugated estrogens and binds it to a protein that helps us excrete it out the body. It takes that protein and it pulls it apart. It takes the handcuffs off that protein, so that allows that estrogen that’s been deconjugated to go back into the body in the general circulation. So, if we have gut issues, that could be a major concern.


We need things like cysteine, glycine, glutamine, sulfur amino acids, and things that help us methylate like B12, B6, and folate. So, these nutrients we have to get them in our diet via a good diet. We need to be able to break down and absorb those nutrients, so we need good digestion to get those things in there.

So, in general, we’ve got to make sure we have a good gut bacteria balance. Even fungal overgrowth can cause problems and H. pylori that can lower stomach acid and make it harder to break down nutrition on one side and then it can create this bacterial overgrowth enzyme that makes it hard to detoxify estrogen. These are really important components. If you have any issues with estrogen, you’ve got to look there.

Now, we may want to do things to help detoxify like make lifestyle changes, food changes, pesticide changes, make the changes in regards to plastics, and make in in regards to your diet, your glycemic load, and your gut. That’s a good first step to get to the bottom. There are also different things we may do to help upregulate detoxification to help get that estrogen. It may be activated charcoal or various soluble fibers. It could be things like bentonite clay. We could use things like DIM or Calcium D-Glucarate or glutathione, sulfur amino acids, and vitamin C. They’re all helpful in different situations. We would recommend them based on what’s happening but at least make the diet and lifestyle changes out of the gates.

If you want to find out the root cause of what’s happening, click this link where you can schedule a chat with me!

The Top 5 Causes of Chronic Headaches

Today we are going to be talking about the top underlying reasons why you may be having a chronic headache. I had a patient come in today who had headaches for 25 years, monthly and chronically, and we were able to get to the root cause and there are many different root causes for every person. Let me lay out the common ones that I find to be a major vector of my patients.

Click here for a consultation with a functional medicine doctor if you are experiencing chronic headaches!

So we have headaches and head pain or migraines where you kind of have that aura and sound sensitivity. There are a couple of different major reasons why headaches may happen.

1. Food Allergens

Most common food allergy is gluten and dairy. There are some studies on gluten affecting blood flow up to the brain. We have these garden hoses on the side of our neck called our carotid arteries. When we have inflammation especially caused by gluten that can decrease blood flow and blood profusion to the frontal cortex, and when you have less blood, you’re going to have decreased performance of the brain. You can see that manifesting in a headache. People don’t know but headaches are actually an issue with vasodilation in the brain.  Caffeine can help as caffeine actually causes constriction and brain’s typical headache signal is caused by vasodilation.

2. Food Additives.

These could be things like MSG, aspartame, Splenda or various artificial colors and dyes.

3. Blood Sugar Fluctuation.

We want to have healthy proteins and healthy fats with every meal. If we skip meals or we eat foods that are too high in carbohydrates and refined “crapohydrates” and sugar, and not enough fats and proteins, our blood sugar can go up and then drop. This is called reactive hypoglycemia. We react by putting a whole bunch of sugar in our bloodstream because all of these carbohydrate sources break down into sugar — processed sugar, grains, flours and acellular carbohydrates. These type of flours and refined processed carbs get converted to glucose in our bloodstream. When glucose goes up, our pancreas goes, “Holy smokes! We got a lot of glucose there. We got to pull it into the cell.” It spits out a whole bunch of insulin and pulls that glucose right down, and we have his blood sugar going up with a lot of insulin driving that blood sugar back down. When that blood sugar goes back down, this is where we have cravings.  This is where we have addictions, mood issues, energy issues, jitteriness, and cognitive issues. Our body makes adrenaline and cortisol to bring that blood sugar back up. Most people literally live on this high insulin where they are making fat, storing fat and engaging in lipogenesis which makes us tired. Then blood sugar crashes which makes people jittery, anxious, and moody. Most people live on this reactive hypoglycemia rollercoaster and that can drive headaches.

4. Gut Infections.

Patients with a lot of gut inflammation, gut permeability, and infections whether it’s H. pylori, SIBO (small intestinal, bacterial overgrowth) or fungal overgrowth have gut stressors can create inflammation in the gut. When we have inflammation in the gut, we have gut permeability. So our tight junctions in our intestines start to open up and undigested bacteria, lipopolysaccharides, food particles can slip through and create an immune response. You can see histamine along with that immune response and histamine can create headache issues.

5. Hormonal Issue.

A woman’s cycle is about 28 days and in the middle is ovulation. Some women have it during ovulation and most have it right at the end just before they menstruate. This is called premenstrual syndrome that is right before menstruation. A lot of women may also have it during menstruation, too. What happens is progesterone can drop out early and that drop in progesterone can actually cause headache manifestations and also the aberrations in estrogen can also cause headaches as well. We may also see it with excessive bleeding too. So if you’re bleeding a lot or too much, what may happen is you may lose iron and that low iron may cause oxygenation issues.  That low level of oxygen may also cause some headache issues as well.  Because if you can’t carry oxygen, that is going to be a stressed-out situation for your mitochondria and your metabolism. For menopausal women who have chronically low hormones and they’re not in an optimal place, that can create issues. Progesterone and estrogen can be very anti-inflammatory. So if there is inflammation in the brain, progesterone is a powerful anti-inflammatory and that can really help a lot of inflammation in the brain.

If you have any questions about headaches, please reach out to a functional medicine doctor to find a way to fix your issue.

Conventional GI Workup vs Functional Gut Health Program | Podcast #297

If you’ve ever wondered how functional medicine differs from everyday conventional medicine, this is the podcast for you. Dr. J sets out to explore conventional medicine GI workup vs. functional medicine gut-health workup. It’s a compare and contrast while looking at what chronic conditions may be missed by conventional medicine. Check out for more info.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, they cover:


0:29     Gut Issues, H. Pylori

7:49     How Are These Detected?

18:04   Tests

24:16   Compare and Contrast of Treatments

32:10   Saliva Secretions

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here really excited today we’re going to be having a phenomenal podcast on the topic of conventional medicine, gi workup versus a functional medicine gi workup. We want to just kind of give you guys a little compare and contrast and talk about where others shine and where others may be better, especially for most people who have chronic health challenges that may be missed by your conventional medical workup. Before we dive in, Evan, how are we doing today, man?

Evan Brand: Doing really well, this podcast started with a story. quick story. The best man in my wedding. He called me last night and Hey, how you doing? Everything’s good. Okay, awesome. And then hey, I need some help with my wife. She’s been having a lot of gut issues for the past several months. She went into conventional doctor then went to a I’m assuming she went to some type of a specialist. Gi probably I told them about her issues which were bloating, major abdominal cramping, cramping, and pain, floating stools, possibly some changes with mood, but I don’t know if that was brought up to the doctor. So just conventional gi stuff and some pain that was radiating to the back. So pain in the front that was in radiating to the back. And her protocol was no testing. I don’t even think they did palpation they didn’t do physical exam. I think it they just listened. And then they said, okay, buy this probiotic. This probiotic was something that you and I looked up. It was one strain of bacteria in the bifido family, and it was loaded with fillers. And it was what’s considered a consumer grade product, meaning you don’t have to be a practitioner to get it. And it was just loaded with garbage fillers and sugar and other stuff. It had sucrose like why do you have sucrose so that was it. So that was it. And so then When you and I called this morning, I just said, Look, we’ve got to cover this because she got nowhere. And she spent all this time sitting in a doctor’s office waiting. And now she’s no better off. So I talked with her for a little bit. And we made a protocol for her that I think is going to be far, far better.

Dr. Justin Marchegiani: That’s great. Yeah. So really excellent. And when we see patients on the functional medicine side, most have already gone through a pretty thorough, conventional workup. So, you know, my perspective on a lot of this, not that I’m a trained gastroenterologist, not we’re functional medicine practitioners. But I see lots of patients who have already been through the gamut. And so I really try to understand what’s already been looked at what’s been tested, and you see a pattern, you know, when you see a couple hundred patients kind of go through these intense workups you see a pattern of what’s already been done, and you can kind of see what’s been missed, or kind of what their perspective is. So, most conventional gi doctors, you know that these are ones that are not functional medicine and nutritionally change right 90% are going to be in the conventional Category right there just following the typical internal medicine gastroenterologist, kind of best practices workup. So most are coming in they’re doing a history, they may do a physical exam some kind of a palpation to see where inflammation may be in the intestinal tract right certain areas may lead them to think certain things right, upper left quadrant, right my left that could be stomach kind of things maybe pancreas things, upper right. Could be more on the gallbladder liver area, you know, bottom, like mid left could be more spleen, bottom right mid right could be more intestines, and then lower right lower left could be either appendix on the right could be colon ascending on the right, descending on the left sigmoid colon on the left so that you kind of get a decent area. If you just know the general anatomy of what the inflammation could be Now, the next step is going to be depending upon you know, how invasive that things need to go right. They may recommend a capsule or endoscopy just to get a window. What kind of inflammation is in the intestine and then almost always though, they may need to go deeper into an actual endoscopy which is scoped down the mouth. Alright, colonoscopy is going to be scoped up the rectum to look in the colon area right you have your sigmoidoscopy, which is the last part of the colon before, stool goes into the toilet. And then you have all the way up the different intestinal tracts in the colon, right you have your descending your transverse or ascending and then on the upper side, you have your tummy. You have your tummy on the endoscopy, and then you have the first part of that small intestine. So obviously on the colon they may be looking for if you’re older, maybe polyps, which could be precancerous, they may be looking at inflamed tissue. It could be inflamed tissue from a ulcerative colitis when maybe there’s bleeding. It could be inflamed tissue from Crohn’s disease, which may manifest a little bit differently higher up usually, and usually there’s some level of skip lesions we’re all sort of colitis may not have that on the upper side. There could be ulcers in the stomach, right? Those are all possible things. And then there may be other tests to look at the levels of blood there may be things done like a fecal occult blood, where they’re testing microscopic levels of blood in the stool, maybe looking at calprotectin, which are inflammation markers in the intestines, maybe doing a barium swallow to look for any fistulas or blockages or even bleeding. On a barium swallow those are all like conventional things, they may pull out a ultrasound to look deeper at pancreas or gallbladder or liver, if some of that area comes back and flame or to even monitor monitor some of the krones type of inflammation. Some of the more progressive gastroenterologist are starting to do more of the breath testing, the lactulose breath testing, which may look at hydrogen and methane gases. Some may even do a glucose type of breath testing, it looks at more of the bacterial imbalances in the stomach. These are all other more progressive, forward thinking kinds of functional medicine, functional GIS, maybe doing that. Not a lot do that though. Then after that you have your conventional blood tests which could look for inflammation or immune cells or calprotectin. Or actually no calprotectin has to be in the stool but you could look at C reactive protein, you could look at immune markers, right. You could also look at the blood, you could just look at red blood cells, hemoglobin, hematocrit, iron, because if you’re losing blood, you may see it on a panel like that as well. And then some may also do stool testing. Now they may do more of your conventional stool testing that is less accurate, less specific, maybe not the more cutting edge DNA testing that’s looking for microbes that are more sensitive level parasites, H. pylori virulence factors Candida sibo bacterial overgrowth, right elastase deatta krijgt elastase is an enzyme markers, the adequate amount of digested fat marker. So these are things that they they’re typically not going to look at that we’re going to really dive in deeper because we’re doing a real functional assessment for what’s happening in the gut conventional medicines more looking at a pathological assessment, where we’re looking at PE, here’s optimal digestion what’s functionally not working compared to optimal, because there’s a big spread between, you know, being functionally optimum, and being disease and pathological is a big spread. So the problem is a lot of people are in between, this is where a diagnosis happens. This is where optimal is maybe somewhere in between that area and they’re just not going to get picked up. They’re not going to get assessed or found. And that’s where most 90% are going to be in no man’s land. In regards to their assessment or diagnosis, now we can go into treatment next, but I’m going to just pause there and give you a chance to comment.

Evan Brand: Sure, yeah. Good. Good overview and H. pylori breath testing is sometimes done. 

Dr. Justin Marchegiani: I forgot H. Pylori. I’m sorry. Yes. H. Pylori as well.

Evan Brand: Yeah. So that’s something where, you know, if we, typically what Justin and I are doing when we work with someone is we’re going to have them send us any labs that they’ve done. Maybe the last six months, maybe a year. If We think it’s still relevant. And we’ll take a look at it. So each problem our breath testing will see those. But the truth is that there can in with all these conventional, less accurate tests, there can be an issue with false negatives. So that’s even more frustrating for the client or the patient because they come to us. They’ve got five or six things they’ve done with the GI people, and they still don’t have any answers. And of course, they don’t have any action plan or protocol. So for me, before I figured out that I had h pylori and parasite issues I did the barium swallow, you drink barium, which is terrible. It’s like drinking chalk. And then you go and you get an X ray. I was having a ton of gi burning upper gi burning so that’s where they did the you swallow it and then you basically lay back they then X ray you and try to see what was going on. And, of course, I wish I didn’t have that done because it wasn’t functional. And it gave me no answers. And all they said was Yeah, you may have some inflammation, they just call it idiopathic gastritis and then they send you on your way. No, yeah, meaning Idiot gastritis we don’t have a clue. And then they gave me the recommended acid blocker and the anti spasmodic and sent me on my way. And I said, I’m not taking them, don’t even give me the prescription pad, I’m not going to take it. And then Luckily, I was able to do functional testing, which then confirm the bugs that I had. So, so I’ve been there, I’ve been there, done that, and you made a great point, I just want to kind of restate it in a different way just to make people make sure people are clear with it, which is this this huge, wide, like you call it a spectrum, the spectrum of all the way over on one side is death disease, celiac krones, just like some sort of like you said, a pathological diagnosis. And then on the other end is like optimal gut health. And you could be so far down this hole, very, very close to pathological level of tissue destruction in the gut, but still not enough to technically be celiac or be krones or be this or that. So until you get to that level, to the conventional world, you’re fine. You just got to keep that Go and keep going, keep going until you get to the level of tissue destruction where you could say you are celiac or Crohn’s or pain, colitis or whatever. Now we can prescribe you this drug. And that’s it. And I’ve actually had doctors tell some of my clients during their workups Hey, sorry, you’re not there yet. You’re not bad enough yet. You’re not sick enough yet. We can’t do anything until you get to this point, like with thyroid, you know, your thyroid is not destroyed enough where we’re gonna put you on this drug or we’re going to cut your thyroid out. So just keep living as if you’re living now, once you’re bad enough, then call us back and we’ll cut your thyroid out or we’ll cut out your colon. If it’s diverticulitis. We’re going to wait until you’re in really bad shape. We’ll go ahead and do surgery. Let’s cut a foot of your intestines out. Yay. No, that’s not the answer.

Dr. Justin Marchegiani: Exactly. And then just to kind of echo on it because we see a lot of H. pylori, and conventional medicine may do a endoscopy for that where they’re taking a sample in the upper intestinal tract view the scope, they may do a stool And that may or may not pick it up. And then they’ll typically do the breath testing and like there’s different kinds of breath testing, as I already alluded, right you have your lactulose, which is going to be more your cebo breath tests, it’ll look at hydrogen and methane. You have your glucose, which may look at upper intestinal, upper gut, stomach type of bacterial overgrowth, right lactose takes about two hours to work through the full stomach, the small intestine, so anything after two hours is usually a pretty good window into the colon, because that’s where lactose starts to get absorbed by the bigger, bigger bacteria in the colon. But glucose tends to get absorbed a lot faster in that first, you know, 20 to 40 minutes so it gives you a better window of the stomach. And then you have your h pylori breath test where they’re giving you like it’s a urea breath test, they’re giving you like a urea tablet or a urea solution. And basically, the H pylori in your stomach will take their urea, right because typically how h pylori works, that makes an enzyme called urease. And that method analyzes the urea and the protein into ammonia and co2. So when you give that urea, the H pylori will convert a lot of it into co2 and ammonia. Ammonia has a pH of 11. So it’s very alkaline so that throws off your stomach digestion and lowers your stomach acid, but it also spits off a lot more co2 than in their mess. They’re they’re measuring high amounts of co2 to get a window if you’re positive for H. pylori on that conventional H. pylori breath test. So they’re looking at three things. Typically, they’re looking at breath, maybe a stool antigen, which is the stool under a microscope, they’re looking at maybe an endoscopy, if it’s more serious to rule out gastritis or ulcers, and then maybe a blood test with a look at like an IGG, IGM, or IGA. And it G’s more of a long term marker, so you really want to request an IGM IGA to see if it’s more active and acute. So those are the big things that they’re going to be looking at on the H. pylori side and I just say that because h pylori is a big thing. We find a lot and can be a problem in a large percent of the population after 30 to 50%. And then I would say things like Candida or a fungal overgrowth are very rarely looked at or assessed and will typically look for that in the stool. And we’ll also look for that in the urine via a functional DRAM and a tough test. So we’ll look at things with a good functional stool assessment. We’ll also maybe do that cebo breath test that lactulose SIBO breath test. Now most conventional gi Doc’s don’t do it. There are some like for thinking conventional MDS that are gastro docs, like Dr. Pimentel at a cedar Sinai, he started making more of the breath testing more mainstream on the conventional side, which is good, which is excellent. But still, a lot of conventional Doc’s aren’t even doing it. So we’ll do that. We’ll look at it we’ll run the more progressive sensitive DNA stool tests. And that will also look at the urine test which can look at bacteria in the urine and it can also So look at fungus in the urine, the [inaudible] or I can look at the hippo rate and the indicator which is a marker for bacterial overgrowth, as well as protein putrefaction not breaking down your protein. So benzoates another big one. [inaudible] in a tick is the fungus. And those are HIPAA raised another big one, there’s a couple of 2 phenylacetic acids. Another big one is about 10 markers that we’ll look at for bacterial overgrowth on an organic acid.

Evan Brand: And none of the stuff that we’re going to do is going to be invasive at all we’re going to get into kind of the, you know, compare and contrast some of the treatment options to we have regarding the testing the stool that we’re going to do, it’s an at home stool test, it’s going to be way more accurate. I’d like to put a number on it and say 100 times more accurate and sensitive but I don’t know the exact number. I would just say that. We’ve had hundreds and hundreds of people who’ve done conventional testing through their practitioners, they show up with nothing, even like doctors data has missed in fact For example, but there’s DNA stuff that will run will find or fill in the gaps where the other testing failed or lacked. So that’s going to be the at home stool testing, and then the organic acids testing. That’s amazing. I mean, that even find stuff that the stool test doesn’t find like the yeast overgrowth, and it’s all done at your house. It’s amazing. Nice.

Dr. Justin Marchegiani: Yeah, it’s very, very nice. It’s non invasive. I’ll tell you the problem with a lot of conventional medical assessment, if they’re doing a breath test, fine. If they’re, you know, obviously a good pal patient is really nice, especially when it’s acute, conventional medicines really good at finding Irritable Bowel Disease, like you know, krones ulcerative colitis, or something more like an ulceration. If you’re older that can be helpful at like precancerous polyps, but even that they don’t address why those polyps grow. That’s another conversation. So they’re really good at finding those kinds of things. But the question is, how do we get there is that underlying cause being addressed a lot of times it’s not, and then a lot of times it’s being managed with ppis proton pump inhibitor. Maybe a corticosteroids, some kind of like they have like natural coating products that kind of coat the gut but still don’t fix the underlying issue. May maybe Imodium or some kind of antispasmodic, or anti nausea medication, especially when IBS is a diagnosis because a lot of IBS type of diagnoses or diagnosis of exclusion, meaning they’ve ruled everything out, therefore, they give you this diagnosis, which means, hey, you have some symptoms, but we have no idea why it’s cost or what the causes so they give you this diagnosis, you feel comfortable that you got a label, but that diagnosis is a diagnosis of exclusion. It’s you rule these things out, therefore it has to be this that tells you nothing about the underlying cause. And you’re still recommended just certain medications that control the symptoms, and may create more problems over time. Like if you’re on chronic acid blockers, you’re going to have issues with minerals, and digesting protein and digesting fats and over time, you can have some serious nutrient deficiencies for sure.

Evan Brand: And then you can have mood issues, you’re gonna have sleep issues, because now you’re not making neurotransmitters from the amino acids. So now you’re irritable, you’re anxious, you’re depressed, you can’t sleep at night, and your guts still a wreck. And that was me. And I got the diagnosis of IBS and it was nothing but drugs. And back to my friend’s wife. So they recommended that we talk about that probiotic. It was just one strain, and it had a bunch of garbage fillers in it. They also, of course, told her to eat more fiber. And this is a woman who’s basically pescatarian and she’s eating cooked organic vegetables for almost every meal, I’m like, wow. So they told you eat more fiber? Did they even ask you about your diet? No, of course they didn’t. They didn’t ask you what you’re eating. I mean, vets are better at helping with gut issues. And dogs then gi dogs aren’t helping with gi issues in humans. Why? Well, because the first thing you do when you go into the vet, what’s the vet gonna say? Oh, what kind of food are you feeding him? You go and you take your puppy and oh, my puppies, you know got diarrhea. Oh, what are you feeding your puppy? But that’s not the first question that gi doc asked. Now It’s not the first question we asked either right boy definitely in our it’s definitely in our workup.

Dr. Justin Marchegiani: Oh it’s something that’s going to be going to be asked on day one is one of the most important things for sure. But kind of getting back to the conventional Sykes I really want to give conventional medicine it’s Do you know hat tip where it’s good, it’s really good at a lot of these conventional, you know, irritable bowel diseases or extreme ulceration, they’re just still not good at getting to the underlying issue. So let’s say you have an Irritable Bowel Disease, right? They may give you something like a lialda or mesalamine or a corticosteroid or a biologic or an immunosuppressant or some type of antispasmodic or Imodium just something to manage those symptoms. If it’s bad enough, they may give you chemotherapy like a methotrexate, something like that. They may do deeper testing like a CT scan, if they’re looking at things or a MRI, which doesn’t have the radiation CT has the radiation they made. They made a deeper testing for that. A lot of times they’re still going to want to go inside Do that colonoscopy or endoscopy for sure, which has its own host of issues because you typically have to be under anesthesia for those, okay? And anesthesia has a major negative impact on your gut flora. And sometimes they may even want you to be on antibiotics post treatment sometimes. So it just depends upon the doctor and kind of your situation. But the anesthesia could have some negative impacts on it. And there’s some data it’s more controversial now, but I’ll put it out there. But there’s some data talking about the fact that the equipment that is used to do a colonoscopy, the cameras or endoscopy cannot fully get sanitized due to the sensitivity of the equipment. It can’t fully get sanitized. Therefore, there could be some potential fecal debris on there. from a previous patient. It’s possible right? It’s more controversial.

Evan Brand: No, I don’t think it’s controversial. I’ve seen it for years man, they call them  HAI- hospital acquired infection. It’s huge. It’s one of the leading causes of death in hospital setting is an infection that you pick up by getting a routine procedure done. I actually had a woman who had this happen, and she developed major, major major c diff infection. So she had issues before. You know, she was having a lot of stomach pain, a lot of burning. She went in, went to the gastro, they did the endoscopic, the endoscopy, and let’s go. And after she got home, she had endless, endless, almost to the point where it killed her diarrhea. And I was like, oh, that doesn’t sound good. And guess what she had Clostridium difficile, also known as C diff. So then what happened? She gets the conventional GI Doc’s to prescribe her antibiotics, very, very strong antibiotics. However, C diff is just one of the major bacterial infections that’s become resistant to the antibiotics. The CDC has been warning this about this for years. They now call what we’re in now is the post antibiotic era. Just look up CDC post antibiotic era, you can read about it. And so this woman still had seed if she did the antibiotics, she killed off any remaining good bacteria. And she was still miserable. We ran the testing on her confirmed the C. diff was there via urine and stool. And then we used anti microbial herbs. And guess what, we got the woman better. We got the C. diff gone, and she was fine. So I’m glad that you pointed out they are good at finding stuff. That’s pathological. But yeah, and then they’re not going to tell you why you have Crohn’s and they’re not going to put you on an autoimmune Paleo Diet like we are.

Dr. Justin Marchegiani: Exactly, they’re not going to do that. Now, just to kind of highlight a couple things here. We talked about the hospital acquired infection, there’s also a chance of, you know, rupture, or, you know, poking the hole with with the cameras that are going into your, into your throat or into your rectum as well. It’s always a possibility. So the nice thing about some of these, the assessment and testing that we do, there’s no chance of any side effects, which is excellent and there’s no chance of disrupting your floor either with anesthesia or swallowing radioactive solution, right? So it’s nice to have an assessment that doesn’t really have a chance of causing any more problems. And it gives you that full spectrum because remember, on the conventional medicine side unless there’s this much inflammation on the scale, here’s optimal. Here’s a diagnose visible condition. There’s a large gap here. And if you’re somewhere in this gray area, this is the gray area where the doctor says, Hey, we can’t help you. Hey, it’s all in your head, hey, you’re just getting older. Here’s a prescription for an antidepressant. Like literally, these are things that happen after the fact and there are some doctors that are saying, Oh, well, here’s a probiotic, like you mentioned with your friend that called you and they recommended a crappy antibiotic right now. Hey, that’s better than jumping on the anti depressant, right? That’s at least a good step in the right direction. I appreciate the thought right A for effort, but outcome Not quite. And so the people are starting to wake up a little bit and I think people are under doctors are understanding that patients are going above and beyond and they’re reaching out the doctors like so some not a lot are striking. Trying to get through games stepped up for sure.

Evan Brand: Yeah. And the other story I had in my head, I may have mentioned this for but a male client of mine, he went in and got an endoscopy. And I don’t know exactly what part what material, what piece of the equipment, but anyway, he has a piece of equipment stuck in his body. And he has to go, he has to go in for surgery now to get that piece of equipment removed. And he just went in for a routine scan into scope. And now he’s got something stuck inside of him. And now they got to cut them open and get it out versus we’re having you wake up and pee in a cup at your house and mail it to a lab and we’re getting hundreds of biomarkers from that. And we’re having you poop into a tray and you scoop that into the collection to and you’re also doing that at home. And you’re sending that into the lab. So I mean, just in terms of ease, and you know, I’ve we’ve talked with quite a lot of few people who they’re worried about their immune system, so they don’t want to go around the hospital anyway, where there may be people that they could get exposed to COVID Yeah, so We’re saying, Look, don’t worry, you’ve never had to go anywhere. And with our practice, you still don’t have to go anywhere. And we’ll still mail you everything. You don’t even have to go to a pharmacy yet to pick it up. We’re going to mail you what you need to your door. So that’s fun, more convenient for sure.

Dr. Justin Marchegiani: Love it. But we did a pretty good job. Now we’ll just kind of compare and contrast a lot of the treatments, right? Because I have my six our protocol on how we work on digests or work on supporting someone’s health. So of course, gastroenterologist are typically going to make zero recommendations on food. Now some of the more progressive ones may say, hey, cut out gluten dairy, refined sugar, that that could be common that a lot of times, that’s not going to be enough, or they’ll recommend a conventional low fodmap diet, which could still have other grains and other inflammatory foods in it. So that still may not be great. So we have kind of our own special kinds of diets that we use, whether it’s a specific carbohydrate diet, cutting out females, salicylates, whether it’s not immune diet, which is kind of paleo plus, right, paleo. No grains legumes dairy right on the immunes no nuts seeds nightshades eggs we may do a keto we may do a carnivore we may look at cutting out histamines and a lot of different dietary templates that we have used thousands of times and we kind of know where the best ones to apply are, that’s important because nine times out of 10 your conventional doc won’t even touch that. Okay, next up is we’re going to recommend digestive support. Now your conventional Doc’s more likely to prescribe an acid blocker than anything to help improve digestion. Now, an acid blocker may be reasonable if there’s an ulcer or an acute ulcer. Now, a lot of times also like pain can improve with digestive support. So there’s also like pain we make ask to try a tiny bit of acid, the tiniest amount, maybe a teaspoon, or an eighth of a teaspoon of ACV or lemon juice. If that causes any irritation. We can all assets we just lean on enzymes. We just lean on maybe some bile salts and then we work on adding in extra healing and soothing nutrients to help support the gut lining conventional Medicine are not going to recommend any healing soothing nutrients, they’re not going to recommend glutamine, aloe, dgl, zinc, rising carnosine, they’re not going to recommend any of these high quality nutrients to help support the Go on.

Evan Brand: Let me point out to if you’re putting anything with acid on the shelf, it’s on the shelf temporarily, we’re likely going to bring that in at a future date where, you know, I got into the debate with the GI doc back in the day, and I asked her, Well, why do I feel better when I do extra acid and extra enzyme? She goes, No, that’s not possible. I’m like, I take more stomach acid, the more stomach acid I take, I feel better. I have less bloating. I have less gut pain. Nope, that’s not possible.

Dr. Justin Marchegiani: Okay, that’s someone that does not have an understanding of physiology, right? Because physiology tells us the more stressed and inflamed we get, the more our sympathetic nervous system is activated. Where does that jump blood to? arms, fingers, feet, why run, fight flee. So all that goes away from the intestine so we have a decrease in our digestive juices and we have a decrease in acidity because that’s part of the juices that are produces and then the acidity triggers enzymes to be produced. So if you have any type of acid irritation, unless we’re coughing up blood, or we have an active Oh sir, I always recommend adding a very tiny bit because sometimes, least half the time, it can make it better. Sometimes the mucosa is so raw that it can’t handle it. So if that’s the case, if we can’t handle it, we lean more on enzymes and healing soothing nutrients. If we can’t handle it, then we just gently taper it up. And again, we’re typically recommending a stool test that’s going to look at old cold blood. So we’re going to get a really good window if there’s blood in the stool or run a conventional blood test that will look at red blood cell hemoglobin hematocrit and particular sites, okay, particular sites or young, immature red blood cells over losing a lot of blood. Guess what goes up particular site. So if we see a lot of particular sites that could be a sign of blood loss. Now, women could have that because they bleed a lot men straight Why’s and have a lot of estrogen dominance? So you have to understand the context of what you’re testing. And when.

Evan Brand: Yeah, good point, good point, the calprotectin we are going to be looking at so that is one marker that does have good overlap from conventional to the functional side. We love looking at calprotectin that’ll kind of give us a clue on just how inflamed is the gut? And is it possible that we could throw in a little bit of acid right away, and I’ve had people that they have had high calprotectin. And we were able to still do a low dose, maybe two to 400 milligrams of patane. And that was enough to really calm things down and improve their digestion so much that we then infer that the malabsorption was creating the inflammation in the first place. And all we did is help them break down their foods better and then the inflammation always drops. It’s so fun to see that I’m sure you get the same high from it that I do where you see high calprotectin you’re like well look at this number. It’s scary. We don’t like it. Yeah, protocol, retest boom, look at the levels drop. It’s so satisfying.

Dr. Justin Marchegiani: Yeah, I would also say a lot of the inflammation and the irritation that is in the inside. decimal track can be from poor digestion. So the food purifies it ferments, it runs cinephiles, it basically rots inside your intestines, and that creates his own host of acids that can be irritating. And sometimes taking a little bit of a digestive acid can decrease the rotting acids from the food. So that kind of thought process is a little bit of acid can decrease the production of more acids from the rotting of the food. And big big clinical pro write this down. I always recommend taking acid with food already in the stomach. People can have false positive ulceration symptoms with HCL by not taking their HCL with food and that’s protein and fat. So I always like protein and fat on the bottom of the tummy kind of coating it and then we’ll typically come in if we’re on the fence with a 16th to an eighth of a teaspoon of ACV or lemon juice, tiny bit and some water just a tiny bit and then that’s a good first step because if you can handle that, then usually you can work your way up. If you can get to a teaspoon to a tablespoon, then usually we can start to add in supplemental HCL and go from there. But worst case, if we can’t, or we’re just being more conservative, we just lean more on enzymes. We go to the gut healing nutrients, and the third are repair right repairing the hormones and the gut healing nutrients where we support a lot of the adrenals. and stuff as well. We need testing for that. The fourth RS where we come in and knock out infections. Most people on the conventional side the antibiotic is prescribed first, not fourth. So we set the table so we can go in there and deal with infections better. And then we’re using herbs that have more of a broad spectrum, but I’m more selective for the bad critters versus the good guys, which don’t create as much of a rebound overgrowth, and then we deal with repopulate rynok good bacteria and we’re not doing just to defeat along them with a whole bunch of additives. We’re doing professional strength professional grade, high potency antibiotics that have you know, that the amount of probiotics on our labels is where that would be at expiration. Not at manufacturing. So when you get a product from us, you’re probably getting double the amount that’s actually on the bottle. And then six RS retesting, and we understand that siblings and their spouses may pass infections back and forth. That’s really important to keep that in mind when we have a chronic issue.

Evan Brand: Yeah, and that’s not that’s not going to get brought up ever. I mean, I actually had a actually had a medical doc send me an email, and they were mad at me because I blamed the husband’s H. pylori infection on the wife. And so the wife was working with this doc and was saying, this practitioner, this guy on the internet, is saying that I’m the reason that my husband got reinfected with h pylori. So the medical Doc’s like that’s not possible. That’s not true. I’m like, Look, man, I could send you hundreds of cases I’ve got before and afters here where we tested someone. We then made a protocol we got rid of the infection two to three months later the infection comes back within test the spouse, boom, the spouse is positive, then we put both Have them on a protocol, boom. Now both of them are clear and both of them stay clear. So, I mean, why that would be controversial? I don’t know. But it was it was a funny email.

Dr. Justin Marchegiani: Yeah, I mean, I have one study right here in front of me it’s called saliva secretions in the efficacy of H. pylori. They’re talking about H. pylori was detected in dental plaque and oral lesions and in the saliva.

Evan Brand: When was the year of that study? Just curious.

Dr. Justin Marchegiani: Yeah, I’ll pull it up here right now. So you can see it may put it right up on the screen-

Evan Brand: Because maybe, you know, maybe this was a guy who maybe he hasn’t looked at a journal in 20 years and he doesn’t know that this is possible or true. And while you’re doing that, too, I want to say something about the-

Dr. Justin Marchegiani: 2011 but there’s a lot of studies on this stuff. So there is going to be some h pylori in the saliva for sure.

Evan Brand: Yeah, and I want to talk about the the herbs in such too. So the cool thing is with the anti microbial herbs, those alone can help reduce them. inflammation and we made out of the gate, as opposed to saying, Hey, here’s an acid blocker out of the gate. If we’re waiting on testing, you know, if someone’s really miserable, it may be 2 3 4 weeks turnaround time. We could throw something in right out of the gate that’s going to address and calm things down, which is very, very good. We talked about a guy had that was a teenager with panchal itis we talked about him a few podcasts ago. But anyway, we got him started on a really potent aloe extract right away. And by the time we got his lab results, Two, Three weeks later, he was already significantly better in less pain, less misery. So that’s the cool thing is there are some quote like, I don’t want to call him urgent care, but for lack of a better term, there are some quick fixes that we can implement right away before we get testing.

Dr. Justin Marchegiani: Totally. And then right here, salivary secretions, the Journal of dental think this is out of two round salivary secretions and advocacy of H. pylori eradication. So basically, they see that hey, the oral cavity may be affected, right. And they see that there could be saliva. saliva could contain H pylori secretions and then the conclusion is they find that h pylori eradication from the stomach may reduce the may reduce the salivary secretion of H. pylori. So we see that in some of the studies and this has been around for a while, so, it’s good to know that and that just kind of supports our theory that we’ve seen clinically with spouses passing things back and forth. And, again, you know, it doesn’t have to be a sexual thing, just sharing drinks and maybe silverware and just living in a house where those kind of things happen easier, right? That increases the chance.

Evan Brand: Oh, yeah, we’ve seen it in kids where it’s like, oh, hey, honey tribe, I did this organic dairy free ice cream, and mom’s got h pylori here. She has given her two three year old the spoon and then you and I’ve seen you know, countless children 2 3 4 5 6 year old kids with H. pylori, and my daughter had it my oldest summer she had h polarized so we tested her gut she had parasites first we eradicated those then on the retest H. pylori showed up and then luckily we were able to get rid of that. So you know, we clinically and personally deal with these things all day, every day, so we have a lot of, we have a lot of sympathy and empathy when it comes to the gut work here. And I just feel for all those people like me that they go to the doctor’s, you have so much hope you’re so anxious about the appointment. I remember feeling comforted. I remember I was in so much pain. I remember being in that office waiting for the doctor to come in. And I just felt comforted back then being in that environment. I’m waiting in the office. I’m like, Yes, she’s going to come in here he or she’s going to come in here. They’re going to give me the answer. They’re going to help me they’re going to get me solved. And then my bubble just got burst. I remember walking out of that place just so disappointed. I thought, oh my god, I remember the beginning of my appointment here. I was so thrilled and happy. I’m going to get to the bottom of this thing. And then here I am, you know, X amount of time later so disappointed and had to keep searching. So we feel for you, we’ve been there.

Dr. Justin Marchegiani: 100% and then again, just because someone has h pylori. The healthier you are, the stronger your immune system, the better levels of IGA you used to create which is going to be in the saliva. mucosa mucosal membrane barriers that’s gonna fight these infections. So it’s just because you get exposed to it in the saliva doesn’t mean you’re necessarily going to get an infection. But the more immuno compromised, you are stressed, weaker adrenals gut barrier integrity issues, poor digestion, the greater chance that h pylori that’s in the saliva could gain a foothold in your body. It’s very possible.

Evan Brand: Yeah, good point. I’m glad you pointed that out. Because there’s going to be a couple haters. Eventually, they’re going to hear this and go, Oh, that’s bullcrap. You know, 50% of the population has H. pylori, you’re painting it to be the bad guy dead. Well, in the modern world, people are so toxic, so stressed, so immunocompromised that I don’t think we can coexist the way we used to, because our buckets are so full. So these things do tend to take on a more pathogenic pro inflammatory state than maybe previously where people stress bucket and toxin bucket was less full. So yeah, I’m glad you made that point.

Dr. Justin Marchegiani: Yeah, and again, not everyone will get exposed to it, because their immune system will just knock it out via their IGA and some may get it but they’re going to be able to be Ace symptomatic, and they’re okay. And then they’re just like, hey, this isn’t a problem. And then they project their their good health and their asymptomatic status to Hey, you know this, this can’t be the problem, because I had the same thing, but everyone has a different constitution. And because of that constitution difference, it could affect you differently. For sure.

Evan Brand: Yeah. Well said, Well, I think we did a good job. We covered the testing piece, kind of the conventional colonoscopy and endoscopy, barium X ray scans, MRIs, CAT scans, CT swallowing, radioactive tracers, compared to the at home, organic acids and genetic DNA based stool testing that we’re doing at home with people. We compared the drugs, the antibiotics, the acid blocking medications, the antispasmodics, the immune suppressant or immune modifiers, like you mentioned, possibly an extreme case a chemo drug, versus we’re going to be going for more inflammatory herbs, natural antimicrobial herbs, anti parasitic antifungals, possibly some extra acid and enzymes, maybe some zinc carnosine and other things to heal up the gut later. Maybe some additional mushrooms and adaptogenic herbs to strengthen the immune system, possibly using these things throughout the family with spouses or children to help protect them as well. And then of course, the diet piece possibly, like my dad when he was suffering. When I was a young kid and he was suffering with diverticulitis, he was told to eat more fiber and that was his diet protocol. And it was take you know, GMO Metamucil psyllium husk or whatever it was with natural with it probably wasn’t even natural flavoring back then it was probably artificial flavoring. And that was the protocol versus you mentioned the templates so possibly, low fodmap low histamine, paleo autoimmune carnivore. There’s different things that we’re going to do based on our educated guesses plus, with the labs, the information and then people’s food journals, how are they feeling basically-

Dr. Justin Marchegiani: Even cooking, cooking, a lot of times just cooking those foods up better, avoiding raw foods and that can help a lot right the cooking is pre digestion and if your tummy has a heart digesting the food The more we can pre digest that food within reason you know steamed sauteed even stews or soups instapot crockpot pressure cooker that can really help with helping the tummy access those nutrients better. 

Evan Brand: I brought out the Instant Pot The other day you know it’s summertime it’s hot so it’s not very attractive to bring out the Instant Pot but man, we threw some organic purple sweet potatoes in that instant pot, 10 minutes. It’s awesome. Oh my god, they were so good.

Dr. Justin Marchegiani: Oh, yeah. Like like my carb cheat on the weekend is going to be potatoes because why? Cuz they’re grain free. They’re starchy. I can handle them on the autoimmune side. Some may not be able to but it’s just it’s a really good healthy safe starts and it gives you that mouthfeel that you’d miss from like, you know, breads or grains. That’s my big cheat and I do 10 minutes on the instapot on that it’s wonderful or, you know, at a nice Steakhouse is pretty good too.

Evan Brand: It was hard to believe I could I mean, it was a pretty good sized potato and I thought 10 minutes there’s no way this thing’s going to be done. It was done. We put some butter on that bad boy, some garlic salt. Delicious. 

Dr. Justin Marchegiani: It takes 45 minutes to do Boiling or steaming in real life. I mean, the instapot is pretty amazing how fast they can cook stuff. 

Evan Brand: This episode is brought to you by Instant pot.

Dr. Justin Marchegian: I know right? Awesome well if you guys are enjoying this content and you wanna share with your family and friends, or you wanna dive in and get support from myself, Dr J or Evan,, reach out for Evan. reach out to myself, Dr. J. If you guys enjoy the content we’re available, click down below, whatever you’re source, we have links down below to get access. Make sure you give us a comment. Let us know what you think, what you like, what parts resonate with you, give us a comment, like, share, hit the bell for notifications and we appreciate you guys sharing this with your family and friends, so they can become empowered about their health. You guys have a phenomenal day. Take care ya’ll.

Evan Brand: Bye now.

Dr. Justin Marchegian: Bye.


Audio Podcast:


Top 5 Causes of Bloating – Functional Medicine Solutions & Mold Bloating Connection | Podcast #282

Hello, everyone! In today’s podcast, Dr. J talks about bloating and its connections with mold, low stomach acid, bacterial overgrowth, h. pylori, fungal overgrowth/candida and parasite infections. Mold and mycotoxins may also play a role in causing sympathetic and adrenal stress that could affect digestion. Food allergens and too much-processed carbohydrates may also feed bad bacteria that could contribute to bloating and gas. The cause of your bloating might not be what you think it is. And how does mold fit in this puzzle? Dr. Justin Marchegiani is drawing a line between the root cause and palliative solutions. We’re also looking at more natural solutions to help treat and relieve your bloating. Of course, very important is the root cause and checking back to that so everything connects and encourages better digestion and less bloating. We’re talking about the tests we conduct to help get down to the root of your bloating, chronic vs. acute bloat, and the next steps. Let’s ditch the discomfort of bloating!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

01:06 Lab Testing, Root Cause and Palliative Solutions

9:55 Mold Exposure

15:33 Digestive Support, Infections, and Fungal Overgrowth

17:21 H. pylori and Mold Connection

25:19 Working with Functional Medicine Practitioners

28:02 Best Practices’ List



Dr. Justin Marchegiani:  Hey, guys.  It’s Dr. Justin Marchegiani here with Evan Brand.  Today, we are gonna be chatting about functional medicine solutions for bloating.  Really excited to get to the root cause.  Evan, how was your weekend, man?  What’s going on?

Evan Brand:  Oh, not too much.  It was very good.  I’m excited to dive in to this topic.  I figured we would divert from the coronavirus.  We’ve done, I don’t know, hours and hours and hours and hours of content on that and what we’re still seeing clinically is that people still have issues outside of that, being concerned with that, and one issue that’s popping up pretty much every single day and that could be because we focus so much on helping improve gut health in people is the issue of bloating, and people will come in with the sort of preconceived ideas of what’s going on.  They’ll say, “Oh, I have bacterial overgrowth or I have this or I have that. I have parasites.”  And that’s what they think is going on but in a lot of cases, and this is why you and I focus so much on doing advanced lab testing, in many cases the people wrong.  What they thought was wrong with them is not what’s wrong with them and then we find a different solution.  So why don’t we dive straight in to the testing?  Maybe talk about some of the tools that we use to investigate these issues and then we could dive in to maybe the specific things that we are seeing that are these triggers or root causes.

Dr. Justin Marchegiani:  Absolutely! So when we look at root cause, we always want to draw a line between root cause and then palliative solutions that may help symptomatically.  We always want to draw a line, right? And of course, there’s palliative solutions that are more conventional-based, right?  Whether it’s like bloating, whether Gas-X or some type of drug to address, Imodium or something else on the tummy side that’s gonna just manage symptoms on the drug side, right?  And then there are even more natural things that do the same like activated charcoal, right?  And then there are some things that are more palliative but may connect into the root cause like digestive support, like enzymes and acids.  As part of a lot of bloating issues, there tends to be some kind of a gut infection or gut stressor followed by low stomach acid, low enzymes, low bile salts.  So there are some palliative things we may throw into the mix that may help support and allow us to feel better but they are also part of the root cause.  So we—we want to always plug in solutions but also make sure we are checking back to the root cause so we’re not—we’re making sure that everything connects.  Palliative, root cause, and they all want to connect and ideally, we’re choosing root cause stuff that’s gonna be more—more natural that’s in alignment with what your body needs for good digestion to begin with.

Evan Brand:  Well said and there could be a lot of overlap between the palliative stuff and the root cause stuff like the enzymes, great example.  So testing-wise, what are we looking at?  How are we identifying the root causes of bloating?  Number one is stool test.  We do a DNA stool test on pretty much every single person.  Unless they’ve already had something run and it was very good or recent testing from a previous practitioner or doctor, then we may use that but in most cases, we’re looking at a DNA sample to try to figure out what’s going on and not only what’s going on, but what specific species of bacteria, what specific pathogens like worms, what specific parasites, what’s the gut inflammation look like, what’s the gut barrier look like, what about H. pylori, is that going on?  Because if enzymes make you feel better or enzymes making you feel better because you have an H. pylori infection that’s—

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Suppressing stomach acid, so I would say stool test is probably the best but not always the best place to start testing-wise.  What would you say?

Dr. Justin Marchegiani:   Absolutely! So I mean, there’s just—we look at underlying physiology, right?  You can tell a lot by underlying physiology with symptoms.  The difference is a good functional medicine doctor is gonna look at the symptoms and go upstream to the body systems that may not be functioning optimally.  So if I’m seeing indigestion, I’m thinking okay, maybe we don’t quite have enough enzymes and acidity to activate our digestive support, right?  Because we need nice low acidity, right?  Low acidity is like a pH of like 1-1/2, 2-1/2, that helps activate enzymes and the acidity also helps then trigger bile release once that chyme goes into the small intestine, and it also triggers more pancreatic enzyme release whether it’s lipase or protease.  These are enzymes that break down protein or fat, so we need that acidity.  Also, acidity makes it harder for bacteria to grow.  So think of acidity as like the—it’s like the Clorox bleach on the dirty picnic table, right?  It just really kinda cleans things up and makes it really hard for a lot of the not so nice guys to grow.  So we know that’s kind of a foundational tenet and that’s always good to look at that.  Now, we have other outside things like emotional stressors and any type of emotional stressor or any type of stressor plays into the adrenals.  Because when we activate the adrenals, we’re either surging cortisol or adrenaline, right?  One is from the outside of the adrenal gland, right?  The cortex, that’s cortisol.  One is from the medulla, the inner part of the adrenal gland.  Either the inner half or inner third and that’s gonna be surging a lot more adrenaline, right?  Both are intimately connected, right?  Adrenaline gets to the scene first.  Cortisol follows by about 20 minutes, okay?  And these are gonna activate a fight or flight sympathetic nervous system response and that nervous system response will take blood flow and shunt it away from the intestines and bring it to the arms, hands, and feet, so we can run, fight, and flee.  So if we have emotional stress and it’s unresolved, or we are putting our body in stress from food allergens or from eating on the go or not chewing our food up well enough, we’re just consuming a lot of toxins in our food, whether it’s mold or pesticides or chemicals, that could be activating that fight or flight response.  So that’s why looking at the adrenals can be helpful because if we have this chronic digestive stress, that could be stressing out the adrenals and a lot of people that focus on digestion in the functional medicine world, they don’t ever bridge the gap between digestion and hormones, and they really come full circle.

Evan Brand:  Yup, so that’s your answer.  Your answer is what will the next test—my question was what was the next test you would say is important for investigating bloating?  So your answer would be adrenals.

Dr. Justin Marchegiani:  The adrenals would be a really important part because the fight or flight, the sympathetic nervous system is helpful.  Now again, this is gonna be more on the chronic element.  This is like a chronic issue, right?  If this is more of an acute problem, the adrenals may be at play but they may not be a big piece in that person’s healing recovery.  But it’s always good to look at because the problem with stress, people associate stress like when you say emotional stress or stress, you’re thinking like family, kids, finances, work, right?  The problem is if you have an underlying Giardia infection or H. pylori infection, even though you are on beach totally relaxing, you know, drinking Mai Tais, you are still gonna have stress in your body that could be activating a little mini sympathetic nervous system response because of the infections.  So that’s why the gut stuff, if it’s chronic it can be under the surface and you may not even be perceptible what’s happening.

Evan Brand:  Yup, and that was my case.  I mean, I had Giardia and other infections, my adrenal test looked terrible.

Dr. Justin Marchegiani:  You had three amigos, right?  You had three amigos, right?

Evan Brand:  Yeah, it was the H. pylori, the Giardia, the Crypto and when I ran an adrenal profile, I didn’t feel stressed, right?  I was taking a lot of adaptogenic herbs, so maybe that was helping but if somebody said, “Are you stressed?”  I’m like, “Nah, not really.”  But when you looked at my adrenal profile, my system was clearly stressed.  I’m glad you pointed that out that even though you don’t “feel stressed” or you think your life is fine or “Oh, my kids are great.  My husband’s wonderful.”  It’s like, okay, cool but that doesn’t matter actually.  You could have plenty of co-adrenal stress and have nothing going wrong in your life at all but that—let’s take this a step further.  So you mentioned the cortisol release and all of that, so what is that actually doing to affect the gut?  Well, the cortisol, it’s catabolic.  It eats things away, so you know, you’ll read or hear about people who go run a marathon and then they’ll have diarrhea.  That cortisol just tears apart the gut barrier.  So I’m sure there’s other mechanisms involved but to me that’s one that comes to mind.

Dr. Justin Marchegiani:  Yeah, also you can look at post-marathon and then look at immune system deficiency.  You’ll see chronically low or at least, you know, for a few days to a few weeks on the low IgA side, from long-distance aerobic exercise.  So you could be over-exercising or just doing too much aerobic, and that could be really compromising your immune system, right?  So that could be playing a big role as well.  So like you mentioned, chronic cortisol can rip up that gut lining and then the more that gut lining is ripped up, greater chance of food allergens.  So then now if you’re consuming, you know, questionable foods, there’s a greater chance that you may start reacting to those foods as well.

Evan Brand:  Here’s the funny thing.  I’m thinking out loud.  So in terms of like Buzzwork–Buzzfeed type titles, you know, I kinda brought this up to you before he hit record.  I’m like, hey, let’s do something on like top 5 causes of bloating.  But the funny thing is when you’re a practitioner, it’s really tough to just go, number one, number two, because as you see, you and I are—we’re connecting all of these dots.  So we could end up coming up with more of like 20 different mechanisms leading to the bloating whereas people, when they go to click on an article or something, they want it to just be one, two, three, four, five.  But when you really do functional medicine and you see this stuff clinically, it just does not work like a one, two, three, four, five.  It’s not like car where it’s like—okay, it’s a bad carburetor.  Remove the carburetor.  No, it’s like, okay, you got the adrenal stress from the gut bug you picked up and then that’s affecting the gut barrier and then you’re training Crossfit four days a week.  That’s affecting it.  So it’s really difficult to just go bang, bang, bang.  So we’re hoping to zoom in but also help you wrap your head around the whole picture of this.

Dr. Justin Marchegiani:  Yeah, it’s really tough, right?  Like let’s go look at your situation, Evan, if you don’t mind. So—

Evan Brand:  Sure.

Dr. Justin Marchegiani:  You know, you had some blood sugar issues, right?  You also had three major gut infections—Giardia, Crypto, H. pylori—three amigos.  You also had some potential tick bite stuff, right?  And then we also had some chronic mold exposure.  So it’s like—like if you just went and saw the mold specialist, you’d still be sick.  You know what I mean?

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Because it’s like it’s not just about grabbing the mold.  Now, the mold was important but you know, we also worked on blood sugar and made sure you were getting enough food, made sure you were digesting your food, you started gaining weight, you supported the adrenals, cleared out the infections.  Then we saw there’s all those chronic molds.  Let’s work on the mold stuff.  You also, in between there, you know, address some of the cavitation stress that may or may not had been a big issue.  By the way, do you think the cavitations were a big underlying issue with your health issue?  Do you think it was just kind of a side thing for everything?

Evan Brand:  It’s tough to say because the heart palpitations that I had for years, I mean when I was living down in Austin, I was 20 lbs lighter than I am now. So—

Dr. Justin Marchegiani:  I know.  You were really skinny.

Evan Brand:  Yeah. So I put a lot of weight back on, thank the Lord, and my wife did, too.  Here’s the interesting thing.  We thought that she was skinny due to breastfeeding, you know, because she had been lower weight than she was when she was in high school and we thought that it was just breastfeeding all the time but no, it was probably the mold exposure because when we got her on binders, her weight restored back to normal.  So to answer the question about the cavitations, I mean, you know, I was having heart palpitations almost every single evening.  I’d sit down on the couch and then, oh my God, you know, the heart palp and then as soon as I got—that night of the cavitation procedure when they cleaned everything out, that was the first night I didn’t have heart palpitations for I don’t know, at least a year.  So it stopped that immediately.  My blood pressure—

Dr. Justin Marchegiani:  The question becomes like well because you were already in pretty good shape before that, what if—what if the mold was addressed before that?  Would the heart palpitations even be an issue?  Would the cavitations even been able to cause a heart issue?  Does that make sense?

Evan Brand:  I don’t know.  Well, it’s hard to say.  Yeah—

Dr. Justin Marchegiani:  And the reason why I’m bringing this up is because I have a lot of patients come in and no one has, you know, very little people have unlimited resources, so like, where do we start?  And when you have like big picture, when people say like mold or like cavitations or heavy metals, like they’re thinking a lot of money is gonna be thrown out those resources, so our job is to be like, well, how do we prioritize that?  How do we get the best results, you know, for the least amount of money.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s really the tricky thing because when you go to like myopic practitioners that are the cavitation person or the mold person or the Lyme person, it’s very hard to get a—or the gut person, it’s very hard to get a holistic perspective because you know what they’re gonna be doing.  You’re seeing that person.  That’s what they’re gonna do.  That’s their stick.

Evan Brand:  Yeah, and the truth is that my blood pressure issues, I have having these weird blood pressure spikes, those mostly resolved but the mold exposure—another re-exposure to mold didn’t happen for a couple of years after that and then the blood pressure issues came back.  So, did it temporarily fix some sort of orthostatic hypertension-type stuff and some hypoglycemia stuff?  Maybe but you know, it was—you have to travel, so the expensive travel plus $5,000 for the procedure.  So, you could have bought a lot of binders for $5000 bucks.  That’s a lot of charcoal.

Dr. Justin Marchegiani:   Or, you know, home remediation stuff but you know, just kind of setting the tone for people that are listening.  Being a patient myself, right?  And helping to fix myself and you as well, and working together, it’s really overwhelming.  But I just want listeners to know that if they wanna find someone like you or like me who had been through this and have the mind’s eye and focus on prioritizing and really figuring out what are the first steps and doing things in an order of operation, I think that makes it less overwhelming and that also plays into the whole stress because if you’re doing a treatment plan that’s gonna be so expensive or so segmented like, oh, we’re gonna do this and then that, then it becomes a little bit convoluted and hard to jump on board because you feel like it’s gonna take so much out of you to get going.

Evan Brand:  True.  True.  Yeah, I’m glad you brought that up and I would say that every step along the way that you’ve had in your health journey, every step along the way I have had in my health journey taught us a lesson.  Maybe it wasn’t the secret sauce, right?  But let’s say it got me 10% better.  That 10% better was what I needed to regain the weight that I lost from my parasite infections and then getting the exposure and then using detox solutions, you know, that got me maybe 50% better and then using immune-supportive herbs and antimicrobial herbs, that gave me 10%, 15%.  So, I think what you’re saying in so many words is that many people come in kinda thinking that they have a need for silver bullet if you will and it’s kinda like, “Hey, Dr. J or Evan, I think I have got this parasite and that’s wrecking me.”  And then we do all the labs and we see there’s no parasite.  We see it’s actually a huge candida problem or it’s a huge nutrient deficiency or major gut inflammation or something that.  And so we focus on that and then they’re 80% better.  Then we kinda go back and we’re like, “Hey, remember how you thought it was parasites? Well, look, the 80% progress you’ve made by pursuing this and that instead.  So, back to the bloating conversation, when we’re looking at somebody that comes in and it’s like the major complaint like bloating, what is really interesting is when you unpack all of it.  There’s actually more coming along with it.  So, it could be like, yeah, bloating is the uncomfortable part but then you look at the bowel habits and then you look at the disturbed sleep and the teeth grinding and then you look at the skin rashes.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And then you look at the dark circles under the eyes and then you look at the 20 lbs of weight gain with doing nothing, and then you start looking at thyroid labs and then as mentioned, adrenals.  So, I guess my point here is that, it’s okay and good to have a one primary complaint, but it’s very rare for it to exist like that.

Dr. Justin Marchegiani:  Yeah, exactly. Yup, 100%.  So, we wanna prioritize everything.  So we look at digestive support.  We may look at infections.  We may also wanna look at fungal overgrowth.  Now, a lot of times fungal overgrowth may come with the stool testing but sometimes that can be missed.  So we’re gonna look at clinical symptoms like fungal toenails or tinea versicolor rash or chronic yeast issues or chronic jock itch, or those kinda things, right?  Maybe chronic dandruff.  We’ll look at that.  We may also run organic acid testing that will look at D-arabinitol or oxalic acid.  Things that may give us a window of fungal metabolites in the urine, and then we may also run a breath test, too, to get a little bit more of a window of what’s happening with other dysbiotic bacteria and we may even see imbalances and commensal bacteria which is normal gut bacteria.  So, a lot of times that always come at the end because if you have imbalances with infections that will always or could drive commensal bacteria, normal flora out of balance.  So, we also want to prioritize things on that note and of course, the diet is gonna be a foundation.  So coming off, we may typically lean more on the Paleo side.  We may cook more of the fibers down.  We may lean more on the lower FODMAPS, lower fermentable carbohydrates especially if there’s more bloating or gas because those fermentable sugars even in healthy vegetables like garlic and onions could drive a lot of these problems, and people tend to like lean into the fact that like, “Oh, I have SIBO.  I have this infection.”  But sometimes, like in Evan’s situation.  Evan had three major parasites and so it’s really good to have you kind of your mind’s eye wrapped around it because if you only thought he had H. pylori and then address H. pylori, and the problem still persisted, you’ll be like going insane.  You’ll be thinking like, “What’s going on?”   So, it’s good to really have that holistic perspective and address everything systematically.  It just gives you the better chance that you’re gonna fix things, you know, a lot sooner than later.

Evan Brand:  Yeah, and you and I haven’t talked about this but I’ve kinda come up with this theory that H. pylori is—and some of these infections are really like a secondary infection due to like a primary mold exposure.  So, I remember being a kid playing in my grandmother’s basement that had flooded on many occasions, they—all they did was turn on a couple of box fans and it took several weeks to dry out.  I guarantee I had H. pylori and parasite issues for many, many years.  You know, I had gut issues as long as I could back into my childhood.  I just wonder because you and I have talked about this idea of like commensal bacteria and there’s this argument, right?  That H. pylori could—you could co-exist with H. pylori and that it shouldn’t cause any problems, but why is it getting so out of control, so out of balance?  Now, granting my diet was terrible as a kid and all of that, but what if the immune-suppressive aspects of mold toxin weaken the immunity so that I wasn’t able to fight off candida?  I wasn’t able to fight off H. pylori and that’s what allowed those infections to thrive and take over.

Dr. Justin Marchegiani:  Exactly, and I think a lot of the argument is more at the level, like maybe there can be a tiny bit of H. pylori present but when it hits a certain threshold, right?  Then there’s a greater chance that it can cause a problem, right?  And then of course, the more food allergies you’re consuming that are gonna inflame the gut, now that maybe makes it cause a problem, and then if you have enough decrease in stomach acid and enzymes from the H. pylori, that can cause a problem, too.  I mean, we know Dr. Marshall who got the Nobel prize for discovering H. pylori, I mean, he thought it was crazy.  He had to give himself H. pylori to see that it caused ulcers and infections or it can, right?  So, we know there’s a connection with it.  So, kinda my issue is let’s lower the infections, fix everything else, and a lot of times people get better and get better much faster.  Now, the problem with a lot of people in a lot of medical approaches to an infection is the antibiotics just a drop a bomb down there and they may not get the infection and they may create rebound fungal overgrowth and disrupt the immune response, so a lot of times you can get sicker from antibiotics with some of these chronic gut issues.  So, you really have to be addressing the problem holistically.

Evan Brand:  Yeah, well said.  So, I mean, if you go to a conventional doctor and you do get diagnosed with H. pylori, the first problem is the testing is really bad in the conventional world and so a lot of times, they’ll miss the infection but if they did find the H. pylori, they’ll do triple or quadruple therapy, 3 or 4 antibiotics at the same time, often multiple rounds of that due to the antibiotic resistance.

Dr. Justin Marchegiani:  Correct.

Evan Brand:  And then as you mentioned, now you’ve got even more–let’s say you came in with bloating as we talked about but you went the conventional rabbit hole, and then now you’ve got the yeast problem and then you feel got even more bloating there.  So, you know, I would never do this study but it would be very interesting to see, to test this theory if you take 10 people that have high H. pylori that also have high mold toxin that we know is suppressing the immune system in various ways, what would happen if you just focused on a mold detox protocol?  Would the immune system gain the upper hand on the H. pylori to get it back in balance?  I would never test that, right?  We’re always gonna do both at the same time, use antimicrobials and use detox support at the same time, but it’d be interesting to test this theory of it being an “opportunistic bacteria” that in theory—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You could shut it down if the immune system was strong enough.

Dr. Justin Marchegiani:  Yeah, and then kinda my theory, if I am gonna address any mold toxins initially while doing other foundational stuff, I mean, my general theory is don’t push, don’t dump too many toxins right away.  If I’m gonna do anything I may just gently nudge in some binders or some gentle lymph support but I’d probably spend more of my time and effort fixing the home if there’s an acute exposure on where those infections, where the mold may be coming from.  What’s your take on that and how your peer does that?

Evan Brand:  The home is always part of the investigation.  So if you see that there’s like high levels that show up, and people are like, “Why—why are you going a tangent about this?”  Well, it is a huge gut issue.  If you just look up Dr. Ritchie Shoemaker, he is the guy who has been working on these issues for 25 years, tons of people manifest only as gut symptoms.  So that’s just the disclaimer but if we see that something shows up on the urine, then we’re gonna go the house to try to match up the species and see, okay, because you’re growing Aspergillus in your gut, you know, you can see it on the organic acids now, at least on Great Plains they’ve got on the first page, they have certain markers that are tied in to Aspergillus.  So you can kinda see, hey, you’ve got mold colonization and then we’ll try to look and see if it matches up to the house at all and in some cases, it doesn’t at all.  It’s like the house has Fusarium but the gut has Aspergillus, so yeah, the house could be a problem but it looks like it’s more you internally.  You’re more of a factory or manufacturing plant, so then we’ll just throw in some silver or something else to try to knock that internal colonization down, and then still working on the other stuff.  It’s rarely a number one priority as you mentioned.  It’s like, hey, here’s a little binders.  Here’s some antifungals that also will happen to kill the candida overgrowth that you have and plus these other herbs that we mix it with are antimicrobials, so that’ll knock down some of the bacterial stuff you have.  So it ends up being like a 3 in 1 combo and assuming the constitution of the person is strong enough, but maybe we need extra liver or adrenal support, they usually do fine.

Dr. Justin Marchegiani:  Yeah, I always pause going after mold right away.  I just find that well, if there’s a lot of symptoms or we have a lot of house symptoms, right?  Any visible mold, tell-tale sign, any chronic humidity in the home, tell-tale sign.  If we see things tend a little bit moist on the wall, right?  We can get a moisture meter.  We can detect some of that stuff.  History of leaks, those kinda things, then we’ll definitely just do a simple house test.  Because the thing about a house test is, if you got 5 people in the house, then all 5 benefit from that test, so it’s kinda like a 5 in 1.  So, I definitely like the house testing because it definitely gives you your best bang for your buck, number one and then we’ll typically remediate or address some of those things or if we don’t see any big red flags, we’ll just maybe get a higher quality air filter.  So, we’ll do a lot of the Austin Air stuff which is a great one because of the zeolite and the activated charcoal and so either for Austin Air or  Evan has his site as well—, store button.  If you guys wanna get a high-quality air filter that we personally use with patients and ourselves, that’s a great option.  And then for me, I tend to always pause that stuff because I can see major benefits a lot of times without that but we’ll kinda put it on that treatment plan on that path.  I like to get gut stuff fixed first because a lot of times the body will dump a lot of mold via the hepatobiliary system.  Hence, Shoemaker and a lot of these protocols binding up stuff that comes from the liver and gallbladder, right?  So that’s kinda my approach to it and that dovetails with bloating because if we have digestive issues, you really wanna make sure.  People don’t think their digestion could be affecting detox, right?  They kinda think of those as compartmentalized things but if we have digestive issues, it could easily be impacting detoxification, so whether it’s metals or mold or just general pesticides from conventional food, all those could play a role and your digestive issues could be affecting that.

Evan Brand:  Yeah and here’s the funny thing.  You know, you and I had thousand plus cases under our belts before we even became educated about mold.  So it does pop up into our conversation a lot and a lot of people come to us and ask us these questions and we’ve done some really great interviews about this but the funny thing is we were getting people better before you and I knew anything about it.  So, I do want to focus on or at least point that out.  Now, I think it’s just helping us to add an extra puzzle piece to the puzzle.  Because there are certain cases where resolving the gut issues, like the parasites and the bacterial stuff, you’ll look at the gut report, right?  We’ll have side by side.  Oh, great!  We cleared out the infections but we still have these symptoms—the brain fog, the dizziness, the sleep issues, right?  So now we know, hey, that other puzzle piece could be this because we did clear out the gut infections.  But I would agree with you and argue maybe what 80%, 90% of the time, you could resolve those type of symptoms—the bloating and such, just from the gut issues, the liver, the gallbladder support alone.

Dr. Justin Marchegiani:  I get scared for my patients or any patient that comes in and is going to see just a Lyme practitioner or just a mold practitioner.  I get really scared if they have not done the foundation because with practitioners like that that are so myopically focused, anytime they’re treating the Lyme or treating the mold and they have a negative issue, it’s that it has to be die off and that means we’re on the right track.  So it becomes this kind of vicious cycle where their—by them feeling worse, it supports them continuing to do that thing which them feeling worse may mean it’s the wrong thing or it’s too fast or it’s not in the right order, and a lot of times those protocols can be very expensive especially if you see a Lyme practitioner that does antibiotics and you are on antibiotics for years.  That can be scary or if you are looking at a home remediation and you don’t know how to do it the right way, and you’re looking at tens of thousands of dollars on a home remediation.  That could be scary, tool.  So you really wanna be able to hit things in the most sequential way possible and the biggest knowledge understated that I have dealt with the last year or two with you and me on our mold side is really how to fix some of these mold issues with our homes as cost-effective as possible.

Evan Brand:  Yeah, I wish I have my $10,000 back.  I was just desperate.

Dr. Justin Marchegiani:  –therapy.

Evan Brand:  Yeah, for the enzymes.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You know, I was sick.  I was symptomatic.  I didn’t feel well.  My daughter had stomachaches.  My wife wasn’t sleeping well.  You know, and we were looking up holistic solutions.  We didn’t have time to fully do the research and figure out what we know now and here we go dropping 10 grand, and my situation was no better and even in some cases, it was a little worse and so, I don’t wanna turn this into the mold podcast but just pointing out the fact—

Dr. Justin Marchegiani:  Yeah, it’s connected for sure.

Evan Brand:  That yeah, yeah, it is.  But the fact that you could pursue rabbit holes like that and be no better off, right?  Symptomatically, I was just as sick as before and that 10 grand could have used for several years worth of adrenal support and liver support and gallbladders and binders and all the stuff I really needed but I was desperate to fix the house because to me that was kind of the blame but I also had some internal gut digestive stuff going as well.  So, I guess the point really here is that you wanna make sure you have all the puzzle pieces and try to work with the practitioner who can be zoom in and zoom out, and that’s what we try to be really good at.  We try to be really good at making sure that if we do need to hyperfocus we’ve got the skills and tools to do that.  We’re gonna use this specific protocol, this many times a day for this many weeks to address this infection.  However, we may also need to zoom out and get your house in better shape and get your spouse in better shape in case they are re-infecting you and we’re also gonna help with those pieces, too.

Dr. Justin Marchegiani:  Exactly.  So, just kinda recapping for people listening.  When I work with a patient, when Evan works with a patient, we kinda have like our best practices’ list and we really make sure we hit things.  So, of course, we are removing the bad foods, we’re dialing in the diet, and of course, that could be more nuance that just a really good whole food Paleo template.  There can be other foods like we mentioned FODMAPS on other sides, chewing our foods, cooking foods, those things.  Number two is replace.  Replacing enzymes and acids, maybe bile salts.  That’s important.  Sometimes other things need to be addressed like prokinetics and such.  Third R is repairing the adrenals, repairing the hormones, repairing the gut lining, partly because of the sympathetic stress that may be driven by the hormones and how that can affect digestion and gut lining.  Fourth R, removing the infections and this could be parasitic.  This could be H. pylori.  It could be bacterial overgrowth.  It could be SIFO or small intestinal fungal overgrowth.  There could be even, we could throw mold toxins in with that as well.  And then the fifth R will be repopulate, reinoculate good bacteria.  Sixth R, re-test and sometimes you’d come back with a new infection, that can happen, and that’s frustrating.  So there’s a kinda an order of operations and again, there may be a certain deviation and certain ways we go deeper based on our experience, but that’s just a general framework at how we’ll dive in deep, so we don’t miss anything.

Evan Brand:  Yeah, it took my daughter three rounds.  You know, we’ve done—

Dr. Justin Marchegiani:  Right.

Evan Brand:  Like five stool tests on her and she’s not even 4 years old yet.  You know, she showed up with one bug, knocked it out, re-test it.  New bug, got rid of it then H. pylori showed up and then candida, knocked those down.  I mean, it’s crazy so it can be a little bit of whack-a-mole and that just comes with the territory.  It took me several rounds, too.  You know, we kinda joke about the gut being like an onion having different layers of infections.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  But it does appear that they do kinda come out in layers.  It’s, you know, is it possible that H. pylori with that little tail structure you see in the microscopic images?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Is it possible it’s burrowed deeper in the intestinal wall and it comes out later?  I don’t know.  It’s tough but we just—

Dr. Justin Marchegiani:  It’s hard to say.  It’s hard because with kids, too, you can’t quite hit it as hard either, you know.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  But yeah, that’s why—and again, that situation is pretty rare to go that many times.  I mean, that’s more in the extreme but it happens, you know.  We always wanna be upfront with people.

Evan Brand:  Kids are barefoot.  They’re out playing in the creek, playing in the dirt, you know.  So it’s kinda like—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  How your kids are.

Dr. Justin Marchegiani:  Kids are a little magnet for critters, right?  I mean, we kinda know that.  They—

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Fall down.  They have no problem picking up dirt, putting it in their mouth, the whole nine yards.  So yeah, I get that.  Is there anything else, Evan, you wanna leave the audience with today?

Evan Brand:  I would just say get a good—get a good workup on yourself.  Could you just go to Whole Foods and go buy a bottle of oregano oil off the shelf because you read some blog that said that oregano oil kills fungus and that may be the cause of your bloating?  That might work, but is it the full piece?  Is it the full picture?  Are you gonna take it forever and then you kill the good bacteria and then you’ve got a more imbalanced gut than you did before?  Maybe.  So, my advice would just be get a good workup.  Try to have a practitioner on your side that’s gonna be able to look at all the pieces, not just zoom in on one tiny piece of the puzzle—

Dr. Justin Marchegiani:  Correct.

Evan Brand:  And convince you that’s everything and if you do want to reach out to us, we are those people.  I mean, we do look at the full picture.  So, Justin’s website is  He is available worldwide for consults via phone, Facetime, Skype, Zoom, whatever you gotta do to connect, and my website is evanbrand.  Same thing.  We both work across the world.  So we are very blessed, very grateful to be in the opportunity to help you, so thanks for tuning in.

Dr. Justin Marchegiani:  And then if you’re listening here, 99% of the people we don’t get the chance to even see in person or you know, over the phone or such.  So if you feel like you could benefit or your family could benefit, you know, share this information.  At least it’s gonna get people moving in the right direction, taking a couple of good action steps, and then put your comments below.  We really wanna know what your experience is, what has helped with you, etc.  What were some of the missing lynchpins to help your care and also a thumbs up and a share.  We would really appreciate it.  Alright, Evan.  It was a phenomenal chat, man.  You take care.

Evan Brand:  You take care.  Buh-bye.

Dr. Justin Marchegiani: Bye.

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Audio Podcast:

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:36 Contributing factors to Gut Inflammation

11:30 H. Pylori

14:31 Overgrowth category

26:13 Immune System Health

36:34 Antibiotics


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: All right. Bye.


Audio Podcast:

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:

B12 Deficiency | Podcast #223

In today’s talk, Dr. J and Evan Brand discuss some important points regarding B12, a topic that is so common yet so overlooked by conventional medicine but could change one’s life. 

B12 deficiency was a problem of Evan Brand that stemmed from gut infections. He believes because he had H-Pylori, it reduced his stomach acid even though he was eating grass-fed beef. Having low B12, it resulted in nausea, digestive issues, and fatigue. B12 is huge even for someone like him who thought they were doing it right. Watch the video and answer your own questions too! Don’t forget to share!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

04:48    How Does B12 Deficiency Happen?

08:33    B12 Shots

10:10   Food Sources of B12

11:03    Why do We Need B12?

16:12    More Food Sources of B12

17:14    Neural Tube Defects


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani, welcome back to the podcast. Evan Brand and I are in the house, we will be discussing on all topics: B12. Let’s dive in. Evan, how we doing today man?

Evan Brand: Hey man, I’m doing pretty well. I’m excited to talk with you about something that is so common, yet so overlooked by conventional medicine, but it could change your freakin’ life, and it’s B12 deficiency, which is a problem that I have, and I had previously, and I think it was all stemming from my gut infections. I believe it was because I had H-Pylori, which reduced my stomach acid, therefore even though I was eating grass fed beef I still wasn’t getting the B12 from my meat, and therefore I was low. And I had definitely some nausea, I definitely had some uh, digestive issues, fatigue, uh it showed up on my testing too. So, B12 is huge even for somebody like me who thought they were doing it right.

Dr. Justin Marchegiani: Yeah, B12 is really important. A couple of things off the bat, just to kinda highlight, B12 is really important for methylation. So, methyl groups are- are carbon and essentially free hydrogens and we methylating neurotransmitters, detoxification pathways, uh we activate various uh genes through methylation. So B12 and- I would say B12 tends to work really well with its sibling, uh folate. Folic acid is kind of uh- uh let’s just say uhm, one of the more slang not so good qualities or not so good uhm, types of uhm folic acid or folate. Folic acid has to get converted to folate and a good chunk of the population, 70% or has at least heterozygous, meaning, they’re missing one gene to help uhm basically convert that folic acid to folate be it as enzyme called MTHFR, methylenetetrahydrofolate reductase. So, essentially, B12 is really important and it uses folate, activated folate along with it for methylation and gene activation.

Evan Brand: Yeah, and a lot of people talk about MTHFR, then I’m really sure what’s going on. You’re just had a reduced- you’re had a reduced capacity than other people to- to work this conversion process. So, that can result in fatigue and the- the question maybe, well, does that mean I go straight on a methylfolate supplement? The answer is not always, ’cause some people don’t feel well with those, so there’s- there’s a- a goldilocks that Justin and I figured out with people. Sometimes you can go too high, sometimes you go too low. So, there’s always a tweak with this, so on this podcast we’re gonna say, “Hey, your magic dose of B12 and folate is gonna be X milligrams or X micrograms per day”, ’cause you gotta figure it out. Uh there’s just not a- a- a number.

Dr. Justin Marchegiani: And then there’s a couple different types of B12 that’s out there. You have your conventional cyanocobalamin, right. Cobalamin is the B12 and it’s bound to a- a- basically almost like a- a cyanide type of molecule, right? And then you have the more bile available types, you have the methyl B12 which is it’s methylated, it’s bound to a methyl group. Then you have the hydroxyl group. Hydroxyl group is bound to a hydroxyl, and then have the adenosyl group. Hydroxyl is gonna be uh- I think it’s gonna be a lot more mitochondrial based, and then B12 can help uh on the methyl side, will help more with detoxification and- and will help more with the methyl donor side. So detox on one side, and then on the uh hydroxyl side will help more with the mitochondria and help with uh nitric oxide which is really important for mitochondrial function.

Evan Brand: I’ve had a lot of people actually react pretty poorly to doing supplemental methylcobalamin B12, er- myself included, I don’t feel well on methyl. So I end up doing- using a combination of hydroxocobalamin and/or the adeno-cobalamin-

Dr. Justin Marchegiani: I think [crosstalk] is from a detoxification like we were loading to I think some of that could have a detoxification effect, and then going more with adenosyl or hydroxyl or combination of those two can help with the mitochondria, a little bit more help with energy, help with nitric oxide. Know you have- with some of the stress issues, you had more blood pressure issues, so of course, nitric oxide is vasodilator, it opens things up.

Evan Brand: Yup. So we’ve got some symptoms of- now, we can test this, we’ll talk about testing towards the end, if you have too little vitamin B12 in your system, what may happen? Uh, could be poor vision, weakness, tingling in your hands and feet, clumsiness, fatigue, nausea, mental confusion, anemia, digestive issues, skin infections, nerve problems. And so, uh Linus Pauling Institute, they’ve got their own opinion of major problems that could be linked to B12 deficiency like breast cancer, depression, osteoporosis, thyroid issues, gastric cancers neural tube defects, chronic stomach inflammation. So this is pretty nuts, and they’ve got quite a lot of literature on this too. So, uh, it makes sense.

Dr. Justin Marchegiani: Yeah, it’s a use. So let’s kinda dive in first. How does B12 deficiency happen? So, number 1, it can happen if you’re a vegan or vegetarian and you’re not getting- let’s just say any animal products, uhm even- even plant-based products, a good vegan or vegetarian is gonna have to supplement B12. You just not gonna get enough in plant-based products, you’re gonna get it in egg yolks, you’re gonna get it in meat and animal products. So, being vegan or vegetarian is one risk factor. Risk factor number 2 is you have poor malabsorption, you have gut issues, absorption issue, whether it’s an- irritable bile disease, or crohn’s, also of colitis type of thing, or even just poor digestion, ’cause, remember, the intrinsic factor is produced in the stomach, and it’s produced by the parietal cells, the same cells that make hydrochloric acid. And we- this intrinsic factor basically- basically tags B12, it grabs on to it, and then from the stomach, you go to into the small intestine, the duodenum is the first part, the jejunum, and then the ileum, it is then released and then reabsorbed back up in the ileum. So it’s like you have this carrier, this tag, or this relay race, where intrinsic factor binds to that B12 in the stomach, and then releases it back down to the very end of the small intestine in the ileum. So it’s really important because if we have gut inflammation, and let’s say we have poor parietal cell function, which tends to mean we also may have low stomach acid. That poor digestion is gonna create more leaky gut, more gut inflammation, and continue to decrease intrinsic factors. So, if we have low intrinsic factor or if we have intrinsic factor antibodies, uh or parietal cell antibodies, this is called pernicious anemia, where we have an autoimmune attack, it’s attacking either the cell or the compound that’s produced to help basically run that relay race for the B12. So the more you have leaky gut, the more you have gut inflammation, there’s a greater chance of autoimmunity, which could affect B12 absorption. And for those kinds of people, which tends to go more on the sublingual side, with intrinsic factor we may even do the adenosyl-hydroxy versions, go sublingual, bypass the guts, and we may also uhm even opt for an injection.

Evan Brand: Great point. Yeah, people were gonna ask, “Well, why can’t I just take a supplements, swallow a pill for this”, well, you just alluded to the gut infections or other problems, inflammation, autoimmune gut conditions, that may reduce the absorption. So just because it says on the label, you’re gonna get “X” amount, that- uh- you know, we always say, “Oh, you are what you eat” but not necessarily, you really are what you digest. So if your digestion is compromised, then you’re not gonna get what’s on the bottle, and therefore you might not get the clinical improvement you’re looking for. No I just sent you a link to a- a PubMed study here, they call it “Impact of Helicobacter Pylori on the Development of B12 Deficiency”. And long story short, the findings prove, strong evidence, H-Pylori infection is associated with cobalamin deficiency. So that probably started it all for me, you know, diet wasn’t great as a kid, but me having that H-Pylori infection, that was probably a huge trigger for my B12 to be so low.

Dr. Justin Marchegiani: Exactly. Yup, totally makes sense. So, this is why it’s so important that if you have B12 issues, you have to make sure the diet is right. And the diet is gonna be super important. Uh, vegan, vegetarians are maybe gonna have a problem, uh, the next is, if there’s a leaky gut or any inflammation in the gut, that has to be rectified and addressed. Now in my line, we use like methylated B12, and- and uhm methylated B-Vitamins, ’cause typically you wanna take you a B6 and folate, and B12, uhm but some people they may need to go sublingual. So we may wanna go in adenosyl-hydroxy form which gets absorbed more in the mitochondria, versus the plasma for the methyl B12. So, very important, you gotta get to the root cause. So, what are some great food sources, or anything else you wanna highlight before we go into the food component Evan?

Evan Brand: Well, I wanted to get your opinion on the whole B12 shot thing. I mean, you and I work with so many people, and we hear every single week someone going into a naturopathic clinic, or some other clinic to go get a B12 shot, yet, we run their testing, and they still look low in B12. So, what are your thoughts on B12 shots?

Dr. Justin Marchegiani: I think for some people it may make sense to do it especially with severe malabsorption and severe gut issues, I think for most people, uh, just a sublingual or just a capsulated B12, with uhm other methylated B’s like the MTHF folate and- and pyridoxal phy- phosphate or good quality pure- uh, you know pyridoxine HCL, uh B1 to 3, that’s gonna be enough for most, some may have to go 1 step up and go to a sublingual, and- and adenosyl or hydroxyl form, for most, that’s gonna be enough. If there’s severe issues, maybe an injection in the beginning, like if we have a- and also of col- colitis or crohn’s issue, we have blood in the stool, maybe-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -to that degree that makes more sense in the beginning, but uh, in general, I work with dozens of IBD patients in, we typically are able to get their choline and their digestion stable and the de-inflammation downward or that stops, and then we’re able to get their uhm- their levels up, which is uh sublingual.

Evan Brand: Yup. The uh- that’s uh- I mean, that’s- that’s my whole point too, I- I’ve really don’t wanna go get a shot. The sublingual works so good. Uh, so, I mean, here’s the thing with the- with the B12, you know, even if you do take more than you need, it’s more fo- a people having problem with deficiency, ’cause if you take excess, your excess B12 gets stored in your liver. So even if you do take more than you need, that’s fine, we’re more concern about you having too little, you know, rather than too much.

And then you mentioned the foods. So yeah, let’s get into that. I mean, organ meats are gonna be number 1. So, I’ve seen a lot of companies out there now where people don’t wanna eat organ meat. So these companies will take like a grass fed liver or a grass fed kidney of a- of a cow, and- or a lamb, and then they’ll put that into capsules. So you can take like liver pills, you can take kidney pills if you want, I personally don’t do that, uh, maybe when I get more into hunting, I will eat, you know- you know, eat- eat the deer or eat the other animals’ liver, but- but currently me personally, I do not do uh liver.

Dr. Justin Marchegiani: Yeah, exactly. So, I mean, I think it- it’s a great source to do it. A lot of my women that are cycling and uhm me- menstruate heavily, I’ll ’em do liver during that time frame just to get some extra B12 and store it up in their liver, even just an ounce or two, per day during that time is enough, uhm, there’s a lot of B12 and- or Iron in the liver.

So, couple of things I wanna highlight, so, we need B12, 1, to help develop our nervous system. So, early on, we can have neural tube defects, which is basically our- our s- our nervous system doesn’t close all the way up, and essentially, we can have it on the back side where we have spina bifida or we can have it on the front side, or we may- we may even have a cleft palate, right? Those are all B12 or neural tube defect issues. Uhm, next we may see macrocytic anemias, right? Megaloblastic macrocytic anemia is where our blood cells are really big. So, red blood cells, unlike us, we start off small and get bigger right? Red blood cells actually are bigger and then get more smaller as they mature and get older. And we need healthy levels of B12 and folate and methylate and B-Vitamins to help this conversion happen. If not, we’ll run an RBC or uh- uh- a CBC I should say – complete blood count – within the C’s. So we’ll run like MCH, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume MCH, MCHC, MCV, these are markers to look at how big the red blood cell is. And of we see a really big red blood cell, that can give us a big sign that uhm, where we don’t have enough of those B-Vitamins onboard, especially if we start to see lower RBC, low hematocrit, low hemoglobin that tells us we got some B-Vitamin issues.

Evan Brand: You know what I found this true in- is women, or I mean, men too, uh do too much alcohol, you know, I’ve looked at some of the literature on how alcohol can damage your liver and as well as your red blood cells, so when you look at some of these like not “let’s freak out level”, but when you look at some of these low red blood cell levels, it could be linked to, you know, a woman doing 2, 3 glasses a wine every night. And all we do, we don’t even have to supplement, in that case, we’ll just say, “Hey, pull out the alcohol for a month”, then if we look blood looked at again, now all of a sudden, the red blood cell count looks normal. Uhm, you and I talked about this book before but I loved it, uh, Dr. Dicken Weatherby’s book, “CBC and Blood Chemistry Analysis”, he’s got some really good functional markers in there for like your red blood cells and white blood cells and all that, so that has a good resource for people if they wanna look at their blood work and see, you know, “How do I stack up compared to a functional range”, which is tighter than conventional range, that’s a good book for that.

Dr. Justin Marchegiani: A hundred percent. Yup, a hundred percent. So, a couple of ways to test like I mentioned, right? You can do the MCV, MCH, MCHC which is, you know, it’s gonna be good to your- give you a good medication, we could also run B12, and if you’re vegan, vegetarian, that could be really good, that could be a good marker. You may have, let’s just say enough B12 in your blood but not enough in your cell. So this is where we like to look at methylmalonic acid or trans holo cobalamin. So if we had adequate levels of B12, we convert methylmalonic acid into suc- succinic acid. So there’s this conversion, right? And then if methylmalonic acid goes high, it’s- could- it’s not able to convert it and- to a succinic acid and then we can make that inference that there’s not enough B12 to make that conversion happen. That make sense?

Evan Brand: Yeah it does. So, you’re saying, with blood- blood might not always show the true picture, correct?

Dr. Justin Marchegiani: It not always show it, I mean, we serum B12, you may have- you- you know, you may show an- an okay amount but we may still have issues, we have to run that organic acid that we always talk about, and then on that test, we’ll look at- for amino glutamate, which will give us a folate marker, we’ll look at methylmalonic acid which will give us a B12 marker, and we may also look at ___[14:29] and ___[14:30] which will give us markers in the B6, we like to look at those key methylating nutrients: B6, B12 and folate together.

Evan Brand: And this is on- I think you said it already but just to be clear what this test is. This is a urine test, it’s a first one in urine-

Dr. Justin Marchegiani: Right.

Evan Brand: -sample. We run it on everyone, it’s an organic acids test, and often what I’m doing now is I’m having that organic acid test combined with a chemical profile or even a mold test. Uh, which- which is a mycotox panel. So we can take one urine sample, run it through multiple machinery at the lab and then we get multiple read out which is pretty cool, that way you- or not just guessing on why this is happening.

Dr. Justin Marchegiani: Yes, and I had a podcast with Tim Jackson just on last Friday and he talked about the idea that lithium helps with B12 transport, and Dr. Amy Yasko talks about this too. So, lithium orotate, not lithium carbonate, the drug, lithium orotate can really help with B12 transport. So that can be something if we’re having issue with B12, you may wanna look at adding, you know, 5 or 10 milligrams of lithium orotate with that as well.

Evan Brand: Yeah, I was gonna say it probably be a low dose, right?

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: Just a- just to get that effect going in, and then lithium too, that’s also used for a lot of brain issues, right? Lot of like-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -depression and- and-

Dr. Justin Marchegiani: Yeah you can see that help with dep- depression, mood, anxiety issues, and we’re not talking lithium carbonate which is commonly used for bipolar, right? We’re talking lithium orotate, the- the nutrient.

Evan Brand: Wow, I’ve heard of lithium orotate being really calming for people-

Dr. Justin Marchegiani: Yup.

Evan Brand: -I wonder if that’s because it’s helping to transport the B12 as you’re mentioning. Maybe that’s why it does- it has the effect that it does, it has multiple mechanisms.

Dr. Justin Marchegiani: Hundred percent, yup. And [crosstalk] on it? Studies showing that it’s connected with lithium- with uh B12 transport, so I think it’s- you know, it’s another tool that we’ll put in our “tool belt” so to speak.

Evan Brand: Well, let’s get back to food just for a couple of minutes-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -and then we gotta wrap up. So you- you know, we talked about the liver. So beef is gonna be good especially your pastured animals, your grassfed beef, uh, you could do your elk, your bison, whatever type of meats you like, eggs are gonna be great if you can tolerate ’em, you know, good pastured eggs, happy chickens that roam the grass and ate bugs like they’re supposed to, uh, clams, I personally don’t eat clams but that was on a huge list of “Hey, here’s all this B12 foods”, clams was up there, uh, there was another one, dairy, but I personally don’t do much dairy except for butter. Would you say there’s some B12 in some good grass fed butter, probably yes.

Dr. Justin Marchegiani: I think so. I think you’re gonna get some of it just for the fermentation of lot of the grass i- in the gut-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -right? You know, the cows gonna basically ruminate a lot of that good healthy butyric acid though, and I think you were gonna- you will get some B12 out of that as well.

Evan Brand: Okay, okay. And then, so we talked about blood, talked about urine, talked about supplementation, talked about foods, what are the mechanisms, what is B12 cause if its low, I think we hit on every point unless you wanna bring a- a couple others.

Dr. Justin Marchegiani: Yeah, so, kind of going back, we talked about neural tube defects if you have low B12, that’s kinda more in the pathological side, and of course that starts early on. So, of course, if you’re a woman, you’re looking to get pregnant, you should be on a really good- your multi should automatically have f- folate in there, not folic acid and it should have at least good methylated B12 if you’re not having any problems. And then we should be eating our leafy green vegetables, we should be getting egg yolks, we should be getting grass fed, high quality meat, maybe even a little bit of liver, especially if- is a woman if you’re having your period, you’re gonna be losing blood, so getting that liver will help with extra Iron as well, and then some good B12 which you’ll store up in your liver. So, that’s a really good starting point to prevent a lot of this. And then number 2, uh, on the back end, we can have let’s call it- uhm, subacute combined systems disease, or posture lateral sclerosis could we need healthy levels of B12 to build our myelin, to build our ner- to build our nervous system up. So it’s really important that we have enough B12 uh for those issues. I already talked about uhm, B12 in the gut, and how that can be a sign of pernicious anemia or other IBD or irritable bowel issues, or just a lot of gut inflammation and extreme malabsorption in the gut. So I think these are all really important things. And then uhm, I would say, I mean, of course you’re gonna see thyroid issues, right? If we uhm, had un- inadequate levels of B12 because we don’t have enough mature red blood cells. Mature red blood cells carry nutrition, carry oxygen, and we need that for healthy metabolism. So we could have lower thyroid function as well, we need B12 to be able to methylate, so we do drugs like the- the methotrexate, chemotherapy drugs for let’s say massive gut issues. A lot of these- a tricky irritable bile disease is with typically corticosteroids and chemotherapy on the gut, methotrexate, that inhibits a lot of B12 and folate, and that can create more DNA damage. So we need adequate levels of B12 to really have good healthy DNA, uhm repair. And that’s really important in activation.

Evan Brand: Yeah, well, just to mention too on the drug front, think of all the people on acid blocking medications, whether prescribed by their GI doctor, their regular doctor, or, even just the over-the-counter zantac, prilosec, any of these proton pump inhibitors, those are all gonna be reducing your ability to digest and absorb B12. So even if you eat a paleo diet, but you’re on acid blocking medications, or you have infections like we test for, parasites, bacterial overgrowth, candida, H-Pylori infections, anything that’s disturbing that gut balance, and they’re stealing the nutrients from you, you could have low B12 there. So always make sure you’re working towards that root cause, don’t just take the pill- a B12, get a good quality as we mentioned but make sure you figured out why. Why did this happen in the first place? Always ask why. Make sure you get there with the practitioner. So I know Ju- Justine and I gotta wrap up, so if you wanna say a couple comments-

Dr. Justin Marchegiani: Yeah. And also, if you have let’s say an elderly parent or grandparent, some dementia and Alzheimer’s like symptoms can come from low B12. So, if you know anyone on your family whose older and has these issues, this is where I think it’s really great to de- bring in, “Hey let’s get ’em a good quality injection, let’s get some nutrients”, ’cause sometimes that can be turned around with simple high quality injectable uh methylated or you know, adenosyl-hydroxy B12 can be super helpful. There’s been some studies on Alzheimer’s dementia patients where, you know, I think it was 10%, so on massive improvement in their memory with the B12 injection. And then also say look for the canker sores. Canker sores are a big uh- big sign that you could have B12 issue, also it’s a big sign of a gluten-sensitivity, right? These are aphthous ulcer, so, that’s another big thing I would say to look at. And I think the B12 injections are really big one, you already mentioned the foods, the eggs, the venison, the beef, the liver, some of the sea food, I think we hit all the major things Evan. So I’ll just say if you guys enjoyed this great info, give us a thumbs up, we’re clinically applying this information with patients every day, so it’s not theoretical for us, or in the trenches applying it. So hoping that listeners here can use it to make them- make their health better. If you like it give us a thumbs up, give us the share. Let us know your comments below, we appreciate it, and uhm we appreciate you guys supporting the podcast. You guys have phenomenal day. Evan, great chatting man.

Evan Brand: Yeah. Take care. If people wanna reach out to you,, you could schedule consults around the world. If you wanna reach out to me, we look forward to helping you. Take care in the meantime.

Dr. Justin Marchegiani: Awesome. Evan, you just take care man. Thanks so much. Bye everyone.

Evan Brand: See you, bye.


A study on Impact of Helicobacter Pylori on the Development of B12 Deficiency by PubMed

CBC and Blood Chemistry Analysis by Dr. Dicken Weatherby 


The Harmful Effects of H. Pylori

How Functional Medicine and the Paleo Diet Can Address H. Pylori

A majority of world’s population have H. Pylori bacteria living in their stomach. This damaging bacterium has been revealed to be the main source of fatigue and other common health complaints. H. Pylori invades and damages the stomach’s protective mucus layer, thereby leaving your stomach susceptible to ulcers.

The Harmful Effects of H. Pylori

H. Pylori is commonly transferred by sharing food and drinks with other people, and multiplies very quickly through the saliva. Those with a weak immune system and other health issues are particularly susceptible to contamination.

H. Pylori is the primary cause of poor digestion and stomach ulcers. This bacterium impedes on the stomach’s capability to manufacture mucus, and irritates the inner lining of the stomach. The irritation turns out to be so severe that it leads to the pathogenesis of stomach ulcers. More than 80% of gastric ulcers are due to H. Pylori. This bacterium, if left untreated, can lead to stomach cancer.

H. Pylori Causes Fatigue

H. Pylori can cause fatigue by blocking your ability to absorb vitamin B12 and iron. As we know, the two common causes of anemia are a vitamin B12 or an iron deficiency. This means that if you’re taking B12 and iron for anemia but still aren’t seeing results, you might have an H. Pylori infection.

Role of Functional Medicine

The gut walls possess more than 70% of the cells that build up your immune system, and a whole host of bacteria. When you think about gut bacteria, you might be thinking of the symptoms that are manifested by gut imbalances. It’s true that a gut imbalance can negatively affect your ability to digest important nutrients. However, by making conscious diet choices, you can help overthrow the bad bacteria and promote the proliferation of the good guys!

Role of Paleo Diet

The Paleo diet focuses on eating natural food that is extensively available. If you’re suffering from H. Pylori infection, here are some great foods to incorporate into your diet:

  • Quality meats – Such as grass-fed beef and lamb,  and wild sockeye salmon.
  • Eggs – Pastured eggs, the yolks will be a deep, rich yellow-orange color.
  • Fresh Organic Vegetables and Berries
  • Natural oils –Avocado and Coconut oil are some of the best.

If you’re suffering from any digestive issues or fatigue, addressing the health of your gut with the help of a functional medicine practitioner should be your first course of action.

By treating any gut infections and optimizing your diet, you can reduce your symptoms by addressing the root issues.

Leaky Gut and Autoimmunity – Dr. J. Podcast #161

Dr. Justin Marchegiani and Evan Brand dive into a discussion about the link between gut infections and autoimmunity. Gain knowledge about leaky gut, how it occurs in the body and it’s connection to Hashimoto’s.

Explore the different stressors which affect gut health and contribute to a weakened immune system. Learn about Dr. Justin’s 6-hour template, which includes his expert recommendation regarding healing, nutrient and supplements.

In this episode, we cover:Leaky gut and autoimmunity

00:34   Leaky Gut and Autoimmunity Connection

04:05   GABA and the Blood Brain Barrier

06:48   Hashimoto’s and Gut Health

12:23   6-hour Template

22:40   Thyroid Health: T3, T4




Dr. Justin Marchegiani: Hello, ladies and germs! Dr. J in the house. Evan, how we doing, man? How was your Holidays? How’s your Thanksgiving?

Evan Brand: Holidays were great. Let’s dive in. I know we’ve got a short limited of time. But we’re doing this on the fly because this conversation of gut health and gut infections and autoimmunity is huge and hardly anyone is talking about this. Conventional doctors don’t have a clue about the link between gut infections and autoimmunity, so dude, let’s dive right in.

Dr. Justin Marchegiani: That sounds phenomenal. So we talked about in the show, kinda chatting about leaky gut and autoimmunity, which is really important because leaky gut is kind of like one of the primary mechanisms of autoimmunity kinda starting, which is kind of gastrointestinal permeability cells in the gut called the tight junctions. They start to unzip, kinda like you unzip your coat on a hot day and undigested food particles can get in there in this kind of creates this uhm— cascade of reactions call molecular mimicry, where certain food proteins— the surface proteins on these foods are similar to surface proteins of the thyroid or the brain or the pancreas, the beta—the beta cells of the pancreas, whatever. So you have this kind of immune system getting primed to similar proteins in foods which then prime the immune reaction for the immune system. It starts attacking these tissues in the body. So that’s kinda one of the first defenses is this autoimmunity leaky gut, molecular mimicry and that while they gut’s leaky, you have undigested bacterial compounds also getting in there, too. And then kinda just perpetuate and windup that immune system. And then also make it prime to—for other infections that kind of slip in there because the immune system now has weaken. Other infections can slip in. And typically, we’re gonna have a lower stomach acid environment so you’re gonna have less sterility in the stomach coz that low pH really prevents a lot of bacterial and critters from growing. But now that pH is like, you know, it’s like walking over to the dirty picnic tables and normally you spray it down with maybe some bleach. Or let’s say in a healthy version, maybe a really good antimicrobial essential oil. But now, we don’t have that because of the stress from the gut.

Evan Brand: Yup. Well said. Now, Hashimoto’s for example, is probably most common autoimmune condition that we’re going to see and deal with and that probably you guys listening are aware of. Leaky gut has to take place for Hashimoto’s to happen. That’s one of the dominoes that happens. So you’ve got the leaky gut situation. You possibly got the gluten in the diet. You got the immune stress, which could be internal or external. So bad boss, bad spouse, bad relationships, bad job— those are kind of the big dominoes we see. And when you all those up together, that’s how you get autoimmune disease. It’s really just that simple.

Dr. Justin Marchegiani: Totally. And then we have people on the live chat here. And again, this is a great reason why you should subscribe to our YouTube channel—justinhealth. Uhm because we have these podcast going live as well and we’ve also incorporated other technology in the background to get a higher quality audio versions. So if you want better audio, you can subscribe to Youtube, but also check out our podcast uhm—Evan Brand, notjustpaleo and then beyond wellness radio myself. So just keep that in the back of your head. And then your question was—I just missed it. We talked about—Oh, yeah! Leaky brain. Leaky brain is connected as well coz we have these live questions coming in. And so we are multitasking like it’s no tomorrow. So leaky brain’s important because we have these called astrocytes or the brain blood or the blood brain barrier which is kind of the interplay between systemic blood and then the passing over to the brain. And we have the cells called astrocytes. And again, same thing, when we have gut lining integrity, it tends to affect integrity of the lungs, integrity of the sinuses, integrity of you know, vaginal wall area, urinary tract. So you have people that have gut issues—gut integrity issues. It almost always can cause sinus issues, brain fog, brain issues, UTI issues, bladder issues, right? So you have all of that mucous membrane barrier, it’s gonna be compromised throughout the body not just the gut. But the guts kind of that first major domino that falls and then everything else tends to follow along with it.

Evan Brand: What you think about the GABA test for the blood brain barrier, where you take like a 500 mg GABA and if it works and you get relaxed, that says you have a leaky brain. Do you agree with that?

Dr. Justin Marchegiani: I’m not sure I buy that because I’ve seen people that do—that are really healthy and that do well with GABA.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And they, you know, symptomatically, they’re doing pretty good. They’re eating well. Again, certain supplement companies have kinda put that out where they have a GABA challenge. They say, “Hey, GABA is this really big amino acid compound and it shouldn’t go through that blood brain barrier; therefore if it does, that means your major blood brain barrier is permeable.” I’m not sure I buy that. I think it’s something to keep in mind, something to try. I have a lot of patient that have gut issues and they’re sick and that use GABA or will only give them GABA and they don’t notice much benefit either.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, you know, how do you sparse that? That’s hard.

Evan Brand: I know. Who knows, man. That’s a good question.

Dr. Justin Marchegiani: Everyone tries to be a little bit trendy and nuance in this functional medicine field.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they wanna make a name for themselves.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And I get that from a marketing perspective, but just looking at the clinical application, I’m not sure there’s ton.  But, heck, if you have GABA and you want to try it and you get uh—benefits, that’s great. I notice a little bit of improvement with GABA. Like when I take it, I feel little but relax. I also do that with Ashwagandha as well. I feel it with magnesium. Someone chimed in and asked if magnesium can be taken with Ashwagandha. Yeah, sure. I’ve no problem with that.

Evan Brand: Works great.

Dr. Justin Marchegiani: Hope everyone’s listening had a great Thanksgiving, too.

Evan Brand: Yeah. Tesa wants to know, “Have you reversed your Hashimoto’s, Dr. J, by healing the gut?”

Dr. Justin Marchegiani: Well, so we have to be careful when we say reversed, right? So have we decrease the inflammation? Have we address underlying issues that made people susceptible to having autoimmune attack? And we—can we lessen those and decrease them to the point where we are no longer symptomatic because we have the inflammation down or quench enough? Yes. I’m just very careful because you know, eyes in the skies and people listening in they’re— they’re looking for that the cure the cure-all word, right? We just got to be careful. We don’t cure anything. We support the body’s ability to—we support the underlying stressors that cause the issue to begin with. And we support the underlying systems that weren’t functioning well. And then the body can start to get these symptoms under control because the symptoms are just a manifestation of the symptoms— the systems not working. Symptoms occur because systems aren’t working. Systems breakdown because of underlying stressors. As functional medicine doctors, we come in, we fixed the underlying stressors, we support the systems that aren’t working and then the body starts to heal itself, right? The body’s on autopilot. We just got to get the stressors in the systems work. If the system’s working, then get the stressors out of the way.

Evan Brand: Yup. Well said. So you had some— you had some gut bugs and things going on, do you care to talk about your story for a minute with the – Hashimoto’s?

Dr. Justin Marchegiani: Yeah. I have—I have a low level of Hashimoto’s kinda in the background, I had elevation antibodies TPO and thyroglobulin antibodies and you know, I had some adrenal stress going on. And I just really worked on fixing the gut issues, which I had a handful parasites—Blasto, uhm— yeast, significant yeast overgrowth and H. pylori. Addressing those, fixing nutrient issues to help with the antibodies, fixing the digestion, fixing gut bacteria balance is of course working on stress reduction, sleep, all those important diet and lifestyle things. And again, the antibodies for me are just still slightly elevated, but there they’re in a range where you know, functionally my thyroid is not beaten up to the point where I need any thyroid hormone. My TSH is in a pretty good place and my T3 levels are pretty good. I actually have to go on for test real soon. So, yeah, I mean it’s possible to—to address the stressors and the system dysfunction to the point where you may not— you can call yourself cure. We just won’t call you cure for me, a functional medicine perspective.

Evan Brand: Yeah. Agreed. I need to get my thyroid panel run to. You’ve been pushing me to do it.

Dr. Justin Marchegiani: Yeah. You should.

Evan Brand: I need to do it. I mean you and I both have had these infections. I had H. pylori as well. I had a Crypto, Giardia and yeast and Pseudomonas Aeruginosa.  So, you know, that’s a fun thing about Justin and I. We both had all the things that we deal with in the clinic. So when you guys are looking to work with somebody, it’s— to me it’s a lot more honorable if you’ve had somebody that’s been in the trenches themselves, where we had to fix us to keep going to help other people. I think that’s always pretty cool. Uhm— what else I know we would have limited time, but what else should we mention here about kinda this autoimmunity piece, the gut piece. We mentioned the leaky gut, we mentioned some of the triggers just in a roundabout way. So Candida, bacterial infections, parasites, H. pylori, low stomach acid, gluten in the diet, dairy, possibly eggs, other food sensitivities. These could all contribute to that permeation of the gut barrier; therefore, causing the situation.

Dr. Justin Marchegiani: Hundred Percent. So, let me just kind of answer some of the things that you’re talking about while injecting some of the live questions we get. That’s the reason why the show is so unique compared to other shows coz we are off-the-cuff. This is the real deal here. So some patients are talking about having a lot of mucusy stools, right? And uhm— wanting to know where they should go for help, right? Of course, I recommend coming to see either myself or Evan, but typically one, we want to make sure food allergens aren’t driving this, right? Number two, we want to make sure we have enough digestive support on board to help those foods be broken down enough. So if there’s fat maldigestion issues, of course, adding in more bile salts or more lipolytic enzyme, right? Lipase— things like that. Uh— protease—proteolytic enzymes, right? These are all really important. And then, of course, once we can have the deck kinda dialed in, if foods are still a problem even with that, we may make them more palatable. We may go with more crockpot kinda GAP specific carbohydrate kind of eating template, where the foods are just easy—more processed via cooking, they aren’t raw, they are peeled or mashed. We’re decreasing salicylates and phenols and potential gut irritants so those foods can be consumed better. And then, of course, we’re gonna look deeper at the hormones because hormones have a major effect on inflammation and energy. And a lot of people that have gut issues, their guts are inflamed, we have to support the inflammation of the gut lining. And then, the big one is getting rid of the infections.

Evan Brand: Yup.

Dr. Justin Marchegiani: And that’s where you know, we’re probably go next.

Evan Brand: (laughs) Yes. You’re right. So uh—Cent50 here, who asked the question. Yeah, the loose, mushy stools, I mean that was me. I had Cryptosporidium, I had Giardia, I had H. Pylori, I had bacterial overgrowth. Until my gut issues were addressed, just FYI, I had IBS for 10 or 15 years of my life and conventional doctors had no solutions for my—my stools. And it wasn’t until actually cleared out the infections that my bowels and my stools became normal again. And so, yeah, you got to get yourself tested. Justin and I run several different companies. Uh—stool testing just depending on you know what—what we’re looking at. But, yeah, get a comprehensive stool test. Your conventional doctor may be able to order through your insurance, if you tell them you want diagnostic solutions Lab, it’s unlikely. You probably have a functional medicine guy like us to run it for you. But either way, once you get the diagnostic tool, you can fix this pretty quick.

Dr. Justin Marchegiani: There’s a lot of healing nutrients. So like, when we work with the patient, we kinda follow that 6-hour template— template that I’ve created over the last decade or so. There’s a lot of ones that are out there— three hours, four hours. In my opinion, a lot of them stink and they’re the wrong order. So the six that I’ve created and began to follow as well, in my opinion, is the exact clinical order which I follow things. So the first hour is removing the bad foods. And again, it’s not cookie-cutter because that maybe just getting someone from a standard American diet to a Paleo template. That may be taking someone from a Paleo template to an autoimmune template. Maybe someone on an autoimmune template and the Paleo template taking them to a GAPs or specific carbohydrate diet or low FODMAP template. I had patient last week who’s been Paleo for three or four years—chronic pain, chronic issues, chronic mood issues, chronic sleep issues. We took him from a Paleo template to an autoimmune-Paleo template and all of the symptoms went away in one week.

Evan Brand: That’s it.

Dr. Justin Marchegiani: This is someone that’s like already been on point for a long time and we just pulled out a few foods. So we have those— that kind of progression because you’d be surprised, the smallest things that we do have a huge effect. And it’s like, whoa! you would’ve thought I would have created the awesomeness protocol ever and found a you know, this hidden infection that everyone missed and got rid of it for that kind of improvement to happen. But sometimes it happens, we’re just removing some food. So, first, I remove the foods, second, I replace enzymes, acids, digestive support, bile salts, too. Third hour is gonna be repairing the gut lining. It could be also repairing the thyroid and adrenals and sex hormones, too. Fourth hour is removing infections. That’s where we go after— bacteria, parasites, uhm—fungal overgrowth. Those kinda things. We may even go after co-infections future podcast on that soon enough. Fifth hour, repopulating or reinoculating probotics. Some of these nice and beneficial bacteria. They’re transient. They only hang out for a month or so and pass on. So, getting some of that it in there periodically is helpful. Sixth hour is retest. We want to make sure infections are gone. And maybe even address family members too to make sure they are not being passed back and forth you know, playing hot potato.

Evan Brand: Yup. Well said. Riley asked a question about—he said, “Evan is your IBS completely healed now after addressing anything?” Uhmm—kind of a confusing question about addressing anything. Yeah, I don’t have IBS anymore. I’m infection free, no more H. pylori, no more parasites, no more bacterial overgrowth, no more yeast overgrowth and I feel good and feel completely normal, which was an amazing thing because after so long, you know, it took me to be so long to get here.

Dr. Justin Marchegiani: Totally. And with your situation, right? Like if you start eating bad foods again and your immune system got compromised, you may have another critter or two that pops back. You may have some inflammation from the food and such. And then those symptoms, they start coming back, right? So it’s not like a cure, like, “Hey, you have scurvy. Here’s vitamin C.” And then as long as the vitamin C is there, you’re good forever, right? It’s like, “Hey, there may be other stressors that may cause the systems to weaken again and those IBS symptoms start to occur, right?”

Evan Brand: Oh, Totally! Yeah. I mean I could go— I could go out to a restaurant and get some type of contaminated food and all the sudden creates a leaky gut situation. Maybe I pick up a gut bug, maybe I was eating while stressed during a week and I didn’t chew my food good. And then I picked up a parasite and have to start all over again. So, yeah, definitely, you know, you could always backtrack. You’re—you’re never permanently in a good place.

Dr. Justin Marchegiani: Totally. And again, one thing I see out there on Facebook, and I see it marketed, and it’s–  I have to call—I’m not  gonna call anyone out directly—

Evan Brand: No, come on. Do it.

Dr. Justin Marchegiani: I’ll call out the concept. But lots of people, they’re like, “You gotta heal leaky gut. Here’s a gut healing program.”

Evan Brand: Yeah.

Dr. Justin Marchegiani: And if you look at it, a lot of times, you know, it’s bone broth or just a lot of healing nutrients and a lot of probiotics, right? And maybe a little diet change. But if we go look at the six hours, what are they really doing? They’re doing the third hour, maybe a little bit of the first, maybe a little bit of the second, maybe a little bit of the fifth, right? They’re kinda skipping around. They don’t have a system and how it’s being integrated a lot of times. And I would say 99% of the time, it ignores going after and getting the infections fixed. Totally ignores it. Because you know, these people are recommending a general program to like thousand people at once in a huge kind of a webinar kind of style, right? Well, how do you get all the types of testing and customize everything in that format? You can’t. So it’s a very general kinda overview approach. And in my opinion, it’s going help some people, which I think is great. It’s admirable. But it’s also gonna  a miss a lot of people and those people that don’t get help may lose faith in functional medicine or say, “This is not for me.” So I’m just kinda calling that out because think about it, right? If the root cause of what’s going on is an infection component and you’re doing let’s say the first, second, third, fifth alright but you’re not getting rid of the infection. Well that’s like me giving you this healing aloe, right? You get a sunburn, you come back from the beach, I give you this aloe, right? The underlying cause of the sunburn is the— is the sun. And then you go back out the next day and you get sunburned again and I just give you more aloe. That’s the equivalent of what a lot of these people are doing. Well, just have some more bone broth, have some more of glutamine, have some more of this healing compound for your gut lining. So we got to get to the root cause. A lot of people are just being very general out there. And you know, the listeners of our show will get it and say, “Hey, I see that the missing piece there.” And that’s why we have those six hours that way coz then you can look at it and you can say, “Hey, this is a really specific way we go about addressing things here.”

Evan Brand: Yeah. Well said, man. And that’s the food is medicine, people. And we love the food as medicine people, but that’s why you know, we pursued functional medicine because the food is just the first step, right? It’s just one pillar of the house. It’s not gonna hold the house by itself as a single column. And also, I want to mention the order—the order of operations. If somebody just go straight to bone broth and probiotics and L-glutamine, that’s the wrong order. And sometimes people get worse. They’ll come to us and say, “Oh, Justin and Evan—“

Dr. Justin Marchegiani: Yup.

Evan Brand: “I took XYZ probiotics coz I heard it on a podcast or a blog and I felt terrible and I had a flare up of my condition. Can you explain what happened?” Yes, if things are just terrible in the gut,. sometimes you have to hit the reset button. You can’t immediately just add in all these probiotics and expect it to work. Sometimes we have to fix the balance first and eradicate the bad guys before the good guys can come back in.  So that’s why the order of operation is just a second when Justin said it’s so important. And this may explain why you’re spinning your wheels even though you’re all—you’re doing everything about the Paleo gurus are saying to do.

Dr. Justin Marchegiani: Yeah. We just want to make sure everyone’s educated. I mean, we have some people out here, they’re chiming about, “Hey, I really want a functional medicine doctor but I don’t have the—the money for it.” Well, guess what? The best thing that you can do right now is be listening to our podcast coz all this information is free.

Evan Brand: Yup.

Dr. Justin Marchegiani: We’re providing tens and thousands of dollars for free information off of people and I get messages all the time. “Hey, made a couple of these changes or recommendations and my autoimmune condition for 10 years is gone.” Right? I didn’t cure him.  I promise. I didn’t cure him, right? The body just heals itself, right? We got to say that as our disclaimer. But that’s you know, what’s that worth. When someone is you know, seeing a rheumatologist for 20 years on lots of expensive medication that’s tearing up their gut and their body and creating more symptoms than they’re actually helping. What’s that worth? So just utilize the pickup as much of the free intel as much as possible. And then you know, allocate some savings or HSA or flex spending. So if you want to dig in deeper, that’s an option. But utilize as much of the free stuff as possible because the diet is the foundation.

Evan Brand: Yup.

Dr. Justin Marchegiani: 50% is gonna be the diet so work on that first. Once you max that out, and you’re seeing some decent results, then you’d want to go in deeper. You can reach out, for sure.

Evan Brand: Yeah. And you can contact likely so. You can contact your conventional doc and try to get some stuff run through insurance. But it’s likely that they don’t have accounts with these functional labs and they likely just aren’t going to do it. Fut if you’re really lucky, you’ve got a really good M.D., you may be able to push push push push at least get the lab so you have the data. Now what you do with the data? Well then maybe that’s where you come to a functional medicine guy that can help in terms of creating a protocol. But getting the data should not be impossible.

Dr. Justin Marchegiani: Totally. And a lot of functional medicine docs that do a podcast or websites, I find that they take information, they wrap it up and they try to make people feel so confused where they walk away from the podcast or the video, being like, “What the hell just happened? What I do now ?” And they walk away feeling less certain. I want to make sure no one walks away from any podcast or video I do, gaining more certainty. And at least walking away with one action item that they can add into the repertoire of whether it’s a lifestyle or a supplement or just a different perspective on the6 hoir healing so they get better and they feel more confident.

Evan Brand: Yeah. I watch a couple of functional medicine videos like over the weekend and they were like hour-long videos I made it through 10 minutes. And I thought, “This is not gonna help me at all.” So I decided to turn it off. So let’s do it, let’s do our action steps and summary here.

Dr. Justin Marchegiani: So of course, we have our six hours, right? So everyone listening kind of our general feedback is gonna be a Paleo autoimmune template to start. And again, depending on where you’re at, that maybe really a lot of— really overwhelming for you, cutting out grains, legumes, dairy and primarily having healthy fats, proteins, uhm more veggies and fruit instead of starch. And having healthy fats like you know, if we’re doing a Paleo, maybe a little butter or ghee. If we’re going fully AIP, no nuts, no seeds, no dairy. Just coconut, Olive oil, may be avocado oil, some healthy animal fats. And that will be a good starting point for people. And then again, an AIP or an SCD or autoimmune diet, again, I’m just kinda laying out the Paleo template to start coz that’s probably the easiest buy in without pre qualifying anyone. I would say that after that, at least getting some digestive support going there. And again, you know, the ones that we formulated, we recommend the most coz we’ve put our stamp of approval. High-quality HCl or enzymes. In my line, it’s HCl supreme or enzyme synergy or I’ll add in the liver supreme for extra bile support for digest energy. And Evans line—Evan has a similar products as well. Uhm— so that’s a good starting point there. And then seeing where you’re at, I think is the next step coz there may be infections, there may be other testing that has to go in deeper. So I think if you can get that, that’s number one. And then I think if you can just make sure the hydration component and the sleep component is dialed in next, that’s a good second step. And that gives most people of really good you know, path to go down and if people are listening, they’ve already done that and they’re like, “what’s next?” well, that’s where I think you’d want to reach out and do a little bit more testing because that’s what I think the infection component and/or the hormone component and/or the nutriend malabsorption component from the infection could be the next vector we’d really have to put up in our sites, so to speak.

Evan Brand: I’m gonna address one comment here and then I’ll bring up a question then we could uh—we could wrap it up. Leslie mentioned the diet’s the foundation which kinda sucks no more pigging out in the middle of the night. The good thing is that could be related to infections. I mean for me, for example, when I had parasites, I would get these food cravings that just didn’t make sense and it wasn’t me. It’s these bugs. They are stealing your nutrients, they want food so they’re cannibalizing your muscle tissue and when you’re eating, they’re messing up your ability to digest especially coz I had H. pylori. My stomach acid levels were lower. I was basically hungry all the time and I was losing weight. Getting to like a scary point of weight loss. So really, the diet is not too hard once you just address your gut bugs, that— the whole like binging type thing on food, it really doesn’t happen once your gut is healed, once your adrenals and your thyroid are helped out and your blood sugar’s more stable. It’s not an issue. I mean you could fasted for a long time and feel stable. You shouldn’t have to get hungry or go on a crisis stage. Justin, a question for you. Uh—some doctors say T3 doesn’t matter; they don’t test it on Thyroid labs. The person’s taking T3 now slowly increasing. Would you be lowering T4 when adding this?

Dr. Justin Marchegiani: Well, I would typically be adding more than likely a T4, T3 put together so there’s gonna be a combination of both. Most doctors don’t care about uhm—T3 because the major pharmaceutical companies, Abbott’s the big one, that has a patent on Synthroid is a synthetic T4. It’s easier to monitor uhm— giving a T4 the half-life’s five days, so it’s really easy. It’s not like a T3, which could potentially have more side effects. Uhm—and it’s patentable, right? It’s the basically tetraiodothyronine with the sodium salt on it. So that’s how they get the patent to it. Uhm—again, they don’t m__ it because that’s just not what they do. They give you the T4, they get the TSH back in range. All your thyroid symptoms could still be present. Cold hands, cold feet, anxiety, mood issues, hair thinning, you know, gut here fitting things you know, gut stuff, constipation all could still be there, but if the TSH is in range, they’re happy. They checked off the list, you’re gone. So that’s where you got a dig in deeper. You got a look at the T4, T3 conversion. You got to look at the autoimmunity. You got a look at the nutrients. You gotta look at the adrenal conversion, the gut conversion connection and the liver detox conversion connection, too.

Evan Brand: Yup. Yup. Should you ignore TSH? No. It’s definitely worth factoring TSH in. You just don’t want to use that as the end-all be-all only marker. But you— but when you have the free T3 and the reverse T3, the TPO, the TG antibodies kinda all the stuff we run, the TSH makes a lot more sense when you got a full picture.

Dr. Justin Marchegiani: Yeah. We like to keep TSH in the equation and look at sometimes people come in with the TSH that’s perfect, but their T4 T3 conversion sucks. And then what do you do? You know when you’re treating the TSH or are you treating the actual patient? So we’ll try to increase thyroid hormones, see if symptoms change and we’ll try to support HPT access communication with specific herbs. And of course, stress modulation and getting infections— getting rid of infections coz that can really mess up the HPT access, the Hypothalamus Pituitary Thyroid connection.

Evan Brand: Yup. For sure. Uh—Leslie and a couple other comments about you know, where to go next? Well, I mean, you know, if people may say, “Oh, we’re biased.” But the answer is get tested. Our philosophy is “Test, don’t guess.” So if you’re confused, you’ve got symptoms that don’t make sense, get tested. That’s the first step. You can look at adrenals, thyroid, gut, get all the puzzle pieces laid on the table. That way you’re not just buying random supplements that you might not actually need. We’ve seen so many people with 20 and 30 supplements that they’re taking and they still feel terrible. And we cut that down to five supplements because it’s based on labs and all of a sudden people get better. So you know, save up your money for that. Maybe you don’t go buy the next newest supplement you hear about. Maybe you— you focus on investing into some testing first.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And you can check it out on Justin’s site. It’s You can look at the supplements, the labs on there. Same thing on my site, and we’re happy to help. So, feel free to reach out.

Dr. Justin Marchegiani: Totally. And also, couple of people asked about Dr. Gundry’s The Low Lectin Protocol. I think it’s the plant paradox. Again, my thing is if you’re just going to a Paleo template, you’re gonna cut a lot of those lectins out. If you actually cook some of the plants, some of the starches,  some of the vegetables and lower the lectins even more, if you still have a lot of gut issues, upgrading it to an autoimmune protocol, you decrease lectins more. If we still have issues and we can move to a specific carbohydrate or GAPS protocol and we decrease lectins even more. So it just depends on where you’re at cooking knocks a great chunk of that out and just going to a Paleo template, where we’re cutting out grains, legumes, dairy and focusing more on non-starchy veg, uhm— lower glycemic, low sugar fruits and safe starches that aren’t grain-based, you’re gonna have a huge effect and grains, where most of the lectins and irritants come from. So again, that— my opinion matches people making things a little bit more complicated than they have to be.

Evan Brand: Marketing.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: I mean, he’s done a good job that book is spread.

Dr. Justin Marchegiani: Yeah. It has gone viral. Everyone asked me about it all the time. I can’t get a go of a— one day without a patient asking me about it. So I have to follow it. I think I found it on fast reads on Amazon. So I got a—like uhm—abridged version of it that I’m siphoning through.

Evan Brand: Nice.

Dr. Justin Marchegiani: I’ve got a couple of services where they do these summaries. And it’a great.  I mean I get 90% of the information.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Suck it up in a half hour and I’m like, “Oop, got it!” That’s it. On to the next one. Well, any other questions you wanted to answer here, Evan?

Evan Brand: I think that’s everything. I think that’s all we can—we can chat on today and we’re gonna do a podcast soon on co-infections. We’re gonna talk about Lyme, Bartonella and Babesia Uh—Justin and I, I mean, we’ve literally got the books like right here that we’re—we’re diving into.  We wanna make sure we’re the most educated and current up-to-date with our information before we broadcast to you guys. So make sure you hit subscribe on Justin’s YouTube channel while you’re at, hit subscribe. And uh—we’ll be back again soon.

Dr. Justin Marchegiani: Totally. And one last thing. Patient asked here—person asked here on the chat list, uhm—“How do you—how do you choose your functional medicine doctor? How do you trust them?” He said, “I can’t trust them. How do I choose them?” Well, number one, I think they should have some kind of content out there whether its video, audio and/or blog post where you resonate with their information. Like their philosophy, their information, you should resonate. I find most patients are the biggest reason why they don’t get better is because, number one, compliance, and number two, they’ve been burnt and the past or they failed in the past and therefore they’re kind of priming their subconscious to fail again. So they don’t follow through and they’re off to the next one other, you know, they’re making a 180 move in can’t see someone else because some little thing happened. They’re not following through enough. So I think keeping—one, making sure you choose someone based on their philosophy and the information and making sure you resonate at an emotional level and just a logical level. Here’s the plan, generally speaking, right? And then number two, making sure you’ve given enough time and then follow through uh—for it to work.

Evan Brand: Yup. Well said. I’ll address— address this last question, then we’ll roll here. Uh—Is it common to have to go through a few rounds of infection killing protocols? Yes.

Dr. Justin Marchegiani: It can.

Evan Brand: You can. It took me a couple of rounds to go through, some herbs to knockout things coz I have multiple infections. When you’re trying to kill five or six or seven things at once, yeah. I can’t take multiple rounds. Why is that? Depends on the person’s immune system health or stress levels, how long they’ve had infections, the amount of damage that’s there, how much inflammation is there, are they sleeping well, do they have a good diet. You know, there’s million factors to answer why that— why that could be. Hope that helps.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Andrea is asking a question about his father’s prostate cancer. PSA levels are rising rapidly. Can we cast opinions or advice?

Evan Brand: I can’t. Justin?

Dr. Justin Marchegiani: That’s about thyroid, it’s about uhm— prostate issues?

Evan Brand: Yeah. Prostate. Prostate cancer this drug—Enzalutamide had been recommended for father’s prostate cancer PSA levels are rising rapidly. Can you cast opinions or advice?

Dr. Justin Marchegiani: Well, let me describe– I have one formula here that’s been helpful. Yeah. I have one compound here that I’ve been using here, just I had a couple of supplement companies reach out and I’m using it. It’s the pomegranate extract, and the flower pollen extract and its cranberry extract. So cranberry, pomegranate and flower pollen. This is an excellent support. Lot of research behind those extracts as well. Lycopene is phenomenal, getting adequate levels of selenium 200 mics a day is phenomenal, enough zinc as well is phenomenal saw palmetto’s great. These are excellent compounds that help. Lycopene is phenomenal as well. Again, the diet has to be in place. You want to get the lifestyle things going and again, these things don’t grow overnight. They probably taken decades to kind of move. So coffee and Coffee enemas may also be helpful to kind of early push detox in a faster more acute kind of way. But some  couple of compounds that I mentioned are phenomenal and wouldn’t hurt getting them on board in the meantime.

Evan Brand: Yeah. And look at my podcast I did with the lady named Dr. Nasha Winters.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: She did a book that’s called, “The Metabolic Approach to Cancer” She— she had cancer herself and she’s been holistically supporting people with cancer for about 20 years. So uh— look up Nasha Winters and uh look up her book and you could implement some strategies there hopefully.

Dr. Justin Marchegiani: Also, get the insulin levels under control. Make sure fasting insulin is five or below at least. That’s important because insulin is gonna cause a lot of cells to grow and then also making sure xenoestrogen exposure is mitigated, right? Don’t drink out of plastic bottles, avoid pesticides and GMO’s and glyphosate and Roundup. These are chemicals that you’re gonna get from conventional foods. Obviously, eat organic, right? Pasteur-fed meats. Again, these things— I shouldn’t have to repeat them, but I just can’t assume that everyone knows these stuff.

Evan Brand: They don’t. Not everyone does. So, yeah, keep repeating it and keep preaching. And I think that’s all the questions. So we did— we did really good. That was fun.

Dr. Justin Marchegiani: I heard a quote back. It’s a quote from the 1940s, where Joe DiMaggio was interviewed and they said that Joe said, “We noticed that you sprint on and off the field every single time at full speed no matter what.” And he said, “Well, there may be someone coming out to see me for the first time ever that seeing me play the way I’m playing and I wanna play at 100% every time.” And then maybe some people that are coming out for the first time seeing us play here, and we want to make sure that they get that information that we may assume that other people uh— may have, right? The equivalent will be like us jogging on the field, so to speak, if we just assume that.

Evan Brand: Yup.  Well said. Well, reach out if you need help. You can schedule with Justin. if you’d like to schedule consults with us. We should have some availability in the next 3 to 6 weeks or so. So just take a look and  we’re happy to help you soon as we can.

Dr. Justin Marchegiani: Oh, by the way, I’m adding in the Mimosa Pudica as well. So I’ll be reporting back on that in the next couple weeks. I think you as well Evan. So we’ll chat about that.  Again, I just got that in stock. That’s the Para-1 in my store. I think you have it in your store as well. So, we’ll put that in the show links, too. So that’s a cool new herb that we’re working on. We have a couple other herbal compounds in the mix that we’re using for different types of co-infections that we’re researching uhm—in the background, too.

Evan Brand: Awesome.

Dr. Justin Marchegiani: Hey, Evan, great chatting with you, man. You have an awesome day. We’ll chat soon.

Evan Brand: You too. Take care

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.



Immune System, Tapping Technique and GI infections – Podcast Live with Dr. J and Evan | Podcast #131

Dr. Justin Marchegiani and Evan Brand engage in a lively and informative discussion about their recent clinical successes with their patients using the functional medicine approach. Listen to them as they dig into the root cause of their patients’ issues and turn chronic and seemingly complicated problems into success stories.

Know about the tapping technique which involves turning something negative into a better, positive thought. Learn more about GI infections, the bacteria or parasite that may be involved, as well as the tests and treatment options that are proven successful in the functional medicine world. 

 In this episode, we cover:

 03:50   Immune System, bacteria, and infection relationship

 15:50   Tapping Technique

 19:17   Treating Hypochloridia

 24:10   GI infections

 28:34   Enzyme Tests






Dr. Justin Marchegiani: We are live on YouTube here. Podcast live on demand. Also, live here on Facebook. Evan, how are you doing, man?

And again, Facebook people you gotta click on the link here uhm—I’ll put in the comments to see Evan’s pretty face and go back and forth on this. How we doing, man?

Evan Brand: What’s going on? I’m feeling really good today. We’ve got a blue skies, the trees are blooming which they probably—

Dr. Justin Marchegiani: Awesome.

Evan Brand: a year ago in Austin. So I’m enjoying myself.

Dr. Justin Marchegiani: Very good. So we got podcast on demand. So anyone wants to write in some suggestions as we chit chat here, we’ll figure out what exactly we want to talk about moving forward.

Evan Brand: Yeah. And I might as well post a link over here to my Twitter page and see if uh—people are paying attention over there. That way, if they’ve got questions, they can get them answered here.

Dr. Justin Marchegiani: Love it. Totally makes sense. Same thing, anyone on Facebook, too, every  chimes in first we can get this thing moving. But let’s uh—just talk about some clinical successes in the last week with patients. Any updates from you, man?

Evan Brand: Yes. So interesting update is uh—there’s a female client that comes to mind and she had seven, I believe, I have to go back at here stool test and count. But I believe it was seven infections and this is a combination of two parasites which—let me just pull it up, that way, I’m not just shooting into the dark here, but—Uhm— with these infections, we started a gut protocol and symptom improvement was seen. She was having a lot of irritable bowel symptoms uhm— running to the bathroom. So she showed up with H. pylori, Blastocystis Hominis, Entamoeba and Fragilis and Proteas  and Citrobacter. Somehow, cal protectin level was still low  which is intestinal inflammation where—

Dr. Justin Marchegiani: Yeah.

Evan Brand: –I look at but I was surprised. And so anyhow, we put her on this protocol. And this is like 8 weeks.  And the H. pylori while it’s still positive, instead of two viral factors, now she’s got one viral factor. The level of H.Pylori has dropped. The Citrobacter is completely gone. The Proteus completely gone. The Blasto is completely gone. But we still got Entamoeba. So there’s still the parasite and there is still the H. pylori there. So we’ve got work to do but yet, we’ve seen 3 or 4 things disappearing. So I think what the takeaway message is from me is that the bodies gonna heal in an interesting way. It may not heal everything at the same time. Some things may be easier to kill. Some things may disappear first, but you gotta heal yourself especially your gut, your microbiome. You gotta heal these things in layers. And that’s what we’re seeing here.

Dr. Justin Marchegiani: Yeah. So typically with a lot of patients that have chronic issues is there are some underlying stress, right? Emotional, physical, chemical stress but even deeper above and beyond that, there is some level – there’s some level of  infection that’s deeper that creating inflammation even though it didn’t show via calprotectin or it’s just creating leaky gut. And the whole leaky gut mechanism is getting the immune system fired up. The more the immune system is fired up, it’s just an energy suck for  your body. It’s like uhm—let’s say guests in you guest bathroom that you never go into your house. And they just leave the water on. Just a little bit—little drip, drip, drip. And then you get your water bill at the end of the month, and you’re like, “Where the heck did that bill come from?” And you’re like, “Oh, yeah. The faucet’s on.” But it’s like that with your energy resources. When got these bugs, it really—when the immune system is overactive. And even just a leaky gut, right? The more your immune system is overactive, the more it’s gonna suck your energy dry. That’s why when you get sick, the first symptom you get when you get sick is what? You get a lot of fatigue and malaise coz the immune system is sucking resources. Go ahead—

Evan Brand: I wanna hear uh—a recent case from you, but first I wanna ask you the question that I get asked all the time. And the answer really doesn’t matter because we need to fix the root cause no matter what. But people often ask well– chicken or egg? Was it that ma—my immune system got taxed first? And then I picked up these bacterial pathogens or these parasites? Or did I pick up the parasite and the bacterial pathogens and then that that set my immune system? What’s your take? Can it go either way?

Dr. Justin Marchegiani: Yeah. So typically it’s one of two scenarios, right? Typically someone gets exposed to a very high amount of infectious debris, right? Parasitic—parasites. So you drink some really bad water, you to go Mexico, you have really bad meal or at a foreign country, you get the Bali belly, so to speak. And then you’re overwhelmed with all of that infectious debris and then there’s so much of it that it compromises your immune system, you get diarrhea, you have a lot of gut inflammation that creates malabsorption. That malabsorption puts stress on all of your glandular systems and then you spiral downhill. That’s scenario number one. So just the infectious—the infection was so overwhelming, it just threw everything else downhill. Scenario number two is there some type of immune compromisation  that’s happening. Meaning adrenal stress, poor diet, poor sleep, or poor diet and lifestyle habits, low nutrient density. The immune system’s kinda a little bit weaker underneath the surface then you get exposed to some of these infectious debris at smaller micro levels that are in the food. And eventually makes its way to the system and creates inflammation.

Evan Brand: So yeah—so let me—let me clarify there. If we’ve—If we’ve got diet, lifestyle mostly dialed in, but let’s say people are cheating with gluten, for example. They still got intestinal permeability going on. You can still have good class, good sleep, blah, blah, blah. But if you’ve got just a simple thing like leaky gut, for example, you could potentially be more susceptible to pick up these infections regardless of whatever else is dialed in.

Dr. Justin Marchegiani: Yeah. I mean—here’s the deal with leaky gut, too. If you’re creating leaky gut, and then there’s some research, you know, on the non-celiac, gluten sensitivity side of the fence, that looks at these foods. Even if you’re not like reacting to a it, like symptomatically, and even if you’re not like having like IBS -like symptoms,  bloating, you know, gas constipation, diarrhea, that gluten can still create leaky gut. Where the undigested food particles in the gut can make their way into the bloodstream and create stress. And then the LPS that comes in there along with that, that’s the— the bacterial debris can get into bloodstream and create a lot of mood issues as well. So you can still have leaky gut and not risk from gluten— and still not respond to gluten in general.

Evan Brand: Yup. Yup. I just posted a post on uh—Facebook which I think might be a slightly controversial which was I wrote this little bit of a letter and I put kind of like these five things that have happened over the last year or so where people have said, “Evan, I’ve ditched psychiatrist or I’ve ditched my psychologist or my marriage counselor, or my conventional doctor because of functional medicine.” I kinda wrote the reasons why of how if you lower inflammation, you may need less adjustments at the chiropractor, for example. If you heal the gut, you start producing your neurotransmitters optimally, you might not you’re your antidepressants anymore, so you might not need your psychiatrist. Or if you heal your adrenals, you’re not gonna snap at your children anymore, so therefore you’re not gonna need the marriage counselor that is telling you need to stop yelling at your kids. And how basically how functional medicine can literally, not intentionally, but it’s just a side effect is that we can replace these other industries. I’m not saying these other industries are bad for mental health care or anything like that. But a lot of times, this is not root cause medicine. And my wife and I went out you with a friend of ours yesterday and she said she had a lot of stress, she had to put her dog down and she called up her psychiatrist and said, “Hey I need help, I’m freaking out.” What does he do? He prescribed her 60 Xanax and says, “Here’s your Xanax bars and take these.” And I told her, I said, “Listen, your anxiety and your stress from this issue is not a Xanax deficiency.

Dr. Justin Marchegiani: Totally.

Evan Brand: How about we do some emotional freedom technique. We start tapping. How about we cleanup the diet? And then before we left, out the parking lot, I had her do the quick coherence technique, the Heartmath, like the heart focus breathing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And focusing on someone that she loved and we got done with it, and she said, “That was weird.”  I said, “What happened?” And she said, “I got tingly and warm.” I said, “Oh, it worked.” And she said, “What happened?” I said, “Well, you just took yourself out of fight or flight that you’re probably stocked in which is causing you to be dependent on Xanax and now we’ve pushed you into that parasympathetic rest and digest mode.” And she feels better. And this is what this is all about. Uh—a little bit of uh—off-subject uh—, but I just wanted to mention to people, check on my Facebook post and you’ll read about what I’m saying. I’m not saying these other uh— practitioners out there are garbage. What I am saying is that if you’re not getting a practitioner to focus on root cause, even if they are psychiatrist, if they’re not a root cause psychiatrist, then what the hell are they doing?

Dr. Justin Marchegiani: It’s all about resources, right? And in functional medicine world, we’re trying to help enhance your resources. So just like someone with more money in their bank account can buy more things, well if we enhance our mental, emotional bank account via healthy and diet and lifestyle functional medicine principles, we have more resources to deal with stress in our life. Whether it’s family, friends, being a parent, being present for our partner, just being able to do the hobbies of a hobbit—hobbits—uh—

Evan Brand: Haha

Dr. Justin Marchegiani: The hobbies and the habits that we have going on in our life.  I got uh—I guess I’m missing my uh – Lord of the Rings movies there. Yeah. So—It ‘s all about resources, right? So we have to make sure that we have enough resources in our system so we can allocate them toward these stressors. And I always tell my patients, “Have you ever tried dealing with stress on 0 night sleep? or “Try doing your taxes the next day when you’re getting like three hours of sleep?”  You’re just  not gonna be able to handle it. You don’t have the resources. So everything we’re trying to do is let’s test the resources of our body systems, let’s look where the hormone’s at, let’s look at where the gut resources are at, let’s look at detox and nutrient resources are at, let’s support them and let’s work on fixing them.

Evan Brand: Well, the analogy I like to use is we’re just using a big spotlight. Because a lot of different industries and health care, what they do is they use like a little laser pointer or like one of those tiny little keychain flashlight. And they shine something real dimly into one corner. And you’re like, “Oh, Justin looks like we found something. We found some anxiety issues, here’s the Xanax.” But instead, we come in with a giant spotlight and we’re like, “Whoa, look at the left corner of this microbiome. We got parasitic and bacterial infections, which can steal your nutrients, can mess up your blood sugar and cause anxiety. Look over here,  we’ve got some adrenal issues. You got spiking of cortisol that’s gonna need to be addressed.” And then we shine the spotlight over here, “Oh, take a look at our detox pathways on the organic acids, you’ve got trouble over here.” And “Oopp, we shine the spotlight behind us, here’s mitochondrial issues. This is why you’re so fatigued.” And that’s the—I think that’s the greatest analogy. It’s a little laser pointer or a little small keychain flashlight, which is just pinpointing one industry of psychiatry or psychology or whatever versus exploring everything. Which is why for you and I, it’s tough for us to become the blank guy. You know people out there, “the thyroid guy” “ the detox chick” “ the bone broth chick” You know what I mean? It’s really gonna be tough for you and I to just say we’re the blank person because I don’t want to limit myself. I wanna let everyone know it is all encompassing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And if rest and niche yourself down, I think it’s a bad thing.

Dr. Justin Marchegiani: Yeah. Like from a marketing standpoint, right? Marketing is just telling the truth attractively. You know it’s good to have the niche because you wanna reach the people that have special conditions. Because if like, my specialty is thyroid. Number one, I have—I have or had a thyroid issue. It’s under control. Autoimmune thyroid issue. So I’m more passionate about that issue. But again, to treat  a thyroid issue, you have to be able to treat all of the systems. So it’s kind of a mythology, like you don’t just ever treat thyroid, you treat the whole thing. But you may mark and put information out there that’s gonna resonate and speak to someone with a thyroid issue more. But again, the underlying issue is from education and clinical standpoint. We’re addressing the key underlying surface issues and the deep root issues as well. So we’re never ignoring it. We may speak to someone uhm—more specifically and get into the more nuances of that condition, but it all comes back down to the foundational stuff that we always talk about.

Evan Brand: Right. I would say my specialties would be— it’s become parasites really. I mean, I’m seeing so many each week and it’s just so fun. I guess because I had parasites.

Dr. Justin Marchegiani: You had a parasite, you.

Evan Brand: Uh—Yeah. And also depression, I mean because depression is what got me into this whole thing. IBS and depression in college, I mean, like I told you before, I had to figure out when I went  into a college class, where’s the bathroom. Coz I have to get out in the middle of the class to run to the bathroom.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so for me, depression, IBS, parasites, you know, those are all linked together—the whole gut-brain connection. And I really am empathetic for people that have struggled with that because it’s so common and if you diagnosed with IBS, that’s a pretty generic diagnosis. And unless you’re with functional medicine practitioners, you’re gonna get an acid blocker, an antispasmodic—

 Dr. Justin Marchegiani: Yeah. Absolutely.  

Evan Brand: — or some other drug and—

Dr. Justin Marchegiani: Well actually, you were diagnosed with IBS, right?

Evan Brand: I was.

Dr. Justin Marchegiani: And you use the antispasmodic, you used the medications that helps with the gastroparesis. You know—

Evan Brand: Well, they never –

Dr. Justin Marchegiani: They even do that—

Evan Brand: Well they never got to use it. They try. They wrote me the prescription pad but I denied all three of the drugs.

Dr. Justin Marchegiani: And the thing is, too, we can also use natural medicines for a lot of those things. That may not fix the root cause, right? There’s root cause medicine and there is using natural medicine in a way that’s gonna help alleviate the symptoms that’s gonna up regulate physiology so things work better. But we have to still be investigating and digging to the root cause, right? So we’re dealing with someone with gastroparesis or low motility, we may add in things like ginger. We may add in things like carnitine. We may add, you know, higher amounts of mag citrate to keep that uhm—migrating motor complex moving. But we are still digging in deep. We’re still making the diet, the lifestyle. We’re still enhancing digestive nutrients, uh—hydrochloric acid enzymes. And then we’re digging deep for the infections. And we’re trying to lock in those diet and lifestyle habits, right? The supplements are great because they can give us that symptomatic relief while we continue to dig over here to the root cause. So as long as you have, you know, that  four pace envision that addresses some of the symptoms without the side effects, you know of some of the drugs, which may have more side effects than what you’re treating, and then working on the functional medicine plan, I think we’re in a really good place. 

Evan Brand: I agree. Yeah. I actually got a good—good success with that IB Synergy product from designs which get Bonigut in there. It’s got the 5-HTP. I had a guy with just super bad IBS and I said, “Man” I mean he was critically, critically stricken with both diarrhea and constipation just alternating every other day.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So I have him going with that 5-HTP Bonigut blend. And he got better. Now we start to wait for lab results but yeah—I mean  sometimes we will do some of the quick fix of band-aid situations to fix things, but we still got to work backwards. I guess to answer these questions uh—should we answer the question about the cancer question here or shall we just make a whole show on the future?

Dr. Justin Marchegiani: Yeah. We’ll do a whole show on that. I’ll get some experts on. I got Dr. David Jocker is coming next month as well. He was in the truth about cancer series. And we’ll go on ketogenic diets and we’ll talk more about therapeutic ways to address cancer outside of just the natural chemotherapy. So we’ll hold that one that—we need more time for that.

Evan Brand: Yeah. Agreed. Uh—Samuel asked, “What is the tapping technique? Can you show us? Well since most of our audiences are gonna be audio listeners we’re not gonna take up the air time to show you the technique, but the best resources—EFT (Evan-Frank-Tom) and you can just view the different acupressure meridians that you’re gonna tap. But then also, you’re gonna learn about the affirmations that you can use for emotional freedom technique and that’s something Justin and I use all the time.

Dr. Justin Marchegiani: I think it’s helpful. I’m—I’m gonna just give it 15 seconds of airtime here, so—just—I do two hands coz it’s adding it’s more efficient. But you just tap the  inners part of the eyebrow, the outer parts of the eyebrow, under the eyes, I do under the nose, and the bottom part of the chin the same time. And then I do both collarbones. So I do this, and you can go top of the head and tap midline. So I do two hands coz I just feel like you get more stimulation. So I go here, and I’m just thinking about whatever is pissing me off, my wife, I just think about it.

Evan Brand: Haha

Dr. Justin Marchegiani: I kinda give it a number. So if I’m a t like 6/10 regarding irritation, I just think about it. Whatever that issue is, whether it’s like, you know, the person driving  in front of me is so slow  or whatever. And I try to knock that 6 out of 10 so that 10 is the worst.  6 is like 60% to being at the worst. I try to knock it down to a4 to a 3. And so every round—every 2 rounds or so, you kinda just check back in and see if you knock it down. And you go as you kinda knock everything down to a 3.

Evan Brand: Yeah. And we have—I—I start at the top of the crown which I usually like—many ways—

Dr. Justin Marchegiani: You can do that. You can start there, you can end there.

Evan Brand: Now do you do the sides? I know Mercola, he’s big on the side of rib cage under the armpit.

Dr. Justin Marchegiani: Yeah. I do that, too, sometimes. It’s just wasn’t good for a video.

Evan Brand: Yeah. So you criss cross?

Dr. Justin Marchegiani: Yeah. I do two at the same time just coz it’s stimulation.

Evan Brand: No. I mean you criss cross your arms so the underarm’s like this. I do like a monkey.

Dr. Justin Marchegiani: Haha

Evan Brand: And then—and then finish with the wrist. I typically finished by tapping the insides of the wrist together then doing the affirmations. So even though I’m angry, or even though I’m anxious, I deeply love and accept myself. But you gotta say the affirmation verbally. I tell people if you can, if you’re just embarrassed, then don’t do it. But why be embarrassed? Nobody—nobody is paying that much attention to you.

Dr. Justin Marchegiani: Yeah. That depends, too. Like you can do this stuff, and you can kinda say like if you’re at—let’s say, if you’re lying in bed and you’re just really stewing on something and your wife’s next to you and you don’t wanna wake her up, then you can just kinda think it in your head. And then you can just, you know, do the affirmations, tap like this.  And then you can tap here, and think about the issues.

I like them to end, though, with a positive thing. So you can end with something positive. So then I just go into like, “What is it that I want to manifest?” So I’m going into right there. I’m thinking about whatever I’m gonna try to create or produce in my life, I just tap it while I’m thinking about it. And the whole idea of tapping is you’re just stimulating various meridian systems that have been mapped out via acupuncture system for thousands of years. And really what it’s doing is it’s neutralizing the negative response that’s stored in the limbic system or in that subconscious of your—more in the psychological side of it. And you’re trying to kinda rewire it so you can get a good pattern there instead. So then, naturally that reflux is to go back to the better thing and not to the negative thing.

Evan Brand: So if you do affirmation about the bad part, would you do like an affirmation about the bad part and an affirmation for a positive?

Dr. Justin Marchegiani: Yes. So I start off with the negative and just try to lessen—lessen it first.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Coz if you’re—feeling negative, it’s really hard to be positive when you’re negative so I try to decrease the negative to about a three. And then I go into the positive because then, you are in a better place to deal with the positive, right? It’s kinda like when someone tells you to relax and you’re pissed off, like relax, calm down. You just wanna punch him, right? Like, “No, I’m too wound up, come on.”

So I wanna get that dialed in and then now I’m relaxed, now I can rewire it and create some positive things.

Evan Brand: I like it. I like it.

Dr. Justin Marchegiani: So calm down first, and then work on manifestation.

Evan Brand: Should we answer a couple of more questions here?

Dr. Justin Marchegiani: Yeah. Let’s hit it, man. Let’s hit it.

Evan Brand: Solam asked, “How long does it take to heal hypochloridia?”

Dr. Justin Marchegiani: It totally depends, right? If you have emotional stressors that are unresolved ore you’re eating foods that are incredibly inflammatory, maybe never. But if you’re making the root causal changes and your managing your stress, and you’re fixing the underlying gut stuff, I would say within 3 to 6 months, you have a really good chance of not needing hydrochloric acid to digest your food. But again, everyone is different. A longer—the longer the issues been going on, the more severe the infections, and the more infections that are layered in there, I’d say longer, up to a year, at least.

Evan Brand: Yeah. I’ll just have my two cents to that, too. If you had a previous history of a prescription, as a blocker’s proton pump inher—inhibitors are now it’s open to counter like the Xanax or the Toms, or anything like that, or—

Dr. Justin Marchegiani: Yup.

Evan Brand: Or if you’ve had H. pylori which we’ve chatted about many times, then I would say it may lengthen that time, too, to fix that stomach acid issue.

Dr. Justin Marchegiani: The longer that gut’s has been worn down, the more the immune system is revved up like you get patients are just supersensitive to every little thing. Like I can’t even put in an enzyme, I can’t even put in our apple cider vinegar or lemon juice or the smallest fermented food sets them off. It’s really hard and you’re looking at a couple of years to really dive into it because the immune system is so revved up and it’s so ready to attack the smallest invader that it’s so hard to put things into help and heal it because it’s looking at everything as a foe not a friend.

Evan Brand: Right. We really, really have the baby step in those cases so that’s why—

Dr. Justin Marchegiani: Totally. Yeah. I mean, just like you heal, with you know, food is medicine there, you go really slow and you do lots of things in broth form, in soup form so it’s – so it is so palatable. There is very little digestion that has to happen. And typically one supplement at a time and one nutrient at a time, titrate up from low to high. Even if it’s something that they can handle, if they go high dose, off the bat,   their immune system just freaks out.

Evan Brand: Well I wanna hit on something you just mentioned which is if we’re talking 1 to 2 years, it takes extreme patient—extreme patience for patients and clinicians because for us, that is a very intensive case for us to take on.

Dr. Justin Marchegiani: Totally.

Evan Brand: And you know, maybe this is to toot our own horns, maybe it’s just calling out the obvious that we do take the time, you know, with people we’re working  with. Sometimes it maybe 30-45 even an hour-long call for a follow-up just to take these baby steps. Whereas, let’s jus say some of the clinicians that we’ve seen out there, it’s too cookie-cutter approach and they don’t have the mental bandwidth or capacity for empathy to baby step this people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So it’s here’s your cookie-cutter protocol, good luck.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Where with us, we’ve really, really, really gonna get super details.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so this is why if you go and you buy like a leaky gut online program or some other type of program, and you get limited results and you get to us, we’re not gonna be surprised if you suffered through that, and you didn’t get a good result. Because at the end of the day, that’s why  Justin and I haven’t created  online courses at this point because it’s—it’s hard for us to sleep at night thinking that we’ve created a program that’s too cookie-cutter. We’ve really got to figure out a way that we’re gonna be able to work in all the minutiae and the small details and the variations—variation A, B and C, D for different people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So if someone uh—packages something up all beautiful and says, “Oh, it’s $297 and all your problems are gonna be healed.” Uh—please be a little bit skeptical  of that.

Dr. Justin Marchegiani: I agree. And I’ve talked to you about a patient that I had today that email in that was dropping out of care. And we try to always set realistic expectations. This person just had her labs reviewed a month or two ago, and had multiple parasitic infections, severe adrenal dysfunction, HPA axis dysfunction, and then a lot of issues on her organic tests. Uh— detoxification issues, mitochondrial issues, and we just started with simple adrenal support, made diet and lifestyle changes and she had some— some side-effects so we try to cut things down, go slower. And we’re gonna kinda reconvene and work on supporting detoxification, but person had dropped out. Now, the problem is, to have expectations that things will work off the bat when so many things are wrong like that, expectations are incorrect. So  a lot of people they have preconceived notions even if you spell it out to them and you let them know, “Here’s where we’re at now, here’s where we’re going.” They forget because they—they want it done now. And they think because things didn’t work in that initial uhm—in that initial experience, that there is no way to fix it. So continuing to harp on patients in managing their expectations, even though they have a lot of stuff they’re projecting from past failures, we kinda have to get through it. Make sure expectations are real and that make sure they know, “Hey, here’s where we’re going now. Here’s where we’re going next.” These things ahead that may have to be dealt with for us to really see great changes.

Evan Brand: Yup. Well said. We got another question here.

Dr. Justin Marchegiani: Let’s hit ‘em.

Evan Brand: Let’s hit Steve’s question. After all GI infections are eradicated, how long does it take the gut to fully heal? All my infections are gone, but I’m still dealing with IBS, leaky gut and issues after H. pylori.” I’m gonna hit on this first Dr. Justin Marchegiani, if you don’t mind.

Dr. Justin Marchegiani: Yup. I know you’re gonna say it, by the way.

Evan Brand: Okay. So – haha if—

Dr. Justin Marchegiani: If you say it—If you say it, I’ll—I’ll tell you that.

Evan Brand: Okay. Alright. Please. Alright. So here’s what I’m gonna say. You say all your infections are gone, but you’re still dealing with IBS, leaky gut, and issues, I would like to know what test was this that says all your infections are gone because I bet all of your infections are not gone.

Dr. Justin Marchegiani: Yes! Whoo! I knew it. Yeah. You’re totally right.

Evan Brand: Haha

Dr. Justin Marchegiani: Yeah. You’re totally right. And then also, just making sure that you have the digestive nutrients on board to help heal the gut lining and the digestive support to break down the food and then I would make the food more—more palatable right now. I’d be looking more at the GAPS or an SCD or more of a soup or broth approach that makes the food really easy to take in. No raw veggies, uhm—try to keep it really palatable so the body can access it without much stress.

Evan Brand: Alright. So the beauty of the Internet, Stevie says—Stevie replied and he says, “DRG” Well, uhm— Justin–

Dr. Justin Marchegiani: It’s missing a lot of them. It’s missing a lot. You gotta do the DRG with the GI map. I a—I never do the DRG by itself for the most part—always both. You gotta do both.

Evan Brand: Yup.

Dr. Justin Marchegiani: And if there’s still an issue with the DRG and the GI MAP, I want them go for the  41 side-by-side.

Evan Brand: Yup. Agreed. So, Stevie, not that—you know, we’re not diagnosing you. That’s not what these calls are for. But, hey, Justin and I have seen a lot of false negatives with DRG and some other test out there. So potentially some stuff going on. And I would like to add a couple of points about like the—the issues, the leaky gut type stuff. You know, make sure you are doing some of the easy supports, too. You know, chamomile is great. You can do chamomile in a supplemental form. You’ve got chamomile teas, uhm—you’ve got L- glutamine. So there are some leaky gut supplements that why your til—still trying to figure stuff out, you can still be taking support of nutrients in the meantime while waiting for retest.

Dr. Justin Marchegiani: Absolutely. Totally. Let’s hit  the uh—last question there by—E Center Riley. See here, just diagnosed with Hashimoto’s, TPO and TGB bodies, 465 is that high? Eliminated the foods, gluten, dairy, soy, balance in blood sugar, hard with 5 kids. What should I focus on next? So 465 is definitely high. The LabCorp reference range for TPO is 34. Anything 34 above is considered positive—I think it’s above 34. 34 below is considered positive. And anything about 20, for me, I considered to be subclinical. So that is high. Anything above or around 500 is definitely high. I’ve seen patients at 2000, though. I’ve seen patients that go from 2000 to below a 100. Now, my goal is to get people—If I were you, I’d like to see a 70 to 80% reduction in that. Again, maybe you were higher before you made those changes. So I’m not sure if it was  gluten, dairy, soy. That stuff was cut out and then you saw the drop. But either way, uhm—getting enough selenium in there, 400 micrograms of selenium, addressing the underlying infections, things like H. pylori, Blasto and Yersinia can be coming to increase the antibodies. And then making sure the adrenals are looked at. There’s a strong adrenal-thyroid connection and a lot of people who have thyroid issues also have adrenal issues. And remember, TPO is a microsomal or essentially it’s uh—intracellular microsomal antibody that helps bind the thyroid hormone together. So if you’re making antibodies to that, it’s gonna prevent that thyroid hormone that I—Iodination process from occurring. So making sure we have the adrenal support there because the adrenals help produce cortisol. Cortisol is an anti-inflammatory that’s gonna help with the inflammation. And with the TPO there uhm—you could potentially have increase in hydrogen peroxide, especially if there’s small amounts of iodine getting in there. So get them the selenium will help neutralize that hydrogen peroxide into H20. High quality H20 which is uh—not gonna be as inflammatory.

Evan Brand: Well said. Yeah. And so uhm—Isabella Wentz, I just did podcast with her a couple of weeks ago. Actually that was my last uploaded episode. And uhm—we’re talking about bacterial infections, too. So you mentioned some of the parasites and she’s seen the same thing the parasite but also the bacteria. The Klebsiella, the Citrobacter, and all these autoimmune triggers has been bad guys for uh—these Hashimoto’s situations and these antibodies, so—

Dr. Justin Marchegiani: Yeah.

Dr. Justin Marchegiani: So, look for the bacteria, too, and you can definitely fix this stuff and you can make significant progress.

Dr. Justin Marchegiani: Absolutely. I mean one person here, wildlab access, “How do you test for various enzymes?”Number one, if you have gut stress, you probably have low hydrochloric acid. And if you have low hydrochloric acid, you probably have low enzymes. Why? Because hydrochloric acid is important for acts of—for converting pepsinogen to pepsin which is the proteolytic enzyme. Hydrochloric acid lowers the acidity of the chyme, which is the mixed up food in the intestine. That inten—that food that chyme that goes into the small intestine which the acidity then triggers the pancreas to make bicarbonate, it also triggers CCK that then caused that the gallbladder to produce bile that also stimulates the pancreas to make light based trypsin and chymotrypsin and all the enzymes that come down. So if you have enzyme issues, you also have hydrochloric acid issues, but we can also assess it by looking at enzyme markers, like elastase, too, which will uhm—look at that in the DRG or the GI MAP test.

Evan Brand: You better get that frog out.

Dr. Justin Marchegiani: Frog out. It just attacked me, man. I’m like, Ugh—

Evan Brand: Alright.

Dr. Justin Marchegiani: My water—so uh—yeah. Elastase, I think it’s elastase 1 is the enzyme marker we typically look at for uhm— low enzymes. But typically, just assuming that we have digestive stress, let’s assume it for sure.

Evan Brand: Yeah. I mean that’s the same—the same answer that I would say for the leaky gut. I had people say, “Oh, can you test me for leaky gut?”  It’s like, “Yeah. We can go to Cyrex and spend 500 bucks if you want to, but based on your symptoms, I guarantee there’s intestinal permeability. You’ve got XYZ. And we can—we don’t need to spend the 500 bucks on that test. Save your money for the organic acids, your comprehensive stool panels, the GPL-TOX, maybe heavy metal testing. Save your money for that stuff that you can’t really guess on.

Dr. Justin Marchegiani: Yeah. Absolutely. I agree, man. Well, anything else you wanna hit off the bat here? I mean I think—I had some really good successes last week, too, with some patients that had chronic pain, chronic mood, chronic energy, hair loss. And I mean—just really simple things. We—we fix their hormones, this person has autoimmune thyroid, uhm—hypothyroid as well. T3 was super low, it was uh– T4 to T3 conversion issue, dysregulated cortisol. They had a lot of malabsorption and they had a couple of infections and we just—we just took them down the map. An then just everything first time around, uhm—just knocked in place. I mean it’s like you swing the bat once and it’s connected. It’s gone. Those were the patients where its like, “It’s just so rewarding coz it’s just—it’s easy” And then you have  some patients where it’s a lot more trial and error and digging in. So it’s nice to have those home runs every now and then.

Evan Brand: Oh, man. I—so I had a home run earlier with this guy that I got off the phone with name Dion. And he was on an inhaler. An asthma inhaler.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And also I believe he was taking uh—allergy medication, like a prescription allergy medication.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maybe it was one or the other. He alternated or he was on the inhaler something. But he was on prescriptions for allergies. And all we did is we cleaned up the diet, we’ve addressed some gut infections. He had candida and I believe a couple bacterial infections. I don’t believe he had parasites. I have to look back. But I remember a couple of infections, fix the gut, uh—supported adrenal’s basic adrenal support, some adaptogens. And I talked with him today and he said, “Evan, I’ve not used my medication in the last six weeks. And everything is blooming here right now. All the trees and plants and everything are blooming and normally, I’m debilitated. He said, “I’m completely fine.”

Dr. Justin Marchegiani: Isn’t that awesome?

Evan Brand: How in the world just by working on the gut and adrenals am I not allergic to the environment anymore? It’s just like, “Oh, it makes me feel so good.”

Dr. Justin Marchegiani: I see that all the time, too. And hydrochloric acid is one of those things that’s really great with allergies, too. You notice that?

Evan Brand: Ain’t that weird? I mean since digestive enzymes, I told him, I said, “Man, we’ve gotta keep up digestive enzymes.” And then actually I am gonna send him a bottle of some of the like natural herbal anti-histamines, just in case. Because he started sneezing on the phone. I’m like, “Whoa, maybe you’re not all the way out of the water yet. Have this on hand, in case you need it.” So the coresatin in, the rutin, some of those–

Dr. Justin Marchegiani: Hesperetin

Evan Brand: Yeah.

Dr. Justin Marchegiani: The things I love for allergies: number one, just really get a good air filter. I used one by Advanced Air. You can see that at Look at the approved products. I like it. It’s good. Uhm—and then your natural anti-histamine degranulating compounds. In my product, Aller Clear. Stinging Nettle, coresatin, and then you’re gonna have like some vitamin C in that, some potassium bicarb as well. So those are really good. And you can go up to eat. The nice thing about it, just not gonna be drowsy. So you can get that allergy support without getting the drowsiness and then really make sure the diet is anti-inflammatory. Up the hydrochloric acid because HDL is really important with low—with allergy. It’s gonna make a big difference.

Evan Brand: Yup, Yup.

Dr. Justin Marchegiani: Ginger. Ginger is phenomenal, too, for allergies. Really good.

Evan Brand: I love ginger. So it’s a great nutrient. I’d do teas, ginger kombucha, there’s so much you can do with ginger.

Dr. Justin Marchegiani: Oh, yeah. By the way, right after this, I’ve got a new grill. So I’m gonna go out, I’m gonna grill some grass-fed hotdogs, right? And then I’ve got some sauerkraut with mustard. And I’ve got a nice ginger kombucha, I’m gonna open up. So I’m really excited for my lunch break today.

Evan Brand: Nice. What kind of grill? Is that one of those  pellet jobs?

Dr. Justin Marchegiani: I actually—I got a new Webber just because it’s—it’s—my other one was 10 years old. And then the knobs are starting to go. So I got a nice, little Webber Spirit. So it’s great. It’s got three burners. Love it. And uhm—I got a smoker that I use sometimes for ribs on the weekend just like a 4-hour job. So it’s good to have a day or an afternoon to kinda be at home to enjoy that one but—Yeah. So love my grilling. Try not to get things charred. Try to keep the heterocyclic amines and the polyaromatic hydrocarbons to a minimum.

Evan Brand: Agreed. Agreed, man. Cool. Well I don’t have one on my end.

Dr. Justin Marchegiani: You wanna have a share?

Evan Brand: No.

Dr. Justin Marchegiani: Hope you guys are liking these calls here. We wanna do more. We wanna connect with the listeners. Our purpose really is to serve and help people get their health back. If people want more feedback, or want more kinda like rolling up the sleeves and specifically diving into your case, go to or, click on the schedule buttons. And we are here to help you out. Evan, anything else, man?

Evan Brand: That’s it. Have a great day people, drink clean water, get rest, reduce stress, be grateful. It’s gonna go a long way.

Dr. Justin Marchegiani: And people on Facebook, I’m hoping we can get Evan on here soon. We gotta just  figure that out. So hopefully, soon we’ll do that. So Evan, great chatting with you, man. We’ll talk soon.

Evan Brand: Take Care. Bye.

Dr. Justin Marchegiani: Bye.



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