Low Potassium, Adrenal Dysfunction Your Immune System | Podcast #288

For today’s live podcast, Dr. Justin and Evan Brand talk about Potassium and our immune system. Among other minerals, Potassium also acts great especially in our body, energy, mood, blood pressure and a lot more. Let’s dive into why potassium is important for our immune health. Check this podcast’s transcript. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:18 All about Potassium

9:11 Oral Supplementation

18:32 Glucose

20:57 Foods with Potassium

27:11 Vertigo and Dizziness

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Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani, we are doing a live podcast here on potassium and your immune system. Potassium is an essential mineral. And it has major effects on the sodium potassium pump, how your cells function, energy, mood, blood pressure has a huge effect on the adrenal glands. I’m excited to dive in here with Evan Brand, Evan, how you doing today man? doing really well.

Evan Brand: So we were looking at some papers on this thing. And turns out a national survey found that approximately 98% not nine not 8, 98% of Americans are not meeting the recommended potassium intake. A Western diet is to blame as it favors processed foods over a whole plant foods such as fruits, vegetables, beans, and nuts. Everybody knows that the American diet is crap. And it’s not just the American diet. Right? This is the standard European diet. This is the standard Australian diet you know, kind of most developed first world Countries they’re doing too much. Too much potassium devoid food. And let’s tie that directly into what we were also looking at which is this paper this based on the names of these doctors. And yeah, actually it shows it right here. When Zhu Zi Yong ha, Province, China, so yeah, so this is a Chinese hospital and Chinese medical universities to study that came out of hyperkalemia and clinical implications and patients with Coronavirus and long story short people that had potassium deficiencies. They had severe hypokalemia, which is the technical term for potassium deficiency. And it said here that the patients responded well to potassium supplements. And they were inclined to recovery so they don’t say directly Hey, low potassium means you’re going to get the virus or low potassium means you’re going to be really sick, but they just talk about how, because of this whole Ace to enzyme thing that you and I’ve covered many times, and the whole relationship to the virus that one of the side effects of the issue can be low potassium, and if you’re already low potassium to begin with, then you can end up in potentially fatal shape, which is not good.

Dr. Justin Marchegiani: 100% in potassium is very important because our sodium potassium pump is requires potassium. So what happens is, you have your cell, and then you have sodium inside the cell and you have potassium outside of the cell. And they do a little switcheroo ski, right. This is called the sodium potassium pump. The enzyme that’s involved in making that happen is ATP. And then you know, it’s an enzyme because of the word Ace next to an ATP ace. So ATP is important because ATP is generated from your mitochondria, right? We have glycolysis outside of the cell in the cytoplasm, and then we have our Krebs cycle, right? And we have our electron transport chain within the cell we generate 36 to 38 or so ATP from that that eight TP part of that ATP runs their sodium potassium pumps that ATP takes that sodium that’s in the cell and that potassium outside of the cell, they do a dance, they switch. So it’s three coming out to come in, right? Boom, just like that. And the cell needs that healthy fluid fluidity to work and to communicate. And if we don’t have that healthy fluidity, we’re going to have side effects. So one of the big side effects is we’re going to have muscle or nerve issues because potassium and sodium are very important for the muscles slash nerves to work, right nerves help control muscles, so very, very important there. You’re also going to see it with you’re going to see it with potential mood issues as well because sodium and potassium play an intricate role with the adrenal glands and part of the reason why people’s potassium gets low outside of a poor diet is going to be because of adrenal function. Now, typically with adrenals. Your dosterone starts to go low, which is a mineral corticoid that exists in The cortex to the adrenals. And what happens is as your dosterone starts going low, your sodium can start to drop. And as your sodium drops, sometimes your potassium can look like it’s not too bad, it can look actually a little bit high, but you could still actually have potassium issues because of the fact that you are your adrenals are weak and you’re pulling out a lot of your minerals. So muscle and cramps are going to be a big deal, weakness and fatigue because your nerves need that. Also, if you don’t have good sodium potassium pump issues, you probably have energy issues because the mitochondria healthy mitochondrial function for ATP is needed for that sodium potassium pump to work so potassium works better when there’s the ATP so that whole sodium potassium pump works. We talked about cramping as well because of the the muscles needing the wiring the fluid wiring sodium and potassium and minerals. So cramping is gonna be a big deal. We’re also going to have potentially digestive issues right? your bowel movements and your motility starts to Coming slower when your potassium drops, so we need healthy levels of potassium. So we have good bowel movements. Also heart palpitations, we need potassium and magnesium. So our heart could pump right our hearts a muscle as well. So if your heart skipping beats or beating harder or faster, that’s a sign of palpitations, which could be from that. And also just achy muscles, muscle breakdown, feeling tired and stiff, right? the breakdown of muscle was known as rhabdo. My license or my analysis, right? And that breakdown is going to be very much helped with good potassium levels, right, you’re gonna have less muscle breakdown, with potassium levels being adequate, of course, tingling and numbness issues are going to be a big one difficulty, you know, using your lung muscles mood stuff because of the adrenals as well. I’ll pause and give you a chance to comment.

Evan Brand: I’m glad you mentioned magnesium too, because, uh huh. You and I were kind of looking with a microscope today, right? We’re kind of spot picking right? One thing to talk about, but all these people that are deficient in potassium, I’m sure they’re going to be deficient in magnesium as well. I mean, we know how hard it is to get it from the food, even if it’s organic, because the soil is so depleted. So it’s a really common problem. And then on that whole mood changes, I just wanted to talk about that real quick. There was one study, and this wasn’t a necessarily a causation, but just a correlation study that we were looking at here. 20% of patients with mental disorders that came into this psychiatric ward 20% of them had potassium deficiency. So it’s not saying directly, the potassium deficiency caused the mood issue, there could very well be other things going on you and I’ve covered hundreds of times about gut infections, which could lead to mineral and electrolyte imbalances you hit on the adrenals. So, of course, as we know, when we hear something like that, we say, Okay, well, if you just give these people potassium, are they not going to have mood issues anymore? And the answer is, they could still have mood issues, even if they supplement Potassium, but it’s interesting and it’s something that often gets skipped. This is really low hanging fruit. Somebody could go to something very nuanced as this particular herb for this retrovirus or this bug, but the person’s just simply dehydrated and they’re not getting enough electrolytes, it could be something very, very simple like that.

Dr. Justin Marchegiani: 100% and low potassium is so common, just like low magnesium is common. I think you said what 98% are going to have some kind of an issue.

Evan Brand: Yeah, and I think this idea that yeah, I think this study I was referencing was probably just a survey where they looked at diet and figured out whether people were even getting the the the recommended daily amount, and 98% of people are not getting the recommended daily amount are already on the recommended daily intake. So I guarantee magnesium is in the same boat, probably 90 plus percent.

Dr. Justin Marchegiani: Yeah, 100%. I agree. And then also there are medications that are going to affect potassium, right. We know a lot of the blood pressure medications as well as things that like water pills or diuretics. So if you’re on a BP medication, right, there’s a good chance some of that’s going to be actually driving further potassium deficiency. So low potassium levels are super common because of that. Also, we’re going to have problems with potassium if we consume too much alcohol, right, alcohols gonna cause us to pee a lot more potassium out because things like diuretics are going to cause you to lose more minerals, right? diuretics basically activate a hormone that causes you to kind of continue to pee. And the more you pee with a diuretic in your system, whether it’s, you know, excess coffee, or even access alcohol, you’re going to pee out a lot of those minerals. So that’s kind of like vitally important, right?

Evan Brand: And even Yeah, and even tea, I mean, even tea could be to blame. I think herbal teas can be great, but there is somewhat of a diuretic effect of certainties as well. So if you’re just like sipping on tea all day and not drinking enough just straight water or our preference water with a pinch of salt or water with some electrolytes, actually to it, you know, this can happen easily. And this is not just a problem in athletes, people hear the word electrolyte and they think you only need that if you’re in the NFL No, you need electrolytes just to function.

Dr. Justin Marchegiani: Exactly, the problem with a lot of people with their potassium is, it’s hard to get too much if you’re taking it orally, right? Obviously, you go back to like the lethal injection people are actually you know, in the lethal injection in the prison system, people are actually being killed by potassium IV right or injection. Now, it’s hard to get too much potassium orally because some of the vomiting and from some of the vomiting and diarrhea side effects and the nausea side effects that you get from have actually having too low potassium. Well guess what, you actually have similar side effects when you go too high. So usually you get so nauseous, and you’ll either throw off or you’ll get diarrhea. So it’s very difficult. The only way to really do it orally is going to be with an oral supplementation. And you’d have to do a lot of it and all those symptoms would come into place. It’d be really high. The only way you You can get your potassium levels to the point where you’re going to be too high is going to be on an IV. And what they do actually on an IV to reverse potassium overdose is they do a bicarbonate infusion, bicarbonate actually neutralizes that high level of potassium. But some of the major causes are going to be diarrhea, right? So if you have a parasite infection or a gut infection that’s causing chronic loose stools, guess what? You may be having low potassium because of your gut. I have some patients that need five or six or seven grams a day of potassium supplementation, whether it’s because of a stress or a malabsorption issue, but all of their low potassium symptoms go away when they hit that level, meaning like the cramping, the twitching, the heart, the mood stuff all go away when they hit that higher level. So I mean, the goal is let’s fix the stress. So you’re not dumping the minerals as much let’s fix the gut. So we’re absorbing but, you know, I don’t typically don’t recommend doing more than one to two grams of potassium supplementally and we’ll do a good high quality keylight whether it’s a discoloration A or A potassium bicarb or we’ll do a potassium citrate like a new salt, which is a cheap source, and then we’ll try to plug in the recipe of the diet but if we have to go above, you know, we’ll do it incrementally and we’ll start looking for those low potassium symptoms to go away but alcohol is gonna be a big one, chronic kidney issues. uncontrolled Type One Diabetes will do it diarrhea, like we mentioned. So gut issues, diuretics is a big one. So if you’re on a diuretic on a blood pressure meds side, that could be a problem. sweating a lot. So if you’re sweating a lot, yeah, you’re gonna need a lot more minerals. Again how Gatorade was figured out I think it was the 1968 late 60s I want to say was the Orange Bowl one of these big bowl games the Florida Gators were actually playing halftime I think one of the exercise physiologist or PT people, trainers said hey, let’s get these electrolytes in and they had a kick butt second half and they just they killed it and won the game. And part of it was the electrolytes they put it and now we have all these things. Gatorade substitutes, but the real they were called Gator lights, right? Gator lights, not Gatorade. They tasted like absolute crap. So what you have now are a whole bunch of minerals with a whole bunch of sugar and dyes. Back then they just had the minerals and it tasted awful. But from a performance standpoint, they did really well because the other team didn’t have it. So they their muscles were functioning better. So sweating, not having enough full later B vitamins, having high amounts of aldosterone, whether it’s a tumor, or just our adrenals being overstimulated. Some antibiotics can actually have problems as well. And then vomiting vomiting too much can create low potassium too. And then obviously, just that junk food diet, we’ll talk about what it takes to have enough potassium in a minute.

Evan Brand: Yeah, and one thing too, that people miss out on a lot of these new companies, they’re doing a good job because they’re getting away from the corn syrup and the fake sugar and all that stuff, but you still do need based on some of the stuff we’ve looked at. I believe you need a little bit of glucose to help get potassium And your other minerals and electrolytes into the cell. So you’ll see if you look at they call it o RS oral rehydrating solution. This is like the military grade electrolytes. There has to be a little bit of sugar there has to be a little bit of a blood sugar spike, I believe it somehow opens the channel to let the electrolytes in. I’m not sure the exact you know, molecular level stuff that’s going on. But I’ve read into formulas that are just stevia or just monk fruit, some of these natural sweeteners that if they don’t affect blood sugar, you don’t actually get the benefit. So when you look at legit like military grade, electrolytes, they have a little bit of glucose spike associated with it.

Dr. Justin Marchegiani: Yeah, and the glucose is better, right? The problem is a lot of these places they have fructose, the fructose doesn’t target the muscles the same way as glucose does. So if you’re looking for an electrolyte formula, you you really want you can get the electrolytes by itself but then if you want if you’re doing a lot of sweating or a lot of glycogen depleting activity, whether it’s football or some kind of a sport that requires a lot of sprinting or running, then you’d want a formula that’s going to have more glucose in it for the sugar source, not fructose. fructose is a problem because it hits the liver more than the muscles. Glucose hits the muscles more than the liver. And like you mentioned, that helps open up that cell with the insulin and helps deplete the glycogen levels and helps that sodium potassium pump work better if you’re using a lot of glucose or if you’re sweating a lot, but if you’re not, and you’re just the average everyday person, probably getting the minerals in without the extra glucose is probably okay.

Evan Brand: Yeah, we talked about mold and detox and sauna and all of that, but I’m really shocked at how many people are doing sauna 234 or five times a week and they’re just drinking water. I’m like, Are you nuts? You gotta be doing electrolytes that is a critical component of detox in my opinion, is you have to make sure you’re replenishing and rehydrating because you’re losing a lot of minerals. You’re not just magically sweating out heavy metals and mold toxin, you’re sweating out minerals and electrolytes. You have to replenish those and you You were drinking a green juice earlier, I think you said your green juice had like 1200 milligrams per bottle or something crazy. 

Dr. Justin Marchegiani: Yeah, this is a great brand right here. It’s called evolution. They sell them in Austin and Selma, even in target now, which is kind of cool. Like, I like the fact that a lot of these healthier things are coming into kind of more mainstream box stores. But organic greens, I’ll typically drink the celery juice, but I’ve been doing the essential greens, they have the celery is the first ingredient so it’s still great. I love celery because of the minerals in there the electrolytes and then potassium is really high in celery, but it’s got cucumber, spinach, romaine kale, lime and parsley. And then they have a green devotion instead of lime. It’s got lemon, so they go back and forth, but there’s no actual fruit outside of the lemon or lime which is pretty low sugar. And this has got just alone It’s got I’m almost about 1200 milligrams of potassium. So I got about 25 to 30% all my potassium right here. So that’s pretty cool. So I just kill that after I have my really nice good breakfast with collagen and then I’m already a you know, a quarter of the Through my potassium needs for the day, which is great.

Evan Brand: Don’t you feel more like your thirst is quenched to like when I drink regular water compared to something like that. It’s just not as quenching to me as the good stuff, the green juices, they’re more thirst quenching. I’ll do like a little bit of electrolyte through a pinch in, like with some beet powder and stuff like that. And I feel great if I’m just doing filtered water and I’m not using aro I’m using like a carbon system even then though I water just doesn’t cut it for me. I like a little extra bang.

Dr. Justin Marchegiani: Well, I think a lot of people what they’re really craving is they’re craving some water, but they’re also craving minerals, right? And so because they’re craving minerals, if there’s no minerals in there, yeah, you’re going to feel like you’re missing out on something, right? So that’s definitely a big part of what’s happening is your body’s craving the minerals, and if they’re not there, that’s a problem. Also, I’m pretty sure Cushing’s is going to be another potassium issue, right? Cushing’s and potassium is going to be a big problem as well. So now what does that mean? So the kidneys excrete large amounts of potassium when you make a lot of cortisol. So what does that mean? So If you have Cushing’s that’s kind of more tumor induced where the cortisol is so high probably because of some kind of a tumor. But what if you’re in between? Right? What if your your adrenals are just overstimulated, you’re not on the adrenal, you’re not on the Cushing’s disease side but you’re just making a lot of cortisol because of chronic stress. So it’s possible your chronic adrenal stress could be causing you to dump a whole bunch of potassium out. So that’s where when you’re getting stress, under stress, physical chemical emotional, maybe that gluten is causing the stress, right? You’re gonna probably need more potassium, more minerals. potassium and magnesium are the most common ones. It’s so hard to get them most people get enough sodium and chloride because of just it’s in their natural junk food. I don’t get they don’t get the good quality from like a good high quality sea salt or Redmond Real Salt, but they’re getting some it’s really the magnesium and potassium I’m seeing as the big big missing pieces and today we’re really focusing on potassium.

Evan Brand: Yeah, makes sense. I mean, think about what happens when you’re dealing with somebody that’s really stressed right? They may have issues with constipation, they may have issues with Sleep, they may have issues with their blood pressure, they may have issues with anxiety as you hit on earlier, potentially Heart, heart pumps. So all of that, to me sounds like stress induced mineral depletion, which then causes other symptoms and you’re stressed about your blood pressure being elevated. So then that cortisol dump and adrenaline dumps more minerals, and then it become more mineral deficient. So you see how this thing can get out of control. And it sounds really cliche and corny to say, well, stress did it but it really does. And it’s not just the emotional, it’s the gut stress. It’s all of it that we always hit on.

Dr. Justin Marchegiani: 100%. Also people are talking about in the messaging. Well, what about if I’m in ketosis and I don’t have glucose to open the cell? Well, I mean, we’re just talking about with x with extra exercise, right extra exercise, extra sweating. If you’re doing a lot of glycogen depleting kind of movement or exercise, you’re probably going to want to do some type of a glucose kind of refeed the night before the movement. And a lot of athletes who do keto still have a punctuated kind of glide And reefy the night before just other tapping their muscles out, because your muscles can hold anywhere between 250 to three to 400 milligrams or grams of glucose or glycogen, right? glucose in the muscles is glycogen, it’s stored, right? That’s the storage form of glucose in the muscles. So a lot of people, they’ll be in ketosis most of the time, they’ll do a refeed the night before, that way they have access to that glucose The next day, and again, depending on how depleting or how long you’re exercising, you probably want a nice little bit of a glucose, electrolyte drink. And again, that’s not most of the time, that’s going to be just more timed up according to exercise and kind of what your metabolic needs are. But for most people, you know, a good natural Gatorade source, guess what coconut water, got a little bit of glucose, a little bit of sugar in there, and it has a lot of potassium, so that can kind of be mother’s nature’s natural kind of Gatorade. It just depends on what you’re doing. If your kids playing football and sweating a ton, they may need a little bit more than that. You’re going to have to just feel it out. See what works. Test it on your own when your practice To sing and playing and see how you feel with that you may not need pure coconut water, maybe just diluted half and a half with a really good clean mineral water. And then you have a little bit of glucose, a little bit of extra potassium plus the other minerals working for you.

Evan Brand: Yep, you want to hit a little bit of the diet piece. Yes, you and I were kind of looking at some of this before you pointed out. Interestingly, and we’ve probably talked about this in previous but if you look at 100 grams of food as a measurement, the potassium per 100 gram of avocado is higher significantly than bananas. If you look at a full avocado, versus a full cup of banana, which maybe is a full banana, you’ve got almost double in the avocado. So you know as a kid, I remember thinking potassium banana, and that’s just kind of this thing you grow up with. But in reality, there’s things that are much much higher like beet greens takes the cake with number one here. 1300 milligram per cup of potassium that is insanity. 

Dr. Justin Marchegiani:  Exactly. So most people don’t get it. So if you’re sitting Get in there. And you’re on keto, right? Well, what are the biggest easiest things you can do? Well, beet greens is number one. Okay? What’s number two salmon, high quality fish that’s per hundred grams. So what’s 100 grams? 100 grams is about 3.3 ounces ish. Let me just double check that hundred grams and ounces. I’m pretty sure that’s what it

Evan Brand:  sounds about, right? Because it says here, potassium per six ounce filet of salmon.

Dr. Justin Marchegiani: So 3.5. So what does that mean? So Alright, so if you’re keto, right, and you want to really be on top of this, or you’re keeping your carbs down, what does that mean? That means Okay, if I eat seven ounces of meat, seven ounces of fish, I’m at 1300 milligrams of potassium, boom, you’re right there. And then you throw in some beet greens with it right? That’s three ounces worth right hundred grams. You’re at another one gram almost. And then guess what? You cut up an avocado with that. Right big avocados. Another 500 I’m sorry, another per avocado. You’re about one gram per full avocado you’re set. Right?

Evan Brand: I want to look up cassava because I love cassava. And what if you like did some guacamole with like cassava chips? I wonder if we’re getting any?

Dr. Justin Marchegiani:  Oh yeah, so we could do like Yuka in potassium because Yuka in protect you guys same thing as cassava. Yeah. So one cup of cassava is 558 milligrams, boom. 

Evan Brand:  So because our chips and I mean now, some would argue, well, you know, the, the baking process and whatever of the chips, okay, whatever, but it’s still better than zero.

Dr. Justin Marchegiani:  Yeah, but a lot of times if you don’t bake it or cook it, you’re not going to be able to get the nutrients anyway. Like, if you look at broccoli, raw versus broccoli steamed, you’re going to see the nutritional value in the content goes up once you cook it, because then the fiber is broken down so you can actually access some of those nutrients.

Evan Brand:  Yep.

Dr. Justin Marchegiani:  So cooking a lot of times can make certain nutrients more bioavailable, too. It’s not Oh, cooking bad all the time. 

Evan Brand:  No, I’m just thinking. I’m just thinking of the one devil’s advocate out there saying oh well you’re eating. you’re advocating Eating, you know, chips fried and avocado oil. It’s like Yeah, I am. I think it’d be great. 

Dr. Justin Marchegiani:  I think it’s okay. I think it’s fine. I mean, don’t make it a staple. But I mean, I think it’s if you’re gonna have something like that it’s all about not going to the place in your head about like, Hey, what do you have to cut out versus Hey, what can I substitute? When you have a substitution mindset versus the cutting out mindset? One, you feel a lot more free and you feel like you’re not missing out on stuff because there’s always a good healthy stuff the tuition option that works. So let’s let’s kind of just create a simple day like what does a day of potassium look like? So off the bat, you know, on the vegetable side, one cup of you know, your typical vegetable greens will be anywhere between 500 milligrams to about 800 milligrams depending on the vegetables, right? Like one avocados gonna be about a gram, right? One cup of Swiss chard is gonna be about a gram. So you’re really at the top with those. One cup of spinach is about 840 milligrams, and then you have on the lower side, which would be like broccoli and brussel sprouts are closest 500 milligrams. So just to kind of give you a sample day here, let’s say we start out with a full avocado, boom, you got one gram of potassium so that now you’re like you’re like really on the way there. If you do a serving of fish like a good six ounce serving of fish, now what? Well now another gram is added, right? No problem. All right, and then now you’re at about now you’re at about two grams. And then if you throw in a green juice like this, you’re over three. And then if you have a serving of squash, or even white potato, or sweet potato, well now you’re at another 500 to 800 milligrams. Okay, now you’re at 35 to 3800 milligrams. And then you just need about four more servings of vegetables. And most people when they have veggies, they’re probably going to have two servings at a time, right? They’ll probably have close to a gram anyway. So you need about, I would say about four to six servings of a good quality green vegetable, you’re probably going to need one full avocado, and then one full serving of a good quality fish. And then you’ll get right about there and then you can always add in an extra avocado, you could always add in a little bit more fish, you could always add in a little bit more beet greens or green vegetables to get you the rest of the way there which is about 4500 to 4700. And then if you’re doing a lot more sweating, you could always throw in some coconut water. So I would say about six servings of green vegetables one full avocado, a good serving of fish and then you can always plug and play coconut water or banana according to what your metabolic needs are. What do you think?

Evan Brand: Yeah, and yeah, very good. And you didn’t mention any nuts which is another easy low hanging fruit so if you can get away with doing like pumpkin seeds, you can get a ton there if you do almonds or almond butter or you put a scoop of almond butter in a smoothie, you can get some there pistachios are super high and then I was looking on this other foods like-

Dr. Justin Marchegiani:  potatoes potatoes are huge so it means depending white potatoes if you’re trying to keep low carb or autoimmune find Nick’s that go to a squash or a potato but potatoes are very, very high in potassium. He will forget that.

Evan Brand:  Yep, yep. I was looking on this nutrient density chart. Whey Protein is number four 100 grams away, you’re getting over two grams 2200 milligram potassium 400 grams away. So if you can tolerate a good high quality Grass Fed Whey protein, that’d be easy. Think about if you made a smoothie with some greens, some whey protein in there, he threw some pumpkin seeds and a scoop on the butter, man, you’re set.

Dr. Justin Marchegiani:  How many milligrams in the way?

Evan Brand: 2200 for 100 grams of, you know substance 2200 potassium.

Dr. Justin Marchegiani: okay, I put 400 grams in the whey protein. Okay, so your typical servings probably like 25. So how many again, per 120 200? Okay, so if you’re doing maybe 25 or 30 grams of protein, which is what most people do in a scoop, I mean, you’re probably about what 500 milligrams.

Evan Brand: I’m going to look up I’m going to see what the serving size is because you and I use a couple professional grass fed powders. Let me see what the what it looks like. Yeah, so so one scoop Typically is 30 grams. So exactly, exactly, yeah, so you could almost call it you could almost call it one third then so you know 2200 divided by 600

Dr. Justin Marchegiani: ish 656 50 ish. Okay, that’s cool. Someone else also asked about the vertigo and dizziness Yeah, low potassium can cause that vertigo and dizziness kind of feeling. So we kind of gave the general recommendation of 45 to 4700 milligrams of what you need per day on the potassium side. Most people aren’t hitting it, you’re getting six to eight servings of green vegetables, a high quality serving a good fish and some potassium and maybe I’m sorry, potassium from a full avocado or a green drink or some extra say starch, squash or sweet potato or white potato, you’re gonna be there at about 45 to 4700 milligrams. Most people may need more if they’re sweating, or if they’re under a lot of adrenal stress. So you may want to think about supplementing, if you’re still doing a great job on your food and you’re not there. You may want to fill in the gap, or you may want to just try it out. Add in a couple more of these nutrient dense foods that Evan and I just hit, and see if that fixes the issue. So, a lot of times people have these low potassium symptoms and they see it go away the BR and all I see is you’re going to see a lot of heart stuff, and a lot of muscle cramping stuff, those are going to be big things. So if you see the heart start to get better or the cramping get better. That’s an easy sign that you’re on the right track.

Evan Brand: What do you think, Kevin? Well, I think this is fun, and it’s something that can’t be ignored. So please address this, work on this, tweak it and see how you feel, I definitely feel better. I feel in a better mood. I feel more energetic when I’m staying regular with getting enough electrolytes as a whole. So I think he could be a game changer. And we can run some of these analyses on your body. You and I kind of talked before we hit record about how the blood really doesn’t change much. So looking at serum potassium may not be the best. So there are some other panels that we can look at, but as a whole, when we’re looking at organic acids testing and stool testing and we’re looking at gut infections a lot of times We can infer just based on observation symptoms, and what else is going on that you probably got a new issue. So the good news is, you can fix this, it’s relatively cheap to free to fix it outside of just tweaking the diet a bit at the grocery or farmers markets, but you can make it happen and make a big difference.

Dr. Justin Marchegiani: Exactly. Now, someone else chimed in about the evolution drinks and the plastic. I’m not too worried about the plastic with these, these are all cold pressed. Alright, so they’re cold pressed so that the juice that’s put in here is cold and these are refrigerated right away. So you’re gonna have leaching of plastics more when it hits UV light and or higher heat. So not now not that concerned about plastic plus, these things have a short shelf life. So it’s not like the the juice is sitting in there for like a year. It’s just sitting in there a very short amount of time it’s not being exposed to UV light or high temperatures going to being refrigerated, right. So you got to keep all that in mind. So I think if someone’s worried about the plastic, I think the extra extra nutrients that’s in there, it overlays any risk from the planet. Plus you’re not getting the heat you’re not getting warm substances and you’re not getting the UV light so I think the plastic is isn’t as big of a deal versus like a dishonor water that sits in there for a year or two and who knows if it’s going to be exposed to light when it sits out back the the the convenience store or the supermarket thought- 

Evan Brand: That’s what I’m thinking when you go to the gas station. You see the guy taking a smoke break you got the palette of dishonor water sitting there getting blasted by the sun on 100 degree day and then he goes and puts the water in the shelf at the gas station. So yeah, I think you got to choose your battles, right so I mean, the other argument would be well, if you were too busy this morning, you’re working with the kids you got to jump on here with me you got to go into clinic after this. You might not have got that green juice and you would have had zero minerals and zero potassium and zero greens because you didn’t know plastic because you would have tried to go for a blender instead. So you know.

Dr. Justin Marchegiani:  Exactly plus the higher quality grocery stores like Whole Foods for instance, they got a big dock the truck just goes right up to its full containment and some of the stores refrigerating it. If you’re going to a gas station and you’re kind of limited, some gas stations have the Pellegrino so you could always go by glass at the gas station. That’s probably a safer way but I’m not necessarily worried about the plastic with that but in general, a lot of sulfur in here anyway which will help you to toxify any lingering estrogen. So if you have the option I think it’s worth it.

Evan Brand: All right, well, let’s wrap this thing up. I think we covered a lot if you want to reach out clinically, Dr. Jay and I we work around the world with people we’re very grateful we’re very blessed for the opportunity to help you guys so thank you so much for not only commenting on these live videos, but of course just being there clinically because you help us learn we learned so much from working with people one on one way more than you learn in any book or any study is seeing how do people feel Hey, when you recommended this or that my energy went up 20% we love stuff like that it’s addicting for us. So we’re very very grateful and if you do want to reach out clinically, please check out Dr. Justin at Justin Health. JustinHealth.com and me, Evan brand at EvanBrand.com and we’ll be back next week to talk more. 

Dr. Justin Marchegiani: Excellent chatting with you guys. And if you enjoyed the content put your comments down below really want to know what you guys think. And if you have any future podcast recommendation topics we’d love to see it as well and sharing is caring. Get this to your families and friends and people that can use this information to help take control of their health. Alright guys, enjoy the fabulous holiday weekend. Take care y’all. See you later. Bye

Evan Brand: Bye.



Audio Podcast:


Hashimotos Root Cause Solutions With Inna Topiler | Podcast #237

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

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

Inna Topiler – MS, CNS

In this episode, we cover: 

0:50 Eczema patient, oxalate issues

05:31 Moderate or high oxalate foods

10:19 Inflammation bucket

14:57 Hashimotos Symptoms

30:41 Solutions


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

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

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

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

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

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

Inna Topiler: Exactly.

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

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

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

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

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

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

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

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

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

Inna Topiler: It is.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Inna Topiler: It’s 100%.

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

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

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

Inna Topiler: Mhmm. Definitely, definitely.

Dr. Justin Marchegiani: And its always a surprise.

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

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

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

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

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

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

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

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

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

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

Inna Topiler: Those are great numbers!

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

Inna Topiler: Thanks for sharing.

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

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

Dr. Justin Marchegiani: All is your T3 free.

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Woah! Holy smokes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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





Audio Podcast:


The Leaky Gut and Hashimoto’s Connection

Most bacteria in foods that slips through is a big stressor that can wind up the immune system and start attacking the thyroid gland. If one wants to get to the root cause and get the immune system boosted, start where it is mostly found, at the gut.

Today’s talk focuses on the root causes of leaky gut and its connection to Hashimoto’s. Listen as Dr. Justin Marchegiani explains the underlying mechanisms, how most thyroid issues and the underlying root cause are autoimmune in nature, and how the gut can affect the immune system. Stay tuned for more!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

00:27    Hashimoto’s

01:49    T3-Deficient Thyroid Hormones

03:58    The Immune System

05:29    Steps to Help Address Autoimmune Attack

Dr. Justin Marchegiani: Hey guys this is Dr. Justin Marchegiani here. Today’s video is gonna be on leaky gut and Hashimoto’s, autoimmune thyroid issues. We’re gonna dive in to the underlying mechanism, we’re gonna talk about how most thyroid issues and the underlying root cause are actually autoimmune in nature, and we’ll talk about how the gut can affect your immune system. So, let’s dive in. Before we do that, give me a thumbs up, hit the bell so you can get notifications of future videos and our awesome live Q&A videos too.

Alright, so, off the bat, we have Hashimoto’s which is an autoimmune condition that affects the thyroid gland. That’s essentially when we have antibodies that are attacking our thyroid tissue. We have TPO antibodies that may attack the inter-cellular enzymes in the thyroid gland, we may have thyroglobulin antibodies that are attacking outer surface proteins of the thyroid. And over time, that gland is gonna be stabbed and attacked by all these B cell infiltration, these are parts of the immune system that are coming in and attacking, and that thyroid can spill out, spew out thyroid hormone which can make us feel even hyper, uhm off the bat ’cause hormone comes out, it gushes out, but then over time, that hormone can be depleted because your thyroid follicle can only hold about maybe 3 months or so of thyroid hormones. So, over time that autoimmune attack can really deplete that thyroid, and of course the inflammation in this tissue can affect how thyroid hormones interact at the receptor site level. Every single cell your body has, a receptor site for thyroid hormone, so the more inflammation we have that can affect how s- a receptor sites and the hormone interact with all these inflammation and antibodies, and of course, as we attack that thyroid gland, we’re gonna lose functional tissue, functional aspects of the thyroid gland that are actually producing thyroid hormone. So, over time, we may need to actually be on a thyroid hormone replacement.

And again, a lot of people may not do well with the conventional thyroid hormone partly ’cause of the fact that it’s missing T3 a lot of times; it’s a synthetic T4. A lot of times there can be additives in there, gluten-like cross-reactive molecules or compounds that can exacerbate the immune system. And a lot of times these compounds, they just have T4 so you’re not really having the full T4, T3, and then even the other metabolically active components called T2, T1 and T0. So, when you give T4, there’s an assumption that it’s gonna go downstream to T3, and that may not happen. Again, check out my Thyroid Reset Summit at thyroidresetsummit.com. I interviewed 30 amazing experts and we go into a lot of these things. But, there’s an assumption that T4 goes to T3 and I test patients, I tested thousands over my career, where I would say about 80% don’t make that conversion optimally. So they do better with a natural thyroid glandular, some even may need T3. But, we need that T4 to T3 conversion, we need to add in that full spectrum of glandular that actually has the T3, and we may even wanna add in additional nutrients that are gonna help with that conversion and activation. Zinc, magnesium, selenium is really important, the major enzymes that’s cleaving the iodine molecules off the thyroxine that which is what thyroid hormone is. T4, thyroxine, 4 molecules of iodine, and we pull one of those molecules off that and becomes T3. That deiod- deiodination, pulling off that iodine is a selenium-based enzymes. So we need healthy levels of selenium to be able to make that conversion happen. Uhm, also, other nutrients are really important like I mentioned, zinc, magnesium. CoQ10 is really important for the autoimmune attack, uhm, so is magnesium, so is selenium, so is copper, so is vitamin A, really important. Glutathione is also really big and important too because glutathione comes from the liver, and when there’s liver stress, there tends to also be glutathione stress as well. So we have to address it from all angles. Liver, gut, right? And the gut is so important because that’s where most of the immune system is.

So, we come back to the title of the video which was “Leaky Gut and Hashimoto’s”. Well, most of your immune systems’ in the gut, in the GALT, the Gastric-Associated Lymphoid Tissue, the Mucosal Associated Lymphoid Tissue. And when that gut’s leaky, we’re gonna be activating and calling on our immune system to calm and be more active. And, essentially foods and bacteria that are slipping through, our immune system will be reacting to those and attacking those. And that can be a big stressor on our immune system, and they can wind up our immune system so it can start attacking the thyroid gland as well. So, we have to get to the root cause of the leaky gut which could be food-based, it could be in a combination of poor digestive compounds, poor digestive enzymes, HCL, bile salts, infections could be at play. We know, infections wind up the immune system, infections like H-Pylori, blasto, or lyme, borrelia burgdorferi, uh, yersinia enterocolitica, these infections can and make the gut more leaky, wind up the immune response and can exacerbate the autoimmune attack on the thyroid. So, get to the gut, get to the nutrients. Selenium’s really important ’cause it calms down the immune system and lessens the immune attack in the thyroid. There’s a lot of studies showing that selenium can help reduce thyroid antibodies, so can CoQ10 as well. So, things that are anti-inflammatory, curcumin, resveratrol, they can calm down some of the immune response and they can help lessen that autoimmune attack. You also have to get to the root cause of the gut underlying issues.

So, number 1, understand the ideology. Number 2, if you need thyroid hormone replacements, we may have to come in there but you need to see a good functional medicine doc that can look at it. Number 3, support the nutrients that thyroid needs to make the thyroid hormone, right? Thyroxine, be careful with iodine, that can exacerbate autoimmune attack, vitamin A, zinc, CoQ10, magnesium, right, really important. Little bit of copper, a good healthy paleo template, work on the liver, work on the adrenals which help with that thyroid conversion, get to the underlying cause of why that gut is leaky. 50 to 98% of thyroid issues are autoimmune in nature. So, you really wanna make sure you’re getting to the root- underlying cause of why it’s there.

So, head over to thyroidresetsummit.com. You wanna click in deeper with myself and my colleagues that work on these situations. Click below, schedule a consult with myself and we can dive in deeper. Hope this information was very helpful, hit the bell and subscribe, appreciate it, leave all comments below. I wanna know what you think, and I wanna engage in a deeper conversation with you on this topic.

Alright, thanks a lot, have an awesome day! Bye now.





Thyroid Reset Summit | Podcast #218

Thyroid Reset Summit is here! It is Dr. J’s compilation of expert interviews and advances talks on the topic of thyroid health. Don’t wait, don’t suffer, support your thyroid now!

In today’s podcast, Dr. Justin Marchegiani and Evan Brand engage in talk that covers the compelling topics around areas of thyroid health like autoimmune thyroid, gut infections, trauma and stress and how that affects thyroid and hormones. Listen as they discuss live interactive podcast with viewers and gain insights about the issues involved in thyroid and ways that go to the root cause to address them. Stay tuned for more!

Dr. Justin Marchegiani

In this episode, we cover:

03:00    Trauma

06:41    Reverse T-3

14:19    Maca and Hypothyroidism

19:55    Molecular Mimicry

26:28    Iodine and Iodide

28:03    Low Dose Naltrexone (LDN) and Hashimoto’s

30:38    Desiccated Thyroid

32:01    Natural Thyroid Glandular

37:37    Nascent Iodine

40:38    Oxalates and Hashimoto’s

44:09    Thyroid Replete or Balance

46:50    Candida Overgrowth and Kale Intolerance


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Guess what’s up, the Thyroid Reset Summit is live today. So, make sure you click below, there’ll be links where you can access the summit, make sure you register. I’m giving up my full, free 88-page eBook, it’s the first 3 chapters in my 12-chapter book, it’s gonna be amazing. I’m here with Evan Brand as well. Evan’s a- was a phenomenal interviews as well. So, make sure you subscribe to go access Evan’s interview. There’s gonna be links below where you guys can access it all, I appreciate it. Evan, welcome today’s chat, I’m excited that thyroid summit is here.

Evan Brand: Yeah, I’m excited too. Your talk is today. So, if people wanna hear me interviewing you, that’s a day 1 of the summit. So, your pretty face is on there, and you great- you gave a stellar interview, and there’s already tons of good comments, we were just reviewing that together, there’s tons of good comments and feedback coming in already on the summit and we’re still in like, you know, day 1. So, this is like the open house so to speak, of the summit. If people, you know, have been living under a rock, or they just don’t know how summits work. Basically, what it is, is Justin put together 30+ expert interviews. These are anywhere between 30 and 45 minutes in length, and they’re all on the topic of thyroid health. So we- he’s gonna get in to anything from autoimmune thyroid to gut infections and thyroid, to mitochondria and thyroid, to chemical toxins to trauma, and stress and how that affects thyroid and hormones. So, each different expert has their own unique view, and he make sure to extract as much information as he can, it’s all free. You just register free. So, thyroidresetsummit.com, you go there, you register free, put your name, your email in, you can access it as long as you get on your computer or your phone, on the day of the talk, you can access about 5 talks for free every day for a week. And then after a week, depending on what your all’s feedback is, they’ll probably do an on-core, you get one last chance to view him for free, and then, what I recommend you do, is you buy the summit, it supports Justin, it supports the mission, it gets his information out to the masses because your average doctor is not having the type of conversations that Justin is having on this summit. These are conversations that are very advanced. And something that’s still broken down, simply free to understand, but in terms of timeline here, it could be another 10 years before mainstream doctors are even addressing the stuff that’s being discussed now. So, don’t wait, don’t suffer. Buy the talks, it ends up being like 50 bucks or something. That’s ridiculous how cheap it is, and you could own all 30 talks, you’ll get transcripts, etc. Is Justin paying me to promote this thing? No, he’s not, it’s just freaking awesome and I’ve already read the book. And, the book is amazing, and the summit is amazing. So, please buy it and support him so he can keep buying grass-fed stakes so- he’d to stay healthy so that he can do a podcast with me.

Dr. Justin Marchegiani: I appreciate that Evan, thanks so much. So, I just, you know, being a thyroid expert and also being a part of the summit yourself, what are some of the topics that you feel like were most compelling for you in and around the area of thyroid? I have a couple in my mind but, what reason they would give the most?

Evan Brand: Oh, man. Well, I would say the ones on trauma. Uh, you’ve got ___[03:03] on there, which is just incredible, because, I think trauma is something that, well, we already know this, uh- a- as Americans, we repress our emotions, we repress our traumas, we try to just move on, we ignore traumas, we throw ’em under the carpet and we just don’t wanna talk about this stuff, but what you and Nicky discussed was amazing which is the fact that, depending on how your childhood uh, was. You talked about the ACE score, the Adverse-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -Childhood Experiences score-

Dr. Justin Marchegiani: Yup.

Evan Brand: -and how- what you all are seeing. And I’m seeing the same thing too, is that, the higher the ACE score, the more likely it is that you’re gonna have a problem, and it could be a thyroid, and/or an autoimmune thyroid problem, all linked back to something 20 years ago. And so, you all had a great discussion about, well, how do you start working on these things that happen to you? It’s not to say, “Hey, we need to go back to counseling, and, you know, go take the guy into counseling with you, who beat you up 20 years ago, it’s not that, it’s no, there’s ways you can clear these traumas from your body, and a lot of it is free. So, I think that’s probably the most powerful starting place.

Dr. Justin Marchegiani: Yeah, and also a lot of these traumas too, they affect the HPA access. And, some people that they may have addressed the issue but, they’re kinda dealing with the collateral damage, whether it’s adrenal issues or gut issues, and- and/or compromising the immune system, maybe even infections just from all that stress, or maybe even they developed an ___[04:23] disorder which is created all kinds of adrenal and blood sugar and nutrient deficiencies. So, we gotta look at everything from the root cause. Okay, is the root cause addressed, okay good, and now, we gotta also do damage control as well. But, while fixing everything in a ___[04:37] root cause kind of, manner using nutrients and- and sport.

Evan Brand: Yeah, now, I will say, if you just focus on traumas and nothing else, and let’s say you start doing the EFT, the Emotional Freedom Technique which is the tapping that you and I both love. I love tapping. I’m gonna start tapping-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m [crosstalk]… uh, so, when you start tapping, this is basically like acupuncture without the needles, so you’re helping to basically recalibrate your nervous system, so you’re not stuck in fight or flight. And I’ll do this, like if  I going stage or if I’m gonna go on an airplane, I’ll just tap, tap, tap, tap it out, and I just feel really good from it. And, there’s practitioners, this is such a powerful tool. There are practitioners that’s all they do, is tapping. Now, you and I, we both agree that tapping by itself is probably gonna be pretty limited, it’s not gonna be fixing root causes, but can they help reset the nervous system, which could therefore improve your thyroid health and potentially lower your thyroid antibodies? I would say, absolutely.

Dr. Justin Marchegiani: Yeah, I mean, if you have significant unresolved traumas, especially in the area of sexual abuse, or just issues growing up. Uhm, even disorder stuff, control issues or any kind of abuse. I think it’s really important especially if- if I’m talking with a patient and, “Have you really fully adro- uh, you know, resolve that?”, “Can you go back and think about it, and talk about it, this is not really bring your emotion up let’s say, pass a 3 out of 10”. And if they can’t answer that, or you start to hear them sob on the phone, or on- on the video, and that tells me we gotta work on that. So, it really just depends on how much they’ve done to resolve and to move past that. Uhm, but, if- if they haven’t done- I have people that I refer out to, they had- they really dive in with that work for sure.

Evan Brand: Yup.

Dr. Justin Marchegiani: [Crosstalk]…that activates the sympathetic fight or flight kind of nervous system response and, if that keeps going, that can just be a drain on your adrenals. And we know how important a cortisol is to inflammation, and if we have thyroid issues and autoimmune thyroid, and we don’t have enough healthy levels of cortisol to- to deal with that stress, or if our cortisol levels had been depleted, uhm, the HPA access dysregulation that- that brain talking to the adrenals, that feedback loop is disrupted, that can definitely creates some major challenges for sure.

Evan Brand: Yeah. So, we should talk about reversed T-3. We actually had a question here from the Doc J.C., uh said, “Please go over the significance of reversed T-3. What range do you feel as optimal? It seems to be frequently ignored or not seems to be so significant. Thanks, looking forward to the summit”.

Dr. Justin Marchegiani: Yeah, I hundred percent agree. Now, think of reversed T-3 as like metabolic blades for our metabolic uh, magazine, or gun- gun cartridge so to speak, right? We put all the bullets in it, uhm, the metabolic blades, they take up space where an actual metabolic bullet would be, we fire the gun, we get the noise but we have no bullet coming out. Basically, these reversed T-3 compounds, they’re blocking the receptor sites; every single cell in the body has receptor sites for thyroid hormone. So, when we had excess, reversed T-3, it’s gonna clog up that receptor site for T-3, and it’s gonna decrease the ability for that T-3 to fill up the receptor sites. Also, you had T-4. Let’s say you have 80%- let’s say you have a higher percent of T-4 convert to reversed T-3 over T-3, it’s also robbing the ability for that T-3 to- to be fully expressed. So, imagine we have, let’s just say, let’s just say we have 10 units of T-4, alright? Just hypothetical numbers here. And let’s say we’ll typically converting 80% to T- to T-3, and 20% to reversed T-3, there’s naturally gonna be some reversed T-3 levels. Let’s say, anywhere between the low 10’s to the upper 10’s, right? Then you know that’s a good level, alright? That’s the actual lab reference range. In my analogy, let’s say we have 20% goin’ reversed T-3, 80% go into T-3, our actual metabolic active thyroid hormone. Well, typically, when stress starts to happen, low calorie diets, more stress, adrenal issues, inadequate levels of selenium, we may start to see a 70-30, a 60-40 split, where more of that building block is going to reversed T-3, less going to actual T-3. So, we’re having less T-3 but we’re also having the congestion of the receptor sites. So, that T-3 that’s now there, the lesser T-3 it’s there, it’s not able to dock in to that receptor site, the locking key methods not able to go in because someone put gum in the keyholes, so to speak.

Evan Brand: Yeah, great analogy. So, let’s take it a step further. So, what happens then? ‘Cause you and I , we’ve tracked my blood for several years, little that I know, I was living with mold, and that mold was messing up my thyroid, that was part of the problem, I had elevated reverse T-3, and you and I been looked at and we’ve been like, “Okay, let’s look at gut”, “Okay, stool test is clean, let’s look at adrenals, okay, adrenals look decent. Well, where the heck was this reversed T-3 be coming from?”. I’ve- in my opinion, I believe it was all the stress that my immune system was dealing with because I had elevated white blood cell count, at the same time as I had elevated reverse T-3. So, it’s not that it changed my game plan of my protocol at all, it was really just an indicator of “Okay, so here’s why I probably have cold hands, cold feet, my body temperature was running like a 97.7. Unless you tell me I’m wrong, I think that was all related to that reversed T-3 being so high. I was in the 30’s.

Dr. Justin Marchegiani: Yup. Yup, it could’ve been. And we also know, you know, if you have a- a liver stress, right? Livers’ really important because it make enzymes that are gonna help activate thyroid hormone, and it also helps to clear reverse T-3. So, make sense over stress, glutathione form toxins in the environment that can affect our ability to clear it as well.

Evan Brand: Yeah, I think I was like 35, uh, on my [crosstalk]

Dr. Justin Marchegiani: And again, how- you know, we can see low calorie diets, increased reverse T-3, that’s why- that’s why in the long run, cutting calories to lose weight doesn’t work ’cause it just slows down your thyroid. So, then when you come back to reality and you actually are eating a normal amount of food, now, your metabolism slower, so now you end up storing more fat on the buckets.

Evan Brand: You wanna know something crazy related to hormones and-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -gaining weight and all that? So, something that I learned the past few weeks, is that mycotoxins can actually bind to your leptin receptor. And this is why some people have gained weight on like 800 to a thousand calories is ’cause the mycotoxins are preventing leptin signaling from working properly.

Dr. Justin Marchegiani: Yeah, I know. I had a conversation with Dave Asprey a couple of years ago. There’s a compound called the Zearalenone. It’s- it’s a mold kind of herpes that actually put into the ears of these cows. And the Zearalenone literally causes the cows to convert more of their calories to fat.

Evan Brand: Oh my gosh.

Dr. Justin Marchegiani: That’s what it does. So, they would use some of these connection-

Evan Brand: And that’s a mycotoxin?

Dr. Justin Marchegiani: That’s a mycotoxin, they put it in their- in the cow’s ear, be the- like a little pellet-

Evan Brand: Oh.

Dr. Justin Marchegiani: -and they re-absorb it through the ear canal. And this is, you know, first hand from Dave Asprey. And it will cause more fat gain, so it would allow them to convert more calories to fat which, you know, bottom line, more weight on scale, so, more- uh, more cost per cow, so to speak, ’cause it’s all weight-driven. So, yeah, mold and mycotoxins are- are a big one, alright? And we’ll do another podcast on that-

Evan Brand: I did another interview- if I did another interview on your summit, my whole talk would be about thyroid and mold because I’ve had tons of hypothyroid symptoms. Now, I still have 6 pack abs, I’m still ripped, uh but I had like cold body temperature, cold hands, cold feet and all that related to mold. So, if I did an “Evan on Justin’s Summit Part 2” it would be all about mold and how I think so many people with thyroid problems probably have mold in their house that’s helping to destroy their immune system and cranking up reversed T-3, elevating liver enzymes, reducing detoxification, and the body’s got to try to focus on mold, and then they can’t focus on other stuffs-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -so then chemical toxins get built up, it seems like a huge like lynchpin.

Dr. Justin Marchegiani: Yeah, I- and the only thing I would add is do all the- the natural- do all the things first and leave that to the end-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -because, you did it that way too. And then we saw there was an issue and then we dealt with it on the back end, uhm, my biggest concern is mold and things like that can be- can be more in the expensive side, and it can be a rat hole for some people, meaning, if they do the foundational things first, they may get some significant relief upfront, and it won’t be as cost- it won’t be as costly as dealing with the- the mold in the back end. But, some people-

Evan Brand: It won’t be as overwhelming.

Dr. Justin Marchegiani: Yeah. And the only exception being, hey there’s active leak, you got water stains on your ceiling, uhm, you know, there’s- there’s an act- you can actually actively visualize mold or water leaking, then I would say that it has to be dealt with right away. [crosstalk].

Evan Brand: I’ve- I’ve probably stayed afloat a lot longer than I did before I developed a lot of major symptoms because I had all the foundations in order-

Dr. Justin Marchegiani: Yes.

Evan Brand: And so that’s- that’s why the summit is gonna be key- it’s not to- it’s not designed to replace a consultation with Justin if you have thyroid problems, you still need to consult with Justin, for sure, but this is more designed for you to get the information you need for you to get the questions answered that you have in your head. And once you have all those questions answered, you’re gonna learn more about types of thyroid lab testing that you need to run reversed T-3 being one of those markers. These are things you can bring up to your endocrinologist or your GP and tell them, “Hey, I heard on this summit, this guy Dr. Justin talked about “XYZ”, can you do that for me?”. And we’ve had clients report back to us and say, “Hey…”, you know, “…thanks to you, or thanks to your podcast, I was able to get this and this, and this run on my blood work, and my doctor only ran it because I asked them to”. So if you just go with the status quo, you’re probably not gonna get the result you’re looking for from the mainstream. Now, if you find a really good endocrinologist or a doc that’s gonna listen and run these extra important thyroid markers that are not generally run, you may be able to make them work, or you gotta go to the functional side. My opinion, I’m gonna say go to the functional side, ’cause your endocrinologist is never gonna look at the stuff Justin’s looking at and saying, “Hey, you know, these bacterial infections do this; this parasite does this”, it’s the last thing you’re gonna hear from them. They’re gonna say, “Oh, you can go to an infectious disease doctor, you think you have parasites?” And then they’ll just refer you out and you’ll go nowhere. That’s why we’re kinda generalist and specialist on the same token.

Dr. Justin Marchegiani: Exactly, that’s really good point. Let’s kinda dive in to the next question here, let me pull it up. Uhm… let’s talk about Maca. Maca and hypothyroidism. So, number 1, if we see- Maca’s gonna be really good especially for women. Uhm, there are some good Maca forms for men too but it’s gonna really help modulate estrogen levels that can even help with progesterone levels. So, why is this helpful? If we have estrogen dominance, that can definitely increase thyroid binding globulin and decrease the amount of free thyroid hormone. So, it can definitely lower our free thyroid hormones. So, if we modulate our female hormones and improve that balance in that estrogen and progesterone ratio that can definitely improve the amount of biologically active thyroid hormone. Also, for in a, estrogen dominant state, we need good levels of progesterone. And progesterone help stimulate thyroid peroxidase and make thyroid hormones. So, good enzyme activity from TPO is important, and that can help make thyroid hormone. So, good levels of progesterone help with that as well.

Evan Brand: Can you talk a little bit about age? I mean, this is something that you ask your average women, aged 15 above, they’re gonna say, “Oh, my thyroid”, or “Oh, my hormones”. Can you talk about kind of what happens when you’re transitioning from a normal cycling female to you go into perimenopause- menopause ___[15:33] when you go to those stages. And ___[15:36] to say, “Oh, oh it’s my hormones”.

Dr. Justin Marchegiani: Yeah. Yeah. So, in general, typically, women may start their perimenopausal phase in their early 40’s. This is where like a lot of these menopausal symptoms start to happen. Whether it’s skipping a cycle, mild hot flashes, mild hair loss, mood issues. And again, it’s- it’s- it can be- it’s hard to distinguish perimenopause and just PMS and cy- and cyclical hormone imbalances. Especially where I see a lot of these symptoms happening with women in their 20 and 30’s, it’s hard to distinguish, but you’re typically seeing some of these menopausal symptoms, they may happen throughout the month, where the premenstrual symptom that are just tend- tending to happen a week, maybe a couple days, sometimes 2 weeks before period. So, you- you gotta look at it and distinguish. Typically, what’s happening is you’re having a decreased ovarian reserve and then the estrogen and the progesterone are starting to drop. And sometimes you see estrogen drop a little bit slower than progesterone, so then you still have low hormones, yet still have estrogen dominance. And again, perimenopause is done once you’ve had cycle for one year. So you have that kind of in between phase and lower adrenal functions in a predisposed at because your adrenals are making a lot of precursor hormone that’s gonna provide building blocks for your sex hormones. So, lower adrenal function, cortisol stress, HPA access stress, that communication from the brain to the adrenals, when that’s dysregulated, you’re draining that backup ge- battery generator to help make more of the hormones. So, when that follicle starts to drop, then the adrenals gonna help pick up the slack.

Evan Brand: So, would you say all women post-menopausal should be on some type of adaptogenic herb hormone support, and can that replace or remove the need for like bioidenticals?

Dr. Justin Marchegiani: It depends how strong their hormones are, uh, it depends how strong their adrenal glands are already.

Evan Brand: Okay.

Dr. Justin Marchegiani: Number 1. And number 2, it depends on how severe their symptoms are.

Evan Brand: Okay.

Dr. Justin Marchegiani: So, we’ll use specific phenotypes of Maca for perimenopausal women or menopausal women, that can help, some do need adrenal support obviously than some may need some of the bioidentical progesterone, estrogen support, it just depends on their severity of symptoms, how long it’s been going on for, and how their hormones look, adrenal wise, female wise and thyroid. And this is where it stop because hair loss, it’s a thyroid symptom but also lower female hormones can cause it too. So, so can like cool their temperature when waking, that could be a thyroid issue, it could be a female hormone issue. This is why testing is so important. It really allows you to like, walk into the situation clinically, feeling like you’re on top of what’s going on.

Evan Brand: Yup, well said. And- and, I wonder, does that change much? If a woman’s had like a partial or a full hysterectomy, or maybe she’s got her ovaries gone, the uterus is gone, is that like, hey, there’s no way adaptogenic adrenal support’s gonna help you?

Dr. Justin Marchegiani: Well, soon as they go- as soon as they have a uhm- a full hysterectomy where the ovaries are gone, they’re menopausal right away, right? So, they’re automatically in menopause. If it’s a partial hysterectomy where the uterus is gone, typically that’s happening from maybe a fibroid, maybe some endometriosis. Uh, a lot of times it’s done in- in haste because there’s excessive bleeding or he- hemorrhagia, and the doctor’s like, let’s just pull it out which is crazy like, let’s fix the hormones, let’s fix the underlying issue, a lot of times you can keep your uterus. Now, there’s some literature, you know, if you look at some of the endocrinology techs, there’s some people saying that, “Hey…”, you know, “…your uterus maybe producing some level of hormone. So, it’s possible that you keep your ovaries, you get your uterus removed, but you- there’s still maybe some hormone stuff that happens, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s kinda like with guys and they get a vasectomy, there are some research showing it, you can still have a drop-in testosterone after vasectomy. What happened? You didn’t touch the testicles, right? But when you mess around with that anatomy there’s probably some feedback loops that are disrupted, there’s probably some hormonal secretion that’s happening from that tissue that were not quite, you know, fully aware of. So, that’s why when in doubt, always try to keep the tissue in place-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -if you can.

Evan Brand: It’s crazy. I mean, for to think, oh, it has no purpose when you’re aged 60 just ’cause you’re not menstruating, those organs have no purpose. That’s- that’s bizarre. Yeah, I mean, if you have no purpose anymore, it would come out just like a placenta comes out after a woman delivers a baby. That organ is there, and then that organ is not needed anymore, and the mom pushes the placenta out and then you’re done. You don’t push out the uterus. So, it- it needs to be there.

Dr. Justin Marchegiani: Exactly. It definitely needs to be there for sure. So, uhm, on that road, I think we answered that question.

Evan Brand: I’ve got another question for you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Okay. So, we got one here, “Can you discuss molecular mimicry?”.

Dr. Justin Marchegiani: Yeah, so, diff- i- in general, we have surface proteins on foods, especially gluten and casein, and these surface proteins, they get tagged by our immune system. And there are other surface proteins on tissue in the body like the thyroid that can look similar. So, imagine you have someone who just did a- a crime, and they’re driving a black Honda Civic. Well, Honda Civics are pretty popular car. Please come on the AP- you know, on the radio, APB, you know, be careful and just person, and the authorities driving a black Honda Civic. They’re driving the Honda Civic, you get pulled over. Why? Because you have a similar identification that was called on the APB there. So, what does that mean? Its surface proteins can be similar, and so of course, when that APB is called up by your immune system, A.K.A, the immune system makes antibodies to target these surface protein, and other tissues have a similar surface protein like the thyroid, then that can, uh, your immune system can attack it. And that’s why you’re see- that’s why gluten is such a big deal. Also, gluten also opens the gut lining. And when the gut lining’s more open and we have gut permeability or leaky gut kind of the slang, there’s more chance of your immune system to get in contact with undigested foods and create more antibodies for more stuff. So, leaky gut’s a big thing and, there’s a lot of data saying, “Hey, even if you’re not reacting to the gluten, gluten may still be opening up that gut lining, creating more gut permeability”.

Evan Brand: Well, here’s one other thing to take it even further on the anti-gluten train, which is the fact that people say, “Oh, I’m not sensitive to gluten, I don’t have any rashes, I don’t have any headaches, I don’t notice joint pain after gluten. It doesn’t matter, we’ve seen, and many, many, many pieces of literature, just google “Non celiac gluten sensitivity” and you could read about it for yourself. Even if a person that says, “I noticed…” quote, “nothing”, from eating gluten. We still notice that the secretory IgA gets lower, that gut barrier gets broken open, you get leaky gut. There’s no like, “I’m a tuff guy, I grew up in Wisconsin, grew in corn and I eat corn and gluten and I love it”, no, it doesn’t matter. You’re gonna have a leaky gut no matter if you noticed anything or not and, why is that important for thyroid health, wll, ’cause once a gut’s leaky, now, let’s say you get bacteria and parasites and toxins from the food supply, you breath in some guy’s diesel truck in front of you on the highway, those toxins have direct access to the bloodstream. And we know that when the gut is leaky, the blood brain barrier is also gonna be leaky, and then you’re getting toxins into the brain. So, you go and need some tuna fish on your night out and sushi, and that mercury can go into your brain now because your gut was leaky and they had access. So, you know, I kinda have like a zero tolerance, you know, policy. I like how, uh Rodney Ford, he was a gastro doc I had on a podcast-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -like, 7 years ago or some crazy, as if one of the first steps which I did. He said, I don’t like to term gluten-free, he said I like to term gluten-zero, because gluten-free sounds- you- you know, just like it’s toys or like, it’s- it’s a rec- it’s a recommendation. But he said, the idea of gluten-zero, is much more direct and blunt. It’s like, “no”, you don’t want any. Because even we’ve seen we- you and I, we test the antibodies, we look at anti gliadin IgA on the stool test, and what we see is that, even up to 3 months, 4 months after somebody’s had gluten, you know, here we are in early March, at the time of this recording, someone could had a bunch of cookies at Christmas and we could still see 3 months later, the antibodies elevated because of that.

Dr. Justin Marchegiani: Yeah, so, I mean, I’m pretty puritanical when it comes to gluten. I will- I met- I do have a cinnamon bun last night but it was gluten free, and I typically never cheat, I ended up getting within 30 minutes after the sore throat, and it’s lingering right now. I’m doing some-

Evan Brand: No way.

Dr. Justin Marchegiani: -essential oil lozenges to help- help [crosstalk].

Evan Brand: Rice flour, what was it that did that to you?

Dr. Justin Marchegiani: It was rice flo- it was rice flour, and it could have been just the carbs, it was pretty carb-heavy. But, you know, it just makes me think like, there’s one more sin in the fridge, am I gonna have it tonight? Hell no, you know?

Evan Brand: [Laughs]

Dr. Justin Marchegiani: I’ll- for my cheat, I’ll do my ___[23:49] chips and some fresh homemade guacamole instead for my little kraut treat. But yeah, e- even that, I still had the decision, you know, should I stop at dunkin doughnuts and get like the awesome cinnamon bun that I have memories of 20 years ago, when I used to eat lots good food but, now, I at least chose the healthier option, but still, I kind recalibrate and say it still not worth it. So, try to find the healthier option if you want a spurge. If you’re autoimmune condition’s under control and you don’t have an autoimmune condition, maybe you spurge every now and then on the holidays. My recommendation though is, you find a healthier option, and if you have thyroid antibodies, you definitely need to. I have thyroid antibodies, so you really gotta make sure that you’re on the right track. There’s a lot of healthy options these days. It’s crazy, I mean, I had some- some I think it was uh, Danielle Walkers got a new pizza that’s like, a yuca based pizza, and it’s freakin’ awesome. It’s really good, and the crust is great. It’s a little carb heavy, so I save it for my carb night, but uhm, it’s a great pizza.

Evan Brand: Wow, she makes it?

Dr. Justin Marchegiani: Yeah, it’s in the whole food section now, it’s frozen. But it’s a yuca based crust.

Evan Brand: And is it already, uh, it’s just a crust and you gotta put all your own toppings? Or-

Dr. Justin Marchegiani: No, it’s got everything on it already. But she’s got some I think where you can buy without the toppings. But I just love yuca for crust ’cause yucas just like- it’s a soft, it’s really uhm, moist too.

Evan Brand: I’ll have to look for it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I- I wanna point out what you said. I think it’s very important which is that, you may go off your diet for a bit and play with this food and play with that food is kind of a treat, but like you said, it’s not worth it. And, you know, people think when we come up with a diet protocol for ’em, then it’s like a diet of depravation. But overall, I would say you and I are not deprived at all. We’re eating good fats, good meats, good veggies, I mean, this is not a deprivation or starvation diet required.

Dr. Justin Marchegiani: No, I mean, last night for dinner, I had a dry aged Kansas City strip steak, step 4 from wholefoods. And, I had it last night with some green beans and grass-fed butter and some sea salt, and it was phenomenal. So, I should have eat really good like that, like, keep it simple, you know. The night before that, we threw some stuff in the instapot, 40 minutes later, some vegetable. I think we had some celeries, some uhm, carrot, and some chicken, it was great. I mean, keep it really simple, easy.

Evan Brand: I did some haddick last night-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: I had couple different fish, I had some haddick and some cod, and then we did some sweet potato fries that we baked, and then we did some broccoli. My wife is all into fresh broccoli now, because we were doing frozen broccoli, but it’s a game changer to do fresh. So, uh, hopefully when I get my garden, we’ve got snow on the ground, hopefully I can get my garden going and get some fresh broccoli. Last year, even despite my really good fencing operation around my- around my race guard bed, those darn rabbits, it ate on my broccoli, so I didn’t get any, I had to buy it all to store [chuckles], or the farmer’s market.

Dr. Justin Marchegiani: Uh, hundred percent man, that’s really cool. Uhm, very cool. Let’s talk about- someone asked about “Iodine and iodide”. So, basically, iodide is the ion form of Iodine. So, you have basically uh, the chemical structure of iodine is- is 2 molecules of iodine, and so essentially, iodine is one. So, typically, iodine’s bonded to a salt whether it’s a sodium salts or a potassium salts, and then in your body, your body converts it and- and puts it together and makes iodine out of it. So, you can have one molecule’s iodide, 2 is iodine, you take it and the it converts it in the body and it goes to through iodination and it- it can makes it iodine.

Evan Brand: How do you approach that with clients in terms of supplementing?

Dr. Justin Marchegiani: I typically use a potassium iodide.

Evan Brand: Yup. How often do you supplement it, is that something where it’s like, yup, a little amount is always gonna be okay ’cause there was a whole, you know fear mongering about “Oh, you know, supplementing iodine could- or iodine can uh… increase your thyroid antibodies”, but I’ve not found that to be true, let alone know.

Dr. Justin Marchegiani: Well, I mean, it’s potential, but, if someone has active thyroid autoimmune stuff, we just don’t go more than the RDA which is between 150 to 250 micrograms.

Evan Brand: Mm-hmm.

Dr. Justin Marchegiani: And if we see they’re stable, and/or they don’t have any that we may play around with going up to a gram or maybe a 1.3 gra- uh- sorry, 1.3 mg, 1.5 mg, alright? RDA’s a 150 to 250 micrograms. So, typically, within 5 or 10 x of the RDA.

Evan Brand: Okay.

Dr. Justin Marchegiani: It can. It- there’s a lot of data in the literature on that. So, uhm, I can just tell you, I see people go too high in iodine and lose their hair.

Evan Brand: Oooh.

Dr. Justin Marchegiani: So, you gotta be careful.

Evan Brand: Wow. I’ve got another question for you if you’re ready.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: Uh, a little one here rom Doc Jacey-

Dr. Justin Marchegiani: Yeah.

Evan Brand: “What is your take on using LDN for hashimoto patients? I do see the antibodies dropping and symptoms improved. Curious, if you’ve seen the same”.

Dr. Justin Marchegiani: Yeah. So, first off, it’s not the first place I go, the low-hanging fruit’s gonna be, uhm, obviously uh, autoimmune template to start getting good nutrients onboard, getting enough selenium onboard, CoQ10, magnesium, these are really important. Then after that, I would go to like curcumin, uhm, curcumin, things like that fur, you know, fur. So, it’d be the first things I would get in there first. You could even play around with resveratrol, uhm, I would do that first, and then maybe even CBD. I would try to do CBD over LDN, but I had seen some people do okay in LDN. I’ve seen some people do worse on LDN. So, I try to go to the more natural compounds first before I go to uh, an ___[28:54] blocking drug.

Evan Brand: Agreed. And I can’t prescribe it. So, even if I could, I wouldn’t because I’m, you know, my toolbox is limited to using natural professional grade products and nutrients and herbs, so I just don’t even have it on the table for me, so I just have to assume that I gotta fix the issue with other things. And you and I’ve seen hundreds of times that, when we just fix the gut, we’ve seen antibodies drop from it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: 2000, 3000 to sub-500-

Dr. Justin Marchegiani: Yeah.

Evan Brand: Just [crosstalk]… the gut and changing nothing else.

Dr. Justin Marchegiani: Yeah, I mean, the gut’s obviously the next big component. But supplement wise, curcumin, resveratrol, selenium, CoQ10, magnesium, a- autoimmune template, and then of course working on the digestion, working through all the 6 hours. Enzymes [crosstalk]… bad foods, replacing digestive support, hormones, moving infections, re-inoculating, repopulating probiotics and then retest it.

Evan Brand: We’ve got a couple other questions here. What’s your- what’s your schedule look like? How much time you got left?

Dr. Justin Marchegiani: I got enough time, I got 10 minutes here.

Evan Brand: Perfect. I’ll just uh, give people another plug. If you haven’t register to Justin’s summit, please do. thyroidresetsummit.com, it’s great. If you’re like geekin’ out on this, you’re about to geek out times 30 for the next week. Every day, you’re gonna get to hear Justin in your ear for like 6 hours. So, better put some headphones on, get your nice cup of camel milk tea and sit down and have a good listen. And uh, Justin did videos too, so that’s cool. If you wanna see the interviews, as opposed to just listening, you can do both, and if you end up buying his summit, you do get transcripts. So, I know, we’re getting a little, yo know, a little tricky, a little complicated sometimes in these interviews, you may want to have the transcript available so you can refer back to that.

Dr. Justin Marchegiani: Wonderful. Hundred percent. [crosstalk]

Evan Brand: Yeah, so that’s my plug. And uh, the next question from Colin is, “Any recommendations for…”, he said, “dedicated” but he meant desiccated, and we know what you meant. So, “Any recommendations for desiccated thyroid? Have you heard of the company thyrovanz?”. And I have not.

Dr. Justin Marchegiani: I have not. I have not in my life. We have a product called thyrobalance that is a natural glands. We’re support- I use with my patients, that I’d formulated, I’ve- I love that, it’s for credit, I use it on thousands of patients. And uh, on the prescription side, I do like WP thyroid, it’s a very clean formula. Uh, NP thyroid is another newer one out that’s very similar to iron, it- it does have a little bit of maltodextrin from corn in there, so you gotta be a little careful. The other good ones gonna be Nature Throid. Supposedly Nature Throid has a couple more ingredients than WP. Some people, if you check out my summit interview with Guillermo Ruiz, we talked all about that but, he said, there just not have extra ingredients and the same formula but, if you look on the back, there is lactose Nature Throid, there’s no lactose in WP. So, WP is the cleanest but, he seems to think they are both uh, equivalent. So, Nature Throid, and/or WP will be kinda number 1 and 2, WP first, Nature Throid second if you’re gonna go the prescription road.

Evan Brand: Supposedly Acella, A-C-E-L-L-A, it’s supposed to be- [crosstalk].

Dr. Justin Marchegiani: That too makes NP- That- that too makes NP.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: I’m pretty sure, that too makes NP thyroid.

Evan Brand: Okay. Excellent. Alright. Uh, here’s another one-

Dr. Justin Marchegiani: And then just to be- to be hundred percent clear on the question though, is with a natural thyroid glandular, you’re getting T-4, which is typically all you get in a centroid  levoxyl levothyroxine support, but you’re also getting T-3, T-2, T-1, T-0, calcitonin and proto morphogenic proteins which are in there that was your natural growth factors and- and taking thyroid glandular can also help lower your antibody levels too which is great. So, if you need a great, we don’t wanna give it unless we need it.

Evan Brand: Yeah, I was gonna say how do you rate when you need it versus let’s say someone was on a prescription, you know, is it possible that they are not doing well their prescription like centroid, but they may do and feel better and be able to use a glandular instead of that with the help of their doctor getting them off of the drug.

Dr. Justin Marchegiani: Well, you know you’re gonna need it if 1 of 2 factors or both are- are there. TSH is elevated, that could be the conventional range which is 5 and a half on the east coast, 4 and a half on the west coast, or, I use the- uh- uhm- the Association of Clinical Endocrinologists standings, once there’s a- above 2 and a half, I’m careful, okay? We’re about 2 and a half, 3’s kind of my cut off, but, then I look at the free T-3 levels. I’d look at T-4, T-3, how’s that conversion happening, and is there adequate levels of T-3, at least 3.0 on a free T-3. If we see a little bit than that, we could look at symptoms and we’ll see if it’s necessary to do anything for on the fence or a close, and then adrenals are shut, we may leave it alone and go after the adrenals come back on that. ‘Caue sometimes that’s enough to fix it. If the adrenals look okay, or the thyroid’s very low, we’ll come in there with support, get the TSH under control so the brain’s not screaming at the thyroid and getting it swollen, and then we’ll also get that functional T-3 level up to an optimum range. You know, 50% of the reference range. So, typically above 3 or so. Other country is different, but you wanna be at least 50% in the reference range.

Evan Brand: With that, you’re saying, take care of everything else like adrenals and all that? You’re saying circle back to the thyroid gland- glandular is kind of a last stage effort you would approach adrenals, maybe thyroid nutrients first, before thyroid glandular?

Dr. Justin Marchegiani: If we’re close- if we’re close. The only exceptional will be if the TSH is high, you know. Even if they didn’t have any symptoms but the TSH was high, let’s say above 3 to 4, then I would definitely look at putting that on a little bit sooner. If it was 3, I may hold off and just see maybe if we get the HPA access back on track, we’re good, if we’re on the 4 or up, I’m definitely gonna at least bring it down to 1 in the meantime.

Evan Brand: Okay, so, if we got a TSH of 5, we’ve got a free T-3 of 2, you’re saying, yeah, probably gonna need the glandular?

Dr. Justin Marchegiani: Definitely. Definitely need the glandular. Now, if we have a TSH of 3, and a T-3 of let’s say 3.2, that’s where it becomes very questionable. I’d wanna look at symptoms, and I wanna look at the thyroid, uh, the adrenals as well as the thyroid. And I probably- I’d probably say, let’s table doing anything directly with hormones on the thyroid for at least a month, and just focus on more nutrients and the adrenals and I come back and retest probably in 4 to 8 weeks and see where we’re at.

Evan Brand: Well said. We’ve seen massive swings in hormones in the right direction-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: -just by focusing on adrenals, it blows my mind-

Dr. Justin Marchegiani: Yup.

Evan Brand: -because I wasn’t someone that was comfortable with thyroid glandulars personally and recommending those to clients, I’d kind of stayed away from it, because I saw with doing rhodiola, and as you mentioned some of those special Maca extracts, and Ashwagandhas and Schisandra berries and helping the liver in detoxing, uh, and all of the sudden we looked and it’s like, whoa, TSH is normal. We didn’t even- we didn’t even try to focus on thyroid and it fixed itself, just with fixing the body, I love when that happens.

Dr. Justin Marchegiani: A hundred percent. I love it. And we’re getting to the root cause, we’re not just gonna throw everything on- throw everyone on the same thing. We really try to individualize the approach, just [crosstalk].

Evan Brand: Uh, I’ve got a question here from Paul, “How is Calcium D-Glucarate daily for detoxification?”. We use Calcium D-Glucarate all the time.

Dr. Justin Marchegiani: Yeah, it’s in my the detox aminos product. It binds to estrogens, so it really helps aid in estrogen detoxification. So, if a woman has extra detox, or if we see estrogen levels with the guys as well, I mean, it’s good to help bind it and pull it out, so I think it’s great. Just wanna make sure that we’re also getting to the root cause. If it’s just part of the general detoxification program, I think it’s great. It’s gonna help with thyroid binding globulin, and help with increasing free T-3 if there’s excess estrogen.

Evan Brand: Yeah, I- I- I don’t use it in isolation, same thing as you. I do have within a liver support product-

Dr. Justin Marchegiani: Yup.

Evan Brand: -our uh hormone support product, there’s kind of a couple things out there that we use will be blends of herbs plus Calcium D-Glucarate added in for PMS and, you know, breast tenderness and moodiness and irritability and all that stuff, we do see a Calcium D-Glucarate does move the needle.

Dr. Justin Marchegiani: Hundred percent. Hundred percent. Next question.

Evan Brand: Uh, Laura gave us some feedback, “Thank you so very much for explaining crucial information about gluten. I have tried for years to get people to realize that gluten hurts us all”. I agree Laura, thank you for the feedback and some people have to hit rock bottom before they listen to you. So, unfortunately that’s a reality.

Dr. Justin Marchegiani: Yeah, and again, some people, you know, they have the mindset of like, e- everything in moderation, it- it just depends. I don’t necessarily buy that, I mean, there’s probably never gonna be in the- in the- in a monitored amount of cocaine or methamphetamines that’ll ever do. But I get the fact that some people, you know, may not have that genetic predisposition. They may not have an autoimmune genetics that are active. But I just- I still think uhm- you gotta be careful if there’s an option to do something on the safer side on the gluten free, grain free side, it’s better. It’s- it’s better to do that. But I get why some people may feel like they- they get a little bit more freedom. You know, when you have a little bit more uhm, uh, health, so to speak, and a little bit less genetic predisposition, it makes sense why you do that.

Evan Brand: Yup. Got a question here, “My friend has hashimoto’s and only 20% of her thyroid. She tried nascent iodine and her face broke out with little lumps like pimples. Any idea why and what she can do to supplement iodine?”.

Dr. Justin Marchegiani: Well, if she has hashimoto’s, uhm I know that’s Dr. Group’s product, it’s a good iodine product, you just gotta be careful because you can go really high in it number 1, and that can elevate antibodies. Number 2, you could be pushing out other halides like bromine, right? And that could be causing the detoxification issue with the skin, is you’re pushing that out to the skin. [Crosstalk].

Evan Brand: Let me ask you this-

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is- this is mind-blowing. So, that you’re saying that nascent iodine can kind of clear out that receptor site?

Dr. Justin Marchegiani: Potentially, but it could also activate autoimmunity if that’s there too. It could-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -too high. So, I mean, if I were to do it, I would make sure that- if she’s my patient, we’re working for a few months, we’re stabilizing inflammation in the diet, all the other nutrients are present, ’cause with high amounts of iodine, the iodination process spits out hydrogen peroxide, H2O2, and with, inadequate selenium levels. Hydrogen peroxide’s inflammatory in the thyroid. So, with adequate selenium, we convert that H2O2, we pull off an oxygen to it and we make it H2O and make it water, something benign. So, we gotta be careful with the iodine and the lack of selenium, especially if antibodies are elevated.

Evan Brand: Yeah, well said. Selenium’s huge. That’s like, critical if you don’t address that, it’s very easy to fix that too. It’s like one of the cheapest supplements ever. Its funny people question the whole Brazil Nut thing, people say, “Oh, only a few Brazil Nuts per day is enough for selenium”. I’d look at some studies comparing that, like supplementation of actual selenium like chelated selenium versus a Brazil Nut, it actually surprisingly, the Brazil Nut actually held up, it actually did worked.

Dr. Justin Marchegiani: Yeah, I mean, the big difference for the Brazil Nut is there’s like a uh, a 10 to 1 ratio of how much selenium could be there. So, it’s just you don’t know if you’re at- if you’re doing 2 or 3 Brazil Nuts, hoping for 20 or 40 microgram, or 200 microgram the selenium, you may get 20, you may get 30, right. That’s the problem with it. So, I think it’s okay if you wanna do 1 or 2, but I think at least get your insurance policy of 200 micrograms of selenium via supplement formula, that’s your insurance policy.

Evan Brand: Yeah, I l- I love the idea of food as medicine but I agree with you. That’s not something you wanna dabble with, like, why try to get it from Brazil Nut if you can spend $8 and get the best selenium product on the market in capsule form, and you know exactly what therapeutic dose you’re getting in terms of milligrams right there on the bowl versus, “Oh yeah! This is a big Brazil Nut! This must be 20 milligrams”, it’s like “No!”.

Dr. Justin Marchegiani: E- exactly. And Brazil Nuts are commonly moldy too. So, if you have mold issues, there could be a problem there.

Evan Brand: [Crosstalk]

Dr. Justin Marchegiani: You know, if you wanna 1 or 2, fine, but just get your 200 from- from supplement.

Evan Brand: Yeah.

Dr. Justin Marchegiani: From selenium ___[40:20] primarily.

Evan Brand: Well, pesticides too, I’ve never seen organic Brazil Nuts on the market, I don’t want some sprayed.

Dr. Justin Marchegiani: I know, and then you also have the phytates and the other types of oxalate compounds in there too, for sure.

Evan Brand: I thought we had a question about oxalates. [Crosstalk]

Dr. Justin Marchegiani: Someone asked about “How do oxalates affect your thyroid?”, I think, right?

Evan Brand: Yeah, here it is. “What are you guys know about high oxalates and Hashimoto’s? Is there a connection?”. Let me just say something first.

Dr. Justin Marchegiani: Yeah.

Evan Brand: What I’ve seen, is that high oxalates are directly can’t- uh, related to uh, high candida. We’ve seen a lot of yeast, like, when I see candida high, I always see oxalates high.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: And then when you fix the candida, the oxalates magically go down. So, I would just throw- I would- I would kinda change that question and I would just say “What do you guys know about high oxalates, candida and Hashimoto’s?”, and I would say the answer is they’re all related.

Dr. Justin Marchegiani: Yeah, also, I would say that uhm, a lot of high oxalates foods are high goitrogens too. And these goitrogens can block iodine uptake. So, if you’re doing a lot of raw cruciferous vegetables, broccoli, cabbage, right? Uhm, those type of things that can easily block iodine uptake. If you’re doing a lot of it raw, that’s gonna really have some major impact. So, if you’re cooking it, you’re steaming it, you’re putting it in soups, you’re gonna have less in it for sure. But, you know, too much of that, if we have low thyroid, we gotta be careful with too much of that on the raw side ’cause that can definitely block our iodine uptake.

Evan Brand: I’m guessing you’ve seen raw vegans that have thyroid problems.

Dr. Justin Marchegiani: Oh, yeah, I mean, that’s a huge thing. Also, raw vegans tend to not have enough protein to make other hormones, so they can have other problems going on too.

Evan Brand: Did you see that article that was a uh- uh- an article the other day that went kinda viral. This medical wrote, that the- the vegan diet killed my mother early? Did you read that?

Dr. Justin Marchegiani: No. I think I heard of this though.

Evan Brand: Let me see if I can pull up-

Dr. Justin Marchegiani: Go ahead.

Evan Brand: -so I can say it, yeah. So, here it was, it was in the U.K., it was in London, this guy, Dr. Aseem, we may wanna get him on the podcast.

Dr. Justin Marchegiani: Yeah.

Evan Brand: He wrote a letter basically about this. And, yeah, he’s a cardiologist, his name’s Dr. Aseem, M-A-L-H-O-T-R-A. He said, my mother’s diet was full of ultra- aah, see here’s the thing I didn’t read before. Her diet was full of ultra-processed foods. So, talks about how uh, she was a vegan, her vegetarian rather, but, that she was consuming tons of, uh, biscuits, crisp and starchy carbohydrates. So, she probably had an unhealthy vegetarian diet. But the way-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -he wrote it, made it just seem like the vegetarian diet overall, killed her but, no, she’s eating that crap, that makes sense.

Dr. Justin Marchegiani: Yeah, she’s on a lot of carbohydrates but, yeah, one thing that you’ll see, you know, this is good for anyone listening is, with vegans’ vegetarians, go look at their hands. ‘Cause what they’re doing is they’re getting a lot of plant-based, uhm- beta carotene, and they’re hoping that converts to Vitamin-A. With low thyroid, you’ll see a lot of the orange deposits or their hands, or their feet, ’cause they can’t convert that beta-carotene, the Vitamin-A, the active uhm, retinyl palmitate. Uh, and- and- Vitamin-A is important for the thyroid receptor sites. So, you’ll see with some of these vegan vegetarians, they’re not getting active Vitamin-A form animal products or Cod-Liver Oil, so you’ll see beta carotene deposits in their skin, orangy skin.

Evan Brand: Whoa! Well, I- you know, I always trip people out about looking at the ridges on your fingernails-

Dr. Justin Marchegiani: Oh yeah.

Evan Brand: -for [crosstalk], but now I have something else to look at, “hey, let me see your hands, I’m gonna look at your nails, now, I’m gonna look at your palms”.

Dr. Justin Marchegiani: Yeah, I mean, it’s always good to look at it, just shouldn’t be excessively orange, but that’s a big thing. And Vitamin-A is really important for your thyroid, uhm, excellent sources of course are gonna be healthy, you know, egg yolks I think you’re gonna get it in, you’ll also see it in any type of high quality grass-fed meat, we’re gonna see it on Cod Liver Oil, and you’ll also gonna see it like liver glandular, for sure.

Evan Brand: There’s a question here which says a treatment-oriented questions so you’ll have to become a client of Justin if you wanna like dive in to supplements and protocols, but I’ll still read the question anyway incase Justin you wanna say something else.

Dr. Justin Marchegiani: Yeah.

Evan Brand: “With slightly low free T3, should…” uh, “…thyroid balance 1 capsule be taken every day?”, and “Dr. J., do you take your thyroid replete or balance?”.

Dr. Justin Marchegiani: I do not need my thyroid replete or balance. My T3 levels are above three and my TSH stays in the low-2’s or in the mid-1’s. So, I- I just don’t need it but, my Malte has enough selenium in there, and other nutrients uhm, for my thyroid to work. I- I just don’t need it based in my labs, so, I only recommend things that patients need that we can objectively quantify.

Evan Brand: Yup.

Dr. Justin Marchegiani: But in general, uhm, the levels are what again? Low [crosstalk]…

Evan Brand: …low free T3 , it was a 2.7.

Dr. Justin Marchegiani: Yeah, so, depending on the other symptoms that are going on there would depend on how the adrenals are doing. But that’s border line. What was the TSH?

Evan Brand: TSH, 1.3.

Dr. Justin Marchegiani: Uh, I probably would say no on that. I’d wanna look at the adrenals more thoroughly. I’d probably say no. Uh, I- I’m- I’m- for- if- if other- if TSH and T3 are- uh- TSH is good and T3 is close, I tend to say, “Let’s hold off and work more on nutrition and the adrenals”.

Evan Brand: See, here’s the problem though, we’re trying to get advice like that on YouTube or wherever else on internet, we know nothing about this guy, we don’t know how he sleeps, we don’t know he’s stressed, we don’t even know what his symptoms-

Dr. Justin Marchegiani: -Diet.

Evan Brand: -are, he may feel perfectly fine [crosstalk].

Dr. Justin Marchegiani: Yeah, exactly.

Evan Brand: You may feel amazing, and then you’re trying to fix something that doesn’t really need to be fixed. If you feel amazing, you- you might not need do anything. So kinda, you know, don’t fix it if it’s not broken. Obviously, if we knew, “Hey I had terrible anxiety and heart palpitations and I couldn’t sleep, and I had skin rashes, and we have a more complete picture”, then Justin maybe able to say, “Well, you know, maybe your free T3 is a little low because of ‘XYZ’ and we can fix that, and here’s the data to prove what you got in the gut”.

Dr. Justin Marchegiani: Yeah, exactly. So, there could be other things that are causing it that- on the gut that only improve it. So, hold off, but, you wanna dive in and become a patient we can also talk a little bit deeper on that.

Evan Brand: Yup. Uhm, Missy, “Thanks for your summits, I’ve learned so much and appreciate both your time and knowledge”. Missy, it’s our pleasure.

Dr. Justin Marchegiani: Appreciate it. Then someone write in about potato juice curing diabetes type 2, it’s a little off-question but because uhm, diabetes is intimately connected to thyroid issues. Diabetes commonly, uh, causes low levels of thyroid conversion because high levels of insulin can disrupt thyroid conversion. That’s why blood sugar is so important in keeping inflammation down. But uh, I’d be careful, anytime juice, I get concerned with, excess sugar and insulin resistance being a problem. Uh, that being said, there’s a high amount of… potassium in potatoes, so could just be some of these extra minerals that are there. But I would say, uhm, probably stay away from the excess sugar if there’s high levels of insulin in your type 3 diabetic.

Evan Brand: Uh, there’s other question here, “Are you saying candida overgrowth in the gut can be linked to kale intolerance?”. Uhm, maybe and around about way, yes, but no, not directly. What I was saying is that, when we see on the organic acids test that we have an elevation in oxalates, generally speaking, candida is a contributing factor to why oxalates are driven up. I had high oxalates one time on my organic acid test, I did not eat hardly any leafy green vegetables for significant period of time when my gut was a mess, and I still had high oxalates, I didn’t have many other foods with oxalates in ’em, so, I saw when I fixed the yeast in my gut, and then eventually found out I had candida in my home, and had to fix the candida in my home because especially if you have dogs, dogs have candida on ’em and then they jump in your bed and they spread the candida to your bed, and then you breathe it in, and it recolonizes your gut. So, if you’re working with a practitioner, and you keep beating yourself up because you feel good and then you feel bad, you feel good, you feel bad, you could have candida, driving that oxalate problem. And if that gets to extreme levels, you can end up with kidney stones and all sorts of problem. So, you know, fix your gut, but fix your home too, that’s gonna be like my new motto.

Dr. Justin Marchegiani: Yeah, I mean, the more people, let’s just say have inflammation, dysregulations in guts- and gut issues, that can create more oxalate sensitivity. Uhm, again, things like potassium and magnesium are really important for oxalate cleaner. It’s now- kale is actually kind of a lower oxalate food. It’s the spinach. Spinach is the big higher ones, so you gotta be careful with spinach. But again, you know, having enough good quality magnesium and potassium in your diet or supplementally can also help clear oxalates. [Crosstalk]. Oxalates high in organic acid test, that’s more of indirect candida marker. So you’d wanna look at like D-Arabinitol, or ___[48:31] if using the GPL test. Uhm, and, you know, uh, tartaric acid, other things like that.

Evan Brand: Yup. Well, that’s all the questions, I think we killed it in, we donated an extra 10 minutes of time here, so why don’t we wrap this thing up, I’ll tell people again about your summit website.

Dr. Justin Marchegiani: Excellent.

Evan Brand: It’s thyroidresetsummit.com, it works. Expecting probably 50, 60, maybe 70, 80, who knows? Thousand registrants. So, if you’re not coming to the party, then you’re missing out. So, this is gonna be probably one of the biggest events of the year honestly because thyroid problems are epidemic in the U.S. I’m sure I can pull up some random statistic for you from the CDC if you wanted to, but I’ll just tell you what, Justin and I see which is that, there are countless men and women out there with hashimoto’s, and they don’t even know it, it’s undiagnosed, autoimmune thyroid conditions around the world, these men and women are having anywhere from one to a million symptoms, it could be heart palpitations and anxiety-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -one day, and they’re energetic, and then the next day they’re exhausted and they don’t know why. And then the next morning, they wake up in the middle of the night and they have heart racing in the middle of the night, they don’t know why. When that thyroid gets attacked by the immune system, it can squirt out little pieces of thyroid hormone and cause you to feel crazy. So, please make sure that you get your antibodies tested. Your TPO, your TG, maybe your TSI if you think you need to, because something you educated me on is that you can have hashimoto’s, and you can have graves at the same time, which sounds insane.

Dr. Justin Marchegiani: Yup, you can and, 1 out of 5 women have, uh, a- autoimmune issue, and, one of the most common thyroid issues, over 30 million people have it and don’t even know is, hashimoto’s. And the big issue with that is, it’s gonna create inflammation, it’s eventually gonna destroy your thyroid tissue, low thyroid hormones and it create all kinds of symptoms, and women tend to be more predisposed. I mean, on the guy, I’ve hashimoto’s too, so this isn’t you know, just me only reaching the females out there, men have it too, so you gotta look at it. Women are a little more predisposed, ’cause estrogen can- can affect the CD4 to CD8, uhm immune cell ratio and can make you more predisposed to autoimmune issues, but heck, we know guys are getting exposed to lots of estrogens too via the food, and the plastics and the pesticides. So, that’s another predisposing factor that can even make guys more susceptible even like myself, so, make sure you register. Thanks, so much Evan for the great podcast today, make sure you sign up and get that free 88-page eBook, my real book, the thyroid reset is coming out in the coming months is head. So, stay tuned, thanks so much, and have a phenomenal day. Take care.

Evan Brand: Take care. Bye-bye.

Dr. Justin Marchegiani: Bye.





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 Justinhealth.com You can look at the supplements, the labs on there. Same thing on my site, Evanbrand.com 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. Justinhealth.com You can schedule with Justin. Evanbrand.com 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.








Low Body Temperature! – Dr. J Podcast # 156

Dr. Justin Marchegiani and Evan Brand engage in a very informative discussion about low body temperature. Learn how different potential stressors like thyroid issues, adrenal issues, gut health, autoimmune conditions, nutrition and low calories cause low body temperature. Find out about the role of micronutrients in thyroid hormone conversion and be aware of the medications that have a negative impact on mitochondrial function.

Gain information about the different foods, including modifications in macronutrients, and various supplements, which will improve your health and prevent different stressors that are possibly causing low body temperature.

In this episode, we cover: low body temperature

03:27   Thyroid issues

07:05   Beneficial Nutrients

14:14   Toxins and Medications

22:51   Food and Supplements

33:46   Calorie Intake






Dr. Justin Marchegiani: And we are live here on YouTube. It’s Dr. J in the house. Evan, my man, how are you doing brother?

Evan Brand: Hey man, happy Monday! We’re talking all fair about that shooting this morning so my mom, she worked right next door last night at the Hotel Luxor which was uh— right next door to that shooting event in Vegas. So I called her this morning and she’s safe and sound and she got released, so she’s home, hopefully sleeping. I’m sure she’s extremely adrenally stressed at this point, but hopefully she’s resting and settling down from all that.

Dr. Justin Marchegiani: Yeah. Lots of empathy for all the people out there going through that. It must be just incredibly stressful.

Evan Brand: It’s insane.

Dr. Justin Marchegiani: It’s just so difficult. So wishing everyone, you know, speedy recovery from that. That is just so difficult and man, everyone’s adrenals are revved up from that, right?

Evan Brand: I know.

Dr. Justin Marchegiani: So let’s go into some stuff here where people, we would get— put some information out there about improving everyone’s health.

Evan Brand: Yes.

Dr. Justin Marchegiani: Uh—and just continue to empower more people. So let’s dig in, brother.

Evan Brand: Yes. Yes, so you and I want to chat about low body temperature, which is something that so many people have. I’ve had it in the winter for a long time. I’m hoping that since I work so much, my gut and my adrenals that I don’t have it this winter but cold hands, cold feet you know that had been something that I mentioned going on with me for—for several years. I know there’s a lot of different causes that you and I wanted to go through. So how should we open this thing? Should we talk about hormones, thyroid, how do you want to lay the groundwork?

Dr. Justin Marchegiani: Oh, we look at body temperature. Temperature is probably one of the best indicators of your metabolism, right? Because the more energy you have, typically the— the better your temperature is. And so typically, you’re gonna have symptoms of cold temperature which are gonna be cold hands, cold feet those kind of things. Also, fatigue, but now there’s also objective ways that we can test your temperature. You know, with the thermometer, obviously. We can do axillary temperature, which is armpit. 97.8 to 98.2 is—is Fahrenheit is a pretty good range to be in. Or 98.2 to 98.6 orally. And so you can kind of assess your temperature. You can do it in the morning and then you can also do it in the afternoon as well. Kinda do it just for before eating. That gives you a pretty good indication but if your metabolism is low and your temperature is low, it could be caused by an interplay of different things. We’ll go into it. It could be thyroid issues. It could be adrenal issues. It could be gut issues. It could be nutrient issues. It could be mitochondrial issues. So all of these things are potential stressors that could be driving that problem.

Evan Brand: I’d say number one is probably thyroid issues. Wouldn’t you suspect because so many people we talk with they have adrenal issues with them on top of that there is a thyroid problem. Like maybe elevated reverse T3, whether you’ve got that blank bullet going on or they just got a low free T3 or like you and I’ve chatted about with adrenals, you’ve got the conversion process that happens where you take the inactive T4 hormone, you convert that to active T3.That conversion process gets messed up if you’ve got chronic stress. And chronic stress as you mentioned, could be gut infections, it could be emotional stress, could be chemical, heavy metals. It could be circadian rhythm stress if you’re working third shift, for example. That could be enough to change this whole cascade. Wouldn’t you say?

Dr. Justin Marchegiani: Oh, yeah. Hundred percent. I mean, again, all of those things can be intimately connected. The first we look at is thyroid because thyroid hormone has a major effect on our metabolism. And our metabolism is the sum of all chemical reactions in the body. And our metabolism is pH driven, right? So if our pH becomes too alkaline or too acidic, like you know blood pH, which exists in a very fine-tune range, right around 7.35+ or -1/10 of point there. And if that pH shifts up or down, that can affect how all of our enzymes in our bodywork. So that can affect temperature and there’s things like—uh like a diabetic coma, right? Where blood sugar can go to he— or too low typically. If someone’s type I dependent and they don’t have insulin, they don’t get sugar into their cell, which can create ketoacidosis. And that can really, really drop that pH and that put you into a coma. So our pH is very driven and has a major effect on our metabolism, so, totally.

Evan Brand: So let’s hit on—let’s hit on the thyroid peace. Now autoimmunity is something we talk about so much. Would you say a common symptom of someone with Hashimoto’s, for example, could be low body temperature or possibly even a fluctuating. Maybe their low body temperature if they’re a bit underperforming but then couldn’t they just bounce right back and get actually hot if they bump into hyperthyroid. If they’re in the Hashimoto’s state, and things are still fluctuating.

Dr. Justin Marchegiani:  Yeah. So, if you’re having Hashimoto’s and your immune systems constantly attacking your thyroid, your thyroid hormone can spill.

Evan Brand: Right.

Dr. Justin Marchegiani: Coz every time it’s attacked, hormone spills out. Eventually those follicles run dry and you’re not gonna quite have that hyper kind of symptoms. So in an acute attack, hyper symptoms may be increased temperature are common, right? You can have like PVC’s periventricular contractions. Uh—you can have, you know, kinda this—kinda heart palpitations. Your heart’s kinda beating erratic and hard, uh—anxiety, night sweats, irritability. These are all hyper thyroid symptoms. You feel warming, right? You feel excessive warmth or temperature. But then, in a chronic state, that will eventually lead to a hypothyroid kind of environment, where your body temperature just gets very low.

Evan Brand: So someone has had Hashimoto’s for quite some time, let’s say there’s been a pretty significant tissue destruction, you would say someone will not end up being hyper long-term with Hashimoto’s. It’d probably be hypo long-term.

Dr. Justin Marchegiani: Yeah. I mean you can—hyper feels very similar. Hyperthyroid Grave’s feels very similar to a hypothyroid autoimmune attack. The difference is with hyper, typically, there’s a specific antibodies or immunoglobulin compounds that come back. So with Grave’s, you’re seeing TSI immunoglobulins or you’re seeing thyroid TSH receptor site antibodies. So that’s what’s typically common in Grave’s. And when those things are high, it’s accelerating the thyroid hormone to produce excessive amounts of thyroid hormone. So there’s like a production stimulation where with the autoimmune attack, from like thyroglobulin antibodies or TPO antibodies is it’s more the spilling of a thyroid hormone out of the thyroid. It’s spilling out where the antibody attack from Grave’s, it’s stimulating the thyroid to produce more.

Evan Brand: Exactly.

Dr. Justin Marchegiani: With Hashimoto’s, you’re not getting the stimulation. You’re more or less getting that spilling effect, which eventually, you know, will run dry.

Evan Brand: Got it. Got it.  Okay. So we hit the autoimmune piece. What else would go on thyroid-wise that will be an issue with temperature regulation?

Dr. Justin Marchegiani:  Well, again, there’s also certain nutrients that have a major effect on thyroid uh—conversions. So we know things like selenium are super important for thyroid conversion. So someone may have decent thyroid levels from a T4 perspective, uh— but they may not have that activation, right? They may not have that conversion uhm— that’s so important.

Evan Brand: So could it just be the lack of trace nutrients, trace mineral selenium, zinc— things like that activators.

Dr. Justin Marchegiani:  So here, we are live on Facebook now, too with the low body temperature podcast. So getting back onto our common thread. Yeah, micronutrients like selenium are gonna be important for thyroid conversion. It’s a five—the enzyme that converts T4 to T3 inactive thyroid hormone to active thyroid hormone is a 5 deiodinase enzyme. It’s also important with glutathione and detoxification. So, yeah, that’s totally uh— important micronutrient that will affect thyroid activations. So when we look at thyroid function, we’re looking at are there blood sugar fluctuations? Are you eating grains or foods that are gonna cause that thyroid antibody attack that could cause the hormones to spill out and eventually deplete the hormones? Your thyroid follicles carry about four months of thyroid hormone. So again, if you have a chronic Hashimoto attack, where the thyroid hormone’s spilling out faster than you can synthesize and make more, then you’re going to definitely get to that depletion state where you’re gonna go hypo from a temperature standpoint. You’re gonna go almost hypothermic. That temperature will drop below that 97.8 – 98.2 armpit temperature wise or 98.2 to 98.6 and I’ll put a handout down below to my uh— metabolic temperature handout. So people can actually track their temperatures and it’s basically a graph of three different lines. And then the top brackets where you want your temperature to be through which ranges 97.8 – 98.6 We want to be checking off daily that your temps are in this bracket not the bottom or the very bottom.

Evan Brand: Got it. Okay. So what else? Should we talk about the nutrients next?

Dr. Justin Marchegiani: Should we talk about the nutrients, right? Vitamin A, we talked about uh— zinc, copper, selenium, magnesium very important nutrients for thyroid conversion. Now if you’re eating a whole food diet, you’re gonna be typically pretty good. If you’re having enough HCl and enzymes, you’re gonna be good as well because we need those type of compounds to be able to ionize the minerals. So it’s the diet component. It’s making sure we have the ability to break down the foods in our diet that are nutrient dense. Uhm— number three is making sure our stress response is okay because stress hormones will affect thyroid conversion. Cortisol being hyper— very high— will affect thyroid T4 to T3 conversion that inactive to active thyroid hormone. Also, if cortisol is too lo from chronic stress. So there’s this, kinda Goldilocks effect that we see here with thyroid hormone kinda need it to be not too high, but not too low to have optimal conversion. Does that makes sense?

Evan Brand: Yeah. It does. Well said. Let me mention about the gut, too, coz you just hit on the fact that you’ve got to have absorption. So even if the diet’s good, which many people listening to us, they probably already dialed in like a Paleo template but they could still have this symptom. You may want to check for infections. Coz like Justin and I talk about almost every week at some level, there could be an H. pylori, bacteria, yeast, fungus, something going on in the gut that’s stealing your nutrients or preventing you from optimally digesting. And then that issue is compounded, if you’ve been taking any type of anti-acid where acid blocking medication something simple as Tom’s or something more strong like a prior was it Prilosec or Zantac.

Dr. Justin Marchegiani: Yeah. So, yeah. Totally.

Evan Brand: Keep that in mind. If you’re looking at your medication list and that includes acid blockers and you have cold body temperatures, it’s probably cause you’re not digesting your foods therefore the thyroid is not getting fed the nutrients it needs.

Dr. Justin Marchegiani:  Totally. And also a lot of medications could affect your mitochondria. Just Google antibiotics and mitochondrial function, you’ll find that antibiotics can negatively impact mitochondrial function. And you’ll also find that other medications can impact the mitochondria. And the mitochondria is like the little powerhouse of your cell where it generates a lot of ATP, which is that currency of energy in which your body runs. So that’s really important and also an important nutrient call carnitine really helps that mitochondria utilize fat for energy, generate ATP out of that good fat, you know, it’s called uh—beta oxidation where you’re generating energy from fat. And carnitine is an important nutrient primarily made from methionine and lysine. Now, I did a video call why vegan and vegetarian diets can make you fat? Now—no—don’t make you fat. But you know, why they the can—meaning it’s not a hundred percent. But if you’re insulin resistant and you’re doing it the wrong way, where you’re emphasizing maybe too much carbohydrates, not enough protein and more gut irritating foods, yeah, it can definitely predispose people that have an inflamed guts and work more on the insulin resistance side to gain weight. And one of the big things is that when you eat certain animal rich amino acids, there are some plant ones as well, you activate the cells in the brain that are called—hold on, one __my notes—uh—tenocytes. And these tenocytes are receptor sites in the brain in the third ventricle area of the brain. And there’s a direct blood flow between them and the hypothalamus. These tenocytes, one, they sense satiety but the big thing that senses satiety for them is arginine and lysine which are really high in animal-based foods. So these amino acids really get that sense of satiation so that means you’re one, gonna have appetite regulation. Coz when you actually start feeling full, you tend to not eat all the crap, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So the more you can keep your cravings in check, the more you eat healthier foods because you got control over your biochemistry. You’re not reacting. You’re acting based on what you know you need to be healthy. But those amino acids are primarily gonna be higher in animal-based foods especially lysine as well.

Evan Brand: Yeah. Well said.  So in a roundabout way, if you are a vegetarian or a vegan and you’ve got low body temperature, it could just be something as simple as a carnitine deficiency. I mean you could probably get a little bit in beans maybe—

Dr. Justin Marchegiani:  A little bit in beans, a little bit in almonds, a little bit in plums and avocados, for sure.

Evan Brand: But even then, once we talked like—we talked all the time, digestion of those foods is probably not very good and the concentration of those is gonna be much less as opposed to a grass-fed beef.

Dr. Justin Marchegiani: Yeah. In my video, I talked about, you know, if you are a smart vegan where you’re not emphasizing a lot of the grains, you’re doing safer starches, you’re getting lots of fats from avocado, olive oil, coconut oil, you’re supplementing DHEA in the form of algae, right? And if you’re getting B12 uh—supplementation and you’re getting a good multi- in there and you’re getting lots of— you’re getting some protein supplementation in there, maybe from pea or hemp, right? You may be okay on a vegan-vegetarian diet, but it’s just— it’s still less than optimal just because of the fact that you gotta go through such extreme lengths to get high-quality protein sources without all the carbohydrate. Coz vegetarian-vegan diet’s typically are packed with 60 to 80% carbohydrates for that 20 to 25% of protein you get.

Evan Brand: Yup.  Well said. You hit on the mitochondria, too. We should take  that a bit further and talk about more toxins. You hit on antibiotics, some mitochondrial issues there. Makes perfect sense. We work with people all the time where they say, “Oh Justin or Evan, as soon as I took a round of antibiotics, all of a sudden things went bad.” And it could be temperature –temperature issues, it could be sleep problems, it could be gut issues, digestive problems. And so also with mitochondrial issues, we’ve got toxins. So if you’re not using 100% organic, that’s an issue because glyphosate and these other pesticides and herbicides, fungicides and insecticides— they all compound with each other. So it’s not that one chemical by itself will kill you, but if you get a little bit of glyphosate from your non-organic berries, you combine that with a little bit of conventional vegetables coz you did a salad at a restaurant, you combine that with in antibiotics that you’re getting from meat. If it’s not labeled “no antibiotics” you stock all those upon each other, you’ve got some bad mitochondrial problems here that you need to fix. And we can measure the—

Dr. Justin Marchegiani: Yeah. The enzymes that are needed to help move those gears that  kinda crank around that mitochondrial Krebs cycle and then flow in so the beta oxidation process. Uhm— you need certain nutrients. You need B vitamins, you need magnesium, you need zinc, the healthy levels of amino acids. You also don’t need all the toxins— the aluminum, the pesticides, the glyphosate. So those things can kinda gunk up the gears of that metabolic machinery. So it’s not only what those gears need to keep it lubricated, but what it is we don’t need to put in that will prevent those gears moving. So it’s a combination of avoiding certain things, right? And again, the medications are a double-edged sword. I’m not saying don’t use them. I’m saying just really make sure they’re— they are prescribed specifically for what you need. And it’s the last case kind of thing with antibiotics. We really want to go to herbs and botanical nutrients over antibiotics. They may have a time or place, but we want to use it only when we’ve exhausted other options.

Evan Brand: Yeah. Well said. And you and I were talking off air, we can quantify a lot of this stuff, too. So you’re talking about measuring your temperature. We can quantify what’s going on in the gut, right? We can test the gut, we can test the thyroid with—with blood using functional reference ranges and using functional numbers that conventional doctors don’t use. They’re only going to detect disease. We’re going to detect the issues before disease occurs. We’re gonna look into the gut so we could test you for infections. We could test the adrenals, look at your free cortisol rhythm so the uh— HPA axis, the hypothalamus, pituitary adrenal axis, you hear us talk about, you know, that is a factor in all of this. If your brain is not connecting the signal to the adrenals and adrenal to the thyroid, that whole system gets often chronic stress. And it’s up to us to figure out when we talk about stress what’s in that bucket. Is it just your job, your bad boss, your relationship, the divorce you’re going through? Is it that stuff only or is that stuff plus chemicals in the diet, plus nutrient deficiencies, plus infections, plus not having enough quality meat in the diet.  You see how these things can all add up.

Dr. Justin Marchegiani: Totally. And just to kinda look at the thyroid component again, there’s dysregulation up top where the TSH is either high extreme, higher extreme, low. Now it can be extremely low because you’re on thyroid hormone and the body needs more thyroid hormone. The body is sense— sensing more thyroid hormone in the brain, but there’s less than the actual tissues. So that you’re keeping the thyroid hormone higher, but that’s keeping the TSH low. That’s step one. The TSH may be low because of HPAT access dysregulation. That hypothalamus pituitary and that adrenal thyroid axis. There’s some kinda short-circuits happening in there because of the stress— the emotional stress, because of the physical stress, because of the chemical stressors. And we have to address those while we support the nutrients to get this hardwire back on track. We can also have low T4 levels. Coz if T4 is low, we’re gonna have low T3 over here. So we got to make sure the nutrients for T4 in there like I mentioned before the vitamin A, the zinc , the copper, magnesium, selenium, uhm— amino acids, tyrosine and potentially iodine. As long as we know that there’s not uh— autoimmune attack that’s the lease active going on. And then number three, after that, we let see how the T4 to T3 conversion is. If T4 is good, how does T3 conversion look? Is it this big drop off? Or also is there a very high amount of reverse T3 because of that stress? All those can make a big difference. And then one person ask here—James asks, “Well, is hypothyroid and hyperthyroid hypo and hyper kind of the same for treatment?” Yes and no. With hyperthyroid from a TSI thyroid stimulating immunoglobulin or TSH receptor antibody attack, we’re more concerned about coz it tends to be more chronically high which can increase the chance of a thyroid storm and then potentially a stroke. So we take that very seriously. We refer that patient out to their medical doctor uh—for monitoring. We don’t want—we wanna make sure there’s not a stroke going on. But typically, the treatment will be, you know, PTU. Uhm—basically  uh—propylthiouracil or methimazole. Things to basically block iodine uptake to make thyroid hormone. Or though— you know, typically, go to a thyroid radioactive thyroid kind of ablation or even a thyroidectomy. I’ve had patients where we’ve been able to avoid those because we give nutrients to help modulate the thyroid response and modulate the autoimmune response like carnitine, like blue flag, like lemon balm, melissa uhm—into certain adaptogens. They could also help kinda dampen that response. There are some protocols that even show higher amounts of iodine can block that sodium uhm— iodine’s import that transfers iodine into the thyroid. So there’s a couple of different protocols you can use to help. And of course, all of the diet and lifestyle things are the same. But we take the Grave’s autoimmune attack a little bit more seriously just because of the repercussions of it not being treated appropriately, what will happen, we really want to sidestep those.

Evan Brand: Yup. Well said. So get the TPO antibodies checked. Get your eTG antibodies checked, you talk about the TSI. Now, have you seen where TPO TG would be high at the same time as TSI? Where it’s gonna look like Hashimoto’s and Grave’s at the same time?

Dr. Justin Marchegiani: It could. I’ve seen it before.  Yeah. It definitely can. So get—we’re  gonna really get patients on an autoimmune protocol to help lower any autoimmune attack from the food, from the gluten, from the leaky gut. And we’ll also work on blood sugar stability coz high and low blood sugar fluctuations have a major effect on the immune system.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Now another person asked here, the reason why you know I’m such a huge fan of how we do our podcast is coz it’s literally on the go and we’re infusing questions from people on YouTube here right into the conversations. So it’s like—remember those books you read when you’re like a kid and you read it and it’s like, “Oh, if you want the character to do this, turn to this page. If you want the character to do this, turn to this page.”  You can totally change how the book goes.

Evan Brand: Yup.

Dr. Justin Marchegiani: Well, it’s kind how our podcast are. So interjecting here uhm—, Gerald asked, “What about T3? How does T3 work?”  Well number one, T3 can just help support low T3 levels. And if there’s some kind of conversion issue, that can kinda biased time to fix the conversion aspect, number one. Number two, giving that T3 in the Wilson protocol uhm— that can have some effect on clearing out the receptor sites. So that now the T3 works better and binds better uhm— in the future. You can do that by starting low and then tapering up, holding it and then tapering it back down. In the Wilson protocol, Dr. Dennis Wilson does that with time-released T3. But we do a glandular’s in it. That can still be helpful as well. We’re using that as a way of clearing out the receptor site but were also not, you know, thinking that that’s gonna be the only issue. We’re also banking that there’s other things that we’re gonna be fixing that will allow it to be a long-term solution, right?

Evan Brand: Got it. So you’re saying the thyroid glandular’s can be used for low—a low  T3 situation.  That’s the fix that’s going to get you better enough to keep moving the needle in other departments.

Dr. Justin Marchegiani: Correct. Like in my line, we have Thyro Balance which is a—a really glandular uhm—nutrient thyroid support from a glandular perspective. And then we have that we have Thyro Replete which is nutrients for the conversion. So there’s some herbs that help with conversion like coleus forskohlii and ginseng and then we have the nutrients for conversion that I mentioned—the vitamin A, magnesium, copper, zincs, selenium—all of those—and tyrosine’s. We wanna make sure all those are in there. Uhm so we hit it from all angles. I mean if we knew exactly what that missing like nutrient component was, we could hit it more practically. But it’s too difficult to do that.

Evan Brand: Right.

Dr. Justin Marchegiani: You’re better off using multiple methods to hit it. That way the patient can get better faster.

Evan Brand: Agreed. And you mention the adaptogens. I’m so glad you did. We use those all the time. I take them every day in some shape or form, whether it’s ashwaganda, holy basil, shoshandra. There are so many options and people ask, “Well, can I just take a bunch of adaptogens and fix myself?” Uhm— it doesn’t work like that. You just want to use them as one piece of your toolbox. You still want to be getting to the root cause. So adaptogens are life-changing but if there’s root causes, you can take all the adaptogens in the world and it won’t fix you.

Dr. Justin Marchegiani: I’m gonna take my ashwaganda right now—

Evan Brand: Perfect.

Dr. Justin Marchegiani: A little bit of immune support. But I mean, like yeah, if you’re doing okay and you’re like, “Hey, Dr. J and Evan talked about some ashwaganda and some of these nutrients. I want to try it out.” Fine, go ahead.  But if you’re actively having issues that are you know, the symptoms that we mention here whether it’s on the hyper or hypo side, you really want to get someone on board to help guide you because it’s never just one magic bullet. It is—it’s a whole bunch of things that we’re doing together. And the more chronic it is, the more you have a you know, that momentum working against you. You got overcome that inertia to stop that— that snowball effect and start pushing it back uphill. So, yeah, if you’re in pretty good shape, fine you know just try some of these things. But if you’re in not so good shape, you want to reach out, for sure.

Evan Brand: Yep. Cool. Oh, we got time for one more question. Uh James said, “It’s not a thyroid question.” He’s taking an antibiotic for root canal this week. “Will this affect the result of organic acids test and stool test if he collects the samples while antibiotics are still in the system?”

Dr. Justin Marchegiani: I mean if we’re doing some of the genetic base testing, it shouldn’t have an effect on it. If we’re doing a stool base to antigen-based testing, then it would.

Evan Brand: Right.

Dr. Justin Marchegiani: So you should be okay but we’re doing the G.I. map which is you know, what my go-to is. It should be okay according to the lab. I try to avoid it— doing it. So I would say in a perfect world, if it’s not gonna delay your treatment, I would say get to the antibiotics give it like a day or two to let it wash out and then do it. But if uhm— timing doesn’t work out, just do it, get done.

Evan Brand: I would also look at Mercola root canals and read about those. I mean maybe you’re too far down the rabbit hole and you can’t avoid the root canal. But you know there are some other options you may have available if you’ve got a good biological Dennis maybe will sit down with you and say, “Okay, root canal’s option A but maybe there’s a option B C you could look at too because we’ve had a lot of people to come to us with infected root canals and maybe Jessica can speak on this a bit. But I’ve seen it as a big needle mover for people.

Dr. Justin Marchegiani: Yeah. There’s a book by Ramiel Nagel that talks all about root canals. It is highly recommended. You take a look at it. Uh— fat-soluble nutrients, vitamin A, vitamin K are very helpful. Uh—oil pulling that kinda help extract any toxins that may be in there and you don’t want a root canal you want to get the tooth pulled out. Uhm— you want to get an implant put in using biologically appropriate material. You don’t want the gangrenous tissue still in the system without the blood flow. And the immune response to be able to get it is just a harboring place for a whole bunch of bacteria and viruses to hang out.

Evan Brand: Right. Yeah. Well said. So James, look into that. Maybe it’s not too late. Uh—hopefully, you’ve got some other options you can pursue it’d be much— much safer and much healthier in the long term. That way, you don’t have a hidden dental infection. There’s a guy named, Simon Yu that you and I should reach out and interview. He’s over in St. Louis he talks a lot about hidden dental infections. I think that’d be a good show.

Dr. Justin Marchegiani: Okay. Absolutely. Hundred percent. So couple of things we wanna talk about. Oh, also carbohydrate, I think is important. Again, my bias is towards a lower carbohydrate template—Paleo template. And again, I hate the word “diet” because it assumes something is temporary and it assumes that it is fixed; where a template gives us flexibility and modification and may change day to day. It may change uh—meal to meal. I tend to be very lower carbohydrate my first two meals of the day and then after that, I may increase in carbohydrate at nights uhm—you know a bit of the starchy based. So I’m very strict during the day. It’s high-quality. It’s— set—it’s 60 to 70% fats, the only carbohydrates are vegetables and then good proteins and then I go higher at night. On the carbohydrates side, maybe a little bit of sweet potatoes and some butter and cinnamon or maybe I have a—some dark chocolate or have couple more berries than I normally would. So there’s that component. So I always go lower carbohydrate to start because so many people are insulin resistant just because of the fact that we eat too much carbohydrate and were inflamed. So I always go lower carbohydrate to start and then typically, patient will do be better and will feel better because insulin resistance can affect T4 to T3 thyroid conversion, which can cause lower temperature. Now, in the double edge side of the fence, if people go too low insulin, they may also get poor thyroid conversion as well. So just like I mentioned cortisol has a major effect on thyroid conversion. Well, guess what? Insulin has a major effect on thyroid conversion. Type I diabetics— guess what? With low insulin levels coz of the autoimmune attack to the beta cells of the pancreas, they have low body temperature. So if you go too low carbohydrate, and this is for certain individuals not everyone, I know people are gonna be like, “But I’m low carbohydrate and I felt great and it reverse my low temperature.” I get it. Again, there are exceptions to every rule. There are tall Chinese people that play basketball even though they are more shorter in the population. There are exceptions to everything, okay? We got to get that in. So yes, there are some people that a low carbohydrate diet, the majority I would say would help partly because our consumption of refined carbohydrate and sugar is higher, but there are some people when they’re chronically load, they may increase that carbohydrate just a bit. And that ups the insulin a little bit which then helps that thyroid conversion. They’re like, “ Dude, my hair started to grow back better, my temperature’s better, my energy is better.” Boom! You at least now figure it out for you. So exceptions to every rule, figure it out. And uhm—if you feel great going low-carb, great, keep it there, hang out. But if you start getting some of those hypo temperature symptoms, then we’ll just ratcheted up a little bit.  And I primarily ratcheted up starting at night.

Evan Brand: Yup.

Dr. Justin Marchegiani: They’ll still get the benefit of keeping it lower carb during the day.

Evan Brand: Well said. I mean that’s me in a nutshell. I went very, very, very low-carb ketogenic, I guarantee. I was probably ketogenic most of the time and then I started to get cold and so I added in some starch with dinner and all of a sudden my body temperature’s perfect now. I feel good. So uh—if I go too low-carb again, it may come back or if there’s a huge piece of stress on my plate, the low body temperature may come back. But for now, I’ve been able to reverse this and been able to clear out all the infections with your help in terms of protocol a couple of years ago getting rid of all my gut bugs, plus supporting adrenals, getting the diet dialed in, getting my sleep improved, blacking out my room. All of those things are still important. So I hope this has been helpful. I gotta run. You’ve gotta run, too. Uhm—or are there any last questions that we could answer? I closed out the chat window. Uh there’s just one thing I want to say is it’s not about being higher carb or lower carb, have a –have a foundational template which you— which you go back to and then you can customize it. And then if you increase carbs, you can still get some of the benefits by having that first 20 hours of your meals relatively lower carb, higher fat, moderate protein and those last four hours you pop up a little bit and so you can still get some of those benefits. If you’re like, “Oh, I feel better with higher carbs.” You can still get the benefits of the first 20 hours of your day kinda in that ketogenic state and then pop up the carbohydrates later. So it’s not an either or thing. We can kinda straddle the fence but we want to customize it. I don’t give a crap if—if low-carb is your missing link and being low-carb all the time helps you, that’s what we’re gonna do. If being low-carb and a little more high carbohydrate helps you out, I don’t care. I’m all about the results and not about what tool I have to use to get the job done.

Evan Brand: Yup. Well said. For me that looks like the breakfast like a pastured sausage, maybe a handful of macadamias, maybe a handful of organic blueberries. Lunch—I  probably do some leftover steak and veggies like a big thing of broccoli with some butter. Dinner— that’s when I may do some type of pastured meat, a little bit of some veggies and then starch, so it could be a medium-size baked sweet potato, butter, cinnamon. That’s all it takes and I feel good. So just to kind of give people an idea what is that look like. That’s what it looks like.

Dr. Justin Marchegiani: Totally. That’s great. And a couple of questions here. Uh— Stephanie talks about menopausal women with lower estrogen and a low estradiol vaginal tablets. Well, this is interesting because typically low estrogen can cause hot flashes. And why does that cause hot flashes? Because typically the FSH and the LH starts to rise in the pituitary which is that signaling hormone trying to yell to the ovaries to make more progesterone and estrogen. So when LH and FSH primarily FSH goes high, that can create some vasodilation effects and create the hot flashes. So by giving a little bit of thyroid—giving a little bit of uhm— female hormone support, we can drop down that FSH then we can also modulate the receptor sites with some herbs as well to help with how flashes. Whether we use maca, or  we use dong quia, or black cohosh or raspberry root, or shepherds purse. There’s different nutrients or herbs we can do to help modulate that. So again, you could still have hypo, low thyroid issues, but have menopausal issues because of the low estrogens, which could drive the hot flashes up. So it’s kind of a conundrum. The hot flashes may—may overshadow this low thyroid thing over here. So as we get the female hormones fixed, you may notice the low thyroid comes back later on because it’s just not a secondary issue and the primary issue is the menopause. Once that’s ruled out, now this one comes to the surface.

Evan Brand: Got it. Well said.  We should probably do a whole show just on low estrogen if we haven’t.

Dr. Justin Marchegiani: I think that’d be great. I mean, I see estrogen dominance is a big problem.

Evan Brand: Right.

Dr. Justin Marchegiani: Where estrogen –the ratio of estrogen is higher than progesterone, right? So progesterone should be like this 25 to 125 times more than estrogen. But if that ratio starts to creep up where estrogen gets higher, that’s estrogen dominance. The problem is a lot of people, though, where that ratio—they’re estrogen dominant, progesterone’s slow but estrogen is also low. So they get this estrogen dominant, but also low estrogen sums at the same time. So it’s kinda like this conundrum. It’s like this little tug of war that’s happening there.

Evan Brand: Wow. Put it on this to do list. It sounds like it’s gonna be a fun one for us to dive into more. And I’ve probably got some stuff to learn from you on that topic as well.

Dr. Justin Marchegiani: I think it’s great. Well any last questions, comments, or concerns, Evan?

Evan Brand: No. I think this has been good. People, you got to get the testing run because if you don’t test, you’ve guessed. So if you’re trying to figure this out on your own, even if you’re not working with Justin or myself, then get the test run. Find a functional medicine practitioner they can take care of you. We are accepting new clients, so if you do need help, feel free to reach out justin health.com evanbrand.com We run these labs on all of our clients because it’s the foundation. We’ve got to have the data. We’ve gotta have the puzzle pieces on the table; otherwise, you can’t move the needle. We could throw a bunch of random stuff at you might help, can’t hurt, but we want to get you better. There’s a systemic process that we do step by step by step to take you through this. So happy to help. Reach out if you got questions and thanks for tuning.

Dr. Justin Marchegiani: Oh! One last thing, man. I forgot to add.  This is so important. Low calories.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just not eating enough calories will cause low body temperature. It’s shown to cause a low level T3. Now this is important because if your diet is 25% crap Ola and let’s say you’re eating 2000 calories a day and then we switch you over— we switch you over to a uh— autoimmune kinda Paleo template, but you’re only able to—to—to switch over 75% of your diet because you don’t—you don’t have enough you—you can’t replace all the crap that you’re eating with the good stuff, right?

Evan Brand: Right.

Dr. Justin Marchegiani: Because if you’re eating a whole bunch of crappy carbohydrates and stuff and then you replace it with a whole bunch of really good vegetables or lower sugar foods, well guess what? You’re probably didn’t replace the calorie amount either. So now you got this 25% calorie deficiency. So now instead of having 2000 calories, right? Now you’re having 1500 calories and maybe metabolically you need 2000 calories. Now you’re 500 calories in the hole which means your 500 calories deficient of various nutrients. So now your metabolism goes low coz there’s less fuel. That’s important. I see a lot. So you gotta  work with someone that really can make sure you’re exchanging the foods and you’re getting enough calories as well. Coz calories equal nutrition. if you’re eating real foods.

Evan Brand: I’m glad you mentioned that. That’s such a simple but common issue. If you’re going AIP, you are going Paleo, you’re eating real foods, you could have an entire plate full of broccoli and it may only be 50 calories.

Dr. Justin Marchegiani: Exactly.

Evan Brand: Yeah. Dude, great job. Way to kill it.

Dr. Justin Marchegiani: And of course, the infections like you mentioned can really suck down the energy. Of course, acute infection, you know, you’re causing a fever, right? Because the immune system’s trying to up regulate itself because a lot of the bacteria and crap there uhm—they’re like—they’re mesophilic. They—they thrive in a medium temperature. So when you go a little bit higher, you can actually kill them off with a higher temperature. But these chronic bugs can really deplete the energy the body and create this kinda lower temperatures as well. For sure.

Evan Brand: Yeah. And I went—I went to low-calorie for a period of time, not intentionally, not on purpose. It just happened. I was eating meats, I was eating veggies and  I track my calories for a few days and I was eating m—and my activity level  and all that. I was probably 4 to 600 calories deficient. So just added in an extra tablespoon of butter here and there, half of an avocado here and there, handful of nuts and seeds. And I was right back up to where I needed to be.

Dr. Justin Marchegiani: Like here’s a seesaw right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So if like carbohydrate is here, if carbs go lower— this is fat over here. The fats have to go up.

Evan Brand: Yup.

Dr. Justin Marchegiani: If you keep the fats here, you keep the fats on—on this side low, and drop the carbohydrates, that’s where the problem happens. The fats also have to go up. That’s the biggest issue. Proteins typically stay in the middle. Typically, proteins only go up if you’re doing a whole bunch of protein powders because proteins and fats are intimately connected. Uh so if you’re eating real whole foods, you know, it’s hard to get just proteins in whole foods, unless you’re doing maybe like venison or rabbit or like boneless chicken breast. But if you’re eating full fat foods, you’re gonna get fat. And then if you’re adding fats to your vegetables, you’re gonna get extra fat without the protein there as well.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So keep that at the back of your head.

Evan Brand: Perfect.

Dr. Justin Marchegiani: Anyone listening here, give us comments below. Give us some shares. Give us some likes. We want to hear thoughts in the comment section. If you’re listening to us on iTunes, that’s great. Click below and subscribe to our YouTube channel. You can see Evan and I’s mugs going back and forth in our little combos here. And then you can give us some comments below here on YouTube. We love the see the feedback. And Evan, hey man, you have a great day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care. Bye.

Evan Brand: Bye.









Hashimoto’s Triggers – Autoimmune Thyroid – Podcast #143

Hashimoto’s Disease - Autoimmune Thyroid

Dr. Justin Marchegiani and Evan Brand talk about the different causes and triggers of Hashimoto’s disease. Find out how it is connected to one’s immune system, diet and gut health and learn why women are more susceptible to having it.

The thyroid, adrenals and gut health are important factors to consider in addressing Hashimoto’s disease. Listen to this podcast and learn about the natural solutions and beneficial supplements to support them.

In this episode, we will cover:

01:29   Hashimoto’s Disease

09:24   Socialized Medicine

13:40   Use of Secretory IGA in Measuring the Immune System

15:39   Women and Stress-sensitivity

18:24   Ketogenic Diet, Insulin Resistance and Hashimoto’s







Dr. Justin Marchegiani: And we’re back! Evan, it’s Dr. J. How are we doing, man?

Evan Brand: Pretty good. How are you doing?

Dr. Justin Marchegiani: Good. I’m loving the ambience. My new plantation shutters in the background; just loving that there. Just nice. Ready for an excellent day. Got a little lunch break here. I’m seeing patients all morning. Ready to drop some knowledge bombs, and then get back to patients in the afternoon. How are you doing, on your afternoon?

Evan Brand: Yes. Likewise, same story. I had a female client this morning, who I was telling you over air. We had run her blood work before…

Dr. Justin Marchegiani: Uhhmm–

Evan Brand: …previously. And it was basically just a checkup. I said, “Hey, why don’t we check your thyroids?” She didn’t really have hyper or hypo symptoms, and she showed up with thyroglobulin antibodies, which is one of the type of antibodies you and I test our clients for on blood. And she showed up with a level of 50. And we should see that, as minimal as possible. I mean, hopefully less than 1, but she’s had a 50. And she said, “What’s triggering this?” And, we can go into that today, but I was hoping you and I could really outline a lot of different causes and triggers of Hashimoto’s because it’s so common in our females, we see it every single week. It’s like – well, there different triggers for different people. So, hopefully, we can try to go into a couple of different arenas here, and talk about the big puzzle pieces.

Dr. Justin Marchegiani: I like that. And then people on Facebook, we also got Evan’s audio on the background, too. So, if you’re listening on Facebook, go over, jump on YouTube, justinhealth.– or youtube.com/justinhealth and vice versa with YouTube. Get on the Facebook page so you can get this live feed. We’d like to them and do our Q&A’s too. So this is great. So, a hundred percent. Hashimoto’s the big issue, vex about 30– or thyroid issues, about 30 million people in this country, uh – I’d say, at least, hmmn– I’d say a quarter of probably undiagnosed, or at least undertreated or undersupported because they’re given synthetic thyroid medication. That’s– is T4, right? T4 in origin. And then you have these various enzymes called D2 and D3, that help convert and activate thyroid hormone. And the problem is those enzymes, if you have Hashimoto’s, there’s a good chance that D2, D3 and even D1 enzymes are not working optimally, so then that conversion of T4 to T3 – that inactive thyroid hormone to active T3, about 400 percent increase in the metabolic activity of T3 versus T4, those enzymes aren’t there for the conversion. So that’s a big issue, right? [crosstalk] And not to mention, when you take a thyroid hormone, you’re getting a T4, right? But you’re also getting T3, right? Triiodothyronine, which is your active thyroid hormone, you’re getting T2, which isn’t even tested, right? T2, uh– Diiodothyronine, is a metabolically active hormone, only measure in the research settings, and not even really talked about in conventional medicine, T1, T0, Calciton, which is very helpful for Calcium metabolism. So, again, we’re not getting that in our conventional thyroid medication. The big thing is those D2, D3 enzymes that you’re missing, that T4 to T3 conversion with. So lots of people are being medicated with thyroid hormone, right? Synthroid, Levoxyl, Levothyroxine. Though TSH comes back in the normal range, so they look good on their conventional doctors uh– thyroid test, but they still have all these thyroid symptoms, right there. The thinning hair, the outer third of the eyebrows, swelling of the hands and feet, anxiety, mood issues, constipation, depression, and they’re not getting better.

Evan Brand: So, why? What’s up with these enzymes? What’s happening to them?

Dr. Justin Marchegiani: Well, I mean, there’s the underlying physiology, typically, inflammation, right? Inflammation is what drives people into that disease, or pathological state, right? And that pathological state means more symptoms, right. All the things I just mentioned, the moods, the digestive stuff, uhhmm– the hair loss stuff, the energy, the weight gain, all those things are gonna be affected. Now, a big component we talked about it, ‘cause a lot of these issues, right, thyroid-based things are gonna be autoimmune in nature, so autoimmune means your immune system is actually attacking your thyroid gland, so you have these antibodies, like TPO or Thyroperoxidase, you have antithyroglobulin antibodies, and these are primarily with Hashimoto’s, for instance, and they come and they attack your thyroid gland. And that’s about 90 percent– let’s say 50 to 90 percent are autoimmune in nature, so you and your conventional medical doctor or your endocrinologist says, “Oh, here’s – here’s the conventional thyroid pill.” They’re not actually getting to the underlying immune– immune imbalance, right? They’re not fixing the underlying things, like gluten, right. Grains and gluten, and that molecular mimicry that happens where your immune system can be exacerbated ‘cause of Gluten. That’s the one, one really big component. Couple of others will be gut – the gut issues. So, small intestinal bacterial overgrowth, gut bacterial imbalances, infections, H.pylori, Blastocystis hominis, uh– Lyme or Borrelia burgdorferi, uhm – Yersinia enterocolitica. So those are just a lot of gut infections that can significantly affect your GI. And again, that sulphatase enzyme in the gut made by healthy bacteria, really helps to activate, that thyroid hormone really helps to upregulate those D2, D3 enzymes to get your T4 to T3. So, all that technical jargon, what the heck does it mean? We’re trying to get your– your active thyroid hormone up higher; that’s the goal. Your T3 levels, get them up higher because, just doing it on the conventional side, and say, “Hey, let’s give you uh– a synthetic thyroid hormone.” That may not be enough to actually get the end stage thyroid hormones better. It may make the upstage TSH look better but not the downstream T4 and T3.

Evan Brand: Conventional, like the National Institute of Health, though, say that the Hashimoto’s affects one to two percent of people in the United States. Do you agree? One to two percent or do you think it’s much greater?

Dr. Justin Marchegiani: So you’re saying– repeat that question, one more time for me.

Evan Brand: National Institute of Health– is it – do you heard– are you hearing echoes? Is that messing you up?

Dr. Justin Marchegiani: No. No problem. I just got a comment here. Someone’s saying they’re not hearing the audio on the YouTube site. [crosstalk] You guys are hearing the audio, give me a thumbs-up here, but I think we’re looking good.

Evan Brand: Okay. So, National Institute of Health, they say, “Hashimoto’s affects one to two percent of people in the United States.” I think it’s much, much higher. Izabella Wentz, I think she gave a number that was much, much higher too. What’s your take on this percentage here?

Dr. Justin Marchegiani: Yeah, I think it could be much higher, for sure. I think it could be much higher, and the big issue is that most doctors they aren’t testing for thyroid antibodies. That’s the major issue. Uh– we talked about a patient this morning over in Canada, whose doctors aren’t uhm– they aren’t even testing for thyroid antibodies. And the big reason why is because, think about it, right? If the solution is a synthetic thyroid hormone, like Levoxyl, or Synthroid, or Levothyroid, right, if that’s the ultimate end game, and that doesn’t change whether there’s autoimmunity or gluten issues, or infections, then it stays the same. Why change that, right? Why change that variable up because they’re not gonna do anything different if something else comes back, right? Does that makes sense?

Evan Brand:  Yes, it does.

Dr. Justin Marchegiani:  Even though 90 percent are autoimmune in nature, right? Even though 90 percent of thyroid issue’s autoimmune, they’re not gonna do anything different anyway, so why even look for it? Because then, it just creates more questions the doctors have to answer, and they don’t like to answer questions they’re not prepared to uhm– to answer. Most people…

Evan Brand: And they’re not trained, because if antibodies do come back, they’ve got nothing. They’ve got no way to talk about Klebsiella and Citrobacter bacteria that need to be treated. Uh– yeah, and so uh – just to give a little bit more back story on the Canada, so– you know, Justin and I both have clients in Canada.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And they’ll say, “Hey, we’ve got health insurance over here. It’s free.” But there’s a catch to that. It’s not that good. All they’re gonna do is they’re gonna run, like, a one-marker, like maybe TSH, and then based on that they may give you a prescription drug. But if you don’t have your free T3, the reverse T3, the TPO, the TG antibodies we talked about, may not always using Algin, maybe you tell me there’s a better analogy, but mine is: if you just have TSH and you’re trying to treat thyroid, it’s like touching the sidewalk and estimating the forecast.

Dr. Justin Marchegiani: Yeah. That analogy sounds really, really familiar. I don’t know why.

Evan Brand: There’s no way you came up with that. I’m pretty sure…

Dr. Justin Marchegiani: I came up – I came up with that one. That’s been around for, like, six or seven years, ‘cause that’s how I teach my patients about TSH– TSH. The receptor sites in the pituitary are hypersensitive. The thyroid hormone, therefore, uhm – TSH will drop– will drop more precipitously because the brain is sensing thyroid hormone being a lot higher then what it is. So, peripherally, the thyroid hormones never get high enough and the periphery in the actual tissues but it’s– it’s high enough in the brain ‘cause the brain’s more sensitive to thyroid hormones. So, TSH will always drop faster than what the peripheral tissues need uh– in the periphery there for thyroid hormone. That’s why you don’t want to base your dosing or your support of the TSH 100 percent, ‘cause the TSH is so sensitive. Touch the sidewalk outside when it’s a hundred degrees out, it’s gonna be able to fry an egg on it, right. But again, the air temperature will always be a lot cooler. The peripheral tissues will always be less saturated with thyroid hormone uh– than the latter. Make sense?

Evan Brand: I’ll give it– I’ll give you a credit. It must have rubbed off of me then, if you had that one before. [laughs]

Dr. Justin Marchegiani: It did. I do– that’s mine. That’s uh– that’s a Dr. J-ism. But I’m– getting back on your thing, man, yeah. Socialized medicine for the most parts thinks– Okay, I’ve seen patients from all over the world. All over the world, Europe, Canada– Socialized Medicine’s great if you only need it for acute traumatic issues, right? You sprain your ankle, right? You have to go to the ER, ‘cause of some reason. But outside of that, if you getting stuck on that chronic conventional model, all you have for options are conventional drugs, right? And then number two the waits are like, three to six months to get in. Again, this is what happens. I have hundreds of patients where I’ve had this story, literally had this story they literally told me over and over again. And then because everything is socialized, the government says we’re not gonna reimburse. Reimburse then guess what happens. There’s not a market place for it, right? There’s less people going underground. Now, I do have people over in Canada that are functional medicine doctors and they’re doing– they’re thriving even in a socio uh– even in a uhm– sociological medicine society there, right? Even with a socialized medicine society because, people aren’t getting better even though the medicine’s free they’re still going in paying a lot of functional medicine doctors. And again, we start today. Why am I hampering on this is because, that doctor wasn’t running TPO or any of the thyroid antibodies. So, the socialized medicine said, “Nope. We are not gonna test your thyroid antibodies. We deemed that not appropriate, and this person needs to know they have Hashimoto’s so they can make changes with their immune system, with their gluten, with the gut, with a lot of the converting nutrients to help T$ and T3.

Evan Brand: So let’s– let’s go through a list. I know, we could kind of jump around but, maybe we could do like a top five [crosstalk] or maybe even like a top ten.

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

Evan Brand: So, number one– in no particular order, but number one, you already mentioned gluten. So, this would include any grains, right? ‘Cause even like our Amaranths, our Buckwheat, our Kiwa. That Kiwa could still be cross-reactive and trigger the antibodies, right?

Dr. Justin Marchegiani: Correct. I would still stay away from all grains. Grains probably being number one trigger becau– partly because of the amino acid sequence in the grains, I very similar to the surface proteins of the thyroid. That’s number one. So [inaudible]…

Evan Brand: What about now? Are you seeing issues with him?

Dr. Justin Marchegiani: Well, I mean, that’s a cross-reactive thing so, if gluten is like, you know – if gluten is like the brother and sister, you know, Hamp’s kind of like, maybe the cousin, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: The second cousin once removed, so to speak. S, again uhm– it may be something that needs to be pulled out with someone on an autoimmune kind of elimination provocation diet for at least a month or two. So, the grains component’s really important. Got to get that out. But not just the molecular mimicry thing. There’s uh– some research looking at Non-Celiac Gluten sensitivity, where they talked about gluten. Even in people that aren’t really Celiac or aren’t even a gluten, like, sensitive person, so to speak. Where just taking that gluten in, they still get gastrointestinal permeability. The guts gets a little bit leaky even with uhm – the fact that they aren’t really gluten-sensitive, so to speak. They aren’t gluten-sensitive but that’s the gut permeability that’s driven by the gluten. And prior, what’s happening is, we’re getting this protein called Zonulin increased. And Zonulin basically unzips, so it’s like an unbuttoning my shirt. That’s Zonulin, right? Unbuttoned zip, right? Opens that gut lining up, and then all these digestive proteins you get right through there.

Evan Brand: So, Zonulin goes up in the presence of grains. We had a question in the live chat about Brown rice. Absolutely, Brown rice would still be in a category of grains that you would want to remove.

Dr. Justin Marchegiani: Yeah.

Evan Brand: If you want to avoid Hashimoto’s. I tried to justify with you for a long time, “Oh, I love my white rice.” You know like, man, it’s just not worth it. And now uh– saw this stew– sweet potato now, and…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …my skin. My skin’s actually gotten better, too. You know, Even though I’ve pulled out – I’ve pulled out the rice.

Dr. Justin Marchegiani: Yeah, man. You go back to your old uh– YouTube videos, you had some– some stuff going on there, [crosstalk] and you like’s porcelain skin.

Evan Brand: I tried gut bugs, too.

Dr. Justin Marchegiani: Yeah. Use some gut bugs, man. You’re almost up to a runway model status, Evan.

Evan Brand: I don’t know about that but I appreciate it.

Dr. Justin Marchegiani: You’re getting there. Good.

Evan Brand: Oh, so gluten, [crosstalk] so gluten grain…

Dr. Justin Marchegiani: Gluten and the Zonulin – gluten, the Zonulin stuff and then also other grains still may have some gut irritating compounds, right? The Lectins, some of the Phytates, some of the Oxalates, some of those things, which can be irritating on the gut. So, really, it comes down to like, getting the immune system in the molecular mimicry going. But then it also has some impact on the Zonulin and the leaky gut.

Evan Brand: Okay, so you already said the immune system. Let’s hit on that piece. Let’s make that like our number two or number three. Uhm – we can measure the immune system with the secretory IGA on the Stool Test that we’re running on people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Uhm – can we go on that number and just use secretory IGA as our immune system, kind of our first line of defense?

Dr. Justin Marchegiani: Yeah.

Evan Brand: And if we see IGA’s low, can we say, “Okay, you’re more susceptible or…”

Dr. Justin Marchegiani: A hundred percent.

Evan Brand: …this will trigger?

Dr. Justin Marchegiani: Yeah. We’ll see low IGA levels. IGA is that mucosal membrane barrier. It’s that first line of defense that lines the gastrointestinal tract, all your mucus membranes, your mouth, you know, our anal cavities, flatulent tract, urinary canal, everything. Every little surface there, even your eyes have IGA in the surface there. Your first line of immune defense. So, when that gets weakened, typically, it will go up and there’s an acute infection. You’ll see it there. We run Stool Test while measuring the stool, and then we’ll actually see it drop down for Chronic Stress. So IGA’s really important, ‘cause that’s a good measurement that your immune system is under stress.

Evan Brand: Right. So, a lot of times, more often than not, you and I are gonna see chronically low IGA, indicating that someone’s been dealing with these issues for a long time. So, Chronic Stress, overwork, maybe they’re not sleeping as well as…

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maybe they have gut infections that are damaging that IGA because people may say, “Well, if I’ve got Hashimoto’s, how did I get a low immune system in the first place?” Well, chicken or egg, all of it– I mean, you could have had adrenal stress, which then weaken the gut. Then you picked up gut bugs, or vice versa.

Dr. Justin Marchegiani: Yeah, absolutely.

Evan Brand: Okay, what’s– what’s next?

Dr. Justin Marchegiani: Yeah, typically it’s a combination of emotional stress that tends to set people up. That tends to be it. So, there’s, you know, you choose with whatever’s happening with your life: work stress, financial stress, family stress, kid’s stress. Whatever’s happening there, that tends to set things up, and that will weaken the immune system.

Evan Brand: I had a female client did uh– that I talked with earlier. She’s a teacher, so she’s on summer break, right now. She’s feeling much, much better. But when she’s back in school, she’s done. She wants to get out of the field of teaching. Everything kind of gets worst, symptom-wise.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So that’s a good example of work stress…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …right there.

Dr. Justin Marchegiani: Yeah, absolutely. And then, women are a little bit more prone to it, because there’s actually a research on this, where their immune system can go out of balance. Like, one emotional, like, you have an emotional argument with the woman, their IO6, their Intergluten-6 can go out of balance for up to two days after a fight. For some of the men, they can go out of balance for like a few hours, but then it’s back in. So I always– this is part of the mechanism why women are more prone to autoimmune conditions. Their immune system probably just a little bit more, I should say, a little more sensitive. And there’s also the Estrogen issue, right, because, Estrogen can affect the CD4 to CD8 balance. And they can skew that balance. So, the more women are Estrogen dominant. That can throw off their immune system. Their CD8, CD4, their natural killer cell, to help her cell ratio. CDH’s your natural killer. Your CD4’s your helper cell. And they could skew that ratio uh – up.

Evan Brand: So, I’m guessing the– like the ancestral view of why woman’s immune system would be more sensitive. Would you say just because of uh– uh– having children, where the immune’s got to be able to modulate itself not to attack and kill the fetus, for example. So, their immune system’s a little bit more variable than a man. Or what do you think is the ancestral lenses?

Dr. Justin Marchegiani: Yeah. I think, it probably has to do with uhm– I think it probably has to do with just raising children in that extra level of empathy, being able to take on other people’s feelings, and kind of be able to uuuh– what’s your need, right? You got, like, you know, you’re raising a child. You have to be to really sense what’s going on. I think that may play into it. I’ve zero evidence outside. That’s just my opinion; just observation. But there’s research and studies on that. Also, blood sugar can throw people’s immune system off to. So like skipping meals, and not giving enough nutrition, and just going long periods of time. So, that’s a big thing, right. That’s a big thing, so, I just, you know, I tell people just make sure you get your communication and your relationships kind of dialed-in. If you’re having issues with the spouse, get the communication down. Try to get, like, try to create a really good environment, where you can communicate, and you’re not gonna get flooded and drive people’s immune systems off.

Evan Brand: Right.

Dr. Justin Marchegiani: You know, that’s kind of, that’s number one. Number two, so let’s get meals, right. Now, when you’re healthier, you can play around with intermittent fasting, okay. That’s a good tool, but you got to get it dialed-in with your hormones good first, and you feeling good first. I may get that dialed-in later on.

Evan Brand: Oh, how about Ketosis too. Like, I tried it with Dr. Mercola, and he’s like– he’s like concerned that a lot of people are going into a ketogenic diet but they’re doing it for too long. So, he’s kind of a proponent of, like, five days on and then two days off. Or hold his go and eat potatoes, and things like that. And really kind of carb-griefy. So, how much of this thyroid epidemic, Hashimoto’s even kid of in the Health Space where you and I are working. These women come into us. They have triggered Hashimoto’s, do you think Ketogenic diet could be a trigger, potentially?

Dr. Justin Marchegiani: Well, I think, Ketogenic diet has actually helped a lot of people with Hashimoto’s, especially ones that are insulin-resistant, because insulin-resistance can actually block thyroid conversion. So, that’s my issue– is if your insulin-resistant, you may do really well with the Ketogenic diet for a while, but then you may hit the wall.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, then the question. When you hit the wall, that’s where you may start gradually increasing your carbs up. Maybe 10 grams a week, and maybe do a couple of low carb days, like Keto days, and then come out for one or two days in the higher carb side. But, I think, if you’re coming into this, being overweight, with uh– hips circum– you know, waist circumference greater than 35 for a female, 40 for a male. There’s probably some level of insulin-resistance that a Ketogenic diet will help reverse. But then you may have to refine or retune your carbohydrate thresholds afterwards.

Evan Brand: Okay, and that will always be based on adrenal health, and that would be based on, maybe, Vitamin D status or gut infections, depressants, of those. There’s always more, more things, so when people find, “Oh! Ketogenic diet,” It’s like there’s so many different variables out there and these other pieces of the puzzle.

Dr. Justin Marchegiani: Yeah, yeah. I mean, Atkins was sniffing around the right area when he started talking about Ketogenic diets in the 70’s. the problem with Atkins is, he didn’t put enough qualifiers on it. I mean, okay, great. So I eat a whole bunch of meat now, is that gonna be hormone antibiotic, free, you know, laden meat, or is it gonna be organic grass-fed. Oh, Atkins says soy protein’s okay. Eeh! Aspartame’s splendid, okay. Eeh! Right, not good. So, protein quality’s really important. So, if you’re gonna do protein powders, you know, Collagen peptides, you know, P protein, like maybe– maybe some really good grass-fed wheat protein, right. Choose really good protein sources if it’s powder. Or choose really healthy meat souces, or really fat sources. Lots of toxins are stored in the fat, so if you’re eating diseased animals, you’re not gonna get high quality of uh– of a meat product passed down to you from a nutrient perspective.

Evan Brand: Yep, well said. Okay, so we hit the secretory IGA, we hit the Zonulin, we hit the gluten.

Dr. Justin Marchegiani: Also, we talked about thyroid nodules too, right. Someone on uhm– Facebook here, had commented here. So, thyroid nodules are just like these little abnormal tissue spots in the thyroid, but typically gonna be driven by autoimmunity, right. So, Hashimoto’s gonna be the major thing. Hashimoto’s, typically, is an autoimmunity that is involving TPO antibodies, and antithyroglobulin antibodies. Now, again, all autoimmunity, for the most part, will end in low thyroid. The difference is grave disease has a couple of antibodies that can jack up thyroid functioning. Keep it up to the point where you may stroke or you may have an issue if left untreated. So, we that with TSI or Thyroid Stimulating Immunoglobulin and also TSH Receptor antibodies, so, which you want to make sure under control. Why? It helped saved many thyroid uhm – from going into uh – graves or a thyroid storm state by using specific nutrients to help it. and also…

Evan Brand: What happened with uh– with thyroid nodules? Let’s say, someone…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …has antibodies at that point. Maybe we suggest they go get a thyroid ultrasound. They say– Okay, hey. Can you palpate? Like, would you suggest an ultrasound, or can you palpate and figure out whether you have nodules?

Dr. Justin Marchegiani: Oh, great. Let’s go into that. So, try to palpate the thyroid is – Find the Adam’s apple, so like, mine’s right here.

Evan Brand: Get a little closer to the mic, so people can hear good.

Dr. Justin Marchegiani: Yeah. This is your Adam’s apple right here. Right. So, I feel here. I go down, about one centimeter, and then out a centimeter. And, you know, I would do it by standing behind myself, who I can step out of my body. About be here. I touched each side and I press it into the other. And I would have myself swallow water. And I would feel, just for any irregularities in the surface. It will be almost impossible to do it to yourself just as I demonstrated with the angle. But you would stand from behind someone, and you have just nice flat palms, and you just go through the surface, and you touched, you pushed, and you want to feel it come out in the other side. And basically, you want to just feel a smooth surface, and you want to not feel it as an inflamed puffy. You have to feel a couple normal ones to know but, that will give you a pretty good idea.

Evan Brand: The ultrasound sounds easier though. I mean, let’s just say, that you come back with nodules, what happens? Do you just – do you just play the waiting game? You just watch him or how do you approach it?

Dr. Justin Marchegiani: Yeah, I mean, it depends where you’re at, right? There’s always that increase chance of potential thyroid cancer, right. So, it’s good to get that screened, ‘cause of the increased risk. But it’s not the first thing I worry about. Because if you just do all the things that we tell you, I can’t tell you how many patients whose nodules have just significantly reduced. Significantly reduced.

Evan Brand: Yep.

Dr. Justin Marchegiani: Though, I’ve seen that happen so many times, so, hey, you know, just run it by your endo. See what they say. And then just let them know that you’re gonna do some things on the functional medicine side. And, come back and monitor it. you just want to make sure it’s moving in the right direction. Now, some nodules can be caused by low Iodine, too. Again, w tend to get enough Iodine, a couple hundred MIC’s really odd. You need like 200 MIC’s is like they already– hey, you may need a little bit more, but you got to be careful with supplementing Iodine because the Iodination process that happens, so– Iodination is nothing more than the Iodine bonding to the Thyroxine molecules to make your thyroid hormone, right? Like T4 is your Thyroxine, your 4 molecules, your Thyroxine bound to four molecules of Iodine. That process of binding it and pulling out the sticking glue getting stuck there. That’s called Iodination. That process spits of a lot of Hydrogen peroxide which can be inflammatory. And that can drive a lot of B cell infiltration. Your immune cells into your thyroid and exacerbate that autoimmune attack. So you got to be careful off the bat when giving any Iodine. So I always like to get in the Selenium in there first, get the diet dialed-in, get the lifestyle stuffed-out then, and then really lower the information first before I go after it. And if we go after it, we’ll titrate that slowly. We won’t go at it hard. There’s a lot of docs out there that go really high in the Iodine I don’t recommend going high of the bat. I think it’s better off going slower, and work on the foundational stuff first.

Evan Brand: Yeah. Love it. Uh – I was gonna ask you a question about Iodine. I forgot what it was. Tsk. Darn. I lost my point. Alright. Let’s keep moving on. What else comes to mind for triggers.

Dr. Justin Marchegiani: Yeah. So we talked about the food stuff. We talked about blood sugar, we talked about emotional stress. That’s still a big one, okay. Because, emotional stress taps in to your sympathetic nervous system and your sympathetic nervous system wires right down to the adrenals. And that’s umping out Cortisol. Pumping out Adrenaline. And your body will always sacrifice sex hormones for stress hormones. It’s just the hardwired adaptation. Right? If you don’t survive today, you’re not gonna have to worry about reproducing tomorrow, right?

Evan Brand: Yep.

Dr. Justin Marchegiani: So, gut component– the gut component’s very important. We talked about gut bacteria, and how the healthy bacteria’s really helpful with the Sulphatase. Also, that’s where we absorb nutrients, right/ that’s where we absorb a lot of our B Vitamins, a lot of our minerals, a lot of our amino acids, right. Thyroxines and amino acids, that’s part of making thyroid hormone. Also, 70 to 80 percent of your immune system is located in your gut, right? So, you want to jack up your immune system, you know, just get your gut in bad shape by not digesting food, putting a lot of inflammatory things in there. [crosstalk] And uh – throwing off your gut bacteria and uh – whole bunch of steroids from the foods, antibiotics from the foods, anantibiotics in your uh – medicines for maybe, reasons that, maybe be unwanted, so to speak.

Evan Brand: Right. Yeah, the gut’s huge. I mean…

Dr. Justin Marchegiani: Yeah.

Evan Brand: I don’t really like the term SIBO because it’s so generic, but you and I, we see so many different species of bacteria. We can assume that most of them are going to be growing up from the colon to the small intestine.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So if you’ve never been diagnosed to SIBO, or any type of bacterial overgrowth, like specifically, Justin and I are gonna  be looking for, like, a Citrobacter or Klebsiella, or there’s two species of Proteus. Those are all autoimmune trigger bacteria. That’s in the literature too. So, if you’ve got bacterial overgrowth, bacterial infections, parasites, Yeast, or like we see many times a combination. So it could be a Citrobacter, plus Blastocystis hominis, a parasite, plus Candida. That’s uh – that a – that’s a triple whammy there.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That could definitely cause the antibodies to go up. The good thing is this is reversible, right. Now, would you say– I know for us, you know, we’re not medical doctors so we can’t use the term uh– cure. Uh– but is it possible for a cure for Hashimoto’s or when you get your antibodies down, let’s say, you were at a 50 on your TG antibodies, and we do all the good work with you. We get the antibodies back down, let’s say, below a five. Are you cured or can you always just rebound quicker than the average person back up to that bad state of Hashimoto’s again?

Dr. Justin Marchegiani: Yeah. I mean, you can always ramp back up, but it’s all about adaptation, right? The healthier you are, the greater ability you have  to adapt to stress. So, when you have the susceptibility for a certain disease. So, someone posted on Facebook, I have anti-NaN antibodies, that’s kind of a very broad sense, but your predisposed to certain conditions, certain diseases. Maybe Rheumatoid arthritis, maybe Lupus, maybe Scleroderma, maybe CREST, right. So a lot of autoimmune conditions you may now predispose for. But that just means you have the genetic triggers, those genetic switches, are kind of right in the middle, and if those stressors flick it down, right, that stress could flip that gene on and they could activate. So we managed all the things that we talked about, right? Blood sugar, nutrient density, stress, grains, gut health, uhm – being infection-free, ideally, healthy probiotics, healthy gut bacteria, and then making sure that if there’s thyroid damage already, we support that, making sure we support thyroid activation, right. Zinc, Magnesium, CoQ10, Selenium, maybe the right Iodine, use your functional doctors resource, making all those nutrients and things are dialed-in. That’s gonna significantly help improve your resiliency, so if you do have a disease, you may be able to– your body may be able to keep it in check enough, were the symptoms aren’t even visible. But some they say you’re cured, but legally we can’t say you’re cured.

Evan Brand: Right, exactly. What about the liver? What’s the role of the liver?

Dr. Justin Marchegiani: Yeah. Yeah. So the liver’s really important ‘cause a lot of those deionized enzymes. They come from the liver, right. So, the liver’s really stressed and taxed dealing with the whole bunch of fructose coming in there, ‘cause your Insulin-resistant or toxins, and round-up and pesticides, and a whole bunch of junk. It may not be able to do its job, activating and converting thyroid hormones, so we want to make sure, number one, that we are uhm – keeping the stress off it. ‘Cause a lot of liver stuff is more about to stop adding crap to the system, right?

Evan Brand: Exactly.

Dr. Justin Marchegiani: And then number two, I know, Izabella Wentz talks about it in her book, the Hashimoto Protocol. She starts a lot of her patients on a liver cleanse that first month, which can be helpful. So, Liver Support Phase 1, Phase 2, detox support. In my line, it’s uh– Phase 1 is either uhm– Antioxidant Supreme or Liver Supreme, and then Phase 2 is gonna be Detox Aminos. That supports all the Phase 1 and Phase 2 pathways that run your liver. The fat-soluble, the water-soluble, and the water-soluble to excretion in Phase 2. That’s really important.

Evan Brand: So, list of some ingredients. So this is like your Methionines, your Taurines, your milk fissles, [crosstalk] your Vitamins A, you Beet powder, your Artichoke extract.

Dr. Justin Marchegiani: Artichoke, yeah. And then your Phase 2 is gonna be  more of your amino acids. That’s like an acetylation, methylation, uh– glutathione conjugation. All that stuff. So cysteine, glutamine, glycine, uh – taurine’s in there, methionine, uh– We throw Calcium-D-Glucarate in there. Those are really good compounds.

Evan Brand: Cool, cool. Uhm–

Dr. Justin Marchegiani: So I think we hit some good triggers. We talked about some things to help about things to help with thyroid conversion too. We talked about the liver, we talked about the infections and the leaky gut, and then yeah. The whole thing about gluten– oh by the way.– uh– I’ll tell you off the air.

Evan Brand: Alright. Alright.

Dr. Justin Marchegiani: But I’m–

Evan Brand: Hey. Let me tell you something that– before you – I want to –  I want to mention two things. I believe we hit it already, but the adrenal piece, uh– with Cortisol stress, with adrenal problems. You can also pack the conversion of T4 to T3 hormone there. So you got to get your adrenals checklist.

Dr. Justin Marchegiani: Yes. Oh yeah. We got to hit that, man.

Evan Brand: Yeah. So…

Dr. Justin Marchegiani: Yeah.

Evan Brand: So, if you’re working on your thyroid, but you’re not working on your gut, and your adrenals, your results are likely going to not be very good, because adrenal stress is gonna reduce the conversion rate. And then, you can go back to it. But let me say one other thing. I had a client this morning. She was trying to justify uh– eating gluten, and grains, and crackers and stuf like that, because of her food-sensitivity test.

Dr. Justin Marchegiani: Exactly where I was going, man. You’ve read my mind.

Evan Brand: Alright. Her food-sensitivity test said, “I’m not sensitive to gluten.”

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so, she’s still doing gluten. I said, throw your food-sensitivity test away.

Dr. Justin Marchegiani: yeah. I mean the big issue, right. Some of the non-celiac gluten sensitivity research. People that weren’t even gluten-sensitive, they have increased gut permeability.

Evan Brand: Say that again. Just to make sure that it’s like super clear for people.

Dr. Justin Marchegiani: Yeah. People that weren’t gluten-sensitive, right, they weren’t like celiac, they weren’t like having any gluten issues, based on conventional standards, when they got exposed to gluten, they noticed some level of leaky gut, some level of permeability in the gut. Based on the study’s objective criteria diagnosis for it. So that means, more leaky gut, means more immunogenic compounds, undigested foods, LPS, Casein, right – all these things. Dysbiotic bacteria may get into that bloodstream, may start to cause some immune system kind of pissed off, right? Then it may go out looking for that thyroid tissue, or maybe even uhm– the pancreas, or other tissues, or other autoimmune tissues.

Evan Brand: Or even if it doesn’t go straight to that, the gluten could still cause a leaky gut situation, which then sets you up. So, when you go to Sushi Night, you could go pick up Blasto, or some other parasite, which then causes even more damage…

Dr. Justin Marchegiani: Yeah

Evan Brand: …which then leads to the antibodies. SO, one way or another, you’re setting yourself up. There’s really just no justification for gluten in the diet.

Dr. Justin Marchegiani: Yeah, exactly. I won’t give any press to the book. It’s out there right now. We’ve talked about it before.

Evan Brand: [inaudible]

Dr. Justin Marchegiani: Yeah. People say, “Oh. Gluten this and that, maybe okay.” Not necessarily okay. I don’t think it’s uhm– something that people should be consuming. Some people may be able to handle it. Again, if you’re gonna consume gluten, you better off doing it and uhm– sourdough form, if you’re gonna do it. Or, you know, if  you are healthier, right, and you’re on the right track. Every now and then you wanna do a little bit of white rice, as a treat. As long as you’re doing good, as long as you’re on point, right, then I think that’s okay.

Evan Brand: Yep. Yeah, for sure. Alright now, uhm– there was something else. I interrupted you. I hit the Adrenal piece, and I had to talk about the food-sensitivity testing and the lady trying to justify gluten.

Dr. Justin Marchegiani: Yeah, that was it. I think we hit it, and I think just the– the adrenal imbalance, whether high Cortisol or low. So, Chronic stress, low cortisol, with the reverse Cortisol rhythm, or acute stress, really high Cortisol, both can affect your thyroid conversion and activation.

Evan Brand: Yep, yep. Got it. So, I mean, yes. You can take adaptogenic herbs. We love, we promote those, but that’s still not addressing the root cause. So if you hate your job, we can give you all the Ashwagandha, Rhodiola, uh– Siberian Ginseng in the world, and we’re gonna help you adapt to the stress, but you still got to remove the stress. It’s like I know you see the analogy of the engine life, putting the tape over the uh – the check engine light in the car. I like the analogy of like a doorbell too. Like if you keep pushing the doorbell. Uh– your still gonna have issues. You can try to like disable a doorbell, but it’s still being pressed. Like, you hate your job, or you’ve got a turbo relationship. I had a woman, who she told me. She said straight up, “Evan, until I divorce my husband, I will not get better.” And I said, “Well, I fully support you in that decision.” And now, she’s going through the divorce. She’s already starting to lose weight, just based on the reduction of the emotional stress. So I think that’s just amazing, and unfortunately, that happens. But, if you wanna be healthy, you got to make some tough decisions, sometimes.

Dr. Justin Marchegiani: I agree. I appreciate you’d actually given me credit for that analogy. I thought you were gonna pawn that one off of yourself.

Evan Brand: [laughs] No, definitely not.

Dr. Justin Marchegiani: Good, ‘cause I wasn’t gonna give you, like, two Paleo demerits for that, but I’ll hold those back.

Evan Brand: Appreciate it. 

Dr. Justin Marchegiani: Good. You got a credit in a bank of Dr. J here. Excellent. So, I think we hit everything: the Cortisol stuff, we hit the gut stuff. Someone over here, I’ll try him in. So, someone talked about this is functional medicine on demand, can Candida hang around in the thyroid? Candida can create things known as acetaldehyde. Acetaldehyde can be inflammatory, right. Like, it’s one of the products of alcohol. So that can be inflammatory and really affect things. Candida can also get the immune system wrap up. Uhm –  Candida or acetaldehyde in the gut can convert in the Salsolinol. Salsolinol’s known to increase uhm– antibodies to uhm– receptors for dopamine in the substantia nigra midbrain. So, that can create other issues with autoimmunity, so yeah. Candida is not a good thing either. And that’s, you know, that’s according to conventional medicine, not really to exist at all. But we see it all the time.

Evan Brand: Oh, yeah. I mean, Honestly, and I think I may have mentioned this. I told you this or I told people on the air already, uh– sorry if I’ve repeated myself. I’m sure we do that all the time.

Dr. Justin Marchegiani: Yeah.

Evan Brand: But, when I first started learning about Candida and yeast, I thought, “Oh, candida, Yeast.” You know, I kind of put it on like the bottom of the totem pole, below bacteria and below parasites, in terms of the effect on the body. But I’ve seen all kinds of crazy stuff with Candida alone, where it’s like, whether it’s brain fog, depression, fatigue, cravings, I mean, something that sounds so benign. “Oh, Candida,” “I’m gonna do a Candida Cleanse.” It’s like, a lot of people promote it, kind of like– almost like it doesn’t exist, or almost like, it’s a trendy topic, and you can just do some type of, like, “Candida Cleanse smoothie”, “go buy my online candida program and you’re gonna get better”. It doesn’t work that way. But, candida can affect almost everybody’s system, whether it’s adrenals, whether it’s gut, whether it’s Lewd…

Dr. Justin Marchegiani: Totally.

Evan Brand: …depression, anxiety, etc., It can all stem just from a Yeast overgrowth. And I would say, you tell me if your stats are different on your side of clients, but for me, I’ve seen about, nine out of every ten people, shows up with Yeast.

Dr. Justin Marchegiani: Yeah, and the big issue with Candida and Yeast is that, some people have it but, it’s just the tip of the Iceberg. The other infections that may trumpet, so to speak in the hierarchy. So, Candida may be an issue in some people, it can be a main issue. Right? Like, we’ll run a Stool Test, and we’ll see it like, “Oh. We have some Candida there.” And then we’ll look at another test. Nothing else comes back. And then on uh– Organic Acids. We’ll see the Arabinose, or the Arabinitol, really high, so we’ll, “Okay. This really maybe a Candida issue.” And then we’d see some clinical symptoms, like uhm– Seborrheic dermatitis or Cradle cap, or just you know, dandruff. You may see some yellow-discolored fingernails, maybe some white coating in the mouth, maybe some tinea versicolor rash. Right? We may see some of those things that may say, “Hey. This may be a primary Candida issue and we hit it hard.”

Evan Brand: You said that a bit quick. The tinea– what’s that? Yeah. It’s like little blotches on the skin.

Dr. Justin Marchegiani: Okay. They just look like little blotches, and it’s uhm– it’s pretty smooth to the skin. It’s not really itchy. It doesn’t really spread but you want to kind of gross yourself out. Just put it in the Google images, and you’ll see the umpteenth degree of it. But it’s just gentle blotches on the skin. They tend to be a little [inaudible]and scarred.

Evan Brand: I know sometimes people may think it’s that but it could be like Keratosis pilaris instead.

Dr. Justin Marchegiani: Keratosis pilaris tends to be a little bit more flaky, and uhm– that tends to hit the back of the arms. [inaudible]…

Evan Brand: Yeah. Such like on your triceps he’s pointing to.

Dr. Justin Marchegiani: …like little back here. Right? That tends to be essential fatty acid stuff. So again, if you’re having issues digesting fats, someone in our live chat, so they don’t break down fat well. Hope you get the gut work done, ‘cause that’s a big, big component. ’Cause if you’re not breaking down fat well, you’re probably not breaking down protein well, either.

Evan Brand: So that would mean, if you’re spinning your heart and money on a good quality fish oil, then you could be potentially wasting your money even if it’s triglyceride form, if digestion’s compromised.

Dr. Justin Marchegiani: Yeah. I mean, most underrated supplements out there, if you were to start on two things: enzymes and HCl. That’s it. Enzymes and HCl get the diet. [clears throat] Excuse me; frog at me. Get the diet a hundred percent dialed-in so, you can actually break down that food. Put the money on the food quality. Get the food quality up.

Evan Brand: Yep. I had a lady tell me, she’s like, “I feel so much better by doing Apple cider vinegar. I don’t notice taking enzymes and HCl.” And I was like, “Okay. You can try it. But I– I’ve still think HCl and enzymes do better than just …

Dr. Justin Marchegiani: Oh.

Evan Brand: …apple cider vinegar but– so…

Dr. Justin Marchegiani: Yeah. Apple cider vinegar’s a great starting point if someone’s like, “Ooh. I don’t know. I’d had some bad reactions to HCl.” Okay. Great let’s just start with the teaspoon of apple cider, but, we’re gonna go with food in your belly first. And then they’ll do good, alright, let’s go to a tablespoon. [crosstalk] Okay, let’s go to–

Evan Brand: You know what I’d do? I make a little tonic. I’ll do like uh– apple cider vinegar. I recently got uh–

Dr. Justin Marchegiani: Yeah.

Evan Brand: …a lime, or like a citrus, squeezer. So, I’ll do like uh– a lime or lemon and uh– apple cider vinegar in there. And then, sometimes, I’ll add like some Vitamin C, or I’ll add that adrenal tincture I told you about. I’ll add that tincture to it. And it’s like a great little tonic.

Dr. Justin Marchegiani: Yeah. I think that’s great, and then, typically, then we do a little graduation ceremony when we go from that apple cider vinegar to the HCl. That’s the next step.

Evan Brand: Yep.

Dr. Justin Marchegiani: Any of the comments said? What do you think, man?

Evan Brand: I think we should wrap it up. I think we’d hit a lot of different triggers here. And if people want to learn more, you’ve done plenty of videos on Hashimoto’s. We’ve done more podcasts on this, so there’s hours of more content, I’m sure, that we’ve created on this. So, just go on justinhealth.com. You can search Hashimoto’s or search thyroid. You could check out my site too, Evan Brand, and make sure you’re subscribed. So, if you want to join in on the conversation, we can answer your questions on the fly. And, of course, if you want to work with Justin, visit his site too, jusyinhealth.com. You can schedule. If you want to schedule with me, same thing, evanbrand.com. And, we’re available. We deal with this stuff all the time, and don’t take no for an answer. Somebody says, “No, I’m not gonna run these antibodies, then you leave.” You fire them because, if you want to get on the root cause of your issue. You have to have the biomarkers. If you’re guessing and checking, you’re building up your supplement graveyard, you’re not gonna get better that way. You really got to get these number on a piece of paper first, because you got to be able to track them and we have to be able to see. “Okay, look. Once we did this, we fix your gut. We got the adrenal support.” And look at the antibodies, drop, drop, drop, drop. And then eventually, “Hey. Maybe you don’t have a thyroid problem anymore.” And it’s totally possible we do it all the time.

Dr. Justin Marchegiani: Awesome. So, here’s the sequence. Ready? Instead of buying crap food, you increase the food quality, and you choose the right kinds of food. That’s number one. That will start to get– that will start to lower inflammation, and give you more energy. As you start having more energy, you can start cutting the emotional stress out of your life. Get used to it with your spouse. Work on it with your spouse. Get a book on communication. Get it– things fixed with your kids. Do your best to fix things at work. Whatever other stressors, all dealing with emotional stress takes energy. So most people that have a lot of emotional stress, typically they don’t have the energy to deal with it. So, get the energy up by just getting the food right. Then you can start to deal with the emotional stress. And then, once that’s kind of dialed-in, you can start adding in some supplements to fast-track it. first set iss gonna be digestive support, and after that, you really want to work with the functional medicine doc to get everything else dialed-in. But work on the foundational stuff first, and then make sure while you’re doing all that, you’re not causing yourself to spin around in a rabbit wheel. While you’re doing excessive exercise, too much CrossFit, just so you’re getting drained with that. And then if you can combine in the good sleep and the good hydration, now you’re set. So, now, when you go see a functional medicine doc, it’s like, “Boom!” You hit the ground running.

Evan Brand: Oh, man. We could– we could have done a whole podcast just on CrossFit and thyroid issues, so maybe for a future day. But yeah, over exercise – I have a lady last week. She said, she exercises CrossFit six or seven times a week. She’s doing CrossFit, and like, “Gosh!” way too much.

Dr. Justin Marchegiani: Yeah. And a CrossFit may be great if you’re – if you’re already healthy, if you’re diet’s spot on, if  you’re resting hard, if you’re doing some good things, post-workouts and pre-workouts to recover. But if you’re not there, it’s not gonna be the best thing for you to start off. Unless, you’re a gym’s got a really good On-Ramp Program, and they get the Arm Wrap style in, where they’re not doing some, you know– they have some great timing with their Arm Wraps, then it’s probably okay. But you got to go somewhere where there’s a good Arm Wrap Program.

Evan Brand: But even then, even if you were optimally healthy like you were talking about, would you still tell somebody, “Go do seven days a week in CrossFit?”

Dr. Justin Marchegiani: No. No,– the only– I mean, professional athletes do that if they want, but they’re taking naps, and that’s their job during the day. But, the average person, typically, I would say, maxes four times a week.

Evan Brand: Working, living a life, being a parent or uh– spouse, I mean, it’s tough.

Dr. Justin Marchegiani: And, ideally, spread it out. Right? Monday, Tuesday– Monday, Wednesday, Friday gig, you know. During the week, trying to keep a day off in between.

Evan Brand: Yep, yep. Well said. You said something else in your, in your small rant. I forgot what it was. I was gonna– I was gonna ping off of it. But I guess we should wrap this thing up.

Dr. Justin Marchegiani: Yeah, I mean, it’s funny, like, you ping me at lunch time, “Let’s do a podcast, alright.” And then we’re like “Only fifteen minutes. Only. That’s it.” Then, it’s all like, an hour later, “Damn it!”

Evan Brand: I know. 

Dr. Justin Marchegiani: “What happened?”

Evan Brand: I know.

Dr. Justin Marchegiani: We tried to be disciplined. 

Evan Brand: I know.

Dr. Justin Marchegiani: Alright. Well, I think we hit all the good stuff on the foundatinal side. Is there anything you wanted to add to the foundational piece?

Evan Brand: That’s exactly what it was. Blood sugar balance, make sure that that’s keep.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That was exactly a blood sugar balance, hydration, you’re getting your good minerals, using your good salts, uh – using trace minerals if you have to, trace mineral supplements if needed.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Uh– we talked about the fatty acids with the fish oil. Optimizing HCl and enzymes, supporting the liver, gull bladder, supporting detox pathways, supporting methylation if you have to, uh– and looking for the root cause, getting the testing. Without the [crosstalk] testing, you’re guessing.

Dr. Justin Marchegiani: Love it. [crosstalk] Love it. Excellent. Alright. Evan, I’m gonna go hang up here on YouTube. I’ll go say goodbye on my Facebook peeps, and we’ll talk real soon, my man.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care.

Evan Brand: Bye.

Evan Brand: Bye.



“Hashimoto’s Protocol” by Izabella Wentz






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) EFT.mercola.com 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 justinhealth.com/shop 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 notjustpaleo.com or justinhealth.com, 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.









Paleo 101 Part 2: Top 3 Roadblocks When Going Paleo

Paleo 101 Part 2 Top 3 Roadblocks When Going PaleoBy Dr. Justin Marchegiani

Welcome to Part 2 of our Paleo Diet series, where we are looking at lab markers to help you transition successfully to a healthy diet and the roadblocks that can get in your way. In part 1 of our Paleo Diet series. We discussed inflammation, blood sugar, and lipid lab markers and what to look for on these tests as you begin a Paleo diet, or template. Briefly, we want to see your lipids improve, whether it’s triglyceride to HDL ratio of cholesterol to HDL ratio, and we want to see improvement in inflammation and blood sugar. These would be the nice benefits of an anti-inflammatory, nutrient-dense, low-toxin eating plan.

So let’s say you’re one to two months in, and you’re seeing some improvement. It’s going well, and you’re on the right track; but now, you’re hitting some roadblocks. Maybe you’re fatigued or have energy issues, your fingernail quality doesn’t look good, you still have some digestive issues (bloating, gas, constipation, or diarrhea). And maybe they have gotten even worse since you you’ve increased your protein content.

Anti-inflammatory, nutrient‑dense, low-toxin food should not make you feel worse unless your digestive system is impaired in some way or another. So now, it’s time to dig in a bit deeper and get those roadblocks out of the way.

What Are the Paleo Roadblocks?

The three main roadblocks we’re going to address are anemia, infections, and thyroid issues. We’ll also cover the lab markers we would look at when considering each.



In people whose hydrochloric acid (HCl, stomach acid) levels are low, anemia can be an issue. Interestingly, this happens in people who eat a lot of easy-to-digest food. Because of anemia, their stomach acid and their digestive secretions weaken because they aren’t staying tuned up with the proper proteins.

This is seen in people who have a strictly vegetarian or vegan diet. There may even be some gastrointestinal inflammation preventing us from binding minerals. And the low HCL may be preventing us from ionizing so the minerals, such as iron, calcium, selenium and magnesium can get into our bloodstream.

Lab Tests for Anemia

When we see anemia issues, the first pattern we’ll look for is a decrease in red blood cells, hematocrit, and hemoglobin. It may not necessarily be low, but it may just be in that bottom 20% of the range. This will tell us if there’s a broad-spectrum anemia.

The next anemia pattern we’ll look for is through the iron panel. TIBC and UIBC are different iron-binding proteins, and they actually tend to go high when iron is low. So the more binding proteins we have, the more iron our body needs. We will also typically see iron saturation and ferritin levels drop. If we see these markers in our anemia patterns, then we know we probably have an iron-based anemia.

We’ll also look for anemia patterns through B vitamin markers. We’ll look at MCHC, MCV, and MCH. These markers just tell us how big the red blood cells/hemoglobin are. The bigger our red blood cells are, the more immature they are. Red blood cells get smaller as they mature. So this will be an indicator of two kinds of anemia—B vitamin and iron.

Click here for professional advice from a functional medicine doctor regarding how to get started one a Paleo template.



A chronic infection, such as a parasite infection, bacterial infection, viral infection, or even a fungal infection, may be present. These infections will affect our immune system. About 70–80% of our immune system lives in the gastric associated lymphoid tissue (GALT) of our stomach and in the mucosal associated lymphoid tissue (MALT) of our intestinal tract. So with so much of our immune system living in our stomach and intestinal tract, it’s clear to see why an infection could be affecting our ability to properly absorb nutrients.

When we have digestive immune stress, it fires the sympathetic nervous system (i.e., our fight-or-flight system). We have two branches to our nervous system. Our sympathetic nervous system is our flight-or-flight nervous system, and our parasympathetic nervous system is our rest-and-digest system.

When our sympathetic nervous system is fired up, it’s going to drive more of our fight-or-flight response. It will decrease hydrochloric acid and enzymes, and it will increase blood flow to the extremities—arms, hands, and feet—to allow us to fight and flee. This is one of the major issues when we’re under chronic stress, and those stressors could come from infections.

Lab Tests for Infections

One lab test we would look at for infections would be a stool panel, and not just the conventional hospital or Lab Corps tests—I run many of those and they sometimes miss the infection. We would run a specialty test, especially the DNA, PCR-based testing. We have a higher level of sensitivity and specificity on them. Also, we can draw conclusions from a CBC with differential panel. This looks at our white blood cells—our neutrophils, lymphocytes, monocytes, eosinophils, and basophils (an easy way to remember these: Never Let Monkeys Eat Bananas). We might consider the following based on an increase in these cells:

  • Neutrophils—If we see neutrophils high, we’ll consider a bacterial infection. Particularly high neutrophils, above 60, and we’re automatically going to gravitate toward pylori issues.
  • Lymphocytes—If we see lymphocytes low, we automatically think a chronic viral issue; if we see them high, we think acute viral issue. When we see lymphocytes low, however, along with neutrophils high, this is a common pattern for an pylori bacterial infection.
  • Monocytes—If we see monocytes high, it typically means our immune system is fighting an infection.
  • Eosinophils—If we see eosinophils above three, we almost always think parasites. At this point, we would run those specialty stool tests because they will help us determine exactly what type of infection we are dealing with.
  • Basophils—If we see basophils go out of range, typically above one or two, we start to think tissue inflammation and potential allergies.

Thyroid Issues

Thyroid Issues

Next we have thyroid issues. Cold hands, cold feet, constipation, mood issues, and energy issues are all signs the thyroid is not functioning appropriately. So we’ll want to run a complete thyroid panel.

Lab Tests for the Thyroid

We typically run our TSH, which is a brain hormone. This gives us a peek inside the window to what’s happening with our brain and how it’s communicating with our thyroid. We’ll also look at thyroid hormones: free T4 and T3, total T4 and T3. T4 tells us what is coming out of the thyroid tissue, and T3 gets converted by the liver and intestines, by healthy stress levels, and at the thyroid (about 20% gets converted at the thyroid).

We’ll also run our antibodies, too, which are basically looking at our immune system. Our immune system could actually be attacking our thyroid gland and making various antibodies called TPO, TB antibodies, thyro-binding globulin antibodies, and even TSH receptor site antibodies. This would tell us if we are dealing with an autoimmune thyroid condition, such as Hashimoto’s thyroiditis.


It takes time when transitioning to an anti-inflammatory, nutrient-dense, low-toxin diet. The Paleo template will get you on the right road, but you will likely encounter a few roadblocks along the way. Don’t let them dissuade you—address them one by one, and before you know it, those roadblocks will be far behind you.

To schedule a consult with a functional medicine doctor to help with lab markers as you prepare to begin Paleo template, click here.


Functional medicine hair loss solutions – Podcast #94

Dr. Justin Marchegiani and Evan Brand talk about supplements, hormones and how the adrenals affect the thyroid in relation to hair loss. This interview is geared towards educating people all about hair loss and functional medicine solutions. Learn all about alopecia areata when you listen to this podcast.

hair loss solutionsAlso find out about the different things that you can do to help improve your hair quality and even grow it back. Get to know about ferritin and iron saturation and why you should pay attention to these. Discover the possible causes of hair loss and what hair supplementation to take which are proven to be very helpful. Learn how the functional medicine approach to hair loss can be very effective at addressing this issue.

In this episode, topics include:

00:23   All about hair loss and alopecia

02:32   Gut issues 

04:35   The thyroid connection

06:37   Blood tests and hormones

09:38   Supplementation










Dr. Justin Marchegiani:  Hey, Evan! It’s Dr. J. It’s a great Friday here over in Austin. How’s it up in Louisville?

Evan Brand:  Howdy! Blue skies and the grass is green. We’ve had about 3 feet of rain it feels like over the past weeks, so everything is super lush.

Dr. Justin Marchegiani:  That’s great. Another great Friday. Well, we talked pre-show we wanted to discuss a little bit more about hair loss and different things that we can do to help improve hair quality and potentially even grow back hair as well.

Evan Brand:  Yes, sir. Yeah, so I’ve had a quite a few—quite a few women, I mean, and it’s—it’s always there. Hair loss is always the symptom, but I’ve found this week especially that alopecia has been popping up, and it almost makes you think it’s more common when you’re hearing it multiple times a week. It’s like, “Whoa! Does everybody have alopecia?” And so we know one of our online friends, Yuri–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  He has alopecia and he talked about it. I believe he’s talked about it at least where he’s basically he’s lost his eyebrows, he’s lost everything, and obviously that’s an extreme case to lose everything, but there’s definitely some—I guess a spectrum of hair loss that can happen. So maybe it’s not a full state like the alopecia but there’s also like some thyroid dysfunction and some other stuff, I suppose we can chat about that it’s gonna be tied into mild hair loss.

Dr. Justin Marchegiani:  Got it. Yeah, I actually had a conversation with Yuri Elkaim about his hair loss and he mentioned a lot of it had to do with poor diet when he was younger as well as gut health issues. And if you look at alopecia or alopecia areata as it’s known in the conventional medical world. It’s kinda fun to say—areata, that’s autoimmune and we know with autoimmune stuff, there’s almost always a gut element connected, right? Because we know leaky gut is when those tight junctions, the epithelial tight junctions open up, undigested, whether it’s bacteria, lipopolysaccharide particles or undigested food antigens which are foreign food proteins get into places in the bloodstream where the immune system isn’t used to it and that can really drive immune attack or an autoimmune attack, and alopecia is nothing more than a disease that describes where the immune system is attacking especially the hair follicles.

Evan Brand:  Interesting. So we would have to assume that any person who has this hair loss issue has some sort of gut issue. Is that a safe statement to say?

Dr. Justin Marchegiani:  I would say anyone that has hair loss and I hate absolutes, but I would say there’s a very strong chance that if you have hair loss, outside of it just strictly being a genetic factor, there’s more than likely a gut issue. And when we look at gut issues, it could be a gut issue where there’s a full on infection, like a parasitic or fungal overgrowth or a bacterial infection. It could be just something like a small intestinal bacterial overgrowth or it could even be something like hydrochloric acid and amino acid or protein—prote—proteolytic enzyme deficiencies where you can’t break down those amino acids, where you can’t ionize those minerals. Now typically any type of deficiency in the gut where there’s lower enzyme levels and lower hydrochloric acid, after a period of time, they’ll typically be an infection present because we need the hydrochloric acid to sterilize the—the gut environment, especially the stomach. That sterile environment is akin to you going to a—a dirty picnic table and maybe spraying some bleach or some kind of sterilizer on the table. It keeps that area clean. Well, that’s what happens in your gut and hydrochloric acid is also important for cleaning the environment but also activating enzymes. So if we aren’t activating enzymes and we aren’t keeping that environment clean, overgrowths can happen and if food doesn’t get broken down, the food rots and ferments, and then typically bacteria will then feed on the remains if you will.

Evan Brand:  That makes sense. Yeah, and I actually had several—several people like I mentioned over the last week with alopecia and one woman, I think she ended up not proceeding with her lab test. I’m not sure what—what ended up happening but I really wanted to take a look at the gut, so at this point I don’t know what’s going on with her gut if we’re not gonna proceed with testing, but I think it sounds like that’s an important place to start. And then maybe you could shed some light on the thyroid issue, because any time we talk about hair loss, women think that it’s automatically the thyroid. Is that a place that you’re gonna look for issues as well?


Dr. Justin Marchegiani:  Yeah, so one of the common symptoms of thyroid or of hair issues can be low thyroid. A lot of women will see it with the outer third of their eyebrows, it’ll start to thin out. We need thyroid hormone for adequate hair growth. So on the things we see with lower thyroid hormone—thyroid hormone can be a really powerful growth factor for that hair follicle to produce hair. So if we have lower thyroid function, and it could easily be from an anemia because a big building block for thyroid hormone is iron—that’s part of the whole iodination process involves iron. So if you’re a female that’s vegetarian or has a gut issue, low stomach acid, which typically also means low enzymes, and malabsorption and/or you’re a vegan-vegetarian, you’re really set up for a world of hurt, of having a high risk factor for thyroid issues because we need that iron to make healthy thyroid hormone, and I did a blog over this a couple of  years ago over at FixYourThyroid.com—you can take a look at it—where we talked about thyroid function and hair loss. And that’s an age-old tell-tale symptom for low thyroid function. So we always wanna look at thyroid issues when we see hair loss and we always wanna look at anemia especially for women when they’re either vegetarian, they have gut issues and malabsorption problems, and/or they’re ec—they’re menstruating excessively. They have a lot of PMS and they’re bleeding—they’re going through more than, you know, 4 or so tampons, or they’re having just a prolonged bleeding period and they’re losing a lot of their iron that way.

Evan Brand:  Interesting. So there’s a few things here. So it could be some iron anemia going on. So we would wanna look at ferritin levels, and then you and I were also chatting off air earlier about iron saturation, correct? Would that be the two most important blood tests to look for?

Dr. Justin Marchegiani:  Yeah, so ferritin and iron saturation are gonna be important to look at. We like iron saturation 25 or above. We like ferritin, at least for a female, 30 or above. Now we can go above and beyond that, we can also look at your iron binding proteins like TIBC and UIBC. These are inverse proteins, so they go high—they go high when iron goes low. So think about it as like LittleFingers, right? The more you need the iron, the more fingers are gonna be up there to try to grab and pull that iron into where it needs to go. So binding proteins go up when iron goes low. So it’s kind of an inverse thing. It’s kinda like TSH, right? TSH screams louder to the thyroid when the thyroid goes lower, like you’re trying to get someone’s attention, right? You’re talking to them across the room, they’re not responding to your voice, so you raise the volume. Same thing, you’re raising the volume and trying to pull that iron and get it into your body so you can carry oxygen and make thyroid hormone.

Evan Brand:  Okay, so you’re talking about thyroid, so when TSH is high, that’s when we know the thyroid function’s gonna be low. So if we’re kind of mixing lab tests here, we’re kinda talking about a few different things that we’re gonna be looking for this whole hair loss picture, the thyroid’s a good place to look. The iron levels are another good place to look. And then what about the adrenals because typically we’re gonna see adrenal issues happening that could be tied into thyroid issues, correct?

Dr. Justin Marchegiani:  Yeah, it’s very possible. I mean, stress hormone will do a lot of different things to our body, right? So stress hormone will typically catabolize tissue and amino acids. So we’ll catabolize amino acids that could be used to make muscle or neurotransmitters, and amino acids can also go and make hair. So it’s very possible the more you are in a stressed out state, the more—the more the adrenals are hyperresponding or being whipped like a tired horse, you could potentially catabolize those building blocks that could go and make quality hair. That’s why many people have had experiences of extreme stress in their lives, like you know, really punctuated stress like someone dies or you know, something really catastrophic happens and they start losing hair. So it’s very possible that extreme stress and higher secretions of cortisol can really drive that hair loss and also we know we need cortisol healthy levels of it for thyroid conversion. So if we’re not activating our thyroid hormone because now our cortisol’s in the dump, we can also have it because of chronic cortisol imbalances that are driving low thyroid activation or low thyroid conversion.

Evan Brand:  Yeah, that makes perfect sense. So now the first place that people like to jump is supplementation. There’s who knows how many millions of products out there that are designed or marketed for women especially for hair, skin and nails. Is that something that we would wanna do right out of the gate, or obviously it sounds like the better alternative is we need to kinda look for these other deeper underlying causes first and then maybe the supplements are gonna be kinda phase 2 or phase 3 in terms of treatment.

Dr. Justin Marchegiani:  Yeah, absolutely, so obviously the diet stuff is really important. We kinda echo this stuff. Supplements are meant to supplement a good diet and lifestyle, so we’re making sure we have an anti-inflammatory diet because inflammation will drive cortisol because cortisol is our body’s natural inflam—anti-inflammatory. So cutting out the grains and a lot of the food allergens, plus we know that alopecia or alopuc—alopecia areata is going to be autoimmune and we know gluten, how important gluten is at being an autoimmune—part of the autoimmune mechanism, being an autoimmune stimulator, we know it can open up those tight junctions. We know it can drive inflammation, it also can be very high in sugar, right? A lot of the carbs, gluten, and a lot of refined sugar can drive your insulin levels up and high blood sugar can also feed fungus and a lot of people will have like cradle cap or aka dandruff or they’ll say—call it seborrheic dermatitis. A lot of times this is driven by fungus. I’ve had a handful of patients just this week that have come in with dandruff and with like psoriasis and things like that, and a lot of the seborrheic dermatitis and dandruff stuff is fungal in origin, like a lot of the—the Nizoral or these anti-fungal Head & Shoulder shampoos, they’re all trying to reduce fungus and we can do that by stopping to feed the fungus in our diet and the sugar and stop driving the leaky gut which could drive the autoimmune element with the alopecia areata.

Evan Brand:  Absolutely, so now are you gonna see—I guess if they’re new patients, then you’d probably don’t have the results yet, but are you expecting to see some elevations of some markers on an Organix to see maybe that there’s some fungus or maybe even some yeast and fungus together that’s causing these issues, too?

Dr. Justin Marchegiani:  Absolutely and if we see imbalance in gut bacteria, whether it’s SIBO, or whether it’s just a kind of run-of-the-mill dysbiosis, whether it’s a fungal overgrowth and H. pylori infection or a parasite infection, we wanna make sure all of those things are eradicated and then at the same time make sure we have enough good clean amino acids and protein in the diet and we’re actually able to digest it. So we wanna make sure we’re at least adding the secretions like the hydrochloric acid, enzymes, bile salts so we can break down these really good fats and proteins so we have the building blocks going right into our system.

Evan Brand:  Absolutely, and the thing that’s beautiful about this model that we use is it doesn’t really matter what the condition or what the symptom is, this net is—is both broad spectrum and specific in terms of the labs that we usually discuss and run to find things. So if it’s gut symptoms, if it’s hair loss in this case, you know, it may seem like just a general blanket approach, but really it’s general and specific at the same time to try to identify the underlying causes of what’s going on and really, there’s only so many ways it seems like that things can dysfunction or function properly.

Dr. Justin Marchegiani:  100%, yup, absolutely. So when you have a systems-based approach, we’re just going in and we’re assessing the body system. So we go and we look at the foundational system which is gonna be diet and lifestyle. Blood sugar? Check. Do we have our macronutrients dialed down? Check. Too much carbs, too much proteins. Are we breaking our food down? Check. Sleep, stress, all those things, and once we have those all checked off, then we can go into body system one where we look at the hormones in particular—adrenals, thyroid, fi—female or male hormones, ATM or ATF, and then we can go into the next system which is the gut and that’s where it gets interesting because we can go through the 5R’s there which are removing the bad foods or placing enzymes and acids, repairing the gut lining, removing infections, reinoculation with good bacteria. So we go through a lot of that there and then we can also look through other deeper infections, too, and then we can go down into detox and other nutrient deficiencies on body system three. So we really have this really great big net so we can catch as many potential intruders or imbalances before they become a major problem.

Evan Brand:  Definitely and that’s the goal about this whole functional medicine approach that we’re using which some people say like you said some people say they’re doing functional medicine but it’s different or it’s not quite this type of approach. This method is simple enough but it’s effective enough, too. So people, you know, when they’re looking on the Internet, say for hair loss supplements, you know, you could probably get locked in to some multilevel marketing scheme product or something similar where it’s really just a lot of hype and marketing but it doesn’t really have any solid foundation in science behind it and so people get frustrated and they go and they drop their money into these products and they don’t really move the needle. So maybe we can talk about some of the—the ethical or the intelligent ways that you could supplement if you really were trying to support, you know, optimal hair, skin, nails, hair growth, etc.

Dr. Justin Marchegiani:  Absolutely. So off the bat, I’ve—I skipped one thing—we also know that blood sugar swings and adrenal stress will encourage more reverse T3 which are like the metabolic blanks in our gun cartridge so to speak, in our magazine, because when you pull a gun—pull a trigger or the—on the gun, right? A bullet comes out, right? You actually have an effect. Well, metabolically, reverse T3 is supposed to bind to the receptor sites where T3 would go, but the problem, reverse T3 is like putting a blank in that gun. So you get the sound, but you don’t get the effect, right? You get the hormone in the receptor site, but you don’t get the increase in metabolic activity, that typical T3 thyroid hormone will produce. So that can cause less thyroid hormone via the reverse T3 mechanism, and we know that blood sugar issues will drive that, too. We know overall stress will drive that as well. So that’s one other mechanism I wanted to add.

Evan Brand:  That’s great. Now so you’re saying here that if we are looking at a blood panel that reverse T3 if that’s elevated, and maybe you can shout out some of the more appropriate ranges that that is gonna be an issue.

Dr. Justin Marchegiani:  Yeah, typically we like it below 24 or 23. Typically in the—in the mid-teens is okay. We actually would look at like a reverse T3 to free T3 ratio or a total T3 to T3 ratio. And pretty sure my free T3 to reverse T3—T3 ratio is around 10:14 is optimal. I’ll pull up my—my little reference range here right now and I’ll confirm that while we’re live, but that’s the general gist. Yeah, and total T3 to reverse T3—T3 ratio is 10:14. Free T3 to reverse T3 ratio is 20:30.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  So that’s the ideal range there. And you can just google those ranges online. There are a couple of good sites that will provide an actual kind of algorithm where you can plug in the T3, plug in the reverse T3, set the standard deviation, you know, whether it’s ng/dL or µg/dL and it’ll give you that number. So total T3 to reverse T3 is 10:14 and then free T3 to reverse T3 is 20:30, and we like to have that reverse T3 ideally in the very low 20s or mid-teens or so.

Evan Brand:  How high have you seen that number?

Dr. Justin Marchegiani:  I’ve seen it, you know, up into the—into the 30s very easily and that could easily happen with stress, emotional stress, blood sugar stress and/or just overall inflammation in the body because that creates internal stress as well. So the reverse T3 is important because it’s gonna take that T3 that would be active and make it go downstream, and then it not only makes less T3 but then it prevents the T3 that’s actually floating around in your bloodstream from binding into the receptor site and doing what it was designed to do in the first place.

Evan Brand:  Makes sense. That’s a big issue there and a lot of people are like I’m not stressed. It—it’s the invisible stressors, too, that we’re factoring in and we can see that. So you don’t have to actually identify as a person that is stressed, that could be invisible stress that we’re gonna see on these lab results here.

Dr. Justin Marchegiani:  Absolutely and also estrogen-dominance can provide problems, too, because that will increase thyroglobulin and thyroglobulin will decrease the amount of free T3 in your bloodstream. So it’s kinda like reverse T3. The difference is reverse T3 is more or less blocking the receptor sites, where thyroglobulin is decreasing the amount of free fraction. So 2% of your thyroid hormone is actually free, the other 98% is protein-bound, and what it’s doing is the thyroglobulin is decreasing the percent of free T3. So instead of having 2%, maybe now you have 1.9 or 1.8, or just having less free fraction available, so when we look at our total numbers, right? Maybe our total T3 is 110, 120 which isn’t bad, but now our free T3 instead of being at 3 or 3.1, now it’s at 2.9, 2.8, 2.7, and it’s dropping because of that estrogen dominance.

Evan Brand:  Yup, so estrogen dominance which we’ll probably have to do a whole show on that if we haven’t already, a lot of that’s gonna be exposure to synthetic estrogens?

Dr. Justin Marchegiani:  Yeah, it’s gonna be exposure to plastics, chemicals, pesticides, fluoride in the water, and also just being stressed, right? Because in women, progesterone predominates that second half of the cycle, and when women are stressed, they can use progesterone as a building block to make more cortisol. So more stress will actually steal from their progesterone. It’s kinda like a progesterone stealer or progesterone escape. We’re pulling progesterone in to make more stress hormones because our body’s epigenetically hard wired to deal with the stress of today versus the healing of tomorrow. The problem is most people live in a perpetual state of stress so tomorrow never comes.

Evan Brand:  Yeah, exactly. It’s crazy, isn’t it?

Dr. Justin Marchegiani:  So, I—I did the political side-step, I—you asked me a question and I gave you the answer that I wanted to give. It had nothing to do with that. So let me go back to your question. I’ll reiterate it for the listeners here. What supplements in particular? So number one, we can add good quality hair support from fatty acids, right? Omega 3s, whether it’s good quality fish oil or cod liver oil or sardines and things like that, salmon, mackerel, those are all really good quality Omega 3 fatty acids that can help with hair. Next you have conventional things that have been around a while like Biotin, which is kinda like, almost like a B vitamin so to speak, and that can very much help with the skin, help with hair as well. Next, I would say collagen is one of my favorite–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Things. Collagen’s amazing. It’s very high in glycine and proline and hydroxyproline, helps provide building blocks for skin, hair, and nails, and I was talking to Dave Asprey last year when he was growing his hair out longer, and I noticed it just being longer and more full. And I’m like, “Dave, what the hell are you doing with your hair? It looks great.” He goes, “I’m megadosing collagen, like 40g a day, 50g a day.” So since then, I’ve been really upping my collagen to really have good high quality hair and skin building blocks, and that’s I think one of the most important things you can do is good quality grass-fed collagen, and by the way we have a collagen product coming out very soon called True Collagen and I was able to source one of the biggest and best distributors for collagen that is grass-fed, hormone-free, pesticide-free. So stay tuned for my True Collagen which is something that we’ll be coming out very soon and I’m already using it now and I love it.

Evan Brand:  I want my sample pack in the mail.

Dr. Justin Marchegiani:  You got it, man.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Coming your way. So–

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  So we talked about Biotin, collagen, fish oils, anything you wanna add to that?

Evan Brand:  No, I think that was good, you know, the fatty acids for sure. Basically, things that are gonna help to reduce the inflammation in general, because if there is something going on in the gut, the gut has to be healthy so if you just or somebody listening and maybe you’re already taking collagen which a lot of women are, they’re frustrated, they’re almost like they’re mad at me. It’s like, “Evan, I’m already taking collagen and my hair is still falling out or my hair is still very thin.” It’s like, well, that’s—that’s the supplement, you know, let’s see what else is going on deeper and usually something pops back up on the stool test, and like, “Okay, well, you know, your digestion’s been impaired, here you are feeding these bacteria or feeding these parasites, not you,” so maybe it’s been good nutritional insurance to get the collagen, but if you have someone stealing your energy, you know, someone like kinda how they used to do in the—they used to steal cable, you know, they’d go up to the main line and–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Slice the cable wire down to your house, if that’s going on in the gut with your nutrients, then you could still have issues regardless of, you know, what you’re supplementing with.

Dr. Justin Marchegiani:  Yeah, I remember Dr. George Goodheart saying in various seminars, you know, years back, “The highest good is to get to the root cause.” The highest good and that’s always in my head. Like alright, “Are we getting to the root cause?” Right? And a lot of times, supplements may be getting to the root cause or they may be palliative and supportive with the fact that we are addressing the root cause but also adding these extra nutrients in so i.e., let’s say we have a gut issue and our diet stinks, but we’re adding in a whole bunch of collagen. Well, is that a bad thing? No. It’s not a drug. It’s not gonna have side effects and kill over a hundred thousand people a year like pharmaceutical drugs do in general taken the right way. So that’s a good thing. We don’t have that nasty side effects. Is it providing more building blocks than would be there anyway? Yes. But we wanna make sure the underlying cause is addressed. So I’m a big fan of if we’re gonna add something in that’s supportive and palliative, at least make sure the underlying cause is addressed or there’s a program set up in place to address it.

Evan Brand:  Right. So there’s nothing wrong with treating the symptoms and sometimes we have to treat the symptoms first to keep people motivated, move the needle enough with them to keep them on their program, but eventually we’re always kinda backtracking from this symptom back to the underlying cause.

Dr. Justin Marchegiani:  100% and like there’s another element here I didn’t talk about which was DHT, which is dihydrotestosterone. So if we look at kind of the breakdown or the formation of testosterone, it goes from DHEA to testosterone or I should say androstenedione then to testosterone and then to DHT. So in each downward cycle, the hormonal molecule gets more potent, more—more strong. So DHEA is weaker than andro. Andro is weaker than testosterone. Testosterone is weaker than DHT. So essentially said in the different way, DHT is the strongest and most powerful out of all of them, and DHT is shown to potentially starve out blood flow to some of the hair follicles. So that’s important. So if we run a profile, we can look at women with elevations like PCOS can drive elevations in androgens, and we can use things like GLA fatty acids like evening primrose oil or black currant seed oil to help with reducing that DHT. It’s a 5-alpha-reductase inhibitor. In men we can also use—I think women, too, this would work—but we can do zinc and selenium, which happen to be great for the thyroid, go figure. And then men we’ll do it a lot. We’ll use saw palmetto and/or pumpkin seed extract as a natural 5-alpha-reductase inhibitors, and you know, a lot of the medications, right? Like the—the names are fleeting me—I can think of all the commercials from the 90s, the—the Rogaine–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And a lot of those types—I forget the actual trade name of it—Propecia. That’s what it is. Those are typically 5-alpha-reductase inhibitors as well at a pharmaceutical level. But we can do it naturally, too. They won’t have all the side effects. So my big 5-alpha-reductase inhibitors for females are really easy one is gonna be the nutrients, selenium and zinc, and then one, I’ll add in the GLA fatty acids like the evening primrose or the black currant. Men can do that as well and they can also go the extra mile and add in some pumpkin seed or saw palmetto along with that.

Evan Brand:  Beautiful, awesome! I’m glad you got there because I—I’ve had that in my radar, you know, the 5—the—the DHT and I was thinking about, you know, men that have used steroids and they have the increased conversion of hormones there so they’re more likely to go bald and I’m glad that you were able to—to pull that out and digest it for us.

Dr. Justin Marchegiani:  Absolutely. So if we kinda break everything down. We talked about the supplements, those are great. Really, really important things. We talked about the hormones. We talked about how the adrenals affect it, right? Cortisol high or cortisol low will affect the thyroid. So if the thyroid’s affected by the adrenals, that’s gonna cause a problem. If the thyroid’s affected by autoimmunity, right? We’re attacking the thyroid gland because of gluten that can reduce thyroid hormone. That can cause a problem. Too much iodine with thyroid issue can drive hair loss. I’ve seen people do excessive iodine with an autoimmune mechanism in the background, massive hair loss.

Evan Brand:  Wow.

Dr. Justin Marchegiani:  Massive. So we have the I—we have the thyroid piece. We have the nutrients that can exacerbate autoimmunity. Gluten potentially. Iodine if there’s already an autoimmune mechanism to process. The leaky gut. Poor nutrients in the diet regarding fats and proteins, not digesting these things, these compounds well. Infections can drive a lot of these things. I’ve heard Yuri talk about it with the gut and the infections causing his alopecia areata. So all of these different mechanisms—we have individual things that like the thyroid. We have individual things that affect the adrenals and thyroid together. We have nutrients that play a factor and then we have different hormonal things like the DHT and the progesterone as well.

Evan Brand:  Great! Great summary there.

Dr. Justin Marchegiani:  Anything else you wanna break down there?

Evan Brand:  Honestly, I think that was great. I think it would just be me doing a broken record pitch there. So I think you did great. You know, the—the takeaway from this is—this is kind of a complex situation so it may sound just easy on the surface. You know, you go to Walgreen’s, you see a hair supplement. “I’m gonna try it. My hair’s gonna grow back.” Maybe not. So if you do have this issue, you know, it would be important to reach out to Justin or myself, you know, let us look for you and see what’s there, at least rule things in and rule things out. And if, you know, run a test and Justin says, “Oh, look, you’re free and clear.” Well, that’s good. But we still need to try to figure out what’s going on. But you’d never know if you don’t test. If you haven’t test, you’ve guessed.  So keep that in mind anytime you’re gonna go invest your money into a supplement. You may need to invest into the clinical data that’s really gonna find out why this is causing it before you can actually work on fixing it.

Dr. Justin Marchegiani:  Absolutely. So let’s kinda back up here, alright. So I’m a male or female that’s dealing with hair loss, kinda what’s—what’s the action tree here? Alright if–

Evan Brand:  Yeah, so–

Dr. Justin Marchegiani:  Go ahead.

Evan Brand:  No, you go ahead. What you got?

Dr. Justin Marchegiani:  Okay, so you’re man, right? Figure out, this hair loss fall in your family. This is a male potter—male pattern baldness thing. Well, number one, we gotta first realize that a lot of how we deal with stress and how we, you know, eat, sleep and drink typically is passed down through our family. So is this purely a genetic thing or is this, “Hey I’m just following the footsteps that my parents did and, therefore, I’m gonna have the same genetic predispositions because I’m eating crap and taking care of myself in a very poor way.”? So figure out how much of this is in your control and how much isn’t. Either way, if it’s totally male pot—male pattern baldness and you don’t have any control, you still wanna be doing all the things we mentioned anyway. So don’t ever let that be your excuse, because you still get other benefits by doing all of these things there, like brain health and performance and muscle and libido and virility and energy. So keep that in mind.

Evan Brand:  Definitely.

Dr. Justin Marchegiani:  If you’re a woman, you g—you have a lot of control over this as well. So the first thing we do is diet. Cut out the crappy foods. Grains are gonna be the first thing. Get your sugars under control. Next, make sure you’re digesting foods and proteins and fats well. You’re having digestive symptoms and things like HCl and enzymes aren’t working, well, guess what? Get on those. Now next, if that’s not working, then we have to do some testing. We have to look at the adrenals. We have to look at the thyroid. We have to look at the gut. Alright, so that’s where you wanna reach out to Evan or I and figure out the next steps, but in the meantime, you can go pick up a high quality collagen. You can try some HCl and enzymes. You can try some of the nutrients we mentioned. But if that’s not working, you’ve already exhausted the low hanging fruit, so just make sure after that you reach out to a good functional medicine doc to get to the next step. But in the meantime though, don’t let the male pattern baldness genetic stuff if you’re a man stop you from taking action. You don’t know how much of it can be slowed or how much can go back. And if you’re a woman, this is a deeper sign that something underneath is happening. So I hope that helps and empowers everyone listening that’s dealing with this problem.

Evan Brand:  Absolutely. Well-said. Yeah, so it’s the gun. You know, you may have the gun there, and it could be loaded with your genetics and your family, just all of that, you’re—you’re susceptibility to stress, your environment, etc. but you have the ability to not pull that trigger, you know? So don’t just, “Oh, screw it! I’m just gonna binge eat on pizza.” That may not be the step that’s best for you. You know, sometimes we get frustrated with our health conditions and we just say, “Screw it! I’m going all in. I’m gonna go off the rails,” but oftentimes, you know, just pause, take a breath, and then think, “Okay, what can I actually do that’s gonna work me towards my goals? And not just self-sabotage myself,” and that is common for people to—to hit this point, and they do wanna just—it’s all over. They get this kind of a—what do you call that—like a black and white approach I guess.

Dr. Justin Marchegiani:  Yeah, absolutely. Absolutely, so we wanna make sure we have a multifaceted systems based approach, alright? And we wanna have objective testing to quantify it. And even things like temperature-testing can be a really good objective kind of test that doesn’t require any resources to do it outside a—a really good fertility thermometer. So kinda grab those low hanging fruits tests, right? We wanna assess, not guess. So get the assessments to figure out what’s going on and if you guys gotta reach out to someone like Evan and I to get more info, we are here at your disposal.

Evan Brand:  Well-said.

Dr. Justin Marchegiani:  Alright, Evan. Hey, it’s a great Friday, man! I’m looking forward to heading out in the water today in Lake Austin, probably tomorrow morning, do a little water skiing and get some good cardio in or I should say, it probably be more—more anaerobic with some of those movements that I’m doing. But anything else on your agenda for this weekend you wanna share with our crowd?

Evan Brand:  Oh, we’re just gonna get out and enjoy the sun. You know, we got 4 weeks left ‘til the baby comes, so we’re gonna be soaking up the blue sky and the sunshine while it’s here. And before you know, we’ll have a baby and who knows? I mean, maybe trapped inside and changing diapers all day. So–

Dr. Justin Marchegiani:  I know. I hear you. Well, make sure you say “Hi!” to Anna for me and you have a great weekend.

Evan Brand:  I sure will. Take care.

Dr. Justin Marchegiani:  Take care. Bye!

Evan Brand:  Bye!







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