The Top 5 Common Digestive Supplement Mistake – HCL, Enzymes and Bile Support | Podcast #338

As a functional medicine practitioner, Dr. J and Evan Brand see many clients who take dietary supplements regularly. But, as simple as it sounds, supplementing can confuse—and people often make mistakes. Do you think you’re taking all the proper nutrients and that you’re taking them the appropriate way? Let’s learn some common errors people make:

Dr. J highly recommends that you avoid having the symptoms cured rather than the source. Don’t just accept your signs and symptoms as usual; consult your doctor and express your concerns. Your doctor may advise you to do diet modifications and have yourself tested to find out the root cause and fix it. Also, watch out for over stressing. Stress can affect your decision-making and as well as your gut health. Another reason can be chewing your food too quickly that makes your digestive system suffer, inadequate water intake, or very few fibers in your diet.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:36    Common Mistakes in Using Digestive Support

12:03   Healing Gut Lining

15:39   Sex Drive and Libido Effects

17:59   Bile Support

21:48   Higher Fat Diets

25:09   Cooking our Food

31:04   Food Quality

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Dr. Justin Marchegiani: We are live, it’s Dr. J here in the house with Evan Brand. Today, we are going to be talking about the top five common mistakes. When using digestive support. Again, we’re in the trenches with patients every week from all over the world. And this is a common issue that we see is people are not using digestive support correctly. And if we don’t break down our food, if we don’t emulsify it, break it down, utilize it absorb it, we’re not going to get the nutrients from that meal. So it’s not a given that we’re eating good food, we have to go through good digestive processes to get those nutrients and to decrease stress in our gut. So I’m really excited to dive in today’s topic on that.

Evan Brand: Yeah, me too. So I mean, I was doing digestive enzymes when I still had gut infections. So I know we put together a list here, and I’m gonna just go straight to the one that was a little lower down the list, which was, I think, possibly one of the big smoking guns for a lot of people is, and I technically should have written in our notes, not testing. My note was not addressing infections and how not addressing your gut infections leads to digestive problems, because if you’re someone who’s taking supplemental acids and enzymes, but you haven’t tested or treated yourself for parasites or worms, or H pylori, bacterial overgrowth, fungal overgrowth, mold colonization, you’re gonna have very limited results with your enzyme, enzymes and acids. So for me, I did that mistake. I just had high quality enzymes. I was taking those but yet I still had diarrhea and other gi issues years ago, because I had parasites, and I hadn’t tested or treated those. So that’s to me, I think the big one because people will go to Whole Foods or wherever, hopefully, they’ll buy from us because it’s professional quality, but they’ll buy enzymes take it and then they still have gi issues. They’re like, well, what the heck, I thought the enzymes were supposed to fix it.

Dr. Justin Marchegiani: Yeah, and I see that we see that all the time. Now the question is, why is that happening? So let’s go over some of the bugs and some of the reasons why that may happen. So first off, h pylori is a super common one h pylori is a bacteria that resides primarily in the stomach, you can also go a little bit into the small intestine, and H. pylori is going to produce an enzyme called urease. And urease is going to take protein from you know, which is the protein metabolite urea and it’s going to convert it into ammonia and co2. And so on a positive H. pylori breath test, we’re gonna see elevations in co2 after you swallow the urea from the breath test, and you’re also going to see a lot of ammonia. Now ammonia has got a pH of 11. And so that’s more on the alkaline side, so your guts only a two or three on the pH. So that can start to alkalize the gut and maybe throw off the digestive capacity because we need that nice that nice low pH helps activate enzymes and acids. Well, it actually activates more of the enzymes that can be pepsin, various proteolytic enzymes, and it sets the table for the pancreas and the gallbladder to produce more enzymes, lipase bile, when we get into the small intestine, so the acidity in the pH sets the deck it sets the domino rally, so digestion works downstream and so, infections like H. pylori can cause problems infections like cebo can also cause problems. SIBO is notorious for making it harder for that esophageal sphincter to close and so that esophageal sphincter can’t close is prone, you have proneness to having that acid rise up and burn your esophagus, right? Those are all potential problems. Also, any stressor or infection, whether it’s H. pylori SIBO, which is small intestinal bacterial overgrowth, or it could even be something like a parasite, these infections are going to create sympathetic nervous system stress. And so the more your nervous system is over stressed that sympathetic nervous system that fight or flight tone is being stimulated. What’s going to happen is that fight or flight is going to take digestive enzymes and acids, it’s going to reduce them, it’s gonna start shunting. A lot of the digestive secretions and the blood flow away from the blood away from the stomach and the core and to the hands and the feet to run, fight and flee because our body is trying to move blood and move resources to the areas that are most metabolically high and expenditure. And in a fight or flight circumstance, that’s going to be the extremities fighting, fleeing, running, and our bodies prehistorically driven that way, because you don’t want to be hungry. When you’re running. You don’t want to think about digestion, you want to be focused on getting away or fighting. And that blood has to carry oxygen so these muscles can work. And so that blood moves away from the intestines. And that’s part of the reason why these infections can really throw off your body, they can really increase that sympathetic nervous system and take away from that vagal tone vagas nerve, parasympathetic nervous system response.

Evan Brand: Yeah, I can totally relate. I mean, when I had infections, I was anxious, but I had nausea and I had no appetite. So I would sit down. I remember like yesterday when I was down in Austin, I would sit down at the dinner table. I just cooked an amazing bison steak and maybe I had some veggies with it. I remember looking at the plate and going Ah, I just can’t do it. And some of that was the infections But some of it was the stress from the infections. And some people, they’ll kind of demonize meats and say, Well, I don’t feel good. Like I just can’t do the meat. It’s not the meat in general. That’s the problem. It’s the infections, damaging the parietal cells, reducing the stomach acid, it’s turning that digestive fire back on, that’s really going to help you feel good with those meats. So I, it’s sad because people get scared away from the meat. But in reality, it’s some of these root causes that we’re talking about. And then you hit on this kind of primal response. This is totally normal, by the way, but it’s not normal in our chronic stress lifestyle. So occasionally, if we were stressed, it’d be great. Like you said, turn off the digestive system. So we can run. But the problem is, we’re are we’re always stressed. Now. We’ve never as humans, we’ve never experienced this level of chronic, ongoing stress. I mean, I pull my audience all the time, I’ll do a little polls on my Instagram page and ask people like how you’re feeling. Everybody’s stressed. Everybody’s overworked, everybody’s burned out. So this is an epidemic problem. This is not like a one off thing. This is everywhere. And I think we could transition now if you’re ready. And we could talk about how too much or too little HCl when you’re trying to get this digestive fire back on, there is kind of a sweet spot, and it’s going to depend on the people, it’s going to depend on gut inflammation, maybe diet, infections, and then let me just bring up before I forget, these infections are very contagious. So if you do have h pylori, it’s very probable that your spouse is infected as well. So if you’re someone working on your gut, and you’re not working on your significant others gut, you probably need to whether you’re running testing, or maybe you’re guessing and checking, which is not as wise, but we’ll see a husband or a wife come in to work with us clinically, they have good results and then two to three months later they go backwards. That’s often because the the infection came back due to the significant other and this could even be from children as well or even dogs. Like if you got a dog with h pylori, you’re playing with a slobbery toy, you’re throwing the slobbery toy there Nope, you pick your nose, you bite your nails, whatever boom, you could get, you know, exposed to the vectors that way too.

Dr. Justin Marchegiani: 100% So with the too much and too little HCl, some people their gut lining is so inflamed, they have atrophic gastritis, meaning that gut lining has gotten really thin. And they may not be able to handle much HCl, even though they need HCl, they may not be able to handle it and that becomes dicey. So it’s all about helping people where they’re at, even though they need something, if they can’t receive it, then we need a backup plan. And so you got to know what people are at. And so some people, their digestive system, or symptoms actually get better. With more HCl, even though their gut has a lot of problems, they have a lot of inflammation. Some people their gut lining integrity can still deal with the HCl when you start adding HCl. And it’s like they start getting better and you’re like, but your guts so inflamed, how were you able to receive it, but then patient a over here couldn’t receive it. So everyone’s a little bit different. And so if we’re going to try HCl, I mean, ideally, don’t try it. If you know there’s any alterations, coughing up blood in the stool. I had one person though cut people who had alterations, though, did it and they’re like, it helped my issues, I felt so much better, and actually my ulcer stopped. Now, that may be the exception. I’m just kind of highlighting if you are that person, tread lightly work with a practitioner. And of course, all reactions are dose dependent. So if you’re going to test it, try the very smallest dose you possibly can maybe even a little bit of lemon juice, or apple cider vinegar and some water, dilute it down and then test it. And if you overdo it, you can always try a little bit of baking soda in water to kind of calm it down if you irritated it. But ideally, don’t do it unless you’re working with someone that’s helping you on the functional medicine side. And if you do it, make sure it’s dose dependent on that side.

Evan Brand: Yeah, good call. So just we’ll give a couple numbers. I think numbers are helpful. So if you’re working in HCl, I know you and I we have some professional manufacturers we work with we make our own line of digestive products. We go pretty conservative, like 200 milligrams of butane per capsule. So we could dose that as low as one cap 200 milligram, we could go up to 3 4 5 6. So you could go I’d say 200 on the low end up to I personally don’t see a need much beyond maybe a couple of grams, 2000 milligrams, and even that, to me is sometimes too high for certain people. I just don’t like to push it. I know you and I’ve talked about that test where people will take a ton of HCl until they get burning and then back down from that dose but I prefer not to poke the beehives I personally don’t do that with people.

Dr. Justin Marchegiani: So I will do that within five or six capsules. It depends if someone has a lot of digestive distress. You know, we’re typically not going to go that high, but usually within five or six capsules, that tends to be okay. And Dr. Jonathan Wright’s book, why you do stomach acid, he talks about, you know, being able to go up to four to five grams of HCl. And again, I typically wouldn’t do that if someone’s having any alterations or any incredible gastritis issues. Usually we’re going to test at a much smaller level than that and even with them, we’re still starting at maybe one capsule and we’re gently going up and up. For taking the digestive support in the middle of the meal, because if your guts Ron and flame just enough of that acid leaning on that gut lining directly isn’t to be a problem, at least if there’s some food down, then think of the Oreo cookie, right, you get the cream that you get the the frosting in the middle of the HCl is in the middle of all the food, and therefore the body tends to mix it up. And then when it starts moving throughout the intestinal tract with the throat, the stomach, it’s not going to be as intense at the tissue area. And so that tends to be very helpful. And I’ll typically, you know, try it within four or five capsules, see if we have an improvement. Some people do, I hear doctors doing that up to 1020 capsules. And that’s I think you’re just messing with trouble, you mess up a fire there because your body has to use bicarbonate and from the pancreas, to start to neutralize the acid from the stomach. So like that Domino rally of digestion, you have all this kind mixed up in your stomach, that kind is all the food with the acids and the enzymes that has to get released from the stomach down into the small intestine. And so it’s nice low pH once that goes into the small intestine, right the dwad, then we start making a whole bunch of bicarbonate to neutralize that. Now bile acid will also be produced bile acids still an acid it’s still a pH of around five or so. So it’s still on the acidic side. People have written in o bile acids. Well, it’s a it’s a p it’s a pH neutral. Well, you know, we’re talking bile acids. bile is made up of bile acids, cholesterol, a lot of different substances. So the bile acids are in their very nature by their name on the acidic side. So typically, your body’s trying to take that pH and bring it up to a neutral pH and the more you stress it with tons and tons of HCl, there’s a greater chance that your bicarbonate system may not be able to handle it from your pancreas. And you could develop a peptic ulcer. So we got to be careful with that. Try to use HCl within a reasonable range. And if you’re going to test it, you know, just be careful with it. Just be careful. Make sure you’re taking a look at your gut and making sure you’re you’re you’re knowing what your calprotectin levels are and you’re in you’re taking it the right way.

Evan Brand: That is like the pinnacle of edutainment right there that was so entertaining to listen to. I’m picturing all this going on in the system, I’m learning at the same time. This is why I love what we do. This is so fun. All right, let’s go to let’s go to number two here on our list, which is supporting or healing the gut lining and how that’s very important to do possibly even before you get to the digestive support. So you and I are seeing tons of people that usually have been to previous practitioners or doctors or naturopaths or whoever before us. And so maybe they have healed their gut somewhat already. Or maybe they’ve been wrecked because other practitioners did too much. Or they did too hardcore things. I had one lady who she got put on really high biofilm busting support right in the beginning, she got put on the interface plus from Claire labs, which we can and do you sometimes but man it wrecked her gut, her stomach was so wrong. We had to do almost six weeks of gut healing support before we could even bring it any other support. And and that’s kind of a reverse order thing. Because you and I talked about this idea of healing the gut after you treat the infections, but man, in her case, we couldn’t do that. So I’ve seen firsthand what can happen if you do too much biofilm support, you’re aggravating an aggravated system, it’s just not good.

Dr. Justin Marchegiani: Exactly. And that’s why if we’re having someone with an inflamed gut, one of the first things we’re going to be doing is trying to really dial in digestive nutrients to heal the gut lining. So we may be adding in things like dgl, licorice, aloe, slippery elm, sometimes we’re going to do a lot of zinc or zinc carnosine. A lot of studies on zinc, helping to decrease gut permeability, which is really important, decreasing gut inflammation, there’s studies on zinc showing the decreased calprotectin in the intestinal tract. So that’s wonderful, of course, l glutamine. If you’re very histamine sensitive or very inflamed, sometimes I’ll clue to me can go downstream to glutamic acid and glutamate, and you may have negative symptoms there. Again, typically, I don’t see that and so we don’t see that. I say 95% of the time, there’s no problem with that. But we want to be able to use other nutrients to calm down the gut, vitamin u, which is vitamin oltre. You see that in like a lot of okra, things like that. cabbage juice, I would say Allah we already mentioned. And then of course, there’s just good old fashioned bone broth, and collagen peptides which are very, very high in glycine. And glycine is very important building block for the entire sites that make up the gut lining the entire sites or little cells that that make up the tight junctions and the gut lining in the intestinal tract. And so they love, love, love glycine, and of course, that the same cells that are helping to build the intestinal tract, they also help with detoxification. glycine is a very important compound and toxification. So if you have a lot of gut inflammation, your body’s going to be using a lot of that glycine for healing, inflamed tissue and maybe not running the toxification. So that’s part of the reason why you can have detoxification problems, because your guts chronically inflamed, it’s sucking a lot of the resources Is that it may be using for detox.

Evan Brand: Wow. Yeah, that’s amazing. So there’s a lot of talk Stephanie sent off. And I know some others have talked about using glycine to help glyphosate detox. Yep. So that’s pretty interesting mechanism there, you’re saying that the system can’t focus on the detox. If it’s so focused on the gut damage.

Dr. Justin Marchegiani: The body is always tending to deal with what the more acute matters. And if your guts Ron inflamed, it’s probably going to prioritize that over detoxification. And again, we don’t have like a test that to say that, we just kind of have common sense functional medicine, healing philosophy, the body’s always prioritizing stuff. And whatever the top stress is, the more apparent stresses, that’s where your body’s typically allocating resources.

Evan Brand: Yeah, and I don’t want to get too in the weeds on this, but I’ll just bring up an example of that, for example, sex drive and libido. When we see people that are chronically stressed and depleted, usually sex drive is going to go down or become non existent. I asked that question on my intake form is your libido adequate, and all the sick people know their libido is not adequate. And my interpretation of that is libido is really, a it’s a luxury to be able to do that. You’ve got to have some optimal things that happen. Obviously, there’s other mechanisms at play, but just at a simple basic level. You know, sex is a luxury when you’re running from a bear, you’re not going to, you know, be aroused if you’re running from a bear. And that bear could be your boss, or your spouse or your kids if they’re driving you crazy. And libido is like that, whatever. So that makes sense. 

Dr. Justin Marchegiani: Yeah, and if you just look at how the the nervous system allocates sexual energy, so typically foreplay, or just, you know, that intimacy that you’re going to have before ejaculation, or before an orgasm, that’s all parasympathetic. And so you need parasympathetic nervous system stimulation for, you know, the foreplay aspect of intimacy. And if the parasympathetic isn’t there, that’s where you see premature ejaculation, right? Because ejaculation or orgasm is sympathetic. And foreplay is parasympathetic. And so if you don’t have parasympathetic stimulation happening, because you’re so stressed or so inflamed, it, you know, that’s where premature ejaculation or just not even being able to rise to the occasion, if you catch my drift, because that parasympathetic nervous system response is so squashed.

Evan Brand: Yeah, this is a huge problem. I mean, I’ve seen 20 year old guys that are jumping on Coke, the little blue pill, and you’ve got all these websites now that are promoting like off the market Viagra. It’s like, what the heck, like we have like teenagers and 20 year olds now like carrying around that that you know, used to be like, when you know, high school is kind of the cool joke thing to have. But you got a condom in your wallet. Now, it’s like you have a condom and you have Viagra as a teenager?

Dr. Justin Marchegiani: Yeah, I mean, that’s why you typically need a couple hours of stress free conversation and, and connection before before that kind of nervous system stimulation can happen. You can’t just go it’s harder to go into a stressful day, switch the switch. And then there you go. It’s just tough. That’s because of the nervous system. So we just got, we got to know that. 

Evan Brand: Give us your comments. Do you want a functional medicine, optimization of libido podcast? If so, let us know.

Dr. Justin Marchegiani: We’ll chat about that’s great. All right, I would say next thing we can kind of we talked about the gut lining support, let’s talk about bile support. So bile is really important for fat digestion. A lot of women are going to be affected by bile issues, because it’s very common women, when they’re 40s, they tend to get their gallbladder removed. It’s a common procedure, you have any upper right quadrant pain issues, boom, they’re taking out your gallbladder right away. And your gallbladder is part of what concentrates bile, your liver will make it and then it stores it in the gallbladder. And then it gets released. It very specific times via coli cystic keinen cck stimulation, and cck is going to be stimulated when you have a whole bunch of fat and protein going getting released from your stomach into the small intestine so that we get to release it. It happens at a very specific time. And it’s concentrated 15 to 20 times more than just what your liver would drip it in. Because when you don’t have a gallbladder just chatter dripping. And when it drips, you can you can have bile acid diarrhea. And so that’s where you have to use bile acid sequestering agents to kind of calm it down. And we got to put our bile in at the right time. And so we may have to take supplemental bile definitely for life that we don’t have a gallbladder. If we have biliary insufficiency, we’re going to have to be taken bio as well maybe extra lipase, which is a fat enzyme from the pancreas. But if we don’t break down that fat, you know, we’re gonna see our stool start to flow, we’re going to start to see, you know, St Mark’s skin marks on the toilet, see, because the fat is, is streaking, it’s not well absorbed. And then you’re also going to see a lot more excessive wipes when you go to the bathroom when you clean yourself because it’s just the fat is streaky, right, it’s it makes a big mess. And so we got to break down that fat adequately and then we may have to add extra bile into digestive support may have to add extra label lytic enzymes as well. Also, if you’re a female or even a male, high levels of estrogen is going to make your bile flow more stagnant. So if your bile flow is more stagnant, you’re not going to have good biliary output. And I would say last but not least, if if you’re one of those people that got thrown into a low fat diet Well, when you go low fat your gallbladder is not emptying because it’s the trigger for gallbladder emptying is coli cystic keinen from fat consumption. If your gallbladder is an empty, empty, what happens all that bile, it can start to form bile crystals. And those crystals are sharp. And when you finally do eat a little bit of fat, it’s like giving a hug to a porcupine. All right, it’s gonna be quite painful. And so imagine your gallbladder contracting on it’s like giving that porcupine a big hug and you’re going to inflame that gallbladder. And so chronic low fat diets with a punctuated higher fat meal, and also coming in there with estrogen dominance, a lot of detoxification issues, not clear handling estrogen, well, maybe having a lot of estrogen in your meats in your pesticides in your plastics goes for guys, too, that could definitely screw up your gallbladder and cause biliary and fissures not enough bile flow to that gallbladder.

Evan Brand: Wow. Okay, so let me just clarify, because this is interesting stuff here, because people online, including us were really big proponents of good quality, pastured animal products, and high quality fats were a big proponent of that. But you’re saying that when a person comes in, let’s say they came from the brainwashing of the even 2000s, I mean, part of me want to say 1980s 90s, and 2000s. But it’s still, there’s still the low fat dogma still there, that’s still like one of the labels on a product low in fat that’s still marketed today. So this is still a trend. You’re seeing someone coming from that with gallbladder issues with infections with low stomach acid, then they try to go keto, carnivore, meat based paleo, whatever, they end up with problems. If they have like a gallbladder issue or a gallbladder attack, the doctor is going to blame maybe the fats and just cut the gallbladder out. But you’re saying there’s kind of a few steps, if you will, that have to be a prerequisite to handle a higher fat diet properly.

Dr. Justin Marchegiani: Yeah, I mean, why don’t we just have the propaganda of the 80s and 90s. And just the fact that calories in calories out, right, oh, you’re worried about how many calories you consume? Well, we know one gram of fat got nine calories in it, compared to four in the protein and four on the carbs. So of course, fat gets to be looked at more deeply on that side, because of the caloric intake. And then also, if you’re, you know, a lot of the studies on fat causing heart disease, which we know are all nonsense, we know that the meta analyses in the last 10 years show there’s no correlation with that, with fat and animal cholesterol, a lot of the studies in the 60s and 70s, they did not differentiate saturated fat with trans fats. And so they had a whole bunch of trans fats mixed in with a lot of these experiments. And you didn’t really get good data because they had the trans fats, which we know hydrogenated vegetable oils are terrible and bad for our health, we know that. So you got to pull out those confounding variables to really get good data. And so we know that in the last 10 15 years, that is not the case. And that cholesterol and fat is going to be fine. It’s really going to be the sugar of the trans fats, and maybe an argument for a lot of the refined processed vegetable oils, these vegetable oils during the processing of them, they get damaged. Because your polyunsaturated fats, omega six, they get damaged, and they create a lot of oxidative stress, and they get stored in your cell membranes for a long time.

Evan Brand: Yeah, these are these are super bad oils, and they’re everywhere. I mean, even at Whole Foods. If you go and look at organic potato chips, you’re still sometimes gonna see cottonseed oil, you’re gonna see sunflower oil, you’re gonna see canola oil. I mean, I get frustrated because Whole Foods kind of markets themselves as healthy. But if you go to like their I don’t know, if you call the buffet, but their hotbar, if you will, every single food item they have, there’s canola oil and everything.

Dr. Justin Marchegiani: Yeah, it’s just cheap. And then there’s also a lot of stuff on the olive oil being fake, right? So you got to look at that too. But that’s why at least half your fat should be high quality animal saturated fats, because one, those fats are just really stable, they’re going to be really temperature stable. And if you’re getting organic, decent fat, there’s no processing of that that’s going to damage the fat like you may have with a vegetable oil. But ideally, try to get cold pressed, try to get organic, try to get reputable brands that you know, aren’t going to be a blend of other canola oil mixed in which is terrible.

Evan Brand: Yeah, yeah, let’s hit another point, which is important is the fact that the bile has some antimicrobial properties and all these estrogen dominance issues you’re hitting on you’re hitting on the low fat you’re hitting on maybe the the no gallbladder. Yeah, it makes sense why we see so many women, for example, that have had their gallbladders removed, they have massive, massive gut infections.

Dr. Justin Marchegiani: Yep, correct. And so bile is antimicrobial. And so it’s gonna make it harder for bugs to grow in the small intestinal tract. And so just having good biliary output, it’s going to act like anti microbials and make it harder for these bugs and dysbiosis to grow. So having good fats in there, going to stimulate good bile stimulation and flow in that bile flow is going to help you emulsify and break down the fat and it’s also going to make the environment harder for bugs to grow. So it’s definitely a win win on both sides of the front there.

Evan Brand: Yeah, you and I don’t have any published studies to say hey, we had 278 patients and, you know, 275 had their gallbladders removed and all 275 had SIBO we don’t have it like published like that. But I know that you would agree clinically what we’ve seen, you know, combined over the last 10 plus years is that We see tons of SIBO SIFO issues and a lot of those people have gallbladder issues or they don’t have a gall bladder period. So it’s definitely, definitely correlated.

Dr. Justin Marchegiani: Yeah. 100%. And it’s good to look at that. No, I would say next thing we can kind of switch into is cooking our foods. I mean, sometimes fermentable carbohydrates, sometimes just the fiber in those foods, the rawness of the foods, the anti nutrients, lectins salicylates, females, can really be irritating to someone’s got if it’s already wrong. So sometimes just one cooking those foods can be wonderful. Sometimes even switching to a carnivore diet, as long as we can handle the fats and proteins can be great, because you’re decreasing all those anti nutrients, sometimes just really making sure everything’s really cooked and steamed and sauteed. Or maybe using an instapot, or some kind of a method really helped break it down. And then of course, low hanging fruit, like just chewing your food up really well to like almost like an oatmeal like liquid consistency, making sure you’re not overly hydrating with your meal, maybe just a couple ounces of water to get some pills down. But that’s it you’re hydrating, 1015 minutes before two hours after because water’s got a pH of seven, right? And your stomach’s a pH of two, two and a half and you add a whole bunch of seven, there’s a bunch of two and a half, you start raising the pH plus you’re diluting all your enzymes and ask for the potencies drops. So all those things matter.

Evan Brand: Yeah, here’s an interesting thing. I looked at some of the videos. And I interviewed him on my podcast too super cool guy, Paul Saladino, who wrote a carnivore book and he talks a lot about carnivore diets. He visited the Hodza tribe. And something interesting is he thinks that we’re really like over hydrating, like, if you watch these people, these tribal people, obviously they don’t have water bottles, and they don’t have really access to water the way we do. But he would notice they would eat an entire meal with no liquid. And then here we are in America, you go to the restaurant, and they’re like, what do you like to drink, sir. And if you’re like water, they bring you a frickin huge cup. I mean, it’s probably 1620 ounces of ice water. It’s cold, which I don’t know, people may debate me on this. I don’t know if ice water is necessarily good around meals either. I just feel like no, from an energetic-

Dr. Justin Marchegiani: Your stomach longer sits in your stomach longer because your stomach’s not going to release your internal body temperature is around 99 98 degrees, and you drink a whole bunch of 50 degree water, your body’s gonna hold that water in the stomach until it gets up to body temperature and then release it. I mean, very simple. Just drink a whole bunch of cold water and you’ll feel it sloshing around drink room temperature water and you’ll feel it move through your body way faster. When you move around. 510 minutes later, you won’t feel the sloshing.

Evan Brand: Ah, you know, see just intuitively I just keep I just drink room temperature water now they’re on a really hot day. Yeah, like some ice water. But just like normally, during the office hours, you know, I’m just drinking room temperature water and I feel so much better with it. But yeah, so sorry, I got on a little tangent. But I would-

Dr. Justin Marchegiani: It’s not a big deal. It’s not a big deal. If you do that and drink wine, drink cold water, just be careful of drinking really cold water right before a meal. Because it will take longer to move through. So at least if you’re going to do cold water, make sure it’s not 10 minutes before meal.

Evan Brand: Okay, Okay, understood. But anyway, the idea was like he saw these tribal people and how they’re how they’re eating and drinking. And, you know, they didn’t really do meal combining, there’s a lot of like, when you go to a restaurant, there’s this feeling that you got to have your meat and then your vegetable and then your potato. And obviously this is different. I’m not saying we all need to live like tribal people. But what I’m saying is I find it very interesting that their life is more what our DNA expects, meaning if they’re walking along and they stop upon a bush, they might just gorge on these berries. Or if they stop and find this bail Bob tree with a particular type of honey in it, they’ll cut open the tree, find the beehive they’ll eat just a meal of honey and then they get the kill and they eat just the meat so I personally have experimented with that like just meat, just berries just starch and just try to play around with it as opposed to doing the steak with the broccoli with the sweet potato and I personally do feel better on just those single items so I’ve I’ve definitely been leaning more that direction I feel significantly better.

Dr. Justin Marchegiani: Yeah, I think you know a couple of things one I think most of their meals are probably going to have more protein in it because if you kill an animal that that meat last way longer and if you look at a lot of the the fruit they were to have back then I’ve looked at a lot of these studies that they’re a lot more tart a lot more bitter they aren’t like overly sweet like we’ve due to hybridization and genetic selection we’ve kind of chose the sweetest berries the sweetest this so a lot of the fruits way sweeter than what you would have typically found in nature on average and things like honey would have been a rarity it wouldn’t have been something that you’re you’re have access to every single day and so we have access to it every day so you know if it’s something that’s every now and then it’s probably not a big deal but if they were doing honey like that every single day and they weren’t as active right because they have to be really active to hunt and kill and do all their stuff there may be metabolic issues.

Evan Brand: Oh yeah, I think I read he was just trying to keep up with the tribe. I want to say they were doing something like 10 miles a day walking I mean there’s an insane amount of steps.

Dr. Justin Marchegiani: Yeah, anytime one your stress is decent right because you know most of their life was just focused on the next meal right killing having their next meal obviously making sure shelter stable but once shelter is good Then really most of your focus is on food as a food and safety for the tribe. That’s it. You know, you’re not having to go pay a big mortgage down or worried about your kids private school, right? Yeah, that’s a different priorities right?

Evan Brand: Have you seen the organic strawberries lately? My god, they’re freaking huge. They’re like small apples, man.

Dr. Justin Marchegiani: Yeah, I had a couple over the weekend. They were like almost the size of my hand. I was like, Holy smokes!

Evan Brand: Because I kind of thought that organic was and I guess I thought wrong. This is me being dumb, I guess. But I thought that organic had a little bit of separation from the conventional practices meaning the hybridization process, but my god, you look at some of these apples now to their like softballs.

Dr. Justin Marchegiani: Oh, yeah, I mean, just farmers naturally over hundreds of years, they’re going to just start selecting seeds and, and crops that are going to be more tasty, just just natural selection of what sells. And so that tends to shift over time, where if things are just growing in Mother Nature, you know, we don’t quite have that ability to select it as much. 

Evan Brand: Yeah, I don’t know if you’ve seen this, but I go, you know, I’ll be out in the woods and I’ll find some wild strawberries. They’re tiny. They’re like the size of your pinky fingernail.

Dr. Justin Marchegiani: Yeah. Real. Yeah. Yeah, no, totally. So yeah, but most important thing is the food quality. And, of course, if you have insulin resistance in your inflamed, you know, leaning to less sugar is always better. Just because your body doesn’t have you know, if you’re the hunza, right, and you’re walking 10 miles a day hiking and doing all these things, you have the ability to burn all that stuff up. No problem. It’s not a problem, but you have don’t have the ability to burn it up, what’s your body going to do with it, then it gets stored in the liver, and it’s stored in the muscles, and then when that’s tapped, it’s gonna get converted to fat. And you’ll get insulin resistance. We got probably that’s I’ve got to be careful that.

Evan Brand: Yeah, and the main last point, there was just adjusting how your food is cooked based on what’s going on with your gut. So if you’ve got infections, like for me, I’ve rarely ever do leafy green salads. Raw just doesn’t agree with my gut. And so I don’t do it. And I could, I’m sure I could work it in, but to me, I feel I feel good. My gut feels good. I feel good. So I’m okay with cooked veggies. And those work for me. So.

Dr. Justin Marchegiani: Yeah, worst case, just take your veggies laid out in the frying pan and put a really good saturated fat down and some sea salt, you know, and, and boil it, you know, for 20 minutes at 400 nice roasted vegetables are pretty good. As long as you’re using the good healthy fat on It’s wonderful.

Evan Brand: Yeah, would you recommend something like ghee, because if you go too hot with butter, you might get some smoke, right? So would you say ghee or what do you like?

Dr. Justin Marchegiani: You could do ghee or any Talos you could do a little bit of avocado oil. Avocado oil is pretty heat stable use got to make sure you’re looking at what the heat is. You don’t overdo based on the smoke point. Okay, that’d be cool. Anything else you want to hit on? I just think people that are listening here. If you’re struggling and you’re having a hard time, you know, feel free to reach out to someone like Evan and I would be happy to help you out. And you can see Evan at and feel free you can schedule with him worldwide, as well as myself, Dr. J at Happy to help you guys out. also put your comments down below, let us know your thoughts on the topic. Let us know what you’ve done. What’s helped you in the past. You know, we learn a lot through our patients. Because you know, when you only have yourself that’s that’s only one person. But when you have 1000s of people that you can learn from you just see what works. You don’t need a scientific study to tell you because you see it, it’s real. And then we apply it to help our patients. And we really appreciate y’all sharing your stories here as well. And reach out links below for everything guys, and then make sure you share with family and friends that they could benefit. Please put it in their inbox or share it on social media. We really appreciate it.

Evan Brand: Yeah, yeah, well, awesome job. And yeah, once again, Or, please reach out we’d love to help you. And you know, we didn’t talk about it too much today, because it’s more focused on other things. But testing is part of this protocol. So figuring out exactly what we’re doing, how we’re doing it, when we’re doing it, why we’re doing it, it is based on testing, we’re not just using you as a guinea pig, we are truly looking at calprotectin and stouter crit and Alaska as there’s, there’s so many biomarkers that we didn’t even discuss that we’re working into that. So I just want you to know that we’re not coming in blind here. We have data that we’re using, which helps us to guide these protocols. And that’s really where the magic happens is once you get to the get the data. So test, don’t guess, reach out if you need help. And we’ll be in touch next week.

Dr. Justin Marchegiani: Yeah, just to highlight that. On the digestive side, we’re looking at markers likes the adequate, which if that’s high, that’s a lot of mal digested fat. If we have a lot of calprotectin or lactoferrin, or increased immune response like IGA that means there’s stuff going on in the gut. And so it’s good to know that ahead of time so we can really quantify what’s happening, or maybe even gut permeability like Sanyo, and that can all be very helpful. So I’m glad you touched upon that. We’ll put links below guys for everything that you guys need to take next steps and you guys have a phenomenal week.


Audio Podcast:

Recommended products:

Genova Organix®

Dysbiosis Profile

Genova NutrEval® FMV

Genova ION Profile

Genova SIBO Breath Test

DUTCH Adrenal Test

Organic Grass Fed Meat

Betaine HCL Supreme

Multi Nutrient Supreme

Digest Synergy

Liver Supreme

Enzyme Synergy


Stomach Acids, Enzymes and Insulin-Driven Issues and Supplementation | Podcast #191

Welcome to today’s live podcast with Dr. J and Evan Brand! Watch as they dig into the different issues concerning gut health and supplementation, like Insulin-driven skin problems, malabsorption, enzymes, kidney stones, detoxifying and other digestion-related topics they randomly answer.

Stay tuned for more functional health information, and don’t forget to share!

Dr. Justin Marchegiani

In this episode, we cover:

02:15  Estrogen and Insulin-Driven Skin Issues

05:50  Enzyme Synergy Versus Digest Synergy

10:00  When to take what Supplements

16:25  HCl, Enzymes and Digestive Supplements

19:49  Organic Buckwheat Crisp



Dr. Justin Marchegiani: Hey, there! It’s Dr. Justin Marchegiani. Evan Brand is here in the house as well. Evan, how is your Father’s Day, man?

Evan Brand: Oh, dude, Father’s Day was great. It was my second. Was this your first…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …Father’s Day?

Dr. Justin Marchegiani: I may— I guess it’s my First. My— My son last year at this time was in my wife’s belly…

Evan Brand: [laughs]

Dr. Justin Marchegiani: …I think six months— s— so, six to seven months in. So he was still— he was still alive and kicking, so it felt like my second. But, yeah. It was great. I got this awesome little gift from my wife.

Evan Brand: What did you get?

Dr. Justin Marchegiani: This. She made this little thing…

Evan Brand: [crosstalk] Oh! Dude, that’s great!

Dr. Justin Marchegiani: Yeah, and then that’s me with him. That’s Aden right there.

Evan Brand: Oh, man.

Dr. Justin Marchegiani: And he’s a super little healthy dude. [crosstalk] Really healthy…

Evan Brand: Actually nice.

Dr. Justin Marchegiani: But yeah. That’s— Melts my heart. [inaudible]

Evan Brand: [crosstalk] Yeah. Your wife was uh— Your wife was showing me his swimming skills when I was over at your house so we went to the pool. Uh— He— He’s doing pretty good for a little guy.

Dr. Justin Marchegiani: He’s doing great. I, too, took him out to a steak restaurant in Austin, and he had a little meltdown halfway through. He forgot to check his diaper. Like— It’s this like…

Evan Brand: Uuuh—

Dr. Justin Marchegiani: …the most obvious thing sometimes.

Evan Brand: [laughs]

Dr. Justin Marchegiani: It’s like phew!

Evan Brand: [laughs]

Dr. Justin Marchegiani: But he was eating a whole bunch of steak and and red wiine. He’ll pound down five ounces for a steak in a meal.

Evan Brand: That’s amazing.

Dr. Justin Marchegiani: Yeah. He just crushed it. And the thing is he has had no real exposure to sugar outside of like having berries so it’s really interesting because he is totally carnivorous, will choose meat over anything else. Where— I see lots of other parents, where their kids are getting like lots of these like eating Yogurt, sweetened things, a lot of juices. I really feel like like that numbs your taste buds ‘cause they really don’t want to eat meat or these higher protein and fat-rich foods. They’re just like all about the sugar. So that’s one thing I’ve noticed. So any parents out there— you know, your kid’s coming to this world with this blank slate. Keeps their taste buds as “El Natural” as possible.

Evan Brand: Do you do uh— applesauce with them?

Dr. Justin Marchegiani: Uhm— Actually, we’ll just cut up apples.

Evan Brand: But no applesauce?

Dr. Justin Marchegiani: Uhm— In the beginning, we did a little bit but not much. I mean, we do like a little bit of mashed sweet potatoes or mashed Avocado. Uhm— But no, not a ton of applesauce. He’s able to just— We do a lot of baby like weanings so we just cut up the thin strip of apple or the thin strip of pear, or the thin nectarine, and then just let him eat— let him eat it like that.

Evan Brand: That’s smart.

Dr. Justin Marchegiani: Yeah.

Evan Brand: That’s smart.

Dr. Justin Marchegiani: Yeah, absolutely. So I know we only have a little bit of time today so we’re gonna just do a live Q&A. We had a couple of questions here. So, we’re gonna just dig in. Let’s go through them.

Evan Brand: yes, let’s do it.

Dr. Justin Marchegiani: Uh— Gabe writes in, “Lately, my wife spends seeing more tiny moles started to appear on her face. Any explanation why?” So, couple of things. When you see moles grow, the first thing I always want to know is Estrogen and Insulin. So, really make sure carbohydrate and Insulin is under control. Insulin will cause things to grow. And then, we can just do a little bit of Google Search and do Hyperinsulin— Hyperinsulinemia and Moles, right— and you’ll see it. Skin manifestations of Insulin resistance, and you’re gonna see that a lot of uhm— skin stuff can be driven by Insulin. A lot of Acne as well. Right? A lot of Acne as well, because Insulin causes things to grow.

Evan Brand: Yeah. You got— You always got to start with the diet. I think that’d be the most simple thing, right? Make sure…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …she got like a Paleo template to start with, she’s regulating Insulin, and there’s always other root causes that could affect Insulin too. Like gut issues can affect blood sugar, which could affect these Moles.

Dr. Justin Marchegiani: Yup. So I would always look at the— the blood sugar, the quality of food. I’d look at pesticides and chemicals in the environment. I want to make sure those things are under control. And then, of course, you know, the gut’s a mirror of the skin. So, everytime I see a gut— a skin issue, I always think gut, so you can always do a nice little gut cleanse. Uh— You get to do some gut testing, do some gut clearing, and then uhm— you can always work on some detox as well because things will get pushed out via the detoxification system, which will be the skin as well. So, activated charcoal, glutathione, Sulfur amino acids are gonna be great, and then uhm— You know, there’s always a chance that it could be a viral thing, too, like a Papillomavirus thing.

Evan Brand: Good point.

Dr. Justin Marchegiani: Uhm— But— Yeah. But, you know, a lot of the herbs we may use. Like in my GIClear 4 and 6, there’s a lot of Olive leaf, so I would just use a 4 and 6 in there and that extra Olive leaf will have some good antiviral effects too.

Evan Brand: Yeah. You— You kind of briefly mentioned some of your supplements, but I want people to understand that uh— you know, part of your goal is to provide professional grade supplements to people even if they’re not your clients or patients. So if you guys tune in to this in the future, if you’re tuning in right now, you can go check out— There’s an entire library, basically online natural pharmacy so to speak, of various nutraceuticals and things that Dr. J has formulated. So when he says like, “Hey! My GI Clear 4,” that’s what it means. And you can go check out those formulas. So, we’re always happy for people to piece together these herbs but, obviously it’s better if you get some lab testing to figure out if you actually need them. But if you’re searching fish oils, Collagen, proteins, which his is amazing, uh— all that stuff is on that Just in Health store. So if you’ve not browsed it, now’s a good excuse to do that.

Dr. Justin Marchegiani: Thanks, Evan. Thanks for the plug. And then, topically, you can always do like a higher quality Vitamin C serum or high-quality Retinol or Vitamin A serum with antioxidants. That’ll always be good topically as well.

Evan Brand: Yep. Good advice. Uh— Let’s go over here to uh— Juan. He was asking, “A Glutathione injection, is it great in an IV?”

Dr. Justin Marchegiani: Uh— IV, I think is great if it’s— if it— if you have a really acute exposure. The problem is most people can’t afford or do an IV daily. So, I think an IV, acutely, is a good situation, uhm— but daily, it may not be the best. So you get like a Liposomal Glutathione like this, and then you just give it a little squirt a couple times a day if you want that.

Evan Brand: That’s far smarter. You don’t need an IV. I think an IV is unnecessary because of the Liposomal technologies.

Dr. Justin Marchegiani: Yeaah. Liposomal technology has really helped. Now, if you get an acute issue, that’s fine. Like if you’re sick or your kid drops a  th— you know— a Mercury-based thermometer kind of thing, right? That’s— You know, for an acute thing, I’m— I’m okay with it, but in general, you want something that you can use daily.

Evan Brand: Yeah. I agree.

Dr. Justin Marchegiani: And then, uh— Charlie writes in, “What’s the difference between Enzyme Synergy and Digest Synergy?” Uhm— Digest Synergy, basically has some different types of acids and a little bit of Pepsin. It— It’s lower on the HCl and has a little bit of enzymes. The Enzyme Synergy’s pure enzyme. So, typically in my line, I use Enzyme Synergy and HCl Supreme together because I get a high dose of HCl and a high dose of enzymes. So if I have digestive issues, I can more therapeutically hit that. Digest Synergy kind of consolidates two into one so it’s lower on the enzymes and it’s lower on the HCl, but for most people that don’t have an active digestive issue, it’s enough. So it’s basically just consolidating the two together. People that don’t have core or very minor digestive issues.

Evan Brand: Yup. Good. Good. Good, good.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Both great products. So here’ another one from uh— Juan, “I took Lamisil. It worked great for my fingernail, fungus and toenail fungus. How can I detoxify my liver from the medication? I tried other things like T3, Oil Oregano, oil, and nothing worked.” Well, first, uh— I mean, you give me your two cents here, Dr. J, but I would say, you got to get tested. I mean, you’ve got to take a look at your liver. If you’re concerned, and you want to detoxify, why don’t you look at your AST. Look at your ALT. Look at your GGT. See if there’s anything like, actually manifesting…

Dr. Justin Marchegiani: Uhmhm—

Evan Brand: …before you go down some like liver detox program. You might not need that.

Dr. Justin Marchegiani: Yeah. I think that’s great. And then, if you’re really having a hard t— You said, “I took Lamisil. It worked great on your fingernail fungus and toenail fungus.” So you’re saying— I sounds like the toenail fungus and all that stuff’s better. So, ideally, if you’re gonna take that stuff, you should be on Glutathione uhm— and/or like milk thistle and liver tonifying support. So, like in my line, it’d be Liver Supreme and Detox Aminos, and you can even add in extra liposomal Glutathione along with it while you’re doing it. So you typically want to do it while doing it because— I mean, what’s the half-life on that stuff? It can’t be that long. So, it’s probably out of your system already. So, you just want to build back your system up to make sure it’s fine. That probably iis fine. It’s unless you use it for a incredibly long time. So I wouldn’t worry about it, but better to do it while you’re actually doing the treatment.

Evan Brand: Yup. Yup, well said. Let’s go over here. Uh— Don’t know who this is. Kind of weird name. Uh— “Small amounts of Calcium citrate a meal’s okay with kidney stones?”

Dr. Justin Marchegiani: Well, with uhm— kidney stones, you’re typically gonna be doing more Magnesium— more Magnesium with kidney stones ‘cause a lot of the kidney stones are oxalate-based. So Magnesium tends to be good, and then also Potassium. I don’t think you want to be doing Calcium citrate. Let me see. I think the citric acid may—

Evan Brand: I don’t think you want Calcium, period. Nora Gedgaudas, a mutual friend of ours, has a great article on Calcium. You really just don’t need Calcium supplementation uh— hardly, ever. There’s very rare situations where you will need that.  

Dr. Justin Marchegiani: Yeah. So, basically, Calcium citrate does reduce the risk of oxalate deposition in the kidneys. So does the Potassium. So does Magnesium. I just rather be using Magnesium and Potassium personally. Uh— it’s harder to get those minerals, nd they have more enzymatic roles than Calcium. So I wouldn’t worry. I would use the Potassium and Magnesium over the Calcium, personally.

Evan Brand: Yup. Yup. Let’s keep going here.

Dr. Justin Marchegiani: I had a large in my back. It fell off after Keto and fasting. Totally makes sense. That’s all about Insulin, right?

Evan Brand: That’s cool.

Dr. Justin Marchegiani: Yup. Makes a lot of sense. Seen that before.

Evan Brand: Here’s Tom. I’ll read this one for you. “Vitamin D, trying to optimize absorption one meal a day in the evening. Should I take Vitamin D on an empty stomach or with the meal in the evening and risk melatonin interference? Any suggestions?”

Dr. Justin Marchegiani: I mean, I would just try to do it in the morning because it makes sense. Vitamin D is typically gonna happen when the Sun’s up, not when the Sun’s down so try to time it in the morning. If you forget, as long as you can take it, and it’s not gonna mess up your sleep and you can relax and wind down, I think it’s fine. A lot of my uhm— Vitamin D’s gonna be at a beta MCT Oil, so take it with a meal.

Evan Brand: Yep. Sounds good. Keep going here. Anita, “Can you talk about the best time to take probiotics, Vitamin D, Vitamin C, Biotin, Zinc? Is it too much to take all together with a meal?” The answer is no. You can take all of that together. The main issue is standing here. So first, I’ll have my two cents. You need to get…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …your Ferritin look there. So, I’d get a blood panel run to look for Anemias ‘cause you can take these magic— magical mira— miracle supplements like Biotin, which every woman under the sun is taking now, and it might not resolve your hair uh— thinning issue. So get the blood work done. Investigate, first of all, and then, in terms of probiotics, we always recommend that you do those on an empty stomach or maybe around bedtime, because then you’re not competing with stomach acid. So, the probiotic can kind of do its job on its own. Vitamin D, do it with a meal ‘cause it’s fat-soluble. Vitamin C, recommended in the morning ‘cause it can help stimulate the adrenals a little bit. Zinc, I don’t think it matters.

Dr. Justin Marchegiani: Yeah. I would just say, anything mineral or amino acid-wise, do it with the food and I’m fine with it. Probiotics, empty stomach, unless, let’s say, acid resistance strain like Omega Support, that can be done with food.

Evan Brand: Yup. Yup. Uh— Let’s go over to Oliver here. Would drinking Water Kefir with mears— meals help or hinder digestion as regular water would?

Dr. Justin Marchegiani: Uhm— I would just say, it probably would help ‘cause a lot of the Kefir uhm— tends to have like a lot of acids in it, like glucuronic acid or a lot of uhm— various acid from the fermentation process. And that may be helpful with the digestion, so I would just say, see how you feel. How do you feel when you have that with the fo— with meals. Do you feel bloated or gassy, or do you feel better. Uhm— So I would give it a try and see how you do. I— I will do my ow— one exception to drinking water with food is uhm— Well, number one, the healthier you are, the more you can do it, right? I would still would do it sometimes, like I ate 30 minutes ago. I’m drinking a little I’m sipping on a little bit of water. I’m not downing it, right? But I always try to drink five to ten minutes before food. But in general, uhm— a good rule of thumb is, if you’re burping a lot and you’re smelling the food, ann your burps right after a meal, you drank too much water. Right?

Evan Brand: Yeah

Dr. Justin Marchegiani: That’s a pretty good rule of thumb. And also, do you feel undigested? But when your digestion is more compromised, you got to be by the book. When your digestion is less compromised, you can have a little bit more uh— latitude in what you do. But as long as you feel good, you’re okay.

Evan Brand: Yup. Let’s keep going here. What’s your time? I know we got— How many minutes more do you have like?

Dr. Justin Marchegiani: We got five more minutes.

Evan Brand: Okay. Uh— Here’s a question from uh— Charlie. Can you just do the H. pylori part of the diagnost— diagnostic solutions test? The GI Map is too expensive. Charlie, I don’t know if you can do it on the GI Map. I know you can with BioHealth. You can do just an H. pylori antigen. However, I would hardly not recommend you do that because if you’re gonna spend money, period, to get any testing done— you know, whether it’s Dr. J or my protocol, our protocols are very importantly based on having a full picture. So imagine like trying to estimate what your— what a puzzle is just by looking. What’s that analogy where you look at the tail of something and you’re like you have no idea there’s an elephant in the room ‘cause all you saw was the tail.

Dr. Justin Marchegiani: Yeah. Yeah. It’s basically you’re walking in around— you’re walking in there blind, or you’re just each person stealing the part…

Evan Brand: Oh, yeah.

Dr. Justin Marchegiani: …of the elephant trying to guess what it is, right? And, there’s also an assumption too. The assumption is, “Oh, I treated the H. pylori— or I treated the other parasites. I only had the H. pylori. Therefore, I only want to look at that.” And a lot of times, you may have other infections that come back on the retest ‘cause these infections were barred in deeper into the gut lining. So you want to rule that out.

Evan Brand: Well, use me as an example.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I— I had Crypto. I had Giardia. We came up with the protocol and guess what? On the retest, the parasites were gone and H. pylori showed up. So then I had to do a second protocol to kill H. pylori ‘cause it was barely in.

Dr. Justin Marchegiani: Exactly. Now, some people like ninety or a hundred percent of their symptoms go away. Okay. Fine. You know, you’re feeling amazing. You only want to test for one thing. Money’s tight, fine. But, if not, I will always retest the whole thing, just to be in the safe side.

Evan Brand: Okay. Okay. Yup. I would agree. If so, how much is it? Uh— Pricing varies. Pricing changes.

Dr. Justin Marchegiani: Yeah. You can go to my site, GI Map test cash is 3.99 and then, we provide the superbill codes so you can always submit it with insurance and you can also use uhm— your HSA of Flex Spending too.

Evan Brand: Yup. Yup. Uh— Let’s see here. Gabe, “Uh— I like to make my 7-year old smoothies, which he enjoys (he does look a bit underweight) Is it okay to add a bit of your guys’ Collagen…

Dr. Justin Marchegiani: Yes.

Evan Brand: …and protein pow— Yeah.

Dr. Justin Marchegiani: Uhmhm— [crosstalk] Of course, without a doubt.

Evan Brand: Super high-quality. Uh— “Iron.” This is a question from Michelle, “Iron-68, Ferritin-51 after a high-dose Vitamin C IV, which resulted in oxalates everywhere. It caused hair loss too. Trying to recover. All those levels suboptimal? I feel oxalates were chelating minerals.”

Dr. Justin Marchegiani: I don’t know. Those le— Those levels are good.

Evan Brand: Yeah. I think so.

Dr. Justin Marchegiani: Again, I like to see Iron saturation in your— in your UIBC and TIBC, but overall, those look good.

Evan Brand: Yep. Uh— Mike, “I got my Viome Test in 23andme Test done. Just wondering which other labs I should run? (many health symptoms)” Mike, you got to get an adrenal test run uh— Justin and I would point you towards the Dutch, which is a urine or do the…

Dr. Justin Marchegiani: Yup.

Evan Brand: …BioHealth #201 CAR…

Dr. Justin Marchegiani: Yep.

Evan Brand: …Adrenal panel. And also, we would recommend you would get the GI Map. The Viome Test sounds sexy and the marketing is great but the read out is terrible and not very clinically usable this time, so we still would highly recommend you get a GI Map in Organic acids uh— test done, which is urine.

Dr. Justin Marchegiani: Yeah. I’m gonna go uhm— I’m gonna go have Steven Berry on my show. Uh— He use the one on the inventors of this test. I think it goes Naveen something. Uugh! I forget his name, but he created the Viome test. I saw him at a conference. He’s like a multi-billionaire Indian dude. Really…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …really smart guy. But I mean, they’re just on his Viome test. They’re just recommending foods to put there like your gut bacteria back in the balance. And it’s like— It’s like sweet potato, Avocado, Romaine lettuce. It’s like really like is that gonna be the key? ‘Cause there’s always people that I’m already seeing. They’re already eating a really good Paleo template where they’re getting a variety of those kinds of foods are ready.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Uhm— I just don’t— I— I’m just really underwhelmed by that intel. [crosstalk] And the biggest issue I see is, you know, you got to get rid of the infections that may be present, that may be driving the Malabsorption. So, I think it can be helpful but I would not put all your stock in it.

Evan Brand: Yep, right. Just a couple more then we’ll wrap up here.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Josh, “Can long-term Ox bile cause problems? I’m having less bloating with eating fat but much more constipation than some nausea.” I’m guessing he means while taking Ox bile.

Dr. Justin Marchegiani: Yeah. So, I want to know. Are you taking Hydrochloric acid and enzymes with it? I want to make sure that’s dialed in. I want to make sure that you actually got to the root cause of your low bile issues. So, were you having a lot of gallbladder issues, or are you having a lot of floaters? If you were and that helped, that’s a good sign. You can always taper off the bile a little bit and see if that helps. But make sure the HCl and enzymes are there, and then also make sure that you really fully address the gut issues ‘cause sometimes parasites like Giardia and stuff can kind of cause bile issues, so can SIBO. So I’d want to make sure all of the root issues are addressed but all the other digestive secretions are also supported as well.

Evan Brand: Yeah, well said. Uh— Digestive supplements are great but there’s a reason you’re having to use those to mitigate symptoms. So there’s probably something under the hood. Uh, Shanice, uh— “Which herbs are best to treat H. pylori?” There’s a ton. We use many different ones.Dr. J’s got a whole line that he uses for H. pylori. I’ve got a whole line that I use for H. pylori. So, it depends because if it’s just H. pylori by itself, which is pretty rare, usually there’s uh— other bacterial overgrowth, we may switch up the herbs a bit. So—

Dr. Justin Marchegiani: Bingo!

Evan Brand: Uh— I want to see. Don’t think we could just give you a list and then, you throw it together and have success. You need to get tested.

Dr. Justin Marchegiani: Yeah. But in general, like Mastika’s gonna be uh— one that’s used for a while. I like Clove. I like Berberines. In my line, it’s like GI Clear 2. It’s my H. pylori killer. But you really want to get treated ‘cause most people very rarely just had H. pylori so you don’t want to fall for that.

Evan Brand: The domestic gum, yeah, that is one thing you could—

Dr. Justin Marchegiani: Yeah.

Evan Brand: …you could throw at it and it could definitely help mitigate it.

Dr. Justin Marchegiani: Yeah. Mastic gum has adaptogenic qualities too so it is a very safe herb too.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yep. Absolutely.

Evan Brand: Yeah. “There is Candida too,” she says, so yeah. That— That’s very common.

Dr. Justin Marchegiani: Exactly! So you want to combine that. And then Josh writes in, “No floaters but uh— no poor Steatocrit on my GI Map.

Evan Brand: Good.

Dr. Justin Marchegiani: So that’s a good sign. So uh— I don’t know why you’re pushing uhm— bile salts the, if that’s the case, you know, therapeutically. I’d only push bile salts if I saw uh— floaters or if I saw high Steatocrit on my stool. If not, I push more enzymes and Hydrochloric acid because the Hydrochloric acid’s really important because if you have low Hydrochloric acid, that’s gonna be the stimulator to stimulate Cholecystokinin, which is this hormone that’s released in the small intestine  that stimulates the gallbladder to contract. So I’m more concerned about the Hydrochloric acid because that gets the gallbladder moving.

Evan Brand: Yep. I just want to add two more cents to the question…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …form Shanice about the H. pylori. And then, she said that, “Yes. There also is Candida.” Uh— when you lower stomach acid levels, that low stomach acid causes these foods to rot in putrefying the gut…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …which generally does in a Candida Overgrowth. So it’s very common. I’d say, 90+ percent of the time, we see Candida and H. pylori together.

Dr. Justin Marchegiani: Yes! One hundred percent.

Evan Brand: Uh— last question then we got to roll. Uh—

Dr. Justin Marchegiani: Yeah.

Evan Brand: Cha— Charlie says Dr.J have you killed H. pylori with your patients in 30 days using GI Clear 4?

Dr. Justin Marchegiani: Uhm— I would never do it by itself, but if I were to do a minimalist protocol, I would do at least GI Clear 4 and 2, or typically, 1, 2 and 4. One (1), 2, and 4, or if there’s Yeast along with it, we’ll do 1, 2 and 5. So, it just depends on what other stuff is going on, but 2 has to be in there. And if there’s no Candida, I would probably throw a 4 in there with it ‘cause it’s very high in Berberine and Goldenseal.

Evan Brand: And— And just to also add ‘cause I know how you work. Uh— You’re likely gonna be doing some type of adrenal support, potentially, some binders [crosstalk] or detox for it too. So—

Dr. Justin Marchegiani: Bingo.

Evan Brand: Uh— We— We can’t just come in and kill, kill, kill! Uh— We got to support the other body systems or you won’t make it through the protocol.

Dr. Justin Marchegiani: Yeah. I mean, most people, you know, they’re used to like, “Oh! I have chapped toe. It’s antibiotics.” Or, “Oh, hey! I get an STD. Here’s— Here’s antibiotics. Here’s a Ziprac.” Right? So most people are like, they find something. They want to kill it right away. But with these chronic infections, it’s a little bit different of a mindset.

Evan Brand: Yup. Yup. Let’s wrap up if you’re ready.

Dr. Justin Marchegiani: Yeah. And then, hold on. One last thing, “Organic Buckwheat Crisp because of bre—” Uh— So, yeah. Buckwheat is more of a root, so it tends to be okay. But if you’re Gluten-sensitive, definitely cut it out for a month. But that could be something you try to add back in. And then, Ali Mo writes in, “Is DiatomaceA, D.A., okay for humans?” Yeah. D.E.— .D.A. is based— or D.E. is basically uhm— just super, super high in Silica. How it works is basically is it dehydrates the exoskeleton on the bugs, and they basically die.

Evan Brand: Yeah.

Dr. Justin Marchegiani: That’s how it works.

Evan Brand: M— My uh— My— I just saw that coming— come through about the Buckwheat. My comment would be that it is a cross-reactive food. So—

Dr. Justin Marchegiani: Can cross-react.

Evan Brand: Uh— Your body can still think that it’s Gluten and could still trigger an autoimmune issue or something. Or if you ar— already have autoimmunity, you probably need to step away from buckwheat and its— and the other pseudograins.

Dr. Justin Marchegiani: Yeah. At least an AIP Protocol for uh— a month, and then you can add it back in. Don’t make it a staple, but if you want to have it a couple of times a week, uh— I’m okay with it. Just make sure it’s— you know, your issues are under control and you add it back in methodically.

Evan Brand: Yeah. And if your gut is healthy, you might be able to get away with it. If your gut’s not healthy, you may have a flare of some sort. You just have to pay attention.

Dr. Justin Marchegiani: Very cool. Hey, I like that picture of the bird over your right shoulder there.

Evan Brand: Oh, thanks, man. Yeah. I took that picture. Let’s say uh— female cardinal.

Dr. Justin Marchegiani: Whoaf! Beautiful!

Evan Brand: I got a bunch of uh— whenever you come over to my house, I’ve got a bunch of canvasses everywhere of pictures I’ve taken of different birds and stuff over the years.

Dr. Justin Marchegiani: Yeah, and you recommended that bird idea. Bright…

Evan Brand: [crosstalk] Oh! You’ve got birds in?

Dr. Justin Marchegiani: [crosstalk] …a lot of kind of birds.

Evan Brand: Oh, yeah. I was playing actually. I heard a pileated woodpecker, which is the largest woodpecker in North America, the other day, about this tall. I heard him calling so I got out the bird app and I played the song— his song. And then, he flew in to go see who is singing. And, he flew right over my head.

Dr. Justin Marchegiani: Oh, my gosh! That is cool, man. Yeah, the older I get, I kind of get into things like that. Like when I was younger, I was like, “Who cares?” But now, I’m like, “Oh! That’s cool.” [crosstalk] It’s cool watching birds.

Evan Brand: I love watching birds. I love birds, trees. Yeah, I love it all.

Dr. Justin Marchegiani: Awesome, man. Oh, hey! Today was a great chat. Appreciate it. We’ll be back next week, my man.

Evan Brand: Yeah. Tell— Uh— Tell people about the— the links.

Dr. Justin Marchegiani: Oh, yeah. So, uh— click below for the Thyroid Summit, And also, Evan’s got his summit going on right now, [emphasis], to get signed up for Evan’s [crosstalk] Candida summit.

Evan Brand: I got to go check out. Go check out the Candida Summit ‘cause we had a couple people in here talking about gut issues. There’s 30 talks in this Candida Summit. It launches July 9th, so go register. Use Justin’s link. Go register. It’s free. Then, you can choose to buy the talks and support the mission. Uh— It’s gonna be a great— great event. It’s all online. Coming up in what? Two or three weeks? So—

Dr. Justin Marchegiani: Yeah. And we need to get you a link for your— for my— for the summit for me, so then you can get some credit there.

Evan Brand: For sure.

Dr. Justin Marchegiani: Awesome, man. Hey! Great chat with you brother. Everyone, give us a thumbs up. Give us a share. Smash the like button. Subscribe. We appreciate you guys, uhm— tuning in. Have a great day. Bye.

Evan Brand: Bye.



“Hyperinsulinemia and Moles”….0…1.1.64.psy-ab..7.3.1181…0j0i22i30k1.0.grg19B8Fk0Y

Viome a Breakthrough in Gut Microbiome Testing with Naveen Jain Viome Founder Metatranscriptome

Enzymes and digestive support – Dr. J and Evan Podcast #127

Dr. Justin Marchegiani and Evan Brand discuss about enzyme, its uses to the body, as well as its impact on digestion and overall health. Listen to them as they go into the enzyme mechanism related to gut issues such as infections and heartburn.

Know about the acidity levels that may have positive or negative effects to one’s digestion. Gain valuable insights regarding the different topics asked by the listeners which include hiatal hernia, PPIs, and antibiotics. And learn more as these functional medicine experts share their knowledge about diet and supplements that have huge effects on enzyme production and stimulation.

In this episode, we cover:

2:13   Enzyme Production

6:10   Gut issues and heart burn

12:30   Symptoms involved with enzyme and acid issues

24:05   Hydrochloric Acid (HCl)

30:05   Types of enzymes

35:48   Antibiotics and gut health






Dr. Justin Marchegiani: Hey there! It’s Dr. J and Evan today. We got an awesome podcast. It’s a great Friday. We are live, too. So anyone’s that tuning in and wants to get some questions asked and/or answered, we are stoked to be able to do that. Today’s topic is gonna be on enzymes and how they can be used therapeutically to help with digestion and to overall improve your health. Evan, what’s going on, man? Happy Friday.

Evan Brand: Happy Friday! It’s beautiful here, the trees are blooming. It is freezing, though. We went from 70° to like 30° so – uhm, hopefully spring is coming because I’m ready to get outside again as soon as possible and go for an extended distance hike.

Dr. Justin Marchegiani: Got it. And people on Facebook here, if you’re not hearing Evan , do your best to head over to the YouTube channel. and click on the live view so that you can see Evan’s beautiful mug staring back at you and get your questions answered. I’ll try to be able to answer questions on Facebook as well as YouTube. So feel free and ask.

Evan Brand: Perfect. So enzymes – where should we start? I mean this is the importance of health; this is the – this is important for longevity; this is important for preventing or reversing disease because you’ve got to build a breakdown of foods with enzymes to be able to actually absorb the nutrients. Time and time again, you and I run organic acids panels on people where we look at amino acid metabolites and we look at these other biomarkers where we find that people are just not digesting their food and they’re not absorbing or assimilating any of their nutrients despite them spending hundreds of dollars a month on food, and organic food. Or they are on AIP diet, and they’re buying grass-fed beef and organic veggies but yet, they’ve got all these symptoms because they have low enzymes. So they could have hormonal imbalances; they could have fatigue; they can have excessive hunger; they could have sugar cravings and carb cravings all which could be tied into this enzyme deficiency because they’re just not breaking down their food; they’re stressed; they’re not chewing their food well. We’re kinda break all this down today.

Dr. Justin Marchegiani: Absolutely. I love that. So off the bat, let’s talk about how your body can actually make an active enzymes first. I think that’s a really important first step. So enzymes are primarily gonna be stimulated through the digestive processes and primarily the parasympathetic nervous system. So the more your nervous system is parasympathetic, right? That’s the – the rest in digest. The more you’re gonna have a nice low pH in your stomach. You’re gonna have gastrin stimulated. All these gastric juices uhm – coming about. That’s gonna lower the pH coz a lot of enzymes are actually pH driven. So if we don’t hit that first domino of parasympathetic nervous system stimulate the nice low pH and the nice low pH is from hydrochloric acid. Hydrochloric acid kinda also has the sterilising effects. So if you get some bad, kinda junkie food in there, it’s gonna have like an effective taking maybe you some bleach and putting it on a public pit. It’s gonna help clean it up. So it’s gonna be more sterile environment. So think of hydrochloric acid as like a bleach in your tummy. And also activates the proteolytic enzymes. It starts with pepsin, it takes pesinogen to pepsin. So it gets the digestive enzymes going. And that nice, low pH, all that food gets mixed up with the hydrochloric acid and eventually goes down in your small intestine at least as chyme. And then it stimulates the pancreas to produce more enzymes in the gallbladder to produce more bile which will help with fat. So that’s kinda first domino reaction and it starts with the parasympathetic nervous system response, and it starts with having good hydrochloric acid levels. Now, one thing to talk about here, “How can we stimulate our own juices?” Number one, chewing your food well is gonna be super important. Making sure you really chew, one chew per tooth is a pretty good rule of thumb. Number two is making sure you’re in parasympathetic state – not eating and not being on the go or eating when you’re in the car. Have a good relaxation kind of state. Number three, making sure you’re hydrated coz a lot of the digestive juices come from the liquids that you eat. And then number four, not consuming water for the sake of hydrating while you are eating.   The more you consume water while you’re eating, think about it- water has got a pH of 7. 7 is going to take the pH in your gut at 2 and bring it up close to the 7. So these enzymes are pH driven. So the lower the pH, the more the enzymes are activated the more water you drink in the meal, the more you dilute the enzymes that are already there, the more you raise the pH and you deactivate future enzymes from being produced. What do you think, Evan?

Evan Brand: Yeah. So people wanna know the number about the stomach. It is very, very acidic. 1.5 sometimes 1.2 to 3 is the range of the pH. I mean this is so intensely acidic that if you opened up that HCl out of your stomach and put it on your shoe, it would melt your shoe into piece.

Dr. Justin Marchegiani: Absolutely.

Evan Brand:  You’ve gotta have that. And I wanna just repeat that because you said it well, but in order to activate pepsin in your other enzymes to break down the protein, you’ve got have an acidic enough stomach. You’ve gotta have enough HCl production.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: And so you’ve got have parietal cells in there that are making the HCl. But if you’re in sympathetic fight or flight mode because your body thinks you’re running from a bear even though it’s just running from email, or you’ve got a bad boss, or you’ve just got some bad news, or you’re eating during a meeting, or you’re eating at your work desk. You know these are all things that are not going to trigger that –

Dr. Justin Marchegiani: Totally.

Evan Brand: You’ll be setting yourself up for you know, tummy trouble. And we can talk about some of the implications of what happens if you have this hypocholorydia state which is a low stomach acid state that basically set you up for infections and things like that which we’ll get into.

Dr. Justin Marchegiani: And again, we got questions coming Facebook and I apologize. People on Facebook are only seeing one side of the conversation here. But – Hey, Steve, how you doing? Off the bat with the gastric ulcer situation. If people have an ulceration or have gut lining issues in the stomach, one of the first things we do off the bat, if we know that history is present, we’re gonna use gut healing and soothing nutrients first. We’re gonna use bone broth, we’re gonna use aloes, slippery elm,  deglycyrrhized liquorice, L-glutamine and we’ll kinda coat that stomach there. We’ll make sure the food is well broken down. We may even focus more on the GAPS kind of approach. And add more liquid soups that are really easy and palatable. And we may focus more on enzymes first. Now depending on how someone is doing, how sensitive the gut is can be a good measure of how the gut’s healing. That’s a good sign. So you can start with like a 6 to an 8 to a quarter of the teaspoon of apple cider vinegar with food. Now if you’re gonna add any acids in, you can start with light acid such as Apple cider vinegar, and/or uhm – just plain old organic lemon juice and do it with food because if the stomach is empty, it’s like someone touching your raw sunburnt skin. It is gonna be more sensitive. Put a little food in there, do a nice gentle, very low dose of acetic acid, whether it’ in uhm – apple cider vinegar or citric acid in the lemon. That is a really good step. Quarter of the teaspoon and upwards and gradually work your way up. If that’s good, once you get a full tablespoon and have no problem with food, we can transition you to an actual hydrochloric acid tablet with pepsin. But in the interim, healing, soothing nutrients, and then we taper. We focus more on the enzymes in the HCl because they are less abrasive.

Evan Brand: Let’s back up a bit. Let’s talk about symptoms people may be experiencing if they need enzymes or if they are in this hypochlorydia, low stomach acid state. So I would say, any type of burping or gas after eating, that tells us you’re not breaking foods down.

Dr. Justin Marchegiani: Huge.

Evan Brand: If you’re a vegetarian or a vegan in the past, a lot of times people go vegetarian or vegan because they say they’ve lost the taste for meat. But in many cases, that just because they don’t have enough stomach acid to digest meat.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And so meat is bad for you, but it’s not. Heartburn – a lot of times people have heartburn but it’s actually too low stomach acid not too much. You’ve got that valve at the bottom of the stomach and it’s kinda regulator. And if your food is not broken down, your body’s smart, it doesn’t want undigested food in the intestines, so if it can’t go down, it’s gonna leak in one place which is up. What about the uh – lower esophageal sphincter? Can you talk about that maybe from like a chiropractic perspective? About how that valve can get stuck open. I mean, can adjustments and massages or stuff help that? Or is that more internal work has to be done?

Dr. Justin Marchegiani: Yeah. I mean you have different issues with the various sphincters that go from the esophagus into the stomach. And then obviously, the stomach into – hold on, one sec. I’ve got a little _ right here. I apologize for that. Okay, so regarding that – you have different sphincters that go from the stomach to the small intestine,  from the small intestine to the uh – large intestine. And obviously from the esophagus into the stomach. So the key elements here is we have to make sure the first domino is gonna be the esophagus to the stomach, right? If we don’t have enough acidity, what happens is that esophageal sphincter is they open. So this is one of the major reasons why stomach acid actually helps a lot of people with heartburn. It helps two ways. The esophageal sphincter gets tighten when there is enough acidity. And then number two, food will rot and putrefy and ferments and organic acids will rise up from the food. So if there’s not enough acidity, initially, that esophageal sphincter may stay open, food will rot and then those acids will rise and burn the esophagus. So 2 mechanisms: tightening of the sphincter and the breaking down of the food. If we don’t do that, it rots. So that’s step number one. Step number two, food goes from the stomach to the small intestine. If we don’t have enough acidity, then we’re not gonna trigger the bicarb release from the pancreas when it goes from the stomach to the small intestine. We’re not gonna trigger the gallbladder and we’re not gonna trigger the uhm – the bile salts. Number three, it goes from the small intestine to the large intestine. If we have dysbiosis and low stomach acid and low enzyme environments, we can have ileocecal valve patency where this  is kinda the first mechanism of SIBO or the bacteria from the colon will start migrating its way back up to the small intestine and then we start getting all kinds of extra methane and hydrogen gas is increasing. And that’s gonna create more malabsorption, more diarrhea, more constipation, more of those IBS kinda sequela. And then –

Evan Brand: I wanted to ask you one thing. I know we’re – we’re a bit biased because of the people that are coming to us typically they’ve been to 5, or 10, or 20 different practitioners –

Dr. Justin Marchegiani: Yeah.

Evan Brand: Before they get to us which is mind blowing and it’s an honor. What percent of people have a low enzyme state, low stomach acid state, therefore potentially SIBO state? I mean, you and I see bacterial infections. I’d almost say it’s 9/10. But I wanted to see what your number is.

Dr. Justin Marchegiani: Yeah. So how many people 9/10 here or out of 10 here do we have bacterial infections? I would say at least half of some type of digestive issue minimum. Uhm – I would say out of the general public, I would say the people that see us I would say a 100% have some level of a gut issue. Even if someone doesn’t know it because – people come, let’s say they don’t have a gut issue, let’s say it’s hormonally driven. If it’s a female, it’s gonna be PMS or mood issues or fog. If it’s a male, it’s gonna be uhm – energy, focus, endurance, exercise, muscle mass, low libido. Again, those issues can be affected by the gut and a couple different mechanisms. And kinda tying it back to enzymes, we always go on our diets here. But if you have enough enzymes and digestive capacity, all the nutrients that make up all the brain chemicals which help us focus and think and deal with stress, also the nutrients that help become our hormones. So the cholesterol and the essential fatty acids they’re gonna become the precursors to our cortisol and our sex steroids. So if we have any digestive issues, any of that could be thwarted by low stomach acid and enzymes. We’re not gonna have the building blocks that we need to – to build a healthy chemicals to help us feel good, deal with stress and inflammation, help rebuild our body.

Evan Brand: Yeah. Just to zoom back out, this cascade, this domino effect you’ re discussing could all happen from you scrolling on Facebook while you’re sitting down to eat your lunch.

Dr. Justin Marchegiani: Totally.

Evan Brand: And that’s the important part. So I wanna go back and just mention a few more symptoms of people that you have a need for enzymes and/or increased stomach acid. If you got undigested food in your stool, that’s an easy one. If your stool is floating, that’s an easy one because we know therefore, that the bile is likely not getting secreted potentially due to a low fat or too low-fat diet. So therefore, you’re gonna have that issue. Uh – also fingernails. So Justin and I, we talk a lot about fingernails. So if you’ve got chipping, peeling, very brittle fingernails, you’ve got ridges on the nails, that tells us that digestion is not good. You’re not getting these trace minerals from your food. Uhm – and then last one, we could just say anemia, right? Because if somebody’s got low iron or ferritin levels, we know that they’re eating grass-fed beef or bison or elk and all these delicious foods, but you’re not  rice and help knowledge delicious foods but you’re not cleaving off the iron and so you gotta have a lot of acid to do that.

Dr. Justin Marchegiani: 100%. Couple of just to kinda piggy back on that, you have the fingernail issue, if you run your finger across the other finger, across the arch of it, if you have that’s relatively, you may see some tiny, tiny lines but when you run on your finger, it should be smooth. You shouldn’t see any white spots or little speckles on the finger. That’s a sign of zinc deficiency. Your nail should be relatively strong. If you push it straight down on an axial low position, it shouldn’t really bend. It should stay pretty straight, pretty strong. People that have issues with this, their nails will start to peel. Those are to be more brittle and weak. You’ll start to see vertical ridge and white spots. That’s gonna be your first kind of sign that you’re not quite digesting protein, fat  and obviously ionising your minerals especially zinc. That’s number one.  Number two, in females, it’s super common, it’s called uhm – keratosis pilaris. So if you look on the females, back in their arm, the tricep here, like this are of the tricep, you’re gonna see this like little dots, like this reddish kinda spots. And this is called uh – Keratosis Pilaris, typically from essential fatty acid deficiencies. And a lot of times if you don’t have enough hydrochloric acid and enzymes, that will show up. So you – you know, you walk through airports or see lots of people, you’re gonna see that commonly on a lot of females’ arms, especially birth control pills can exacerbate it more.

Evan Brand: Why?

Dr. Justin Marchegiani: Uh – because it affects digestion.

Evan Brand: Oh – yeah. And my wife for example –

Dr. Justin Marchegiani: And it affects nutrient deficiencies, too. B vitamins, minerals and such.

Evan Brand: So I’ve got two personal anecdotes to what you’re talking about. So when you first looked at me, you say, “Evan, you’ve got a parasite.”

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: And you said I had two parasites and my nails were terrible. Now they start to get much better because I’ve cleared the infections and now I’m supplementing with enzymes like – you know, it’s water. I love them. I’d take them with every meal. Uh – but also, my wife, when she was on birth control pill as a teenager, she had major Keratosis Pilaris on the back of her arm.

Dr. Justin Marchegiani: Huge.

Evan Brand: It was crazy. I mean –  massive amount. And she thought that, “Oh, my mom had it, so I should have it.” No, that’s not the case. And so now, with the fish oil –high potency fish oil, the enzymes and then making sure the gut’s healthy, it’s gone and it’s amazing.

Dr. Justin Marchegiani: Yeah. Typically, the birth control pills gonna affect the pH uh –in the – in the intestines primarily the urinary track. That’s one the big things you see with females on the birth control pill. You see increase in yeast infection. They’re gonna affect pH and that vaginal kind of environment. and obviously it can have an effect in the gut, too. So the more you uhm – negative competing opportunistic microbes to kinda  invade in there, they’re gonna the shift the environment to be more favourable to them. And that’s gonna take away from the digestion capacity. And the more your digestion is down, harder  to breakdown those proteins and fats and ionised minerals. And then you can start getting those deficiencies. That’s why B vitamins, and minerals, and essential fats one of the first deficiency you’ll see on birth-control pill. So tying it back in here, enzymes are super important. Couple of questions from uh – YouTube, pH – like the whole idea pH, I mentioned, people say you wanna be alkaline, the question is where? Where do you wanna be alkaline, right?  With the stomach, you wanna be very acidic. In the stomach or in the small intestine, you wanna start becoming alkaline again. As you go back on the colon, you’ll start to be a little more acidic. The urine typically is gonna be a little bit more acidic coz you’re putting more acidic waste out through it. Uhm – you’re gonna have bicarbonate that’s gonna bind with uhm – CO2 in the blood to help rid of the CO2. So you’re breathing out acid via the CO2 and making bicarbonate in the blood. So a lot of pH regulatory systems that are happening. The biggest thing that’s gonna affect pH is inflammation. Inflammation is gonna have an effect on pH a hundred to a thousand times greater than your diet. Uhm – you’ll see –

Evan Brand: Say that again.

Dr. Justin Marchegiani: Yeah. Your pH is gonna have about a 100 to a 1000 times more of an effect because of inflammation due to your body, not because of your diet. Now you’re diet – you can have inflammatory things in your diet such as grains, excess sugar and trans fat, but again, meat – people meats are acidic, right? About 5 or so on them. 5- 5 ½  on the pH scale which is logarithmic. But grains are 10 times more acidic than, let’s say meat. And if you listen to my podcast it will be coming in a few weeks with Doctor Robert Rakowski part 2. He talks about that apect. That it’s the inflammatory things in our environment that are creating far more acidity than our diet. But again, healthy green, organic vegetables in every meal, you should be totally fine from the pH perspective and then getting some good extra minerals in your multi-support whether it’s magnesium, potassium, calcium. Those extra buffering mineral should – you should be buying.

Evan Brand: Let’s also bring up alkaline water and how big of a scam and ridiculousness it is to do alkaline water if your goal is to have optimal digestion especially people drinking alkaline water. They buy these expensive machines were they’re pumping of 9 or 10 on the pH scale of water.

Dr. Justin Marchegiani: Yeah.

Evan Brand: You’re drinking with the meal. I mean, you’re setting yourself up for failure. Now, could there be some type of therapeutic benefit of alkaline water by itself? I don’t really know maybe you’ve got some advice on that. But for me, I’m gonna go with a good spring water or a good reverse osmosis water with trace minerals back in like you do. I mean, for me, the alkaline water, it’s just been debunked so many different places and it’s not worth even talking much more about.

Dr. Justin Marchegiani: Yeah. I’m not a huge fan of alkaline water. The question is anytime  someone sells me an alkaline water, I’d say, “What are the buffering minerals that you use to make it alkaline?” And typically, they’re like, “What?” Coz if you got just a really good clean water, I mean, just adding some good-quality electrolytes or a little pinch of high-quality sea salt with the spectrum of minerals, you’re probably gonna be pretty good and that may raise the pH up a little bit. But I’m not concerned about getting up – you know, having super, super alkaline water. I’m fine with drinking water that’s clean  and filtered. Infuse some minerals back and I will have a little electrolyte solution. I’d put my reverse osmosis water filter, so I’ll put a little bit of minerals in there first thing in the morning. Or I’ll just – I have a little salt shaker there, too. And I’ll get some extra minerals. And that way,  1 to 2 glasses in the morning, one to two big glasses in the afternoon with infused minerals and just salt my with – with good Celtic or like typically like real salt better just for flavour variety. But that’s a good way to get the minerals. Not a huge fan of you know, these crazy expensive water machines that are alkaline. I think the really high-quality filters are better. And uhm – I  like things like Pellegrino and natural sparkling water too because of the extra sulphates that are in there which is so good for detoxification, too.

Evan Brand: Yeah. So, I wanna ask you, chicken or egg question and then we can probably hit some of these YouTube questions about the hiatal hernias and HCL supplementation, all that.

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’s hard to say, did someone get a low enzyme, low HCL state, which then led to undigested food particles, which then were to intestinal permeability or leaky gut, which then set them up for SIBO or parasite infections? Or did the infection come first? Like I told you about yesterday. I had a little four-year old girl that had her stool test back and she  had two parasites. And it’s like – being that young, we would assume that HCL and enzyme production would be pretty good, being a tiny little kid. But, she had tons of rounds of antibiotics. So it’s like chicken or egg. Was it the HCL and enzymes that got low that did set her up? Or was it just the decimation of the flora via about antibiotics that didn’t set her up for infections? Which one do you think it is?

Dr. Justin Marchegiani: Yes. When it comes to infections, there’s a couple of  scenarios how that happens. Number one is your stress. Your immune system is compromised and you get exposed to some infectious debris. And your IgA, your enzymes and hydrochloric acid levels are low and you can’t – you can’t quite – uh, you know, uh – knock it out. It’s just kinda like you leave the drawbridge down in the castle, you’re flying around the Star Trek ship and the force fields are down. So invader can come in, the Klingons can attack, right? Those are my analogies. Now that’s scenario number one. Now scenario number two is you’re relatively healthy and you just get exposed to a large bolus of infectious debris, right? You’re hanging out and you’re drinking some water in Mexico. You’re on the beach in Bali, you’re out in uh – Lake Austin, like I do and maybe someone water comes in your mouth, and you get some GERD, right? So those are the two major scenarios. And it’s – number three is uhm – I would just say food vector, the compromised immune vector.Those are gonna be the two biggest ones. There’s a couple of out there – ones and that’s gonna be the animal vector. You’re just getting exposed or you’re letting your animal lick your face all day, and you’re just not even – you’re not connecting the fact that your cat may have crypto and now you got the crypto infection. Or I’ve seen it with dogs and GERD is super, super common.

Evan Brand: What about this question here about, “Can a hernia cause hypochlorhydria?” What’s your experience from a chiropractic perspective on hiatal hernias? Can you fix those chiropractically? And will that cause low stomach acid?

Dr. Justin Marchegiani: So regarding hiatal hernias, and I just posted a link online for people on YouTube or Facebook that wanna see the full, kinda dual side of it. We only kinda do my side with the technology that we have here. But regarding hiatal hernia, in my opinion, if you’re only fixing a symptom of the hiatal hernia, if you’re doing a chiropractic adjusment for it. Now I think that’s fine because it palliative, it’s natural. You know, what’s the risk to reward? Very little risk, only reward. We just wanna fix the root cause. And typically that’s gonna be getting the inflammation vector away from the intestines.  Once the inflammation is better, the nerves that go to those muscles won’t be sending the inflammatory response that’s creating that tightening. It’s called the viscera somatic reflex. Visceral is organ; somatic is muscle. So the organs and muscles  are on a two-lane nerve highway and the more those nerves are stimulated, it’s like the more you do bicep curl, the bigger your bicep gets, the tighter, tighter it gets, right? The more stimulation that goes to that area that’s like pain, the more it can pull that stomach up above the diaphragm which is based the hiatal hernia.

Evan Brand: Wow.

Dr. Justin Marchegiani:  You pull it down, but then you wanna make sure you get to the root cause. Inflammatory soothing nutrients, fix the infection, fix the ability to digest the food.

Evan Brand: Okay, good. You answer the question. So you can help with physical adjustments of hiatal hernias but you also gotta be working back to the root cause to make sure it doesn’t just pop back.

Dr. Justin Marchegiani: Exactly. That’s the key thing.

Evan Brand: Okay. Here’s another question then. Uhm – “When can you start minimising HCL?”  He’s been taking them for three months. So I guess the question is – is there ever a time where you stop taking them? And I’ll just go ahead and give my two cents first, which is not really. There’s never really an expiration date of when you should uh – minimise HCL. Because if you look at Dr. Jonathan Wright’s book, “Why stomach acid is good for you?”, we look at age. With the Heidelberg test, we see that HCl just drops and drops every year that you get old. Uh – any age past twenty, actually you start reducing HCl. So for me, I consider it the foundation. But what about you?

Dr. Justin Marchegiani: So couple different theories on that. I think hydrocholoric acid is the most under rated supplements in the toolbox for any functional medicine doctor and patient. I think it’s absolutely essential because if you buy a really awesome, organic diet, healthy meat, healthy proteins, healthy fats, and you’re not quite breaking it down fully, well you’re really not gonna be accessing all the nutrients that are in those food. So I think that – from that perspective, it’s a great insurance policy to access your nutrients from your expensive diet already.  Number two, I think it’s something is you get help that you don’t need it all the time but like for instance, I’m heading down to lunch here over at Paris down in Austin. So it’s like I’m doing like let’s say, Friday lunch. I’m really excited about it. I’m gonna bring some hydrochloric acid and some enzymes. Its gonna be some nice little pork chop I’m gonna have there. So we’re gonna up the HCl and enzymes big time. That’s number one. Uh –number two,  if people don’t want to be on it all the time, there are things they can do if they need a little support such as Swedish bitters whether its gentian, or chamomile, or little bit of ginger, can very easily just stimulate your hydrochloric acid levels. Or even just a tablespoon of apple cider vinegar or a little bit of lemon juice can be really stimulatory for the hydrochloric acid. There are ways you can stimulate it naturally. And also, there are studies looking at gastrin. Gastrin is the compound that’s produced in the stomach that actually feeds back to produce hydrochloric acid. And that compound –  that chemical does not decrease as you take hydrochloric acid. So it doesn’t have a negative feedback loop. So negative feedback loop is you take steroids, right? Testicle shrink, right? The feedback is more of the steroids cause the testosterone in the internal production to go down. Now taking that analogy to the stomach, as gastrin – as hydrochloric acid goes up artificially, gastrin levels don’t drop. You don’t have this atrophy happening. So it’s good to take it if you wanna give your digestive system a break or you’re eating a bigger meal and you just wanna make sure you can break it down better so you don’t have indigestion afterwards. Totally fine. Uh – ideally, you shouldn’t need it all the time. And number three is you can artificially or just uh – naturally stimulate it with the bitters, gentian, the chamomile, the ginger, etc.

Evan Brand: Well I kinda use the three S, too. Soup, salad, or smoothie. If you’re doing any of those three, you could probably opt out of the enzymes and be okay.

Dr. Justin Marchegiani: 100%. Unless you have a lot of digestive symptoms, that’s the key thing.

Evan Brand: Yeah. See, there’s another question here. Dale asked, “Can we share a quick functional medicine perspective on vaccinations?” That – we’d have to save that for another show, Dale.

Dr. Justin Marchegiani: I went into this with Dr. Robert Rakowski last week. So I would say, Dale, check out that podcast coming up very soon. We go into that a little bit.

Evan Brand: Here’s Betty. She’s got a question, too. What’s the logic behind any acids and PPIs? Profits don’t count as logic. Ahh. Okay.

Dr. Justin Marchegiani: So I talked about this a lot. So PPI is like if you’re – if you’re trying to create the perfect drug that works but creates so many other issues that will create more pharmaceutical dependency down the road, it’s the perfect drug. Let me walk you through it.  So you have acid issues because you’re not digesting your food, right? You have you know, the esophageal sphincter ‘s open, the food is not digesting. It’s rotting in your gut, the acids are rising up and hitting the top part of your throat. You start having symptoms. The first thing you may reach for is the over-the-counter Tums, right? Calcium carbonate lowers the acidity, it works. You feel better. Eventually you need to reach for a Nexium or Omeprozole or some kinda Prilosec, a proton pump inhibitor that prevents the hydrogen binding to the chloride molecules that makes the hydrochloric acid. So then you start having less as acid reflux symptoms. It works. You feel better. Now the problem is the more you shut down those proton pumps,  the less stomach acid, typically the less enzymes – one of things that starts happening is you become dependent on it because the gut lining becomes so irritated, inflamed. You’re not digesting your foods. So then what happens is you don’t break down the neurotransmitters, you don’t break down the fat and the protein that become the neurotransmitters and the hormones. So you start having mood issues. So now your chance of antidepressants go up, your – your chance of having more anxiety – because you don’t have the L theanine and a lot of the GABA coming in. So your chance benzodiazepines goes up. You’re not breaking down the cholesterol, so your chance of needing Viagra goes up because you have erectile dysfunction coz you can’t make your sex hormones. Uhm – you become more inflamed, typically. So then your chance of needing a cholesterol medication goes up because inflammation will increase your cholesterol. And the more you can’t break down certain minerals like magnesium, your chance of Lisinopril Hydrochlorothiazide, ACE inhibitors, blood pressure medications goes up. So you can see what happens. You’re on this medication and all these other medications are needed to help manage all the symptoms that come from it. It’s crazy.

Evan Brand: Yeah. I was gonna mention some of the research, too. I mean there’s research that links PPIs to kidney disease, dementia, heart attacks, bacterial overgrowth, infections, bone fractures, and also the fastest growing type of esophageal cancer. So there is a lot safer ways of dealing with heartburn than the PPI.

Dr. Justin Marchegiani: Yeah.  And HCL and enzymes are totally safe if you’re pregnant, too. I’ve had no problems with that uhm – with my pregnant patients – not an issue.

Evan Brand: Should we go to other questions?

Dr. Justin Marchegiani: Yeah.

Evan Brand: Or was there other stuff you wanted to mention first?

Dr. Justin Marchegiani: I think there’s one other element about enzymes – that’s taking specific enzymes on an empty stomach away from food can be excellent for cellular detox, cleaning up scar tissue, and even treating cancer. Dr Nicholas Gonzales, before he passed, was doing that successfully for many years. And you know, taking high-dose enzymes on an empty stomach, for me, that’s a first-line therapy for anyone with cancer. Those enzymes get into the bloodstream and they’re gonna be able to digest any bad cancer cells that weren’t tagged by the immune system for apoptosis.

Evan Brand: And can you mention briefly just the types of enzymes? Coz I think people may think enzymes are just one thing, but we’ve got digestive enzymes we’ve got proteolytic enzymes, we’ve got systemic enzymes which you were teaching me about last night. Uh – uh – talk – talk people through just the different categories. Just that way, we know  what we’re covering here.

Dr. Justin Marchegiani: Yeah. You’re gonna have enzymes like amylase and such which are gonna be more your carbohydrate enzymes, okay? You’re gonna have various proteases that help digest protein and those will have different names like trypsin or chymotrypsin, right? Protease, etc, etc. And then you’ll have various enzymes, lipases. And these will be more for digesting and breaking down fat. And also, you’ll have bile salts that kinda work synergistically with that. So those are your major categories. Carbohydrate, protein and fat. And like you said, the biggest people that tend to move away from me are ones that have low hydrochloric acid and enzymes, so they move away towards vegetables which actually have more natural occurring enzyme. So they – people that go vegetarian, right? They’re thinking, “Oh, you know, I just feel better on vegetables and not so much on meat.” If the meat’s inherently bad, it’s like, “No, the meat is exposing a weak link in your digestive track.” That’s what’s happening.

Evan Brand: Yup. Yeah. I wanna give a brief anecdote about my use of proteolytic enzyme specifically bromelain. After I got my wisdom teeth surgery, I was taking tons of bromelain and my gums healed in rapid time and the surgeon on the one-week follow-up was like, “Evan, I never seen anybody heal this quickly. What have you been doing?” And I say, “Well, I’ve been popping arnica like it’s candy and also doing tons of proteolytic enzymes.” And he was like, “Wow, this is – this is cool!” So, it worked.

Dr. Justin Marchegiani: I love it. And when you do these kind of enzymes for systemic use,  you want – there’s a couple out there. They’re a lot more expensive coz you’re using more serrapeptidase enzymes which come from the silkworm. Silkworm if you will look at kinda look at the thread that comes from their spinning or however – whatever they produce from a byproduct. The thread that they make their nest with and such is incredibly strong. The tensile strength is unreal. So they are actually extracting the enzymes the silk worms make uhm – make their net out of and they’re using in systemic enzyme formulas. And they put these enzymes in terracotta capsules coz you don’t want to use digestive enzymes for systemic enzyme purposes coz they won’t outlast the stomach. They won’t get to the stomach intact.  So you want something that’s enterically coated that gets into the small intestine, and then gets into the bloodstream without breaking down food. You don’t want any food to be there. You want it to be in a full empty stomach. And we use high-dose arm serrapeptidase enzymes enterically coated. And again, they’re gonna be a lot more expensive than your typical digestive enzymes.

Evan Brand: And when are those cases? I mean what – what’s like top few situations where S__  would wanna be on that?

Dr. Justin Marchegiani: Oh, yes. So we’re gonna do that with any type of cardiovascular issues – issues with uh –history of blockages, cardiovascular-wise. Uh women are trying to dissolve endometriosis and fibroids that can be helpful. Uhm – people that have cancer issues that are trying to just knock down some cancer cells. And then also just for uhm – scar tissue in the joints or just  the general cellular cleanse that help cleanse out debris in the body. But again, none of these treat or diagnose, right? These are all therapeutic things to help support whatever health issues that are already there. We just have to say that as our disclaimer.

Evan Brand: Agreed. Yeah. So I wanna just mention briefly about infections. So once someone’s got an infection, regardless of how they acquired, whether it was chicken or the egg which happened first, once you’ve got parasites, you’ve got this SIBO situations, etc, you’re set up for lower and lower enzymes and lower and lower HCL. So it really is uh – a long process that we take people through where you’ve got to remove infections, you’ve got to restore the gut, you’ve got to restore the enzymes, you’ve got to heal up the gut lining that are totally damaged. It’s a long process. Uh – Samuel asked – oh no, it was Cory here. He asked what would be the best HCL supplement for somebody with SIBO. And should you take both HCL and enzymes at the same time? You wanna hit on that one?

Dr. Justin Marchegiani: Yeah. Take HCL and enzymes at the same time? Absolutely. Because –

Evan Brand: You have to –

Dr. Justin Marchegiani: I mean enzymes – the only time I give them by themselves if someone’s gut is really raw and they can’t handle it. But again hydrochloric acid will help your body make its own enzymes by activating via pH – via low pH.

Evan Brand: Well – And I wanted to mention too, you know, you and I both got professional enzyme formulas, but the dosing is pretty conservative for that reason.

Dr. Justin Marchegiani: Uhm.

Evan Brand: So you may only get 200 mg of HCL per one capsule of enzymes and that’s so low that unless you’re just terribly inflamed, you should be able to tolerate  such a low dose of HCL like that.

Dr. Justin Marchegiani: Yeah. In my line, I have two formulas with HCL. I might digest energy that has lower hydrochloric acid levels that are meant for people that are already  have pretty good digestion, but just need a little bit extra support. And then they’ll have some enzymes in there, too. And then I have my two that I break up for more – for people that have more digestive issues. We’re trying to get more of a therapeutic dose. And some can’t handle that much HCL but need a lot more enzymes. So we don’t want the fact that they are in the same capsule to limit how much we can give. So we can go lower HCL, more enzymes, or vice versa. And we’ll kinda throw in some HCL tolerance test 1-4, 1-5 capsules on the HC – HCL. Any warmness, we back off by 1. Enzymes will typically go up between 1 to 4. If we feel a lightening, or better digestion, or improved bloating, or gas, or any symptomatic relief, or just a feeling of better digestion, then we’ll keep it at that those. If not, a standard 1 to 2 capsules per meal is typically okay.

Evan Brand: Here’s another question. “My doctor put me on Ornidozole and Levofloxacin.” Oh, man. “I have hunger pains, fatigue, constipation, felt better for a week and then hit a wall. How effective are these? And side-effects?” So, those are two antibiotics and –

Dr. Justin Marchegiani: Well, anytime you take an antibiotic, one of the big side-effect is gonna be a rebound fungal overgrowth, alright? Lots of females have noticed they take antibiotic, they get a reoccurring yeast infection weeks later. And a lot of conventional physicians are actually growing wiser that their patients – their female patients a lot of time, like a Diflucan  or Fluconazole after antibiotic. Now again, you’re much better off giving them a probiotic. You can do it even during just away from the dose. And then do a probiotics after a month or two afterwards just to prevent that rebound overgrowth. And a rebound overgrowth is let’s say you have a lot of good and bad bacteria in your gut, you give antibiotic, what happens is you lower all of it. Now, the good bacteria provides a nice environment so the bad stuff can’t grow. So as soon as the good stuff is low, then the bad stuff naturally proliferates. It’s the whole idea of once you clean out your garden, the tomatoes don’t just automatically, the weeds do. You actually have to go in there and plant the tomato seeds or whatever you’re growing. You have to plant those seeds, you have to aerate, you have to put the fertilizer down to create the environment so the vegetables grow.

Evan Brand: Good analogy.

Dr. Justin Marchegiani: You don’t have to do that with the weeds. The weeds are automatically there on auto dial, so to speak.

Evan Brand: That is such a good analogy. Yeah. And it’s amazing. How about unless it’s a life-threatening situation, try not to go with antibiotics, anyway. Figure what the root cause is. There’s so many natural antimicrobials that you and I use in they’re so effective. They have no side-effects, no lasting – anything. They’re in and out.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: And then we don’t need stuff like Diflucan which is also terrible, which in many cases you’re gonna just basically piss of the candida. And yeah, you’re gonna get rid of it  but then the candida’s gonna come back with a vengeance. And we test your urine, we’re gonna see massive arabinose –

Dr. Justin Marchegiani: Yeah.

Evan Brand:  Or tartaric acid.

Dr. Justin Marchegiani: Yup, yup.

Evan Brand: Back with a vengeance you’ll say, “Oh, I just finish a round of Diflucan.” And it’s like, “Whoa! Maybe it worked for a day, but candida is back and she’s mad.”

Dr. Justin Marchegiani: Exactly. Alright. So let’s summarize everything we chatted about here, Evan So like, let’s say you’re just tuning in now or you just get really overwhelmed and your eyes got a little gloss over. What’s the Reader’s Digest version? I’ll let you go first.

Evan Brand: Yeah. So to me, reader’s digest version – enzymes and HCL are crucial. They are one of the most important foundations you should have if you want to be a healthy human that lives a long life, plain and simple. And then the caveats to that are well, do have things in your body that you need to work with a functional medicine practitioner and get tested for, such as infections like parasites and bacterial overgrowth like SIBO and candida. Now, if you get the testing piece done, you find out that your free of infections, which is pretty rare, then awesome. Maybe you’re just at a lower dose of HCL and enzymes, and maybe if you do soup, salad and smoothies, you don’t use enzymes but otherwise, you’re kinda cycling on. And you’ve got a cute little glass jar like I do that I shove in my wife’s purse. It’s got may enzymes and HCL in there. I take it if we go to restaurants and I always have it on the dinner table because if its out of sight, it’s out of mind.

Dr. Justin Marchegiani: Totally.

Evan Brand: So when I sit down at the dinner table, the enzymes are right there. Uhm – as you get older, we know with the works of uh – Steven Wright. HCL is gonna drop, so to me, it’s not an optional supplement if you want to be healthy. Mother nature just doesn’t care about your optimal digestion once you’re 40, or 50, or 60 because you’re pass the hunter gatherer reproductive age which was like 16 to 20 years old. So mother nature doesn’t want to kill you but she just doesn’t care if you digest your grass-fed beef when your age 40 to 50. So enzymes become a must. You wanna mimic the stomach acid levels of when you were younger and you had an “iron stomach” You wanna try to macht that with supplements.

Dr. Justin Marchegiani: Absolutely. And then in the future, what I’m gonna do is, anyone on Facebook, I’m gonna put the link in for the live YouTube side just so we can have people that uhm – want to see the full thing, they can go to YouTube and check out the whole thing. I wish we could make a go live on both sides here but right now the technology doesn’t quite do that. So we’ll shoot over the YouTube link in the future and just to add one last thing. Get the parasympathetic nervous system response going. Make sure you’re in a stress free, kinda relaxed environment; make sure you’re chewing your food enough times, uhm – get the saliva going to help start the digestion in the mouth. Then last but not the least, if you are really gluten sensitive, and you may be getting exposed somewhere like you’re going out to eat, and there maybe some contamination that you’re unaware of, enzymes that have dipeptyl peptidase for DPP4 enzymes can be helpful because that will help break down any bits of gluten. And the more the gluten can be broken down into smaller constituents, the better the body has a chance of dealing with it better. So keep that as a little side note, DPP4 enzymes can be hepful.

Evan Brand: What – When is the right and wrong time to use those?

Dr. Justin Marchegiani: Well, the wrong time is I’m gonna have a birthday cake, but it’s okay because I’m taking my DPP4 enzymes. It’s not necessarily for that, but if you are gonna have it though, it will lessen out the blow. But we don’t wanna give someone a crutch to be able to make a whole bunch of bad decisions. But if, let’s say I’m ordering some food at the restaurant and maybe there’s something in there, having it be handled by someone that just have their gloves on that handles someone’s breaded item. So you will do it more for incidental exposure just to prevent that so your body can deal with the gluten of – from that perspective.

Evan Brand: Love it. That’s great advice. So that should in your suitcase then if you’re travelling. We should do an episode on that. I think we did a travel hack episode.

Dr. Justin Marchegiani: We did.

Evan Brand: We should do a – on the go. Like if you’re not travelling but you’re just going out and about in the city and you may stop somewhere to get some food. What should you have, just in case.

Dr. Justin Marchegiani: Totally. That makes sense.

Evan Brand: So much fun.

Dr. Justin Marchegiani: And I’m gonna do maybe another Q&A. If I have time, I’ll make you another quick Q&A taken today. We have a couple of people here that are asking questions. They’re a little bit off-topic which is fine. But we’re only gonna answer the ones that are more on-topic. And I’ll try to have more Q&A conversations wherein we can take of everyone else’s questions.

Evan Brand: Also, last thing. If you have it, you should sign up for SpeakPipe. That way, people can send us audio questions and then we can play the audio clips and put them in for our podcasts.

Dr. Justin Marchegiani: Love it. Great idea, man. Any last thoughts, Evan?

Evan Brand: No. If people need help, reach out. We’re available and this is the stuff we work on everyday.

Dr. Justin Marchegiani: Love it, man. Well you have a- awesome Friday, man and we’ll talk really soon.

Evan Brand: Take Care. Bye.

Dr. Justin Marchegiani: Bye.


5 Signs You May Have Low Stomach Acid

5 Signs You May Have Low Stomach Acid

By Dr. Justin Marchegiani

Do you suffer from any of the following?

Suffering from Indigestion, heartburn, constipation, gas, nutrient insufficiency

  1. Indigestion: Food doesn’t sit well after you eat.
  2. Heartburn: You have GERD (gastro esophageal reflux disorder).
  3. Constipation: You don’t pass at least 12 inches of stool per day.
  4. Gas: This is primarily in the form of belching or flatulence.
  5. Nutrient Deficiency: You have a past history of anemia or are low in certain micronutrients.

What is stomach acid, and why is it important?

Your body produces hydrochloric acid (HCl) for these primary purposes:

  • It activates pepsin, a specific proteolytic enzyme found in the stomach.
  • Pepsin’s primary job is to break down protein.
  • It provides an acidic pH in the stomach. This helps to decrease the chance of outside infections from proliferating like parasites, bacteria, and fungus.
  • It produces acidic chyme (the mixture of food in the stomach). When chyme is released from the stomach into the small intestine, the acidity stimulates the gallbladder to release bile and the pancreas to produce enzymes (lipase and chymotrypsin, to name a few).
  • It ionizes minerals so they can be broken down and absorbed by the body.
  • It stimulates gastrin, which helps protect the stomach and improve digestion.

Digestion and HCl

HCl is really, really important to start the domino cascade of healthy digestion. If that first digestive domino isn’t knocked over, it’s safe to say you are at a higher risk of digestive symptoms.

As mentioned above, HCl activates enzymes in the stomach, small intestine, and pancreas to start breaking down carbohydrate, protein, and fat. If HCl secretion isn’t initiated in the stomach, you will start to see a putrification, or rotting, of the proteins; fermentation of carbohydrates; and a rancidification of fats (1).

Digestion And HCL

Indigestion Creates Gas and Burning!

When the enzymes that are needed to break down these foods aren’t present, we start to see malabsorptions occur. These malabsorptions cause an increased intra-abdominal pressure, which can cause a weakening of the esophageal sphincter. When the esophageal sphincter loosens, this allows the organic acids from the rotting foods to rise up (reflux or GERD) and burn the esophageal tissue (2). Remember, esophageal tissue doesn’t have the protection (mucus) from an acidic environment like the stomach does.

Essentially, low stomach acid provides the environment for bacterial overgrowth in the stomach/small intestine to occur, which then creates malabsorption. You are now set up for a vicious cycle of poor digestion that almost never improves on its own unless the underlying cause is addressed (3) .

When food isn’t broken down completely, gas in the form of belching or flatulence is common. A dependency on pharmaceutical medications, like acid blockers, is now created that doesn’t address the underlying problem and only creates even bigger problems down the road, like B12 or iron anemias to name only a few (6).  In my clinical experience, HCl helps reverse these conditions and improve digestion; therefore, decreasing stomach acid in the long run with drugs isn’t a good idea most of the time.

Stomach Acid Protects Your Stomach and Your Esophagus…Huh?

Yep, you heard it here first! Most people associate stomach acid as a problem. Yet stomach acid is needed for the stimulation of mucus from pyloric glands. This mucus acts as a shield against the stomach acid and protects the gastric mucosa.

The pyloric glands secrete mainly mucus for protection of the pyloric mucosa from the stomach acid. They also secrete the hormone gastrin.

~Guyton’s Text Book of Medical Physiology, 11th edition.

The more your digestive track loses the ability to break down protein, fats, and carbohydrates, the greater the chance for a bacterial overgrowth to occur. As the balance of bacteria becomes more dysbiotic (more bad bacteria in relation to good), this can weaken your esophageal sphincter as mentioned above and allow burning in the esophagus to occur.

Why Am I Constipated?

Why Am I Constipated

As the ratio of good bacteria and bad bacteria becomes flipped in favor of bad bacteria, all kinds of bad things occur. We start to see incomplete digestion, which has an effect on motility. The excess of bad microbes in the GI tract can produce chemicals that slow down peristalsis, or the wavelike contractions that move food through your intestines. If you have more bad bugs in your gut, your transit times get slower (4).

Most people I see with digestive symptoms have some sort of gut infection, either H. pylori or a myriad of other parasites that are notorious for causing these types of issues. Unless these infections are addressed, these digestive symptoms tend to linger. To learn more about how you can address these issues, click here! 

Chronic constipation can also be connected to hypothyroidism as well. I strongly recommend ruling out any potential thyroid imbalances as well.

Stomach Acid Helps You Absorb Nutrients

HCl is needed to ionize minerals so they can be absorbed, assimilated, and utilized. There have been studies showing nutrient deficiencies in calcium, iron, and B12 when low stomach acid is present. Low stomach acid can even increase your chance of osteoporosis as well (5,6).

One of the most underutilized supplements is HCl, especially if you are already spending a good deal of money on organic food; you want to make sure you are absorbing and assimilating it properly. The old adage “you are what you eat” isn’t true. “You are what you eat, digest, assimilate, absorb, and utilize!”


If you have serious gastrointestinal irritation or a history of ulcers, you should not add any HCl into your supplement regimen without the guidance and support of a skilled functional medicine doctor. Some patients need more enzymes and gut healing herbs and nutrients before any HCl is introduced. This is on a case-by-case basis.

If you are having problems with you digestion, click here to schedule a complimentary consult to figure out the best solutions for you. 

Physiology References:

Guyton’s Text Book of Medical Physiology, 11th edition.

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