How Your Iron Levels Are Negatively Affecting Your Health | Podcast #346

Iron is a mineral part of hemoglobin, the protein in red blood cells that transports oxygen from the lungs and throughout the body.

Dr. J and Evan also discuss identifying underlying issues to deal with them effectively. You could be having digestive problems, menstruating for women, or you’re not eating the right foods to source iron or adequately absorb it. So if your body doesn’t have enough iron, it won’t get enough oxygen, and your cells (powered by oxygen) won’t function efficiently. Suppose you’re experiencing symptoms of iron deficiency.

In that case, Dr. J and Evan suggest consuming vitamin C to help increase iron absorption, eat iron-rich plant foods, and have yourself tested to have comprehensive test results and fix your health issues.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:19:       What is iron deficiency and how to test it?

5:36:      Iron-rich food template

10:04:    Other issues to consider when dealing with iron deficiency

17:09:    Iron deficiency in men

Dr. Justin Marchegiani: And we are are live! It’s Dr. J here in the house with Evan Brand. Today we’re going to talk about about iron levels and how can they negatively impact your health. Of course, we have two sides of the same coin here. We have high iron and low iron. And then, high irons going to be a bigger issue, right? Men don’t menstruate and women potentially, low iron is going to be a bigger issue because women menstruate every month at cycling; it’s a cycling age. Menopausal women, when their cycle tends to cease, then there could be more issues there. But out of the gates, women iron is going to be an issue. Most of the time if it’s hormonal issues and men’s going to be the opposite. We’re going to dive in and give you guys a crush course on both sides of the fence. Evan, how are you doing today, man?

Evan Brand: Doing well! Let’s jump right in. So looking at blood work. If you’re looking at a female, you and I test ferritin which we find conventional medical doctors rarely test ferritin. Ferritin being the iron storage protein and I did a whole video on Youtube. Those are my most popular videos ever on low ferritin and hair loss. We’ve seen how if your ferritin is let’s say 20, that’s far too low. You’re going to experience maybe some shortness of breath, major hair loss. If we can get the ferritine to 70, 80, or 90, women feel much better. Their hair stops falling out and they can catch their breath. So do you mind like, teasing a part when you’re looking at these labs, like total iron versus a ferritin. If you see a female with low total iron, are you really prioritizing that or are you after ferritin or are you going after both? How do you approach it?

Dr. Justin Marchegiani: Well the first thing that we look at with iron, we have to see how low it is.Okay? There’s func- I consider functionally low levels of iron. And um, and there could be um, you know more, I just say more acute levels of iron that are are more low. Right? We could have functional imbalances versus the more anemic that conventional medical doctors would say you’re low in iron. We have both side of the fence, right? We have the functional issues, and we have the pathological issues. So the first thing we look at is going to be a CBC, right? On the CBC we’re going to look at red blood cells, hemoglobin, and hematocrit. If we see those start to get low, especially red blood cells you’re going below 4, hemoglobin into the 11, hematocrit below 30s, we have problems. Danger will rob– the red blood cell size is dropping which is the hallmark of low iron. Because we need iron that attaches to hemoglobin that help us carry oxygen. So we have hypochromic microcytic anemia. These are going to be smaller red blood cells, right? Smaller blood cells are going to be on the iron side. On the B12 side, it’s actually the opposite; they’re actually bigger. It’s called megaloblastic anemia. They’re actually too big. The red blood cells are opposite. We think of humans, we start off as babies and as we get bigger right? Red blood cells, they start off bigger and they actually get smaller as they get older. And so, B12 is needed to mature. Red blood cells, and so if we don’t have enough B12, you’re stock in this more immature state which is bigger, and you don’t have enough B12 than you can’t get smaller. Now with the iron, it’s actually the opposite. You actually get too small when the iron is too low. And of course, you can’t carry oxygen which is really important because aerobic metabolism which is how we mostly generate energy requires oxygen. And so that’s like, you know partly the kreb cycle, the electron transport chain, and all that stuff um, requires oxygen. So on that front, just kind of out of the gates there, we’re looking at um, iron from that perspective. Red blood cells, CBC, hemoglobin, and then we can dive deeper into an actual iron panel. And that’s we’re going to look at serum iron, that’s going to look at iron in the blood. Then we can look at ferritin. It’d going to look at our storage form of iron. So iron serum and ferritin are two different things. So think of, You’re driving a car, right? You have your check engine,Or should say you have your gas gate, right, for your fuel, right. Your fuel gauge that’s kind of your ferritin. Are you on full are you an empty? The iron serum, that’s the fuel that’s in the– ready to be, ready to be um, combusted to generate energy. Think of iron serum, that’s what’s in the engine, that’s what’s in the blood right away. Ferritin is going to be what’s in the gas tank. So you know of course If you see iron low on the serum side, you wanna look deeper but it’s not beol or endol. You have to look deeper on what’s  in the gas tank. That’s where iron serum um, sorry, that’s where ferritin will be more helpful and other markers like Iron saturation can be helpful too. Because that tells you how saturated the cells are, and also things like binding proteins. Um those tend to do the opposite, those tend to go up When iron goes um, goes down. So think about it, thinking about iron binding proteins is like fingers right. The more or hands right, the more hungry you are the more hands reaching out to grab stuff right. And so your body creates this protein and will try to reach out and grab these extra irons to create more binding proteins when iron is lower. It’s trying to get that much iron into the cells as possible. Does that make sense out of the gates?

Evan Brand: Yeah it’s a great breakdown. The analogy is super helpful. Because you know some of the blood chemistry training that you and I have looked at, some of the doctors, they will talk about the importance of ferritin. But that visualization of the gas tank Makes a whole lot of sense because you have doctors, if they do recognize low iron, they’ll treat that. But then if you see low ferritin, The woman still doesn’t have the results she’s looking for with regards to hair loss and catching her breath and all that. So once you get the ferritin levels up, Which typically I go for lactoferrin. What are you doing in terms of trying to get the ferritin back up? I know optimizing the gut is some of it, we can talk about that. But what about just straight supplements?

Dr. Justin Marchegiani: So first thing is you may see higher levels of iron in women that may have low iron. So you have to look at all the markers that I’ve mentioned because if they are inflamed, iron is also a reactive oxygen species right? Think of it as like It’s kind of inflammable if you will and so, and so when you are in inflamed because of poor food, poor diet issues, or toxicity issues, you may have higher levels of iron ferritin because of inflammation. If you’re really inflamed i always I like to make sure that it calm the inflammation down a little bit first before throw iron in there, it’s like gasoline in the fire. So you really want to make sure you know if iron’s really high or looks really high and then we see some inflammation markers like CRP also high, we see a lot of symptoms, right? Brain fog, joint pain, energy issues; Maybe we wait a little bit before we jump on that iron train right away. Maybe we just chew some iron rich foods, you know on the animal side and work on getting the inflammation down. So it depends upon where they’re at.

Evan Brand: That’s smart, let me comment on that real quick. That’s really smart and really wise to say, because people would just jump on that iron train right? Those doctors who prescribe iron probably low-quality form which is going create constipation and other problems. And if they are already having high iron Information due to some toxicity, that makes them worse. I had one high iron when I was first exposed to mold. I actually look back on some of my olde levels. My ferritin was high, my iron was high. And i did some pretty high potent seed turmeric extract, and i was able to get the iron back down. And i’m sure the blood donations may have helped too. But it was interesting to see that on paper, how my exposure to toxicity cranked that up a little bit.

Dr. Justin Marchegiani: Exactly and then There is a marker called Seruplasman Which is a marker for copper So sometimes copper and also affect iron as well. Again i’m not too worried of copper If you’re like Paleo and you’re eating high quality organic meat and high quality animal products.   close your typically going to see the zinc and iron products cause you also have copper in there. So i don’t typically get worried about copper unless we’re really I don’t know, eating a lot of plant-based products. And we’re kind of deficient and some of those minerals, and so eating good quality animal products may not be that big of a deal. And also it’s good to look at if we’re doing iron, If someone is vegan or vegetarian, you know there’s different kinds of iron that we use right? So in my line, i have a product called vegan supreme which is an iron disglycente which is found in the glycine, which is good. It it’s better like conventional medicine which is ferrous sulfate which will be more constipating, leaving the stool black-er and darker. Glycinate  tend to be pretty well absorbed so i like that in the glycine Which is same kind of amino acid and collagen and bone broth so i like that. Also, i would say depending on vegan vegetarian you may want to add some grass fed liver. Something like that that’s going to have some other nutrients like B12, vitamin A in there as well. Just depends upon how good or bad someone’s diet is too, if they can eat animal products. And so…

Evan Brand: How about lactoferrin? Do you use lactoferrin?

Dr. Justin Marchegiani: I mean lactoferrin it’s like it’s like a protein right? It’s gonna also… Yeah, it’s like a milk protein like it increases iron levels, kind of vitamin C in a senseWhere it increases that binding in absorption of iron, is that correct?

Evan Brand: Yeah, yeah. I’ve seen like a couple of iron lactoferrin combos that we’ve used. Man, it’s like rocketfield to get women back up really quickly.

Dr. Justin Marchegiani: Yeah for me i don’t typically use lactoferrin in general. I’ll do my iron supreme which is the bisglycinate, And then i’ll throw in some potential iron granular Is there a not eating enough animal products (Evan: like a liver) Yeah, like a liver glandular and a little bit vitamin C on top of that. But um, don’t you know, I see a lot of guys out there. I see people say “Don’t eat vitamin c, it’s going to increase your iron.” No, if you’re a guy, eat vitamin C it’s not a problem. It’s in every leafy green vegetable, every high quality fruit that’s out there, it’s too Important. Guys the solution to iron is just give blood. Get a comprehensive blood test once or twice a year. Maybe give blood once a year um, twice a year depending on how many blood tests you get, just give blood is the solution. Don’t avoid nutrient dense food that have vitamin c that would increase your iron. Just give blood and do some testing. Keep it simple.

Evan Brand: Yeah. That’s the fun part. When you do comprehensive panels like we’re doing. I just donated a blood, got blood work this morning. I gave a lot of tubes. It was probably not much as a donation, it wasn’t a pint but for me, it was a good slow drip out of my system If i’m running some blood panels throughout the year. And you get data. You get data out of it too.

Dr. Justin Marchegiani: I think it’s fun for sure So we talk about you know how to assess these are patterns right? We have our general cbc, we have Iron panel that will include Iron serum, ferritin, Iron saturation um, TIBC, UIBC, which are your similar binding proteins. You can also look up reticulocytes for baby red blood cells you’re losing blood. You’re gonna see a lot more red blood cells because the babies are being formed to kind of filling the gap of the older adult cells that were losing it; it there’s an ulcer or some kind of tummy bleed, IB you know, Irritable bowel disease kind of bleed in the intestines or colon or wherever. So that’s helpful to look at. And in general, you know, if you’re vegan, vegetarian, and you have a history of not getting iron in your body, you gotta fix that. That’s whole different podcast conversation about animal products. We’ll, you guys can go back to our channel, search for that, we had conversations, just on those topics. The second issue for women Is just to get rid of the hormonal Imbalances that are causing you to bleed too much. So if you are bleeding four more tampons, 4-2 days or more, probably just menstruating too much, you know classic cases of hemorrhagic if you will. And there’s probably a lot of estrogen dominance, way higher estrogen, lower levels of progesterone. Maybe progesterone is falling out soon in the cycle and some of the things are diving just excess bleeding and that’s possible too, and you gotta get to the root cause of why that is. Estrogen dominance usually some adrenal stress that affects some underlying issue that is causing that. And of course if you have a lot of digestive inflammation, whether in the stomach area or intestines, or lack of stomach acid, or enzyme you may not be able to break down the high-quality animal products that you’re consuming  that could also create a bottleneck of absorption.

Evan Brand: Yeah when somebody here’s that, they might not realize how big of an impact that could be, right? When somebody here’s what you’re saying. It’s like “oh this gut Ingestion, digestion blah blah blah” But we’ve seen it on paper and clinically Where you have women that are eating paleo, doing breastfed meet, doing a great job with diet, and they’re still very low. Some of it like you said high you know, the excess menstruation but, i’ll tell you personally i’ve seen big changes with my wife’s energy levels after clearing her gut infections out. And we knew that she was having malabsorption. So, and so I mean when your 40 50 or 60 and beyond, you are making Left stomach acid due to age even if you’re eating that grass fed steak, and that liver capsule, who knows how much you’re getting from that. So to me, i think enzymes will be part of a good Iron supporting protocol because you know, people will say you are what you eat. But really, you are what you digest from what you eat. So i think This is a good point to bring up enzymes and acids to make sure that if you have H.Pylori Infection that could be something to address, that will be driving the low iron. Is that a safe statement to say? Is h pylori that big of a smoking gun, that it could drive blow iron due to the malabsorption?

Dr. Justin Marchegiani: Yeah, i mean there’s always you know. There’s always going to be different degrees of how that infection is causing a stress in your body. If it’s there, it’s chronic, it’s creating a lot of  inflammation, digestive wise enzymes have dropped significantly. That may impair your ability to absorb usually there is going to be symptoms that will tell you the severity you know, just things like not having a good bowel movement, having a lot of bloating, or  gassing, or flatulence, and gut inflammation, those are pretty good signs there’s stress going on there. Um, looking at your stools, how formed do they look, are you regular, are there undigested stool pieces in your stool? Those are all pretty good ideas that you’re on a bad track. So it’s good to look at that. Of course if you have chronic iron, and you’re fixing menstruation issues, you’re eating meat, you’re adding in Digestive support that’s all great. You probably want to look deeper and get your got tested and see if there are other bugs in your gut like SIBO, or just general dysbiosis, or parasites or h.pylori, or other issues that could be in place. You gotta look at all of it.

Evan Brand: Yeah. And you mention the inflammation I mean. That could be exposure, that could be the diet, it’s simple. It sound simple but It’s still worth mentioning. We still have so many women that are going to the starbucks drive-thru and getting a pastry, a bagel or a muffin, or whenever, and they have their coffee and that’s it. That’s it for their breakfast and they wonder why they are exhausted. I mean nutrient density is just foundational.

Dr. Justin Marchegiani: Yeah, nutrient density is really important and um, to really have good nutrient density You have to be eating some level of animal products. You’re just not going to get same level of nutrient density from an amino acids standpoint. You’re not going to get the iron, the b12. It’s harder to get the fat soluble vitamin A, I mean you can get some from b12, I mean some from beta-carotene but, you won’t get enough. And if you have insulin resistance, you won’t convert b12, you won’t convert beta-carotene well. You also won’t convert a lot of your ALA-based omega 3. It’s like flax and Chia. You won’t convert that to your longer chain EPA and Your DHEA fats which are good for inflammation in your brain. There’s a lot of precursor things that We just assume like “Oh, we’re getting iron from spinach. I’m going to convert that non-heme iron to non-heme based iron right.” No, I’m getting enough bioflavonoids In my vegetables that are vitamin A right? Well, no. That’s beta-carotene you may not convert that. Or same thing with um, i’m trying to think here what other analogies that you can do. So You have the plant-based iron, you have beta-carotene stuff, you have the vitamin, I’m trying to thank you for what else um, zinc and a lot of your minerals may be tied up in antinutrient plants. You might think you’re getting a lot of this vitamins and minerals but you may be having them tied up with a lot of antinutrients – the lectins, fitates, the mineral blockers, the trypsin inhibitors,  and so you might think you’re getting some of these things on the nutrient label but, there might be some absorptions because of this nutrient blockers. Proteolytic enzyme blockers.

Evan Brand: That’s a good point. So far vegetarians-vegans listening, if you could get them on liver capsules, you’d say get them on some pastured liver would be a great option. If their opposed to that even, I mean what do you do? I’ve seen women from paper suffered for years, and I honestly just used the labs as justification to push them harder into something like liver capsules if they just absolutely don’t wanna do the meat.

Dr. Justin Marchegiani: Yeah liver capsules or going to be ideal That’s where i put my iron supreme which is a ferrous-glycinate, and add in some amino acids like collagen and some kind of free form amino acid to get the protein of without antinutrients and carbs in there as well ‘cause a lot of vegan vegetarian proteins, they’re just very carb heavy right? Rice and beans, quinoa, they’re just you know, they’re just 60, 80% carbohydrate for the protein to get in. So it’s hard if you need to keep your carbs down for insulin, For inflammation or fat burning means it’s hard to do that If you try to stick to a vegan vegetarian diet I need you can do that if you’re adding some protein or rice protein but then, you’re heavily reliant on processed food for most of your protein. And that’s not great so we don’t want to have things to be so processed, like we have to be overly reliant. It probably tells us that your diet needs to be tweaked and adjusted if you’re heavily reliant on processed food to get your nutrients up.

Evan Brand: Yep. Well said. So men definitely get your iron tested too I mean females are probably gonna be more symptomatic than men, meaning, the fatigue, the hair loss-that kind of thing with the low iron. But man, you can have symptoms from that. I will tell you i’ve had, when i went to donate blood, I found my hemoglobin was very high. They’ll cut you off by 20 It’s above 20. You have to get a prescription to donate blood, and then back at the therapeutic blood donation but I would like a 19.6. I felt like I was going to be mentally foggy, mentally cloudy and certainly more brain fog, and I would say my energy levels were a little bit less. And I ask some of the donation people like, “What would you think i will experience based on this level of hemoglobin?” They were like “Oh, man you’re high.” And I go like, “Ok, what should I feel like?” And they actually said exactly what I felt. They thought you would feel cloudy and then I would remember this feeling when donating a pint, boom! It was like this release. Like literally almost like an energy drink after I got that excess iron out. So i tell you, it’s very very therapeutic.

Dr. Justin Marchegiani: Yeah, and again iron is going to cause oxidative stress. So if you’re a male, and you are over accumulating iron you know, give blood. Get some therapeutic functional tests doneSo you’re actually losing blood via the testing means. And make sure that you know, taking in a really good high antioxidants you know, through organic vegetables, maybe low sugar fruit. Because at least the antioxidants that you’re getting in will help at least buffer the oxidative stress from the iron right? So at least you want to make sure Antioxidant levels from fruits and vegetables Are dialed in and we’re getting healthy. You know antioxidants and maybe through curcumin or other high quality nutrients that help buffer some of that, help offset some of it.

Even Brand: Yeah yeah cool well If you want to get tested uh, Dr Justin able to run blood work, I’m able to run blood work, we do it around the world which is pretty cool; I guess, technically blood work that we do In the United States. Little tricky internationally for blood work (Dr. J: It’s still better but it’s harder), yeah it is harder but for the other, for the functional testing which you can do functional blood testing and that’s what we do. Our panels are much more comprehensive than what you’re going to get down the street from your doctor. So if you need help you can you can reach out And just please let us know If you have trouble a lot of time people are begging their physicians to run a comprehensive fire oide panel, run the antibody, to run the ferritin, you shouldn’t have to beg someone to get these markers done. This is very simple we can literally get your requisition form the same day. You go straight to the lab, you don’t have to beg somebody to run it. So if you need help, please reach out to Dr. J justinhealth.com or me Evan Brand evanbrand.com. We would love to help you with this and other related things too. Whether it’s gut Infections we need to look for Four sources of inflammation driving this. There’s probably some root cause It’s not just magically going to happen like this. There’s probably a couple others– you know, It’s an entangled spider web If you will. So we’re going to kind of tease that. We love doing that; it’s very rewarding when you see a woman who is buying all these hair loss control shampoos and these special products and their get sucked in into by their hair salon, and they just simply needed to optimize their ferritin levels.

Dr. Justin Marchegiani: Yeah if your iron levels are low, It can impact your thyroid. If your iron levels are low, it can impact your adrenals because you need high quality you need to carry oxygen to be able to um, you have aerobic metabolism, you need to carry oxygen to have good thyroid function. If you don’t have good thyroid hormones Important for stimulating hair to grow, and of course if you’re not breaking down your protein, and or iron you’re not going to be absorbing all the proteins and facts to build up your hair to make our hair healthy. So all those things can play a major role. So guys get blood, get some testing done. Women, make sure people in general, women especially make sure you’re eating high quality animal products or at least something right. Maybe eat some egg yolk. Maybe eat some liver capsules. Just try to do something that ‘s going to meet the middle of it. And then outside of that, get tested as well, and if you’re female and you’re bleeding, you gotta look at the estrogen dominance, and you gotta look at the progesterone. Conventional medicine is just going to throw birth control pills at you and that’s not going to fix the issue. It’s actually going to compound and make the problem worse because estrogen pills can lower B vitamins-B-12, and Folate, and calcium. It can lower other nutrients and it actually makes your estrogen dominance worse right. It’s giving you more estrogen; giving you a consistent level which is better you know, having the up and down but, it’s not fixing all of the hormonal imbalances; Just covering things up. So If you want to get to the root cause, reach out to Evan Brand evanbrand.com or myself Dr. J at justinhealth.com, we’re here to help.

Evan Brand: Amen! You did a great job. I think we killed it.

Dr. Justin Marchegiani: Alright. Excellent. By the way, what are my ranges, uh, ferritin 30-40 enough for women, uhm, men you know 60-80sh i think pretty good for that, iron saturation 25 and up. And i think it’s a pretty good kind of starting point there. Maybe binding proteins below 300 that’s a pretty good thing out of the gates.

Evan Brand: Yeah, i had a woman with a ferritin level of 6 She can hardly get up a flight of stairs because she was so short out of breath, her hair was falling out In clumps, her husband is mad at her because she was clogging the shower all the time. Once we got her ferritin back up to the 50s, her hair stopped falling out. She felt so much better. She can run of the stair without passing out. I mean, it was just incredible so don’t underestimate this. I know you guys listen to us on a regular basis. Even some clients they tell us they listen to us while going to sleep. Don’t sleep on this issue. This is something you really got to address.

Dr. Justin Marchegiani: Yeah, it’s an important issue for sure. And for guys, with low iron yeah, vegetarian-vegan, make sure you’re not doing that. Vegetarian vegan, look at the gut. You are probably not absorbing or digesting or breaking It down. Get the gut, look deeper. All right Evan, have a phenomenal day, man! Great chatting with you!

Evan Brand: Take care now you too.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/how-your-iron-levels-are-negatively-affecting-your-health-podcast-346

Recommended products:

Iron Supreme

Genova NutrEval FMV

Comprehensive Bio-Screen Blood Test

 

Natural Solutions to Heavy Menstrual Bleeding and PMS | Podcast #299

Dr. J is tackling menstrual irregularities and heavy menstrual flow, symptoms, what your cycle should look like, looking at hormones, when to best test, triggers of irregular cycles, and some tips for helping regulate menstruation.

Most women cope with their PMS and irregular cycles like it’s a normal thing, but really heavy menstrual flow can be a sign of something deeper, maybe even estrogen dominance. Heavy menstrual flow can cause fatigue, lethargy, mood issues, irritability, brain fog, hair loss, and most importantly low iron. Heavy menstruation can drive anemia and low iron which is essential to the body, then it can take weeks to replace iron, by the time you feel more yourself the cycle starts all over again. What can we do? Well Dr. J has much to say from the perspective of a functional practitioner.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

2:54      Menstrual Issues and Terminologies

11:12     Social Isolation, Supplements and Herbs

15:10    Tests for Menstrual Irregularities

17:44    Fasting as Stressor

20:16    Diet Restrictions

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Dr. Justin Marchegiani: And we are alive. It’s Dr. J here in the house. Evan and I will be chatting about menstrual irregularities and heavy menstrual flow. Evan, how are we doing today man?

Evan Brand: Doing really well excited to dive in. This is an issue that many women just deal with. And they don’t really get help with. They just assume that hay, it’s normal to have PMS. It’s normal to have this happen with my cycle where this month, it’s 28 days. And then the next month, it’s 17 days and the next month, it’s 36 days. And I mean, we hear these stories all day every day.

Dr. Justin Marchegiani: 100% and the problem with heavy menstrual flow off the bat, it’s a sign of something else deeper, usually some kind of estrogen dominance. And then what’s driving that right? A lot of times progesterone is falling out too soon in the woman’s cycle. And then you have all this heavy menstrual flow, and that can drive in anemia that can drive low iron and that’s a problem because we need iron to bind a hemoglobin to carry oxygen. And we need oxygen for aerobic metabolism right for our mitochondria today. burn fuel, generate energy and burn fuel. So we need adequate oxygen. So if we have heavy menstrual flow, you can easily see fatigue and lethargy and mood issues. And a lot of times takes a couple of weeks to even replete that iron back up, and then you do it all over again. So it becomes this really, you know, you’re in the boxing ring every month, and you’re just getting beaten up, and it’s really tough. So you got to fix the anemia, and you got to fix that heavy menstrual flow for sure.

Evan Brand: Would you say this is a functional problem, meaning if you go to your doctor and you’re getting conventional bloodwork done, it’s going to get missed or even on conventional bloodwork. Are you going to see certain things pop up? That would be a red flag to even a conventional doctor that they would see.

Dr. Justin Marchegiani: It depends. A lot of times conventional doctors aren’t going to run like a functional iron panel, they won’t run like ferritin or iron saturation or iron binding proteins. A lot of times they don’t do that they’ll run a CBC and they may look at RBC see if it RBC is below four or a hemoglobins in the elevens or dramatic rates in the middle Low 30s they may run that but it just takes a lot. Like the issue has to be a lot more severe for the RBC, hemoglobin hematocrit to be a problem. So, you know, I’ll run a CBC to see where you’re sitting, right? We don’t want the RBC below 4.2 we ideally want the hemoglobin in the 13th, we want to get in the upper Upper 30s. So we want to make sure that’s good. But if you’re using a late stage indicator, the problem needs to be going on for a lot longer to fix it. That’s the issue.

Evan Brand: Okay, let’s go into symptoms briefly. I think this would be helpful for women because they’ll say okay, menstrual irregularity, you know, what, what do you how do you classify that? And then what symptoms would be associated with this? Are we talking to typical PMS issues where, you know, there’s breast tenderness stuff, or are we talking where the the cycle is changing? Where, like I mentioned, you know, some months it’s 28 days, others it’s 36 others, it’s 17? Are we talking headaches? What are we talking?

Dr. Justin Marchegiani: Yeah, so let’s kind of get a couple. Let’s get some terminology stuff out here. First, I find it I’m not sure if It’s an educational issue. I speak to a lot of women, I say how long is your cycle? And the first thing they tell me is how long they man straight for. So it’s this weird kind of disconnect. And I think it’s just people aren’t really educated in school about this. People, most people conflate their cycle is to how long they men straight. So a woman’s cycle is their entire hormonal cycle. Usually it’s 26 to 30 days right from day one’s the first day of leading to the next day one. That’s their whole cycle, right, which is built on a follicular phase right where the follicle grows, and estrogen predominates. It’s built on oscillation where estrogen predominates and progesterone rises. That’s oscillation and that it’s built on the luteal phase, the last half. So think f follicular first, think l luteal last, okay. And then luteal is where progesterone predominates. And a lot of the cycle irregularities may happen because of estrogen bouncing around or progesterone being either too low or dropping out too soon. And so when we talk about a woman cycle, that’s the full cycle when we talk about menstruation. That’s the period right? So most women they confuse menstruation and cycle length. So menstruation is when flow is happening period blood flow, and the cycle is going to be the entire length of that hormonal rhythm day one the first day they’re bleeding blood flow to the next day one, that’s your cycle. So just from a terminological standpoint, so when we’re looking at the heavy menstrual flow and a lot of the irregularities, it tends to happen a couple of days to even a week before we have blood flow. And of course, some women when there’s a lot of estrogen dominance occurring in that progesterone drops out too soon in the cycle and I’m doing a lot of hand gesture stuff so people are aren’t quite following on the auditory side. We’ll put the video link below so you can see the video. But when that progesterone drops out a little too soon in the cycle, that’s where we have a lot of menstrual flow. And this can really mess a lot of women up because of what I said earlier. You’re going to have a lot of low iron here, low low iron, low hemoglobin, and then you’re ability to carry oxygen really get some hair, and that’s gonna make it harder to generate a Robic metabolism and support the mitochondria. Mitochondria needs oxygen. So we need that. So that’s one of the collateral damages of menstrual irregularities is the menstrual flow. And then of course, other things can happen like irritability, breast tenderness, back pain, mood issues, brain fog, but the key thing that that’s going to happen after that is going to be a lot of that blood flow driving the anemia and the low iron, low hemoglobin. And the I was-

Evan Brand: I would Oh, yeah, I was gonna say the fatigue is probably the big one, right? Maybe exercise intolerance. These are women that they feel like they have to do some exercise. Maybe they’re pushing themselves hard, but they just don’t feel like they have enough gas in the tank to get the exercise done. It just feels abnormally difficult to do physical things. And then hair loss is big too. I mean, we’ve seen countless times on bloodwork where women will show up with really low ferritin. And they’ll say that every time they take a shower, I mean they’re losing a clump of hair, you know, per shower, and that’s just insane.

Dr. Justin Marchegiani: Yep 100% 100% so it’s always really good to take a look and test where you’re sitting during the luteal phase like right around day 21. The 22 is usually a good time to test where that progesterone sits to make sure it’s high enough. If you’re having a lot of heavy bleeding early, a lot of times that progesterone just falling out a little too soon in that cycle. And so we may support there’s a lot of stress, we may support the hypothalamic pituitary, go Natl axis, right that’s the brain talking to the to the gonads or to the ovaries in this example or to the adrenals. So we can support adequate levels of progesterone output. And we may use herbs like you mentioned shepherd’s purse, we may use things like chase tree, we may use estrogen modulators like Don Chi or black cohosh may use things like that we may use special phenotypes of Makkah, we may even use byway denticle progesterone as well to kind of carve out and work on supporting that healthy female rhythm too.

Evan Brand: And What led to these issues in the first place? I mean, we’re talking just age, we’re talking stress, we’re talking pregnancies having babies, like the xeno estrogens in the environment. I mean, what are you thinking are some of these big triggers?

Dr. Justin Marchegiani: Um, so in regards to the biggest trigger, in my opinion, is going to be the fact that progesterone can make cortisol. So when women get stressed, their stress hormone is cortisol. So they’re going to take a lot of that progesterone, and they’re going to, they’re going to pull it from their cortisol. All right, I’m sorry. They’re going to take a lot of progesterone and they’re going to pull it down to cortisol. So then that starts to skew the relationship. So stress, takes progesterone shunts it downstream to cortisol that can create some functional estrogen dominance, okay. Number two is just they’re depleting a lot of their cortisol output from the adrenals. And their adrenals are, you know, are making some other hormones but there’s needles are just more depleted. That can be a big thing too. And then three would just be potential Xena And exposure, there’s three big variables there. That’s gonna be from pesticides, right? These chemicals, they kill plants by disrupting their hormonal system and nervous system. So that’s one. Number two is gonna be plastics. Plastic does you know estrogens, right BPA or even some of the BPA free ones have other types of xenoestrogens that aren’t good. And the third one is going to be hormones and meats, animal products were to dairy milks, beef, chicken, right, just the hormones that are given to the animals to fatten them up. And so it’s going to be plastics, pesticides, and hormones in the meat and animal products. So those are the big ones. So of course, eating organics and to be good. Using Pyrex, or glass containers is great, especially when heating plastic isn’t that bad, as long as everything’s cool, and isn’t in the sun, not as big of a deal. Once it’s in the sun and you’re heating it forget about especially a microwave forget about ovens. Obviously, that’s a no brainer. And then of course, um pesticides and pesticides could be in the food Okay, so organic helps that it could also be in the water. So high quality water filter, reverse osmosis, or at least a carbon filter will filter a lot of that junk out.

Evan Brand: Yeah. And people listening, they may say, God, why does everything have to be so complicated? It’s like, Well, we’ve just changed a lot. I mean, you mentioned the adrenal thing. Women now where historically they were in the tribe, and they had other women to help with the kids. Now you’ve got the stay at home mom, parents-

Dr. Justin Marchegiani: -and grandparents, man. Yeah, I mean, that’s back in the day. Think about it. grandparents would be like in their 40s and 50s, probably right. You have kids in your late teens, your kids would have kids in their late teens, that puts you like, you know, that puts your grandparents in their in their 40s, early 50s. And typically, you know, you’d be out earning a living paying for the home and maybe rearing the kids a lot, maybe taking care of the kids. So there was a little bit less stress on the child rearing aspect of it, because you had someone there. And then typically, you didn’t have a big mortgage, you didn’t have all this. So usually One income was enough. So then, you know, one person could help out with the family, grandparents helped raise the kids, one person required for the income. So there wasn’t a ton of stress. And the income back then could be hunting. Right? It could be hunting or fishing, right? It could be doing something that were just really providing food and shelter. And that’s it. That’s all you need it. So our society has evolved and changed, and there’s a lot more financial stress, and some people have to have two incomes to survive to and, and grandparents are older and have their own health issues and can’t really participate on the day in day out of raising kids. So a lot of good things have shifted.

Evan Brand: Yeah, well, then you go further back, and before there was even bills and currency and you had the tribe that was hanging out with each other where you’d have, like you said, multi generational tribes, and then you would have potentially other people that are related somehow or maybe not related. They’re just part of the tribe. And, I mean, you read about these, you know, hunter gatherer societies where you’ve got women that would sometimes be nursing the children of the They’re not theirs, you know. So there must be a shared motherhood experience. And now you’ve got the stay at home mom driving the minivan with the three, four kids running them to the park and then doing the groceries and all that alone. So, you know, I think a lot of the social isolation aspect is really big for this stress component you’re talking about with this whole pregnenolone, progesterone, cortisol, everything getting robbed and diverted. And, yeah, I mean, it’s like, it’s a big hormonal chaos, really. And it’s because the, we know, there was actually a study done on that isolation issue. And that isolation, being socially isolated, was comparable to like smoking a pack of cigarettes a day. In terms of the the toxicity, we’re just not, we’ve never been a species like this. And now with shutdowns and everything going on, you’ve got people even more isolated. I mean, I have a client who’s a therapist, and she said, Man, everybody’s a wreck. And I said, What do you mean? And she goes well, because everybody’s separated from each other people are afraid to be next to one another. She said, I’m hearing all sorts have new symptoms for my clients. I thought Wow, that’s really interesting. So what’s the remedy? Well, you mentioned some of the herbs already some of the adaptogens will use and maka extracts and shepherd’s purse and wild yam and cohosh and chase tree and all those things are amazing. But I think at the end of the day, you’ve got to try to build some type of a community. You know, like Facebook, moms groups are one thing, but you actually have to have like an in person, place where you can sit down with other people have a conversation, you know, let somebody else handle the kids chaos for a minute. While you can just relax. I think we’re all just stuck in fight or flight. And that’s really one of the big root causes is our nervous systems are just so turned on. And especially if you’re watching the news, you’re not turning off. And I think that’s a big root cause outside of the environmental dietary pieces.

Dr. Justin Marchegiani: Yep, I totally agree. There’s some data also Showing that there’s more relaxing, which is a hormone produced by women’s bodies that can relax a lot of the ligaments and tendons. There’s some data showing that there may be more ligament laxity in the last half of the cycle where progesterone is. So just be careful of over exercising or doing too strenuous exercise. During the last half of the cycle. Just keep that in the back of your mind exercise stress could be a big one. We don’t want to be over exercising that’s important. Of course, nutrient density is essential. So nutrient dense, anti inflammatory, low toxin foods are going to be key one because we provide building blocks and two hormones are made from good high quality cholesterol compounds and cholesterol is connected with animal products and that’s usually connected with fat soluble vitamins at Okay, so we got to make sure all those foods are dialed in egg yolks. High quality grass fed beef by the grass that are by last night with some organic green beans was wonderful, right? So you can do all these things with the food good paleo template and you know, line up your macronutrients according to what you need. As a woman, if you’re more of an ectomorph, you’re more lean, you’re more skinny, you may be able to handle some more starch starch on the reg. Right? Every day, you can handle more starch. If you’re more on overweight, you may have to lean more on your non starchy vegetables and less fruit and starts maybe some but just a little bit less. So really get your macros dialed into.

Evan Brand: Yeah, I would say on the supplement side to one thing we didn’t mention would be like calcium D glucoerate could be really helpful. And then also, you know, since we haven’t gone down the rabbit hole yet on this podcast about it, you know, we could briefly mention the gut and how the gut is involved in these hormonal issues and how we’ve had many women that have had issues with their cycles that have spontaneously resolved just by fixing gut infections because we’ve hit on this idea of the beta glucuronidation enzyme being elevated, which causes the research ulation of toxins and hormones due to bacterial overgrowth. So if you’re having menstrual irregularities and you’re not addressing or looking into your gut, you know, you could work on the diet piece all day and still have issues. We have many women that have come to us that they’ve done a great job on the diet. But there’s still suffering. And so that’s where we dig deeper. And then something like calcium D glucorate may be used. And it can do a lot of good really, really quick with the detox piece, even for mold. It’s been helpful.

Dr. Justin Marchegiani: Yeah, so when we test a lot of these, we’ll do a Dutch test. And we’ll look at things like right around day 20 or so. So we can see where progesterone peaks out. And we’ll also look at estrogen levels and ashra metabolism. We’ll look at two methoxy, two hydroxy. Estrogen we’ll look at methylation markers. We’ll look at pirate glutamate, including violence that can give us a pretty good window for impaired on the detoxification side and we can add in phase one, phase two detoxification support whether it’s B vitamins and antioxidants, or sulfur amino acids, or extra binders or extra vitamin C or extra fibers to kind of bind up some of that that’s a really good option to therapeutically support detoxification, as well as just to help excrete extra hormones that may be laying around from some of the other reasons we chatted about.

Evan Brand: Yep, absolutely. So the testing piece, you know, Dutch is going to be important. I would say stool test is going to be amazing. Blood panels could be important. You know, if we did have a history like heavy bleeding, we’re going to look into ferritin do like a full iron panel, potentially thyroid could be important as well. organic acids. I mean, I would argue that be important too, we always run those for looking at the gut piece, the mitochondrial piece, if a woman’s complaining of, you know, major fatigue associated with this wells is related to the iron ore is is related to possibly the mitochondria as well that have gotten damaged by some sort of toxicity issue. So I think those would be top priorities. What about anything else? Are there any other tests that you would you would run to investigate this issue?

Dr. Justin Marchegiani: Well, if there’s a lot of insulin resistant issues, insulin is a big one. So carbs are out of out of whack and they want to look at insulin levels, make sure they’re closer to five, five to sevens ideal. They’re too high, there could be some resistance going on. Of course, I always get worried about pcls right. pcls is primarily driven by high insulin and then that can cause elevations in androgens and testosterone and that can also cause an increase in something thing called prolactin and prolactin can start to dis regulate the HPA axis that can kind of dis regulate the cycle. And again, that’s all supported by getting blood sugar stable, right. dysglycemia is a major hormonal stressor. And I asked them and don’t, don’t jump into hormonal stress and start fasting and doing all this stuff. Get your blood sugar relatively stable, you know, make up proteins and fats as the foundation of your meals. And make sure make sure 100% you’re getting enough nutrition, go look at go look at your chronometer, or My Fitness Pal and look at your calories. Make sure you’re getting enough. Make sure those calories are all nutrient dense, anti inflammatory, low toxin. Make sure you’re getting enough magnesium and potassium and high quality minerals. Very, very important.

Evan Brand: Well, you said it quick. So let me just restate it and confirm to make sure it’s clear. You’re mentioned you’re mentioning fasting as potentially being a big stressor that could make this situation worse, correct because you’re saying if a woman’s already nutrient deprived, or she’s having major issues Potentially too much blood loss. Fasting is something that could throw off blood sugar balance. But also, as you mentioned before, there’s no nutrition and starving. So you’re saying in this case, three meals a day maybe better than doing a fasting protocol?

Dr. Justin Marchegiani: Yeah, the problem with fasting fasting can help when there’s insulin resistance, but one there needs to not be a lot of blood sugar stress meeting up and down, right? So people think like, oh, if I have blood sugar issues, then fasting is great. Well, not if there’s display see me because this glycemia means your blood sugar’s up and down and up and down. And every time it goes up, your pancreas kicks in every time it goes low, your adrenals kick in with cortisol and adrenaline. So there’s stress on those glands. So the problem with that is you want to make sure you buffer that with healthy proteins and fats, it’s like putting a fire going and having putting, you know, twigs and paper on it. If you ever started a fire that way, you’d be feeding the fire every 30 minutes to an hour or even more because the fire would burn out fast. So a log on the fire that stays For hours, it’s like proteins and fats. And most women, they metabolically keep their fire going with twigs, and paper and gasoline, and you just can’t you’re going to be next to the fire all day. Those are your grazers, okay? Or if you’re trying to fast, well, eventually the fire is just not on you’re going to get cold, ie your metabolism is going to decrease. And if you’re already nutrient deprived, and now you’re fasting and not getting enough nutrition, that’s a problem. Now, of course, if you’re going too fast, and you’re compressing your feeding window, the key mistake is not getting enough nutrients. So you have to get enough nutrients. Now, if you’re doing it a day or two a week and you’re already healthy, and you’re getting an overabundance of nutrients those other five days, of course, you get your body can handle that right. But most aren’t in that over abundant state, they’re already depleted. And that’s where it’s a problem.

Evan Brand: Yeah. And you’re mentioning the grazers. I mean, these people are not grazing on grass fed beef jerky, typically they’re going to be grazing on, I don’t know, maybe some gluten free pretzels or something. I mean, it’s going to be more of a A process thing it’s not going to be. I mean, maybe it is maybe you’re grazing on macadamias or something like that, and you’d be okay. But in general, you want to be able to have three solid meals per day. I find, once women do actually calculate how much they’re eating, most of them are under eating.

Dr. Justin Marchegiani: Most are and then also, I’m not a big fan of snacks. Snacks typically mean a carbohydrate, primarily a carbohydrate macronutrient balanced meal, it’s smaller, and it’s primarily carbs and it’s usually not enough. And a lot of times snacks can be used to compensate for a poor meal previously. So I like the word mini meal, because it provides a there’s a balanced like a meal, meaning there’s some protein fat, maybe a little bit of carbs in there. Ideally, you’re doing a mini meal because your next meal is just a longer gap. So like if you had lunch at noon, but you and your husband are going out to eat at seven, well that may be a little bit long for you. So maybe you want like a good protein, fat, kind of keto bar here or a little more Any smoothie like around five o’clock, right? to kind of give you a little bump so your blood sugar doesn’t go super low until you feel good. Now if you’re healthy, you could maybe be able to handle it if you have blood sugar issues, and maybe a little mini meal is good right there to provide balance. Does that make sense?

Evan Brand: Yeah, it does. It does. And you’re mentioning to like the meals should be nutrient dense enough to where you shouldn’t have to snack But yeah, I mean, I don’t go much more than five hours. I will start to get a little shaky if I go six, seven hours. It’s too much for me.

Dr. Justin Marchegiani: Yeah, also just go to chronometer, man, just try to like put a sample me at like people that do omad stuff one meal a day. I’m like, dude, go to chronometer and put all the things you have to eat in that one meal and you tell me if you’re getting six to eight servings of vegetables, you tell me if you’re getting a pound and a half of me, you tell me if you’re getting that much fat, it’s really hard. Like, you’re going to literally be eating like eating probably for over an hour like eating chewing. It’s probably gonna be hard. Oh, yeah. Really full and you’ll probably take a break. That’s why two meals is doable, but you really have to be like There can’t be slack in the meal. It’s got to be a very intentional awesome meal. And you have to do it three meals. It’s relatively easy. Yeah, you know, you have two really good meals and one pretty good one and that you’re there. One is very hard. Yep. Yep. I would agree if you have tummy issues, if you have SIBO and you already have low stomach acid, well, now you’re just now you’re eating all that calories in one sitting. It’s like, Whoa, yeah. And how would you possibly digest and assimilate all that without having any issues to that’d be very, very difficult. It’s harder now people can do it if they have a really chill night and they can just sit around and relax for two three hours and in their lives aren’t that stressful, right? But in their digestion is really good. They can maybe get away with it, but I think minimum two meals is gonna just make your life easier.

Evan Brand: Yep. I just want to point out that if you have menstrual irregularities, you may need to come in and do some specific herbs to address those but sometimes this issue in the same category as many other issues we’ve talked about, where it gets fixed as a side effect of just getting healthy, just running you through kind of our functional medicine workup, supporting and looking at adrenal supporting and working on gut, the mitochondria, the nutrient absorption, the acid and enzymes, the probiotics, sometimes just those simple steps fix this. But if they’re having an issue that’s not resolved, then we can come in with these extra tools. Yep, that and vice versa. And maybe we should mention this to vice versa. You can’t just come in and do the chase tree, or the vytex, or the wild yam or whatever, and call it a day. You can’t do that either, because now you’ve ignored the issues that led to this problem in the first place, whether it was the glucuronidation pathway, or the bacterial overgrowth or the parasite infections and messed up the nutrient absorption which caused the nutrient deficiency which caused the hormonal issue. So you really have to do all of it. But I don’t want this to be Hey, let’s go to the hormone section at Whole Foods, buy a supplement and call it there. You don’t want to do that either.

Dr. Justin Marchegiani: Yes, you want to really get to the root cause of the food. stuff is important. We talked about some of the herbs we talked about even doing a kind of a cyclical augmentation kind of reset by using progesterone accordingly. And of course, we’re supporting the adrenals. The adrenals play a big part. So when I always test, when I test hormones, I’m always looking at female and adrenal together, they tell a really big role. And it’s nice to be a look at hormone detoxification. That’s really helpful too. Because it really gives me a window in all three sides of it.

Evan Brand: Yep. I think I’ve said all I need to say, do you have anything else you want to go into?

Dr. Justin Marchegiani: Yeah, so blood sugar, nutrition, right diet stuff’s very important. The gut plays a big role, because that’s where we digest and absorb all the building blocks to make our hormones. So if we have bloating or digestive issues, that could be a problem. Don’t just get myopic on the female hormones. Don’t you got to remember the adrenals play a huge role. So female and adrenals. And, you know, don’t jump on these fat things. Oh, just fast and do this and you’ll get better. You know, get your nutrition gets your blood sugar. Get it dialed in. And then if there’s things like iron, that’s a problem in the interim, you know, you really want to support that I have a product called Iron Supreme, it’s a bisglycinate iron. That’s a really better iron ore. If you’re more sensitive, a high quality liver, glandular is great. And then obviously eating a lot of high quality red meat before and during menstruation if flow is heavy, just to really make up some of that extra iron if needed.

Evan Brand: You know, good news is you can reverse this is not something you have to live with. So like I said, in the beginning, many women just kind of live with this and they just know hey, I’m quote messed up, you know, my cycle does this or that and they just live with it. But you can get it resolved to where if you track it on an app, I mean, my wife, she’ll track it on an app, and it says, cycles supposed to start boom 28 it’s 28 day cycles. So you know, and before due to birth control and other issues, I mean, her cycle was not always perfect. So you can fix these things. You can adjust them you can modulate them and there is hope.

Dr. Justin Marchegiani: 100% so if you guys want additional help and support, we are available worldwide. Feel free to head over to EvanBrand.com you could schedule a consult with Evan or JustinHealth.com you could schedule a console with myself we’re there to help you. Click down below for links and if you enjoy the content give us a review we really appreciate it EvanBrand.com/iTunes, JustinHealth.com/iTunes, and share with family and friends. And we appreciate you guys for joining. Take care y’all.

Evan Brand: Take care. Bye now.


References:

https://justinhealth.com/

https://www.evanbrand.com/

https://justinhealth.com/water-pitcher

Audio Podcast:

https://justinhealth.libsyn.com/natural-solutions-to-heavy-menstrual-bleeding-and-pms-podcast-299

Nutrition is Science-Backed Medicine

By Dr. Justin Marchegiani

Nutrient: “a substance that provides nourishment

essential for growth and the maintenance of life.”

You Are What You Eat

Why do people change their diet? While popular answers are to lose weight (fat), or to get in better shape (adding muscle), good nutrition is in fact about so much more than changing your physical appearance. Proper nutrition–diet and supplementation–is a science-backed way to improve your health. “You are what you eat,” and everyday you have the power to decide how the foods you consume will serve you. Let food be thy medicine: heal your gut, balance your hormones, improve your mood, boost your energy, and more.

Nutrition as Medicine

As kids, many of us were told to eat our vegetables–why? ”Because they’re good for you.”

As adults, we are told to eat our vegetables–why? “To shed some weight.”

Neither of these answers demonstrates the true healing nature of what we put in our bodies, so, without further ado, here are some of the most powerful science-backed healing properties of a healthy diet!

Click here for a personalized health plan from a functional medicine doctor!

Physical Appearance

We all know that changing our diet can help us lose weight, but did you know that a healthy diet can improve the appearance of your skin and hair too? B-vitamins, like biotin, have been shown to improve the appearance of skin and nails. Collagen also supports healthy hair, skin, and joints!

Increased Energy

A poor diet lacking in healthy macro and micronutrients–paired with a diet high in sugar, alcohol, and processed foods–can lead to headaches, brain fog, and fatigue. On the other hand, eating grass fed meat, healthy fats, and lots of fresh vegetables will give your body the fuel it needs to function optimally.

The Standard American Diet (“SAD” – a fitting acronym) is full of inflammatory processed foods and refined carbs & sugar which deplete the immune system, increase the rate of cancer, and increase the risk of developing autoimmune disease. 

Inflammation is the root cause of most diseases: but a diet rich in anti-inflammatory foods is the best gift you can give yourself to feel and function at your best!

Better Sleep

Poor sleep–whether you’re lacking hours, or your sleep quality is not that good– can increase your risk of diabetes, decrease your immune system, and accelerate aging. 

Alcohol and caffeine both impair sleep quality. Caffeine has a half-life of around 6 hours, so ideally you want to have your last cup by 2pm. Alcohol robs you of restorative REM sleep, which in addition to its dehydrating effects, lead to the next day’s dreaded hangover.

Food that positively affect sleep include veggies, grass-fed beef, chia seeds, sweet potato, wild-caught salmon, and those rich in magnesium. On the other hand, simple carbs and sugar negatively affect blood sugar and sleep–especially if consumed in the evening.

Balanced Hormones

Your body *needs* fat! Fat is required for your body to produce various hormones and keep inflammation low. Carbs, especially simple carbs, can actually increase inflammation and disrupt the delicate balance of your hormones.

If you suffer from leaky gut or other gut issues, you may be deficient in gut bacteria. Probiotics, like those from fermented foods–like sauerkraut, kimchi, and kombucha– provide your gut with beneficial bacteria which can help keep your hormones in balance.

Improved Mood

Did you know that dairy, sugar, and gluten are linked to depression? While the Mediterranean diet, rich in saturated fat, fish, and vegetables is associated with both decreased rates of depression *and* a longer lifespan!

Ready to Take Charge?

By now, you should have all the motivation you need to make a change for the healthier. Here are some resources to help you get started:

  • The JustInHealth Eating Plan
    • How to Eat, What to Eat, and the Healthy Meal Matrix
  • Nutrient Support
    • If you or your diet is deficient in certain nutrients, supplementing with high quality supplements shouldn’t be overlooked!
      • Iron Supreme: Hypothyroidism, anemia, and iron deficiency are all linked. Many women are iron-deficient, which can be remedied by eating red meat and supplementing with a high-quality iron supplement, like Iron Supreme.
      • Magnesium Supreme: Magnesium is essential for proper function of over 300 enzymatic reactions and for the performance of many vital physiological functions. A magnesium deficiency can lead to osteoporosis, blood sugar problems, poor sleep, muscle cramps, and more.
      • Multi-Nutrient Supreme: Your daily all-in-one for general nutrient support! Vitamins A, B, C, D, E and so much more!

Questions? Click here if you are ready for help learning how to take your health back into your own hands!

References:

https://www.ncbi.nlm.nih.gov/pubmed/24939238

Jun S Lai, Sarah Hiles, Alessandra Bisquera, Alexis J Hure, Mark McEvoy, John Attia; A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults, The American Journal of Clinical Nutrition, 2014;99(1):181–197

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532289/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/

 

Hypothyroidism, Low Iron and Anemia | Fatigue

Hypothyroidism, Low Iron, and Anemia

By Dr. Justin Marchegiani

Today’s video is going to be on hypothyroidism and low iron or iron-based anemia. Again, we’re going to talk about thyroid conversion; we’re going to talk about thyroid synthesis, as well as your thyroid activation.  We will also touch upon your adrenal function and how it plays into anemia.


So off the bat, iron – really important. Your animal-based heme iron source is going to be the best. There are going to be plant-based heme iron sources, but those aren’t going to have a real big effect on increasing your ferritin and raising your iron saturation

Big 3 things that may cause iron issues

  1. Vegetarian / Vegan diets
  2. Excessive menstruation
  3.  Malabsorption

Causes of Iron Issues

So when we look at why the iron is not getting into where it needs to go, these are going to be the big three why’s.

Again, iron is really important. These are the 3 mediums we got to deal with animal based-sources. In my line, we have a product called, Iron Supreme, that’s a Ferrous Bisglycinate. A lot of conventional iron, like the ferrous sulfate, can be constipating, cause your stools to go black, not the best. So we have an amino acid blend one that works good, called,  Iron Supreme.

Low iron and T4 production

There’s a process called iodination. And that’s basically binding iodine, tyrosine and thyroglobulin together in making your T4 molecule. T4 is tetraiodothyronine. So T4, really simple: it’s going to be your tyrosine, and it’s going to be 4 molecules of iodine around it – that’s going to be your T4.

Low Iron and T4-T3 Conversion

We need iron to actually make this process – the iodination process that binds these iodines to the tyrosine up there. That is going to be iron dependent. So we need enough iron for that process. Low iron and T4 to T3 conversion is also really important because iron is also part of the five deiodinase enzyme as well. And so we have selenium as part of the enzyme, but iron plays a role of coming in here. And it is actually converting this molecule T4 to T3.  How does it do that? It becomes in here like this and it’s actually going to play a role at knocking that off. Again, selenium also plays a role with that, too. So low iron and T4 to T3 conversion is very important.

Low iron and adrenal function

There’s some research showing there’s correlation with low iron (Fe) equals low cortisol.

low iron = low cortisol

Cortisol, an adrenal corticosteroid hormone produced by the adrenals. So we actually need cortisol to actually activate thyroid hormones. If you go look at the T4 to T3 conversion, one of the big things that’s needed in this conversion step is cortisol. So if we don’t have enough cortisol, that’s going to affect how we convert and activate T4 to T3. It’s also going to affect T3 pooling. We need enough cortisol to get T3 into the cell. So we can have T3 pooling and an increase in reverse T3, if we do not have enough iron – so really important.

Click here to have a functional medicine doctor help you with iron issues

What is low iron effect?

Low Iron Effect

Low iron affects T4 synthesis, iodination with tyrosine thyroglobulin and iodine. It affects T4 to T3 conversion with the iodination process and also affects cortisol in that conversion process. And also, iron is really important for thyroid hormone recycling as well –so very important.

What to look for in determining iron levels?

Determining Iron Levels1. Ferritin: A storage for iron. It will go low when iron is low. So below 30, there is an issue.

2. Iron Saturation (Iron Sat): This below 25, there is an issue.

3. Iron Serum:  It isn’t really that big of a deal. It’s typically around 40-80 on average. You can have normal iron serum, though, and have these other things out of whack, though. So it’s good to look at iron serum. Sometimes we’ll see that high and these can be low. And we’ll see increase in inflammation. So it’s good look at iron serum but it’s not going to be-all, end-all. Most people only focus on that.

4. TIBC & UIBC: Are binding proteins that go high when iron is low.

To access a highly absorbable iron supplement to boost your low iron levels, click here.

And again, these are your real good,  your more complete, advanced iron panel. Ferritin, iron stat, iron serum, TIBC, UIBC. Your typical medical doctor may look at RBC, hemoglobin, and hematocrit, and see if they’re all low. So RBC below 4.1; haemoglobin below 11.5;  hematocrit – I think, low 40’s. That will give you a pretty good idea of how to analyze your iron levels. And again, iron and anemia – iron-based anemia are deal busters. So if you don’t get your iron levels looked at and assessed, you’re not going to fix your hypothyroidism issue.

Click here and have your iron levels looked at and assessed by a functional medicine doctor


Again, this is Dr J here.  Click here and subscribe. Go below if you need help and you want to dig in, dig deeper your thyroid or other health issues, click below and schedule a consult. And again, subscribe for more videos coming your way. So, look for the live stream videos. We’re starting now on that, too.

Thyroid and Nutrient Deficiencies Q & A – Podcast #125

Dr. Justin Marchegiani and Evan Brand dive into an exciting discussion all about thyroid. Listen carefully as they engage in a dynamic conversation with the listeners and share some valuable information regarding their functional medicine approach on issues relating to thyroid; its connection to adrenal health, gut health, nutrition, and infections.

Learn about the hyper- and hypo- symptoms related to thyroid issues. Find out how other conditions like leaky gut and other infections are linked to thyroid health. Gain valuable information on different tests used to assess thyroid health and rule out other conditions contributing to thyroid issues. Increase your awareness about the different sources, like foods, supplements, and metals which all impacts thyroid function.

In this episode, we cover:

04:19   Thyroid and its connection to adrenals and leaky gut

12:50   Testing for Autoimmunity

16:42   Infections and Thyroid Health Connection

21:35   Cortisol Lab Test for Adrenal Issue

28:36   Thyroid Symptoms and Assessment

32:23   Iron

37:20   Gluten and its connection to leaky gut

54:23   Mercury

58:25   Iodine

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Dr. Justin Marchegiani: YouTube as well. Any questions, feel free to type them in. Today’s podcast will be on thyroid. Evan, can you hear me okay?

Evan Brand: I sure can. You sound good.

Dr. Justin Marchegiani: Awesome, man. We are live. What’s going on, man?

Evan Brand: Oh, not too much. Like I told you, somebody in France has had a fun weekend with my business credit card. So uh – besides that, everything is good.

Dr. Justin Marchegiani: Very cool, man. Yeah. Well, at least you got a capital one card, so you’re pretty well protected, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: That’s awesome. So we’re live on Facebook and YouTube. Again, better to be on YouTube, my opinion coz you get to see Evan and myself. If you’re watching me on Facebook right now, we’re a little compromised. We only got my feedback. You’re not gonna hear Evan’s side of it. So feel free and check out YouTube.com/justinhealth to be able to see Evan’s pretty face and be able to get some questions there. But we will answer questions on Facebook Live, too.

Evan Brand: Cool. So today we wanted to talk about thyroid. There is many lab test out there that you can get. Still, conventional doctors are not running the lab tests that are important, though, some of these antibody markers, some of the reverse T3 markers. Maybe you should briefly chat about that just since people maybe on Facebook. Talk people through why is this happening? Why are these conventional doctors not running these other important thyroid markers? Why is it just TSH and some of the other boring stuff?

Dr. Justin Marchegiani: Great question. And again, today we’re talking about thyroid and we talked about this topic a lot, done a lot of videos on it. I have a book coming out on this very shortly as well. So I’m just kinda do a brief overview. Feel free and check out Evan’s page not just Paleo.com and his podcast from more info as well as mine. We’ll give you more info here today. Hopefully we’ll be able to have a live interaction. But Evan’s question is for the Facebook live listeners. “Can we get podcast live on YouTube, too?” is the question about conventional thyroid issues versus functional thyroid issues. And this is a big difference, and most people they go and get help from their conventional physicians on matters of thyroid issues. They think that their conventional doctor is ruling them out for thyroid issues and they may, if it’s an extreme thyroid issue. You know, very, very high TSH, extreme thyroid swelling, uhm – maybe while hyper-symptoms if their grades are on the hyper side, or if they have a lot of thyroid destruction, or goiter things. They may get picked up by conventional testing, but many patients they aren’t getting picked up on conventional testing because they’re kinda in no man’s land. Conventional medicine looks at things like an on and off switch. You’re either healthy, right? The light’s on. Or you’re unhealthy, the light’s off. And we know in functional medicine world, that light switch is more of the dimmer switch, right? The light may be on halfway, right? You’re halfway healthy; or another way to look at it, you’re halfway to not being healthy. But it may not be all the way off. Maybe just flickering a little bit. And unless you’re all the way off, what’s gonna happen is they’re not gonna see anything wrong with your health issues regarding your thyroid. And they’re not gonna make any recommendations for interventions. And that’s the biggest problem. With thyroid issues, looking from the conventional to the functional medicine realm. And also, you have to look at the tools that they have right there. One tool – most part two, you’re gonna have some kinda surgical intervention or you gonna have some kind of uhm – pharmaceutical intervention. None of which typically fixes the root cause of what’s going on. Especially when we understand that thyroid issues are 90% autoimmune in nature. I’d say at least 50-90%. So we know if it’s autoimmune, and we don’t fix the underlying cause of why the autoimmunity is there, right? Then the underlying mechanism of the antibody is in the immune system attacking the thyroid tissue is still happening in the background.

Evan Brand: That’s terrible. I mean we’ve got thousands of people at this point who we work with, where they’re on thyroid drugs, and they still feel terrible. And I’ll go back and say, “Hey Doc, look, give up my Synthroid or other pharmaceutical, I still feel terrible.” And they’re just gonna up the drug more and more and more. So it’s like you’re jamming this gas pedal down, but you are not figuring out what’s the issue in the first place. And so for us, we’ll always gonna be looking at the gut; looking for infection; seeing what could be going on; why is there some type of attack going on. And then also looking at adrenals, too. And figure out what’s the adrenal thyroid connection. Maybe you could brief people on that a little bit? How someone with adrenal issues could have thyroid issues and vice versa.

Dr. Justin Marchegiani: Yeah. So Evan, your question was looking at adrenals thyroid issues, we also have a listener question as well, talking about thyroid and gluten sensitivity. I’ll try to intertwine with the two answers. But again, adrenals are really important because you have cortisol production coming from the adrenals, which is important for managing stress and inflammation. Also, generally energy via blood sugar. Also, cortisol – is they differ healthy thyroid conversion. So if we have two high cortisol, or if your stress response is too high, we’re kinda in a Stage I adrenal issue that can block thyroid conversion. So we have this T4 thyroid hormone that gets converted down to the T3. And T4 is relatively inactive compared to T3.  So we have to make this conversion. There’s a lot of things that are needed for that, whether it’s selenium, or zinc, or vitamin A, or other nutrients to help make that conversion. But cortisol, from a hormonal perspective, is also needed. So if we’re too low on our response, right? We have this HPA axis, this regulation, the brain, the agent P, the hypothalamus and pituitary are hypo functioning. They’re dysregulated like a broken thermostat in your house – doesn’t turn on the heat, or turn on the air conditioning. That same thing is needed to help make that conversion from T4 to T3. So we have depleted adrenals that can strongly, strongly be an inhibiting factor of thyroid conversion. And also, if we have too much stress, one of the mechanisms the body does to regulate the stress response, is to make more reverse T3, which is essentially like taking uhm – the clip by the – your gun and putting blanks in there. So they kinda – they fit into the – into the magazine. They fit into the cartridge, right? But they fire, but that then you don’t get the same metabolic effect. You don’t get the increase in energy; don’t get all of the hormonal benefits; you don’t have the warmness and the increased blood circulation; and you don’t have the degradation of cholesterol and other hormonal byproducts. So you can see that the adrenals are intimately connected. Now answering the person’s question here on gluten. Gluten is really important because that’s a big strong – That’s a big stimulator of leaky gut. So gluten exposure can drive leaky gut. What it does is it increases zonulin, which unzips the tight junctions in a lot of patients, even people that are necessarily having a response to gluten. It shows that there is still uh – intestinal permeability that’s happening. And the more food particles that get into the bloodstream, the more LPS is in the gut, the more that can unzip the gut, the more – allow more food particles in there, and create more immune stimulation. And it’s also inflammatory in the gut, too. And also can create this concept known as molecular mimicry, where the immune system sees the surface proteins, and it can mistakenly identified it is the thyroid, and it starts attacking the thyroid tissue, creating more inflammation. And that can cause these thyroid follicles. So still, that hormone is creating unbalanced levels.

Evan Brand: And this could all come from gluten exposure, you’re saying?

Dr. Justin Marchegiani: It can all come from gluten exposure. Gluten is one strongest stimulators of leaky gut, along with distress, along with LPS, which is a compound produced from bacterial overgrowth, right? So the worse stomach acid, the more stress we have, the more essentially we’re not breaking down our food, the more we’re gonna have bad bacterial overgrowth that’s gonna increase LPS, that’s gonna unzip those tight junctions even faster, which is gonna create more immune issues, more food allergy issues. Because think about it, right? The immune system shouldn’t be getting revved up to deal with food; shouldn’t be getting revved up to deal with the digestion. So the more that’s happening- well what that means is that your immune system is going in overdrive. One of the major reason why people are when they’re sick – think about it. Because their immune system sucks up so much energy. So the more you’re revving up your immune system by just consuming food, you’re gonna be constantly tired. And that’s just gonna drain your adrenals, and drain your thyroid, and increase that thyroid autoimmune attack.

Evan Brand: Yup. Well said. So I mean, we got the zonulin. What’s the link there between the zonulin and LPS? So are these connected at all? Or are these going up and down in relationship to each other?

Dr. Justin Marchegiani:  Yes. So the more zonulin you have, typically the more leaky gut you’re gonna have, right? So vitamin D is actually a zonulin inhibitor. So the more zonulin you have, the more leaky gut. So LPS will increase zonulin. Infections will increase zonulin. Gluten will increase zonulin. And that basically, if this is like Parker jacket, you’re wearing that’s kinda like unzipping those tight junctions and then basically food particles can get in there.LPS particles can get in there. When LPS flows to the brain and makes it way up to the brain, leaky gut, leaky brain that LPS can create inflammation in the brain which feels like brain fog, which feels like mood issues, which feels like depression, which feels like anxiety. And this is really hard for a lot of people. Getting back to Evan’s question on gluten and the brain, is people may have a gluten issue. Think that well gluten has to cause digestive problems diarrhea, bloating, gas, reflux constipation, diarrhea. But it may not – It may be causing depression, anxiety brain fog, poor memory, poor uh – just word recall. And you may have a gluten issue, but it may not be even because by – you know, you may not see it because it’s not those conventional symptoms. And again, that same thing is gonna create thyroid issues, too. Coz that same mechanism that opens up the lining of the blood-brain barrier and the brain, also affect the gut, which then creates that more autoimmune thyroid attack.

Evan Brand: Well said. And there’s a lot of people that justify eating gluten to us. Whether it’s like organic wheat, or they’re doing some type of like sprouted wheat, or something like that. But gluten is gluten, and even if you’re not celiac – now there is research that shows that celiacs are gonna have30 times higher zonulin levels than a non-celiac. So massive, massive leaky gut in the celiac person in comparison.

Dr. Justin Marchegiani: Right.

Evan Brand: But still, we could even talk about the study. It’s Scandinavian Journal of Gastroenterology. It showed that gliadin, which is a gluten protein can affect zonulin even in people without the gene for celiac.

Dr. Justin Marchegiani: Yes.

Evan Brand: And so basically they said, “All gliadin, regardless of what – whether you are celiac or not, it’s still going to activate zonulin, therefore leaky gut, therefore this LPS, these endotoxins are gonna get in there.”

Dr. Justin Marchegiani: Totally.

Evan Brand: Which is crazy. And – and I love that. I love that the science because then you and I aren’t the bad guys when we’re telling people to get rid of gluten. It’s like, “Look, here is the research.” Yeah, maybe you don’t get a – acne from gluten, but you still causing leaky gut, regardless. I love that we can actually prove that and it’s not just up for – it’s not just our opinion coz we’re the nutrition guys.
Dr. Justin Marchegiani: That’s the key thing that you mention there, Evan. The zonulin and the gluten can trigger the leaky gut and you may not necessarily have an autoimmunity, and the question is the more stressed you become, the more compromised you become, the more your toxic burden, your stress burden, the more  your – the physical, chemical, emotional stress buckets get full. That’s where your body’s ability to adapt to stress really becomes inhibited. And again, the biggest mechanism really is, leaky gut. Even if you’re not necessarily gluten sensitive, you may be getting a leaky gut, which is adding stress to that stress bucket, right? It’s decreasing stomach acid; it’s decreasing enzymes; it’s increasing the ability to have food allergens; it’s increasing transfer infections and SIBO.Because the more your immune system is weakening the gut, the more that force field, that IgA gets lower, and the more critters can come in. So, yeah, 100%. And again a lot of people – I’m not a big fan of gluten because its, one: it’s hard to break down, it’s heavily pesticide, it’s low in nutrient density. A lot of the anthropological data shows that it’s been consumed only about 10,000 years ago, and the people that are consuming it typically have lower bodies – body stature, smaller in uhm – skeletal structure and increased risk for osteoporosis. Again, hunter gatherers tend to be more forgers uhm – starchy tubers, berries. Those kind of things, and obviously, meat and bone marrow. You study how the brain evolved. Really, it was the hand axe that allowed us to carve into bones and access bone marrow, and then creates spears to kill animals, and access that nutrients to grow our brains massively. Omega-3 is fat from the fish. So all of those things were huge in evolving our brain. Now, getting back to thyroid-We got a couple questions over here from the listener’s here on YouTube. So I’m gonna list a couple of. Couple is “how do you test autoimmunity?”Number one: kinda tying it back thyroid. We would look at TPO, or Thyroid Peroxidase antibodies or anti thyroid globulin antibodies; we’ll look for immune attack on the thyroid tissue. Also, we can look at TSI, immunoglubin, which is a marker for Graves’ disease, which is also a thyroid condition; or TSH receptor antibodies for the hyper- TSH receptor antibodies for the hyper; TSI for the hyper; and then TPO and thyroglobulin antibodies for the hypo. Now again, you can have the hypo antibodies, though, and have hyper symptoms initially. So you can kinda be on both stages at one point. So just kinda keep that in mind.

Evan Brand: And then more time, just so people are clear to that. Seems a bit confusing.

Dr. Justin Marchegiani: A lot of people that start out with hyperthyroid – or sorry – hypothyroid antibodies, low thyroid function antibodies, the TPO and thyroglobulin bodies, even though those are markers for a hypo-, Hashimoto’s, they can progress into hyper- symptoms initially because your thyroid follicle have about four months of thyroid hormone stored in it. So what that means is, you can spill out that thyroid hormone many, many months before, even up to a year or so, before you actually get depleted and go low. And that’s where the TSH gets really high. TSH will go high as the thyroid gets depleted, but in the initial attacks, in the first year or so, you may feel more hyper- symptoms even though it is a hypo– Hashimoto thyroid mechanism that’s happening.

Evan Brand: Uh, got it.  Well said. Okay. So, people may self-diagnose themselves with hyperthyroidism, your saying that it could actually be a hypo-caused by Hashimoto situation that’s going on. They just don’t feel the full effects yet coz it’s a new – it’s a new attack. Is that correct?

Dr. Justin Marchegiani: Totally. So the symptoms they may have is irritability, anxiety, mood issues, difficulty sleeping, heart palpitations, uhm – they may have like tired but wired kinda feeling. Those are the big things that they’re gonna have. I would say, yeah, the anxiety is gonna be a big one. Difficulty sleeping is gonna be a big one. Where the hypo- symptoms star to come in, again you may still have anxiety; you may still depression. The big differences is you’re gonna start to see the hair thinning because thyroid hormones are needed for hair follicle growth. So the outer thirds of the eyebrows go; the hair starts to thin on top; cold hands and cold feet it starts to happen. You may start to see constipation issue, too. You may start to see your triglycerides and your cholesterol go up. Again, infections can cause constipation, too. Uh – increase insulin can also cause increase cholesterol and triglyceride, too. So there’s other things. But that’s a general indication, is the cold hands, cold feet, the fatigue, the hair loss, the constipation and the increase in lipids you’re gonna see. That’s why you wanna test full thyroid panel, which is gonna consist of TSH, brain hormone, T4,inactive thyroid hormone (free and total), T3, which is converted peripherally 20%, and 80% throughout the body (free and total) and obviously you T3 uptake. You can look at thyroid binding globulin, which can go up or down if you have PCOS or on birth control. And then also reverse T3 and all the antibodies I mentioned.

Evan Brand: Yes. So I’ve also16:19read about another one that I’ve not seen used very much called TRAB, thyroid stimulating hormone receptor antibody, but it says that the antibodies are only ordered when someone is hyper- . And a positive result for that usually means great. So I’m not seeing that one that often, though.

Dr. Justin Marchegiani: It’s just a different name for I think the TSH receptor antibodies. Like TPO also has a like a name called,microsomal antibodies. So again, typically it’s the same names. So TSH receptor antibodies that’s probably another name for that, just like the microsomal is the same name for TPO.

Evan Brand: Uhh. Okay, got it. Now should we talk about – Is this is the time we should talk about the link between infections and thyroid health? Because people that were looking at, we’re not just gonna look at thyroid, we’re gonna look at the gut, too. And the average between us is about 1 in 3 of having infections. You know, every third person is gonna show up with infection. Sometimes even – you know those weak. Sometimes it’s 9 out of every 10 people has a parasite or other infection.

Dr. Justin Marchegiani: Totally. So we have a few questions coming on the uhm – YouTube Live board here that we’ll kinda tie in. But yes, so the big infections that can affect thyroid and can increase that thyroid autoimmunity: H. Pylori, okay, Yersinia, Enterocolitica, blasto, E. histo. Those are gonna be the big ones that are really gonna affect the thyroid. Even Lyme has a specific amino acid pattern that can create autoimmunity to the thyroid. So for sure, those are the big ones. You know, there’s been study showing that when you eradicate H. Pylori – It’s Italian study out there, that thyroid antibodies significantly drop. I have a video on blasto, right? Blasto infections are resolved, antibodies drop. Same with Yersinia, infections drop. As you attack Lyme, antibodies drop. So that can be a big stimulator and drive more leaky gut, more zonulin, more immune stress, which then creates more stomach acid and enzyme environments, which creates more adrenal stress, more thyroid stressed, and more nutrient deficiencies which perpetuate everything. So you can see, if don’t get to the root cause in this, that’s fine. You can go see your conventional medical doctor to make sure your TSH isn’t elevated, right? But in the end, you’re still gonna be suffering. And that’s why I have so many patients then I know you do as well that have all these symptoms. And I’ve seen a doctor for over a decade and are just tired of it. Alright, you know, this can’t just be my thyroid and all that we done is on 50 mics or 100 mics of Synthroid and that’s it. We can’t do anything else. They know there’s something more and that’s why they are reaching for people like you and myself, Evan.

Evan Brand: Yeah. Well in toolbox, it’s just not there, right. I mean, it’s not their fault. They’re just doing all that they’ve got. That’s the only tool in the – in the shed. The surgery or wait till you have some type of disease, or some big nodule, or a goiter or something crazy. And now, okay, now we have to do surgery.

Dr. Justin Marchegiani: Yeah. And a lot of people are talking about, “Well, what if you don’t have antibodies coming back on your thyroid?” My personal take on that is, above 40% comeback false negative. So it’s negative, but it could be positive. So what does that mean? Well, typically I’ll run the antibodies on someone at least three or four times before I say that they probably don’t have – they probably don’t have an autoimmune issue – at least 3 or 4 times. Now, the gold standard is a biopsy. Still going with a needle aspiration, and they poke it into the thyroid, they’ll if the tissues have any lymphocyte infiltration. So there’s an immune response going into the thyroid. So you can also have – you know your conventional physician palpate it. They’ll typically reach around your neck. So here’s my Adam’s apple, so it’s down just maybe a centimeter, and then out 1 or 2 cm. So it’s right here. And then you can typically run your finger right across it, then you can touch and push from one side to the other, and just feel the surface. See if it’s smooth, and then you can swallow, and feel that structure. And you can feel like a little nodule or a little bump and that’s possible. A nodule can typically mean autoimmunity or can mean an iodine deficiency. You can go to your conventional physician for that. I talked about the needle aspir –aspiration, but I don’t recommend unless you have – must you really want to know a hundred percent. The next more conservative approach would be a thyroid ultrasound to see if there is any swelling at all. Yeah. And that will be – those will be – My first line of defense would be, “Alright, let’s do your antibodies.” Second line would be ultrasound. I typically wouldn’t recommend the needle biopsy unless you are more worried about the cancer side of it, right? If I’m more worried about cancer then we may do that, or we may do a thyroid scan. But again, those are more invasive. I really only want to see those if we’re trying to rule out cancer. Coz typically the ultrasound and the antibodies will be the best. And we know, uncontrolled Hashimoto’s can lead to cancer, right? It increases your risk of cancer. So everything we’re doing is actually decreasing someone’s thyroid from progressing to a mandibular, papillary, follicular cancer. That’s – that’s the goal. So regarding that piece, everything we’re doing is gonna work either way because we’re mitigating the gluten in the food; or reducing the infection load; or upping the nutrients to help lower antibodies and help the thyroid convert; or making all diet and lifestyle changes and getting rid of the infection, which are gonna help improve the thyroid conversion, activation, and  the upstream signaling downstream.

Evan Brand: Early on in the chat, someone asked, “How should one read the cortisol lab test for adrenal fatigue?” “What numbers indicate the issue?” That’s gonna depend on the lab. Justin and I really like Biohealth, especially because they’ve got a brand-new test that were using now, which is six-point cortisol test. So any practitioners that are using a four-point cortisol test on you-

Dr. Justin Marchegiani: Uh-hmm. Yup.

Evan Brand: They’re outdated. They need to get with the –the times. With the 2017, six point is the new one. And how can you read the numbers? Well, typically there’s gonna be like a high patient line, a low patient line and then you would wannabe right in between those sandwich. And it’s gonna depend. So other labs are gonna have different – you know, different markers, different reference ranges. So for us to read a reference ranges to you, will be really boring. Uh – but basically long story short, you wanna be perfectly sandwiched in between those two lines. And it’s very rare that we see somebody in that. Most of the time we’re gonna see a low cortisol picture. And this is a low-free cortisol.

Dr. Justin Marchegiani: Yeah. Exactly.

Evan Brand: They’re gonna be low pretty much all day. And this is for most people. And so, then we have to keep digging deeper.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand: We don’t just throw them a bunch of adrenal support and say, “goodluck” We gotta figure out what – why is this happening?  Is there a lot of emotional stresses, or chemical stresses, or thyroid issues, or parasites? And these are the other pieces of the puzzle.

Dr. Justin Marchegiani: Exactly. So you made some really good points there. So with the adrenal, the car test, the adrenal, the uhm – the cortisol-adrenal response, especially in the morning. Cortisol starts off low in that first initial bit of waking up, and really pops up in the first half-hour to one hour after waking. So Evan and I are looking more at those types of test to see how that cortisol awakening response is happening in the morning. Coz cortisol is so important for thyroid activation to prevent T3 pooling, which is T3 not getting into the cells, as well as to prevent reverse T3 up-regulation, right? Reverse T3 is the uh – the blanks. The blank bullets that fit into the magazine that prevent the real bullets from getting fired. The real thyroid hormone being the real bullets, upregulating your metabolism. So those are the things that we’re looking at. And I agree, cortisol, and low cortisol, and low thyroid can intimately feel the same, right? We have patients sometimes that will feel like, “hmm, do they have a thyroid issue or adrenal issue?” We’ll run both test and we’ll see their TSH is, let’s say: 1, 1.5; T3 is at 3, 3.2; and their conversion is okay. But we’ll see, “Oh, yeah” their cortisol awakening response is terrible. Their cortisol is low; their DHEA is depleted. If they’re female patient, their hormones are off, right? So we’ll see. We’ll be able to  differentiate the two. And if you’re just going based of a symptoms, and trying to self-treat yourself, it’s gonna be really hard. You start going in one direction over the other. You may not get better. And a lot of patients, they instantaneously wanna go get their thyroid supported and treated first. The problem with that is, you increase thyroid hormone levels, and you already have lower cortisol. You can actually lower your cortisol even more, right? Just go google uhm – Addison’s disease, which is cortisol failure, right? – Addison’s disease, contraindications – And one of the contraindications you’ll see on their thyroid hormone because thyroid hormone can actually lower cortisol more. Coz think about it, right? Thyroid increases metabolism. The more your metabolism is increased, the more you metabolize through your hormones as well. So if we lower our hormones, and you are already at super low cortisol to begin with, you can actually feel worse as well. A lot of people feel worse when they just go after their thyroid and it can really create more problems.

Evan Brand: Wow. Now that you say that, I’m picturing a woman last week who, she was on Levothyroxine for a very long time. Her cortisol levels were like the lowest I’ve ever seen. So I wonder if it’s that drug that’s contributed to her cortisol being even lower than it would have been without the drug. What do you think?

Dr. Justin Marchegiani: Yeah. Absolutely. Absolutely. You can see patients that they go on their thyroid support, and they start feeling worse. And it’s just – it’s really difficult because if they’re seeing a functional medicine practitioner, they may lose faith in that person, right? And – and just say, “Hey, I’m just gonna keep on doing what I’m doing. I’m just gonna go back on the Synthroid.” So you have that aspect there, right? And then uhm – also have the fact that you know, what’s primary? A lot of people have in – the adrenal issue is the more primary issue. And if we start treating that first, then we may get the patient feeling better, which then creates more compliance. The more compliance, the more – the more the patient’s gonna follow through on diet, on lifestyle, on addressing infections. And that gives us a better chance to leverage the patients to do the right thing to heal.

Evan Brand: Well said. And plus, if the adrenals get back online, then we know that that conversion from T4 to T3 active is gonna be better. So they may not even need to go to the “thyroid support” if all these other root causes were the biggest thing. I mean it’s a parasite and an adrenal problem. If you fix those two things, is it possible you can get away with never going into, “Hey this is your thyroid program now. We just have to fix the other pieces.”

Dr. Justin Marchegiani: Yeah. Absolutely. So uhm – looking at that piece, you’re hundred percent right. I see so many patients, we’ll measure their thyroid temperature like their basal temperature. And again, for basal temps: 97.8 to 98.2 °F is gonna be where you wanna be for your armpit axillary temperature; and then98.2 to 98.6 °F is oral temperature. And typically do that in the morning before you get out of bed. And also do it sometime in the afternoon before you have lunch, and kinda do a general average. And again, a lot of people will be relatively low, and they’ll start to see their temperatures start going up uhm – as we treat the adrenals. One of the big things we see with the adrenals is we see an erratic temperature. The temperature is kinda bouncing around. Anything greater than .3°F can be – can lead to be a sign of a potential adrenal issue via a temp.

Evan Brand: Let me ask this. Let me ask this with you. So you’re saying, .3 difference. So that would mean if you woke up one day and you tested your armpit temperature, let’s say you were 98° flat in your armpit before you got out of bed, then the next day, you’re at 98.3. To you, that’s gonna signify thyroid and adrenal issues. Is that right?

Dr. Justin Marchegiani: So we went from 98 to 98.3?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. So it’d be greater than .3 So if you’re 98-98.4 and we’re consistently seeing this back-and-forth oscillation, so we’re seeing 98, 98.4 or 97.9 and it’s constantly bouncing back and forth greater than .3 that could potentially mean an adrenal issue, right? And because it’s erratic, but at a good level of temperature 97.8 or higher. So we typically mean of an adrenal issue. If we see it low and erratic, let’s say, 97, 97.4, 96.9 to 97.5, then that would potentially be an adrenal and a thyroid issue. And again, temperatures aren’t perfect, right? Like when we assess thyroid, there’s three indicators we use. We use subjective, which in my opinion is the most important. How do you feel? Do you have a lot more hyper- or hypo- symptoms, right? Hyper- symptoms being anxiety, palpitations, mood issues, tired but wired.

Evan Brand: What about sweating? Increased sweating?

Dr. Justin Marchegiani: – sweating, irritability, difficult sleeping. Where the hypo- symptoms, again, you can still have the mood stuff; you can still have the anxiety and mood stuff; you can still have some tired and wired – some tired and wired

feeling but typically more tired, though. And then the big thing is the cold hands, the cold feet, the thinning hair, the thinning eyebrows, the constipation. Those are gonna be the big differences. And obviously what trumps any of it, is an increase in TSH or thyroid antibodies are gonna be the biggest distinguishing factor, if it’s TPO or TSH receptor antibodies.

Evan Brand: And I just wanna mention one thing, too. In a lot of cases, the people we’re working with are gonna have both hypo- and hyperthyroid symptoms which can be equally confusing.

Dr. Justin Marchegiani: Totally. Yup. Equally confusing. I mean we look at like the test that we give our patients to assess that uhm – right? The other big one’s losing weight. Losing weight uhm – even though you’re – or unintentionally gaining weight if you’re on the hypo- side or unintentionally losing weight if you’re hyper- side, right? That’s gonna be another, another big one. Elevated cholesterol – another, another big one. So those are a couple of the other ones that I mention there where the anxiety, the excessively sweating, uhm – again, hands shaking, difficulty sleeping, uhm – feeling more warm on the hyper- side. Those are gonna be the other big ones. And obviously having a family history. If your mom, or your aunt, or uncle, or your sibling has a thyroid issue, right? That’s gonna be a big – just, you know, big factor. One of the big questions I do in all my intakes is, are there celiac disease or any autoimmunity that runs in your family? Whether it’s thyroid, or Parkinson’s or MS, or ulcerative colitis, or Chron’s or anything autoimmune related, type I diabetes. And if there is, that really gets me to hone in there. But testing for autoimmunity, conventional medicine typically does it like ANA, or HLA-B27, or an RA Latex like – these are like the conventional, like broad markers for like scleroderma, or like – or celiac, right? Or see, rheumatoid arthritis, or lupus. They’re very non-specific a lot of times. And again uhm – and they typically are late stage markers. It takes a while for them to pop-up.  And again, a lot of people they may be asymptomatic and still have them. So it’s not a real motivating factor for a lot of people. Where some of the things we look at it with the thyroid antibodies, well even just a little bit above like the normal range. So like LabCorp, it’s 33 or 36 for the TPO. Where I think the thyro – the thyroglobulin antibody is anything greater than 1 is positive. So if we’re like at 1.5 or 2, you know – we will look at that and we’re gonna really push for autoimmune changes and autoimmune protocols. We see TPO going above 20, we’ll start to say, “Hey, you know, you wanna be careful with this.” And we’ll keep an eye on that. And then we have the – you know, people are on the thousands on the antibody levels. And we’ve made this change and I’ve seen 70, 80% drops. We take a patient from 2300 down to like 3 to 400, which is a massive drop.

Evan Brand: And so that’s diet, that’s lifestyle, removing infections, supporting adrenals. All those pieces, right?

Dr. Justin Marchegiani: Yeah. Absolutely. And I got a question here on FacebookLive. I’ll try to connect it in here. And again, I apologize for Facebook Live listeners here. If you’re watching us there, check out the YouTube so you can actually see Evan. I’m gonna try to reiterate the questions so that you can hear it. Uhm – but that will be the best way to get the full conversation. Regarding uhm – question on Facebook Live, he’s talking about iron. Now, iron is really important coz it’s a really important building block for thyroid hormone. And we also need triiron for thyroid activation from T4 and T3, and we need it for just generally carrying oxygen to ourselves, which is really important for cellular metabolism. So if we have low iron levels that could be an issue. Now I did a full video this for people to get back to the iron video to get like the specifics on that. But again, typically we’ll recommend, like in my line, we use an Iron Supreme. It’s a Ferrous Bisglycinate. And we’ll do about 25 milligrams of iron, anywhere between 2 to 4 times a day to help support that. But also, we’ll figure out the root cause. Coz a lot of females, it’s excessive menstruation or hemorrhage. It could be vegetarian and vegan diets, or it could be the x factor of malabsorption from gut inflammation, to low stomach acid and enzymes and not being able to ionize minerals to an infection that’s stealing your minerals.

Evan Brand: Yeah. I’m so glad you brought that up because here I am thinking about myself, and the whole time, I had two parasite infections.

Dr. Justin Marchegiani: Totally.

Evan Brand: I guarantee I have low stomach acid. I guarantee I had issues with iron absorption. And people, let’s say, even if you’re eating the best organic grass-fed beef, if you got an infection that is causing stress on the gut, therefore reducing stomach acid; therefore reducing the ability for you to cleave off those amino acids and iron from them – from the meat, you can still have trouble. And what about – what about ferritin, too? Because the iron storage protein, that’s what we’re gonna test. For many times, you’re gonna see, especially women have very, very low ferritin levels where – and you’ve got a woman with ferritin levels you know – in between say 20 and 40. You may be experiencing something like breathlessness, for example. You could definitely have hair loss falling out. Sometimes I’ll hear women say when their ferritin is about 20, let’s say their hair is falling out in clumps. So you wanna get ferritin, which is the iron storage protein. You gotta get that levels tested, too. And we like people to get up, you know, 60, 70, 80 with ferritin just to ensure that – that iron storage protein is actually working. Now – and this is something that I haven’t looked at very often, but I’m curious if you know Justin, if you’ve got low ferritin, are you always going to have low iron as well? Or is it possible that with low ferritin, your iron could still check out okay?

Dr. Justin Marchegiani: So with lower ferritin, iron serum can pop up, and it can pop up because – imagine like ferritin is like the gasoline that’s in the gas tank, right? And then think of like iron serum is like the iron is actually in the carbonator and then the piston’s ready to be – ready to be combusted, right? So one’s like – iron is like, what’s ready to go that’s in the actual engine and carbonator; and ferritin is like, what’s in the gas tank, right? So obviously the more important one is gonna be what’s in the gas tank coz that gives you the bigger picture, right? You don’t care, you know how much – how much engines – how much fuel’s in the carbonator. It will only take you maybe a couple of hundred meters, maybe a mile. I don’t know, I’m not a big car guy, so – But keep that in the back of your mind. Now the difference is your body has a little bit more of an interplay with other systems. So inflammation can increase iron serum. So that’s why we look at ferritin, but then we’ll also look at it with iron saturation, too. We see iron saturation low, below 25, when we see TIBC or UIBC on the higher side, that means your binding proteins are growing more and more fingers –  to have more iron. And if we see iron serum up, then we’ll be like, “hmm, maybe there’s some inflammation” We may wanna look at C-reactive protein, right? We may want to look at some of those inflammatory markers. Uhm – if we’re running a gut test, you may look at lactoferrin or calprotectin and see it – inflammation is occurring in the gut. So it really depends on what else is happening in the body. Does that make sense?

Evan Brand: Yeah. It does – it does. So, if you had to pick one or the other. Let’s say, somebody only gave you the option to run some of the specific iron markers or ferritin, what would you pick? For me, I think – I feel like I’ pick ferritin, if I could only pick one.

Dr. Justin Marchegiani: Yeah. I mean, ferritin for sure. But an iron panel is like 30 bucks. There’s no reason –there’s no reason why anyone should nickel-and-dime on that because you don’t wanna compromise $30 getting a complete picture. So I think we run it. We keep doing it for 30 bucks and that’s everything.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And that gives you the ferritin, the iron serum, and that gives you the UIBC, the TIBC, the iron stat. So then you have a real complete picture of what’s happening. And then you know, even just looking at someone’s CBC can be helpful coz you can look at red blood cells, hemoglobin, hematocrit and if that’s starting to go low, then we can look at MCH, MCB, MCHC, which is basically markers to see how big your red blood cells are, right? Smaller red blood cells typically mean iron issues; bigger red blood cells typically mean B12, folate and B6 issues.

Evan Brand: Wow. There’s another question. Actually there’s a comment up here by Tonya. She was talking about how she was able to eat gluten and dairy now after she had infections. And I guess she treated those, and now she’s able to eat gluten and dairy. I feel like that depends on the person. Me, personally even if I could get away with it, I still wouldn’t do it because you’re still gonna increase zonulin and leaky gut. Potentially set yourself up for future infections.

Dr. Justin Marchegiani:  Yeah. That’s the problem, right? Disaster doesn’t occur in –a day or a week, right? And we know that leaky gut can still happen even without the symptoms, right? We – there’s just been studies where they’ve given people pieces of gluten and they measured symptoms, they didn’t see necessarily an increase in symptoms or negative side-effects. But they saw this increase in zonulin and leaky gut because of it. Now we know that when that happens, you increase your risk of having other issues. So I know there are people right now, we get the same conversation. We’ll be talking to people that have been able to smoke cigarettes and not get lung cancer. Okay, great. Now, does that mean that you’re gonna go out and recommend smoking cigarettes to anyone? No. It’s still not gonna be beneficial. It’s still gonna be inflammatory. It still increases your risk. You don’t know who the people are that are gonna have the negative effects to begin with, right? It’s all like you have that looking glass that you can see in know. And also uh – you don’t know down the road when stress comes on and other things happen. Coz usually it’s not just one thing. It’s like, “great, now this person who’s talking – their stress bucket, they’re already filling it halfway.” So they’re going into with a half-full of stress bucket thinking that they’re okay, right? Alright. So, I got a half full of stress bucket. So now when other things come into their life, they’re gonna overflow faster.

Evan Brand: Agreed.

Dr. Justin Marchegiani: And then also – and also other people, that may overfill their stress bucket right away. And so that’s why you have to make sure that you know that some people may be the exception to the rule. They aren’t the rule. And this is where it’s –We have the advantage, Evan, because we see so many thousands of people that we can make correlations and can actually even see causation because we make changes and we see direct changes in the person’s physiology and their symptoms are getting better. So we can’t make – we can’t create all these protocols for the exception to the rule coz there are so many exceptions. There are people that smoke and don’t get cancer, alright? We know that. People that may consume gluten and may be okay, but the majority may have issues. Or they may set themselves up in increased stress bucket, right? Meaning increase their ability to handle less stress, so that when more stress comes on, boom, now they’re laid up.

Evan Brand: Exactly. Yeah. Tonya we had to put you on the chopping block there because for you commenting about saying gluten and dairy and you can get away with it now. You’re speaking for thousands of people that listen and do the same thing. And Justin and I will look at the symptoms of someone, and if there are still health complaints that haven’t been resolved, then let’s say we get the retest on GI-MAP stool test, and we look at antigliadin and antibodies, and I caught the lie detector test. I don’t know if you do, Justin. But it’s uh – when you get the antigliadin antibodies, it’s like, okay, one of three things happen. Either you’ve got gluten, you ate gluten, or you’ve got cross reactivity going on. And so, even if your symptoms are not supposedly there, your body is still fighting internally. There is still this internal battle going on, which is not what we want because then those antibodies can get confused and start attacking other tissues, which we don’t want.

Dr. Justin Marchegiani: Yeah. And it’s tough because there are people that we see eat a diet that is you know – highly processed with a lot of carbs. And their blood sugar is relatively okay. And that maybe because they’re naturally more insulin sensitive, or they exercise more. And we see some people that eat the same diet, and they’re diabetic. So what do you do? Like I can’t sit there, and say, “well this person who eats this way isn’t diabetic” that means that diets is fine. No, it’s not. You have to look at the greater picture. You also have to look at what – does that diet now, is it nutrient dense? Is it anti-inflammatory? Is it low in toxins? And no, it’s not. But again, don’t get me wrong. Like dairies are open-ended topic, right? Ghee may be perfectly great. Butter maybe perfectly great.  Raw milk may be perfectly great for some people. But then we go to the pasteurized dairy, we go into more of the yogurts, which could be great, but it may not be. So do – we have to kind of uhm – can have a criteria for all those different compounds, right? Because some dairy may be okay, some may not be okay. And sometimes bread, too. Some people may do okay with bread over in Europe. Or they’ll do fine with sourdough bread coz it’s fermented and has less gluten in it versus, let’s say, wheat bread here that’s conventional. So you got to look at it, too. Some of those things may be okay and may have to be more specifically talked about.

Evan Brand: Yup. She commented back. She says, we’re missing the point. If parasite is the cause, you can go back to the way you were, prior to eating – oh the way you were prior, like eating gluten. We as people, ate gluten for a millennia and now it is the cause of all ills. I’ll comment on it first, and then I’ll let you say something about it. In the modern world, we have a lot more toxins. We have a lot more things that we’re up against, and so gluten, where maybe only would have change someone’s health 2 or 3% 5000 years ago, now,  has the ability to modify someone, tell 50 or 75, or even80% in some cases. We’ll see 80% of symptoms get better without it. So for me, comparing millennia to the modern world, we’ve never had a world like today. So it’s just not really a valid argument.

Dr. Justin Marchegiani: Yeah. And the grains aren’t even like– If you look at the biblical grains, they talked about in the diet, and Dr. William Davies totally debunks this. If you look at the grains 2,000 years ago, reference in the bible, these are 12 chromosome uh – grain products versus the ones that they have right now, they’re hybridized and genetically modified, they’re up to 50 chromosomes. The gluten content is much higher and is also the extra stress of potential GMO nutrients, poor soils, as well as pesticide exposure. So it’s not quite the same way. Plus, people have to look at it from this perspective, if you drive around on your car, and you get a flat tire on your car, right? And you change the tire and you put the little – let’s forget that. Let’s just say you’re driving around on that flat tire for like a year, okay? So the flat tire is the cause of what’s happening here. But you drive around the flat tire for a year. That’s like ignoring the stressors of your health. It could be gluten. It could be parasite. But the longer you drive around on the flat tire, the more you front angles out of alignment; the more your suspension goes out of whack; the more your whole shock system in the car becomes stressed. And even if you decide, let’s say a year later, I’m gonna change that tire and put on a nice, fresh tire, which is like cutting out the gluten, managing stress, managing sleep, your car has been compromised where just changing the tire won’t fix it. You’re gonna have to go in for a full frontal alignment. You may have to get your tires rotated; you may need new shocks; your brake pads may have worn unevenly. There’s so many other issues that may happen with the car that where collateral damage from that flat tire being ignored. So just because you, let’s say, it was a parasite issue, and the parasites are now gone; or it’s a gluten issue, and the gluten’s now gone, doesn’t mean you now have nutritional deficiencies; doesn’t mean your enzymes and HCL are now effective; doesn’t mean your thyroid and your adrenals hormone system are now stressed; doesn’t mean your detoxification systems are now stressed, right? So this is what is happening. And other analogy is you’re in debt for 5 years. Great. You stop – you curtail your spending habits but you don’t get out of the hut – but you don’t get 100 grand out of debt by just changing your spending habits today. You need a bailout, or you need a lot more time just to start saving and get that money back up. Does that make sense, Evan?

Evan Brand: Yeah. Or the analogy of the spider web.

Dr. Justin Marchegiani: Yes.

Evan Brand: Where there’s other pit of the web that’s affected, too. So for example, we can use me as an example. You look at me when uh – first time I came to your house. You’re like, “Evan, man, you look like you get a parasite.” You just- you just saw it. And I was like, “okay” It’s been a year plus since I’ve eradicated those infections, but I still am using enzymes and HCL because I was in such hypochloridic state that I still need to use supplemental HCL and supplemental enzymes. And I don’t really have an end date in mind where I’m not going to use enzymes because if I’m busy, or If I feel like I’m just not chewing my food as much as I should, to me, I like that nutritional insurance policy in place.

Uhm – there’s another question too that Chris asked earlier. He said, “not to be the dead horse, but isn’t there another marker to show autoimmunity of failsafe?” I guess since he’s asking because a lot of times –

Dr. Justin Marchegiani: I already answered that one with the ANA and the conventional ones.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: And then the TPO. And also the gliadin antibodies be the stool testing we do. And then there’s uh – a test by Cyrex Lab that looks at leaky gut, which could give you a predisposing marker, where it looks at zonulin and occludin toxins which can open up the tight junctions. So that one will be another one when I look at.

Evan Brand: It’s pricey. Have you run that one often? The Cyrex, I mean, it’s like 600 bucks.

Dr. Justin Marchegiani: Yeah. I’m not a big fan of that because it doesn’t tell me any of the cause. So if people have infections and their diet is not good, and they have – we’re seeing a low stomach acid and low enzyme environments, it’s not worth it. We just kinda work on treating the cause and then a lot of times, the clinical picture changes. Peoples bloating in gas and all these symptoms improved, which we know that means their digestion is getting better, their absorbing more nutrients. That means there has to be a leaky gut mechanism happening. I’m a bigger fan of looking at causal test versus the effect test. The effect tests are only good if you’re trying to convince someone or that people are skeptical. But once – people that are coming to see us are very intelligent because they’ve already educated themselves. They listen a lot to podcast. They read lots of blogs. They watch a lot of videos. They already get it. They don’t need to be convinced. They just wanna be fixed. So it’s a different mindset with those people.

Evan Brand: Agreed. Well said. And we don’t have people that need to be convinced they have leaky gut. Most of the time, they’ve already self-diagnosed themselves. In many cases, you don’t need to spend – I’d say99.9% of the cases, you don’t need to spend the money on a blood test that’s gonna say you have leaky gut. We could just list off symptoms – boom boom boom. Yeah, you probably got leaky gut. Cyrex, for their food sensitivity test, that is – that is cool one, but even then I feel like it’s a unnecessary in most cases because if you and I are gonna put somebody on like a AIP approach, let’s say thyroid disease did show up, some Hashimoto’s. We’ll have to go AIP and maybe we could try to reintroduce things. But they’re gonna be able to be a better barometer of Austin than the test in most cases. Like, “Oh when I added dark chocolate back in” or “when I added dairy back in” and this is what happen. I feel like that’s more valuable than a blood test.

Dr. Justin Marchegiani: Totally.

Evan Brand: Totally.

Dr. Justin Marchegiani: We’ll do a full autoimmune elimination protocols and it’s gonna be very valuable for 90% of people. We’ll go an autoimmune diet, cutting out nuts, seeds, nightshade, eggs, obviously grains, legumes, dairy. And again, for people that are like the gluten fans that are on the message board here, they still aren’t nutrient dense food. If you look at the nutrients, if you look at the other compounds that aren’t gluten-related, right? Let’s look at the fact that some people are intolerant. They just can’t break it down because they’re missing the enzymes to do that. And that any time the food is not broken down, it can create stress in the body just like people that can’t break down lactose. They’re lactose intolerant and then they have diarrhea and bloating. So, some people just may be intolerant to breaking down the protein. Some people may be increasing inflammation because of the lectins and the phytic acid and then the oxalates that are just shutting mineral absorption. Other people may be having the autoimmune issue. So it’s still not a nutrient dense anti-inflammatory low toxin food. It’s not like there’s this missing nutrient that you can get out of gluten or out of these grains that you can’t get in some really awesome nutrient rich vegetables or healthy fruits with –or healthy starchy tubers. Does that make sense?

Evan Brand: Yeah. It does. Now – this is off-topic. But –

Dr. Justin Marchegiani: It’s not a missing link. That’s my thing. If people had to say that – we – could show me a nutrient density chart and say, “But Dr. J, you get these nutrients, or the zinc and this is amazing or this, B vitamins”. I’d say, “Okay, but there’s not that evidence that it’s there.

Evan Brand: Right.

Dr. Justin Marchegiani: Now a great – a great talk on this uhm – what’s his name, out of Harvard there – Matt Lalonde did a great talk at the Ancestral Health Symposium at 2012 on nutrient density. I highly recommend anyone watching that. But when you look at the nutrient density that you’re gonna get in meats, especially organ meats, it’s insane. It just destroys grains. And grains are the lowest out of all those foods.

Evan Brand:  Yeah. Now, we’re – we’re off-topic from the thyroid, but that’s fine because I love that’s it’s a dynamic conversation.

Dr. Justin Marchegiani: It connects in, right? Because-

Evan Brand: It does.

Dr. Justin Marchegiani: -nutrients help in thyroid conversion, they help with thyroid activation, they help with the adrenal, which helps the thyroid cells. Even though we’re off-topic, we’re gonna do our best to kind of meander our way back to the thyroid.

Evan Brand: Yeah. Now, what I was gonna say was a bit off- topic, which is – well all you’re saying is totally on topic but what I’m gonna say is it’s funny how even some of these professional healthcare companies are now designing supplements, which I’m not gonna even give them the credit of naming these products. But there are gluten supplements out there, where it’s like, “here, go eat gluten, but then here is this enzyme or here’s this XYZ supplement to where you can still try to eat gluten, but you just take these pills with them instead.” It’s like, that’s ridiculous. That’s like covering up the engine light in your car. The light’s still there, but here’s this magic tape that’s gonna hide it. I just don’t think supplements that enable you to eat gluten is a good idea.

Dr. Justin Marchegiani: Now, here’s the deal, right? If you have thyroid antibodies, if you know – if you have objective measures of autoimmune issues, or your heightenly celiac sensitive, another word is – almost like – almost like if you have gluten, like you’re laid up, like you’re just – you’re junk for days on it, I don’t ever recommend cheating with gluten. If you can manage, if you’re really healthy, and you don’t have severe thyroid or antibody markers popping up, then you could try going gluten-free you know, right? It maybe rice, or corn may be okay. If you do that, I typically recommend the enzymes, like the DPP-4 enzymes and we’ll take it with charcoal. But it’s a cheat, and we’re just trying to mitigate it. And we wouldn’t wanna ever do that as a staple to allow ourselves to eat gluten. Now, like myself, like maybe once year, like if I’m in Boston and I’m in the north end, I may have like a cannoli, but I found an alternative uh –modern bakery and get some gluten-free ones that are white flour-based. But if I go, I mean I’ll up the DPP-4 enzymes, increase the charcoal, and the vitamin C in the knack. And that will help me deal with it. Uhm – but again, that’s like – if you look at it, the 2000 meals I have a year, you know – maybe one or two have that in there, right? Not a lot. We’re talking .001% But people who are really, really sensitive or having gut over their health issues, initially you really wanna be puritanical. And then – I’ll kinda dovetail this with Johnny’s question here. Some of the testing that I will do to fine tune, if like patients are on the autoimmune, they kinda reintroduce things back in and they’re still having issues, and not quite sure what works, there will be some testing we’ll do like an MRT is a pretty good test. I’m liking the ELISA / ACT test as well coz it’s not just antibodies, it’s looking at various lymphocytes, too. And I do a combination of the ELISA and I’m – I’m kinda testing the MRT as well. And I’ll actually be doing some blind testing and sending some uh – different vials in with different people with actually my blood on with different names. I’m doing some blind testing on that. So hopefully I’ll do a video on that.

Evan Brand: You ought to try the, if you have it already, I believe it’s the Array 2. And there’s a couple of other Arrays form Cyrex, too. I’m a bigger fan of that than the MRT.

Dr. Justin Marchegiani: Well the problem with Cyrex, though, it’s only looking at Ig or IgA – that’s the issue. So with the ELISA, it’s also looking at T-cell lymphocyte response and you’re not gonna get that picked up on Cyrex. That’s the big issue. And if you’re not exposed to gluten, let’s say we’re doing this test, and “yeah, I haven’t eaten gluten in a month or a couple of months” Well, if the immune system isn’t responding to it coz it’s not being exposed to it, it won’t come up in the test.

Evan Brand: Uhhh.

Dr. Justin Marchegiani: And people will be like, “Oh, look, I’m fine.” But may not be the case. So you have to look at it in a complete spectrum.

Evan Brand: That makes sense. So the ELISA / ACT.

Dr. Justin Marchegiani: Uh- hmm.

Evan Brand: And that’s blood.

Dr. Justin Marchegiani: That’s blood. Exactly.

Evan Brand: Cool. That sounds great. Well, I feel like we should probably wrap this up. I know this has been a lot of information uhm – if people are interested in your book, then they need to sign up for your email list. I mean – you’re so passionate about thyroid health, it’s definitely infectious. And do we have a date on that? Of this thyroid book? What’s up with that?

Dr. Justin Marchegiani: It’s done, man. I’m shooting it up to the editor. So we can buff it out and – and you know, I read all – every thyroid book on the market, I pretty much read. And my biggest issue is, you can summarize every thyroid book in like 5 pages.

Evan Brand: I know.

Dr. Justin Marchegiani: So I want a book that’s shorter. It’s more condensed. I want every page to be neat. I want every page to be __I want every page to have like action items. People can walk away and really improve their health and then throughout – in a standstill, they can reach out to people like myself and you, to kinda like get to the next level. So that’s where I’m at right now – to fine tune and boil it down. I want to touch just one question. Dale mentioned it earlier, he talked about mercury. And mercury is an important aspect coz mercury can pinch it and affect the thyroid. There’s this study showing that lowering mercury can decrease thyroid antibodies. I have one patient that had thyroglobulin antibodies over 2000 and we saw the antibodies drop below 100. So we saw a 99% drop in antibodies by removing mercury. So we’ll test that. We’ll do challenge test via urine and we’ll use various provocation agents like DMPS, which is 2, 3 dimer propanoic acid, or we’ll do uh – 2, 3 dimer succinic acid, which is DMSA. Or we can even do EDT as well. But I typically do the DMPS challenge and we’ll be able to provoke that and see what’s coming out from the mercury. That can be a big, big uh – kind of underlying revealer of another aspect of what could be driving an autoimmunity, which is the mercury. And again, I know you’ve done the shade testing which looks at urine unprovoked, hair, and blood. Not a big fan of hair and because they don’t tell you an active or chronic uhm – a chronic level. Doesn’t give you a tissue burden. And also, there’s study showing that people that push more mercury out on the hair actually have better detox pathways, and they measure people who push less mercury on the hair, and they actually found that they had more provoked mercury in the urine even though they push less out in the hair, partly because their detox pathway is impaired.

Evan Brand: Wow. I’m gonna try yours coz it sounds like it sounds like I could be getting some numbers that are not what they actually are. I wonder what other heavy metals are impacting this, too? I wonder if cadmium, for example, or aluminum is also gonna impact thyroid. It seems like all heavy metals potentially could. Or do you think it’s specific to mercury. Mercury’s gonna be the biggest?

Dr. Justin Marchegiani: Well mercury is definitely gonna be the biggest coz it’s one of the second or third most toxic compounds in the world. It’s really bad. So that one. Obviously lead is gonna be really bad, too. Because lead and mercury interplay, right? If you look at the lethal dose of one – if you take uhm – the dose, you get hundred rats lined up, and you figure out, you keep on titrating the mercury dose up. So the first rat dies out of a hundred. So you titrate the mercury up, the first rat dies, right? That’s called the – the lethal dose of one, right? The 1, the 1% that kills – the dose of 1% of that kills. And you do that for mercury and lead, so you have the hundred rats, right? One dies of mercury, right? You increase the lead up here or one dies of lead. And you now combine the mercury and lead those together to all 100 rats, they all die. Did you get that?

Evan Brand: Yeah, I sure did.

Dr. Justin Marchegiani: So what they’re saying is even though it only kills one of here over a hundred and the lead over here kills one out of a hundred, but when you combine it together, and gives it all to 100, all of them die. Meaning that, these metals are synergistically connected and can have exponential effects when added. So if you see mercury and lead together, typically the compounds that we’re using, are gonna be specific to mercury and lead for sure. So you don’t have give a special one for mercury and a special one for lead, right? So you give it and it would globally affect mercury and lead and typically cadmium, as well. And we’d also wanna give extra binders. Crochet talks about this like MC but MCT like modified citrus pectin, MCP actually. Uh – we’d also give maybe charcoal or bentine clays. We’d also use things like chlorella, especially for mercury. And we’d also use things to support detoxification. So in my line, we use heavy metal clear and then we also use DMPS and we use a lot of sulfur amino acid support to run phase 2 detoxification, as well.

Evan Brand: And still eat your broccoli, folks.

Dr. Justin Marchegiani: Oh, yeah. Your cruciferous are gonna be really important for your DIM and Indole-3-Carbinol which all help run phase 2 detoxification.

Evan Brand: Awesome.

Dr. Justin Marchegiani:  Well, anything else here? Any other questions we wanted to run to? Uh – on the YouTube live here, anything else we can answer?

Evan Brand: I think that was everything.

Dr. Justin Marchegiani: I think we hit it all up pretty well. Oh, I didn’t touch upon this. Let me just hit it real quick. Iodine. Iodine is a really important nutrient for the Iodination process to make thyroid hormone, right? If you look at the T, the T typically stands for- some people say thyroid or tyrosine. And then the 4 number is the Iodine. So you have the Iodination process and then you have the 5 prime, the iodinase that comes in there and it grabs and pulls off an iodine, and activates it and makes it T3. Well, that enzyme that activates thyroid hormone is selenium dependent and comes from the liver. So healthy liver function is really important. But having adequate iron uhm – adequate iron level as well is important, but having adequate iodine is also important. RDA is about 150 to 200 µg a day to at least prevent goiter. Now some people may need more than that. Now you have people like Brown Steen and other doctors that are going super, super high, 2550 mg a day. I’m very, very cautious of doing any high-dose iodine. I have seen too many patients uhm – like literally just lose their hair. Like just like gaps, like handfuls come out and their thyroid has gotten worst. Number one, like if we give iodine and they have autoimmunity, it’s typically months later after we’ve stabilized the gluten, stabilized the adrenals, supporting thyroid, supporting nutrients, supporting the gut, get their diet in shape, get their digestion better and then we’ll start very low and we’ll gradually work them up. But we’ll be checking in, we’ll be monitoring it and we’ll be doing very low doses and then gradually tapering it up or also making sure there’s enough selenium there, enough B vitamins, enough minerals, enough vitamin C. So we’ll make sure there’s a lot of other cofactors coz when you give iodine, it can spit out hydrogen peroxide, which can increase D cell lymphocyte infiltration into the thyroid. So it can exacerbate autoimmunity. So if we do it, we’re doing it responsible. We’re doing a lower RDA doses as a starting point and then gradually working our way up from there.

Evan Brand: So what about working with foods at the same time? So I’ve heard some people, anti-kelp people out there. And I don’t know why there’s some anti-kelp people.

Dr. Justin Marchegiani: Well, I think you just gotta be careful with kelp just because just coz where it’s coming from, the whole Fukushima disaster two years back.

Evan Brand: Yeah.

Dr. Justin Marchegiani: -radiation. So just gotta be careful. There are some really good sources out there. You gotta make sure it’s not coming from one of those places and number two, there’s a whole list of foods that you can give. Typically, like in my multi- there’s gonna be at least the RDA there, which is great.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Egg yolks are gonna have some iodine as well. Uhm- obviously seaweeds have some good iodine sources. You just have to make sure that it’s not gonna be the Fukushima kind. I’ll get a list right here. I’ll read out a couple of foods that are really high in iodine in just one second.

Evan Brand: I’ve heard strawberries, too, which is interesting. And then I also wonder – it’s hard to get a composition sheet for a Himalayan pink salt. I wonder if you’re gonna get any iodine from pink salt or not?

Dr. Justin Marchegiani: Yeah. I mean there’s some maybe some trace amounts there. I know iodized salt; 1 gram will have about 77 µg. There are some research showing that increased iodize salt consumption did increase autoimmunity. And it could just be that these are the general public. They’re just taking it, they already have a poor diet, and they don’t have the selenium, and the B’s, and the minerals, and the vitamin C in the background. And maybe that’s why that happened. So it’s hard to say. So there are studies on that showing there could be an issue. But things like cod, right? Things like shrimp, uh – things like turkey. Even some navy beans, even some tuna, even some eggs are gonna have some good iodine. I mean one egg is gonna have 12 to 15 µg iodine. So if you do 4 eggs a day, that’s about 60. You got a good multi- that will be 150. Uhm – you have some fish, you got some other food, now you’re like at 3, 400µg. Now you may need to go higher, but you had to work with physician or functional medicine practitioner to be monitoring the antibodies and make sure you have all ducks in a row first, before you go there.

Evan Brand: Yeah. I mean there’s people that will just start covering themselves in iodine. And so that could be a bad idea, you’re saying, coz you could actually increase antibodies, right?

Dr. Justin Marchegiani: Totally can increase antibodies. Uhm- you gotta be careful with that.

Evan Brand: I’m not – for some reason iodine, one of those things and kind of the eggs will call the natural health community that is – it’s been portrayed as very benign. And I remember even in some of the – the classes I was taking down in Austin, I remember a girl in class, she like paints everyday, she was painting her arm with iodine. And she was like, “it’s the greatest nutrient ever.” I was like, “Oh, my Lord. This is out of control.”

Dr. Justin Marchegiani: Well painting on your skin for the most part, 80% of it evaporates.

Evan Brand: Uh-huh.

Dr. Justin Marchegiani: The only time I recommend painting it on your skin is if you have fibrocystic breast disease uh – you have a lot of cyst and painful breast tissue. Painting it on the breast tissue can be great coz you’re driving the iodine right into the localized spot, where there’s the cyst, which could help. But outside of that, I mean, if you have –if you need iodine systemically for your body and for your thyroid function, you wanna take it in – in your body. And typically do a liquid potassium iodide.

Evan Brand: So she wasn’t – She probably wasn’t making herself toxic then. She was just turning herself uh – brown.

Dr. Justin Marchegiani: Yeah. 80% of it – you know, the iodine pass test, like the faster it evaporates, meaning the more your body absorb it; the slower it evaporates the more iodine you have. It’s very crude measurement, right? The better test is gonna be like Hakala or I think doctor stated, there’s an iodine loading test. I think it’s 25 to 50 mg of iodine then you test uhm – your urine and see how much GPL. So the goal is, if you pee 90% or more, it means your iodine levels are saturated; if you pee less than 90%, right? You pee less than 90% that means your body grab more of that iodine. So it’s – you’re essentially low. That’s the theory on that. 90% and more, you’re okay; less than 90, you’re low.

Evan Brand: Uhh. That’s interesting.

Dr. Justin Marchegiani: But again, regarding iodine, you gotta do it responsible – responsibly. If you’re – think of iodine gasoline on the fire.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Gasoline is not bad when you put it in your car. But if your car is on fire, and you start putting gasoline in your car, you can create problems, obviously, right? That’s what’s kinda happening in your thyroid. You wanna look at everything holistically. And you want the body system approach that Evan and I use, the key three, looking at the hormones, ATF( adrenals, thyroid, female hormones); ATM (adrenals, thyroid, male hormones), gut and infections, putting nutrients, digestion, better food, allergies, and then looking at detox and nutrients, as well.

Evan Brand: Yup. Well said. Go to justinhealth.com to schedule consultation with Justin. Check out the thyroid videos series. He’s got hormone videos series, too. You’ve got the supplement line there. And then, you could check out my stuff, too, notjustpaleo.com or you could just google either of us. Justin, or Dr. Dr. Justin Marchegiani. Evan Brand. You’ll find us both. And stay tune because this is really fun. And I don’t know about you, but I’m loving this. I think maybe 3 to 5 times more than just doing an off-air podcast coz people are asking questions. And it’s like shaping and structuring this.

Dr. Justin Marchegiani: Yeah.

Evan Brand: This little organic podcast ball.

Dr. Justin Marchegiani: Yeah. I love it. We love the questions. We like just having this little kinda dialogue back and forth and “ooh, someone responds over here, let’s see what they said” and we kinda see if we can interject it into the conversation. That’s great. Totally m__we’re on the fly.

Evan Brand: Love it.

Dr. Justin Marchegiani: Like impromptu, right? It’s like we’re on the stage, doing a little impromptu podcast.

Evan Brand: There’s no cuts; there’s no edits; there’s no –

Dr. Justin Marchegiani: Overall man, this is it.

Evan Brand: This is – this is the real deal. This isn’t – there’s not a makeup person coming in and touching you up here. I mean this is the real deal.

Dr. Justin Marchegiani: I know. If you guys are liking this, we’re gonna do it a lot more. We just need thumbs up; we need likes; we need shares; show us the love. Go like Evan’s channel. Share the podcast. And then we’re gonna do more of this, and get everyone’s questions answered, and just provide more value. Like how could we provide more value to our listeners and improve your health.

Evan Brand: Yeah. And I think I mentioned it already. But if you wanna schedule a consult with Justin, just go to the website, justinhealth.com you could schedule the consults there.  And same thing for me, notjustpaleo.com and we’ll chat with you all next week. And let’s do something next week, maybe – maybe on like clinical success stories we’re having in the practice.

Evan Brand: Well that means they’re coming in –

Dr. Justin Marchegiani: And just like, maybe go over our top 3 stories of the week. Coz we see – you know, so many patients. We can pick out 3 easily.

Evan Brand: Well, yeah. I thought of something, too. Uh- actually, a woman who was struggling with fertility is now pregnant. And I figured, getting her on and talking about her story with parasites and how her fertility was compromised due to the infections. Getting her on the air, maybe asking them– we have to make it fun for them, too. 

Dr. Justin Marchegiani: Yeah.

Evan Brand: For them to take time out of it, get them to share their story and just kinda talk them through what we did. I think that’s- that’s the most remarkable part of all this, is getting to hear the feedback, which a lot of people, they’re not getting to hear the stories. And this is what keeps us motivated and keeps us going.

Dr. Justin Marchegiani:  I love it, Evan. That sounds awesome, man. Well, let’s connect real soon, brother.

Evan Brand: Take care.

Dr. Justin Marchegiani: You take care. Bye now.

Evan Brand: Bye.


References:

www.notjustpaleo.com

YouTube.com/justinhealth


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.