What Are The Strategies to Treat Fibromyalgia and The Firbo Summit | Podcast #291

Hey, guys! Here’s Dr. Justine Marchegiani and  Dr. Roger Murphree talking about things to be checked and pointed out in dealing with fibromyalgia. 

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain with fatigue, sleep, memory, and mood issues. Dr. Roger shared that the frustrating thing is there are still doctors who don’t believe that it exists, and those who do, don’t understand it. 

Some issues reported by most patients with fibromyalgia include pain, lack of sleep, tired/fatigue, brain fog, restless leg syndrome, adrenal fatigue, and more.

Watch the entire podcast to learn more about this disorder and interesting approaches on how to fix it!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover: 

0:38          Diagnosing Fibromyalgia

10:13        Approaching the Issue

20:14        Unique Treatments

25:16        Infection Pattern with Patients

32:50        Compromised Immune System  

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Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani with Dr. Rodger Murphree  here. We’re going to be chatting about fibromyalgia and the fibro summit coming your way. Dr. Roger, welcome to the podcast How we doing?

Dr. Rodger Murphree: Hey Dr. Justin, so glad to be here. Thanks for having me. This is gonna be fun.

Dr. Justin Marchegiani: Yeah, I’m really excited to be part of your summit as well. That summit will be coming out, I think on September 28. So we’ll put some links down below so you guys can get subscribed to the summit. So let’s talk about fibromyalgia. It’s kind of one of these, you know, subjective diagnoses, right? A doctor kind of comes in and you and they do these like they look for different tender spots. How does that diagnosis work?

Dr. Rodger Murphree: Well, you know, the frustrating, frustrating thing about Fibromyalgia is there’s still doctors who don’t believe it exists. There’s, there’s still some out there, have that mindset and those that do don’t really understand it, they don’t really know how to treat it and then tell their patients to learn to live with it and the diagnosis is one of elimination. So there’s no really definitive Lead test after that will show you right. And it typically takes you know, three or four years and half a dozen to a dozen doctors before you finally get the diagnosis. And you’re right it typically is a you know, it’s a hands on type of examination but but after they’ve done all the the other workup to rule out, you know rheumatoid arthritis or any type of autoimmune disease or Ms. And then eventually you get the, you know, the diagnosis of fibromyalgia and you kind of stuck with that because it’s kind of a good thing and a bad thing. I mean, it’s good to finally get a diagnosis. But once you do get that diagnosis, it follows you forever. And a lot of times it didn’t serve you very well.

Dr. Justin Marchegiani: Yeah, totally. So you go online and you look you can you can get a an image of all the different kind of tender pain spots that they’ll they’ll kind of rub gently and they’re kind of looking for this central allodynia this pain that’s, that’s it’s, it’s not proportional to the amount of physical stimulus stimulus you’re putting in when you’re touching these different spots, whether it’s the shoulder, collarbone, neck arm, just kind of the different joint. So the doctors coming in, they’re going to be running maybe, AMA, HLAB 27, all of these kind of autoimmune markers. If none of them come back, then they’re going to that physical examination. And if there’s pain in those spots at all right, then then that’s kind of the diagnosis, but it’s not really helpful outside of the fact that you know, you got it, but we got this kind of path in the road, we have functional medicine, and we have all of these biologics and pain meds. So what happens next?

Dr. Rodger Murphree: Well, you know, the thing is, once you get the diagnosis, oftentimes, I think people have a sigh of relief, because they, they think, oh, at least you know, I’m not crazy because a lot of times, they’re made to feel they they’re lazy, crazy or just a hypochondriac. And nothing can be further from the truth. I mean, nobody would want to make this kind of stuff up that you can’t sleep. You know, he had this diffuse, sometimes disabling pain, no energistics, exhausted, irritable bowel, restless leg syndrome, low moods, anxiety. You know, nobody wants to Make that kind of stuff up but totally the diagnosis then unfortunately what happens is you get past from more you know another doctor you know, you get you get on this medical merry go round. And every doctor you come in contact with, if you mentioned any symptom, any condition, they’re going to try to sweep your fibromyalgia symptoms underneath the Fibromyalgia rug and tell you Oh, yeah, the, you know, the, the stomach pain that you have. That’s fibromyalgia. Oh, yeah, the, you know, the thrush the chip on your tongue. Oh my gosh, there it is the migraines and you know, all these all these are warning signs or symptoms and symptoms or just telling you, you know, telling us that there’s something under underlying this symptom that is, you know, where’s the we need to be looking for the causes, and not treating the symptoms, but unfortunately, once you get that diagnosis, really most doctors just happy to change and learn to live with it, they’re not going to keep looking for the underlying causes.

Dr. Justin Marchegiani: Yeah, I tell my patients this all the time, like most of the time conventional medicine, I, they’re looking at the downstream symptoms, and typically a diagnosis is a bunch of symptoms that are in an organized fashion, right with a lot of the central allodynia pain, right? That’s your fibromyalgia, if it’s if it’s autoimmune type of pain, where there’s autoimmune markers, maybe that’s rheumatoid arthritis. So you’re just looking for these different symptoms and in these different pattern and once you have those symptoms, they give you an ICD 10 code and then from there, they can prescribe your drug. Now, Fibromyalgia tends to come together a lot of times with chronic fatigue so you get people that are sore, and also tired. Now, we know in functional medicine, that there may be other kind of root causes upstream like with the gut or with the hormones or the adrenals or the thyroid, what are like just the top three like root cause patterns that are upstream that you see are driving a lot of the fibro symptoms downstream.

Dr. Rodger Murphree: Well the main thing Justin is there at this allodynia, which is this low pain threshold, right? For them, their pain is magnified and you and I can go, you know, we can go get a massage, we can shake cans, we can, you know, hug our partners, we can do things that you know wouldn’t bother us at all but the fibromyalgia patient any that stimulation, which could send them over the top that so pain is magnified? Yes. But that pain is coming from it can be from wear and tear osteoarthritis or osteoporosis, bone loss, it can be from scar tissue. Past surgeries, it can be from nerve damage, it can be from elevated blood sugar issues, but they have central sensitivity pain syndrome, which means their nervous system is over ramped up, and pain is magnified. And the place to start with these individuals is you’ve got to raise the pain threshold and the best place to do That is making sure that they have plenty of serotonin. So brain hormones, you know you’re familiar with your serotonin level, the higher your pain threshold, and the higher your serotonin level, the less anxious you’re less depress your more mental clarity app. And less likely you have are to have IBS because you have more serotonin receptors in your intestinal tract than you do in your brain. So the place to start for these individuals is number one making sure that they have plenty of serotonin because anybody that has true true fibromyalgia, they’re going to be deficient in serotonin and that’s one of the main driving factors of the underlying symptoms that they have.

Dr. Justin Marchegiani: That’s interesting because serotonin we know comes from the amino acid tryptophan right? So I find common thread is going to be poor digestion, in a lot of these fibro patients. So poor digestion, maybe low stomach acid, low enzyme, maybe their diets poor, maybe They’re not eating enough protein, maybe they kind of were on a vegan vegetarian kick. Maybe there’s a gut infection that’s impeding digestion as well. How much do you see digestion? Being an impediment as well as maybe digestive infections too?

Dr. Rodger Murphree: Well, it’s certainly a big part of it, for sure. And in the Fibromyalgia community, what we see is that genetically some of them at our disadvantage, just the way God made them. Yeah. Convert trip to fan into five, proxy trip to fan they have a block and they’re kind of around kind of an enzyme pathway. Yeah. And because that conversion is not made, they’re at a disadvantage. So they’re, they’re low and seratonin. Certainly, you know, you

Dr. Justin Marchegiani: B6 playing a big role in that too?

Dr. Rodger Murphree: Yeah, so the cofactors as you bring up, you know, to make seratonin you need tryptophane, which turns into hydroxytryptophan, the B vitamins in particular B2 B3, and then any vitamin C and magnesium that’s what Yes, you know, No one has an antidepressant deficiency, you know, yeah. But you could have a five HTP deficiency or B vitamin deficiency and yes, you probably have a magnesium deficiency, if you have fibromyalgia, but the place to start for these individuals is making sure we get that serotonin level up. And when we do that, we see their pain threshold goes up. Absolutely.

Dr. Justin Marchegiani: Yeah, I see that a lot. I run a lot of organic acid tests, and I’ll look at five hydroxy and dolo acetate, and usually that’s very high or very low. So there’s usually a burning or a total depletion issue there. And I’ve never seen a fibro patient with really good digestion. There’s always some bloating, some gas and cebo or a gut infection. I almost always see that. Now what’s your take on beta endorphin? Because beta endorphin is kind of our natural opiate, and it’s made from 19 amino acids. So I mean, obviously, we see this amino acid kind of trend there any feedback on beta endorphin?

Dr. Rodger Murphree: Yeah, one of the things that you don’t have a patient’s do they fill out in the new patient questionnaire, they’ll have a brain function questionnaire, little survey and it across the board, it shows that they’re low in serotonin, but then they may be deficient in dopamine and opioids and some of these other things that show that they have other amino acid deficiencies besides five HTP. Bingo. No, no. So it definitely shows up. That’s a pattern that we see that they’ve Yes, deficient in these amino acids for, you know, whether it’s genetics, or you know, poor diet, or there’s something that’s compromising their ability to be able to absorb these nutrients like SIBO, or leaky gut or some type of bacterial overgrowth.

Dr. Justin Marchegiani: Yeah so my strategy, I’m curious to get your so my strategy is I try to figure out a way to get the sympathetic nervous system in check, because most of the time, the adrenals is that kind of gateway between, you know, the sympathetic nervous system. It’s kind of how that when you interpret stress, you’re making adrenaline, you’re making cortisol and when you have that level of stress, you’re going to be burning up a lot of those neurotransmitters. So I try to get the adrenals under control, and then I’ll I work on supporting more of those amino acids, more of those cofactors. I try to get tests so I can get specific. What is the root issue? And I’m just curious to know your take on that. How did what’s your kind of out of the gates approach?

Dr. Rodger Murphree: Well, there’s for me from doing this for 20 years, found there’s four key things that have to really be addressed. Because if you got 15 tax in your foot, and two or three tax, you’re not going to notice a difference. And that’s-

Dr. Justin Marchegiani: A great analogy. Excellent analogy.

Dr. Rodger Murphree: You know, what they’re doing is they’re taking resveratrol, or, you know, they’re taking coq10 or tumeric and those things, those are great. But if you don’t pull out a bunch of tacks real quick, you’re never going to see a difference. So totally. It’s the analogy that we’re all born with a stress coping savings account. And in that stress coping savings account, we have certain chemicals that allows us to be able to deal with stress. So we have serotonin, dopamine, norepinephrine, cortisol, DAGA, Panasonic acid, cortisol, these things Are there and anytime we get under stress, we’re using these chemicals to deal with stress. But those who have fibromyalgia, they haven’t bankrupted their stress coping savings account. So they have this deficit. And then when they, you know, get up to face the day, they’re already done, you know, they just don’t have those chemicals they need. So the first thing that’s gonna happen is we got to replenish that stress coping Satan’s count. And that is done by deep, restorative Delta wave sleep. So if they’re not getting a good night’s sleep on a consistent basis, they’re going to have many of the symptoms that we you know that we associate fiber Imagine if you’re not getting deep restorative sleep, your inflammatory chemicals are increased by 40%. They’re going to have more pain. If they’re not getting deeper short asleep, their pain threshold goes down so pains magnified. They’re going to obviously going to be tired gonna have fatigue, brain fog, which is a common symptom of these individuals. Eero bow, you have more as I mentioned, more serotonin receptors. In your test or trial, you’re doing your brain. restless leg syndrome starts to show up. Once they can get a consistent deep restorative sleep, then they’re going to see that many of those tacks we can start to pull those out. So the first place to start is deep restorative sleep, making sure they’re getting plenty of serotonin. And then the next place is, as you already mentioned, is the adrenal fatigue. But because they get a good night’s sleep, and they start to feel better, then even though they’re cautioned not to do that, do this, you know, in my book, they’ll go out and do things hadn’t been able to do in years, and then they’ll have a fibro flare and they’ll be back in bed because they don’t have the stamina, or resiliency to stress, physical stress, mental stress, real or imagined. And so if they don’t fix their stress coping glands, the adrenal guess, be vulnerable. The third thing is in your already mentioned up mentioned this astutely. You, you’ve got to fix any kind of gi issues. Yeah, amongst with digestion or problems or elimination, you know, problems absorbing in every fibromyalgia patient I’ve ever worked with last 20 years. There’s something there whether that’s SIBO leaky gut, yeast overgrowth, parasites are just reflux and malabsorption. They’re not absorbing, they’re huge. That’s that’s got to be fixed. The last thing, which really could easily be the first thing, it’s you’ve got to lay the foundation with high doses, but the right combination of vitamins, minerals, amino acid and central fatty acids, because if you don’t have these building blocks, you can’t make these hormones and chemicals that they need to write themselves. In. Now, most people have tried a multivitamin. They tried this, they tried that. But what they’ve taken is, is so inferior to what they need, they’re they’re looking And things like, a Centrum silver or one a day.

Dr. Justin Marchegiani: Oh, yeah.

Dr. Rodger Murphree: Which is you know, based on the RTA the recommended disease allowance, right? Yeah, it’s just enough to get, you know, keep you from getting scurvy, or berry berry, it’s not gonna, you know, provide optimal nutrients that you need to be healthy is, you know, so So it’s this, this four pillars that I think are just crucial you got to get those. And then, you know really once you do that you’ve pulled out a lot of tax, you may be pulled out 10 or 12 tax. Now there’s three texts that are still left, and they’re still giving you trouble. But at least you’ve made this dramatic impact. And then you’ve got to go look for what are some of the underlying other underlying conditions that may be driving the symptoms like, you know, problem with their thyroid?

Dr. Justin Marchegiani: Yeah, it’s really interesting because not all the tax create the same amount of pain. So sometimes it’s the eight tax you pull that out, so Whoa, a really big improvement and sometimes you pull them out. And then the improvements delayed like it’s like, oh, I’m starting to see a five or 10% improvement one to two months later. So it’s interesting. Where the compliance factor like really getting the patient’s mindset on board is is crucial because it’s never going to be a meet every now and then that you get a miracle tax. Sometimes it’s too late. So you got to paint that big picture and compliance is big. And when you talk about some of the nutrients, you do have a really good multivitamin that you formulate or what what should people be looking in their multis at certain doses at certain the quality of the nutrients? What should they be looking for, Dr. Roger?

Dr. Rodger Murphree: Yeah, so years ago, when I start treating Fibromyalgia we had I had a medical clinic where we had five medical doctors work for me. And we did high doses of IV therapy. So we did Myers cocktails back then. Yeah. And we found by doing that, Justin that if we gave them these vitamins and minerals, that they slept better, they had less pain, he had more energy, they had better mental clarity. They just felt better. But it wasn’t practical for people every day couldn’t do it hooked up to an IV. Yes, years ago, I developed this thing called the CFS fibro pack, which has high doses of vitamins, minerals, amino acids and essential fatty acids in there and some other things like malic acid, magnesium, potassium sparks a to help drop the cellular energy, it but you can find something, you know, similar for you but, but that is the cornerstone of what my patients take. They take that, as well as some other supplements like a good digestive enzyme, an over the counter adrenal cortex, supplement and then the five HTP that makes up this thing called the jumpstart protocols, that people who read my book, they’re encouraged to try that on their own and get as far as they can before they reach out to me to set up a phone console.

Dr. Justin Marchegiani: Interesting. And you mentioned the serotonin which you mentioned lowers that pain threshold which is which is really important. But we know serotonin also is that precursor to melatonin. Which helps to sleep and you mentioned the Delta wave in the sleep. So it’s kind of like, everything’s kind of connected. It’s not just like, one web, it’s like you hit one web, it moves the whole spiderweb. So you Okay, you you increase the pain threshold, and then you help the sleep. And then the sleep helps the adrenals and the adrenals help the inflammation, and it just keeps on spiraling.

Dr. Rodger Murphree: Yeah, it’s all connected. You know, it’s a myriad connections there. Yeah, the five HTP increases your natural sleep hormone melatonin by 200%. So that was when I started doing the research on that. Well, it’s been two decades ago, and found that correlation, it was a no brainer to start putting my patients on that. And then thankfully, along with making the serotonin, it really encourages them to be able to wind down and be able to get a good night’s sleep. Now there’s some other things typically have to add to that sometimes adding some additional melatonin to the five HTP. But the five HTP has been extremely helpful for these folks.

Dr. Justin Marchegiani: And if you’re not getting I mean, if you’re not getting the optimal results regarding sleep, I mean, imagine you may keep the five there to help with the serotonin so the pain improves but Wendy added melatonin to the mix. When does that happen?

Dr. Rodger Murphree: Bite promote sleep protocol it’s they start off with 100 milligrams of five HTP 30 minutes for bed with a little bit of grape juice doesn’t take much, but the grape juice is going to cause the body to release insulin to help pull that serotonin pass the blood brain barrier. Yeah, going to the stomach just a little trick. And then if they don’t fall asleep within 30 minutes, then that in sleep through the night, the next night they go to 200 milligrams and then they need to they get a 300 milligrams, but they get up to 300 milligrams and they’re still not falling asleep or they’re not staying asleep. That’s when I would start adding the melatonin preferably sublingual melatonin somewhere, you know three milligrams or so and they and they can increase that up each night up to about 12 milligrams and, and then hopefully that does the trick. If it doesn’t. Then I would add things like gamma means butyric acid GABA. So I have a little sleep form that I put together that it’s combination of GABA and l theanine, ashwagandha and delirium, and passion, passion flower, that can be taken to really calms them down before bed. But it’s even more useful for those individuals who wake up at, you know, two, three o’clock in the morning can’t go back to sleep, they can take this product called Delta sleep, or something similar. And it allow them to fall back to sleep within, you know, 10 minutes or so, and it doesn’t make them feel hungover, dopey or sleepy The next day, like some of the prescription medications would.

Dr. Justin Marchegiani: Tat’s great. I think we’re just really dropping a lot of key clinical pearls here. So if you’re a patient and you’re have these kind of issues, try to glom on to one or two of these things. I think it’s really important especially if you’re in that Fibromyalgia camp, you really want to work with the practitioner because there’s a lot of as Dr. Roger gave the example of tax you got to pull out and these are a couple of one or two key tax, but there’s always a Plan B a Plan C a plan D, it always seems easy when everything works with Plan A the first time around, but I think Dr. Roger will probably agree a lot of times you have to dig deep into that tool basket with a lot of other plans too. Would you agree?

Dr. Rodger Murphree: Oh, absolutely. But I think you’ve got to lay the foundation for what, what trips people up with fibromyalgia and those trying to treat Fibromyalgia is they try to put the cart in front of the horse, you know, is you know, there’s such a unique individual. And a lot of times they may go to an integrative doctor or maybe a function doctor. And, and he or she will, okay, let’s put you on biomechanical hormone replacement therapy because that’s, you know, as a female, it’s, you know, that’s a lot of times what they do, but that may not work and usually does it you to me, these four steps that I just mentioned, that 

Dr. Justin Marchegiani: Do you mind if we repeat the steps one more time, what they are?

Dr. Rodger Murphree: Deeper store to sleep. You got to replenish your stress coping stages account. And the way you do that you you make deposits into your stress coping savings account by going into deep store to sleep. So you’ve got your peritonei level up. So five HTP and then the second one is you got to fix adrenal fatigue every everybody as far as adrenal fatigue, so I use adrenal cortex glandulars for my patients. And then number three was digestive issues. I put everybody on digestive enzyme and then if they need other treatments for cebo, leaky gut or things we’ll deal with that. And then the last one was a good high dose, multivitamin mineral formula with essential fatty acids Fishel, malic acid, extra magnesium, which is so important, but those four things provide the foundation really to build upon it really, you know what it does? It’s, if you kind of think of you know, if you got this complicated jigsaw puzzle. And you just throw all the pieces out on the table. And until you get the corner of the puzzle, right? You’re, you could just be looking forever to put the pieces together. But once you get the corner, now everything starts to come together, you can build that puzzle. So the first four things, make up one core in a corner, I’m sorry. And then the puzzle starts to come together. But you may have to, you know, find another piece of the puzzle that’s, that’s eluding you could be a problem in your thyroid. Could be a problem with yeast overgrowth could be a problem of food allergies. But if you don’t get that first corner, boy, you’re going to struggle, you’re really going to struggle.

Dr. Justin Marchegiani: Totally agree that makes a lot of sense. Now, when you’re working with patients, are you testing their adrenals? And it sounds like you’re finding a lot of low cortisol in your patients. Is that true?

Dr. Rodger Murphree: Yeah. So I think you know, we These individuals are very complicated ideally, although I do have programs where they can try to do it themselves to talk about that in the book. Ideally you want to test I mean, you’re not trained in functional medicine. You know, you don’t want to guess you really want to try to laser in find out where the key linchpins for helping these folks and you want to know what’s going on. So yeah, when I’m when I’m doing a four sample saliva test for their adrenals, I see it’s all over the place. So it’s low. In the morning, it’s bottomed out and sky high first thing, you know, because they’re not yet now drive that, that level up. But it’s about really balancing that out because it’s, you know, very well, a lot of times we’ll see that there. DAGA is it then of course, our levels, okay. But their DAGA is really high. And that’s a sign that the body’s trying to hang on. Yeah, but it was going to bottom out right. Or they’re gay is bottomed out and of course, all levels are bottomed out. So you had treat both of those, or you may find, like I do a lot of patients is that they have a low cortisol in the morning. And then as the day goes on, you know, it should, it should keep going lower. But for, for these individuals, their cortisol level actually spikes towards bedtime. So there’s like they’re catching their second window.

Dr. Justin Marchegiani: And they just rhythm almost.

Dr. Rodger Murphree: All day they’re exhausted. And then about nine o’clock they catch the second wind and like, Oh, well, I haven’t been able to do anything all day. Let me go clean up the kitchen or straighten up or you know, wherever it is, and then they miss the window of opportunity to get in bed on time and now they’re, you know, they really just continue to throw their sleep wake cycle into further Helter Skelter.

Dr. Justin Marchegiani: That makes sense. Do you test any of the total cortisol? Do you do any of the urinary cortisol as well to get a window into free as well as total?

Dr. Rodger Murphree: I don’t. I don’t do that and find it. I guess. Probably just from doing this for so long, I know that the majority, I would say when I say the majority, I mean 98% of them are gonna have a problem with their adrenals. And if I can just make sure what the pattern is, then I can on the right supplements that will you know, that will correct that.

Dr. Justin Marchegiani: Yeah, that makes a lot of sense. What also do you see in regards to an infection pattern like pate with patients? I’m seeing h pylori blastocyst is hominis. Sometimes you see things like epstein barr, maybe even a Lyme issue, what kind of infections Do you see? And it sounds like you kind of have that priority. You hit those four pillars that you mentioned. Right? adrenals and, and the nutrients and the sleep and etc. And then you kind of do dive into infections later, is that part of when you’re addressing the gut stuff? Where do the infections come in? And what are the top maybe three or five infections that you see that play a role with fibromyalgia?

Dr. Rodger Murphree: Probably the most consistent one is yeast overgrowth. So I test everybody for yeast overgrowth, test, everybody for parasites. blastocyst is hominis definitely shows SIBO is definitely a thing that is for whatever reason, you know, I think you kind of run into these patterns where you you know you get one and you get two then you get you know dozens I’m at a time. Mold issues certainly starting to show up. But definitely infections are there. I’m really careful not to go after them. Initially, certainly not aggressively because we Fibromyalgia they, they they can’t handle the stress they bankrupted their stress coping chemicals, and they bankrupted their stress coping gland. So stress is magnified. I don’t want to get aggressive on treating yeast or SIBO or some of these things that show up until I get them going into deeper storage of sleep. Start working on their dreams and then yeah, absolutely. Then you have to look at you know, definitely h pylori shows up as well. You have to start dealing with those because that’s something that’s going to be leftover that’s going to create, if it’s, you know, if it’s if it’s leaky, God is you know, that’s going to create More information and more pains. Yes, with at some point.

Dr. Justin Marchegiani: I just really wanted to highlight that for the listeners because this is probably the biggest mistake I see with a lot of my patients and people that I connect with online is we just live in this generation that’s antibiotic driven. Oh, you have an infection, staph strep STD, here’s an antibiotic knock it out. And that can be stressful on the body. Number one, it wipes out the microbiome which affects the immune system, gut permeability, but it’s stressful going after an infection. And when you don’t have the reserves, your sleeps already amassed, you’re nutritionally deficient, you can’t digest that’s like a big stress ball on that bucket or another five tacks underneath that foot. So I’m really glad that you highlighted that.

Dr. Rodger Murphree: Yeah, you know, and I think that’s the thing is what you want to do with fibromyalgia you want to try to find and fix the underlying causes, because really, you know, Fibromyalgia is just a name. It’s all it is, is a name given to a group of symptoms that people have in common, and we call it fibromyalgia. And so if you can start to find and fix each underlying cause Eventually you’re going to get your life back and that may take you know, that may take different things but certainly the God is you know, that’s number four you have to you know, you have to fix that.

Dr. Justin Marchegiani: Totally. And you mentioned a couple of different things and I know the protocols are going to be specific to each individual person and where they’re at. I get that so people that are listening, I want you to just talk about do you have like a couple of your favorite herbs on the gut side and also do you have a couple of your favorite herbs on the virus side and how much do viruses play a role in this whole thing?

Dr. Rodger Murphree: You know, as far as I don’t use a lot of herbals I do use some but I don’t use it. He is some may think think that that in the fiber match community. A lot of them have chemical sensitivities have issues. A careful what you what you do in the having said that I also really recommend everybody a food allergy test because food allergies, right masqueraders but for digestion, the first thing I do is put them on digestive enzymes or on the team You know, make sure that we we start from the beginning, you know, make sure they’re digesting their food. 

Dr. Justin Marchegiani: That’s key. Yeah. 

Dr. Rodger Murphree: If they have issues with with yeast overgrowth, or even SIBO then I’ll turn to things like bio seed, which has oregano, and berberine and some of these golden still herbals in their-

Dr. Justin Marchegiani: Black walnut, ekinesia. Yep.

Dr. Rodger Murphree: But I don’t use a tremendous amount of herbals, just for the fact that I really find that using the right doses of vitamins and minerals, essential fatty acids and amino acids typically start to turn these individuals around, you know, but but definitely there is a place for for berberine and undecylenic acid and caprylic acid. I mean, there’s definitely those can be incredibly helpful for these folks.

Dr. Justin Marchegiani: How about the virus stuff? Do you use any natural antiviral supports, and what viruses Do you see in And what are your like top three on the anti viral side?

Dr. Rodger Murphree: You know, it’s interesting that I don’t see a lot of viruses, which really surprises people when I say that I used to more so than I do now, let me let me explain why that is. You know, people think of fibromyalgia is being driven by a virus, and they can’t have viruses. But if you look at you know, Fibromyalgia is on one end of this clothesline, and chronic fatigue syndrome is on the other end of the clothesline and sometimes they get lumped together and you can have both, but if you look at true fibromyalgia and true chronic fatigue syndrome, with true fibromyalgia, their symptoms are number one pain, right, but they can’t sleep and they have no energy and, and then if you look at the true chronic fatigue syndrome, they can have trouble with their sleep and they do have achy flu like pain. And obviously the number one symptom is no energy, so fatigue, but the difference between the two is that those are Fibromyalgia don’t necessarily have anything wrong with your immune system. Those with chronic fatigue syndrome all have some type of immune dynamic, something that is, you know that is compromised that so that they’re always fighting off some type of infection. And absolutely in those individuals, you got to go after that, find out what that is and use things like lacto Fearon, or using thymus extract some of these things in Oilers system that can be incredibly, incredibly beta one, three glucan some of these things that I use for these individual, but you know, it’s odd because over the years, for whatever reason, I have attracted less chronic fatigue syndrome patients in the last probably 10 years, than I have fibro to me fibro, and I hate to be careful how I say this. Yeah, Ramalgyia is I won’t say it’s easy but for me it’s it’s there’s a system that seems to work chronic takes syndrome. Once you start working with that, if you’re not careful, you open up Pandora’s box and you find that not only is it viruses, but then you also have parasites and you have Lyme and many things that you mentioned, that tends to be more down on this end of the clothesline with property syndrome, than it does fibro.

Dr. Justin Marchegiani: And you’re differentiating that between the fact your fibro have the central allodynia that’s just the wound up nervous system the pain spots at the joints and throughout the body, but they don’t really have the energy problems or energy still pretty good is that the differentiating factor?

Dr. Rodger Murphree: Know the difference because we’ve thought about them and they have many of the same symptoms as those with chronic fatigue syndrome. Yeah, separates and you can be anywhere along the clothesline, you know, but what separates the two is that those with chronic fatigue syndrome always have a compromised immune system. 

Dr. Justin Marchegiani: And your by your saying compromised immune system, so they the fibro patients still might have fatigue, but you’re just not seeing what a diagnosed autoimmune condition along with fibro or they get sick a lot. How are you defining compromised immune system?

Dr. Rodger Murphree: So for those who have fibromyalgia, they, they normally don’t have problems with random sore throats. They don’t have swollen lymph glands. If we test them, they don’t show antibodies to epstein barr virus, or cytomegalovirus kraftig syndrome, you’re going to see elevated epstein barr virus cytomegalovirus herpes viruses, they’re going to get random sore throats out of the blue. They’re going to have palpable lymph nodes, you know, they’re gonna be swollen glands. Oftentimes, they have issues with laryngitis, they just lose their voice for days at a time because they get so exhausted. With fibro, you can have some of that. But that’s not the norm in kraftig syndrome. That’s the norm.

Dr. Justin Marchegiani: So I’m just trying to wrap my head around this because the diagnoses are kind of a little bit flaky. So if these fibro patients still have they’re still really tired, right? What’s the conventional different like, if you’re a conventional Medical Doctor, what makes you diagnose this person with chronic fatigue with the immune stuff, but these people over here without the immune stuff, they’re still tired. What what allows them to get that chronic fatigue diagnosis on the conventional side?

Dr. Rodger Murphree: I think typically it comes down to the doctor that they see. So that’s more familiar with complex syndrome, they’re probably going to get that diagnosis than they would fibro. If you said doctor this more for me with fibromyalgia, they’re going to get that diagnosis. And right now you got even though there’s not a lot, you probably got more doctors who are familiar at least with fibromyalgia, they don’t really know how to treat it. Then they have conflict syndrome that that illness, chronic fatigue syndrome is something that most doctors really don’t know anything about.

Dr. Justin Marchegiani: And there’s another name for for fibromyalgia over in Europe, right it’s the mycologia with it with the name Britain Europe.

Dr. Rodger Murphree: Yeah, what now for [inaudible] syndrome is myalgic encephalitis so with us.

Dr. Justin Marchegiani: Yeah, okay. And so it sounds like to me it’s not necessarily the diagnosis that matters it’s more the immune symptoms of antibodies to these different viruses and then that chronic immune reaction lymph nodes chronically sick is that is that kind of if we kind of really boil it down is that more specific you think?

Dr. Rodger Murphree: Yeah, but I think we got to be careful because I think there’s a misconception that Fibromyalgia is an autoimmune disease ever seen that in any in you know, we’ve been looking for the smoking gun, it’s not there. So I don’t believe Fibromyalgia autoimmune disease. We don’t know if chronic fatigue syndrome is it probably could have an autoimmune component to it. We haven’t found that yet either.

Dr. Justin Marchegiani: So a lot of thyroid autoimmune people that have fiber though?

Dr. Rodger Murphree: Now that I was gonna say is see a ton of autoimmune hashimotos thyroiditis. So with in the patients that I work with F5 about 70% of them have something wrong with their thyroid. Many of those have Hashimotos many, many of those with hashimotos have never been properly diagnosed. So they have the, you know, the festering symptoms they had for 5-10 years. No one’s ever checked their antibodies or thyroid antibodies. So that they never knew they had it. But yeah, definitely that, but you know, I don’t see. I don’t see lupus. I don’t see rheumatoid. I don’t see sjogrens I don’t, it’s there. It can be, you know, could be could be a companion to the Fibromyalgia but it’s not what’s driving the fibromyalgia.

Dr. Justin Marchegiani: Yeah, cuz I see did you see patients though with a lot of the hashimotos and the fibro and of course I do find that like gluten. Cutting gluten out really helps a lot of the the pain symptoms and I know gluten plays a big role of gut permeability. So even though the research may not show that I have a sneaking suspicion there has to be something underneath the hood, or we wouldn’t see a lot of these connections. When you address them, they improve prove a lot of those fibro symptoms.

Dr. Rodger Murphree: Yeah, you know, and you know, that’s one of the big conundrums for fibromyalgia. I think there’s just so many things that are wrong.

Dr. Justin Marchegiani: Yes, the hard part. 

Dr. Rodger Murphree: Can write itself the way that you and I were trained in chiropractic school that innate intelligence. You know, we’re born with this incredibly inborn healing Dynamo system, that normally we don’t have to think about taking 12 breaths per minute or pumping blood to 60 miles of arteries and veins, we just write these things. But with fibromyalgia, those systems get get compromised the hypothalamus, the pituitary adrenal HPA axis, when it gets under too much stress, it can’t regulate these different systems. And now because of that, you see, so many symptoms start to show up, because so many systems are not working like they’re supposed to. And that’s incredibly challenging for the doctor that wants to try to try fibromyalgia, most most work because it’s too complicated. And it’s incredibly challenging for the patient. Because where do you start?

Dr. Justin Marchegiani: No, I totally agree. And you’ve done a great job during the podcast just to kind of outline a couple of the really good pillars. Obviously we have the fibroid, the fibro summit coming up in the next two weeks on the 28th. So really excited. We’re gonna put the links down below as well. I see a book on the shelf back there. Is that your book? Would you mind put it on screen?

Dr. Rodger Murphree: Yeah. So this is my Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome book. It’s in his fifth edition, the sixth now? I didn’t November so yeah, labor of love. You know, for the last 20 years, you know, it’s been my mission to help those with fibromyalgia, learn how to live healthier, happier, more productive lives because you know what they’re being told right now Justin is just learning to live with it. But you know, I want to learn to live with chronic pain, no energy, brain fog, insomnia, restless leg syndrome, irritable bowel mean. That’s it. That’s not living that’s existing. So, you know, the fibro summit is an opportunity for individuals with fibromyalgia, to get a breath of fresh air, sort of set off all the doom and gloom out there. They actually can learn from people like yourself, she did a fantastic interview, all about thyroid, we did a deep dive into this interview. So people like yourself are sharing incredible information, that if you have fibro or even if you just want to be healthier, there’s so much we share in the summit, about mold and parasites and adrenal fatigue and insomnia and leaky gut and gluten intolerance and food allergies, huge. If you’ve just can’t get a few little key things from these interviews. It may be the missing piece of the puzzle that you need to put it all together and get your life back.

Dr. Justin Marchegiani: I mean, that’s awesome. Now, if patients want to get a hold of you, they’re like, great, I’m going to get the book. I’m going to get the summit. I’m going to start applying some of this stuff, but I want to work with you. How did patients work with you?

Dr. Rodger Murphree: Yeah. So appreciate that. They can go to yourfibrodoctor.com and there’s free videos in there, blogs, free protocol and a tremendous amount of free information so I encourage you to check out, see if it resonates with you. If it does, you’re on the right track.

Dr. Justin Marchegiani: That’s great. We’ll put the links down below for the book, for the summit, for Dr. Roger’s website. Dr Roger, anything else you want to leave the listeners with?  Do you have a youtube channel or a podcast? Anything else people can get more info about you?

Dr. Rodger Murphree: Yeah so we do have a youtube channel and you’ll see that on the website, a blog, both of those podcasts coming soon. And you’re going to be one of my first guests by the way. We’ll be coming soon and I just want to say thank you. I want to thank you for for everything that you do because the information you’re sharing is so needed and without people like yourself taking the time, making the time because I know you’re busy just like I am and you’re dedicated to getting the the message out there, that you you know that you don’t want to be just treating symptoms. You really want to be finding and fixing these underlying causes whether you have fibromyalgia or you have migraine headaches or type 2 diabetes and your podcast which I’ve been checking out here recently is just fantastic. So thanks for what you do.

Dr. Justin Marchegiani: Thank you so much Dr Roger. Really appreciate it. And people listen to so much information here especially if you’re coming at this with fibro or chronic fatigue, it’s hard to grab a lot of these things. So just rewind it, listen to it again, try to grab one thing that Dr Roger said. Try to get the book, get access to the information and make sure you get on that summit. Amazing great speakers there. Dr Roger thank you so much for being a part of today’s podcast.

Dr. Rodger Murphree: Thank you Justin so appreciate it.

Dr. Justin Marchegiani: Thank you.


References:

https://justinhealth.com/

Audio Podcast:

SIBO Can Cause Histamine Intolerance, Here’s How. | Podcast #268

For today’s podcast, we’re focusing on SIBO, gut infections and more histamine issues, and how SIBO can cause histamine intolerance. Last podcast about histamine went well last week, so today we’re going deeper into these topics. Check out this podcast with Evan Brand.

 

Dr. Justin Marchegiani

 

Dr. Justin Marchegiani

In this episode, we cover:

1:43 Histamine, symptoms and solutions

8:21 Diet recommendations

15:20 Fat Consumption

17:07 Gallbladder issues

22:10 Solutions

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Youtube-icon

Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan brand, Evan, how you doing today, man? 

Evan Brand: Hey, man, Happy Monday. I’m doing really well. 

Dr. Justin Marchegiani: Happy Monday to you as well. I know we chatted, kind of in our pregame interview, we chatted about what we’re going to talk about and we kind of chatted about histamine, histamine went really good last week, we see a lot of patients with potential histamine sensitivity. And the histamine a lot of times may not be– a little reverb there. histamine may not be a root cause of the issue. It may just be a symptom of other issues going on in the gut. We always kind of keep that in mind. A lot of people. You know, if you don’t have a lot of experience, clinically, it’s easy to think that histamine is the root cause. And then you feel like you have all these food restrictions and you’re not sure what next steps to do and that’s tough. So we’re going to be focusing on SIBO we can even expand that to gut infections, and histamine issues. So I’m really excited for today’s topic.

Evan Brand: Yeah, you made a great point right from the gate which is people that are focusing on The nutrition piece too much or focusing on maybe some of the supplemental things correct. Many people discuss DAO, which is something I’m experimenting with just to play with it and see how it works. DAO is the enzyme in your body that naturally helps to grade histamine. But as you have infections and stress and toxins, you are either unable to produce less, I mean, we’re not 100% confident with the mechanism, you may produce less or maybe is less effective. So people will do a DAO supplement say, Oh, well, I feel better. I’m not having these food reactions, and they’ll just stop there. But this is where we’re starting now at the end of that rope, and then we’re taking you to the whole next level, because if you stop there, you’re just you haven’t addressed what’s actually going on.

Dr. Justin Marchegiani: Exactly. So in general, histamine is a neurotransmitter made from histidine. It’s designed to help with the inflammatory response. It’s designed to vaser dilate open up the blood flow of the blood vessels so you have better blood flow, which helps with an inflammatory response. So you bumpy your elbow, right, you bump your head there’s a histamine response that helps vaser dilate helps migrate a lot of those white blood cells into that area kind of helps promote healing. The problem is acute acutely and acute situation not that big of a deal because it happens and then your body recovers. We’re more talking about a chronic kind of low grade inflammation or low grade histamine issue where you’re chronically swollen, you’re chronically inflamed. You may have a lot of chronic histamine symptoms, this could be headaches, it could be flushing, right, that chronic red and flushing symptoms. It could be nausea, it could be hives, right, those kind of wheels are you to carry a hives and the skin could be fatigue, it could be brain fog could be just kind of chronic low grade swelling could be allergic shiners under the eyes with a lot of lymphatic pooling in the face. So it’s good to keep an eye on these symptoms as they could be part of what’s going on. And then of course, there’s a lot of medication that are typically treating these things, whether it’s Xurtak or [inaudible] or Pepcid AC, different medications. The problem with a lot of the medications, they tend to have more side effects, whether it’s fatigue or brain fog. And a lot of people, they just get knocked out when they take a lot of these medications. So they’re kind of stuck because their performance and ability to function at work, if they’re doing hard work are dealing with their kids, they’re going to be pretty much a zombie or zonked out for a lot of them. So we want to really get to the root cause of why these symptoms are present. And a lot of times the guts going to be a big role because a lot of chronic inflammation is going to be at the gut level, whether it’s inflammation from food that you’re dealing with, whether it’s gluten or dairy, and or other histamine foods, right fermented foods or age meats or citrus or avocados, or it could be from a deeper infection that sets you up to be more sensitive, right. If you have SIBO or bacterial overgrowth, or other infections, it’s going to potentially make it harder for you to digest food, the harder it is for you to digest food, the greater chance that you’re going to develop food allergens. And also the more inflammation in your gut, the greater chance that you’re going to have gut permeability. So the more permeable your gut is, the more these foods have a way of getting into the bloodstream, the more your immune system sees them and an undigested state increases the chance that we’re going to make antibodies for those foods. And then also just the fact that we have other bacteria that may be slipping into the bloodstream. These compounds are lippo polysaccharides these can also go and create histamine issues. They can also go to the up to the brain hit and hit a lot of brain fog and mood issues. So there’s a lot of like dominoes they get hit. His to me maybe one of those dominoes, but there’s a lot of dominoes that get me hit. And then you have a lot of symptoms happening from it. And then the question is you have to kind of corral all these symptoms in to a root cause of like, what’s the next step but it gets very, really overwhelming.

Evan Brand: Yeah, I want to go back to the symptoms real quick. Something that’s really interesting is the fact that you could have issues with your sleep, you know, trouble falling asleep or even dizziness. You know, I noticed when I went low histamine with my diet, some of this Kind of disequilibrium, dizziness stuff that I was having that I thought was mold exposure, or possibly co infections I bartonella. I noticed when I went lower histamine, it got better, like my head got more clear and then I was able to go to sleep better. So this is kind of why you mentioned some people do the anti histamines and then they get knocked out. You know, I think part of the reason that some people’s nervous systems are so revved up is excess histamine, but here they are taking melatonin. Now, that may help or passionflower or, you know, we’d like to use like, Mother Ward or Valerian or Thean or Skullcap there’s a ton of good sleep options, but you may be missing the boat so those herbs are fine. Those are much safer than a sleep drug which are extremely hard to get people off of. But this the the sleep herbs may not be the root cause it may be histamine. So you could try going with a lower histamine diet during the meantime, that’s something we may recommend you do is go lower histamine while we’re working on labs are waiting on labs. And then if we find that just by lowering histamine in the diet, All the sudden, you have less blood pressure problems, you fall asleep easier, you’re not flushing, you’re not having the nasal congestion, you’ve got rid of headaches, maybe your energy’s better, well, then that’s a great clue that we’re onto something. But we don’t want to get you stuck on low histamine forever. I just don’t think that’s a way to live. So that’s when we’re going to go into these gut infections. So you mentioned bacterial overgrowth, and how we’re going to be looking at that as with stool and urine. So, Justin, I run honor, no problem between us both probably thousands of labs per year. And I would say, Now, granted, we’re a little bit biased, right? Because people that come to us have already been to many practitioners, and so they often are going to have real problems. But I would say 90% of people we look at are going to have some sort of a bacterial overgrowth problem that’s leading to these issues.

Dr. Justin Marchegiani: 100%. So histamine, it’s an important first step to look at and kind of know the histamine foods. We’ve already talked about some of the foods last time And we I think there’s a handout up there from last time as well from last week. So take a look at last week’s podcast. Try to put some of those links down below so you can access them but more common histamine foods are going to be ones that are rich in probiotics fermented foods. And that’s tough because people are following the Paleo template or following Weston a price or understand the benefits of probiotics and fermented foods. That’s kind of a curveball. And a lot of people kind of walk into this and they’re like, wait a minute, that’s supposed to be good for you. Yeah, it should be good for you. But for some people, it may be a problem with histamine and if they have SIBO it could be a problem as well. I call it probiotic intolerance. And that’s very possible. That’s what’s happening. Next are going to be your citrus foods, your age meats. Of course, a lot of paleo foods are going to be on that list. So if you’re just going paleo you cut about half of them out anyway, just by default.

Evan Brand: You know what got me in trouble though? coconut aminos I love- 

Dr. Justin Marchegiani: Yeah, and amino acids are pretty high.

Evan Brand: Super high. And I was for I was, you know, there’s basically fermented coconut blossom nectars what it is, but of course The longer things ferment the higher the histamine so I was making my steaks and marinated steak and then maybe even add a little extra coconut aminos during the cooking process. Yes. And I was going too crazy with it. So I’m taking a break from coconut aminos that’s something that gets heavily used and abused and healthy foods because people are trying to ditch soy sauce for example.

Dr. Justin Marchegiani: Exactly. And that’s a good first step. And if you don’t have a histamine issue, that’s a really good first step. But if you do and you have some symptoms, like we mentioned earlier, then you know what, where to look. But in general, regarding histamine, we want to keep those foods down. So I mentioned some of the avocados, the tomatoes, the egg plan. So if you’re cutting out night shades, you may get that out. By default, avocados are kind of a curveball, right? Because that’s a really good fat. We also have the age meat, so try not to let meat sit around longer than a day or two, or even meats that tend to be preserved, whether it’s jerky or, or bacon are those kind of things. And then of course we have your probiotic foods and then our citrus So those can be curveballs. And then obviously teas and coffee, and britisher teas are the big one teas and energy drinks. That’s a DAO inhibitor. So they’re not really high in histamine, but they inhibit that enzyme DAO that helps break down histamine. So, you know, keep that in the back of our mind. So in general, the more information we– go ahead, yeah.

Evan Brand: I was just gonna say one thing about drinks. I’ve had some people that go on to like a CVO like these natural stevia sodas, where you’re doing carbonated water and a lot of time there’s added citric acid to those. And so there’s a lot of citric acid added to some of those drinks and I’ve had people drink those and then all sudden they flush out and so just cutting the drink out with the citric acid that could be something that kind of created some type of either a mast cell response or a histamine response. So that’s just one other one other potential cause and it’s tough because if you’re eating like if you’re drinking a carbonated drink and you’re doing a steak with coconut aminos, and then you’ve got your sauerkraut or kimchi on your plate with your whole grass fed dairy, it’s tough to know what you’re actually responding to. So sometimes you really have to just keep a food journal and go really simple where you just drink that carbonated drink for 15 minutes and then wait, see if you get a response and then move on to the next food item and the next food item. Hopefully, the average person it’s not that tricky, but for some it can be.

Dr. Justin Marchegiani: 100%. And of course, we already mentioned the kombucha, there’s some higher sugar ones, there’s some lower sugar ones. If you’re probiotic intolerant, that’d probably be something you want to pull out for at least a couple of weeks to a month and see kind of where you sit after after the fact. It’s got to make sure that we’re fixing digestion. We have enough HCl and hydrochloric acid and enzymes and good digestive support. Foods not being digested appropriately are going to create stress and inflammation in the gut. And then we got to look deeper at you know, making sure the common food allergens are out because a lot of times regular food allergens like you get from grains or dairy, or lentils or the goons, those can create similar symptoms of histamine and the question is welcome Is there a histamine response to these foods from an inflammatory perspective as possible, right? Because the more you create inflammation, we know that histamine is a part of the inflammatory response. It’s it. It’s part responsible for the vaser dilation that happens. So it’s possible that inflammation from other foods that aren’t necessarily histamine sensitive foods could potentially drive histamine symptoms, we have to keep that in the back of our mind. And this is why it’s so hard because you’re like, wait a minute, this foods not a high histamine food, yet I’m having high histamine symptoms, how do I connect the dots and that’s how it’s all from inflammation. inflammation is the first domino and there’s many different Domino pastor trails that could take based on inflammation being present. Now, the hidden sources of inflammation are things that we don’t really see or we’re not aware of like low stomach acid low enzymes are not necessarily aware of that we may be aware of the fact Hey, I take hydrochloric acid, I feel better, I have less bloating and less gas and more regular or I do a SIBO test, I treat my SIBO and my motility My histamine symptoms improve after the fact that’s also another thing that can create awareness, but you may not be aware of it unless someone helps guide you in the process and does some testing as well.

Evan Brand: Yeah, and I’m not going to say that all the time it happens to older people, we’re talking 40 50 60 70 80. But in general, I think it’s going to be more common for someone who is older because they’re going to make less stomach acid just due to age. Now we have seen kids and teenagers that have a lot of skin issues and gut issues, and I was one of those teenagers. And that’s because my diet was terrible, right? So you’ll still get younger, younger people that have these histamine intolerance issues, mainly because their guts been wrecked by antibiotics or they just had a bad diet to begin with. But if we’re just saying, as you mentioned, some of these dominoes that fall, one of the dominoes that falls with age is just HCl, so you become at a higher risk of getting bacterial overgrowth because now you don’t have enough acid to neutralize what you get exposed to from your foods. 

Dr. Justin Marchegiani: 100% And again, I think part of it As you get older, there’s a natural drop in hydrochloric acid and enzymes as you get older. So there’s that. So I think age does play a role because of stomach acid dropping. And we need stomach acid to activate our enzymes and we need stomach acid to activate our bile salts. And we know bile has natural antibacterial effects. So the less bile you have, the more easy it is for bad bacteria to grow. So if we have good stomach acid, that’s going to provide an anti microbial environment meaning harder for bad critters to grow. And then with good HCl we also produce better bile salts. bile salts have that good acid byproduct that keeps bacteria down as well. That’s why you see a lot of people that have SIBO they’re also typically taking bile salts to help with one the environment but also to being able to break down fats really, really important. 

Evan Brand: So how about people with had a gallbladder it sounds like they would be brain risk for this problem, then?

Dr. Justin Marchegiani: Well, they have to be on bile support for life now. Because what’s happened is that don’t really have a gallbladder anymore. They’re common hepatic bile doc and the liver is now the gallbladder. And so it doesn’t hold bile. Like the gallbladder concentrates bile like 15 to 20 x. And then it contracts and punctuates to release a bile at the right time, ie you have a fatty meal. Do you have a hormone that’s produced or a neurotransmitter kind of peptide called coli sista kinda, and that triggers the gallbladder to contract, it releases all this stored bile that’s been concentrated. And that bile can now come in and hit that fat and digest it and emulsify it. The problem is, you don’t have that punctuated release, because the gallbladder is gone. So it just kind of drips, it just drips drip strips, like a leaky faucet all day long. And then you don’t have the concentration of it. So it’s kind of a little bit more watered down. It’s a little bit weaker, and you don’t have the concentrated release at time of that fat being ingested. So that’s the problem.

Evan Brand: Yeah, well, you know, conventional doctors don’t educate people on this when they go into a potential gallbladder removal surgery. They’ll just say, Yeah, you’re Liver still is going to make some bio for you, but they don’t talk about that concentration factor and how it’s literally, you know, that’s like taking a, you know, a little fairy dust of some HCl and throwing it in and hoping it works. It’s not a therapeutic amount that’s going to come without that gallbladder, I mean, no still going to survive, right? I mean, there’s tons of people living but it’s just they’re not thriving.

Dr. Justin Marchegiani: Well, what tends to happen after that is to cover up a lot of those symptoms. conventional medicine says, Well, you have to be careful of your fat consumption. Well, yeah, you do because you don’t have the same level of bio output, but you need good fat, you need fat soluble vitamins A, D, and K, your long chain omega three fatty acids are really important for your health. So you’re not getting good fats. That’s a bad thing. I mean, we’ve seen with the obesity epidemic over the last hundred years, the last 30 or so years, fat consumption has dropped significantly and weights gone up. So it’s not really a fat issue based on the correlation. It’s really a carbohydrate issue. Maybe a trans fat issue, maybe an excess refined junkie vegetable oil issue but good healthy fats are not part of the play. And if we now affect our digestion when we can’t absorb those things, well every membrane in our body has good fats in them. So we need healthy fats to make our cell membranes. We need vitamin A, which is a fat soluble vitamin for our thyroid receptor sites. We need fish oil for inflammation. That’s our long chain omega threes. We need cholesterol which tends to come trapped in with animal fat for our hormones for our brain mass. So all this stuff is so important for healthy hormones. healthy body healthy brain

Evan Brand: Yep, absolutely. And there’s no education on that. It’s just Yep, you gotta gallbladders gotta come out and then that’s it. And then they don’t have here’s the interesting thing that the surgeon and then the doctors and such they don’t deal with the collateral damage. They just kind of got it out and move on. So then they end up coming to us. Hey, look, here’s this list of 20 symptoms I developed after gallbladder removal surgery. not to get too distracted from our from our topic, but this is all related because it could have been connecting a histamine problem could have been what led up to this and then it could have, you know, continued after the removal.

Dr. Justin Marchegiani: And I’ve done some articles and podcasts on gallbladder issues in the past and there are some common paleo foods that could be a gallbladder issue as well. Porks one of them, especially Bacon is also a histamine overlap there. So is I think sauerkraut as well, onions. There’s a bunch of paleo foods that like, you know, on the surface, you’re like, wait a man, these are pretty healthy foods. But if you have a gallbladder issue, it could be a driving factor and yes, some of these foods overlap with histamines. So take a look at just go to my site JustinHealth.com just type in gallbladder and you’ll find those articles and videos there for y’all.

Evan Brand: Perfect. So we hit on the the SIBO, we often discuss that SIFO small intestinal fungal overgrowth is very commonly occurring at the same time. And so that’s where once we get the proper lab testing, looking at stool and urine primarily, we’re going to be finding the answers that We need to start resolving this. As we mentioned, you may be using extra enzymes and acids. Maybe you’re using histamine degrading enzyme supplementally to try do yeah, you’re using that as a band aid knowing that you’re working backwards. And then once we come in with herbs to address, which is the, the opposite of the conventional neomycin, die flu can Neistat and kind of protocol, we’re going to come in with herbs instead, and then eventually retest and then of course watch symptom improvement at the same time. But with retesting labs, with watching symptom improvement, may be doing those band aids you can reverse this issue.

Dr. Justin Marchegiani: Yeah, we need to calm down the inflammation in the gut because those mast cells are what’s making a lot of histamine right. So your basal fills are in your blood when those basal fills go into the tissue goes into the gut lining there, they’re all become mast cells. And mass cells are what produces histamine and imagine this, you know, this mass cells sitting here, the longer we’re not exposing ourselves to inflammatory food, that mass cells like swelling up because it’s used to having a reserve Now that reserves is kind of like, kind of in gorging itself bigger and bigger and then now you eat some food that’s kind of off your food recommendation, then you get this massive flood of histamine. And when you feel like even worse, and this is what happened with someone’s on a good diet for a while, and then they go off the wagon. They’re like, Holy smokes, I got hit by a bus. What happened? I thought I was doing really good. Why have I not become more adaptable at these foods? Well, it takes some time. And then a lot of times these mast cells are just sitting there in the short run, filling up with histamine waiting for you to just go off your diet.

Evan Brand: Yeah, what about alcohol? Do you have anything to say about that? Because I had a woman who’d been off alcohol for a long time. We kind of discussed Hey, you probably shouldn’t do it. your gut barriers toast and she went to some work party and had two drinks and then she emailed me the next day Oh my god, I’m so miserable. Alcohol has never done this to me before. Granted, she was on a protocol. So some of the herbs mixing with alcohol is not smart, but just from a avoid leaky gut perspective and then going back to it, she seemed like she got worse than alcohol used to make her feel. Do you have any insight on that?

Dr. Justin Marchegiani: Yeah, so I always tell patients like don’t add any alcohol and until we have a level of clarity, a level of improvement. So then if we add an alcohol and we go backwards, we know that the alcohol brought us backwards that way. We’re not feeling crappy. And then we’re putting alcohol in there. And maybe the alcohol is what’s holding us back from getting better. And we don’t know it, right, because we always felt crappy to begin with. Yeah, so kind of get clean first. So then when you get dirty again, you know, okay, I know what clean feels like. There’s something that changed here. So regarding alcohol, there’s different quality of alcohol. So you could have like a mixed drink with a whole bunch of sugar in it, you know, that’s going to cause a whole bunch of problems just because of the sugar and the crap that’s in there. And obviously, there’s like different wines that may have pesticides or sulfates or potential gluten in there. A lot of wines are contaminated because there’s a lot of flour that lines the barrel the wines. So hard alcohol is going to be your cleanest and keeping the sugar content if you do a mixed drink, and then also like a champagne or a dry white wine will kind of be your next step up, right, the dry or whites or the dryer kind of champagne is going to have less sugar, it’s going to have less potential irritants. So you kind of start with the fruit, the kinds of alcohol that will have the less additives and inflammation compounds, and then kind of work your way back. And that wave, it just gives you the chance to have in the least issues now there are some cultures where they just have less da o to hang out with in your in their in their guts in their bloodstream. So they’re going to react to alcohol, they’ll get like a facial flush. You see this in a lot of Asian cultures because they don’t quite make as much do. So they’ll take that Pepsi they see a lot of times and that blocks that histamine response. So a lot of cultures may just have less histamine issues. You see it with Asians and alcohol, they get very flush, so you just got to know where you’re at, and then just try to choose an alcohol that’s gonna have the least possible chance of a reaction. And then you can always do some activated charcoal. In between to kind of help with that, too.

Evan Brand: Yep, that’s good advice. Anything else you think we should say about testing or herbs or things we’re doing to work on this issue?

Dr. Justin Marchegiani: Well, there’s different herbs that we’re going to recommend depending on if we’re methane dominant SIBO or hydrogen dominant SIBO, and a lot of times people have the right to have more than one issue going on at once. So, you could have SIBO and a parasite infection, you could have SIBO and H. pylori, you could have SIBO and SIFO and SIFO is nothing more than a fungal overgrowth. It could be Candida, various different yeast, mainly the main ones, Candida, but you could have all of these things going on together. It may not just be SIBO, you have the right to have more than one issue. People get fixated. They’re like, I know it’s Candida. I know it’s a worm. I know it’s this and it may be but it may be that and a whole bunch of other things. So keep your mind open to all the different stressors that could be going on at the same time.

Evan Brand: Well, the funny thing is to maybe the person’s right and they did have a parasite or they did have Candida, but we may find something even higher up on the priority list and that like if I see, you know, okra toxin levels we know okra toxin and other mold toxins we know those damage that go if I see those things off the chart and I look at dizziness and they can’t sleep and they got heart palpitations and all these other symptoms that don’t sound like SIBO. We might go after that first and SIBO  and histamine and all that may be secondary and tertiary problems. So that’s another fun and important reason that we do multiple tests on people is because if you come in and you’re like, hey, Dr. J, I know it’s SIBO just run the SIBO test. He’s gonna say, No, I really think we need to also look at this and this and that. And that’s not just because we like to run labs. It’s because we like to have data so that when our puzzle pieces are on the table, we can make a more complete picture, as opposed to trying to identify your problem and make a protocol based on one little piece if we don’t, I mean, if we’re using the just one little puzzle piece, it’s just not you know, your success rate may be hindered.

Dr. Justin Marchegiani: 100 & 10%, and I think it’s, it’s really important to kind of keep that in the back of your mind. That could be a lot of different things happening. And like you mentioned earlier, an important component is the history. Hey, do you live in a house where there was recent water damage? When you’re in your home, and you leave for a period of time? Do you feel better? Have you rectified the water damage? How did you do it? Is there any visible mold in your home? So these are really important questions to know. And sometimes I’ll see in my history, I’ll see patients Yeah, there’s water damage, and they didn’t really do much to address it. And they really feel foggy in the home. They feel better when they’re outside, getting fresh air. These are important signs and symptoms. A lot of times you’ll see more neurological things like you mentioned, Evan, whether it’s brain fog, or just spaceyness or headaches. And again, we’re looking for that timing in regards to a flood or there could be even a chronic issue where there’s just high humidity in the home. And that’s where doing some of the mold testing for the home is ideal. The multitasking for the home is great because if you have you know, five people in the house We get a positive Mold Test. Well, we know that that could be affecting all five people. So it’s good to know that.

Evan Brand: Yeah, absolutely. I had a building I went into when I was in Florida. And I literally got flushed. After entering the building. I had like a reaction to the building. I started to feel off, I was just like, Whoa, this is not a good building. And I look up at the ceiling and there’s water spots, water stains, all over the ceiling. I was like, Oh my god, and this is not. Oh, Evan, you’re crazy. This is placebo. You looked at the ceiling, and then you convince yourself you felt bad. No, I felt bad before I even saw the ceiling. This was on the way, walking out of the building, I look up and see all the water stain. So most people are not that sensitive, and most know are not that in tune to their situation to know, hey, I’ve been in this building for an hour and every time I am in this particular building, for example, like college students, they’ll say when I go to this one classroom, I can’t focus I get brain fog. I get really tired. Maybe the subject is boring and they don’t like the teacher but it could be the building, particularly Making them bad. So I’ve had some college students I work with where I’ll just tell them, hey, try to sit in a different part of that room. Or if it’s a big auditorium, move to a different corner where maybe you’re closer to a door where you get fresh air and see if you feel better. And yeah, obviously, this is a more like, nuanced small percentage of the population, but it does happen. And I want people to know, they’re not crazy. This is a real phenomenon you may be experiencing.

Dr. Justin Marchegiani: Yeah, and the nice thing about it is you should be able to figure out some correlation from this, because you’re in that building, you’re out, you’re in your home, you’re out, maybe you’re walking around all day. So hopefully, you can notice a correlation there. Like you mentioned earlier, everyone’s not going to be that level of sensitive, right? There’s different genetic variation, obviously, depending on how long you’ve been exposed to something and how much is it already in your cells in your fat in your body already can make you more sensitive. So with some of your mycotoxin testing, which will do a lot of urinary testing for mold, will see some of these things and we if we do a urinary test for mold, we have to also challenge it. So we’re going to be using glutathione for at least a couple of days ahead of time. Just because if your detoxification pathways are a little bit weak, or let’s say the molds overwhelm your system, you may have lower glutathione. Anyway, so it may be harder to push the mold out to begin with. So you have to keep that in the back of your head. That’s why we test the home first. Because if we have a high level of mold in the home, we don’t see a lot coming out in the urine. Well, it’s really important that we provoke that and just give you enough detoxification support to at least get a window and how much is coming out in your year and that way, we have a baseline. So as we treat over 369 months, we can come back and see if those levels are dropping.

Evan Brand: Yeah, infrared sauna is great too. For that you can measure a lot of higher increased levels after sauna so somebody can’t tolerate glutathione and for some reason you could do a sauna, and also fasting which is pretty interesting. That’s why a lot of the samples we do in the first thing in the morning because fasting can help excrete some of these toxins too. So we could obviously dive more into that on another show. My mood levels are almost gone. I had okra toxin level of 195 you want it below four.

Dr. Justin Marchegiani: Fasting, though, with fasting, you only can do that really acutely, though. That’s like a short term thing. It’s not a long term strategy, right?

Evan Brand: Yeah, yeah, I’m just talking overnight fasting, but maybe, you know, like intermittent fasting. Maybe in between those meals, you are exceeding a little more and flushing a little more toxin out.

Dr. Justin Marchegiani: God. Okay, so you were saying okra toxin. Go ahead.

Evan Brand: Sorry. Yeah, yeah, that’s okay. I think the reference range was below four is optimal. And I started out at a 195. And here we are talking almost exactly one year later, and my levels are down to a 15. So-

Dr. Justin Marchegiani: 195 to 15. So it’s like, 98% 95% reduction.

Evan Brand: Yeah, it’s a lot but it took a year and that’s hardcore work. That’s conventional and prescription binders that sauna, that’s extreme avoidance. That’s liver lymphatics. I mean, that’s a lot of work. So I just want to end this by putting a realistic timeframe in people’s heads, you know, when they have a reaction They take a Benadryl and they feel better in half an hour. You know, they’re really happy about that, or when they have a headache and they take an Advil, they feel better in 30 minutes, that’s great. But with these issues here, we’re talking reversing potentially 10 20 30 40 50 years of toxins and damaged gut barriers and overgrowth and antibiotic usage and all that crap. So, you know, when we tell somebody, hey, six months to a year timeline, I think that’s extremely short when you factor all that in.

Dr. Justin Marchegiani: 110%. Man, I like it. I think you’re on the right track. with that. I think we’re on the right track with today’s chat, trying to connect the SIBO component, trying to also connect the different gut components that connect the SIBO. And then also I think the mole and we need to do our own little show on mold and histamine. Maybe next week, we’ll come back and do more than his mean, it gets really important. I think it’s a big issue. And the problem is a lot of people have multiple issues at the same time, and this is where it’s really hard. We want to glom onto one thing we want this one, hey, we want to have this one label. This is my issue, it’s kind of easy to wrap your head around that. But it could be a lot of different issues. So everyone that’s listening, keep your mind open to their being lost at problems at the same time. And also, if you’re overwhelmed, this is where it’s good to reach out to a practitioner like Evan. EvanBrand.com, or myself Dr. J. JustinHealth.com if you want to dive in deeper, kind of get your arms wrapped around it with some objective lab testing. So we actually know what is happening underneath the hood, so to speak. Yeah. And anything else you want to add today, man?

Evan Brand: No, I just want to give people a little bit of boost of hope and encouragement. Just say hey, look, as you mentioned, there may be layers to this, but you can peel back the layers you can you can get better, no matter how long you’ve suffered. You can you can you can keep that in mind.

Dr. Justin Marchegiani: Yeah, and your story is great with the mold because you really had some pretty debilitating symptoms. And mold one of those things. It’s like if you don’t know what’s there, man, it’s like, you’re just in it in an environment where there’s just toxins all around you and you don’t even see it and it’s a slow creep and the time symptoms start really in their head, it’s been going on for years. That’s the problem.

Evan Brand: Yeah, I got to give a shout out to our mutual friend, Dr. Jack Wolfson, for telling me that it was mold. I didn’t want to believe it. But I was talking to him and said, Hey, I was waking up dizzy. This is weird blood pressures going all over the place. And he writes back in all caps, one word mold. And that started at all.

Dr. Justin Marchegiani: Yeah, and the thing is, I mean, I’ll give credit to Jack. I think that’s us right on there. The problem is, there are a lot of let’s just say, mold, myopic doctors, where everything’s mold, right? Everything’s mold. And that’s a problem too, because it may not be so the differences with you, you got this feedback from Dr. Jack you tested your home, guess what? Really high mold, you tested your urine, you provoked it really high mold. So we had some objective data to kind of support us. So we weren’t kind of flying blind. So I think you did the right thing. And for people that are listening to this and think it’s mold, get that testing done first so you can be more confident. And then more importantly, because you’ve gone through the whole mediation process that’s even more overwhelming. And that’s where you want to work with an expert because You can feel like you have to spend six figures to get your home remediated. And that’s not the case. You can do it for way, way cheaper. And it can be, let’s just say a process that isn’t as bad as it thinks. Or if you feel like it is based on what you see online and everything. 

Evan Brand: Yeah. And into Jack’s defense, you know, he is he works on hearts. You know, he’s not a mold doctor, but his wife was really sick. Yes, last few years from mold. So luckily, he had had first hand experience. So he thought, hey, this sounds kind of weird, and at least had enough in the trenches experience with his own wife to know, hey, that might be it. So very interesting how it all turns out, I think it’s one of the biggest hidden epidemics going on.

Dr. Justin Marchegiani: Yep. I see the whole mole thing and the Lyme thing as well. Anytime there’s some kind of a weird neurological symptom. people throw that out there. And it could be right but get the whole thing worked up. I mean, the thing with Evan Evan had three different other infections to begin with. So you had I think giardhia blast on h pylori. 

Evan Brand: Crypto. Yeah. 

Dr. Justin Marchegiani: Crypto, Giardhia, H pylori, right. So now just kind of for everyone listening so they can have insight, Evan had already addressed those issues ahead of time. And he gotten a little bit better, but there was still something holding him back. So if Evan just myopically focused on the mold and didn’t get rid of those infections, he may not have the same level of improvement. So there’s kind of an order of operations and how we want to hit this. And because you had three series, I mean, each one of those infections individually is kind of a big deal. The fact that you had all three going on at the same time, I call it the three amigos. It’s definitely going to be a major stressor on your body, and then you throw in the mold and the adrenal stress and then potentially blood sugar issues. Yeah. So you had a whole host of things that we were able to kind of sequence up and have it all makes sense.

Evan Brand: Yeah. And we’re talking we’re talking over a four to five year period, you know, those gun reactions were cleared out almost five years before the mold protocol. And that’s not due to that that’s not the way that necessarily I wanted it or that that we wanted it to happen. It’s just the way it happened. That was you The exposures came later. And so not everything could be perfectly sequenced and care but it’s just a matter of peeling back the layers you can to get some level of improvement. And that quality of life hopefully will continue to motivate you and allow you to pursue other layers of healing.

Dr. Justin Marchegiani: Well, the nice thing with us is we’re getting better because we’re also treating ourselves and thousands of patients so because of that, it’s not just like you know, textbook information, it’s real world actual results kind of driving treatment, driving protocols, driving kind of our perspective on what the next steps are for patient so it allows your treatment allowed me to get better at this and allow you to get other patients better so we just continue to grow like that which is excellent.

Evan Brand: Yeah, it’s a very, very, very cool place to operate.

Dr. Justin Marchegiani: Anything else you want to add Evan?

Evan Brand: That’s it. mentioned the links again, you can reach out to Justin, Dr. J, at JustinHealth.com my website’s EvanBrand.com. We both offer intro console where you can book 15 20 minutes, you can chat about your symptoms and goals. See if you’re good Fit for care if so, we’d love to help you. We’re very grateful to be in this position. So we honor it and we’ll be back next week.

Dr. Justin Marchegiani: Excellent. You guys have a phenomenal day. Look forward to checking in soon. Take care y’all. Bye now. See ya.


References:

https://justinhealth.com/

https://justinhealth.com/water-pitcher

Audio Podcast:  

 http://justinhealth.libsyn.com/sibo-can-cause-histamine-intolerance-heres-how-podcast-268


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