How to Investigate The Root Cause of Your Gut Issues | Podcast #366

In functional medicine, it has long been familiar that gut health is paramount to the rest of the body. We didn’t fully understand why for years, although we knew the gut was the seat of the chronic inflammation and immune system. With the gut microbiome renaissance, we also need to understand how integral gut bacteria are to our health.

Dr. J and Evan discuss that screening for more serious underlying issues is essential. These may include gastric ulcers from an h.pylori infection, leaky gut, and other digestive system problems. Finding out whether these conditions are an issue also impacts how you manage gut health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
3:34 – The Signs and symptoms of digestive disorders
7:35 – What tests are effective to find the root cause of gut issues
13:58 – The downside of ordering lab tests on your own
26:21 – Food template modifications that will fit for your gut health


Dr. Justin Marchegiani:  Here, Dr. J, with Evan Brand. Really excited to have an excellent podcast today. We’re gonna be chatting about how to investigate the root cause of your gut issues. We see lots of patients come in and they’ve gone to see the SIBO doc or the Candida doc or the parasite doc or the thyroid doc and whatever the symptoms that they’re dealing with, magically that issue, that doc only focuses on is the problem, how coincidental right? And so, we want to talk today about having a holistic mindset not being necessarily attached to what the diagnosis or what we think is the root issue but really be focused on the outcome and the different tools we use and have to investigate and support healing. Evan, how you doing man?  

Evan Brand: Doing good. And not to mention too, the conventional approaches, right, maybe they get to the SIBO guy or to the parasite guy or to the worm guy, maybe they went to the endocrinologist first for their hormone symptoms and then they got referred to the gastro doc and then the gastro doc did an endoscopy or a colonoscopy or a barium x-ray scan like you did to me and then they say oh you’ve got gastritis and that’s the only thing they can pull out of you is hey there’s some inflammation and then it ends there so whether you’re coming, listening from the conventional approach whether you have tried to go more natural holistic approach. As you and I’ve talked many times, people over-specialize and that’s the problem. You and I are what I would consider very good specialists but we also have a generalist undertone to us, meaning, we’re not gonna get caught up in just the SIBO, we’re not gonna get caught up in just the parasite, it’s rarely that simple. 

Dr. Justin Marchegiani: Absolutely. It’s like, imagine, like you hired a handyman to come over and fix something in your home and the handyman just takes this Phillips flat head screwdriver and it’s like, or, I’m sorry, not, but let’s say a regular Philipps screwdriver and just say hey I’m gonna use this Philipps screwdriver even if it requires a nail, even if it requires a wrench or a drill, I’m married or attached to this Philipps head screwdriver and we don’t want to be attached to the tool, we want to go in, know that we have a myriad of tools in our tool belt and pick the right tool for the right job. There’s a nail, I’m going to pick a hammer. Hey, there’s a, you know, a wrench, you know, we’re gonna use something that is good for a wrench etc. So, we’re picking the right tool for the job and we are focused on the outcome, getting the results and we’re not focused on how we get that outcome, right? The vegan diet people, they’re gonna make it so everything is solved by a vegan diet and that’s it, right? And so, we are independent of the tools that we use to get the success that we need. 

Evan Brand: Yeah. Yeah. That’s a great point and a lot of this comes from just experience but also our own personal journey too, I mean, you know, my story, you helped me through my story of having digestive issues and skin issues for decades of my life and we looked at the H. pylori, worked on that then it was parasites then it was bacterial overgrowth then it was Candida then it was mold, I mean, so, I went through the ringer personally and I think personal suffering but of course clinical experience really gives you the non-biased approach and I think that’s what you need because if you’re trying to just sell book or you’re just trying to just get clients in from a book you wrote on SIBO, as you said, everything’s gonna be SIBO and if somebody is not in that box, you’re gonna still give them the same treatment, you’re not gonna get them better and then they’re gonna move on and the average person who comes to us has already been to 5, sometimes 10 or 15 practitioners, so it’s not surprising when we look what they’ve done and they’ve still missed some of the pieces. So, why don’t we talk now about some of the pieces, like when we’re looking at someone with gut issues, what are the pieces we’re trying to lay out on the table in front of us to gather enough information to find what’s truly going on and then of course how to fix it.    

Dr. Justin Marchegiani: 100%. So, the first thing that I think is essential is you got to do a good history, you have to understand how everything unwound, right? And so, when you look at most people’s history, a lot of times there’s poor diet, there’s usually some stress issues, a lot of inflammation compounded by junky fats, um, poor digestion, in general, not being able to break down proteins and fats, lots of refined sugar usually processed grains, excess omega-6 or trans fats and these things just continue to put the body in a pro-inflammatory state and what that means is, when you become overall inflamed at a higher level, your body starts to break down faster than it can heal and so the goal of being anti-inflammatory, right, is restricting a lot of the foods that drive inflammation, so your body can heal faster than you break down. So, there’s always this net buildup versus net breakdown and so when you’re breaking down over time what starts to happen is just as you know from a joint standpoint, you’re starting to feel a little bit inflamed, stiff from a mood standpoint, you may have anxiety, depression, obviously fatigue starting to creep in. Because, the more inflamed you are, your body’s having to deal and allocate adrenal resources to deal with the inflammation, to deal with the stress where normally those adrenal resources would help with energy and good mood and good circadian rhythm and so of course then that starts putting stress on the thyroid then you start having mood issues, temperature, hair loose and then of course the more stressed you are, the more that starts to suppress your body’s ability to digest optimally. So, HCl levels, enzymes levels, maybe bile salt levels start dropping. You start to have a harder time breaking down protein, breaking down fat. You may start getting burpee or gassy or more flatulence, now, your motility starts to go south typically more on the constipated side but you can still have more diarrhea too. And then, your absorption starts to go south and when that starts to go south, now you start to have, um, a bottleneck and all the nutrients, whether it’s B vitamins, flat soluble vitamins like A, D, E, K, whether it’s minerals or amino acids to help your brain chemicals or cholesterol to help your hormones. Those building blocks start dropping and then those pathways start getting shorted and they don’t have the resources to run optimally. And, when we don’t have the resources, more symptoms start to happen. And of course, this kind of compound in this whole journey is the immune system starts to drop and then when the immune system starts to get weaker, now, bugs start coming into the situation, whether it’s parasites or yeast overgrowth or SIBO or bacterial overgrowth or H. pylori. And again, we don’t have to be married to which one or which system is the one, right? But we have to look at things objectively and, um, I think it was Dr. Kaler said this to me over a decade ago, it was kind of a good line, he said, ‘patients have the right to have more than one issue, more than one infection, more than one hormonal imbalance going on at the same time, so don’t get married to one thing because you have the right to have lots of things going on.

Evan Brand: Yeah. Yeah. And you illustrated beautifully, just the constellation of symptoms that can happen. So, if someone is coming in with gut symptoms that’s usually the tip of the iceberg. Underneath that iceberg, just like your poster, you got right there. If we put the tip of the iceberg is gut under the water there, it could be the anxiety, the depression, the fatigue, the low sex drive, the cold hands the cold feet, the brain fog, the concentration issues, the memory problems, the skin issues. And so, once you do a good history, you’re also gonna be talking about pharmaceuticals too, what kind of like proton pump inhibitors were you on. That’s a big thing, like were you on acid blocking medications, were you on other things disrupting your gut. So, of course, figuring out, if you’re still on those medications, you’re not fully gonna get better, if you have a ton of drugs that are causing these side effects and then you get into the testing. Now, this is where you and I differ from other people. Some people, they’re married to the SIBO test and I don’t want to speak for you, I’ll ask you about this but me personally, I think a SIBO test is a waste of time because when we look at a GI map stool test, we’re gonna see a more detailed breakdown of specific pathogens like Strep and Staph and Pseudomonas. And the way I look at it is your mouth to your but is one long tube, so, if there’s dysbiosis in there identified on the stool or the urine organic acids, we can assume it’s probably in the small intestine but the protocol, the herbs that you’re gonna use, are gonna treat the whole thing. So, to me, I want to hear your thoughts on this too, but to me, if I see positive hydrogen or methane, all I’m going to go and do and say is gonna to be, ‘yep that makes sense’, but beyond that those breath tests are not really that helpful.     

Dr. Justin Marchegiani: Yeah. I mean, a SIBO breath test is just looking, it’s an indirect measurement, looking at the gas created by the bugs, so methane or hydrogen gases that are created. So, if we can find bugs that typically produce those gases or an imbalance in but bugs that shouldn’t be there, then we know more than likely, there’s something going on in that SIBO realm. It doesn’t change the treatment that much because a lot of the herbs we use to knock down those bugs that they’re gonna be similar if not the same on the SIBO side. Now, my philosophy may be a tiny bit different than yours but I find anyone with these type of bug issues we’re running a comprehensive stool test and usually an organic acid test and on one or two of these tests, we’re gonna see either the bugs, the bacteria imbalances, whether it’s Citrobacter, Prevotella, Morganella, Pseudomonas, Klebsiella, or H. pylori or parasites. We’ll see these bugs elevated if we don’t almost always, we catch it on the organic acid side when we’re looking at 2,3 phenol acetate or benzoate or Hippurate or D’arabinitol for yeast, usually we’ll catch it there. If I don’t catch it on any of those tests on the stool test or the organic acid test then I’ll pull out a lactulose breath test but I’d say 99% of the time we never have to go that far.  

Evan Brand: Okay. Okay. Good point. Maybe it’s a 1% of the time test for you and I guess what I would do if let’s say we missed it, we felt like we missed it on stool and urine, I might just come in or if sometimes if someone just has no budget to do anything, we may just look at symptoms scan history and just come in with some herbs and see how they do. And, a lot times, a lot of these antimicrobials, antifungals, anti-parasitic herbs, a lot of times it clears up the issue anyway so we don’t like to come in blind but in a few rare cases we have come in blind and we’ve still had good benefits. A lady just chimed in on the live chat here, my gut is not happy, chronic constipation after using pain meds for pain and recovery from five back surgeries. Yeah, that’s a common issue with the opiates, right? Because that’s gonna slow everything down so yeah, I guess the answer is eventually this person’s gonna have to try to get off those opiates, right? But there are some, maybe some brain-gut motility activators we can use, right?  

Dr. Justin Marchegiani: Of course, you know, if you’re on those opiates, you probably had some surgeries and surgeries man, meaning typically anesthesia, maybe a lot of antibiotics along the way so that’s probably really screwed up the gut microflora. So, first off, you have to get to the root cause of the pain. Second thing is you have to have a good, uh, doctor to work with to taper you off those medications while providing anti-inflammatory support because you need whether it’s systemic enzymes or anti-inflammatory herbs plus that brain takes time to get rewired from the opiates because you’re processing pain totally differently. Remember, opiates don’t have an anti-inflammatory mechanism, they just block pain at the brain level which isn’t good because pain is a good indication like if I have pain in my ankle and it’s there then I can know okay I shouldn’t walk on it because I’m causing more damage, right? So, even if I were to take Ibuprofen and my pain went away, I would still want to be very careful, I don’t do too much on it because I’m gonna cause damage, right? So, most people that are chronically inflamed by these opiates, they’re just causing more and more damage because just because they can’t perceive the pain, they’re still causing this inflammatory breakdown.  

Evan Brand: Yep. That’s true. Someone else has chimed in, my gut has been destroyed by many rounds of antibiotics. And, that’s super common, I mean how many times have you and I see that where someone comes in after a round of antibiotics, I mean that’s probably one of the top five things we see, right?  

Dr. Justin Marchegiani: 100%

Evan Brand: They said they’re dealing with IBS-D so that would be diarrhea and eating a limited vegan diet. So, my first thought is, uh, oh vegan diet, raw leafy greens, if you’re dealing with diarrhea, vegetables are gonna irritate the gut, I would push you more towards getting some good animal proteins in even if you could only handle like a carnivore collagen like a beef peptide protein powder or you know collagen shake maybe with some organic berries that’ll be my first thought. How would you think about this one? 

Dr. Justin Marchegiani: Yeah. I mean, you could definitely look at reducing some of the fermentable carbohydrates and really look at cooking and steaming a lot of those things so it’s easier to break down but you really got to reach out to a good functional medicine doctor that can kind of help navigate you through it because if you don’t have all the digestive enzymes and acids there, it may be hard to break these things down. Also, someone chimed in, what about Vagus nerve issues. So, this is kind of a classic area in functional medicine where people try to talk about things differently in a nuanced way and they’re just talking about the same thing in a different way but people think it’s a new thing, right? So, when we talked about like inflammation and adrenal stress, when the more stressed you are and the more you activate the sympathetic and the more inflamed you are, right? Guess what happens when inflammation goes up and the sympathetic nervous system goes up, the vagus nerve or the parasympathetic nervous system always goes down, does that make sense? So, when we talk about these things it’s implied that the vagus nerve or the parasympathetic branch of the nervous system that would helps with healing and recovery is always going to be impaired and so people talk about things kind of as a way to nuance themselves make them seem different kind of market themselves in a different way which is fine but, you know, the average person may get a little confused about it and so just know that, that’s kind of under same umbrella that we’re talking about. We talk about the vagus nerve or the parasympathetic, it’s being factored into this whole adrenal stress inflammation umbrella, I think, yeah, inflammation is the bigger umbrella then you can put adrenals and parasympathetic and sympathetic all under that umbrella. 

Evan Brand: Yeah. Very true. Very well said. Teri chimed in, I’ve been experiencing constant belching, a new symptom for me. So, once again, you got to get the labs run, I want to look at your organic acid, see what’s going on there. Get a GI map stool test run. Are you on proton pump inhibitors? Are you taking supplemental acids and enzymes? How old are you? If you’re above the age 40, you probably have low acid, low enzymes, maybe gut infections too. So, with stool, urine sample and good workup, you could probably resolve belching. I mean, that’s a pretty easy one.  

Dr. Justin Marchegiani: And, I strongly recommend, do not get these labs on your own because, just because you get a lab, you’re not gonna have any ability to know what to do next and that’s everything, right? You gotta know what the plan is next, uh, and then typically you wanna look at like when I order a lab, it’s in conjunction with we’ve done a b c d e f and then not the lab is gonna plug in at g. Does that make sense? So, it’s never just this is a or this is it. There’s a whole bunch of, sequence of things that we’re doing before we get to all the data from the lab. And so, when you work with someone, most people are gonna have that plug in at some level in the clinical chain downstream. So, most people think, oh this is just it, this is a, this is the whole piece of the puzzle and it’s not. So, just kind of keep that in the back of your head. I know that can be a little bit confusing when you’re a lay person coming in there but it’s important information. I think, just start off with a lot of the foundational things first, just kind of wrap your head around it. Don’t get kind of myopic in this tunnel vision. Oh, it has to be Candida, it has to be this, be very open minded that it could be many different stressors and just have that really good differential kind of diagnosis list of all the things that we’re gonna go and hit and not get overly focused on one thing. 

Evan Brand: Yeah. Good point. I’ll also say too, I’m not saying go to your doctor who’s failed here for the last 10 years and try to ask them for organic acids test or stool test because even if they were able to run it which most of the time, they don’t have accounts set-up with the lab so they’re not going to. But even if they were able to and they run it, they’re not gonna know how to interpret it, they’re not gonna know how to make a protocol based on it. So, this is a shameless plug for you and I and what we do as functional medicine practitioners, we work clinically around the world with people. So, uh, Teri’s asking where she can get the labs from. It depends, uh, we use a couple different companies. It depends on where you live and what you got.

Dr. Justin Marchegiani: We’ll do this, we’ll put some links on the videos below so for you and on your site and mine. So, if you want to get it from us, I recommend getting it from us and then work with Evan or work with myself. We’re here to help you. We’ll put the links below or you can go to evanbrand.com for Evan or Dr. J here, justinhealth.com for me. And then, just to kind of highlight what you’re saying, I see so many people that have some of these tests sometimes and the first question is walk me through what your doctor ordered this test, said about it. Did they give you a real thorough review? How much time, oh, hey they just spent a minute, they just said x y z and it really was, I’m like wow, you know, you have all this information here and yet it really isn’t thoroughly addressed, I would say 90 plus percent of the time. So, it’s really important when you get these tests ordered. You really want to come through it thoroughly, so you can extract as much actionable information as possible. And, if your doctor doesn’t have that level of, uh, skill set of information on it, that’s fine, just find someone else. 

Evan Brand: Yeah. You make a great point. I mean, so many times, I know, you and I have a section on our intake form where you can, like attach previous labs. I’ll see 5, 10, 15, 20 labs and I’ll be from a medical doctor or a chiropractic or some other type of practitioner. I’m like wow, they did a really good work-up on you. Like, how did this go, why are you coming to me, what was the protocol? Oh, they didn’t have a protocol. Like, well, why’d they run the labs? ‘Because I wanted them to’. Okay, then what did they say about the labs? ‘Oh, well, that was not bad but I could use a little improvement and so they gave me an enzyme’. And it’s like, they give you an enzyme, you’ve got 20 pathogens, you’ve got parasites, you’ve got H. pylori, you’ve got major gut inflammation and the sequencing of this is important too. So, even if they read a cookie cutter protocol where it says like take oregano oil, you might not be a good candidate for that if you’ve got a bunch of inflammation. Your gut’s irritated, you go throw a, you know, a nuclear bomb in there, you’re gonna irritate your gut more. So, the sequencing is important. So, I guess, just to highlight here what we’re talking about, it’s the sequencing. As you mentioned, when does the lab come in? That’s not just the end all BL tool, there’s other strategies you’ve implemented up until that point. And then, when you work in the killers, is it right out of the gate? Do you got to settle the gut first? 

Dr. Justin Marchegiani: Yeah. It’s never. The problem is people have done, the patients come in and they’ve done a lot of different things. So, like maybe, they’ve tweaked their diet and so they think, okay I’ve made these diet changes, right, whether it’s enough or not is besides the point but they think, okay I’ve done these diet changes, check. Diet isn’t part of the equation, so in their mind they kind of check that off. So, when they see another practitioner, they kind of have this list of things in their mind they’ve checked off. And then, they’re like okay, I’ve already worked on the diet stuff. Yep, I’ve already done some digestive support. So when I lay out my plan, there’s kind of like, we’ll I’m not gonna do this because I’ve already done some of this or I’m not gonna do that. No. it’s like, if I give you a safe and the combination is 6 or 7 numbers. You don’t say we’ll spin number 33 on my other state therefore I don’t have to do it this time around. The combination has to be done in sequence together. The other analogy is cooking. If you want to crack the eggs after you bake the flour, well that cake’s gonna be pretty nasty, okay. So, it’s kind of the same thing as a sequence and just because someone has done something before in the past. One, it may not have been all the way there but we still have to plug that sequence back into the overall flow of things. Does that make sense?    

Evan Brand: Yeah. It does. And I know

Dr. Justin Marchegiani: You’re smiling, so it sounds like that’s something that you deal with and hear a lot. 

Evan Brand: Oh yeah. Yeah. Well, it’s just, you know, once 

Dr. Justin Marchegiani: It’s so much easier dealing with patients that have done nothing that have no, um, no predisposition to like what’s next, they’re like a blank state because then you can kind of come in and there’s zero resistance and you can work through your flow. When people have done a lot of things and they think they’ve done everything in that area, it’s always hard, you kind of have to convince them to redo these things over again. That could be tough. 

Evan Brand: Now, well, I’m just smiling because of the safe analogy, you know, you always kill it with the analogies and I’m also smiling because I don’t know if it was your kids or my kids screaming, I’m like, I’m pulling my headphone out like is that my kids is that Justin’s kids. And, one of the things that I hope you guys love and appreciate about us is that we’re dads, we’re family men at the end of the day. And so, we’re working, we’re hustling, we’re grinding with our clients but we’re implementing this stuff into our family we’re helping kids, our own personal kids, we’re working with kids clinically. I’ve got kids that are 1 year old, 6 months old, 3 years old that are clinically working with us to get help. And so, we’re practicing what we’re preaching with our family too and I just want to highlight that because there’s so many people out there, so many practitioners that they were so focused on medical school or their practice that they never have the chance to even start a family, you’ve got these mid 40s late 40s upper 50s practitioners out there. They have no family experience and I think that’s where you and I are different because we know when you’re working on a gut protocol. Let’s talk about that for a minute. When you’re working on a gut protocol with a kid and you’re like okay, we’ve got terrible tasting tinctures that we can try, we’ve got some capsules that maybe mom or dad can open up and put into apple sauce. You know, you and I have personally and clinically dealt with the logistics of implementing this stuff so even if you’re gonna get this perfect gut protocol put together, the logistics of following it and getting your kids to take it, 3-year-old Johnny who doesn’t want to take the Artemisia, you know, it’s like, well how do you get that in. That’s the important thing because the proper labs is a step, the proper nutrition is a proper step, the protocol is a step, but the implementation of it and then what do you do after step one and then you if they react to that herb, how do you go to step 2, this is where the hand-holding is necessary. So, you know, when we talk about labs, I think, it kind of devalues the art of medicine a little bit because you and I have so much artist, you know, artistry to what we do and it’s hard to translate that just with a lab test because, you know, anybody could start running labs and like you said we’ve seen 5, 10, 15 labs come in from previous practitioners but they did nothing with it. So, the real art is when you take the protocol, you take it with, you and I are injecting confidence and we’re injecting motivation. I talked with the client this morning who said that she came to me because she was so afraid of her gut symptoms and she came out of fear but now we have basically transformed that fear into empowerment and education and the labs were a tool to help change that. So, don’t put all your eggs in this lab basket, they’re still amazing, you and I still run them on everyone but there’s other stuff that’s injected into that lab that really makes the magic happen.    

Dr. Justin Marchegiani: Yeah. 100%. I think, the hardest part too is you work on dealing with the stressors, with patients. You fix their stress. You get your digestion better. You fix a lot of the microbiome. You knock down a lot of the bugs. Again, in the realm of Candida or dysbiotic bacteria, it’s still going to be there. You’re never ever gonna knock it out 100%. So, there’ll always be a small residual bit, maybe lingering in the background, way beneath threshold but if the stress starts to come back or if people start to add too much of food that’s questionable into their diet, sometimes these things can come back and the amount of flexibility, some kind of can follow the 80-20 principle. If they’re right 80% of the time on things 20% they have a little bit of flexibility. Some got to do 95.5 or some got to be 100 but just really try to make sure if they cheat, they still keep grain free anti-inflammatory etc., like last night, I went to True Food Kitchen for my birthday, and I had some of the, um, their chocolate cookies which inside the cookie, it’s like cassava and banana based. So, that’s great. If I’m gonna cheat, I’m gonna try to do it in a way that’s not gonna cause me to get bloated or gassy or have any skin issues or you know, digestive problems. 

Evan Brand: Uh, a lady commented and Dr. J seems super energetic today. Yeah. He’s a birthday boy. That’s why he’s feeling better.

Dr. Justin Marchegiani: Oh, yeah. No problem there. 

Evan Brand: So that’s good. Another comment here, I wonder which lab test should I run, uh. 

Dr. Justin Marchegiani: I would say just here, out of the gates, regarding labs, I don’t wanna name specific companies on these videos because if we change it in the future and someone just watches the video, um, that they may just go to the old one. So, we’ll put links down below. That way, if we decide to change things in the future then you could just go look at the links down below and so my staff typically will update this in the next 12 hours or so. Just check back at the end of the day or tomorrow, we’ll have everything in there so just keep an eye on that. In that way, if something changes, um, it’ll be reflected in the description below. 

Evan Brand: But here’s what we can say, we’re still gonna run a stool sample, now, maybe that type or whatever. 

Dr. Justin Marchegiani: Cutting edges, some kind of stool testing is gonna be great, right? Organic acid is gonna be excellent. I love that because of the, I mean, every now and then I’ll get a stool test coming back and the gut issues look pretty good like not too bad nothing crazy but then you’ll see a lot of yeast because sometimes you miss the yeast on the stool test, that’s common or you’ll see 3 or 4 markers like Hippurate, benzoate or 2,3-phenylacetate right or D-lactate really hides. Okay, good, I’m glad I had this extra net to catch it because the stool test missed it. 

Evan Brand: I had that last week actually. You know, I had a lady and I kind of got freaked out at first, you know, I was looking at the stool and I’m like, oh my God, this lady has every gut symptom in the book and normally on page 3, page 4 you’ll start to see some crazy stuff going on. In this lady, it was clean, oh man, like, is she crazy, I didn’t really think that but you know partly it is like, uh-oh, where’s it coming from, is this really her stool test. Then we get to the organic acids and holy smokes, as you mentioned, oxoglutarate, D-arabinose, tartaric acid, tricarbolic acid, everything was off the charts and I go, oh, thank you Jesus we have the answers on the organic acid. So, that’s why we love to run both urine and stool because certain things get missed and it’s the synergy of the information from the labs. You may find a parasite on stool and then you may find the Candida on urine then you really go, oh holy crap, that’s where it’s coming from. So, um, let’s hit this other one here. There was a person

Dr. Justin Marchegiani: I want to hit one of the questions. Anthony wrote to me there, thanks Anthony for the great feedback, and again guys, we’re trying to interact with you guys live and I want to answer questions live, so this is like I call it, uh, functional medicine improv, right? You know, you get your comedy shows, this is our functional medicine show so I appreciate that. Thanks for the feedback Anthony. Isabella writes in waking up distended, right in the morning. So, with that, a lot of times, you got to calm down a lot of the fermentables in the diet. If you’re waking up distended in the morning, almost always there’s a lot of fermentation happening in the gut and these gases are being produced. Now, there’s a couple of variables that you can do to help that. One, you starve it out by reducing all the foods that feed that. Two, you have to be able to break down your food because even if it’s good food, if you’re not breaking it down well, it’s gonna essentially have the ability to rot and rancidify and putrefy. So, you got to make sure enzymes, acids, and potential bile salts are addressed because HCl, hydrochloric acid, and bile salts, if you have low levels of that, those things in and off themselves are actually antimicrobial. They have a mild antimicrobial effect, not like oil of Oregano, but they have a mild antimicrobial effect. So, if you have, like, digestive distress and you have poor levels of these things, guess what, these bugs are more likely to grow and of course we have to come in there and do some killing, you know, making assumptions that like if you have a lot of distention like there’s no fiber, there’s no raw vegetables even though you read all these things have this big salad, you know, you could steam some of these things, you may want to look at low fermentable things that’s great. You may want to make sure your stress is good and you’re chewing your food up really well and you’re you know avoiding hydrating outside of an ounce or two of, you know, water to swallow and some supplements so that’s kind of your starting point. And if you wanna reach out, Isabella, you feel free to use the link down below, you can reach to Evan and I. 

Evan Brand: Let’s read the rest of her comment here because I think it’s helpful for people. So, she said that she tested negative for SIBO, I’m guessing that might have been a breath test and she said she’s 21 years old and it affects her daily life. So, when I hear 21-year-old female, a lot of bloating as you mentioned, I think the veggies, I think cutting out leafy greens, no salads, maybe or 

Dr. Justin Marchegiani: If you do it, keep them low FODMAP and steam it or sauté it like I’m pretty sure Bok Choy and Kale. That’s low FODMAP, if you sauteed that in some coconut oil or some ghee or some kind of good animal fat, you’d probably be okay but test it, right. I’m all about testing not guessing. 

Evan Brand: True. True. So, I think about hormones, I think okay, she’s 21, right? This is a healthy fertility age. Is there some sort of issue with hormone imbalances? Are there estrogen dominance type issues as well? What about breast tenderness? What about PMS, irritability? Are there mood issues as well or is it just an extremely distended belly? 

Dr. Justin Marchegiani: Now, in the history that’s gonna come out with a good history because you’re gonna see it cyclically happen typically premenstrual or typically ovulation. So, a good history will fret that out. Let’s assume it’s every day, hormones are probably not the root cause but of course we know we’ve already talked about it, chronic digestive issues will eventually cause hormone problems because of the inability to digest the nutrients to make the hormones overtime. 

Evan Brand: Good point. And, the bacterial overgrowth which will crank up beta glucuronidase. That creates the recirculation of toxins. So maybe that. What about birth control too? Is that in the equation? I start thinking about that so 

Dr. Justin Marchegiani: Birth control pill will, it definitely has an effect on, um, alkalizing some of that tissue in the intestinal tract and the vaginal tract. That’s why one of the big effects that you see with, like birth control pills is yeast infections, right? Because it’s shifting the pH. It’s also creating a lot of nutrient deficiencies. So, if you have birth control pill issues, they can definitely put you in that microbiome, um, area where it kind of goes the wrong way there. 

Evan Brand: Yeah. So, hopefully that helps and as you mentioned if you wanna reach out, you can. Dr. J at justinhealth.com and me at evanbrand.com. With a stool and a urine and a good workout, we could probably get to the bottom of that. I would say that digestive issues are something you and I have the most experience of out of anybody that I know because all the people that have failed others then they come to us. 

Dr. Justin Marchegiani: Absolutely. The hardest part too is once you kind of get on that straight and narrow, finding out how much latitude you have, right? Some people, they may not be able to do dairy afterwards. Some may still have to be grain free, they can’t even do rice or, um, oatmeal, right? So, some people they got to be a little bit tighter on their diet. Some can be a little bit looser. And it’s hard. The hardest thing I think is with kids because kids, I mean, I have two, a two- and four-year-old boys, right? And most kids in their age eat like crap. It is just like absolutely mortifying to see how most kids eat. And, normal and typical are two different things, right? So, people say, I wanna be a normal kid, I wanna eat like a normal kid. It’s like no, you wanna eat like a typical kid, like normal 60 years ago was a totally different diet than normal today, right? 60 years ago, everything was mostly organic. Kids ate relatively, you know, whole foods and there wasn’t all the GMOs and all the crap and all the excess omega-6 fats and trans fats and people were eating good proteins in every meal and we had actually home-cooked meals and home-cooked dinners. That’s totally different today, right? And so, typical and normal are two different things. 

Evan Brand: Yeah. Not many seed oils or non-existent seed oils or go back a little further, go back 5000, 15-20000 years in United States, even just a few hundred, you read the native American stories, I mean those kids were eating Bison, breakfast, lunch, dinner, you know, what were having, they were having Bison. If it was a time where they maybe didn’t get a kill, they had pemmican which is gonna be like a dried meat product, maybe some tribes, they would integrate berries into it. But if your food has a brand to it, now there are some exceptions like there are some really good companies that make Bison meat and all that but in general

Dr. Justin Marchegiani: The jerky, yeah, there’s some good stuff, there’s some decent paleo granola. If you can handle nuts and seeds then that stuff’s okay as well. 

Evan Brand: But in general, my point is if your food has a brand to it, it probably has some level of processed. Now, if you say a farm, like a farm name, I don’t consider that a brand. I’m talking about, like Kellogg, that’s a brand. If your food has a brand to it, it’s probably not something good. I’m not looking at the brand of my wild blueberries, I guess technically they have a name or a store but they’re blueberries. So, you just got to think simply and as you mentioned long term, there may be dietary changes but overall, I think a lot of people can get back to foods that they previously avoided or were previously afraid of, not to mention, people that are afraid of meat, so many people are afraid of red meat. We interview people all the time and they say, oh, I eat red meat a couple times a month, I eat red meat every day, like why, and oh well you know, my cholesterol or my heart or my doctor said this and so there’s still so much programming. I think you and I forget, now, I know you have TVs and you probably have some exposure to this but in general I don’t have any exposure to pharmaceutical ads and so I forget just how much indoctrination and programming of dietary information people have and so part of the art of what we’re doing too is just removing any of the historical programming, they’ve had about certain foods. I think some people freak themselves out so much, they’ve been told a certain food is so bad for them, they go into it, thinking if I eat this steak, I’m gonna have problems and they literally will put so much stress and emotion into the worry of food. That then drives further symptoms.  

Dr. Justin Marchegiani: Yeah. I always start with you gotta have a framework on how you analyze any data or any concept, right? So, my first framework that I look at anything with is old foods don’t cause new diseases, right? When you look at most of the diseases we have today, the regular there routinely Neolithic, right? They weren’t at the same level that we saw a hundred years ago, right? Obviously, we had different problems back then because we didn’t have the same level of water sanitation, indoor plumbing, antibiotics which you know for like, you get a major cut, you had an infection, you don’t have antibiotics, you could die, right? So, we have that, that’s different. So, Neolithic foods cause most diseases. And so, when you look at good proteins and animal fats and these kinds of things, they have been eaten for as long as you can go back. So, those typically aren’t going to be the problem, right? It’s mostly gonna be the processed foods, the excess omega-6. And also, you know, the whole vegan bent that’s something that’s not really supported by anthropological data. You look at the works of western price so you look at people that studied indigenous societies, almost always meat was consumed when it was available. The only societies that typically didn’t consume meat were societies that didn’t have access to it. And if you look at the works of Western price when meat was accessible, it was typically consumed. It wasn’t like, oh let’s just not consume it. It’s typically, they didn’t have access to it and when they did eat it. And so, people that tend to do really good on a non-vegan diet are your ectomorphs, these are people that can handle lots of carbohydrates. It’s impossible to do a vegan vegetarian diet for the most part and not be very, very high carbohydrate and also, typically, you also got to plug in a lot of protein powders to do it well, whether it’s free form amino acids, whether it’s collagen or pea protein or rice protein or hemp protein, mostly having to plug in a lot of amino acids to get enough especially if they’re trying to put on muscle and be, you know, on the fit side.  

Evan Brand: It’s hard to be Vegan, it’s easy to be an animal-based person, I’ll tell you that. There’s just a lot of hacking, have to do. So, Isabella chimed back in, she was a little bit behind on the live stream so she chimed in here. So, here we go, we got some more evidence guys. I hope you’re having as much fun as we are because this is like a, you know, on the fly functional medicine, uh, workup here. So, she said, loss of period for six months as well, mood issues like anxiety and racing heart upon waking irritability which is what I was thinking some kind of hormone stuff. I’m a bit behind wanted to input that so.  

Dr. Justin Marchegiani: The problem with a lot of those symptoms, it requires me having to ask a very important question, I won’t ask that question but we’ll just say the meat of that question begins with a letter v and we’ll just let people linger on that and Isabelle, if you want to reach out feel free. I think we chatted in the part, so feel free to reach out, I’m happy to help you.    

Evan Brand: Yeah. Yeah. That’s a very, very good point and would make perfect sense especially with the timeline here. I would be wanting to look at some blood work. You know, actually, I had a woman last week, 33 years old, loss of period, other issues, we ran her blood, elevated D-dimer that indicates breakdown of clotting so we’ll leave it at that for today but mid-30s women should not be having elevated D-dimer. 

Dr. Justin Marchegiani: Yeah, and we’re speaking kind of like we are in a very, uh, discrete type of manner because we want to keep this information flowing to you, okay, so people out there hopefully you most, you mostly get that and you want to continue to see us on the air. That’s our goal. 

Evan Brand: Here’s another question then you and I can wrap this up here in a minute. So, can gut health issues cause high resting pulse and arrhythmias. Let me tell you my personal experience and maybe we could chime in on the clinical side too but when I had gut issues when I had H. pylori, I was anxious, I had issues with my blood pressure. I had heart palpitations. I had panic attacks. I had all sorts of mood issues. I had heart issues. I had sleep issues. I had skin issues. So, 100%, gut issues can cause this.  

Dr. Justin Marchegiani: Yeah. The bugs in and of themselves definitely can cause anxiety so you can go type in their scientific studies, type SIBO or H. pylori and anxiety, there’s definitely mental health association, connection with the two. Also, if you have digestive issues, you tend to have hydrochloric acid issues. When you have hydrochloric acid issues, you tend to not ionize minerals and absorb minerals optimally. The two big minerals that are intimately connected with your heart and heart rate and heart rhythm are potassium and magnesium and a lot of times people aren’t getting sodium and chloride as well. So, the electrolytes have to be looked at and potassium and magnesium have to be looked at and most don’t get enough, you need 4 7 00 of potassium a day, most get half that and so I have a product called potassium synergy that does about 13 00 per 150 in magnesium or so side by side. It’s really hard to get enough. Most supplements for potassium stink, they’re like 50 or 100 milligram capsules so you got to take like 15 or 20 capsules a day so sometimes, you need to plug in a supplement if you’re having issues, I mean you can go look at the most potassium-rich foods, salmon, avocadoes, sweet potato. Those are really good options of course, um, some animal products as well, are going to be right up there as well. And again, avocados have twice the amount of potassium as bananas, I know we’re kind of o a carb-centric society. If I say potassium, you’re gonna say bananas, right? But avocados have twice the amount.  

Evan Brand: Yep. Good call. Good call. So, long story short, gut issues definitely cause other issues, mood issues are very common. Fatigue is also very common and so that’s gonna affect neurotransmitters so we would be looking at all that. We’d be looking at neurotransmitters, gut inflammation, um, secretory IgA. You can look at fecal fat. There’s a lot of stuff that goes into that, that may affect the high resting pulse. Also, seeing a lot of things right now with viruses and high resting pulse rate. So, if there was a current infection, previous infection, pulse rate could be there. You mentioned potassium. 

Dr. Justin Marchegiani: Hydration, sodium chloride and then your potassium, magnesium. Those are gonna be your big ones out of the gates. And then also, blood sugar, you know, some people, they really get into a stressed-out state if they wait more than an hour or so to eat. And if you have digestions, a little wonky, you may want to start with something really simple like some gentle ginger tea or some collagen amino acids or something really light and simple in the morning and some electrolytes even before that. 

Evan Brand: Yeah. Yeah. Good call. Sometimes, you know, herbals, I might come in with like motherwort or passion flower, valerian, some kind of like calming ginger.   

Dr. Justin Marchegiani: Yeah. I was looking at the nutrients first because the nutrients could be actually root cause and the herbals will never be root cause but they are a palliative supporting mechanism, right? You know, it’s like, you can do passion flower or lemon balm or you can do a benzo on the pharmaceutical side. It’s like obviously the herbs are better and then even before the herbs the actual nutrients that may be deficient that are driving it. 

Evan Brand: Very good at all. I’m ready to wrap this up, if you are

Dr. Justin Marchegiani: Herbs aren’t going to have the, you know, the side effects so I’m always down with supporting something palliatively if they aren’t going to have the side effects or you know any of the negative consequences like some of the meds may. 

Evan Brand: Yeah. Well said. Are you ready to wrap this up? 

Dr. Justin Marchegiani: Yeah. Great chat with everyone here today. I’m glad everyone’s on the chat interacting. We really appreciate it. Functional medicine improv is our flow here, uh, you guys wanna reach out to evanbrand.com for Evan, Dr. J here, myself at justinhealth.com. We’ll put links down below. If you’re seeing it on youtube, you know, great, excellent. If you’re listening to this on itunes or any of the podcast places, there will be a video link below. If you wanna see us interacting as well, there’s that as well. And phenomenal chatting. Anything else, Evan? 

Evan Brand: Yeah. If people wanna chime in and they want to watch, if you guys are listening or if they’re on my podcast because we’ll upload these on my show as well. If you want to check us out here on video, give or take somewhere around 11 to 12 eastern on Mondays on Dr. J, justinhealth YouTube channel. So, if you wanna look for us, join the party. Look up Justin on YouTube justinhealth, Justin Marchegiani, Dr. J something like that. You’ll find him on there and, uh, we’ll put the link in the show notes too. So, if you wanna join the YouTube community, you can. There’s what 60 something thousand on there. So, that’s pretty

Dr. Justin Marchegiani: Also on Rumble, also on Betshoot, also on a couple other places. So, we’ll put the links on the websites so you can get the banners, get the links but Rumble’s our new one that we’re going to just get more exposure, people. 

Evan Brand: And you’re reuploading the YouTube videos too there, right?

Dr. Justin Marchegiani: Yep. You got it. 

Evan Brand: No live function on there or anything yet? 

Dr. Justin Marchegiani: Not yet. Not yet. 

Evan Brand: Okay. Okay. All right, well, you guys take it easy, we look forward to helping you get your gut health back, just stay patient and don’t give up. And so, we’ll see you next week. 

Dr. Justin Marchegiani: Take care of you all. Bye now. 

 

Signs and Solution for Gut Inflammation and Leaky Gut | Podcast #351

In this video, Dr. J and Evan stress the importance of what you eat and how it impacts the rest of your body. However, what you might not realize is how your food is digested in your body, and when it gets inflamed and leaky, how do you fix it?

A lack of digestive enzymes can cause leaky gut syndrome—another unfortunate result of chronic inflammation in the digestive system. Many culprits cause leaky gut, including stress, medications, poor food choices or quality, alcohol, cigarettes, and even hormone changes.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
1:08  – Poor Gut Health Connection to Virus.
4:31  – What is the role of bile movement and production?
11:16 – The influence of gut michrobiota on Inflammation and Insulin Resistance
19:29 – General recommendations on carbohydrates and for a healthier gut


Dr. Justin Marchegiani: Hi! Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the signs and solutions of gut inflammation and gut permeability or leaky gut for short. Really exciting topic. We see it a lot in our patients every single day. Evan, how are we doing today man? 

Evan Brand: Hey. I’m doing really well. I can’t remember if we covered this on the podcast or not, this specific study but there was a paper that came out all about leaky gut and worsen outcomes with the virus and so people could put in the, you know, what virus in PubMed and leaky gut and we’re finding that a lot of people with leaky gut that’s actually one of the precursors and that’s what’s leading to worse outcomes so this is more important, It’s always important but this is more important now because we know that there’s a massive link and I’ll actually pull this up here and I’ll show you this, American Society for Microbiology, they did this. Did we talk about this yet or not? 

Dr. Justin Marchegiani: Let’s talk about it. Let’s go ahead. 

Evan Brand: This particular paper. Let’s bring it up there. 

Dr. Justin Marchegiani: Let me check here. Oh yeah. Let me add it on. Go ahead.

Evan Brand: Yeah. So, there we go. So, poor gut health is connected to severe blank, new research shows and long story short, you can go into this microbiology article but long story short they actually show a picture too. Let me see if I can get to that picture. Here we go. That was the picture. I think, we already showed this picture but forgive me and people listening on audio. Basically, we’re just showing that viral particles with a leaky gut are gonna be able to get into the circulation and that’s gonna increase your inflammatory response so the real goal of today is making sure that your gut is in good shape because therefore you’re not gonna have leakage into your circulation. You’re gonna be far far better if you have that healthy gut barrier. So, that was really kind of the spark notes of that but that’s like a 19 pages paper that you can dive into and many people I think have thought of leaky gut as kind of trendy topic that only people like you and I talk about but this is finally, actually getting into the mainstream. So, I hope gastroenterologists are gonna realize the importance of addressing the gut and I hope they actually start taking it more seriously. Right now, it’s just antibiotics that’s really the only thing that gastroenterologists do for gut, right? I mean steroids maybe and immune modulating drugs in the case of like, ulcerative colitis and Crohn’s but beyond that there’s not really much leaky gut conversation going on. 

Dr. Justin Marchegiani: No. There’s not and again, really, a leaky gut has an effect, right? Or we’ll call it gut permeability, right? If you go on PubMed, a leaky gut is like a slung. If you want to really find it, you want to look at, you know, gastrointestinal permeability, right? These are gonna be the big things, it’s the tight junctions, the epithelial cells and the small intestine, they start to come apart like my fingers here interlocked like I’m saying a prayer, they come apart and then you can see lipopolysaccharides undigested food particulate can slip out. So, this is, um, this is part of the major, major mechanism. Now, with gut permeability, it’s an effect not a cause so I always tell patients, we don’t go in and treat leaky gut, we treat the corresponding vectors of inflammation that drive gut permeability so that could be food allergens, that could be immune stressors like virus, parasites, small intestinal bacterial overgrowth, general dysbiosis, poor digestion, antibiotic exposure, creating rebound overgrowth, fungal overgrowth, you know, just poor digestion, lots of stress, increased sympathetic tone and adrenal stress, that’s shutting down the digestive system and making gut permeability more probable. So, these are the big vectors so we always wanna draw a line. What’s the root cause and what’s the effect and gut permeability is in the effect not necessarily a cause.  

Evan Brand: Yeah. I’ve seen a lot of, even advertisements now on social media for all these leaky gut healing formulas and that kind of stuff and it always has the word heal involved but you could take as much glutamine and whatever else you want. You could go into an elemental diet and all of that. It’s not gonna get rid of these big root causes and certainly for me, I tried some gut support but ultimately it was resolving my parasite infections. That was the most important thing for me and so, you can test for this. This is not an uncommon situation; you and I personally and clinically see parasites every single week. So, when you hear this idea of like, oh, it’s a third world country problem, you haven’t traveled to Mexico or anything like that. That’s just crap, I see it all the time and I had them and I was not out of the country and I had multiple parasite infections and then that affects your bowel flow, right? Can we talk about the bowel for a minute, what’s the role there, because you and I talked about how you have to have adequate bile to act as sort of a natural antimicrobial but how is this happening. What do you think are the big driving factors for why bile production is just not good? 

Dr. Justin Marchegiani: Well, first off, we look at the domino rally of digestion. The first thing that has to happen is good, nice aesthetic pH in the stomach. So, we need adequate HCl in the stomach, hydrochloric acid that lowers the pH and again, lower pH tends to have an antimicrobial effect, right? So, if we have to bring the pH down a little bit, that makes it harder for bugs to grow and that pH is also responsible for activating a lot of proteolytic enzymes in our stomach so if we have a good pH, we activate our enzymes, that starts the digestive cascade, we make it harder for bugs to grow and then once all that kind that mixed up food and enzymes and acids and all the stuff in our stomach is all mixed up. That’s called chyme, C-H-Y-M-E, that gets released into our small intestine, our pancreas then produces a bunch of bicarbonate to bring that pH back up to around neutral but that pH being nice and acidic, it triggers bicarbonate and then it also triggers cholecystokinin production, CCK, which then causes the gallbladder to contract so then you get a whole bunch of bile that comes out, you get a bunch of bicarbonate that comes out of the pancreas but then you’re also gonna get a bunch of lipase and proteolytic enzymes, trypsin, chymotrypsin lipase, lipolytic enzymes is coming out of the pancreas as well. So then, you bring the pH back up, you add the fat digestive enzymes, the proteolytic enzymes and then you also stimulate that bile production which then emulsifies that fat. Think of emulsification as you have a nice greasy pan where you cook some bacon on, right? Throw under water, you feel the fat on the pan, throw some dawn soap on there, it emulsifies it. It breaks that up so then you can get it all out the intestinal tract and be able to absorb it, carry on, mycells and be able to use it for lipid bilayer, hair, skin, nail, energy all that stuff. Prostaglandins. 

Evan Brand: Yeah. Well said. And though bile is produced by your liver but it’s stored in your gallbladder so people that have had their gallbladders removed which is a very common surgery, a lot of surgeons are very happy to remove gallbladders, I think in many cases, they may have been saved with fixing these other upstream issues but, well, once it’s gone, it’s gone. So, people listening that have no gallbladder, you have to take that into consideration. There was a study here in 2018, it was in the annals of gastroenterology, it found that poor bile flow can contribute to the development of inflammatory bowel disease. So, you’re really setting yourself up and find all the time with people clinically when they come in, they’ve had gallbladder removal, we see a lot of issues, we see massive bacterial overgrowth problems in these people and I think that’s partly due to not having enough bile being stored anymore like you and I have talked about it before, I think you said it was a 10x concentration in the gallbladder, is that right? 

Dr. Justin Marchegiani: 10 to 15x. Yeah. 

Evan Brand:  So, you’re missing out on that when you have just liver production, you don’t have that storage facility. I mean you have some but just nowhere near what you would have had if you had your gallbladder. So, please. Try to save your gallbladder. You got to fix these upstream infections because that’s gonna be and get off proton pump inhibitors with the help of your doctor if you can because we know that, that suppression of stomach acid is gonna lead to the overgrowth which then fuels these downstream issues to not happen the domino effect, it literally gets stopped or prevented by the PPIs.

Dr. Justin Marchegiani: 100%. And so, we need good, think of bile, it’s an emulsifier, it breaks down fat, it’s also an antimicrobial and so we create antimicrobial environments by having good, nice, low pH by having good enzyme and acid levels that also helps and then also by having good bile output and plus the longer that food sits there and rots and putrefies because we are not breaking it down into its constituent parts, right? Then it’s gonna create future petrification, fermentation, and rancidification. Essentially proteins and fats and carbs are rotting, right? Then you can get gas and bloating and that just creates this incredible breeding ground for bugs to grow. It’s like you can have this beautiful home that you take care of but if you leave the garbage in there like, a week too long it’s gonna get like, stinky and then you’re gonna get a whole bunch of bugs attracted to it, right? Same kind of thing in our microbiome so it’s really important that we stay on top of, you know, those good health practices.   

Evan Brand: Let’s hit the symptoms and signs and symptoms because people know most of the gut ones but there are some that you and I find clinically that maybe people wouldn’t think are a gut symptom, right? It might not manifest outside of that so we can cover the stuff like unusual color texture, smell, messy poops, you have floating stool. You have maybe alternating diarrhea, constipation, bloating, gut pain. But, what about like, skin issues and what about anxiety and depression and hormonal imbalances and brain fog. I mean, you and I have seen, we lost count how many times we’ve seen cases where we simply just fix the gut and all the sudden, this depression is lifted. I had one client named Miranda, who she had been depressed for, she said quote 20 plus years, all we did is do a gut protocol. I gave her no antidepressant herbs. We simply just did a gut protocol and when we did a six-week follow-up, she said her depression was 90% better and when she said 90% better, she didn’t even sound too excited and I said, are you realizing what you just said to me. You’ve been depressed for over 20 years and you’re 90% less depressed in six weeks of doing a gut protocol like do you realize how profound that is and she goes oh yeah, I guess that is amazing. Thank you. And, I think people, they get so used to feeling a certain way that when the clouds lift. They’re almost not even ready for it but depression, anxiety, I would put at the top of the list for mental health issues connected to these gut inflammation problems, I will tell you. And, you and I discussed this I remember calling you one-night years ago is probably like coming up on be six, seven years ago was like 2014, 2015 and I was like man, I’m having like a panic episode or something and this was when I was living down in Austin and it was H. pylori. It was driving that because as soon as I cleared the H. pylori, all those weird episodes of panic completely disappeared and I’ve seen that more than just the n equals one, me, I’ve seen it many, many times. So, if you have anxiety problems, you go to the psychiatrist. They’re not going to suggest you have gut infections but that’s something you need to be thinking about. 

Dr. Justin Marchegiani: 100%. Yep. 110% for sure. Anything else you want to add in that topic?   

Evan Brand: If you’ve got mental health issues, look in the gut maybe even look in the gut before you look in the brain. Now, obviously, we’re gonna be doing organic acid testing and other things to look at neurotransmitters so we’re gonna check out dopamine, serotonin. We’re gonna look at what’s called quinolinic acid so we can look for actual brain inflammation or brain toxicity related to gut infections like sometimes Clostridia, we’ll see will drive up the quinolinic acid markers but we still have to fix the gut. So, if you have a family member, they’re anxious, they’re depressed, they’re fatigued. We’ve seen a massive link between chronic fatigue and gut infection. So, there’s another big one that people may not recognize, the gastro doc may not suggest your chronic fatigue is from a gut infection but it certainly can be skin issues as well. My skin was a wreck years ago. I had major acne even though my diet was clean. It was my gut.  

Dr. Justin Marchegiani: Totally. I also wanna highlight one other kind of variable here. I think it’s really important. I’m gonna pull this on screen here. I think this is really interesting. So, an interesting abstract here and it’s looking at the influences on the gut microbiome on inflammation and insulin resistance so this is interesting because we talk about insulin resistance, right? Consuming too much carbohydrate and refined sugar. All carbohydrates get broken down typically into glucose, fructose or a combination of the two, right? And so, the more sugar that gets released into our bloodstream that gets broken down whether from refined sugar, sucrose which is fructose in glucose, high fructose corn syrup is fructose in glucose 55, 45 concentration and then of course we have starches which get primarily broken down into glucose and then we have fruit which is more on the fructose side. These things all have an impact on our blood sugar and the more insulin resistant we become, we, it drives inflammation. It’s hard to utilize these fuel resources and these fuel sources to get deposited in our fat because our muscles don’t have the ability to store it. our liver loses the ability to store it. We don’t have the activity level. We don’t have the mitochondria stimulation to burn it so we store it as fat. Now, this article is interesting. It talks about obesity as the main condition that’s correlated with the appearance of insulin resistance. Think of this as when your cells get numb to insulin. Now, this is on screen here. People that are looking if you’ve got mental health issues on the audio version, we’ll put the link below for the whole video. Whole bacteria, their byproducts and metabolites undergo increased translocation through the gut epithelium. Translocate, let me give you the translation on that. Here’s your gut. Leaky gut happens, right? Where it talks about gut permeability and things start to translocate meaning move from the inside of the gut back into the bloodstream, right? So, it translocates through the gut epithelium into circulation due to the degradation of tight junctions. This is a leaky gut, right? Here. And it increases intestinal permeability that culminates in inflammation and insulin resistance. So, what this says is the inflammation caused by gut permeability caused by gut permeability caused by lack of enzymes, bile, food allergens, all the gut microbiome issues can actually drive inflammation and insulin resistance. Now, it makes it harder for your mitochondria to generate fuel because you’re not able to get that fuel into your cell and you start to become more of a sugar burner. It’s very difficult to burn fat when you have high levels of insulin, Very, very difficult. So, several strategies focusing on modulation of the gut microbiome using antibiotics, again, we would use antimicrobial herbs, probiotics and probiotic fibers are being experimentally used to um, in order to reduce intestinal permeability, increase the production of short chain fatty acids. Guess what, things like butyric acid, medium chain triglycerides. Those are all very helpful. And again, this helps promote insulin sensitivity and counteracts the inflammation. So, really, really important here. This study, influence of gut microbiome on subclinical inflammation here and this is the 2000, see what’s the study, 2013 study so we’ve known this stuff out for a long time here that the gut microbiome plays a major role on your blood sugar, blood sugar handling and if you’re a diabetic or someone with insulin problems, you need to be looking at the gut. Yeah. look at the diet, look at, you know, getting your diet and your macros in order, make sure your food quality is good and then look at really getting the microbiome dialed in to really help. That could be a missing piece of the puzzle for people that have really changed their diet but not quite gotten the metabolic benefits of losing weight yet. 

Evan Brand: Wow. That’s a good point. You know, when I think back, when I had gut infections, my blood sugar was definitely not as good. I mean, 2 to 3 hours is as far as I could go without having to eat a meal. Now, I could fast all morning and not eat till 1 pm and I’m perfectly fine. I think there is an adrenal component too. I think I’m in a lot better place with that but I can tell you that certainly after mixing my gut, my blood sugar and blood stability is much better. So, I think you’re onto something with that paper and how people that even have gone paleo or animal based or keto. That still has issues with blood sugar regulation. That could be a sign of gut issues and I think even If diet dialed in in some cases what like you’re showing here, there could still be issues with the blood sugar. So, sometimes, it’s portrayed as like just fix your diet and everything else falls into place but you have to consider these other factors and also, I’ll throw in at the, you know, 11th hour here, mycotoxins, we know that mold toxins significantly affect the gut barrier and create a leaky gut. They damage the mitochondria, and we know that certain mycotoxins promote the overgrowth of bacteria like Clostridia and Candida. In fact, the lab will tell you that on paper, for example mycophenolic acid, it’s a very common mycotoxin that we see that comes from water damaged buildings. You breathe that in, that’ll then affect the gut and allow the overgrowth. So, if you’re just treating the antimicrobial herbs or fungal herbs and you’ve missed this giant mold exposure that can still affect the gut, still affect the brain and people won’t get fully better. So, that’s really the beauty of what we do is we try to work through all these puzzle pieces and help you because you could have this guy who says everything is gut and you go all the way down this gut rabbit hole and not get fully better or you go all the way down this insulin resistance rabbit hole and you still miss the smoking gun. You got the leaking dishwasher and your whole kitchen cabinetry. We had a woman in Texas last week, her dishwasher apparently leaking for years. Her entire kitchen has to be replaced now. She’s looking at 25k, just to replace her whole kitchen and she’s been to 10 doctors, 10 practitioners and nobody’s figured it out and I’m not trying to toot my own but I’ll just say I kept suspecting something because she said that she would always feel weird while she was washing dishes at her sink. She would get a little bit of a headache, feel a little bit sick to her stomach, said, ‘huh, is it possible that something’s leaking?’ and then boom brought in the remediator and they found it. There was a leaking dishwasher black mold everywhere.   

Dr. Justin Marchegiani: Yeah. Mold plays a major role in stressing out the immune system. It can create gut permeability within itself and then obviously drives the insulin problems. And also, people that eat this type of diet, I mean, it’s natural when you have microbiome issues to create a bunch of sugar because these foods are from an evolutionary standpoint, things that had a lot of sugar in it ended up having a lot of nutrients in it, right? Oh, a bunch of berries, some honey, right? And they were very rare in society. It was hard to find a lot of these things. Even fruit, you know, back then, tended to be a lot more sour and bitter and we’ve kind of hybridized and you know selectively grown fruits that tend to be sweeter and more, uh, and more plump and luscious now they taste. And so, we have sweeter fruits today and so it’s natural for people to want to crave all the crap that feeds the bad bugs because the bugs are producing chemicals to make you crave these foods. So, you have to be educated and understand that these foods, even though you’re craving them, you need to like not listen to those cravings sometimes and really shift your gut in it. If it shifts your macronutrients in a way to starve out some of these bugs, it can make a big difference.   

Evan Brand: Yeah. Well said. I mean, a lot of fruits hybridize now too as you mentioned to be sweeter, so like a strawberry. I’ve seen strawberries as big as my hand sometimes, like, ‘God’, you know wild strawberries, they’re tiny. I mean they’re like the size of a fingernail, if you’ve ever seen wild strawberries out in the yard, very tiny and definitely not anywhere as sweet as the other ones. So, when you hear people talk about fruit, like our modern fruit, like you said it’s not really, it’s more like candy with some, it’s like natural candy as opposed to the more ancient fruits so If I can find like some heirloom apples and that kind of stuff, I’m totally into it. 

Dr. Justin Marchegiani: Exactly. And you know, my general recommendation with carbohydrates, just make sure you earn it, make sure you’re not in a place where you’re inactive and try to get some activity because sugar goes three directions: gets stored in the liver and muscle, okay, so, if you’re working out, you’re always draining that muscle every day, you have a storage reservoir for it a little bit in the liver; It goes to fat or it stays in the bloodstream and gets burned up by the mitochondria essentially. It gets burnt up mitochondria-wise by the muscles etc. So, it’s gonna go either stored, burnt, you know, it’ll stay in the bloodstream but burnt up by the muscles of mitochondria or it gets converted to fat. So, if you’re doing things that allow you to utilize the glucose in that bloodstream, not as big of a deal, but that’s what you really have to look at what activity level is and you have to work with your functional medicine doctor about dialing in those macros and some people they need to starve out certain macros especially the fermentable carbohydrates and a lot of the inflammatory foods especially grains, legumes, dairy. Those things are really, can be, drive a lot of inflammation and that can keep your sympathetic nervous system and your immune system on high alert which just drains a lot of energy from you. Food allergens can make you fat and they can drain energy from you. Yeah. Seeds too. You know, I cut out almond seeds, nut seeds. Yep, even some eggs too for sure. 

Evan Brand: I cut out eggs for her while greens, I mean, some people are way overdoing it on the leafy greens. I can’t tell you the last time I ate a salad. I don’t really care. I don’t do leafy greens. I used to but, you know, I see way too many people doing these like kale smoothies. I had a lady doing like a pound of kale a day. Oxalates were off the chart. We know those affect the gut barrier too so there are downsides to plants. 

Dr. Justin Marchegiani: Yeah. I mean, it’s all about, you know, how you tolerate it, can you eat and feel good afterwards, how does your stool look? Do you see a bunch of undigested particulates? If so, you may want to work on just chewing your food up more. Taking some enzymes. See if that helps or sauteed it a little bit and see if that moves a needle. Again, there’s almost always a way, we can adjust things so it works but everyone’s a little different. 

Evan Brand: If you need further help, you can reach out to Dr. Justin at his website, justinhealth.com. Now, we do worldwide consultations, phone, facetime, skype, whatever it can connect to, we do it. Lab tests are sent around the world. It’s awesome we have distributors to work with. We can get these things to your door. We sign off on it and get you rolling so we can investigate and look deeper. So, justinhealth and then for me Evan Brand, it’s evanbrand.com. You can reach out and we’re both happy to help you. We love what we do. We’re very blessed for the opportunity to be in the trenches. We’re always improving our own health. We work on our families, our children. We work on everybody around us. We’re always trying to improve them and to be able to do it clinically too is just great. We learn so much from you all and we like to be the shining light in a world of darkness where people have been to countless practitioners and the stuff that to you and I is just common everyday conversation, functional medicine stuff. This stuff to some people is like wow why has nobody ever mentioned that to me before. And for us, it’s like, oh yeah uh-uh, we do it with everyone. So, we look forward to helping you uncover your root causes if you have gut inflammation, what’s going on. There’s something under it so don’t give up, keep pushing forward and please reach out if you need help. We’d love to help you.  

Dr. Justin Marchegiani: Yeah. Evanbrand.com, work at Evan. Dr. J, justinhealth.com, works with me. We are here with you guys. And, put your comments down below. Let us know the different things that you guys are applying, what’s working, what’s not and if you get overwhelmed listening to this. Try to take at least one action item out of it. I would say action items from a supplement standpoint. We’ll put our recommended supplements down below. We have different hydrochloric acid and enzyme support products that we’ll put down below for links. That’s always low hanging fruit. Again, diet wise, you know, a good autoimmune, lower fodmap diet can really be a good starting point and I would say for liver gallbladder, you know, we have our different formulas. I have one called liver supreme and again some of the hallmark nutrients in these products are gonna be bile, phosphatidylcholine, taurine, some products will have things like Tudca, which can be very helpful for biliary flow. Beetroot can be really helpful. if I didn’t mention Ox Biles. These are all maybe some milk thistle, very supportive for liver, gallbladder function, liver-gallbladder flow. So, very beneficial, we’ll put the links down below so if you guys enjoy the information and you wanna take action feel free to take a look at some of those links and support the show by grabbing some of those products and Evan will have his links down below as well. Anything else, Evan, you wanna add?

Evan Brand: I think, I said, we give people the links. Make sure you subscribe to the podcast if you’re listening on apple that’s probably where most people find us if you’re looking up. Justin’s show, make sure you subscribe there or my show, Evan Brand. We don’t care how you’re listening, you know, obviously we cross pollinate. We put these on each other so make sure you’re subscribed to both of them so you don’t miss it and we appreciate it. give us a review too. I think we should probably do a giveaway. I know some people giveaways so we can give away a book or you know free supplement or something but, in the meantime, give us a five star review on apple, we would love it. That’s how we stay up in the rankings so that we can actually share true functional medicine education to the masses because right now there’s still a lot of people that are in the top charts just theory. They’re not clinicians. They’re not in the trenches every day, all day, I mean we look at an exhaustive amount of lab testing that helps us to really dial the stuff we’re saying in. We then sprinkle in some studies and we stay up on the research but you could keep your head in the research all day and totally miss what actually works and it’s all about what actually gets people the results. So, keep that in mind and make sure you subscribe. Give us a review on Apple, we’ll love you forever. Thank you. 

Dr. Justin Marchegiani: 110% All the links will be below for you guys. Alright, thanks a lot. Evan, great chat with you man. Have a good one. Bye everyone.  

Evan Brand: You too, take it easy. Bye-bye. 


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/signs-and-solution-for-gut-inflammation-and-leaky-gut-podcast-351

Recommended products:

Enzyme Synergy

TRUCOLLAGEN

Liver Supreme

Digest Synergy

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Genova NutErval

The Top 5 Nutrients to Address Gut Inflammation and Leaky Gut | Podcast #339

Whenever you are worried about your gut health and having inflammation, Dr. J and Evan are here to share five essentials that may help you.

Lessen your intake of highly processed foods, refined carbs, sugar, artificial sweeteners, and alcohol. Opt instead for anti-inflammatory foods like fruits, vegetables, spices, and healthy fats but, if you suspect that several foods are triggering inflammation in your gut, it might be worth giving an elimination diet a try.

It may require removing foods from your diet that you suspect are connected to your gut problems for roughly two to three weeks at a time. Inflammation in your gut may cause a host of harmful health symptoms, from fatigue to irregular periods and chronic constipation. However, a few changes to your diet and lifestyle might be vital to helping you control these symptoms and improve your gut health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this podcast, we cover:

0:48   Looking into the Gut Deeper

3:53   Good Foundations

6:26   Chewing is Important

8:22   Mushrooms as Anti-Inflammatory Properties

16:00  Probiotics

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Hey, you’re doing really well. And you know, we always come up with a title. And then we over deliver on that title. So we’re calling this something along the lines of top five nutrients to help your gut or to heal your gut or support intestinal permeability, but maybe we end up going over five. So I’m just gonna go straight to my favorite because it’s so easy. It’s so broad spectrum in its use. And it’s so safe for people across the board to use it, whether it’s kids, adults, the elderly population, even people that don’t have testing, you know, our philosophy is test don’t guess we want to have the data, we want to have good stool testing, and good organic acids testing to look into the gut deeper and figure out what’s going on under the hood. But there is usually a three, sometimes four week timeline between talking with a client or a new patient and then getting the test results. So what do we do to help these people in that in between time before we can do the real work based on the data, I’d say my favorite is probably aloe, and specifically you and I use an aloe extract. It’s a 200 to one, so it’s 200 pounds of gel converted to one pound of extract, and then that’s encapsulated. We had a young boy, not super young, maybe 16 17. But he was diagnosed with autoimmune gut issues, Crohn’s all sort of colitis, actually pan colitis where the whole digestive tract was affected major bleeding in the store. We got him on simply a 200 to one extract of aloe. And within three weeks, we did a new gi map stool test, and we dropped his calprotectin levels, which is his gut inflammation by 1000 points, just by aloe alone.

Dr. Justin Marchegiani: Unbelievable. Yeah, it’s powerful what nutrients can do now I always tell patients, if you’re trying to come in and make some changes out of the gates, I mean, your best bang for your buck would be fixing the food, because the food is constantly getting your body getting your gut in flames. So the first thing we can do is look at the the the inflammatory food that could be coming in this could be gluten or other technically gluten free grains like corn, oat, rice, those kinds of things. So you want to really get the grains out, you want to really get a lot of the poly polyunsaturated omega six vegetable oils. And again, the reason why vegetable oils tend to be more, let’s say poor is because they’re highly processed to extract the fat. And the processing actually damages the fat and creates free radical stress within those fats. Because the more you take in damaged fats, your body has to utilize antioxidants to stabilize the fats. So they don’t create free radicals. And so it depletes a lot of your antioxidants. And then those fast take on and become part of your cell membrane. And to have healthy cells you have to have good membrane. Because the membrane essentially is the brain of your cell. It provides a lot of good cellular communication happens with the membrane. So if you have junky fats, whether it’s omega six junky fats, or trans fats like hydrogenated soybean oil, right, those kinds of things, canola, you know, safflower, those are going to be more junky omega six, and they’re going to really not make the healthiest cell membranes, they’re going to deplete your antioxidant reserves. And if they’re on the trans fat side, they’ll make your cell membranes very inflexible too.

Evan Brand: Yeah, good point. And I apologize for skipping over the diet piece, you know, you think of the typical American person, they think, just give me the pill. Give me the magic remedy. So we’ll talk about some of those remedies. But yeah, you make a great point, you can’t go out to Pizza Hut for dinner, and then just take an aloe capsule, and everything’s going to be okay. Correct.

Dr. Justin Marchegiani: Yeah. So that’s it’s good to look at the foundation out of the gates. I’d also say like, I’ll just kind of put this next category into a broad category and just say, amino acids. And these amino acids could be things like an acetylglucosamine, NaG that could be things like glycine, which are going to be very high in collagen or bone broth. And they could also be things like glutamine, so I kind of put these in the amino acid bucket, when they tend to be very good support for the entire sites of the gut lining, that can be used as fuel for the gut lining, they also can help with gut permeability. And, and glycine is a really good backbone for connective tissue. So it can be very helpful for that lot of that connective tissue healing out of the gates.

Evan Brand: So how about enzymes? When you hear nutrients to heal the gut or support the gut, you don’t necessarily think about enzymes, you think of more like you mentioned, the glutamine, Aloe, the kind of calming, soothing things, but I would argue enzymes have a role in helping with reducing gut inflammation simply by improving digestion and reducing the putrifying and fermenting of foods because I know my gut was Super inflamed. If I look back at some of my original stool tests, when I had gut infections, yes, I was doing things to soothe my gut, but simply just treated, the infections alone got the inflammation down. And part of that process of treating the infections was using enzymes, because my digestion was so terrible, I would get exhausted after a meal. And that was a sign that I had low stomach acid. So I would say the enzyme should be on our list here, because so many people do to age due to stress. Maybe you’re eating in a loud restaurant, like you’re on your lunch break for work, and you’re listening to us or there’s music, boom, boom, boom in the background, and you’re sympathetically stressed while you’re eating enzymes, to me would be a good insurance policy to help break down your foods and then therefore reduce inflammation.

Dr. Justin Marchegiani: Yeah, foods are not broken down properly, they’re going to sit, they’re going to ferment, they’re going to purify, they’re going to read certify also, those foods are more likely to create hydrogen and methane gases because they’re fermenting, and those gases can throw off your motility, motility and how you move the bowels. And if the bowels are one too short, or should take too fast on the diarrhea side, you may not absorb those nutrients well. And if they’re too long, on the conservation side, you may reabsorb fecal toxins. And so you know, long or short on the bowel motility can definitely affect absorption or create more toxins in the body. So I think that’s a big one. And then just kind of connecting the enzymes and we could throw HCl in there too, because HCl helps activate enzymes, I would say chewing, chewing and and really just the mastication and healthy eating habits because chewing your food up really fine, allows more surface area for those enzymes and acids to work. So you can have a good amount of enzymes or acids, you only have a couple of chews. you swallow your food, those enzymes and acids aren’t gonna work as good as you really chew it up, you know, 30 to choose one chew per tooth, you know, ideally like an oatmeal like consistencies and allow those enzymes and acids to work better.

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Evan Brand: It’s hard. I’ve tried to do that I’ve tried to do that many choose, oh man, my jaw gets tired. So and that’s the that’s the problem too, that we have with our food is like you go to Chipotle, a for example. Everything’s really soft. Like if you get rice if you get like carnitas. Or if you get the chicken, you barely have to chew it. It’s almost like mush. So I try to personally seek out occasionally I will seek out whether it’s like beef jerky, or no bison jerky or even just a steak, you know, I try to really get something that works my job because I just feel like in America, our food is so soft and easily digestible, that we don’t have to really chew anymore.

Dr. Justin Marchegiani: Yeah, so if you have a nice steak or a nice whole chicken, just make sure you chew it up. Same thing goes with over hydrating, you know, try to get your first thing I do is and I get to go eat a meal, I kind of go to the reverse osmosis filter, get a nice big glass of water to add some minerals, one, two, and then I get my meal going that way it gives me 10 15 minutes or so for everything to absorb. And of course the colder the water you got to take a little bit longer because your body holds that water in your stomach, heats it up to about room temperature and then passes it through. So the colder that water is, the longer you should wait in between the meal

About mushrooms. This is something that you know, just doing a little bit of research before we hit record, that this is something that I don’t necessarily go to right out of the gate but I’ve been using mushrooms for a long time. I know you and I personally have been taking mushrooms for a long time. And it turns out that for example, Lion’s Mane mushroom has some really, I would say probably just as impressive as some of the other herbs you’re mentioning, whether it’s like dgl, licorice or marshmallow kind of the conventional gut healing ones. Lion’s Mane has some really awesome anti inflammatory properties. There were two papers that we had found here on Lion’s Mane mushroom being shown to protect from and shrink gastric ulcers. Also, Lion’s Mane was shown to significantly improve symptoms of two major inflammatory disorders of the digestive system. And so that’s cool, because normally we’re using Lion’s Mane for cognitive problems. I know for me, my brain is much more clear. I’ve got Lion’s Mane mushroom in my system right now. I took two capsules this morning, and I certainly feel it mentally. But I did not even think that I was feeling it in my gut. So that’s cool.

Totally. Yeah, that gets really important. Again, a lot of gut issues, the immune system can be a big player at it. And so of course, if you’re able to modulate the immune system with the medicinal mushrooms, or immunogenic compounds that are going to be in those mushrooms, whether it’s beta one, three, D glucan, whatever that is, it could have an effect on gut permeability and improving digestion. I think all that’s very, very important. Also, just kind of one pet peeve of mine. Someone in the comments was chatting about this. A lot of people when they talk about leaky gut, they talk about leaky gut like like it’s the cause of Problem. leaky gut is the effects of on what’s happening with the gut. So the more inflamed you are, the more you’re not breaking down your food. The more crappy The food is, the more inflammatory The food is, the more dysbiosis we have, the the lack of certain nutrients we have, the more stress we are right. All that then creates and increases the chance of gut permeability. Gut permeability isn’t the cause unto itself. It’s the effects of a lot of other issues happening. So when people talk about Oh, you gotta fix the leaky gut. It’s like, not necessarily, you know, it’s like, it’s like saying, Oh, we have to fix. Imagine you have a leak in your roof and the waters pulling on the carpet below you. So we got to fix that water on the floor. It’s like, No, no, you fix the hole in the roof. And again, it may be semantics, but we got to call a spade a spade. If the water’s coming into the roof, you talk to them, we got to fix the hole in the roof. You don’t say we fixed the the water on the ground, right? So I just want everyone I want to train everyone to kind of get thinking about things from a root cause standpoint, versus labeling the damage at the end result conventional medicines really good at labeling damage down here and not talking about the effects of top that should the cause up top there labeling the effects down here. So we want to go root cause?

Yeah, that’s great. And I’m sure we could come up with other analogies on it. But that makes a lot of sense. It’s kind of like, okay, we need to come in with the towel. Oh, no. Now we have this super absorbent towel, this towel is going to absorb 1000 times more water on your floor than any other towel. And then yes, this, this carpet is mold resistant. So if you use this carpet, that water in your carpet won’t create mold, but you’re still missing the frickin hole in the roof roof.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

Well, let’s call it out. Let’s call out why that happens, though. It’s simply money. And it’s the supplement industry. There’s a lot of money. Yeah, it’s marketing. There’s a lot of money made on leaky gut this and this leaky gut book and this leaky gut protocol and this leaky gut practitioner. The problem is you could take all these leaky gut support for a decade and never treat the infections like if you just went and did like you mentioned glutamine, and we hit the zinc carnosine and the dgl. And we did the aloe, like we talked about in the beginning, none of those are going to erase a blastocyst is hominis, parasite infection, none of those are going to get rid of Giardia. None of those are going to treat the H pylori, they may help. But they’re definitely not going to eradicate the issue causing the leaky gut in the first place. So that’s just marketing. It’s money involved in this. And, you know, as practitioners, I think it’s really smart of you to call it out like that, because it’s, it is frustrating for us because we’ll look on a new client or new patients intake form. And they’ll be taking all these quote leaky gut supplements. Yeah, I found this leaky gut protocol online, and I still have all these digestive problems. And it’s like, well, yeah, look at your stool test, you have all these issues. And you could do that for 20 years and never fix it. So I could rant on that all day.

Yeah, other thing I would just say out of the gates is it’s okay to palliative Li support the leaky gut, we just have to make sure when you’re palliative Li supporting something we’re also root cause supporting it as well root cause fixing it. Palliative support, totally fine, right. Nothing wrong with that we just got to call a spade a spade and and not pretend the palliative leaky gut support is root cause support. Yeah, long as we can do that, then I think we’re pretty good. Next thing I would highlight out of the gates and you see this herb being listed as being very helpful for the gut permeability, but it’s also very helpful on the adrenal. So that’s licorice. And so when we use licorice is a lot of licorice being used in leaky gut supports. That’s that’s d glycerides. And this is the glycerides component of the licorice is pulled out. And the glycerides component of a licorice is is the component that slows the breakdown of cortisol, I think it’s the 11 beta hydroxy steroid dehydrogenase to enzyme. The licorice inhibits that enzyme. That’s the enzyme that helps break down cortisol. So we know cortisol too low, we need healthy levels of cortisol to actually build up the gut lining. It helps with building up the gut lining. Of course, if our cortisol levels are too high, and we’re chronically stressed, right, that can also break down the gut lining. We know that with people that are chronically stressed getting ulcers, right, we know that as well. And so when we look at licorice, it really helps with cortisol improvement. So if we do a cortisol test, and we see chronically low cortisol, that can actually help with the gut lining with the mucosa with the stomach with the duodenum. And that can actually help with the cortisol bringing that back up. And that can help build back up that gut lining. And so we like licorice, that’s non diglycerides for the gut and Nanda glycerides licorice, we give it typically orally sublingually, to our patients, that will eventually trickle downstream to the gut as well. And so licorice can be a powerful thing. You just have to be careful if you’re giving a non diglycerides version that people that have already higher level of cortisol, that may make things worse. So we just got to make sure we’re testing that to know what kind of pattern we’re seeing.

Yeah, that’s a good point. So we could do a whole part two on that. If you want. Give us some feedback. Like maybe the gut hormone connection. And we could hit that in detail. But yeah, you highlighted a very important point, which is that cortisol is involved with this whole process. And it really is a Goldilocks zone. If you have too little cortisol, you’re exhausted. And you’re probably going to be dependent on stimulants and caffeine and sugar and things that are going to damage your gut. But then simply, you don’t have enough to build up the gut. And then if you have too much, now you’re catabolic, you’re breaking down your muscle tissue, and you’re breaking down your gut barrier. That’s probably part of the reason that I lost a lot of weight and a lot of muscle. When I first moved to Texas, I had gut infections, and I was incredibly stressed, just moving and leaving my family behind, you know, emotional stuff, homesickness gut infections, I had the perfect storm to tear up my gut. So I can tell you firsthand that adrenal supports did help. And that was probably because it was helping regulate the cortisol levels, which then in turn, took the load off my gut, so to speak.

100% Yeah, I like that. And so it’s good to really make sure that’s under control. 

Evan Brand: How about probiotics? I think it’s worth mentioning. These are totally valuable tools that can help regulate histamine. Yeah, and regulate bacteria with it. So let’s dive into that.

Dr. Justin Marchegiani: Yeah, so you have to you I said you have three to four big families. Okay. So you typically have your lactobacillus and bifidobacterium, which are typically come together and usually a good high quality broad spectrum probiotic. So my line we have one called profile, Florida doesn’t have a lot of the different lactobacillus whether it’s kci acidophilus Bulgaria’s brevis, rhamnosus. And then of course, you have a lot of the bifidobacterium whether it’s bifidobacterium, bifidum, longum, brevis, right. So those are your broad spectrum lactobacillus or bifidobacterium. Probiotics, lots of good data, lots of good research anywhere from food poisoning for inflammation reduction, gut permeability reduction. nutrient absorption is all kinds of different studies connecting the dots on those so that’s kind of the bifidobacteria, lactobacillus Of course, we have more of our spore based or soil based probiotics. These are going to be a lot of your bacillus strains, right, whether it’s bacillus, subtlest class ei coagulans, like Informix, right. These are the bacillus strains. These are really good if you are very much cebo sensitive, fodmap sensitive, we may use some of these over a bifido lactobacillus species. And then of course, I’m a big fan of the probiotic that’s kind of more of a beneficial yeast called Saccharomyces boulardii in my lammie, one called sacral flora, again, we’ll put the links below for for all y’all so if you want to see it, we’ll put the links below sacral Flora Saccharomyces boulardii is very helpful a lot of studies on it, helping to improve immunity in the gut IGA IGA levels going to get low and just gut inflammation or gut stress. Of course, it’s going to help with food poisoning a lot of studies on it helping with H. pylori, C. diff, Clostridium difficile, blastocystis hominess. It also helps crowd out yeast and Candida so there’s a lot of excellent benefits with saccharomyces we love it and it’s usually going to be a core part of my probiotic, my fifth r which is repopulation re inoculation on the good healthy probiotics, once the fourth hour is done right fourth hours and to be removing the gut bugs removing the gut infections. Fifth hour, we come in repopulate re inoculate with good bacteria. Most people kind of sweet they want to start probiotics sooner, and that may not be the best step. Not saying it may not help. But some people have just found one that’s just a lot of pills. And two, if they have a lot of bad bugs in there. It’s like going and getting a whole bunch of good fresh grass seeds throw down on a lawn full of weeds, right? You got to get the weeds done before we throw down the seeds right got to get the car washed or we get waxed.

Evan Brand: Kind of like that. Yeah, we had a lot of good feedback on the podcast we did remember we were talking about probiotics and how a lot of new research is showing probiotics are being used to help with getting out mycotoxins and we know that mold toxins damage the gut. So yes, so I have been I’ve honestly been working in probiotics into the protocol sooner and most people do well. There are some like you said that just don’t you got to pull the weeds before you throw the seeds. But there are a lot of people doing really good with throwing probiotics and sooner in the protocols now. So like you said, if they can handle the amount of pills, maybe we try to sneak one or two in or we could do like powdered versions, typically, it’s like a quarter teaspoon, we could throw in a blend like that sack be you could you could do powder and maybe throw it in a smoothie or something. So we are trying to integrate those a lot. And I’ve had amazing success personally with probiotics. So I think it’s interesting, there’s still a lot of people that poopoo probiotic probiotics I know you and I we kind of get, you know, so caught up in the clinical trenches that we may miss some things, but I do get a couple of emails, you know, here and there from from people, clients sending them like, hey, this guy like says probiotics are a waste of money, and you know, that they don’t work. And I would just say that’s not true. We have so much clinical data personally.

Dr. Justin Marchegiani: It’s all about context, right? It’s like if someone comes in, they have chronic gut issues, and they’re just taking a probiotic thinking that that’s going to be the answer to their gut problems. It’s probably not right, and that’s where we’re trying to have a comprehensive functional medicine plan. That’s root cause and not just trying to Pro supplements at the wall thinking that that’s going to fix it. So yeah, I understand if that you know where that person is coming up with that, that bias that biases from not having a comprehensive root cause plan with a functional medicine practitioner, they’re just trying to throw stuff at them instead it hoping it will fix the symptoms, not fix the root cause.

Well, here’s Yeah, good, good point. Here’s the other thing, too, it’s even some probiotic companies will say that about other companies, it’s more of a marketing thing like, hey, their probiotic is crap, or it doesn’t work because of X, Y, or Z. But I will just say with what you and I use, clinically, we’re using professional supplement manufacturers exclusive only to health care providers. And a lot of the stuff we use, we have extended release technology. So when arguments like probiotics are going to die in the stomach, they’re not even going to make it to where they need to. But a lot of the new technology we use, they’re not even going to break open, they’re going to be resistant to the stomach acid. So that’s another problem too, when you hear these little like, super sometimes buzzworthy type articles. It’s not taking into consideration the quality, the quantity, the purity, the potency, the technology involved, it’s like probiotics, they get the label, and then that’s it. And that’s just not a fair classification.

Correct. And then also consumer reports that a study on probiotics a couple years back maybe 5 10 years ago. And what they found is most probiotics that they put a number on the outside of the bottle, hey, this is how many colony forming units. And what a lot of the cheap companies do is they say, Okay, this is how many should have been in this probiotic at manufacturing of this product. Let’s say it’s 20 billion. Now, what the professional companies do is, right, when you’re buying high quality, professional ingredients, they’re gonna say this is how many colony forming units should be in this capsule at expiration. And so you’re looking at something like two to three times the amount of those that species that CFU on the bottle colony forming units, is going to be typically in there. So when you see like, in my probiotic, I think it’s 40 billion per two capsules, right? That’s going to be what’s in there two years from now at expiration, right? And so obviously, it’s going to be two to three times the amount of that before. And so you want to use professional companies. So what you see on the label is always worst case, scenario, number one, and then also how products are stored by professional companies is very important. So like, where we have our warehouses, like everything is stored in an air conditioned or a refrigerated environment for a lot of our probiotics, some don’t necessarily need that. But which we value, the the scenario and how that store because that really increases potency, too.

Evan Brand: Yeah. And the funny thing is, too, we’ve seen some papers on supposedly expiration dates, you know, this is something that you and I are forced to do with the professional companies we work with. But you know, we’ve seen some research on supplements from 2030 years ago, still being viable, meaning they still had some potency and purity to them. And obviously, they still had a biological effect. So to me, I would if I had to pick like a consumer shelf bought probiotic, or a suppose that expired professional product, I’m going to go for the supposedly expired product, I’d go for a five year old professional probiotic, then, you know, on the shelf today consumer level.

Dr. Justin Marchegiani: Yeah, exactly. And also a lot of the probiotics or supplements that require refrigeration on the warehousing side, a lot of times you’re just not going to get that on Amazon, you’re not going to get that level of specificity just because that’s not how their warehouses are set up. And so with ours, we make sure that that refrigeration components is there because we’re working with patients and we need we need that potency, because we’re trying to get clinical outcomes, right. We’re trying to sell and provide a clinical outcome for the patient. And if we’re just providing products that aren’t meeting that standard, we’re not going to win. And of course, we want to be successful on that front.

Evan Brand: Yeah, yeah. Well say Well, I think we covered a lot of it. So the mushrooms are beneficial Lion’s Mane the mushroom is amazing for the brain, but for the gut also Chaga mushroom would be great reishi mushroom could also deserve a good mention, you hit upon the amino acids. So the glutamine or the various types of glucose amines involved. We love amino acids, we use those all the time you mentioned like collagen also being you know, part of that makeup, we hit on some of the herbs like the the licorice, or the dgl version of it, the marshmallow, we like to use a lot, we hit upon the aloe, and then we hit the probiotics, I think those are the big categories. And then the enzymes we hit that too.

Dr. Justin Marchegiani: I think we did a really good job hitting a couple and I just I really want to plug in concepts, right? Like a lot of people, they just try to throw information at people and and try to memorize that. I think that’s not beneficial. But if you can just understand concepts, right? A concept is just something that sticks. You either get it or you don’t. And so we try to use a lot of analogies and understand we try to plug in a lot of the concepts of root cause versus palliative cause. We try to get you to think about, hey, if this helps, why does it help? is it just an anti inflammatory? is it helping just improve better digestion? is it helping your immune system? is it helping your adrenals and helping you that your body’s natural process to build back up that gut lining? What’s the underlying mechanisms if you understand that, then you see how it plugs into the greater matrix of healing.

Evan Brand: Yeah, I mean, I agree 1,000%. So, I think the big concept of today is Yes, here are some things here are some nutrients you can use. However, we really want to make sure you’re testing, not guessing. So if you do need the aloe to calm the gut for now, you need the enzymes to help improve digestion. For now, you notice that HCl is helping with your heartburn or you notice that the enzymes are reducing your bloating, or your burping or your gas. Great, but what led to all that in the first place? What led you to need the aloe because you had gut inflammation, what led you to need the enzymes, that’s where somebody like us can come in and help you figure that out and plot it on paper. And, you know, we’ve been through the trenches personally. And clinically, we’re always improving upon herself. You know, I work on my children, I know you work on your children, we’re giving our kids things to help their guts, I mean, so this is like a, there’s no finish line, I don’t want people to think, Hey, I just do this aloe for a month, and then I’m done. You know, there’s not a finish line with the gut, we’re constantly being exposed to new toxins and new pathogens. We’ve even seen with the virus that’s been going around a lot of issues with the gut there, we’ve seen a lot of issue with tissue destruction in the intestinal tract. So who knows? Right now with the 5 10 year outlook of the GI health in the US is right now, our guts are notoriously bad, due to glyphosate and other things, damaging them. So just a quick note, you kind of started with the diet all and with the diet 100% organic is important, if you’re going to go buy all these probiotics, but yet, you’re going to eat strawberries with an average of 22 pesticides on them. If they’re not organic, you’re wasting your frickin time and your money because we know all those pesticides are just killing the beneficial bacteria in your gut that you’re trying to re inoculate or repopulate with. So please go organic, you know, before you spend money on probiotics.

Dr. Justin Marchegiani: Exactly. And then also how long do these probiotic strains last in your gut, I mean, a lot of times, you’re going to see the data show in about one month or so. So that they don’t stay forever. So when you take a probiotic, it’s not like it’s there forever. So it’ll it’ll hang around typically for a month, it’ll help with a nutrient synthesis, it’ll help with nutrient absorption, it’ll help with inflammation, modulating the immune system, there’s some data that maybe the spore based probiotics hang around a little bit longer, and they may help proliferate the growth of other beneficial species. So just think when you take a probiotic, it’s not forever. Now the goal is that we’re getting some level of fermentable foods in your diet, whether it’s from sauerkraut, or low sugar kombucha, or some kind of fermented pickle or something, or, you know, cultured coconut milk or potentially high quality raw milk if you can tolerate it. So you know, that’s typically how we’re getting exposed to probiotics more on a day in weekend kind of situation. If you’re someone that can’t get that level of exposure with fermented oils from food, then you probably want to be on a probiotic a little bit more frequently, if you’re not getting those fermentable. So we just got to plug and play where we’re at. I think our ancestors probably did more fermentable foods, which is ideal. But if we can’t we plug in a good quality probiotic, or at least throw in something every couple of months, just to kind of fill in the gap to make sure we’re getting exposed to those good for mandibles.

Evan Brand: Yeah, great point, I just want to highlight what you said too, which is like your gut bacteria are actually going to help you with your health in other ways. So once gut bacteria optimize your healing the gut, you’re making neurotransmitters the way you should you’re making serotonin, you’re making things to improve yourself, you’re making B vitamins to help your energy and your mitochondria. So this is why I really the gut, I mean, we just we can’t stop talking about it because it literally is the foundation.

Dr. Justin Marchegiani: Exactly. So just kind of want to make sure that is understood. And that makes sense for everyone. We’ll put a list of recommended products down below. So you guys have access to those you want to support us support the show, we appreciate it put those down below. Also, if you guys want to reach out to Evan brand, head over to EvanBrand.com, Evan is there for you guys worldwide. And again, I’m there for you as well, justinhealth.com, Dr. J myself, there’ll be a little link button, you guys can click and reach out to us we are available worldwide to help you guys help you help support y’all. We want to make sure they have the support you need. And you have a good comprehensive plan to get what’s going in the right direction if you’re not having success. And then also just try to apply one thing today as well. If you’re having if you’re overwhelmed, and you’re having a sticking point great to reach out, if not just try applying this information, we want to really help as many people as possible. And we know we’re going to help many more people than we actually see in person with this information. So just make sure you’re applying it. And if you are enjoying it, share it with family and friends that could also benefit put your comments down below. Let me know the best part that you liked about this what resonate with you the most. And give us a like and share as well. We appreciate it.

Evan Brand: Yeah, and if you’re on the apple listening, if you’re on your Apple podcast app or Stitcher or wherever else, give us some stars, let us know what you think the show deserves between us both we have I lost count, but it was somewhere over 705 star reviews for our podcast in between our various feeds. So please give us some stars. Give us some sentences give us a blurb on whether you still call it iTunes or Apple podcast. We’d love to beat out people that are not clinically oriented. There’s still like top health podcast out there that it’s just theory theory theory theory. And then we have to like recalibrate people’s theories because they’re not clinically based. So we would love to beat those people. How do we beat those Before we go higher in the charts, how do we do that? With your reviews! So we have a some stars. 

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take careDr. Justin Marchegiani  

Hey guys, it’s Dr. Justin Marchegiani here. Today’s podcast is we’re going to be talking about the top five nutrients to address gut inflammation, and leaky gut or gut permeability. So this is a topic that’s pertinent to a lot of our patients as gut inflammation, there’s usually some component in why they’re not feeling good. So I’m really excited to address this today with Evan, we’re gonna dive into the things that we do clinically, the things that work with our patients, the things that actually get results, we’ll break it down, and we’ll kind of give you guys some action items for today as well. And what’s cooking man? How are we doing?

Evan Brand: Hey, you’re doing really well. And you know, we always come up with a title. And then we over deliver on that title. So we’re calling this something along the lines of top five nutrients to help your gut or to heal your gut or support intestinal permeability, but maybe we end up going over five. So I’m just gonna go straight to my favorite because it’s so easy. It’s so broad spectrum in its use. And it’s so safe for people across the board to use it, whether it’s kids, adults, the elderly population, even people that don’t have testing, you know, our philosophy is test don’t guess we want to have the data, we want to have good stool testing, and good organic acids testing to look into the gut deeper and figure out what’s going on under the hood. But there is usually a three, sometimes four week timeline between talking with a client or a new patient and then getting the test results. So what do we do to help these people in that in between time before we can do the real work based on the data, I’d say my favorite is probably aloe, and specifically you and I use an aloe extract. It’s a 200 to one, so it’s 200 pounds of gel converted to one pound of extract, and then that’s encapsulated. We had a young boy, not super young, maybe 16 17. But he was diagnosed with autoimmune gut issues, Crohn’s all sort of colitis, actually pan colitis where the whole digestive tract was affected major bleeding in the store. We got him on simply a 200 to one extract of aloe. And within three weeks, we did a new gi map stool test, and we dropped his calprotectin levels, which is his gut inflammation by 1000 points, just by aloe alone.

Dr. Justin Marchegiani: Unbelievable. Yeah, it’s powerful what nutrients can do now I always tell patients, if you’re trying to come in and make some changes out of the gates, I mean, your best bang for your buck would be fixing the food, because the food is constantly getting your body getting your gut in flames. So the first thing we can do is look at the the the inflammatory food that could be coming in this could be gluten or other technically gluten free grains like corn, oat, rice, those kinds of things. So you want to really get the grains out, you want to really get a lot of the poly polyunsaturated omega six vegetable oils. And again, the reason why vegetable oils tend to be more, let’s say poor is because they’re highly processed to extract the fat. And the processing actually damages the fat and creates free radical stress within those fats. Because the more you take in damaged fats, your body has to utilize antioxidants to stabilize the fats. So they don’t create free radicals. And so it depletes a lot of your antioxidants. And then those fast take on and become part of your cell membrane. And to have healthy cells you have to have good membrane. Because the membrane essentially is the brain of your cell. It provides a lot of good cellular communication happens with the membrane. So if you have junky fats, whether it’s omega six junky fats, or trans fats like hydrogenated soybean oil, right, those kinds of things, canola, you know, safflower, those are going to be more junky omega six, and they’re going to really not make the healthiest cell membranes, they’re going to deplete your antioxidant reserves. And if they’re on the trans fat side, they’ll make your cell membranes very inflexible too.

Evan Brand: Yeah, good point. And I apologize for skipping over the diet piece, you know, you think of the typical American person, they think, just give me the pill. Give me the magic remedy. So we’ll talk about some of those remedies. But yeah, you make a great point, you can’t go out to Pizza Hut for dinner, and then just take an aloe capsule, and everything’s going to be okay. Correct.

Dr. Justin Marchegiani: Yeah. So that’s it’s good to look at the foundation out of the gates. I’d also say like, I’ll just kind of put this next category into a broad category and just say, amino acids. And these amino acids could be things like an acetylglucosamine, NaG that could be things like glycine, which are going to be very high in collagen or bone broth. And they could also be things like glutamine, so I kind of put these in the amino acid bucket, when they tend to be very good support for the entire sites of the gut lining, that can be used as fuel for the gut lining, they also can help with gut permeability. And, and glycine is a really good backbone for connective tissue. So it can be very helpful for that lot of that connective tissue healing out of the gates.

Evan Brand: So how about enzymes? When you hear nutrients to heal the gut or support the gut, you don’t necessarily think about enzymes, you think of more like you mentioned, the glutamine, Aloe, the kind of calming, soothing things, but I would argue enzymes have a role in helping with reducing gut inflammation simply by improving digestion and reducing the putrifying and fermenting of foods because I know my gut was Super inflamed. If I look back at some of my original stool tests, when I had gut infections, yes, I was doing things to soothe my gut, but simply just treated, the infections alone got the inflammation down. And part of that process of treating the infections was using enzymes, because my digestion was so terrible, I would get exhausted after a meal. And that was a sign that I had low stomach acid. So I would say the enzyme should be on our list here, because so many people do to age due to stress. Maybe you’re eating in a loud restaurant, like you’re on your lunch break for work, and you’re listening to us or there’s music, boom, boom, boom in the background, and you’re sympathetically stressed while you’re eating enzymes, to me would be a good insurance policy to help break down your foods and then therefore reduce inflammation.

Dr. Justin Marchegiani: Yeah, foods are not broken down properly, they’re going to sit, they’re going to ferment, they’re going to purify, they’re going to read certify also, those foods are more likely to create hydrogen and methane gases because they’re fermenting, and those gases can throw off your motility, motility and how you move the bowels. And if the bowels are one too short, or should take too fast on the diarrhea side, you may not absorb those nutrients well. And if they’re too long, on the conservation side, you may reabsorb fecal toxins. And so you know, long or short on the bowel motility can definitely affect absorption or create more toxins in the body. So I think that’s a big one. And then just kind of connecting the enzymes and we could throw HCl in there too, because HCl helps activate enzymes, I would say chewing, chewing and and really just the mastication and healthy eating habits because chewing your food up really fine, allows more surface area for those enzymes and acids to work. So you can have a good amount of enzymes or acids, you only have a couple of chews. you swallow your food, those enzymes and acids aren’t gonna work as good as you really chew it up, you know, 30 to choose one chew per tooth, you know, ideally like an oatmeal like consistencies and allow those enzymes and acids to work better.

Evan Brand: Yeah, I’m 18th down. So I guess I get off the hook with 32. You know, I have my wisdom teeth and my 12 year molders out so.

Dr. Justin Marchegiani: Oh, yeah, there you go. I mean, I have my wisdom teeth out as well. So I’m kind of at 28 as well. So I get it. So let’s just say 30 plus or minus a couple.

Evan Brand: It’s hard. I’ve tried to do that I’ve tried to do that many choose, oh man, my jaw gets tired. So and that’s the that’s the problem too, that we have with our food is like you go to Chipotle, a for example. Everything’s really soft. Like if you get rice if you get like carnitas. Or if you get the chicken, you barely have to chew it. It’s almost like mush. So I try to personally seek out occasionally I will seek out whether it’s like beef jerky, or no bison jerky or even just a steak, you know, I try to really get something that works my job because I just feel like in America, our food is so soft and easily digestible, that we don’t have to really chew anymore.

Dr. Justin Marchegiani: Yeah, so if you have a nice steak or a nice whole chicken, just make sure you chew it up. Same thing goes with over hydrating, you know, try to get your first thing I do is and I get to go eat a meal, I kind of go to the reverse osmosis filter, get a nice big glass of water to add some minerals, one, two, and then I get my meal going that way it gives me 10 15 minutes or so for everything to absorb. And of course the colder the water you got to take a little bit longer because your body holds that water in your stomach, heats it up to about room temperature and then passes it through. So the colder that water is, the longer you should wait in between the meal

About mushrooms. This is something that you know, just doing a little bit of research before we hit record, that this is something that I don’t necessarily go to right out of the gate but I’ve been using mushrooms for a long time. I know you and I personally have been taking mushrooms for a long time. And it turns out that for example, Lion’s Mane mushroom has some really, I would say probably just as impressive as some of the other herbs you’re mentioning, whether it’s like dgl, licorice or marshmallow kind of the conventional gut healing ones. Lion’s Mane has some really awesome anti inflammatory properties. There were two papers that we had found here on Lion’s Mane mushroom being shown to protect from and shrink gastric ulcers. Also, Lion’s Mane was shown to significantly improve symptoms of two major inflammatory disorders of the digestive system. And so that’s cool, because normally we’re using Lion’s Mane for cognitive problems. I know for me, my brain is much more clear. I’ve got Lion’s Mane mushroom in my system right now. I took two capsules this morning, and I certainly feel it mentally. But I did not even think that I was feeling it in my gut. So that’s cool.

Totally. Yeah, that gets really important. Again, a lot of gut issues, the immune system can be a big player at it. And so of course, if you’re able to modulate the immune system with the medicinal mushrooms, or immunogenic compounds that are going to be in those mushrooms, whether it’s beta one, three, D glucan, whatever that is, it could have an effect on gut permeability and improving digestion. I think all that’s very, very important. Also, just kind of one pet peeve of mine. Someone in the comments was chatting about this. A lot of people when they talk about leaky gut, they talk about leaky gut like like it’s the cause of Problem. leaky gut is the effects of on what’s happening with the gut. So the more inflamed you are, the more you’re not breaking down your food. The more crappy The food is, the more inflammatory The food is, the more dysbiosis we have, the the lack of certain nutrients we have, the more stress we are right. All that then creates and increases the chance of gut permeability. Gut permeability isn’t the cause unto itself. It’s the effects of a lot of other issues happening. So when people talk about Oh, you gotta fix the leaky gut. It’s like, not necessarily, you know, it’s like, it’s like saying, Oh, we have to fix. Imagine you have a leak in your roof and the waters pulling on the carpet below you. So we got to fix that water on the floor. It’s like, No, no, you fix the hole in the roof. And again, it may be semantics, but we got to call a spade a spade. If the water’s coming into the roof, you talk to them, we got to fix the hole in the roof. You don’t say we fixed the the water on the ground, right? So I just want everyone I want to train everyone to kind of get thinking about things from a root cause standpoint, versus labeling the damage at the end result conventional medicines really good at labeling damage down here and not talking about the effects of top that should the cause up top there labeling the effects down here. So we want to go root cause?

Yeah, that’s great. And I’m sure we could come up with other analogies on it. But that makes a lot of sense. It’s kind of like, okay, we need to come in with the towel. Oh, no. Now we have this super absorbent towel, this towel is going to absorb 1000 times more water on your floor than any other towel. And then yes, this, this carpet is mold resistant. So if you use this carpet, that water in your carpet won’t create mold, but you’re still missing the frickin hole in the roof roof.

Exactly, exactly. So we just got to really be on top of that. Make sure everyone’s thinking root cause I think that’s really helpful.

Well, let’s call it out. Let’s call out why that happens, though. It’s simply money. And it’s the supplement industry. There’s a lot of money. Yeah, it’s marketing. There’s a lot of money made on leaky gut this and this leaky gut book and this leaky gut protocol and this leaky gut practitioner. The problem is you could take all these leaky gut support for a decade and never treat the infections like if you just went and did like you mentioned glutamine, and we hit the zinc carnosine and the dgl. And we did the aloe, like we talked about in the beginning, none of those are going to erase a blastocyst is hominis, parasite infection, none of those are going to get rid of Giardia. None of those are going to treat the H pylori, they may help. But they’re definitely not going to eradicate the issue causing the leaky gut in the first place. So that’s just marketing. It’s money involved in this. And, you know, as practitioners, I think it’s really smart of you to call it out like that, because it’s, it is frustrating for us because we’ll look on a new client or new patients intake form. And they’ll be taking all these quote leaky gut supplements. Yeah, I found this leaky gut protocol online, and I still have all these digestive problems. And it’s like, well, yeah, look at your stool test, you have all these issues. And you could do that for 20 years and never fix it. So I could rant on that all day.

Yeah, other thing I would just say out of the gates is it’s okay to palliative Li support the leaky gut, we just have to make sure when you’re palliative Li supporting something we’re also root cause supporting it as well root cause fixing it. Palliative support, totally fine, right. Nothing wrong with that we just got to call a spade a spade and and not pretend the palliative leaky gut support is root cause support. Yeah, long as we can do that, then I think we’re pretty good. Next thing I would highlight out of the gates and you see this herb being listed as being very helpful for the gut permeability, but it’s also very helpful on the adrenal. So that’s licorice. And so when we use licorice is a lot of licorice being used in leaky gut supports. That’s that’s d glycerides. And this is the glycerides component of the licorice is pulled out. And the glycerides component of a licorice is is the component that slows the breakdown of cortisol, I think it’s the 11 beta hydroxy steroid dehydrogenase to enzyme. The licorice inhibits that enzyme. That’s the enzyme that helps break down cortisol. So we know cortisol too low, we need healthy levels of cortisol to actually build up the gut lining. It helps with building up the gut lining. Of course, if our cortisol levels are too high, and we’re chronically stressed, right, that can also break down the gut lining. We know that with people that are chronically stressed getting ulcers, right, we know that as well. And so when we look at licorice, it really helps with cortisol improvement. So if we do a cortisol test, and we see chronically low cortisol, that can actually help with the gut lining with the mucosa with the stomach with the duodenum. And that can actually help with the cortisol bringing that back up. And that can help build back up that gut lining. And so we like licorice, that’s non diglycerides for the gut and Nanda glycerides licorice, we give it typically orally sublingually, to our patients, that will eventually trickle downstream to the gut as well. And so licorice can be a powerful thing. You just have to be careful if you’re giving a non diglycerides version that people that have already higher level of cortisol, that may make things worse. So we just got to make sure we’re testing that to know what kind of pattern we’re seeing.

Yeah, that’s a good point. So we could do a whole part two on that. If you want. Give us some feedback. Like maybe the gut hormone connection. And we could hit that in detail. But yeah, you highlighted a very important point, which is that cortisol is involved with this whole process. And it really is a Goldilocks zone. If you have too little cortisol, you’re exhausted. And you’re probably going to be dependent on stimulants and caffeine and sugar and things that are going to damage your gut. But then simply, you don’t have enough to build up the gut. And then if you have too much, now you’re catabolic, you’re breaking down your muscle tissue, and you’re breaking down your gut barrier. That’s probably part of the reason that I lost a lot of weight and a lot of muscle. When I first moved to Texas, I had gut infections, and I was incredibly stressed, just moving and leaving my family behind, you know, emotional stuff, homesickness gut infections, I had the perfect storm to tear up my gut. So I can tell you firsthand that adrenal supports did help. And that was probably because it was helping regulate the cortisol levels, which then in turn, took the load off my gut, so to speak.

100% Yeah, I like that. And so it’s good to really make sure that’s under control. 

Evan Brand: How about probiotics? I think it’s worth mentioning. These are totally valuable tools that can help regulate histamine. Yeah, and regulate bacteria with it. So let’s dive into that.

Dr. Justin Marchegiani: Yeah, so you have to you I said you have three to four big families. Okay. So you typically have your lactobacillus and bifidobacterium, which are typically come together and usually a good high quality broad spectrum probiotic. So my line we have one called profile, Florida doesn’t have a lot of the different lactobacillus whether it’s kci acidophilus Bulgaria’s brevis, rhamnosus. And then of course, you have a lot of the bifidobacterium whether it’s bifidobacterium, bifidum, longum, brevis, right. So those are your broad spectrum lactobacillus or bifidobacterium. Probiotics, lots of good data, lots of good research anywhere from food poisoning for inflammation reduction, gut permeability reduction. nutrient absorption is all kinds of different studies connecting the dots on those so that’s kind of the bifidobacteria, lactobacillus Of course, we have more of our spore based or soil based probiotics. These are going to be a lot of your bacillus strains, right, whether it’s bacillus, subtlest class ei coagulans, like Informix, right. These are the bacillus strains. These are really good if you are very much cebo sensitive, fodmap sensitive, we may use some of these over a bifido lactobacillus species. And then of course, I’m a big fan of the probiotic that’s kind of more of a beneficial yeast called Saccharomyces boulardii in my lammie, one called sacral flora, again, we’ll put the links below for for all y’all so if you want to see it, we’ll put the links below sacral Flora Saccharomyces boulardii is very helpful a lot of studies on it, helping to improve immunity in the gut IGA IGA levels going to get low and just gut inflammation or gut stress. Of course, it’s going to help with food poisoning a lot of studies on it helping with H. pylori, C. diff, Clostridium difficile, blastocystis hominess. It also helps crowd out yeast and Candida so there’s a lot of excellent benefits with saccharomyces we love it and it’s usually going to be a core part of my probiotic, my fifth r which is repopulation re inoculation on the good healthy probiotics, once the fourth hour is done right fourth hours and to be removing the gut bugs removing the gut infections. Fifth hour, we come in repopulate re inoculate with good bacteria. Most people kind of sweet they want to start probiotics sooner, and that may not be the best step. Not saying it may not help. But some people have just found one that’s just a lot of pills. And two, if they have a lot of bad bugs in there. It’s like going and getting a whole bunch of good fresh grass seeds throw down on a lawn full of weeds, right? You got to get the weeds done before we throw down the seeds right got to get the car washed or we get waxed.

Evan Brand: Kind of like that. Yeah, we had a lot of good feedback on the podcast we did remember we were talking about probiotics and how a lot of new research is showing probiotics are being used to help with getting out mycotoxins and we know that mold toxins damage the gut. So yes, so I have been I’ve honestly been working in probiotics into the protocol sooner and most people do well. There are some like you said that just don’t you got to pull the weeds before you throw the seeds. But there are a lot of people doing really good with throwing probiotics and sooner in the protocols now. So like you said, if they can handle the amount of pills, maybe we try to sneak one or two in or we could do like powdered versions, typically, it’s like a quarter teaspoon, we could throw in a blend like that sack be you could you could do powder and maybe throw it in a smoothie or something. So we are trying to integrate those a lot. And I’ve had amazing success personally with probiotics. So I think it’s interesting, there’s still a lot of people that poopoo probiotic probiotics I know you and I we kind of get, you know, so caught up in the clinical trenches that we may miss some things, but I do get a couple of emails, you know, here and there from from people, clients sending them like, hey, this guy like says probiotics are a waste of money, and you know, that they don’t work. And I would just say that’s not true. We have so much clinical data personally.

Dr. Justin Marchegiani: It’s all about context, right? It’s like if someone comes in, they have chronic gut issues, and they’re just taking a probiotic thinking that that’s going to be the answer to their gut problems. It’s probably not right, and that’s where we’re trying to have a comprehensive functional medicine plan. That’s root cause and not just trying to Pro supplements at the wall thinking that that’s going to fix it. So yeah, I understand if that you know where that person is coming up with that, that bias that biases from not having a comprehensive root cause plan with a functional medicine practitioner, they’re just trying to throw stuff at them instead it hoping it will fix the symptoms, not fix the root cause.

Well, here’s Yeah, good, good point. Here’s the other thing, too, it’s even some probiotic companies will say that about other companies, it’s more of a marketing thing like, hey, their probiotic is crap, or it doesn’t work because of X, Y, or Z. But I will just say with what you and I use, clinically, we’re using professional supplement manufacturers exclusive only to health care providers. And a lot of the stuff we use, we have extended release technology. So when arguments like probiotics are going to die in the stomach, they’re not even going to make it to where they need to. But a lot of the new technology we use, they’re not even going to break open, they’re going to be resistant to the stomach acid. So that’s another problem too, when you hear these little like, super sometimes buzzworthy type articles. It’s not taking into consideration the quality, the quantity, the purity, the potency, the technology involved, it’s like probiotics, they get the label, and then that’s it. And that’s just not a fair classification.

Correct. And then also consumer reports that a study on probiotics a couple years back maybe 5 10 years ago. And what they found is most probiotics that they put a number on the outside of the bottle, hey, this is how many colony forming units. And what a lot of the cheap companies do is they say, Okay, this is how many should have been in this probiotic at manufacturing of this product. Let’s say it’s 20 billion. Now, what the professional companies do is, right, when you’re buying high quality, professional ingredients, they’re gonna say this is how many colony forming units should be in this capsule at expiration. And so you’re looking at something like two to three times the amount of those that species that CFU on the bottle colony forming units, is going to be typically in there. So when you see like, in my probiotic, I think it’s 40 billion per two capsules, right? That’s going to be what’s in there two years from now at expiration, right? And so obviously, it’s going to be two to three times the amount of that before. And so you want to use professional companies. So what you see on the label is always worst case, scenario, number one, and then also how products are stored by professional companies is very important. So like, where we have our warehouses, like everything is stored in an air conditioned or a refrigerated environment for a lot of our probiotics, some don’t necessarily need that. But which we value, the the scenario and how that store because that really increases potency, too.

Evan Brand: Yeah. And the funny thing is, too, we’ve seen some papers on supposedly expiration dates, you know, this is something that you and I are forced to do with the professional companies we work with. But you know, we’ve seen some research on supplements from 2030 years ago, still being viable, meaning they still had some potency and purity to them. And obviously, they still had a biological effect. So to me, I would if I had to pick like a consumer shelf bought probiotic, or a suppose that expired professional product, I’m going to go for the supposedly expired product, I’d go for a five year old professional probiotic, then, you know, on the shelf today consumer level.

Dr. Justin Marchegiani: Yeah, exactly. And also a lot of the probiotics or supplements that require refrigeration on the warehousing side, a lot of times you’re just not going to get that on Amazon, you’re not going to get that level of specificity just because that’s not how their warehouses are set up. And so with ours, we make sure that that refrigeration components is there because we’re working with patients and we need we need that potency, because we’re trying to get clinical outcomes, right. We’re trying to sell and provide a clinical outcome for the patient. And if we’re just providing products that aren’t meeting that standard, we’re not going to win. And of course, we want to be successful on that front.

Evan Brand: Yeah, yeah. Well say Well, I think we covered a lot of it. So the mushrooms are beneficial Lion’s Mane the mushroom is amazing for the brain, but for the gut also Chaga mushroom would be great reishi mushroom could also deserve a good mention, you hit upon the amino acids. So the glutamine or the various types of glucose amines involved. We love amino acids, we use those all the time you mentioned like collagen also being you know, part of that makeup, we hit on some of the herbs like the the licorice, or the dgl version of it, the marshmallow, we like to use a lot, we hit upon the aloe, and then we hit the probiotics, I think those are the big categories. And then the enzymes we hit that too.

Dr. Justin Marchegiani: I think we did a really good job hitting a couple and I just I really want to plug in concepts, right? Like a lot of people, they just try to throw information at people and and try to memorize that. I think that’s not beneficial. But if you can just understand concepts, right? A concept is just something that sticks. You either get it or you don’t. And so we try to use a lot of analogies and understand we try to plug in a lot of the concepts of root cause versus palliative cause. We try to get you to think about, hey, if this helps, why does it help? is it just an anti inflammatory? is it helping just improve better digestion? is it helping your immune system? is it helping your adrenals and helping you that your body’s natural process to build back up that gut lining? What’s the underlying mechanisms if you understand that, then you see how it plugs into the greater matrix of healing.

Evan Brand: Yeah, I mean, I agree 1,000%. So, I think the big concept of today is Yes, here are some things here are some nutrients you can use. However, we really want to make sure you’re testing, not guessing. So if you do need the aloe to calm the gut for now, you need the enzymes to help improve digestion. For now, you notice that HCl is helping with your heartburn or you notice that the enzymes are reducing your bloating, or your burping or your gas. Great, but what led to all that in the first place? What led you to need the aloe because you had gut inflammation, what led you to need the enzymes, that’s where somebody like us can come in and help you figure that out and plot it on paper. And, you know, we’ve been through the trenches personally. And clinically, we’re always improving upon herself. You know, I work on my children, I know you work on your children, we’re giving our kids things to help their guts, I mean, so this is like a, there’s no finish line, I don’t want people to think, Hey, I just do this aloe for a month, and then I’m done. You know, there’s not a finish line with the gut, we’re constantly being exposed to new toxins and new pathogens. We’ve even seen with the virus that’s been going around a lot of issues with the gut there, we’ve seen a lot of issue with tissue destruction in the intestinal tract. So who knows? Right now with the 5 10 year outlook of the GI health in the US is right now, our guts are notoriously bad, due to glyphosate and other things, damaging them. So just a quick note, you kind of started with the diet all and with the diet 100% organic is important, if you’re going to go buy all these probiotics, but yet, you’re going to eat strawberries with an average of 22 pesticides on them. If they’re not organic, you’re wasting your frickin time and your money because we know all those pesticides are just killing the beneficial bacteria in your gut that you’re trying to re inoculate or repopulate with. So please go organic, you know, before you spend money on probiotics.

Dr. Justin Marchegiani: Exactly. And then also how long do these probiotic strains last in your gut, I mean, a lot of times, you’re going to see the data show in about one month or so. So that they don’t stay forever. So when you take a probiotic, it’s not like it’s there forever. So it’ll it’ll hang around typically for a month, it’ll help with a nutrient synthesis, it’ll help with nutrient absorption, it’ll help with inflammation, modulating the immune system, there’s some data that maybe the spore based probiotics hang around a little bit longer, and they may help proliferate the growth of other beneficial species. So just think when you take a probiotic, it’s not forever. Now the goal is that we’re getting some level of fermentable foods in your diet, whether it’s from sauerkraut, or low sugar kombucha, or some kind of fermented pickle or something, or, you know, cultured coconut milk or potentially high quality raw milk if you can tolerate it. So you know, that’s typically how we’re getting exposed to probiotics more on a day in weekend kind of situation. If you’re someone that can’t get that level of exposure with fermented oils from food, then you probably want to be on a probiotic a little bit more frequently, if you’re not getting those fermentable. So we just got to plug and play where we’re at. I think our ancestors probably did more fermentable foods, which is ideal. But if we can’t we plug in a good quality probiotic, or at least throw in something every couple of months, just to kind of fill in the gap to make sure we’re getting exposed to those good for mandibles.

Evan Brand: Yeah, great point, I just want to highlight what you said too, which is like your gut bacteria are actually going to help you with your health in other ways. So once gut bacteria optimize your healing the gut, you’re making neurotransmitters the way you should you’re making serotonin, you’re making things to improve yourself, you’re making B vitamins to help your energy and your mitochondria. So this is why I really the gut, I mean, we just we can’t stop talking about it because it literally is the foundation.

Dr. Justin Marchegiani: Exactly. So just kind of want to make sure that is understood. And that makes sense for everyone. We’ll put a list of recommended products down below. So you guys have access to those you want to support us support the show, we appreciate it put those down below. Also, if you guys want to reach out to Evan brand, head over to EvanBrand.com, Evan is there for you guys worldwide. And again, I’m there for you as well, justinhealth.com, Dr. J myself, there’ll be a little link button, you guys can click and reach out to us we are available worldwide to help you guys help you help support y’all. We want to make sure they have the support you need. And you have a good comprehensive plan to get what’s going in the right direction if you’re not having success. And then also just try to apply one thing today as well. If you’re having if you’re overwhelmed, and you’re having a sticking point great to reach out, if not just try applying this information, we want to really help as many people as possible. And we know we’re going to help many more people than we actually see in person with this information. So just make sure you’re applying it. And if you are enjoying it, share it with family and friends that could also benefit put your comments down below. Let me know the best part that you liked about this what resonate with you the most. And give us a like and share as well. We appreciate it.

Evan Brand: Yeah, and if you’re on the apple listening, if you’re on your Apple podcast app or Stitcher or wherever else, give us some stars, let us know what you think the show deserves between us both we have I lost count, but it was somewhere over 705 star reviews for our podcast in between our various feeds. So please give us some stars. Give us some sentences give us a blurb on whether you still call it iTunes or Apple podcast. We’d love to beat out people that are not clinically oriented. There’s still like top health podcast out there that it’s just theory theory theory theory. And then we have to like recalibrate people’s theories because they’re not clinically based. So we would love to beat those people. How do we beat those Before we go higher in the charts, how do we do that? With your reviews! So we have a some stars. 

Dr. Justin Marchegiani: Thanks to all you guys have a phenomenal day. Take care.


References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/the-top-5-nutrients-to-address-gut-inflammation-and-leaky-gut-podcast-339

Recommended products:

Amino Acid Supreme

TRruKeto Collagen

TRUCOLLAGEN (Grassfed)

Probio Flora

Enzyme Synergy

Betaine HCL Supreme

Genova NutErval

 

What are the Natural Anti-Inflammatory Agents for Pain Relief

In general, we have our COX pathways. Now, Arachidonic acid can feed those pathways. A lot of excess, junky, refined Omega-6 from animal products can definitely feed those pathways. That sets the table like gas in the kitchen where a little spark can take it off.

Click here to consult with a functional medicine doctor for recommendations on natural pain relievers.

Where to find anti-inflammatory agents:

  1. Natural herbs like ginger can help with COX-1.

  2. Fish oil is excellent for COX-2 at high doses. If you do high doses of fish oil, you can increase what’s called lipid peroxidation because fish oil is a polyunsaturated fatty acid. It’s more unstable. It’s got more double bonds in it. Omega-3 means three double bonds. The more double bonds that are they are, the more unstable the fatty acid is to heat things like that and the more, let’s say it can be oxidized. So, having extra vitamin C or extra vitamin D on board when you’re taking extra fish oil just to make sure you don’t have oxidation is great, and we already talked about things like systemic enzymes.

  3. There is also curcumin but liposomal curcumin is better due to the absorption or something with black pepper in it helps with absorption, too.

  4. Frankincense or Boswellia.

  5. White willow bark which is kind of how aspirin is naturally made though aspirin works more on COX-1. So, aspirin can be your other natural source and you can do white willow bark which is the natural form of aspirin.

  6. There are things like Tylenol but Tylenol works more on the central nervous system perception. So, it decreases the nervous systems’ perception of pain. Note: We have to be careful of Tylenol as it can actually chronically reduce glutathione. So, if you’re taking Tylenol longer-term, you definitely want to take it with NAC and/or some glutathione, just to be on the safe side.

  7. At the extreme example, we have opiates which block pain receptors in the brain, the opiate perception of the brain. It’s not the best thing because you’re just decreasing perception of pain. Obviously, the opiates are way more addictive.

  8. We can block some of these natural pain perceptions with CBD oil. So, CBD is another great way to reduce the perception of pain.

In general, we want you to try to do more of the herbals and more of the natural stuff out of the gates because that really, really, really can help reduce inflammation.

If you have osteoarthritis, rheumatoid arthritis, sports injury, or you’re just trying to heal maybe postoperation, these things may be something to implement and then obviously work in all the other root causes, too. You are not just what you eat. You are what you digest from what you eat.

So, if you’re doing all these good nutrients, but you’ve got some type of malabsorption issue in the gut, you’ve got ridges on your fingernails, you’ve got thinning hair or falling out here, you may need to look deeper at the gut and try to find some of these more root cause issues that led you to that amount of inflammation or slow recovery in the first place.

If you need to reach out to talk about your pain and inflammation issues, click this link to schedule a chat with me!

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

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

WHAT ARE ESTROGENS?

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

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

WHERE CAN WE FIND ESTROGENS?

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

HOW DO WE ADDRESS THE PROBLEM?

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

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

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

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

The Top 5 Causes of Chronic Headaches

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

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

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

1. Food Allergens

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

2. Food Additives.

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

3. Blood Sugar Fluctuation.

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

4. Gut Infections.

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

5. Hormonal Issue.

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

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

Oils That Cause Gut Inflammation

There are various top-causes for gut inflammation but a big one is an oil. The oil you use to cook or bake into foods could be a major culprit to your very uncomfortable gut inflammation. Let’s look at the good and stable oils vs. the unhealthy oils. 

Click here for a consultation with a functional medicine doctor if you have questions about what oils to use for cooking!

If you look at the standard American diet, just even a hundred years ago, your grandparents or your great grandparents, they did not have access to these type of oils. They were cooking with traditional fats. They did a lot of lard and maybe some beef tallow.

If I asked my grandfather, “What did your grandmother cook you and what did she cook it with?” She was not using soybean oil. She was not using corn oils. She was not using rapeseed oil, which is canola.  She was not using peanut oil. If they did something fried, it was going to be fried in possibly bacon fat, which came from the pig in the backyard of the farm or it was going to be cooked in some type of like a beef tallow, where the cows were on the back part of the farm.

When it comes down to fats, most plant fats are not going to be the best unless they are cold extracted or unless they are minimally processed to extract the fats. Partly because of the processes of extracting, it tends to damage the fats because the heat and the extraction process also makes the fats rancid and taste bad. There’s a lot of like deodorizing and filtration and different processes to make it more palatable that you would never be able to have at a natural state.

So the best plant fats are:

  1. Coconut oil because it’s a saturated fat and it’s more temperature-stable.
  2. Cold-press olive oil and good-quality avocado oil, which is primarily a monosaturated fat.
  3. Palm oil, which is more in a kind of saturated state.

There are some nut-based and some seed-based oils, but then you start ramping up the Omega-6 and those may not be the best.  There are some supplemental oils that are more GLA-based that I’ll give supplementally, like black currant seed oil but we’ll give it supplementally and that’s coming from great sources that are going to be in capsules that won’t be oxidized and such.

Bad fats are going to create a lot of oxidative stress and they are going to deplete a lot of your antioxidant reserves because if those fats are oxidized, your body is going to need a lot of vitamin C and vitamin E to help with the oxidative stress that those fats may cause your body.

Now what it you find a good fish with gluten-free breading so it’s not covered in wheat with some type of non-gluten containing flour, but then you’ve got canola oil. Do you think you’re still going to be net positive in terms of nutrition because you’ve still got the good fish, but yet you’ve got the inflammatory oils or would you say, just get you some grilled fish and then if you want to bread it, you bread it yourself?

There’s a product that we like of sweet potato fries that my wife will do for my son because it’s really easy, but they have a little bit of canola oil in there. So you have this kind of convenience factor where ideally if you could you always would want to put your own fat on there if you could and my easy saturated fat or my easy fat for cooking that’s plant-based would be avocado. I like avocado because it tastes a little bit more neutral. I do not like olive oil as much. Olive oil is better for dressings, but I’ll do avocado for cooking. If you have control over it, you always choose the better fat over the junky fat if you can.

So the interesting thing is like coconut oil and avocado they’ve become kind of trendy and I would say avocado is not going to be a traditional fat meaning, meaning like traditional people were probably not doing it because you’ve got to have some heavy-duty equipment to extract the oil, but coconut oil would be super traditional.  I mean, this would be something that has historical use.

Your big fats that are going to be plant-based would probably be primarily coconut. But your biggest ones that I think are going to be used more long-term from generation to generation will be your tallows, your bacon fat, your duck fat, and those kinds of things because saturated fats don’t go bad. They stay good for a long time because the carbon is saturated with 4 hydrogen bonds between them, which makes the fat really, really, really temperature-stable.

Take note of oils are that bad for your gut because they cause inflammation and oxidative stress.

If you have any questions about what the best oils to use for cooking, please reach out to a functional medicine doctor to learn more.

 

Top 7 Nutrients to Heal Your Gut | Podcast #294

Our gut is a group of organs that needs to be in good condition in order for our body to function properly. There are a lot of ways to take care of our gut. For today’s episode, Dr. Justin and Evan Brand talk about Top 7 nutrients to heal our gut, and also the root causes. Read more of the podcast below.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover: 

1:21    Downside of OTC Medications

9:18    Healing Nutrients for the Gut

19:11  Gut Irritating Symptoms

31:57  Probiotics

32:47  Mold

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Dr. Justin Marchegiani: We are live. It’s Dr. J here in the house with Evan Brand. We are really excited to chat about the top seven nutrients to help heal your gut. We’re going to talk about the root causes of why your gut may be inflamed and irritated to begin with, and how we as functional medicine practitioners, help the body heal faster while addressing the root cause. Evan, how are we doing today, man?

Evan Brand: I’m really good. Feels good to be back in the saddle. And excited to dive in with you here today. We’re in a gut disease epidemic. Maybe I should try to pull up some statistics here on like, IBS, your typical idiopathic chronic inflamed, you know, inflammatory gi issue. Let’s see what the numbers are. According to the CDC real quick, but this issue is huge. It’s I know it’s in the millions. So CDC, I it’s got to be bigger than this. This seems this seems low. Okay, well, these are people diagnosed with autoimmune gut disease. diseases. So Crohn’s disease or ulcerative colitis, back in 2015 was 3 million people. But those are people diagnosed and you’re talking the most extreme manifestation, Crohn’s and ulcerative colitis. So if we’re talking IBS, completely different from IBD, the numbers, I’m going to say probably in the double digits of millions for sure.

Dr. Justin Marchegiani: Oh, I mean, I mean, if you just go look at the top medications by sale, you’re going to see I’m almost positive, you’re going to see omeprazole or some kind of a Nexium or acid blocker in that top five or top 10 for sure, I know and pass It’s been three or four. It’s been common. I mean, you know, it just really depends on what you market, right? A lot of times when these medications go over the counter, it becomes a little bit less of a deal because everyone has access to it. No companies in the market it quite as much right? True. But in the past, it’s always been a big, big top selling medication. And when you’re on medications like that, you can actually create more damage and more inflammation, partly because you’re not breaking down your foods, partly because you need acidity to prevent bad microbes from growing. So number one, you start having indigestion issues because you’re not breaking down your food all the way. Number two, you don’t have that good acid so other bacteria and critters can grow. Number three, yeah, it could potentially block some of the irritation in the gut. If you’re not making enough acid, a lot of times your food rots and creates organic acids from the rotting process. That’s, you know, that’s real. Now the problem is having enough acid though, can also help break down that food and prevent that acid rotting from forming as well. So it’s a double edged sword. The question is, is the gut mucosa in the stomach? Is there enough integrity to handle the acid? That’s the question. Sometimes there is sometimes there isn’t. The people where there is these are the ones that merely start getting better with some apple cider vinegar or some betaine HCl, the ones who feel a little bit worse. These are the tricky ones, right? These are the ones that have a whole bunch of back pain, right, but have a sunburn so they can’t really get a massage because there’s their skin on the outside is so irritated where the inside support that is needed right from those deep muscles and tendons can’t receive it because of the inflammation. Think of that as a gut lining, right? That’s irritated from all of the ads or inflammatory foods or a lack of stomach acid. All of that can be driving that for sure.

Evan Brand: Let’s go into like story mode. Because people love this. I mean, lecture lecture mode is fun, but people love story mode. So let’s go into story mode for a few minutes. I just want to tell a story and if you’ve got one to share, to have gut issues, you know, so I guess I have to me personally, you know, my gut issues were that I had major weight loss. I had depression, I had anxiety I was having panic attacks. I was having sleep issues, skin issues, just bad bad acne. I had burping I had bloating, I mean pretty much across the board. That’s Something people don’t think about is that it’s not just your gut that’s affected when you when your guts affected it’s your brain and a lot of cases too. And long story short, I had many infections and I do believe even back then I didn’t know this, but I do believe that mold was part of my journey and detoxing, it has improved my gut because mold can cause diarrhea. And so I had a lot of issues with my bowels that have gotten way better after doing binders. But the story that I was going to mention was a teenager who I saw within the last few months who was around 16 17 I think it just turned 17 and the GI doctors basically gave him a prescription pad he was diagnosed with pain colitis, which is where it was the entire colon, not just the the later section of it that was inflamed, and they gave him I don’t remember the name of the drug but some sort of immune modulating drug and send him on his way. And we ran a stool test on this kid. His inflammation level was above 1000 on calprotectin, which is crazy. We don’t like to ever see it even post that correct. And we just got him on some of the gut healing nutrients. So you and I always use and we’re going to dive into what those are later. But within six weeks we retested his stool just because it was an urgent situation. Typically, we don’t retest that soon. And we had already got the inflammation down into triple digits. So I mean, within six weeks, hundreds and hundreds of points of calprotectin had dropped, I think we got it down to maybe a 200. So from a it was over 1000, I think was 1200, down to a 200 in about six weeks.

Dr. Justin Marchegiani: So unprotect is like the equivalent of C reactive protein for your blood, right? Calprotectin is produced by the immune cells in the gut. So when you have a lot of interleukins are cytokines or nuclear factor Kappa beta, these are all like these inflammatory signaling molecules, your white blood cells and immune cells will produce calprotectin as a end result. So it’s a good way of monitoring it like you’re going to see it very high, you know, greater than 500 and a lot of irritable bowel diseases, colitis, ulcerative colitis, Crohn’s, those kind of things, right.

Evan Brand: Yeah, we don’t see it that often though. I mean, maybe I mean, more than the average person more than the average practitioner, probably because the people that we’re seeing have already struck out with conventional doctors. But I would say out of a given month, I probably only see calprotectin above 500, maybe five to 10 times.

Dr. Justin Marchegiani: Yeah, me above 500. It’s a lot. I’ll see it typically above 50. You know, 50 is kind of my functional range. And hundreds, I’ll see that quite frequently. And it just depends, right, we see a lot of patients that have already gotten very educated from us on the podcast. So they’re already making a lot of first line changes. And that’s kind of the benefit of the podcast, patients already come in with a lot of momentum and wind at their back because they’re following a lot of these first line kind of low hanging fruit therapies. So they’re making some diet changes, they’re doing some simple things, and that provides a much better foundation so we see less inflammation coming in. So for sure, now, root cause what are some of the well we’re going to talk about some of our favorite nutrients in a minute, but root cause you know, food allergens are going to be a big root cause grains, dairy, right booms, anti nutrients and plants. Some can be big deal. Not enough stomach acid, not enough enzymes, right? A lot of chronic stress, people don’t realize but over exercise is actually known to create gut permeability. A lot of studies on post marathoners and lots of aerobic exercise, actually increasing gut permeability. People were like thinking about their gut and their leaky guts, which can create a lot of immune stress or thinking about inflammatory foods and infections and enzyme and acid deficiency. But guess what overexercise can also aid in that permeability.

Evan Brand: Yeah, so you mean you could think you’re doing great and oh, I eat keto and 90 bulletproof coffee, but then you go run five miles every day. That’s just not gonna be good.

Dr. Justin Marchegiani: Maybe a stressor? Yeah, stressor was a big article. I think it was like last month in a golf magazine. Tiger Woods blamed all of his back in the surgeries on on chronic cardio. He was doing lots of running, which, you know, anyone that’s in the athletic industry would know that, that doesn’t really translate to the golf field that well, right. You need very specific types of movements and training modalities to allow That to transfer and chronic long distance cardio guess what it really only transfers to chronic long distance cardio sports. If you’re not doing a chronic long distance cardio sports, most people are going to do better with a better targeted resistance training and or circuit training or Burst Training kind of workout. But that’s neither here nor there. But it connects back to the gut permeability, which could be causing a lot of your digestive issues if you’re over exercising.

Evan Brand: Yeah, I had a I had a girl who was in college, I want to say maybe sophomore junior in college, and she was running three to five miles per day, at least five days a week. So you’re talking 15, sometimes 20 miles a week, Her skin was a wreck, and her gut was a wreck. The only protocol for the first six weeks after we got the labs back was samana microbial herbs to address all the infections. And then we did some omegas we did some enzymes. And and then the piece that I think was most important was I told her Hey, only do two runs a week above a mile. So like a mile, you know, twice a week and then the other days you know, do something else do yoga, do stretching, do weightlifting. And that alone was enough to to significantly change her her story and she’s like, Oh my god, I didn’t realize how tired I was. I was beating myself into the ground. And these athletes, they get addicted to the endorphins from the running.

Dr. Justin Marchegiani: Yeah, there is the big endorphin rush. So kind of moral of the story here is do the low hanging fruit have the right foundational things, you may need to see a really good functional medicine practitioner to kind of get these things dialed up and lined up. Now our first healing nutrient, let’s plug it in right now would be zinc. Zinc is a very powerful nutrient in my gi restore. I have a zinc in there a zinc carnosine, which is a very absorbable zinc in the in the gut, which is great. That has been shown to decrease inflammation in the stomach. It’s also shown to be very helpful on the gut permeability side. And in some studies that’s actually been shown to decrease gut permeability induced by excessive cardio exercise. So keep that in the back of your head. back of your head there, zinc is gonna be one of those nutrients you’d want to be adding in. Very important, and it’s going to be foundational and zinc is also very high and a lot of paleo foods, right. And a lot of your high quality meats and seafood products you’re gonna get a lot of zinc will typically do, you know, anywhere between, you know, 10 to 30 milligrams of zinc in a day to really help on the gut permeability.

Evan Brand: Yeah, there’s a really good study on this American Journal of Clinical Nutrition 2016 zinc carnosine works with bovine colostrum and truncating heavy exercise induced increase in gut permeability in healthy volunteers. So, yeah, long story short, and we like colostrum too. So we will use that some people can’t tolerate it, but most people can. So take, you know, zinc alone or colostrum with I wasn’t on our original list of nutrients, but hey, it’s done really, really well for me and many people too. So why don’t I go ahead and throw colostrum into the mix as well.

Dr. Justin Marchegiani: Yeah, we’re gonna put our links to some of the products that we personally formulated and recommend for our patients and have been doing for years. We’ll put them down below. Evans gonna have his, what’s the name of your GI product?

Evan Brand: Mine’s called GI Sooth. So you do powder and I do capsules, they’re both great. You can’t go wrong with either one.

Dr. Justin Marchegian: Exactly. Mine is GI Revive is the designs for health product. Yours is the GI Sooth the mine is the GI Restore. And I’ve been using that one for about two, three years. That’s a phenomenal product. And then the thing with yours is you don’t have any additives or flavors in it. Neither does mine. The problem with the designs product has a little bit of additives and flavor in the powder form. And I’ve seen patients really react to some of these added flavors and sweeteners and gums. So you got to be very, very careful with that. You either want a powder that does not have a lot of sweeteners in there, or you want a capsule one that’s very important. So there’s some brands out there that are really good and clean, like I just mentioned, but have some of those binders in there. That could be a potential problem. So you really got to look at some of those binders.

Evan Brand: Yeah, we love them. But when you throw in natural flavors and then you’re throwing in tapioca dextran. I mean, a lot of people complain to me that if they’ve tried that one before with other practitioners that it would mess up their blood sugar too, because that tapioca, I don’t know the body recognizes them, you know, sort of as a blood sugar spike or so. So we, so we don’t use that one clinically, but a lot of people have used that one previously, if you’re working with like a naturopath, they may have brought that tool out on you, and it’s probably still going to do more good than than bad, but that’s not what we use.

Dr. Justin Marchegiani: I think another low hanging fruit, a lot of people use this and a lot of people may even go do it to it as a first line therapy would be glutamine. Now, glutamine is excellent because it’s a primary fuel source by the parasites in the gut, which is awesome. So these are like the gut cells that make up the gut lining. These these cells are going to require a lot of glutamine. So glutamine is very, very important for providing that fuel source. It really helps provide good integrity kind of like collagen and glycine. glycine is also really good for the gut lining collagen provides Good integrity for hair, skin and nails. Think about glutamine is providing really good integrity for the gut lining. And the problem is, why does the gut become permeable when there’s lots of exercise? You know, Evan?

Evan Brand: I mean, cortisol is going to be my main my main thing.

Dr. Justin Marchegiani: Catabolic physiology right and catabolic physiology. What does it primarily attack it attacks protein and amino acids, right? That’s why chronic cardio people that have a certain physique, right, they’re much more leaner, more emaciated looking, definitely less muscle tone than a sprinter. Just Google sprinter versus marathon runner, you’ll see an instantaneous side by side and what the difference is and part of it is because runners are going to engage in more catabolic physiology more cortisol, right. And sprinters are going to engage in more anabolic physiology testosterone growth hormone, right, and that’s going to cause muscles to grow. So l glutamine is going to help balance out that catabolic physiology now that catabolic physiology could be from overexercise. It could be from inflammation in the gut from gluten. Right? It could be from all those different things. It could be from potential infections. Now, we could use glutamine in a way that’s just symptomatic, right? Like we’re not getting to the root cause, meaning I have an infection. I have poor diet, but I take this, that’s okay. But we’re always trying to get to the root cause. So if we add in L glutamine, we’re gonna add it in with a lot of these other things as well and ensuring the root causes dialed into.

Evan Brand: Yeah, so you could say glutamine is basically anti catabolic. So looking at that zinc study, it was talking about how the intestinal permeability went up by what they say here three fold. So the intestinal gut permeability went up three fold after exercise the zinc or colostrum, basically truncated the rise by 70%. So if you threw in something like glutamine, which actually, you know, there are some kind of pre workout nutrients that we could use blends of amino acids that may have glutamine in there, and I’m sure with a good Grass Fed Whey protein, we We use some of those, you’re going to get some glutamine there too. And so to me, it’s, it’s the great, you know, maybe pre or kind of post workout nutrient as well.

Dr. Justin Marchegiani: Correct. I’d also say the synergistic nutrients that work with glutamine, I would say are also gags, which are like coastal amino glycans. You know, being a chiropractor for a while I work with a lot of disk patients. I don’t do this anymore. But a lot of the disk material, the raw material in that disk is made out of these guys like also amino glycans. And these can be severely impaired with lots of insulin and oxidative stress. And of course, if we’d have had digestion, we may not get enough of it through our diet, right? So we may add in an acetal Glucosamine, which is a form of a glyco glycosaminoglycans a gag for short, so very, very helpful and helping connective tissue helping the gut lining lots of anti inflammatory benefits and they kind of work in conjunction with the glutamine because they tend to be connected, and then we’ll connect in there the glycine right glycine is very high in collagen. So, collagen is also very high in glutamine, so glutamine, glycine and EDIS and an acetal glucosamine or the gags that the glycosaminoglycans are going to be very helpful at building blocks for the gut lining, and they’ll be a really good buffer for catabolic physiology when cortisol and stress is present. And that tissue starts to get broken down.

Evan Brand: Well, here’s another cool thing about glucosamine that came up in the research was that it helps to reduce biofilm with different pathogens like E. coli. So, you know, you and I, we talked so many times about using anti microbials. And we’ll come in and use our gut healing nutrients. What if there were some biofilm left behind? And by accident you and I were actually eradicating the biofilms therefore keeping people in good shape as opposed to allowing them a relapse if you didn’t do a gut healing phase is kind of just gives us a little more credit and ego boost for doing the gut healing phase. Because if you just came in and kill, kill, kill, maybe there was something left like a biofilm of ecola then comes back but this paper on the NSE two glucosamine it talks about, you know, reducing that biofilm formation so that’s pretty awesome.

Dr. Justin Marchegiani: Exactly and any of my patients that are listening biofilms are important. That’s why I recommend a specific ginger tea protocol. And the ginger tea I recommend is going to have one high dose ginger in it that’s juice ginger. Ginger is a very powerful biofilm Buster you can go into PubMed and just type in ginger and biofilms you’ll see dozens of studies. It’s also anti inflammatory, it’s very safe as well. It’s a natural blood thinner too. So it prevents a lot of the cells from getting stuck and sticky. And then also I typically recommend a little bit of the Manuka honey in there and Manuka honey really helps biofilms and has an antibacterial effect. But just dovetailing on what you were talking about regarding the gags the anesthetic glucosamine or the the glycosaminoglycans. They also have immuno inflammatory modulating effects, right. So we have different cytokines which are signaling molecules that are produced from the inflammation So these are like TNF alpha, this is nuclear factor Kappa beta, interleukin six different interleukin molecules, it helps modulate those and kind of dampen those down a little bit, which is helpful. So it’s kind of like the fire is going, and I’ll just kind of put that fire out. Now it may not be a root cause of the fire. But if you’re working with a good functional medicine doctor, they’re gonna make sure we use things that modulate the firewall at the same time we get to the root cause of the fire.

Evan Brand: Yeah, let’s talk about that real quick. There’s been a couple cases where we’ve had people in such bad shape that will actually come in and bring some of these gut healing gut soothing nutrients right away in the very beginning. I mean, if I’ve got somebody that’s so miserable, let’s say they’ve got major Cold Blood that’s showing up they’re bleeding every time they poop, I mean, their guts in bad shape. We may come in knowing it’s not root cause it’s palliative care, but we’ll come in and use gut soothers in the beginning, maybe even before we get to the end of microbial phase, I mean, if their guts just so so hurting we might not be able to come in and kill the parasites are whatever is at the root of this thing. Have you done that before? Have you come in and said, Oh my God, this person, they’re not even ready to go to the phase one we got to go phase like point five here.

Dr. Justin Marchegiani: Patients have typical gut irritating symptoms in the top three to five complaints on their chief complaint list. And then we’ll add in some of these healing and soothing nutrients off the bat, I find a lot of my patients, I don’t really need to use them off the bat, if I get their diet and digestion working better, and I get enzymes and acids and food and maybe even, you know, some simple bone broth or some ginger tea in there. A lot of times I won’t need it. But anyone where it’s in that top five, will kind of come in there and use it for a couple of months just to really accelerate the healing, partly because I want to get people ready to deal with the gut killing part of the face. And if someone’s guts too raw, sometimes those herbs, they’re not going to tolerate them well. And the herbs right in my analogy of someone having a sunburn but needing a really good massage or a chiropractic adjustment because of their Their lower back, but at their skins really burned, they may not be able to receive that right? Same thing on the gut killing, we may need to come in there with some really powerful gut killing herbs. But patient is to run the mucosa. And they can’t handle the herbs, or they can’t even handle any stomach acid, right? So then we have to, that’s where it’s really important to get these things in on the front side.

Evan Brand: Yeah, and your average person listening who just wants to improve their health and their gut health, you may not be in that category where you have to go to gut healers, we’re talking to people that have been a gastro doc for 5-10 years, they’re really suffering or maybe they’ve just been undiagnosed this whole time, but they’re in really bad shape. That’s where we’re going to bring that out in the beginning. So your average person listening that may not apply.

Dr. Justin Marchegiani: But you know, I think low hanging fruit for anyone is going to be collagen, we can always add in the collagen, which is going to have a lot of the glycine in there. And it’s also going to have some of the glutamine in there, right. And so that’s at least a good first line step because no one’s getting enough connective tissue in their diet unless they’re doing lots of bone broth soups. That’d be the only exception. So if you’re not doing a lot of bone broth, soups and things like that, You probably need some extra collagen in there. Yep, yep. So favorite brand. So I mean Evan has his gi su died my gi restore, but I also have my true collagen, which is a product that I formulated. And with that product, a lot of collagen or actually they add sulfuric acid into the collagen. with mine we were able to do proteolytic enzymes, why does that matter? It matters because your tummy doesn’t really have to do much of a breakdown process because the enzymes already make the the collagen so absorbable there’s very little digestion that has to happen to take in those nutrients. And when the guts really inflamed, you want a lot of these things pre digested so it’s easy for me to handle. We’ll put our links down below in the description below. 

Evan Brand: Beautiful, beautiful. So speaking of sunburn, let’s go on to the next one. Let’s talk about aloe. I love aloe, and actually have one I’ve got one called GI Sooth 2, which is just a straight aloe extract just because, you know there’s some cases where I don’t feel like we need the full shebang with the glutamine and all that. So we’ll just say well, let’s try out By itself, and there’s a paper here, some kind of pharmacology therapy paper, randomized, double blind placebo of oral and this is just aloe vera gel. This is not even the concentrated extract that we’re using, we’re talking just straight aloe vera gel for ulcerative colitis. And even just in four weeks, it was a clinically significant benefit for colitis. And so we’re talking people in major autoimmune gut issue and in four weeks, they’re in really, really good shape with it. That’s not going to happen with drugs, I’m sorry, the pharmaceuticals are not going to have that fast of an outcome. And it’s probably going to be a hell of a lot more expensive for for the drugs. And once again, it’s not really gonna, I don’t know it’s just not root cause for me aloes, more root cause it’s going to soothe the gut, it’s going to reduce the inflammation. It’s not just going to try to modulate some enzyme or modulate this. It’s just, I like it.

Dr. Justin Marchegiani: Aloes, also has some anti inflammatory effects, right? There’s a so we talked about C reactive protein and nuclear factor Kappa beta and interleukins and cytokines. There’s another answer. There’s another inflammatory marker called MPO, or Milo peroxidase. And aloe helps modulate Milo peroxidase. And it’s also shown to have a lot of antispasmodic effects. So a lot of people that have IBS, for instance, a lot of times they have a lot of spasms. I know Evan, when you were diagnosed with IBS, at what, 10 years ago, they recommended a lot of antispasmodic drugs and it’s too bad yeah, you didn’t have that functional medicine knowledge. You know, you could have been taken out of the get go to help with that.

Evan Brand: I did. I didn’t do the drugs but yeah, they recommended them. And so luckily though, the the stats The funny thing about it, the spasms it wasn’t what I’ve learned our spasms clinically it was more just Hey, urgent, boom, gotta run to the bathroom. versus some people it’s they’re just sitting there at their chair trying to type on their computer and Boom, they’ve got these spasms happening. So for me, luckily, it wasn’t as miserable as it could have been. At the time, though, you know, even though I didn’t know what I know, now, I still was doing some of the enteric coated peppermint oil. And that was very, very helpful. I don’t mean of course, it wasn’t root cause it didn’t magically erase my infections, but the entire code of peppermint did do some good for me.

Dr. Justin Marchegiani: That’s good. That’s excellent.

Evan Brand: And that wasn’t on our list, but why not throw it to the list? It’s gonna end up being like 12 nutrients for your gut, but we had to have some kind of buzz, you know, Buzz worthy title. So we said seven but peppermint, I think could also be considered.

Dr. Justin Marchegiani: Yeah, we’re gonna provide overvalue here. I would say next is gonna be sulfur compounds. So one of my favorite sulfur compounds is MSM, which is methyl sulfur on methane, so powerful organic sulfur compound. Again, first mechanism, what’s the underlying root cause mechanism for you science junkies out here? It’s going to be modulating your B cells, it’s gonna be modulating nuclear factor Kappa beta, it’s gonna be not not modulating TNF alpha, interleukin one, interleukin three Looking sick, these are all chemical signaling molecules from inflammation, it’s going to be decreasing Milo peroxidase, like the aloe, a lot of studies showing that MSM and these sulfur rich compounds are going to have a lot of powerful antioxidant compounds in there, really helping to suit providing a lot of, let’s say neutralization of the oxidative stress. Why is the oxidation there? Well, because of the inflammation, inflammation, cause oxidation. Oxidation is when you lose electrons. When cells lose electrons, they become very unstable, and that can create DNA damage. And so we need antioxidants, things that have extra electrons that can donate them. And that helps prevent the oxidation thus preventing the DNA damage. So the sulfur rich compounds, they reduce inflammation, interleukin cytokines, and they have antioxidant properties to help stabilize the cells in your gut. Very good.

Evan Brand: Well, how about the How about the Cox 2 pathway too because that’s going to change Increase inflammation and the MSM back can also down regulate Cox 2. So, I mean, you can’t say that it’s gonna act in the same way like is aspirin but I mean it can definitely help with some of the gut pain I would say associated with some of these infections.

Dr. Justin Marchegiani: Well yeah also, you know, we know we need so the Cox two enzyme also is going to be modulated by, if you remember back in the early 2000s to drug Vioxx, that was a big drug also NSAID’s modulate that Cox two, right? Cox stands for cyclooxygenase. Two. The problem is if you do too good of a job blocking that enzyme, we need that enzyme to build up our gut lining build up our heart and stuff. That’s why we saw lots of strokes and even potential ulcerations from those kinds of medications because they do too good of a job. That’s the problem with drugs is they create lots of side effects herbs and they tend to have more of a modulating kind of use where they kind of bump it and move it in the right direction but not So far where it causes the side effects where drugs go way too far, and then you have a lot of side effects, right? Like it was a journal article in the New York, New England Journal of Medicine 1998 by Wolf at all talking about ibuprofen, killing 19,000 people a year taken appropriately. So the nice thing about these natural supports, if you’re not gonna have to worry about those kind of side effects, which is great.

Evan Brand: Wow, what was I mean, not to get too off subject, but what’s the mechanism on that? It’s just the intestinal bleeding that happened or-

Dr. Justin Marchegiani: -bleeding, which then affects the liver, which also can affect the alterations in the stomach. And that can also affect the heart. It’s so yeah, it’s that Cox enzyme is to to dampen and torque to good on it. And then that enzyme is needed to do other things that are important in the body. Wow It’s kind of like, imagine if like you had a high ashwagandha or high levels of cortisol and you took some ashwagandha demodulate it well, if it not cortisol all the way down. to the ground, you’d be in a state of Addison’s disease. Right? And yeah, like that you kind of trade one thing. It’s not all the time, right? And if people that are using it chronically, those are the ones that really have to worry about it. So if we’re going to use something more longer term, we want it to be more natural, because it’s gonna have a safer profile to it.

Evan Brand: Yeah. So if you’re out there and you’re on daily dose of ibuprofen, because you got a headache because you’re still eating gluten, you know, consider that your warning get off gluten, get rid of the headache. 

Dr. Justin Marchegiani: 100% 100%. All right, what else do you want to chat about? How are we going to licorice?

Evan Brand: Love licorice. So let’s talk about the difference real quick, because you and I love licorice for many reasons. I mean, it’s one of those nutrients that can be used for different body systems. So we’re often going to use more of an active licorice for adrenals. So where you have the glycerin, the active component that can help extend the half life of cortisol. I use the analogy of plugging up your smartphone to one of those little battery packs where you’re going to get a little extra juice out of your phone. That’s what we use it for regarding adrenals if we’re working on that, but if you take the glycerin out, and you remove it, and then it becomes called dgl, where it doesn’t have the, the active component anymore, so it’s not necessarily going to affect cortisol now, now it turns into like a gut healing nutrient. So dgl is in both of our blends, and you and I’ve used it, I don’t know thousands of times by this point, and it makes things taste good to dgl. Like if you have it in some bitter herbs, it can, it can kind of blunt that nasty taste a bit

Dr. Justin Marchegiani: 100%. So DGL is excellent, you already talked about it. Regular licorice is going to have an effect that increases cortisol, which can then also increase your mineral corticoids, which hold on to water and sodium, which on the adrenal side may be a good thing if we need it, and we have a test showing low cortisol. But if we don’t have a test and we want to make sure we don’t over increase cortisol or our blood pressure, that’s why we use the test. dgl licorice though I think you kind of highlighted that dgl is is very powerful because you have the anti inflammatory benefits without the cortisol increasing blood pressure increasing sodium fluid retention effects.

Evan Brand: Yeah, I had a study here I was trying to see exactly what it said it was called integrative treatment of reflux and dyspepsia in children. Of course, all the good stuff licorice was on there gingers on the list here of botanicals. talked a little bit about sleep hygiene. Anyway, I was trying to just get a number right now in terms of how beneficial it was. It just talked about they didn’t say a number they just said here that compared to placebo licorice extract showed a significant decrease in the total symptom scores of the gut issues. So of course, they always put this in there, although more evidence is needed. DGL can help people wean off acid drugs acid blocking medication.

Dr. Justin Marchegiani: Yep, that’s powerful. I think we hit seven already, which is great. So let’s kind of go into a bonus round here off the bat, I would just say probiotics can be very helpful. A lot of times we don’t add probiotics in on the front side. But we’ll add them in after on the back side just because there’s a lot of things we can do on the front side, but probiotics, bifidobacterium, lactobacillus, acidophilus, etc. These have been shown to have anti inflammatory effects on the gut. And now the timing is everything because there’s a lot of things that you can do. The question is, at what time and the thing is, Evan and I have seen thousands of patients we have a lot of experience in the timing of things. So a lot of times we’ll use probiotics on the backside are really help. One, help gut permeability help IGA levels help crowd out a lot of these bad bugs which can them them in their own right, create inflammation. So if we crowd them out a little bit in a gentle way that can also reduce inflammation and then just naturally helping to modulate a lot of these interleukins and cytokines and all these compounds are very powerful.

Evan Brand: Yeah, I’ve been a bigger fan of probiotics. Lately just because of dealing with mold and trying to detox that out of my system and helping people deal with mold, there’s this pathway that happens. Basically, you can convert more toxic molds into less toxic molds using probiotics it basically, I don’t want to say it conjugates them because that’s not the mechanism but for lack of a better word, it’s sort of maybe de granulate. The mold toxin, makes it less toxic, and then you can excrete it out and the remaining toxin does less damage because now you’ve converted it. I don’t have it in front of me, but those are just charred of okra toxin, with the help of probiotics being converted into maybe alpha okra toxin or something. It’s kind of downstream tablet, and then downstream again, and then the toxicity drops with the help of probiotics. So long story short, I use probiotics all the time, and they work great.

Dr. Justin Marchegiani: Love it. Also, let’s do a little bonus round people. Let’s talk about mold. This could be well, so we have gut infection that could also be big things that are holding people back. I don’t think we have to go into this in depth. We’ve done podcasts On this, but a lot of people forget about the mold aspect. Because mold has various mycotoxins, which can increase gut permeability. We’ve done a podcast where we go more into how we deal with this clinically, but can you just go over that concept, Evan?

Evan Brand: Yeah, the main thing is, you know, after interviewing a guy, Dr. Nathan, he’s a medical doctor been working on mold for 2025 years, he told me, he said, You can’t fully heal your gut unless you get rid of the mycotoxins and I thought, well, how is that true? Because, you know, I’ve been working with people for a while now. And I’ve had many people who their gut symptoms are so much better so that I just get lucky that those people did not have mold. Was I missing the mold? Or, or what? How could How could you say something so strongly, you can’t heal your gut without it. And then I started looking back at some of these cases where people would be in really good shape for a few months where you eradicate the infections, you come in with some gut healing nutrients, and then a few months later, they’d say, you know what, I’m kind of, I’ve got Candida coming back or my tongue is white again, or I’m having sugar cravings again, and now I’m Going kind of circling back to those people and testing them for mold, and I’m finding that they’re positive, they’ve got it, they’ve got toxic levels. So now we just throw it into the mix. It’s not that I’m saying it’s the end all be all biomarker, it’s the end all be all catalysts for leaky gut at all. But if you’re somebody who’s gone down the rabbit hole of addressing H, pylori parasites, bacterial overgrowth, and all that, and your integrative natural functional, whoever practitioner didn’t look at this piece, I would consider it because it’s also the mechanism of weakening the immune system. So it’s not just the direct damage on the gut barrier, but I would assume that weakening the immunity has a role in this too. I mean, if you look at <INAUDIBLE> acid, something we test for, they give that to people when they’re doing organ transplants, so that it’ll kill the immune system so much that their body won’t reject the new organ. I mean, that’s how they use any conventional medicine. So this stuff is potent, potent, potent, and then you’ve got things like glio toxin, which affects the gut and the brain. So It’s a game changer. I mean, I feel like we talk about it so much now, but it’s really transformed my life and in our clinical lives too, because this is the epidemic. We used to not build houses with drywall. And now we do. So when you look at your great, great grandpa, he didn’t have a problem because this house was built with plaster. And now the house is built with drywall with paper backing. So it’s it’s a new epidemic, but I do believe it’s the number one cause of chronic fatigue that we’re seeing out there based on Dr. Brewer study, you know, 95 plus percent of his patients with chronic fatigue tested positive for mold, and all those chronic fatigue patients, they often have gut symptoms. So a lot of people have diarrhea, and they’re tired. Is it the diarrhea causing the fatigue? Maybe, but it also could be the mold. So that’s my rant on that.

Dr. Justin Marchegiani: Yeah, the only comment, I would say it just really depends, right? Because I’ve seen a lot of patients that are in a moldy environment or could be in a moldy environment. I have seen a lot of benefit and a lot of improvement, with a lot of the foundational changes that we do without even talking mold. So it just depends upon how chronic and how much is there. And then also genetically how sensitive you are to mold. There are some genetic types, they can just handle a lot of mold, and some not. So I don’t think it’s a be all end all. But I think it’s definitely an important factor that should be on our checklist, and we should be aware of it. And anytime we see a chronic health issue, we should be testing for mold in the home as an easy low hanging fruit. Because if you have high levels of mold in the home, you know, that can affect everyone in the house, right, which is great. You don’t have to test everyone’s urine individually. But then once we see high levels in the home, then we can go and start being more specific on what that individual person’s load is. And then, you know, my biggest thing is, Hey, if you’re out of the home for a week or two, how do you feel? Do you feel better, and I’ve seen a lot of patients they’re out for a week or two, they come back and it’s like, boom, now we got to be careful if you’re out of the home because you’re on vacation and you’re hanging out relaxing all week or two, and then you come back to a stressful environment. That could be a factor too. So you got to keep stress under under that control, so to speak. So you’re comparing apples to apples.

Evan Brand: True, true. But yeah, I mean, Dr. Nathan, when he’s talking about he can’t heal the gut unless you get rid of mold. Yeah, maybe in the 25% of the population who doesn’t genetically detox mold. But you and I have seen so many cases of probably the 75% of people who they can detox mold, so it wasn’t an issue. And that’s why we we were like you mentioned able to get them such good progress and results in success without even addressing them all, because they were probably genetically gifted. He seen the genetically gifted like me, who built the mold toxin up and then it had some downstream effects.

Dr. Justin Marchegiani: Yeah. And also, if you get tested for mold, and you’re gonna test your urine, make sure you challenge it with a lucify on for at least a couple of days to a week ahead of time, I typically recommend one gram of solidify on a day, you know, for three to seven days ahead of time, too many people I see come in, they’re like, Oh, my molds, fine. And I’m like, did you do a challenge ahead of time? They’re like, nope. So you got to make sure you’re really challenging the urinary mold levels ahead of time. Can you speak to that?

Evan Brand: Yeah, that’s very helpful. And if you’re you might not need a gram. If you’re doing that. Like a better quality if it’s like bizarre more maybe a seagull you may get away with, you know, a few hundred milligrams to half a gram. You know that less? Yeah,

Dr. Justin Marchegiani: yeah, it was almost probably 500 milligrams to a gram would be fine if it’s SSE or one of the other types that we like, then you get a couple hundred milligrams, it’s probably fine.

Evan Brand: Yeah, but the sawn has been helpful too. I’ve had some people just as an experiment, right? You and I are we’re experimenters. We’re in the trenches. So I’ll have people you know, I’ll have you know, Jane Doe I’ll have her do five days glue to fine and then I’ll tell her on the morning of when you wake up hold up, jump right in the sauna 2030 minutes then collected Whoa, it’s crazy how much more you see coming out. So and we know that we know that heating up the body helps mobilize toxins of all kinds. So if we’re going to do like a combo urine, organic acid, Miko chemical profile, man, we really do get a better read on people. My analogy is it kind of squeezes the orange, you know, in the cup of tea shows up just more accurate.

Yep, totally. Yeah, that makes a lot of sense. Totally. Makes a lot of sense. Well, let’s wrap it up if you’re ready for the highlight today. 

No, I’m done. You want to wrap this thing up? 

Dr. Justin Marchegiani: I think so. I think we’re on the right track with everything. So anyone want to reach out to myself JustinHealth.com available worldwide for console Evan at EvanBrand.com. So if you guys want to dive in deeper and get to the root of what’s happening here, we are happy to help you. We do a lot of these testing all over the world. So if you’re coming in, we test them all. We’ll test the gut, we’ll do all these things. We have kind of have the right algorithm, the right formula to kind of get people on that healing journey. Anything else? Anything you want to highlight around?

Evan Brand: I would just say that the issues we talked about are worldwide. You know, this is not just an American problem. You know, we’ve got clients in Australia, we’ve got clients in Canada, we’ve got clients in Europe. I mean, this is this is something happening around the world and it’s amazing how many people don’t get the proper help that they need from the conventional doctors. It’s really really sad. I was looking at my podcast reviews this morning. And of course, you know, I and you were in the alternative health category and I thought you know what we need to stay in this alternative. Category until this becomes the mainstream, you know, and that and people have made that argument before that what we’re doing. This is the original medicine. This is what people were doing thousands of years before the quote, conventional medicine existed before the vaccines and the drugs and the prescriptions and the acid blockers. Allah was around before all of that. So this is not really alternative or, or new age at all. This is just legit.

Dr. Justin Marchegiani: 100%, appreciate it. We’ll put the recommended products that we love. Evan has GI Sooth, I have my GI Restore, we’ll put the links down below so if you guys wanna support us, we appreciate that. And you guys have a fabulous day. Take care ya’ll.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye.


References:

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/top-7-nutrients-to-heal-your-gut-podcast-294

Histamine Intolerance and Root Causes | Podcast #289

Hey, guys! We have a new podcast today with Dr. J and Evan Brand talking about histamine intolerance and possible root causes. We start with symptoms of histamine intolerance. While mostly linked to allergic reactions, they can be IBS, cramping, anxiety, dizziness/vertigo, fatigue, flushing, hives, brain fog, and more. Often, you’ll see these overlap as symptoms of hypothyroid, adrenal issues, or Hashimotos. So, what next?

Nutrients important to helping break down histamine are DOA enzymes, Vitamin C, Copper, and B6 (very important to neurotransmitters). We know that gut permeability and absorbing the nutrients you need can be difficult in itself when mixed with gut irritation, stress, and/or certain symptoms and this becomes a triple-edged sword. You need the nutrients to break down the histamine but your body can’t break them down because it’s stressed, overwhelmed, or not working as it should and you don’t want to eat certain foods you used to be able to consume because the histamine’s memory is messed up and you’re exhibiting more food allergies. It can be overwhelming, so then what?

Dr. Justin Marchegiani shares common foods that increase the histamine response, palliative solutions for relief, and the reality behind finding the root cause.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:00 Symptoms of histamine intolerance

10:57 How to metabolize histamine

12:59 Testing for histamine, histamine markers and root cause

19:03 Histamine medications

24:06 Hormonal link

Youtube-icon

Dr. Justin Marchegiani:  Hey, guys! It’s Dr. Justin Marchegiani here.  I hope you guys are having a fabulous week.  We are gonna be diving in to histamine intolerances and functional medicine solutions and what we do in our clinics.  Evan, welcome to the show, man.  How are we doing brother?

Evan Brand:  Hey, I’m glad to be here and glad to talk about this subject.  Something that I used to look at and I was confused by.  I would look at these histamine issues and I would say, “This just doesn’t make sense.”  Why does Jane Doe over here, why is she able to eat XYZ food and then you’ve got the other lady over here, and she can’t eat leftovers and she can’t eat mushrooms, and she can’t eat smoked meats, and she can’t eat ketchup, and she can’t do dried fruit without having problems?  And I was like, “Okay, what the heck is going on?”  Why, why, why.  I didn’t understand it and now that you and I have worked on this issue a thousand plus times, we start to find some connections.  And so, let’s first talk about some of the symptoms of histamine intolerance.  Many of these are similar to allergic reactions and allergic reactions can create histamine.  It could be anything from gut symptoms like IBS could be related to histamine, so abdominal cramping.  Anxiety could be part of it.  Dizziness, believe it or not, dizziness, vertigo could be part it.  Fatigue could be related.  Flushing, so when you rash out like on your skin or it could be your face from certain foods, like when you see people rashing out from alcohol, like red-faced from alcohol that could be histamine.  Alcohol is high in histamine and then it’s also gonna reduce DAO, right?  It’s gonna block the enzyme that helps metabolize histamine.  I believe that’s true.  Is that right that alcohol is high histamine?  I know it messes with DAO but is it high histamine as well?

Dr. Justin Marchegiani:  Um, alcohol—what alcohol does, it’s also a histamine blocker.

Evan Brand:  Right.

Dr. Justin Marchegiani:  It also blocks the metabolism of histamine and it just depends because a lot of alcohol, there’s fermentation in the alcohol.  So of course, the fermentation will create histamine as well.  So it’s a combination of the two.  I’m pretty sure there’s gonna be histamine in it due to fermentation, right?  Like wine will be, you know, fermented or beer, and then of course, if there’s gluten in there, the inflammation could create more histamine and then you have the effects of blocking histamine as well.

Evan Brand:  Yeah that, it is a double whammy.  Yeah, here it is right here.  It talks about how like for example, red wine has up to 24 mg per liter of histamine while champagne has 670 mg of histamine per liter.  So of course, heart rate, flushing, those type of symptoms from drinking alcohol is no good.  But the problem is you’re depleting DAO.  DAO is what’s gonna help you—diamine oxidase.  It’s gonna help you to break down histamine that you ingest and so if you’re putting in histamine and reducing the ability to metabolize it.  You get in bad shape.  I got a few more symptoms and we can go on and on and one.  I mean, any list online you look at may have 50 different symptoms.  So blood pressure issues or blood pressure changes, itching—

Dr. Justin Marchegiani:  Yup.

Evan Brand:  So like the back of legs, you could just have itching.  I mean, for lack of a better word, it’s not necessarily a rash there but you could just be itching.  Nasal issues, sinus problems, nausea, and then swelling.  So like—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Tissue swelling.

Dr. Justin Marchegiani:  Yeah.  I mean you see a lot of it with Asians and alcohol.  For instance, Asians typically will get flushed when they drink alcohol because they’re missing genetically some enzymes to be able to handle it and they take a lot of Pepcid AC which is like an H2 blocker.  So a lot of times you’ll see that with alcohol and you’ll see it in certain ethnicities.  They’ll miss certain enzymes to be able to metabolize it.  I’d be curious how someone of that ethnicity would do with like extra DAO.  I wonder if the DAO would work over just a—over a histamine blocker so to speak.  Because we know the side effects in some of those medications, you know, can be drowsiness, brain fog, you know, not so good symptoms either and a lot of times you’re just trading one symptom for another.  Hope—

Evan Brand:   I bet it would—

Dr. Justin Marchegiani:  Side effects or less.

Evan Brand:  I bet it would work great.  I mean, I’ve done some experimentation with DAO.  If I have certain foods that will irritate me, like a big spice blend of you know, curry and cayenne and chili powder and cinnamon and those type of things.  Those can all irritate things, so I’ll take some DAO if I’m gonna do something with like a mixed spice blend and I feel fine with it.  I don’t really have any issue with dried fruit.  I know that’s an issue for some people but I’ll do like some freeze-dried blueberries just to see what happens and I feel fine.  So I think some of this stuff is there’s gonna be a spectrum of sensitivity with this.  Some people are gonna be extremely histamine-intolerant and then some people are gonna be totally fine.  So we’re trying to cater to all of those people.  If you’re somebody who—you can’t do fish, for example.  If it’s fresh-caught and freshly eaten or fresh-caught and flash-frozen for example.  That should be okay but if you’ve had, you know, fish that’s kinda sitting out at the market, open-air, you know that may be a bigger problem than if it were flash-frozen like on the ship,  I know there’s a couple of companies out there like Vital that they’ll freeze the fish as soon as they catch it.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And those are supposed to be well-tolerated.

Dr. Justin Marchegiani:  100%.  So you kinda went over like some of the symptoms, right?  The common ones, the flushing, the wheels or the urticaria, kinda hives on the skin, brain fog stuff, headache stuff.  It could just be allergy stuff like itching or sneezing or eye wateriness.  It could be fatigue.  It could be breathing issues.  It could be just swelling or inflammation or heart rate.  It’s just pounding, kind of the abnormal heart rate beating.  Now the problem is a lot of these symptoms can overlap with hypothyroid.  A lot of these symptoms can overlap with Hashimoto’s and adrenal issues.  This is the problem.  It’s this big overlap so that you get people that are like the histamine person or the adrenal person and you’re like, “But what’s the issue?  Is it an adrenal issue?  Is it a histamine issue?”  And this is where it gets really tough because you’re trying to seek out whose that person that can help me with this issue and the problem is everything overlaps.  So imagine like a venn diagram and then you have all these different issues, adrenal or thyroid, or histamine or gut, and then they all overlap in the middle and a lot of times that’s where people’s health issues, you know, really sit and you need a very good generalist to kinda parse these out because sometimes when we have these issues we don’t really focus on histamine, we focus on other things.  Like when you just magically reduce inflammation in the body through diet, lifestyle, supplement strategies, magically histamine can drop.  And we actually do need some histamine because histamine is a big stimulator of hydrochloric acid.  So it’s like, well, if you don’t have no histamine then we’re not gonna have good HCl stimulation and we know HCl is so important for digestion.  So it’s this, you know, it’s not like one of these things where we wanna just knock histamine down to nothing, right?  But we wanna modulate and prevent the, you know, the abnormal highs of it which tends to be driving a lot of the symptoms.

Evan Brand:  Yeah, that’s a great point and many people don’t hit that if you talk about the word histamine.  It’s sort of like a bad bacteria.  It’s just kill, kill, kill, kill, knock it down, knock it down, knock it down, knock it down but yeah, you’re right.  I mean, it’s a neurotransmitter and it does affect the immune system, too.  So it’s not something that you want zero off.  I know—I don’t know the exact mechanism but I know histamine has some role on energy like your sleep-wake cycle is somehow related to histamine.  Appetite, I know is involved with histamine.  So there’s a lot of things that people just, they skip out on and then they get on these H1, H2 blockers and then who knows what’s happening downstream?

Dr. Justin Marchegiani:  Yeah, I mean histamine is part of the stress or inflammation response.  I mean, it can cause clots.  It can cause cells to get more sticky.  It can cause your lungs to constrict a little bit more.  It can cause more swelling and fluid retention.  It can open up the blood vessels partly because imagine if you bang your elbow, right?  What happens?  Does it get more swollen or less swollen?  It gets more swollen.  Why?  Because of the inflammatory response.  It’s driving vasodilation, meaning it’s opening up the blood vessels.  Why?  Well, to help bring the immune cells there to help kind of bring the inflammation and recovery process under control.  So the problem is a lot of these mechanisms, they’re acute punctuated mechanisms.  They’re on then they’re off.  With chronic inflammation in the system through gut or other hormonal imbalances, it’s on and then it stays on and then now that it’s on, certain foods that may have been—may have not been a problem before, now perpetuate the problem.  Does that make sense?

Evan Brand:  Yes, it does.

Dr. Justin Marchegiani:  So it becomes this vicious cycle where like, yeah, you may be fine.  You should be able to have some kombucha and some bacon, but now because of the inflammation.  Now that bacon’s a trigger, now the kombucha is a trigger, now the citrus fruits are a trigger, now the good avocados are a trigger, and it’s like people are pulling their hair.  They’re like, “What is going on?  I don’t get it.  These are good foods.  What’s happening?”  And they have to look deeper at of course, you know, when we look at the symptoms, the first thing I do is I say, “Okay, let’s try cutting some of these histamines out of our diet food-wise, do we feel better?  Yes or no?”  That tells me something and if that helps, then we look at, okay, let’s work on better digesting our foods, number two.  Let’s work at gut infections because we know the microbiome, if out of balance, can really create these abnormal histamine responses and we know how the microbiome is so important with gut permeability and that increases autoimmune issues, hence, thyroid, hence adrenal, hence gut issues, irritable bowel disease, so everything can just really spiral out of control if the microbiome is not there, if the food is not there, and of course, if stress is there, we know what the sympathetic nervous system response does in regards to burning up our B vitamins and decreasing HCl and enzymes and decreasing dopamine and adrenaline over the time and then we also know that certain nutrients are gonna be vital for histamine—for making the enzymes to break down histamine, right?  We know certain enzymes, the DAO enzymes are really important and we know vitamin C.  We know copper.  We know B6.  B6 gets burnt down so much during stress, it’s very important for our neurotransmitters, and we also know that if we have low stomach acid levels and we’re stressed, we’ll be burning them up at a much higher level and we know that when our gut microbiome is out of balance, we have more bad stuff than good stuff.  We know that the bad microbes will be eating those nutrients versus making it and we know those bad microbes will be actually making more histamine byproducts as well.  So it’s this double-edged sword, when the gut’s out of balance, we eat the nutrients we need to break down histamine, the bad bacteria makes more of the histamine and then we don’t get a lot of those nutrients absorbed that help us make the enzymes to degrade histamine.  It’s a triple-edged sword.

Evan Brand:  Yeah and then think about, too, you need vitamin C to help reduce or sort of metabolize histamine for lack of a better word and a lot of people are gonna be pulling out citrus, even like lime-lemon.  Those are kinda demonized in the histamine world, if you are reacting to it.  So now, you don’t have enough vitamin C.  So I’ll try to supplement vitamin C personally and clinically and see if it helps and in many cases, it does.  So we’ll have people do quercetin which is in the vitamin C family to help stabilize mast cells that way we can prevent the release of histamine.  At least in theory, if we take a, you know, a shot of 500 mg of quercetin before—when I say a shot, I mean a powder, put in a shot glass with a shot of water and I’ll shoot it down like a 500 mg quercetin before a meal and then mix a little vitamin C with it and that tends to help reduce some of the reactions and then also the DAO before meals.  Let’s go in, just real quick list and then we’ll keep talking because you hit on something that I think people miss the boat on which is that and this is something you and I talked about before we hit record, which is that histamine intolerance or histamine issues are in effect.  What is the cause?

Dr. Justin Marchegiani:  Correct.

Evan Brand:  So if histamine issues—

Dr. Justin Marchegiani:  Correct.

Evan Brand:  Are in effect, what is the cause?  So let’s rant on that more in a minute but we hit the alcohol, fermented foods, cheeses, smoked foods, shellfish—many people that say they have a shellfish allergy, we suspect it’s a histamine issue—beans, nuts—my voice cracked, I said nuts, almonds, nuts.  I don’t know why but certain nuts get moldier than others, so for example like macadamias, for some reason, those and cashews tend to be more intolerable versus I find a lot of people do well with almonds.  Chocolate, vinegar, tomatoes, citrus.  So those are kinda like the histamine triggers but let’s go back to the gut because what you were saying is that the gut bacteria are gonna be doing several things.  They’re gonna messing up the gut barrier.  They’re gonna be producing histamine.  So regarding testing, if someone says, “Hey, how are you gonna test me for histamine?”  Let’s dive into that because the answer is we’re not directly gonna test you for histamine, correct?  We’re gonna be—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Looking deeper.

Dr. Justin Marchegiani:  Correct.  I mean, there’s the markers like the, you can do the tryptase marker.  It’s a tryptase enzyme marker that you can do.  When you break down histamine.  DAO is one of these enzymes that helps break it down and there’s also histamine N-methyltransferase (HNMT).  I think you can also test some of those enzymes.  But for me, I just—I make clinical changes with the diet and I also give specific supplements and I let those symptoms kinda dictate.  But we also understand that that’s not root cause and this is where it’s very important where a lot of functional medicine people.  I see it a lot with naturopaths where they’ll kinda come in there and they’ll use supplements to just treat symptoms and they’re not getting to the root cause.  So we always have—I always draw a line with patients.  What’s gonna be palliative changes to allow you to feel better in the meantime and then number two is what’s gonna be more root cause.  Because sometimes root cause stuff’s a little bit slow and that’s not good if you need relief now.  So we need to figure out a way to get relief now, like you mentioned some of the natural antihistamines—stinging nettle, quercetin, NAC, bromelain, kidney tissue that has the DAO enzyme, maybe B6, copper, zinc, good quality multi.  So we’ll do those things.  We’ll make the diet changes.  We’ll look deeper at the gut and the adrenals because we know steroids also are part of what’s given to address some of these issues, right?  From a symptomatic standpoint.  We know steroids, like the big medication we know are the H1 receptors and H2 receptors are the big ones, right?  We know the H1s like your Benadryl and your Claritin, these are the H1 histamine receptor blockers.  The Benadryl, the Claritin, right?  And then the H2 ones are gonna be like your Peptid AC, right?  H1 is gonna be more the histamines in the muscles, where H2 histamine is gonna be more in the intestines in the abdomen and that’s gonna be affect the heart.  So H1, H2, so keep that in mind.  Those are the big ones.  There’s actually H1 through H4, but the big meds are H1, H2 and we know that the medications can be helpful but they have a lot of side effects and we have to be very careful with that.  And we also know that the gut and all these nutrients play a huge role and when we look at the nutrients, we have to one, get a good quality multivitamin there that’s gonna have a lot of these nutrients that are gonna be bio-available so we can absorb it easily and number two, we have to get our digestion under control and number three, we have to look at other issues deeper.  That could be a mold issue or it could even be a Lyme or a co-infection issue.  I always table Lyme stuff unless there’s a strong history of tick bites, I always table it and deal with the gut first and the adrenals and hormones even before that and then personally after that I’ll—I typically will deal with mold—Evan and I may differ on this.  I’ll typically look at and test mold right away if there’s a strong history, water damage in the home, history of visible mold or if we’re on the fence, we do a plate test or a urinary mold test or hey, do you feel better when you leave your house for a week, right?  If those symptoms are there, we’ll look a little bit deeper and we’ll test.  I typically don’t go after and address mold right away because a lot of how the mold is removed is via the hepatobiliary system so that’s liver, gallbladder, gut, and the stools.  So if we don’t have great gut issues, a lot of times we can re-absorb stuff.  A lot of the binders that we may give to help pull out mold can actually cause constipation, so I always fix the gut, fix the gut motility, fix digestion before going after mold but we can at least test in the person, the patient.  Test it in the house and we can at least start making house changes right away.

Evan Brand:  Yeah, so I go after it straight away regarding testing but yeah, you’re right.  You gotta get people pooping before you go and do binders.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And a lot of times like some of the binders you and I are using have folic acid so constipation is really an issue and if you’re bumping up magnesium and vitamin C and that kinda stuff, generally it’s no big deal but how I approach it is that way you mentioned, plus what will make me go after it more beyond just history is just looking at the mold symptoms.  So in my intake form now, I’ve got like 25 different symptoms and if they check off more than a handful, we’re like, “Huh, this doesn’t look good.”  So we’ll look into it and a lot of times, I mean, it’s showing positive.  One thing I wanted to mention on the drug piece, you did a great job talking about like all the over-the-counter stuff that people get into on their own now.  So the Zantac and the Pepcid and the Benadryl and the Zyrtec and the Allegra that kinda stuff, those antihistamines may work in the short term but we’re gonna downregulate DAO and you get for lack of a better word, you get stuck on it because now you don’t have enough DAO so, therefore, histamine rises more than it did before.  And then one other thing, too, is that—and there’s a lot of people talking in forums about this on antidepressants and I don’t know exactly the mechanism.  Maybe it’s depleting DAO, maybe it’s increasing histamine.  I don’t have the mechanism and the study right in front me but if you just look at histamine intolerance Zoloft or histamine intolerance Cymbalta, Effexor, these really, really extremely in fact common prescribed and commonly dosed antidepressants—those cause histamine problems.  So how many people out there, in fact, there was a lady who had a big website dedicate to this which was histamine intolerance after discontinuing Zoloft, and so I don’t even know if the science is clear on it but a lot of people are talking about this.  So if you have been doing an antidepressant and now you’re reacting to more foods that may be something to look into.

Dr. Justin Marchegiani:  Yeah and also, so we talked about some of the big medications, right?  A lot of the Allegra, the Zyrtec, the Benadryl, a lot of the H2, 1 blockers, right?  Here’s the rub here and this is where it gets really, really, really, really confusing is that we talked about how histamine is actually needed to make hydrochloric acid.  So guess what happens with this histamine medications.  They also reduce acid levels and guess what happens when you reduce your acid levels.  Now your digestion goes down south.  What happens when your digestion goes down south?  Now you start to have more SIBO and bacterial overgrowth.  Guess what SIBO and bacterial overgrowth does.  It produces more histamine metabolism.  So it’s this unbelievable vicious cycle people get on and it’s—

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Very, very frustrating.  Not to mention that okay, there’s the other class of medications that help with histamine, guess what.  They’re corticosteroid-based.  You see it with Singulair, right?  Or a lot of these steroid-based medications, well, maybe our adrenals are so weak, we don’t have enough of our natural cortisol, corticosteroids, so we’re not—we have to fix the adrenals with it as well because the adrenals help make that that corticosteroid called cortisol which helps with our natural inflammation and if we can’t put the fire of inflammation in our body out every day that fire is gonna run rampant and create more inflammation and that inflammation is gonna drive more histamine issues and like we talked about before, all of those histamine medications, they deplete the DAO enzyme so then the histamine that’s made, it hangs out way, way longer so it’s not just about making histamine.  It’s about now you can’t break it down so now it stays at the party.  It’s like it’s the guy at the party that just lingers way too long.  It’s like you should be out of here, dude, right?  Closing time.  But that’s what’s happening with histamine in our body.

Evan Brand:  Oh, man.  Well, it’s not to say that we’re saying, “Hey, don’t do those drugs.”  But man, it would be a lot of better if before you get to the point where you get put on a daily Zyrtec or a daily Allegra or something like that or a Zantac or a Pepcid, it would be so much better if we could just stop those people and just say, “Hang on, hang in there.  I know you’re symptomatic.  I know you need relief.  Hang on.  Let’s try some of these herbal antihistamines.  Let’s give you some extra Vitamin C, maybe some extra DAO.  Let’s get you on maybe some leaky gut support.  Let’s get you on low histamine diet for now.  Let’s run a stool test.  Let’s run organic acids.  Figure out what’s going on.  Let’s test your environment.  Hang tight.”  And then if we could do that, it’s just such a deep rabbit hole.  It seems like every time you and I do a conversation on a different health aspect, there’s always a drug that’s involved in terms of being palliative but it seems like there’s always a double-edged sword to that.  No matter what the topic is.  Isn’t it funny how you and I always end up here?  It’s like crap.  The drug helped but now it actually put us in a bigger hole and now we gotta get them out of this hole because now they are downregulated of DAO even more than they were before.  It’s like, ugh!

Dr. Justin Marchegiani:  Exactly.  This is the problem, right?  And so, in general we gotta look at the adrenals, gotta look at the inflammation because if you’re taking steroids, we need to have our natural anti-inflammatories going.  We have to be very careful of the medication.  If we’re using the medication, fine, use it sparingly, but just know it’s gonna create more dependency in the long run.  Also, I’d say a big thing is environmental allergens.  Environmental allergens can dry histamine.  So imagine like we have this big stress bucket, right?  And I’ve given this analogy a lot over the years.  We put our stress balls in this bucket.  When that bucket fills up and overflows, this is where symptoms happen.  So, some people they come in genetically with a big bucket.  They can handle a lot.  They can deal with more stress and they have more adaptability.  Some come in with a small bucket and that bucket is already half full because they are exposed to mold, right?  Or heavy metals or they’re not eating organic.  So that now they’re bucket’s already at the very top and then you add in a little bit of gut dysbiosis or you add in some environmental allergens—BOOM! Histamine symptoms are going crazy now.  So we have to look at that.  So one of the first things is get the stressors out of that bucket and a lot of times so those stressors could be things unrelated to histamine, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that could be just eating organic, clean water.  The other component is environmental allergens can be a big deal.  If you’re out in Austin.  Cedar is big this time of the year.  You’re breathing in cedar and that hangs out in your sinuses all day and you don’t have a good air filter at home at night then you’re in this stressed-out state because that cedar’s up in your nose causing problems.  So my protocol with patients is we have a really good sinus irrigation system to flush thing’s out.  We clean it out with saline and Xly or Xylitol to knock out any biofilm.  We do it twice a day especially once we come in for the day, we are flushing our sinuses out so it’s clean for the day and we have really good air filtration so then when we are resting at night we are not in this fight or flight state because all the cedar is up in our frontal sinuses creating inflammation all night.  We flush it out once we come inside.  We flush it out when we start the day.  We may even do it midday if we’re really bad just to keep our immune system from overreacting and then we gotta have that clear air filtration at night so when we come home our immune system can relax.  Because if these environmental things are just keeping us in a fight or flight state, it’s gonna be hard to feel better.

Evan Brand:  Yeah, so you’re basically saying, “Let’s try to get some of the things in the bucket, the external histamine bucket down, that way potentially you could tolerate that food and then we’re working behind the scenes to work on the gut and reduce some of the bacteria making histamine there.”  Now here’s one thing we didn’t hit upon yet which is the hormonal link and so I have had many women say that they’re symptoms are worse right before their period starts and I’ve heard of many women who are postmenopausal who are now doing like estrogen replacement and other hormones and estrogen decreases the breakdown of histamine because it actually messes up with DAO, too.  Estrogen can lower DAO.  So if you think about all these women that were doing birth control pills or hormones or anything to mess up estrogen or you just think about the thousands of ways we’re exposed to the xenoestrogens in the environment like reheating our food in plastic and drinking from single-use water bottles that got exposed to sun and things like that.  The whole estrogen-histamine link is big and maybe that’s why we see so many more women than men, you know, I would say it’s a vast majority.  We see a lot more women deal with histamine problems than men.  I think it’s probably due to the hormonal changes and so like if we’re looking at that stool, you hit upon the gut bugs.  When we’re looking at the stool, we’re also gonna look at that glucuronidation pathway and if we see that that’s messed up, and if they’re taking hormones or if they just have estrogen dominance as a history, that’s gonna mess them up more.  So we have to address that as well.  So if you go to the gut guy and he hits on your gut and gives you some herbs there and you don’t get better, the hormonal piece and I guess that would factor in to your adrenals, too, because the adrenal test that we’re looking at, you know, that’s gonna look at hormones, too.  So we’d probably kill 2 birds with 1 stone there.

Dr. Justin Marchegiani:   Exactly and also I would say, so you’re—what you’re proposing as a mechanism is that estrogen helps break down histamine?

Evan Brand:  No, so estrogen depletes DAO.

Dr. Justin Marchegiani:  Okay, so when you’re estrogen’s too high, you’re depleting DAO.

Evan Brand:  That’s right.

Dr. Justin Marchegiani:  Okay, so if you’re estrogen-dominant, you’re gonna be depleting DAO.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  I would also say that when a woman goes through PMS, what’s happening in PMS, right? PMS is premenstrual syndrome, so right before menstruation that’s right at the heart of the luteal phase, if progesterone drops out early, that’s a lot of times what’s driving PMS.  That one, that enhances the estrogen dominance, right?  So high levels of estrogen deplete DAO, that supports and kind of, you know, backs up your mechanism there.  The other thing is progesterone is an anti-inflammatory.  Progesterone is a precursor to steroids like cortisol.  What do you get when you take Singulair?  You’re increasing cortisol.  If your progesterone is dropping out too soon?  What does that mean?  Less anti-inflammatory building block, right?  So all of this makes sense.  We’re trying to be the bridge to connect these hormonal issues to the deeper histamine but also connect the gut issues because it’s all connected, you know, in the interwebs of functional medicine.  So progesterone, estrogen dominance, all makes sense.  Progesterone anti-inflammatory.  Progesterone drops out too soon, that’s the PMS symptomatology there and that’s what driving the inability to regulate inflammation and then also estrogen dominance, right?  Estrogen higher in relation to the progesterone will deplete DAO which is the enzyme that cleans us histamine.  So all of this makes so much sense.

Evan Brand:  Yeah, and there’s a couple of papers on this, too, about the estrogen effects and allergy and asthma, and there are these papers kinda talking about women that are doing supplemental hormones and all of a sudden they’ve got new-onset asthma when they’ve never had it before and it started after they were doing hormones, and so that talks about how boosting up the hormones is affected the mast cells too much and then that’s creating more of an inflammatory chemical-release of histamine and probably other mediators, too.  So this is interesting and I think this is probably the answer.  I didn’t really know this but until I looked at it but it makes sense why we see so many more women than men suffering.  What you say clinically, I mean, women as a whole more in general but with this specific issue, would you say what you’ve seen is more women than men?

Dr. Justin Marchegiani:  Women’s hormones are much more of a symphony that happens throughout the month and it’s very easy for a symphony to turn into noise, right?  If the strings aren’t in there with the percussion instruments, you’re gonna get noise.  So when you start to have hormones a little bit out of balance, it’s gonna affect women in their ability to deal with stress and part of those stressors could be histamine.  So that’s really important and with stress in our environment, we are going to knock down progesterone and with a lot of the estrogens being in our environment, in plastics, pesticides, various chemicals, water, it just only drives more estrogen dominance, right?  It just drives more of these histamine issues.  So it totally makes sense but we have solutions and functional medicine is gonna be the best thing because we know just throwing birth control pills in there, guess what?  That depletes DAO further because that’s just heightening estrogen dominance, right?  And then just throwing in there antihistamines, well, guess what?  That creates more low stomach acid situations.  That’s gonna make digestion harder, breaking down proteins and fats harder, and that’s gonna perpetuate more SIBO, right?  Because if we don’t have good digestion, bacteria proliferate and an environment where there’s not good digestion.

Evan Brand:  Humans always have to complicate things, don’t they?  Will all the drugs, it’s like, “Darn it!”  I mean, without the drugs, I know drugs save lives, drugs save people, antidepressants prevent people from committing suicide and you know, heart drugs help stabilize the heart rhythm and blood pressure drugs help get the blood pressure down so they don’t have stroke.  I mean, I know drugs are needed, but man, every time we uncover some of these connections between the medications and these deeper issues, it’s just like ahhh.  I wish—

Dr. Justin Marchegiani:  I know.

Evan Brand:  We could save people from getting on them.  Yeah, if people just wanna look up, you just put in like estrogen DAO or you put in like sex hormone DAO, you’ll find some papers on this stuff.  It’s just—it’s pretty crazy how connected this stuff is and so.

Dr. Justin Marchegiani:  It is.

Evan Brand:  We’re trying to cover it all.  It’s tough to do what we’re doing in half an hour but we’re trying to make sure you address hormones, you address gut, you address adrenals, you address the sleep, you address the diet, you have to hit all of these pieces if you fully wanna beat this issue.

Dr. Justin Marchegiani:  Exactly.  Well, to get more info on this, guys, head on to evanbrand.com to reach out to Evan and schedule with him.  You can also head over to Dr. J, myself, at justinhealth.com.  We’re here to help you guys.  We’re available worldwide via Skype, Facetime, phone, video consultation.  We’re here to help.  Just make sure you guys take one piece of intel from this conversation today.  Apply it to your health and life.  We hope that you guys understand some of the deeper mechanisms and why some of the medications may help acutely but long term may set you up for more problems.  I hope you guys enjoyed it.  Sharing is caring.  Give us a share.  Put your comments down below.  If you’re suffering from histamine, let us know.  We’re curious about it.  We wanna engage in a deeper conversation and hope you guys enjoyed the podcast.  Evan, anything else?

Evan Brand:  No, that’s it.  Y’all take care.  Have a great day.

Dr. Justin Marchegiani:  Take care, guys.  Bye y’all.

Evan Brand:  Bye.


References:

https://justinhealth.com/

Audio Podcast:

Two Ways To Take Binders To Detox The Gut

If you’re seeking out functional medicine, you may have your own agenda but listen to the practitioner’s agenda, too, because even if you’ve gone through this a thousand times, we can tell you straight up, “Hey, look, if you’ve got way too much inflammation–I know you wanna get rid of the bugs, so do we–but you may feel crap if we do it too soon.”  So we want to build everything up so we have that foundation ready to go.

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There are two ways to take a binder:

  1. When you know you’re eating questionable food or drink and you want it to be in your system to bind any potential crud with that up.  That’s where you would take that with that food.
  2. When you’re in the middle of a detoxification program and it’s a longer term thing.  We probably don’t want you taking that binder every single day with regular healthy food.  So we would have you do it typically an hour before meal and/or 2 to 3 hours after a meal to avoid binding up those minerals and nutrients.  So we would try to time it up on an empty stomach.  Now sometimes it’s easier to do it mid-day between breakfast and lunch and lunch and dinner or some people will do it when they get it and then when they go to bed, and just leave an hour before, half-hour or 45 minutes before breakfast in the morning, and then at least 2 hours after dinner at night.  Those are really good prime times and of course, a holiday weekend.

You can always take activated charcoal with any of your questionable foods and drink.  That’s super helpful. Dosing-wise, most of the time when you find activated charcoal, it’s going to be in about a 250 mg to 500 mg dose.

Detoxification and Binding

You have to mobilize a lot of your toxins but you have to detox them at the same time, so it’s kinda this seesaw where if you do too much glutathione but not enough binders, you may feel worse.  Or if you don’t do enough glutathione or enough binder, then you may still feel bad. When you feel like your best and you’re not recirculating toxins, it’s the perfect dose of glutathione. As per Evan Brand’s experience, it is about 200 mg of acetyl-glutathione with NAC 1 gram and then 500 mg of charcoal.

How to take it?

As an example, glutathione would come first in the morning 7 AM then wait an hour to do binders or in reverse.  So you could do binders first thing at 7 am, glutathione at 8 am, and then breakfast right after.

The hardest part is the timing and remembering to take them. Just remember to take them away from your medication, your other supplements and herbs.

Supporting the Lymph

  1. Drinking enough water helps support the lymph.  The solution to pollution is dilution, right?  Say that 4 times fast.  We wanna make sure we’re providing hydration so the lymph can move.
  2. Ginger tea is awesome.  I use this with a lot of my patients because ginger is anti-inflammatory.  It’s essentially an anticoagulant.  It keeps things moving.  It’s also a biofilm buster.  So the biofilm or these protective shields used by critters, it will definitely help with that and take those shields out of their hand and allow the antimicrobials to be more effective, so that’s for sure.
  3. Now a couple of other gentle lymphatic supports that we’ll do is we’ll do a red root which is gonna be a powerful anticoagulant.
  4. Slippery elm.
  5. Dandelion.
  6. Milk thistle.
  7. Skullcap.
  8. Rhubarb.
  9. Rosehips are shown to be incredibly effective at mobilizing toxins and just kinda gently nudging it out of the body.

These are all very, very powerful strategies that we can utilize to keep things moving.

If you have gut issues and would like to use binders to detox the gut effectively, click here to schedule an appointment!


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.