Investigating Your Adrenal and Hormones With a DUTCH Test | Podcast #327

In this video, Dr. J and Evan talk about the adrenal glands in our body – to produce certain hormones directly into the bloodstream. These hormones will respond to stress and other necessities to our existence. Also, they are discussing the detailed test needed to identify the root cause of problems and what other materials and hormones are essential to keep our adrenals and body healthy.

To support the body naturally, Dr. J recommends using herbs such as maca and ashwagandha. Progesterone, estrogen, and estriol may be fit for a patient. However, it is essential to know that protocols may be different for every patient since presentations and lab results may differ.

Dr. Justin Marchegiani

In this episode, we cover:

0:20     Labs At Home

5:07     Low Cortisols

9:37     Hormones

11:09   Dutch Tests

28:19   Useful Herbs

34:47   Healthy Estrogens

Dr. Justin Marchegiani: And we are live. It’s Dr. Justin Marchegiani in the house with Evan Brand. Today we’re going to be talking about hormone and adrenal lab testing what we’re actually using in our virtual clinic to assess our hormone imbalances in our patients and different things that we’re doing to address those imbalances. Evan, how are we doing, man? 

Evan Brand: Good, excited to get back in the saddle here and talk about something that we can test at home, which is amazing. I think that’s the first benefit to point out about some of the testing you and I are utilizing is that many people now they care more about their health than ever obviously, the state of the world has convinced people that health does matter. You need to prioritize this stuff. And so we can send these labs to your door. And so the test that you’re going to be showing people today will be something that you can do if you’re listening via audio, you might miss the visual, you can go to Justin health YouTube channel and see the video, but we’ll be sure to make sure we talk about it in a way that you can still understand even if you’re just audio only today.

Dr. Justin Marchegiani: Yeah, if you’re listening to the audio, we’ll put a link down below for the video so you can see it. And also if you’re listening, you can go to Justin health.com slash YouTube and hit subscribe. Alright, so let’s dive in. And so we deal with patients from all over the world virtually that have all kinds of different hormonal imbalances. It can range from a menopausal woman with lots of hot flashes, mood issues, vaginal dryness, depression, skin elasticity, hair loss issues, it could be a cycling woman that has a lot of PMS. pmdd breast tenderness, cramping, back pain, mood issues, irritability, also infertility as well. And then it was a lot of different imbalances in between excess androgen issues like we see in pcls, polycystic ovarian syndrome, we may even see estrogen dominant issues just like which could be PMS as well. Could be infertility, could be fibroids could be endometriosis could be fibrocystic breast issues, all of these things are on the table and of course, even manage a male issues to could have men could have excess estrogen and or low androgen and or low or high cortisol and or low or high Da, da all these imbalances are potential, I always tell my patients, you have the right to have more than one issue at the same time. And you can also have a hormone imbalance and also have multiple gut infections too. Of course, it’s all possible, right?

Evan Brand: Yeah, people hearing that too. They’re like, what the heck kind of mumbo jumbo? Did he just say, and how does that manifest? Well, you know, low libido, too. I mean, that’s one that I’d say at least 90% of the people I’m working with, that’s a question we always ask is, you know how you drive. And sex drive is always terrible for people. I was actually a study that came out. And the vast majority of people surveyed said that they would rather scroll on their smartphone on social media than have sex with their partner. And I thought, Oh, God, is that where we are in the technology world that the phone is more desirable than our partners? That’s no good.

Dr. Justin Marchegiani: Yeah, definitely not good. 100%. So I just kind of laid out a couple of potential patterns there, we’ll kind of dive into them one by one will actually show you a real live patient lab here for y’all to kind of look at obviously, it’ll be centered regarding who the patient is. But we’ll put all that information out there for y’all. So you can kind of see how a lab looks out of the gate. So one of the first things that we do when we look at a patient, male or female, we’re going to look at adrenal function. And adrenal function is very important because your adrenals make cortisol. Cortisol is an anti inflammatory hormone. Most people in today’s day and age, they’re not under inflamed, they’re over inflamed. So having your body’s natural anti inflammatory system on board is vital, very, very important. Second is cortisol rhythm. Cortisol rhythm plays a major role in your circadian rhythm, which is waking up energy in the morning. Having good rhythm helps a lot with mood, and also lower cortisol at night. And that nice gentle taper of cortisol. So cortisol starts, it starts mid range, when you wake up, and in that first 30 minutes to an hour, it almost doubles. And then from there, it tapers down throughout the whole day. And we want a nice lower cortisol rhythm, lower cortisol level at nighttime, so we can wind down and relax not too low, when we start having maybe blood sugar issues, which could wake us up at night and not too high, where we could have problems going to bed because we’re too wired right, or not a reverse pattern, we’re lower in the morning, which means low energy and higher at night, relatively speaking, which could cause us to have too much energy at night and then we don’t get good sleep. So the adrenals play a really big role because of cortisol and its effects on anti inflammatory mood, rhythm, sleep, and then also especially for women listening men too, but da da da da sulfate is a precursor to a lot of our sex hormones, that helps with our female hormones. And that plays a big role in healthy, healthy reproduction. people. People think when they talk about female hormones or just thinking about having babies no your hormones there to reproduce you Yeah, reproduce the baby but also reproduce you which means healthy aging, healing recovery as a man to healing recovery. Healthy libido, good muscle building. In good building the ability to turn over your tendons and ligaments and bones, all these things require good healthy anabolic metabolism.

Evan Brand: Yeah, great point. You know, one thing you pointed out, which I think a lot of people miss with cortisol is you mentioned cortisol being too low at night and that impairing your sleep. See most people just a buzzword, or if they’ve ever heard of cortisol, they’ve heard of adrenal testing and things like that. They think, okay, high cortisol at night equals poor sleep. But you mentioned low cortisol at night or too low cortisol at night could also be an issue because of that blood sugar. And then what can happen is you and I’ve covered this before, but there’s some sort of a spike, right? Maybe an adrenaline cortisol spike in the middle of the night, is that what you think is happening?

Dr. Justin Marchegiani: Yeah, so with sleep issues, you could definitely see a low cortisol kind of going into nighttime or low cortisol during the night. And that can cause a drop in blood sugar, and that drop in blood sugar can then signal a increase in adrenaline. So adrenaline tends to come to the scene first, cortisol tends to come to the scene 1020 minutes later, or so. So you get this spike of adrenaline that’s very stimulatory, that increases cortisol. And then now you’re alert and you’re waking up, right? So we want to make sure higher cortisol, lower cortisol at night that’s causing a increase in cortisol is not happening due to blood sugar regulation. So we want good blood sugar, good healthy protein, and fats, maybe work on amino acids and melatonin production at around bedtime, and maybe have something by your nightstand to help stabilize blood sugar before in your end. Or if you get up like a nice simple college and smoothie, or a really good protein and fat base, simple bar by your nightstand to stabilize blood sugar, those are all really really good options to help you on the sleep side.

Evan Brand: So like if you had a good quality protein, fat, maybe some carb starts with dinner, but let’s say I don’t know, 9:10pm, you go to have a snack and you just do. I don’t know popcorn or I don’t know, handful of strawberry, some kind of a simple sugar, you think it’s possible that your glucose could spike and then it will crash in the middle of the night if you’re doing something too simple or too high on the glycemic index?

Dr. Justin Marchegiani: Well, it depends on how blood sugar sensitive you are. I mean, the two examples you gave are two different things, right? Because grains and popcorn are going to be a little bit more higher glycemic, higher sugar stuff, strawberries, pretty low glycemic and a lot of fiber there, so probably not as much with the strawberries. But could you have some strawberries and maybe a spoonful of almond butter, right or some kind of a good fat or protein probably better, right? It just depends upon what time you’re going to bed and what time you’re eating. Usually you see people that are eating around five or six o’clock dinner, and they’re going to bed like around 11. And there’s like a five hour gap between their last meal and sleep potentially. And again, it has to do with how dysregulated their blood sugar is and how weak their adrenals are. So it really depends. But if sleeps an issue, that’s one pattern we want to look at. We talked about da da playing a big role. If you’re a female going into menopause, that means your egg follicles are being used up essentially. And you’re not going to get that hormone production from that follicle that’s now no longer there. So we require a lot of the DA DA from our adrenals to now be made. And if our adrenal reserves on da, da are low, guess what? We’re not going to have that that backup battery that we had already to go right we’re in middle of, we’re just coming out of a bunch of storms in Austin here. And if you didn’t have a generator ready to go, guess what you you went without power for a while, well, that’s kind of like going into a spa, menopause is going into a storm with a generator that’s maybe three quarters empty. And so the adrenal is play a really important role as the backup generator for sex hormones. And so the better that generator is charged up, the easier you’re going to sail into menopause and not have all the hot flashes and mood issues and sleep issues and skin issues and hormone issues and vaginal dryness issues that you may have with lower sex hormone reserves.

Evan Brand: Yep, well said you’re ready to show us this thing. I’m sure people that are on video want to see what the heck we’re talking about. We can see some of the rhythms and also da da is measure two, which is cool. So when we talk about a cortisol test, we’re getting a lot more than cortisol to right we’re getting melatonin also.

Dr. Justin Marchegiani: Exactly. And then one last thing to look at is PCOS, which is also common. You see it more in younger women, you know, 20s and 30s. But blood sugar issues high level of insulin, this can really jack up testosterone and this can do a whole bunch of issues in regards to abnormal hair growth, you may see an increase in libido, some still go down. And then of course, weight gain is going to be another another big side effect there. Let me share my screen with you so you guys can see an actual lab test for y’all. Okay. All right. So while I get that going here, in the meantime, anything else you want to say about that, Evan?

Evan Brand: Well, you and I were talking about this before we hit record and that was the idea of retesting hormone. And so you thought well, based on a lot of people with progress, you don’t necessarily need to incur the cost again. So a lot of times you and I may run this as an initial snapshot, but depending on symptoms, you may not need to do this over and over and over again because a lot of the support We’re using a pretty broad spectrum. And they’re going to help regulate your rhythm regardless of where it’s at. Right? So initially, we may want to tweak one thing a certain direction or the other, but long term care wise, you and are using things that are pretty, would you just stay state stabilizing, not necessarily a big sledgehammer to the hormones.

Dr. Justin Marchegiani: It depends for me. So if someone has very, very low cortisol levels, or very, very high cortisol levels, and or significant estrogen dominance and low progesterone, the more significant the hormonal pattern, the more significant the imbalance, the more I want to retest less significant if we see corresponding symptomatic improvement, usually it becomes less necessary because the patient knows they’re getting better we can feel it, we can see it in their their physiological activation and how they’re sleeping, their mood, their energy, their libido, we can you know, their cycle, there’s just so many things that are improving that the patient is confident that we’re good. And if the imbalance isn’t major, right, they’re not a fertility case. They don’t have a major hormonal imbalance right there that may not be necessary, but I always kind of I’m on the fence always give the patient the ability to to make a decision on that. So this is my screen here, Evan, are you able to see it?

Evan Brand: Yep, we see it just fine.

Dr. Justin Marchegiani: So here’s a Dutch test that’s done with a patient whose kind of perimenopausal menopausal, meaning their cycles kind of been on and off hasn’t really had it for six to eight months or so kind of in that area of transitioning into full menopause, which is usually not having a cycle for a full year 12 months in a row. So they’re kind of in this Peri menopausal phase, and usually perimenopause and start to hit in your, in your early to mid 40s. When you start skipping months, maybe you start having some hot flashes like symptoms, whether it’s mood or libido or a hot flash stuff. And again, it’s always tough to say because perimenopause can easily feel like PMS too, right? I think that the biggest differentiating factor is not having all the hot flashes and not having the skip cycles. When it comes to more of the PMS like stuff, that’s usually a distinguishing factor. But we look at the Dutch test a couple things here. This is our cortisol pattern, our daily free cortisol pattern. And you can see you wake up here at a and your cortisol should taper up in the morning, this isn’t within the first hour and then go down throughout the day. So this patient actually started with a here, right, this is cortisol with a pretty good rhythm out of the gates. But instead of picking up 100% or so they actually went down. So they started here that having that nice rise, they went down This is big, this is a big problem, right not going to have the energy you’re not going to have that good rhythm that good up and Adam kind of energy in the morning and they trace low the entire day, relatively low and flat the entire day. So we call this a flat cortisol rhythm relatively speaking, it’s flat, they should be starting here a peaking up at B and then gently tapering down throughout the day. And they basically start at a at their highest point. And they go down throughout the day. So very low and flat cortisol rhythm. Now when we look at their cortisol levels, they’re free cortisol, which is a+b+c+d, this is what’s represented on the graph here. And again, if you’re listening on the podcast, click down below to watch the video link if you want, if not, we’ll just try to describe it. They’re free cortisol when you add a plus b plus c plus d is 73. That’s very low. So if you see this little gauge here, imagine this is like the volume knob on your stereo, this is all the way up high this star and this on the left all the way up low. So they’re almost all the way till the to the left. It’s like their volume knob is like 5% on it’s like having a whisper out of their stereo. So 73 is very, very low. Now this is the cool part, right? So normally with a salivary test, right, the Dutch test is the dried urine for testing comprehensive hormones. The benefit of this test is we get a window into free cortisol, but also total cortisol could its urine with a salivary test, we’d only be able to see this 73 number, which is the which is the free cortisol, that’s two to 5% of all cortisol is free, and biologically available. The other total, which looks at the free, which is the two to 5% Plus, everything else that’s protein bound, is give us a window into all of our cortisol, we’re making them this is the cool thing. We never would have this number on a free cortisol test from saliva. But you can see their total cortisol, which is everything is very high. It’s 93 04. Right? It’s way off the charts. Hi. So they have very, very, very low free cortisol, very, very, very high total cortisol. So there’s not like an adrenal fatigue issue or like a low adrenal pattern. Even though the cortisol is low, their adrenals are making a lot of it right. And this is a common pattern we see when there’s HPA access dysfunction. So if you go down to this page over here, you’re gonna see what the HPA axis is. I’ll go back and I’ll just explain this in a minute. But if we go down to this page here, the HPA axis we have this feedback loop from the hypothalamus and the pituitary. This is the HP portion of the HPA axis. And this communication feedback loop talks to the adrenals where we make cortisol with We make DAGA. And we have our free cortisol, we have our total cortisol, we have our DAGA, this feedback loop from our corticotropin releasing hormone to the adrenal corticotropin releasing hormone. This feedback loop is our HPA access. And when this starts to break down, and that feedback loop that miscommunication happens, this is where we start seeing a very high amount of total cortisol and a very, very low amount of free cortisol. Does that make sense out of the gates questions they’re having?

Evan Brand: Makes perfect sense. So what do you do?

Dr. Justin Marchegiani: Yeah, so let me continue to roll with that. Let me go back up here a little bit more.

Evan Brand: DAGA production look good there, though. That was nice to see.

Dr. Justin Marchegiani: Let’s kind of break it down. So I always hit things like this. I might order of doing things that way. I don’t miss anything. So the first thing I look at is cortisol rhythm. How’s the cortisol rhythm? Good in the morning. A and then B, C, and D morning after night are low, low, low. So normal, low, low, low. So definitely poor cortisol rhythm. How’s the cortisol amount? Well, free cortisol is low. Okay, total cortisol is high. Now, so I tend to treat someone more in the middle in regards to their adrenal support, I won’t over support their cortisol too much, because we know they’re making a lot. So we’re really going to focus on an in between amount of cortisol and more HPA access support in regards to adaptogenic herbs, we really have to support good adaptogens. This being a menopausal woman, or Peri menopausal, we’re going to support the adrenals. We’re going to support HPA access. And we’re also going to use herbs to support the estrogen and progesterone receptor sites, we’re going to do both Okay, so you can see her now the next part is sex hormones. So we talked about the total cortisol right free cortisol, low total cortisol high strong HPA access pattern, and then the sex hormone wise, estrogen Astra diawl is low. This is primarily the hormone that’s going to be used in cycling women, progesterone is low, they’re both equally low, you see how they fall in the same place in the dial. So if you’re looking at the volume knob, they’re both in the same place, they’re both low on the volume knob. Usually with estrogen dominance, we’ll start to see the estrogen knob higher up relative to progesterone. So that tends to give us a good ratio if we’re intact. So estrogen to progesterone ratio is good. But the hormones are just low altogether. And then testosterone for a perimenopausal woman it’s in the bottom 25% of the range. Not bad. For a perimenopausal woman, you know, top 25 or top third to half is ideal. Not bad at all.

Evan Brand: And this woman was not doing anything correct. She wasn’t doing any dapa or testosterone support-

Dr. Justin Marchegiani: Correct. And then I ignore total da da, I look at these numbers individually here, I look at da da sulfate, eat a clan alone and I look at them all separately. Her total da da number it looks okay. But that can give you a false interpretation. And again, I’ve been doing labs like this lab for six years, I’ve been looking at hormone labs for over a decade. So I mean, I’ve done 1000s of these things. So I always try to boil it down to the to the patterns and the data that matters and ignore the fluff.

Evan Brand: So how would this woman feel I think important to mention, you know, all these numbers, people may look at this and think okay, this looks like Greek so can you just explain how would a woman with that pattern be feeling we’re seeing that cortisol was okay?

Dr. Justin Marchegiani: Peri menopausal symptoms, a lot of Peri menopausal symptoms, libido, mood, hot flush stuff, skipping cycles, of course, low energy, mood stuff, all of those things are present for sure. And then look at her DAGA sulfate here, right? This is the backup generator of the sex hormones to the bottom 25% of the range. So this is the dial here, right? 170 she’s definitely on the lower part here that bottom 25% I like to group things based off a percentage, then the actual numbers don’t matter as much like I just say, hey, you’re in the bottom 25% of the reference range. I like my patience in the top half the top 25% or so. So I always look at things as a percentage. That way you don’t get overly infatuated on the numbers, the numbers can kind of confuse things testosterones in the bottom 25% not as bad there. But I mean, if we get the DAGA to the mid range, that testosterone should take care of itself because that’s gonna trickle downstream from DAGA to Android to testosterone. All of her androgens are okay, they’re all mid to upper 25% no problem. They’re her hormones are pretty balanced in regards to five alpha reductase. This is kind of the enzyme is very important to things going down a less androgenic pathway versus like DHT, which can be more associated with hair loss and prostate issues. And then if we go look at her estrogen levels over here, so this is progesterone, progesterone is calculated by pregnant a dial press plus alpha prineta dial so alpha and beta combined and we already saw her levels here. This is 1.9. I don’t know why the lab doesn’t show that number here. It should it’s like an error, but it’s 1.9 should be the progesterone number Now go look at the estrogen and that’s low. I mean from a cycling female we want at least 10 ideally 15 on the progesterone and then if we go look on the estrogens right, she’s low across the board. So estrogen is he one you know how you know it’s you want it has plenty in it, right? And that’s how we know it’s a one. And then Astra dial, this is your primary cycling estrogen. And it’s easy to because it’s got the prefix di and their di meanings two right, like two sets of dice die. And then we have estria, which is e three and the TRI prefix is how we know it’s e three. So for short e one e two, e three, or estrone estradiol estriol. And again, Esther dial will predominate when you’re cycling more, and estriol we should shift when you’re more menopausal, okay. And we tend to support more estria when they’re men appointment, women are menopausal. So her estrogens are pretty low across the board, you can see that you know, it’s gonna, these are all the metabolites downstream. But you can see, and again, if we want healthy estrogen metabolism, right, we have e to e4 and e 16, which are a different estrogen metabolites. And then you can see here, it goes down this protective pathway from a one to two hydroxy astone. And then that goes down into it and gets methylated into two methoxy. estrogen. And you can see here, right to keep it really simple. This 2.5 number on the estrogen metabolite should go down this pathway, at least half of that should be metabolized. It’s not so you can look at this at this methylation gauge. Don’t look at the numbers, just look at the gauge. So her methylation activity for metabolizing. Estrogen is actually low. So this is not getting fully metabolized. Now, why is that a problem? Well, one, she’s not metabolizing estrogen to her estrogen levels are low to begin with. So it just tells me that there’s some methylation detoxification issues that are a problem. Why could that be a bigger problem? Well, if we start supporting more da, da, maybe start supporting hormones better, this could cause a backup in regards to her hormones being metabolized, we may want to really work on supporting extra sulfur groups extra methylating nutrients, so there’s not a clog in these hormones getting metabolized. So, in general, we want to see at least half of this getting metabolized downstream. So if we look at two hydroxy, one, we want at least 1.25 there. And again, forget the numbers, it’s all represented in the gauge. So I want this gauge at least mid range. If the gauge is not mid range, and it’s on the lower side, it tells me we’re not metabolizing or methylating, our hormones actively, you know, as optimally as possible, and we may want to provide supporting nutrients to help that.

Evan Brand: So let me ask you this, if a woman, maybe she had run this and got the analysis from you, but then she just went to her conventional hormone doctor down the street, and he goes and puts her on some estrogen and maybe some progesterone, maybe some testosterone, how would that differ in terms of outcome based on this versus what you’re going to do?

Dr. Justin Marchegiani: Well, number one is they’re going to look at your extra dial just via the blood. And that’s okay. But it may not be able to look at free SSL dial as well. And most of the time, they’re not going to time it up at the right time of the cycle, you really want to time some of these things up around day 20 of the cycle to get a window of where progesterone is at. And then of course, you have to compare it to where in the cycle it is. And the next thing is no one’s going to look at how it’s being metabolized downstream. So we get a window into our total estrogen. All of our estrogens e one, e two e three, not just extra dial, we’re getting a window of progesterone as well. We’re getting a window into our androgens, we’re getting a window into d h, EA and our testosterone. And then we’re also looking at how it metabolizes downstream from 16 hydroxy from four hydroxy and to two hydroxy to four and 16.

Evan Brand: And then what’s the protocol? What’s the protocol for this woman?

Dr. Justin Marchegiani: So it depends. So off the bat, we may want to support estrogen metabolism a little bit better. That could be giving something like NAC it could be giving something like glutathione, it could be doing something like indole, three carbinol DIMM, or calcium to glucose, they could all be really good options. Even just giving some extra fiber could also be really helpful. Just to help out of the gates just to make sure there’s no bottlenecks there. Number two, we would support the adrenals accordingly, okay, we would support sex hormones as well. So depending on if she’s cycling or not, because remember, this woman kind of was skipping cycles. We would definitely do herbs like different kinds of phenotypes of Makkah that we use I use a product called feminine essence menopause as a special phenotype of Makkah. You can get that adjusted health.com slash shop and the female hormone section that’s wonderful because it works on upstream HPA axis. We may work on the in different herbs to help the HPA access to like ashwagandha which is wonderful at modulating that hi level of cortisol. And then depending on hormones, we may want to throw in some progesterone, especially if she’s cycling in the last half of the month. And we may want to throw in a little bit of estriol. It depending on if she’s cycling or not, if she’s transitioning into menopause at her age, right 52, I think is the age of this patient. Well, the average age of menopause is 4852. So she’s definitely on the later side. So she may be transitioning into menopause. And if she has no cycles for a period of time, we may want to throw a little bit of estriol in, but if she’s not, if she’s still cycling, we don’t want to do any sgl. Right now, we want to focus on good healthy herbal support for astron production, we want to focus on good da ta support, we want to focus on progesterone, the last half of the month, we want to also focus on good estrogen metabolism. We want to focus on really, really, really good HPA access, support, all of those things are going to be really, really important. I’m not going to give like an exact protocol on dosing, just because it’s you know, this is a very general kind of thing right now, I don’t have the patient in front of me, but it just kind of gives you a good idea. What what I’m looking at there.

Evan Brand: Totally. So someone may think, oh, they saw that high metabolized cortisol and they may need, they may think they need to come in and do something like relora, which a lot of people talk about to lower cortisol, that is not the right choice to do because her total, or the free cortisol is already on the low end. Correct. So like at nighttime, like if this woman says, Hey, I’m not sleeping good at night, you’re not going to come in and use relora are you because that would take the low situation and make it lower? Is that right?

Dr. Justin Marchegiani: I wouldn’t give something that would lower the free cortisol more like something like a phosphatidylcholine or serine. Right. But I would do some things to calm down the HPA axis for sure. So things that really can help calm it down. Because that total cortisol being really high is what’s telling me that there’s definitely HPA access issues. But I mean, you know, it’s possible some of these symptoms could could kind of conflict because our free cortisol so low and our total cortisol so high, but I wouldn’t overly lower the free cortisol, I would just focus more on adaptogens to help modulate over cortisol. Just the the overactivity, the overstimulation of the adrenals the whole, and that would still come in there and support with some pregnenolone and dapa as well. I wouldn’t overdo it either, though, because her cortisol is total on the higher side. So this is where it’s really important. Like, it’d be really easy to want to give this woman a lot of licorice and a lot of pregnenolone. Some of that may be necessary, but you may want to just take the fact take into consideration that she has a total cortisol level that’s very high. And we may want to have some kind of in between those. So we got to really look at that total cortisol production in relationship to the free not overdo it.

Evan Brand: Yeah, what you’re saying is because she’s desperate to feel better, right? And you want to give her more energy and you’re going to look at that rhythm and say, Okay, yeah, it’d be great to give her a boost here some licorice at breakfast time and maybe some lunchtime dose to perk her up. But you’re saying you can overdo it because of how high the total is in this case.

Dr. Justin Marchegiani: Yeah, very easy to do that.

Evan Brand: Yeah. And so then that would manifest how maybe anxiety heart palpitations, insomnia.

Dr. Justin Marchegiani: If we overdo it, yes, harpy, potentially heart pals, potentially insomnia, potentially, anxiety, all of those things are potential issues that you may see a problem with.

Evan Brand: Yeah, and this is why we love to to mix herbs to right you’re rarely going to be using an urban isolation, right? You’re going to be coming in possibly with ashwagandha. But you may come in possibly morning. Maybe she could benefit from something like some eleuthero. Some holy basil, maybe some other more stimulating things. If you don’t want to go too high on the licorice. Is that what you would do?

Dr. Justin Marchegiani: Correct. Yep. 100%. Cool. Any other questions there so far? It’s great to see it.

Evan Brand: I think this should should help a lot of people.

Dr. Justin Marchegiani: Yeah, in general, you really want to make sure you kind of clearly delineate where the patient is in their in their hormonal pattern. I think it’s really tough. The hardest part is when you have a woman who’s perimenopausal who’s still cycling, but is starting to not cycle and starting to switch into menopause. Because you’re kind of you kind of have two ways to handle a woman if they’re still cycling versus they’re not because hormones have a rhythm, rhythmic fashion, and you want to add them in, pull them out. And if a woman is more menopausal, you can keep hormones really in throughout the month, you’ll have to cycle them as much. And so I always err on the side of treating a woman like they’re cycling until they clearly delineate that they aren’t cycling, because if I start getting hormones monthly, daily, and that could throw off their their cycling pattern. I don’t want to do that right first, do no harm. Let the body clearly delineate where it’s at in regards to its natural hormonal patterns. So the hardest part in dealing with women, is if they’re perimenopausal transitioning to menopause, I really want their bodies to clearly show me that they’re ready to stop cycling and that’s why I always treat them like they’re cycling until it’s crystal clear they aren’t.

Evan Brand: Yeah, and then that The most common time for symptoms, right? So that’s probably the majority of what what people are going to feel in that stage of their life, they’re going to feel the most symptomatic in that transition time, or at least in what you and I’ve seen, this is probably the most common time a woman’s going to reach out for help.

Dr. Justin Marchegiani: 110% Yep. So it’s really, really important to kind of take a look at that and make sure that we keep that in mind. Absolutely. And then also, you know, we have different estrogen metabolism risks, right, we have different estrogen metabolites. So if we look over here, we have e one, e two, and E three. And when you look at these different metabolites, you know, he one tends to be a little bit more, you know, safer, right? He one tends to be a little bit more safer in regards to his to his detoxification, okay. And then when you look at e4, or sorry, two hydroxy, estrogen, right, or Astra dial here, this can go down pathways as well, are four that could be a little bit more damaging to DNA. So our four hydroxy, could be a little bit more damaging, as you can see.

Evan Brand: Let me ask you this real quick. So if you scroll down a little, it’s showing how on that pathway, you can get DNA damage, it’s showing reactive there. So we have to factor in what we learned from the stool test into this also, right, because if we see like a high beta glucuronidation problem due to bacterial overgrowth, isn’t that going to mess up this same pathway or my..?

Dr. Justin Marchegiani: Yep, it definitely can. And you can see here with the different, you know, metabolites, right, your four is going to be a problem area, right? So you’re for your your two hydroxy. Your two hydroxy going into the this four hydroxy right here could be a problem. Two hydroxy tends to be a little bit less damaging right here, especially if you have good CMT and methylation, when you go when you because all these things can can conglomerate. So you can see how e one e two and E three can all go side by side, they can all transition. But then you can see they can go down to 16 pathway, which tends to be a little bit more gentler. It can go down the four pathway, which can go into reactive oxygen species, it can also get methylated, right? What’s methylation, full eight, B six, right? b 12 really helps support methylation, Coleen, and then also gluta phi m can help decrease a lot of this too. So healthy gluten diet and healthy sulfur, healthy cruciferous vegetables, healthy digestion of our animal products. And that can help a lot of this, this methylation issue, and detoxification. And then of course, we have our E, two hydroxy. Over here, which again, methylation is very important, full A B 12. b six, Coleen, right, healthy cruciferous vegetables are going to be really important if you’re here. And we can even if it’s really high, we can even do things like dim, we can do things like calcium to glucose, we can do extra fiber, things like that to help bind it up.

Evan Brand: And the reason you’re saying this is so important is because we need to get out these excess hormones, right, we don’t want them just sitting in the tank, so to speak, after they’ve gone through this process. So you’re saying the gluco rate, the Bluetooth ion, the methylation, these are all the processes in the body to get rid of these, once they’re done is I don’t know what the right word is. But once they’ve been used by the body-

Dr. Justin Marchegiani: -agreed, though, your body will conjugate them bind that proteins to them and excrete them. And so we’re gonna really focus on a lot more gluta phone support more sulfur amino acids. If we see this guy over here, the four hydroxy ones higher. And then of course, you know, you can always give sulfur support methylation as well, which is going to be the B six, b 12, full eight, Coleen all of that as well. And this will support both of these two methoxy, two hydroxy, as well as four hydroxy. One, all of these are going to be very helpful, you can’t hurt to support any of those. And if we have anyone that has, you know, estrogen cancer, you know, risk? Well, we tend to if we need estrogen in someone’s more menopausal, we’re going to try to support more estria, which is going to be more cancer protective. But if someone has a previous cancer history, we probably will not do any hormones at all on the estrogen side. And just focus on progesterone as long as their their cancer is not progesterone sensitive, and good, healthy herbal support to help modulate some of the receptor sites.

Evan Brand: Yeah, awesome, awesome question there. This ties into a lot of stuff we do with the gut to which is really cool, because we’re often going to be in detox to we’re often going to be using Bluetooth ion for mold or chemical toxins, we’re going to be using calcium D glue, great to help with zero unknown or other mycotoxin removal, we’re going to be using possibly a methylated multi based on what we see with poor mitochondrial function on the organic acids test. So the cool thing that I’m seeing here, the trend is that the whole picture works together. So by working on the other body systems, we’re already really fixing the majority of stuff we’re seeing here plus the addition of some of the extra hormonal support.

Dr. Justin Marchegiani: Yeah, exactly. And then kind of the general ratio of healthy estrogens, is we like to see a kind of, you know, we have the, what’s called the estrogen ratio, where we look at Astra dial thrown relative to 16 hydroxy. Right? So it’s like we’re looking at basically each one. I’m sorry, e to e4 and 16. We like to see a higher level of 16 in relationship to four and two, right? 16 tends to be more cancer protective. Why? Because most of its coming from estriol. And then you can see two and four tend to be a little bit more from stronger estrogens, e two and E one are stronger estrogens, e three is a weaker estrogen. So we kind of have our two, four and 16 metabolite ratios, right. So you could say to four and 16, we want to have higher levels of 16 in relationship to lower levels of two and four. And again, it just depends upon how the metabolism is to right. If we’re metabolizing these things well, not as big of a deal, right? Because why these hormones come up higher typically is where they’re getting the hormones in our body from, from hygiene products, from plastics, from chemicals in our environment, or we’re just not metabolizing them. So we make sure the lifestyle components are dialed in, where we’re not getting them in our body and to we make sure that we’re metabolizing them as well. Does that make sense?

Evan Brand: It does it does and why we’re not metabolizing metabolizing them, I just wanted to make that clear to people that could be due to gut issues, right, there is a gut hormone component here.

Dr. Justin Marchegiani: Yeah, so the beta glucuronidaze enzyme really helps metabolize a lot of estrogens. And when beta glucuronidaze goes high, it takes the SD estrogens that would have handcuffs on them or a straitjacket on them that would be escorted out of the body. And it breaks those handcuffs and allows them to go back into general population. And so having good healthy gut levels is very important. Now, if you come down here a little bit more, this is kind of cool. We look at melatonin levels, patients mid range, not that big of a deal. These are the same markers over here. So we’re not worried. This is cortisone pattern, I don’t really care about it, it almost always is congruent. What we see on the cortisol side, you can see this kind of with more emotional stress issues. This is more like inflammatory stress. But almost always, they always tend to have a similar pattern as the other side. So I don’t really care as much, because you can see the cortisone pattern is almost the same as the cortisol pattern, right? And that’s not going to change protocol. It’s not going to change protocol. And the cortisol is the more physiological active compound, right? cortisol gets gets broken down downstream to cortisone, which is a weaker kind of metabolite, it’s the weaker sibling. So it’s not quite as it’s not going to be the stronger one we’re worried about. And these are all the same numbers on here. This test is very confusing if you don’t know what you’re looking at, because there’s a lot of repetitive data. That’s just more I think, so people don’t have to scroll around as they’re going over the labs. It’s kind of repetitive for the doctor so they can explain it to the patient. But if the patient’s looking at it, they think, wait, this is new, this is new, this is new. It’s just like this is like the third time they’re saying it not a big deal. All right, and then this is where we’re looking at some of the the markers here in regards to organic acids.

Evan Brand: How you can correlate to the Oh, I mean, have you-

Dr. Justin Marchegiani: It’s pretty good. It’s it’s on point, most of the time, sometimes it can be off, I always tell patients, if we have an organic acid test, like the gray plant lab or the Genova, we’re going to always listen to that one as the most important because that test is specific for organic acids. And there’s a greater sample there too, so it’s going to be more accurate. But if we have this test in by itself, we’ll still utilize it. So out of the gates, you can see here, b 12, this is for methylation looks pretty good 1.5, Santhi RNA can be six marker, kind of urinate look pretty good. glutathione is on the lower side, right? So with this patient, we may want to support either some kind of a sulfur amino acid or some kind of fluid found to help with estrogen metabolism. And again, it just depends out of the gates if we’re not providing a ton of hormone support. Her hormones are so low as well, it may not be a top priority out of the gate. If the person’s hormones were higher, definitely a top priority out of the gates. Okay. And then this is interesting. This looks at the catecholamines it looks at basically adrenaline, or catecholamine. do the exact same thing. By the way, norepinephrine, epinephrine, exact same thing. Three words that mean the same thing. I know it’s really confusing. So we have dopamine, which is the home of anolyte metabolite, and then we have vandalia Mandalay, which is a which is a metabolite of adrenaline or epinephrine. And so dopamine is a precursor to norepinephrine or epinephrine. So the more chronically stressed you you are you will pull dopamine, and so they have high levels of dopamine metabolism and high levels of adrenaline metabolism. What does that mean? It means this pathway, this pathway here is is redlined. So we’re really breaking down and metabolizing lots of dopamine, a lots of adrenaline, and that could be part of the reason why the adrenals are more depleted here, right. And so we may want to add in some amino acids to support some of the catecholamines catecholamines. Definitely stressed. Now, we just have to make sure as we add some of those support in that we’re fixing underlying issues. So we’re fixing diet, we’re fixing blood sugar, we’re trying to get sleep better. We’re not over exercising, we’re making sure all those things are, are pretty good. And then again, Melatonin is on the lower end of the range, but it’s at 24. The range is 10 to 85. So it’s not that bad. I mean, it’s in the bottom third. I only work on this if there’s sleep issues. And typically, I’m always going to be supporting melatonin with amino acid precursors. First, I’m never going to target melatonin by itself unless we absolutely have to. I rather give building blocks and let the body do with it what it’s going to do first, then force melatonin, but if we have to, we can at the lowest possible dose, like-

Evan Brand: What are you doing? What are you going to do for aminos on the homo vanolate vandal mandalay you’re mentioning there, you may come in and support aminos.

Dr. Justin Marchegiani: Yeah so if you look at the range, they’re not super high. It’s six remember, this goes six point four um high end of the range four to thirteen. So i’d probably come in there with some tyrosine. Definitely i throw in some extra b vitamins, extra b6, even though b6 looks good. Just because these pathways are going to be stressed, so i really want to make sure some of the b vitamins are there. Some of the extra amino acids are there. I’m going to work on some of the adaptogens for the adrenals, i’m going to work on some of the adaptogens for the female hormones, uh we’ll throw in a little bit of DAGA, we’ll throw in a little bit of pregnanalone building blocks as well, if we go look here –

Evan Brand: So would you come in and never do dlpa over tyrosine in that situation, would you go based on symptoms like if somebody was like super weepy and crying at the drop of the hat, would you say okay we’re going to go dlpa instead or you’re just going to have tyrosine?

Dr. Justin Marchegiani: I would just do tyrosine out of the gates. I’d only do more dlpa stuff if there’s like a lot more chronic pain because dlpa will tend to go down more of that beta endorphin pathway which could be helpful for chronic pain stuff. If not i would just hit more of the the tyrosine and the b6 and then really calm down the hpa axis. Does that make sense?

Evan Brand: Yeah it does.

Dr. Justin Marchegiani: And then again you could see here pregnanalone is an important building block that we like to use because it’s it’s the mother of all hormones. Now i like it but you don’t want to just take it willy-nilly. I like to always use the lowest possible dose and i like to use it sublingually to bypass the gut and you can see chronic. So you can see here pregnenolone can go downstream to progesterone, right and then you can see pregnenolone, um can also go downstream to DAGA which can then go downstream to our sex hormones right, potentially some of the androgens. Potentially some of the female hormones right go right from here to andro to e1, that goes to e2 and then that can go to e3, all right and then it can also go downstream to testosterone too. Okay and then it can also go downstream to your mineral corticoids which are right here DAGA to where’s um.. Aldosterone here? Help me find aldosterone, where is it there.. Uh andro e1 let me know if you can see it but there should be a pathway where it goes downstream to aldosterone which helps hold on to our minerals.

Evan Brand: Is it at the bottom scroll down i’m seeing it.

Dr. Justin Marchegiani: Maybe they left it out on this graph but there should be a pathway that goes down to aldosterone which is a mineral corticoid, which helps you hold on to your minerals as well. Now also too if you have progesterone right, but then you’re having a lot of like um inflammation right, you can go progesterone down to 17 hydroxy progesterone and then that can go down to cortisol right, so if you’re chronically inflamed you can create low levels of progesterone. Because progesterone is going from here right downstream to cortisol. So that’s why chronic stress and chronic inflammation could throw off your female hormone balance. Does that make sense?

Evan Brand: Yeah it does. Yeah it shows there too uh mother’s diet during pregnancy. Insulin, resistance, obesity, inflammation, hypothyroidism, licorice phthalates, I like how they put the information about what’s going to contribute to the problem that’s really cool.

Dr. Justin Marchegiani: Yep exactly. And then also you can see here you can go your cortisol right and then your cortisol this is your free cortisol here. Right, this is your your active cortisol. Um so this is your this is your free cortisol here, and that the free cortisol is going to be what we measure on the cortisol rhythm graph and then it can go down the um the cortisol. That’s more inactive right we have our the cortisol as well, which is part of our cortisone.

Evan Brand: We need to do a show. Let’s do let’s do another one on this and review our own. I’m going to get a new one. And let’s do it.

Dr. Justin Marchegiani: Yeah, absolutely. So our metabolized cortisol is thf plus th e right, this is our total cortisol and then our free cortisol which is the th the thf so f for free right, so when we look at this here when we look at this here the cortisol, right this is the free cortisol right and then the total cortisol is the free plus the e just an fyi so we’re looking at the cortisone plus the cortisol is what the total cortisol is on that on that graph above. Just so you guys kind of wrap your head around that. And they they left out the uh the aldosterone here. Let me just see if it’s there albosterone. No not there. So yeah. They left that out but that should be in there somewhere as well. I’ll put a i’ll put a graph on that all right. Anything else you want to highlight there evan?

Evan Brand: No. I would just tell people that this is a really good starting place. But i just want to make sure that if you go to just the hormone person that they don’t just treat this because i think it’s really important to understand that there is a massive issue with bacterial overgrowth messing up some of these pathways. So if you come in and you’re doing all these hormones but you’ve got the build up because of those glucuronidation pathway issues. I’m seeing that with mold too that these glucuronidation issues people are on hormones and sometimes they feel worse and i think it’s because they’re not addressing some of these other pathways. I don’t think it shows glucoronidation on this does it this this panel.

Dr. Justin Marchegiani: No no. That’s gonna be more on the detoxification side okay. Any question there?

Evan Brand: No. I’m i’m good.

Dr. Justin Marchegiani: Cool and then just so you guys can see i’ll pull this over here real fast so if we look at this one right here just so you guys can see it so normally progesterone. Um it can go from progesterone down here into aldosterone and so in general if we look here it should go progesterone to aldosterone. So this pathway here you’d see aldosterone kind of coming down here if it really extends it all the way. Just an fyi on that all right. Anything else?

Evan Brand: I think we hit everything pretty good here. So are you saying progesterone could help aldosterone problems?

Dr. Justin Marchegiani: Yeah exactly so if we support pregnenolone that could also help aldosterone issues also supporting licorice can help aldosterone there’s a basically a drug called fluorine f right there’s cortef that’s supports cortisol levels that are very low okay and there’s fluorina which supports aldosterone and licorice has a an effect of mimicking um aldosterone so that can be helpful because when your adrenals are really weak you may have a hard time holding on to your minerals and so that’s important because we need healthy blood pressure to perfuse blood to the brain oxygen to the brain and we also need good minerals to help our sodium potassium pump to work properly we need electrolytes for our nerves to work so. All these are really really important.

Evan Brand: So one last question then we should wrap it up. So if someone is taking adaptogenic herbs or doing adrenal supports they’re doing hormones they’re doing licorice. What’s the approach or protocol to doing this test if we get the test kit in their hands and they’re on let’s say an adaptogen blend. They’re Doing the ashwagandha, the licorice, and everything do you suggest taking a break or does it not matter we gonna we’re gonna see how the body’s functioning while on those herbs?

Dr. Justin Marchegiani: You’re talking about down the road?

Evan Brand: No i’m saying like right now they’re already on them.

Dr. Justin Marchegiani: If they’re yeah if they’re already on them it may not be bad to take a look at kind of where they’re at with them already on them yeah for sure that i don’t see that  being a bad a bad situation if they’re taking hormone support it just depends where they’re at i usually don’t like it the day of just because you can get an artificially high reading.

Evan Brand: Yeah.

Dr. Justin Marchegiani: If it’s if it’s in your system that day so usually maybe take 24 hours off that way it’s not overly high in the system.

Evan Brand: but you still see the trend. Yeah i’m always on the fence about it because you’ve got so many people taking blends which is great. I think you and I have really helped educate people about adaptogens but you’ve got people taking so much and it’s like well are we seeing an artificially good cortisol pattern or is this really how your cortisol pattern looks so i think maybe a day or two off sounds smart.

Dr. Justin Marchegiani: Yeah if it’s herbs i’m not worried about those as much because that’s they’re going to be more modulating and it’s just where they’re at you know and if they tell me that hey i’ve been on them for the last couple of months and i’m feeling better good we’ll just have you stay on and we’ll just take that into consideration  on the test.

Evan Brand: Okay.

Dr. Justin Marchegiani: When we’re interpreting it because if they have some adrenal issues and they’re doing well with that well guess what we probably still want to make that part of their plan anyway we’re not going to change it too much right.

Evan Brand: Yeah well said.

Dr. Justin Marchegiani: Any questions there so far?

Evan Brand: No that no that’s it i think we should do a part two and review our own that’ll be fun i’m gonna get another one and run one on myself and you should do one too yeah i think that’s a great idea i like it a lot so.

Dr. Justin Marchegiani: I think we hit a lot of good stuff here hope um you know anyone listening you can see that you know Evan and i are kind of the real deal when it comes to this like we actually do this we’re in the trenches a lot of people that you may see online are kind of they’re like thought leaders from a um let’s say esoteric standpoint meaning they’re not actually doing this to not actually practicing so we try to differentiate ourselves by bringing actual information so just kind of know this isn’t theoretical stuff this is Kind of the real deal and and hopefully that gives you confidence to take action and to try some of the things maybe you want to dig in. Maybe you want to get testing maybe you want to reach out to Evan or myself. We’re here to help you out, if you need more help. Of course start with all the foundations, we have thousands of hours of free content because we know 99.9 of patients that that we work with or help, they’re doing it with our free content. We’re not even seeing them now if you’re ready for that next step and you want to dive in. We’ll put links down below so you guys can reach out evanbrand.com and reach out to Evan. Evan’s available worldwide and myself, Dr. J at justinhealth.com to schedule with myself as well. We appreciate you guys um connecting with us all anything else you want to say Evan?

Evan Brand: No people really appreciate it and yeah we’ll make sure  to have the link if you listen on audio your mind’s probably blown right now you thought what the heck just happened we will make sure to give you the link that way you can see this thing because the screen share is great and you just want to give you kudos you’re a great teacher and you’ve taught me a lot about the dutch too so i really appreciate it and your eye to detail on this thing is awesome and most people don’t have that eye so we we really look up to it and really appreciate it.

Dr. Justin Marchegiani: Hey thanks Evan really appreciate it. And if anyone has any hormone issues that are way out of balance and you want to double check it with some blood work too. I don’t have a problem with that either especially some of the androgens I always like to double check with blood if we’re seeing some chronically high stuff um feel free to do that as well. And i hope you guys enjoyed it. Feel free give us a share as well thumbs up and if you want to write us a review that gets us motivated. Um we’ll put a review link right down below if you want to write us a review on itunes. Appreciate it you guys have a phenomenal day. Take care now.

Evan Brand: Bye-bye. Take care y’all.

References:

https://justinhealth.com/

https://www.evanbrand.com/

Audio Podcast:

https://justinhealth.libsyn.com/-investigating-your-adrenal-and-hormones-with-a-dutch-test-podcast-327

Recommended products:

DUTCH Adrenal Test

DUTCH Complete Hormone Test

DUTCH Sex Hormone Metabolites

FemmenessencePRO

Low Serotonin Signs, Symptoms and Natural Solutions | Podcast #325

Serotonin deficiency has common symptoms, including low mood and poor sleep quality. Most of the time, taking antidepressant medications called selective serotonin re-uptake inhibitors (SSRIs) can improve serotonin deficiency symptoms. So in this podcast, Dr. J and Evan talk about the root causes and presentation of this condition. 

Our serotonin helps regulate a wide range of bodily functions, including sleep, bladder and bowel functions, orgasm, and emotions. It plays such an essential role in the body, it can be hard to determine whether low serotonin is causing a problem. 

Dr. Justin Marchegiani

In this episode, we cover:

1:22        Serotonin Neurotransmitter

5:17        PMS for Females

9:00      High Serotonin Symptoms

15:13     Neurotransmitter Nutrients

19:42     Herbals

25:47     Products for A Better Serotonins

Dr. Justin Marchegiani: We are live! It’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about low serotonin signs, symptoms, and natural functional medicine root cause solutions to get to the root of why everything’s happening, why these mood issues, energy issues, cognitive issues could be a play, Evan, how you doing today, man? 

Evan Brand: Doing really well. I’m excited to dive in with you here. This is an issue that I suffered with when I had gut issues. And, you know, once I figured out the connection between gut and mood, it was a game changer because I was focused so much on mood supplements, right? I would take like rhodiola is a natural antidepressant helped to boost energy. I would take ashwagandha to help with hormones and adrenal support. But I didn’t realize that I was missing the smoking gun, which was all the gut infections I had. So I was playing with adaptogenic herbs, long before I had the knowledge I have now about gut infections and serotonin. And so what I first want to tell people is that you can come in and you can spot treat things like you can use different nutrients and amino acids to help serotonin. But in reality, we really need to be focusing on the gut you and I’ve discussed this many times, but a large percentage of serotonin is going to be made in the intestines. And if you’ve got bacterial overgrowth are parasites or other infections, that pathway is not going to be working as optimally and no, this is not a deficiency of antidepressant drugs. 

Dr. Justin Marchegiani: Exactly right. So serotonin neurotransmitter helps a lot with motility helps a lot in the digestive tract, right. Also, a lot of serotonin supposedly does not cross the blood brain barrier. There’s a lot of people that talk about this, a lot of the precursor amino acids like five HTP, or even dopamine or tyrosine, the precursor amino acids can actually cross the blood brain barrier and then also convert. So of course, there’s some people that say like, like Kevin just said about the serotonin being made in the gut really important, helps motility probably does have some mood influences just because the guts so important for absorption of all these nutrients, and we need serotonin for reasonably healthy gut function. But we also need to be able to break down all of our protein and amino acids because all these amino acids are the building blocks for all of our neurotransmitters, whether it’s serotonin, dopamine, glutamate, GABA, whether it’s our beta endorphin, all these are really, really important and we have to be able to break them down. So of course, things like low stomach acid, low enzymes, gut inflammation from food allergies, gut bugs, infections, being overly stressed over a sympathetic nervous system output, adrenal dysfunction, high chronic, higher, low cortisol, all of these things are going to shift our nervous system, it’s going to act our activate our fight or flight, nervous system response. And those things can play a major role, and being able to digest, absorb and assimilate. So that’s like kind of a foundational thing, I want to just kind of start with off the bat because we need that to be in place. And then once that’s in place, that gives us a good neurological foundation to not overly activate our sympathetic nervous system response, have the enzymes and the acids. And then of course, we’re making an assumption that we’re eating really good foods that are anti inflammatory, nutrient dense and low toxin to kind of provide those building blocks out of the gates.

Evan Brand: Yeah, well, you just highlighted something important here, which is this serotonin issue. And other neurotransmitters too, can be a vicious cycle, in the sense that if you have gut infections, reducing stomach acid levels, now you’ve got this malabsorption issue, so you’re not going to get the amino is any way to manufacture the neurotransmitters. So you could come in, and you could use amino supplementally to try to spot treat. But in reality, if you don’t fix the infection, creating the malabsorption in the first place, it doesn’t matter how well you do on the diet. It’s not about what you eat. It’s about what you digest from what you eat. And I think that’s the important piece of the conversation that’s missing with people is they focus on do this food do that food, but it doesn’t take into account Are you actually absorbing and assimilating that and we know based on Dr. Wright’s work in his amazing book, why stomach acid is good for you that by age 30 40 50 60 and beyond you make less stomach acid just with age alone. And that doesn’t even account for the fact of modern life stress, circadian rhythm issues adrenal issues not chewing your food, that kind of stuff. So your regardless of the lifestyle factors just age alone is enough to create a bigger problem. So let’s just run down the list real quick together here of too low of a level of serotonin. Now you may see various lists across the internet, Justin and I found one that we like from a respected source. So I’m just going to kind of run down the list here of two low serotonin. Course depression. Everyone thinks about that, but also anxiety, insomnia or sleep problems, nervous or worried, poor response to stress, negativity or pessimism, irritable or impatient, self destructive, potentially even suicidal thoughts, low self esteem or self confidence you feel worse in the winter. So you could call it a winter depression if you’d like younger, rage, explosive behavior inflammation. Here’s one that’s interesting. We need to, I think, talk about this further PMS. And then OCD or eating disorders as well have a link to serotonin. So the PMS is interesting. What do you think the meccan mechanism is there? 

Dr. Justin Marchegiani: Well, a lot of female hormones like progesterone, for instance. And or just healthy progesterone, estrogen balance, have major effects. Basically, they’re like mono amine oxidase inhibitors. So essentially, they almost are like mini antidepressants, they help kind of keep a lot of the neurotransmitters in between the post and presynaptic synapse. So you kind of have this presynaptic synapse, we have a postsynaptic synapse. And this is what’s called the synaptic cleft, right? This is these are where the neurotransmitters accumulate between the two. Okay? And things like progesterone, for instance, they have a mild serotonin reuptake inhibition effect. Now, when you do medications, the problem with medications, the longer you keep those neurotransmitters between the synapses here, the faster those neurotransmitters are recycled and broken down. That’s why over time, people that are on antidepressants, or SSRIs, their dose has to go up, not down, especially if you don’t fix like underlying root issues. So I think a lot of these hormones like progesterone, we know is a GABA chloride channel inhibitor. So GABA is big, because it promotes relaxation, the more relaxed and calm your nervous system is, the less chance you’re going to be burning through serotonin because you’re less stressed. And there’s a mono amine oxidase inhibition effect, right, MAO, inhibitor, so it’s almost like a mild antidepressant in a way for sure. 

Evan Brand: Oh, cool. Totally interesting. Yeah. So I mean, it sounds like, you know, part of the protocol could be both, it could be using potentially some hormones, like maybe some progesterone, but also coming in with the amino acids. And then once you figure out what’s going on, after you test, then you could come in and start fixing the infection. So let me just tell just a brief story. I think people relate to the stories here. So I just remember, you know, when I was down in Texas, and I had gut infections, I had just a baseline anxiety level that was so high. Now granted, I was away from home, I had some homesickness, I missed my family, that kind of thing. But this was different. This was related to my gut, because as soon as I was doing no microbial herbs, the anxiety was 25, maybe 50, maybe even 75% better. So I can just tell you, personally, you know, you and I’ve seen it clinically as well. But just personally for me, you know, I was doing supplemental gabbeh, I was doing motherwort passionflower, all the calming herbs. But it didn’t matter how many calming herbs I did, it was just a band aid. It wasn’t root cause. So I just want to make sure people understand that there’s a difference between natural and functional. So natural medicine is like, hey, you’re anxious take passionflower functional medicine is like okay, fine, take passionflower. But why are you anxious? And that’s the secret. The secret sauce?

Dr. Justin Marchegiani: Correct. I think with you mean, part of the underlying reason was you had multiple gut infections that were not being addressed. Yeah, there was there was that kind of thing in the background, I think that was really important. And so fixing that played a big role, you had some potential mold stuff that was hiding as well. I think there was also some blood sugar stuff that was happening with you as well, that we were looking at, I think you also had like really low blood pressure, too, didn’t you? 

Evan Brand: Yeah, my blood pressure was like, maybe 100 over 70. 

Dr. Justin Marchegiani: So on the lower side, so there was definitely very weak adrenals where your mineral corticoids were paying a price and you weren’t able to hold up a lot of the holding a lot of the minerals that your blood pressure was dropping, and so you weren’t able to really perfuse blood flow adequately. Right. So yeah, all these things play a big, big, big, big role. 

Evan Brand: I was peeing a lot too. So I was up in the middle of the night, three, four or five times to pee. I now know that that was related to mold, because since using appropriate binders, I no longer wake up in the middle of the night to go pee. So just folks listening, you know, could be an adrenal component as well. But, you know, for me, the excess urination was definitely a mold thing, and it’s luckily resolved. 

Dr. Justin Marchegiani: Exactly. So you already kind of talked about a lot of the symptoms. Let’s just kind of go over those real quick. So we have our high serotonin symptoms just briefly here. Let’s hit them again. So too high depression, anxiety, nervous being a worrier. 

Evan Brand: And these are low stress. These are low. You said to- 

Dr. Justin Marchegiani: I’m sorry. Yeah, I’m sorry. These were too low depression, anxiety, nervous worry. Anger, PMS, right. And then on the high side, let’s go over the high ones again, briefly. There’s no high Okay, there’s no high for those. Okay, so those are the big ones with the seratonin. Right. Now, we already talked about the foundational things. So when we talk about nutrients, just kind of make sure everyone that’s listening understands Foundation has to be in place, good foods, good digestion, good hydration management of stress, and we can talk about different techniques that help decrease stress. I won’t go into specifics but I’m a big fan of EFT, EMDR, NLP a lot of times techniques or eye movement techniques that can help rewire the nervous system that can help dampen sympathetic nervous system responses. There’s another one that you like Evan, that you did that does a lot of rewiring as well. Which ones that? 

Evan Brand: You talk in the brain retraining? 

Dr. Justin Marchegiani: Yeah, brain retraining, a lot of that requires NLP? 

Evan Brand: Yeah, I’m playing with a couple of them. Yeah, some of it is kind of NLP strategy. There’s one called gupta. There’s another one called dnrs. They’re just doing our online one. Yeah, they’re online brain retraining, I’m gonna work through the Gupta, the one and I’ll have feedback for people, but I have done the dnrs. It’s basically just trying to rewire your brain, right, you’re trying to tell your brain that your issues are fine, and all of that. So I like it. But I personally, I think EFT is better. I like the tapping aspect of EFT tapping is nice-

Dr. Justin Marchegiani: You can feel a nice reduction of that nervous system response. It’s like when your brains are used to firing a certain way. It’s like, if you have a big backyard and you go on a hike or you go for a hike, where your local park, there’s a path kind of carved out when you go into the woods and that paths there. Where do you go, you naturally walk on the path, you don’t just go randomly go in the woods with all the sticks and trees and ticks, right? You kind of go on that carved out path, your brain kind of works the same way. So when it’s used to thinking about something a certain way, it carves out a path. And when you jump on that when you jump in the woods and you see that path, you naturally go down that way. And so essentially, the tapping is kind of like it’s a way of like pulling out the machete and kind of carving out a new path in the brain to fire a little bit differently. 

Evan Brand: That’s that’s a great analogy. Yeah, that’s a great analogy. You’re saying how basically with this low serotonin that you can get stuck in these pathways of like, pessimism and negative thinking and all of that. So it’s harder to break out.

Dr. Justin Marchegiani: Yeah, I’ve listened to Julia Ross lecture one time, because she does. He’s an MFT marriage family therapist. And she has done counseling on lots of people. And she has had clients and patients for decades, where they just couldn’t get over certain issues. And she just started utilizing nutrients and amino acids and these problems that were problems, just naturally, were non issues, they they just became they just people were able to get over them so much easier. And a lot of that is is you need the mental neurological equipment to be able to process and handle them. You know, my my analogy, I get patients, it’s like staying up all night and then trying to do your taxes the next morning, like you just may not be able to have that mental capacity to handle it. And so I look at neurotransmitters, it’s giving you the equipment, you need to deal with these issues, it’s like giving a child adult level problems like they just going to be overwhelmed, they’re not going to be able to handle it and process it. And so if you have the right neurological equipment on board, that gives you the ability to handle it. And then also having these extra strategies in our back pocket. Like I mentioned with the EMDR. EFT Now the easiest thing is you just talk about the problems and you just kind of tap all the different EFT spots, side of the eyebrows, middle of the eyebrows underneath the eyes, underneath nose and chin, collarbone, underneath the nipple area, under the armpit, right. And those are just those are the really good spots you can do you can do right in the parietal line in the center of the brain here. Those are all good spots. And you can just kind of talk about the problem, whatever the problem is, let’s say you’re at a seven out of 10 and 10. Being you know the most sensation or irritability or emote, you know, palette of emotion that you could feel, ideally you want to get below five. So I always just say talk about the problem, talk about the fear, talk about the emotion you’re feeling and try to get it below a five. And ideally, if you can get below a three even better. And so you just keep on doing that it’s a good way out of the gates. And then also NLP kind of comes in where you you really are focused on the pictures that you have in your brain, right? That the pictures that you have in your brain are very important. So you really want to put pictures of yourself succeeding doing the thing, right? And then an easy kind of NLP technique is you can do the stop sign. Have that stuff sign flash in front of your, your, your mind’s eye when you start thinking things that are negative or you can do no stop. Right you there’s a DNR s one that you can tell about to. 

Evan Brand: Yeah, yeah. And then that’s what they do. You basically just kept pace. tell yourself that your brains sending your body false messages. So it’s like this negativity, it’s this fear. It’s this hyperstimulation it’s the overreaction, you’re trying to just shut that down. And the mind is powerful. And I think it’s I think it’s an underappreciated thing. Now, you made a great point, which is that you got to have the fuel in the fuel tank, right. So you could do all the the physical tapping and all that stuff. But if you simply just don’t have any neurotransmitters in the tank, it’s going to be tough to focus on this, it’s going to be tough to have drive to get this done. So that’s where you and I are going to come in. And you know, let’s talk about some of the testing now. So we’re going to be looking at like an organic acids testing. And we’re going to look and measure some of the various aspects. We did a podcast recently on low dopamine, so check that out if you’re interested. But in that same category, we’re going to be able to measure the serotonin marker. And once we look at that we can see where people are at. And then of course, we’re going to factor in what’s going on with the gut to because rarely is the serotonin good To become a dysfunctional problem, unless there’s a gut issue as well. So we may see Candida bacterial overgrowth parasites, H. Pylori, gut inflammation and low serotonin. It’s rarely just low serotonin by itself.

Dr. Justin Marchegiani: 100% and so it’s good to have the foundation it’s good to have some tapping techniques. Now let’s go talk about some of the other nutrients. So we know things like five HTP, or triptophan is a precursor to serotonin and serotonin. You know, obviously, that neurotransmitter that helps with focus and feeling good. It’s a very, you know, happy neurotransmitter. A lot of times dopamine can overlap because dopamine helps with focus, it’s an I love you neurotransmitter. So a lot of times there can be an overlap in those symptoms. And a lot of times people that have low serotonin could have low dopamine as well. And also the enzyme that metabolizes serotonin that metabolizes five HTP, and converts it downstream to serotonin is the aromatic decarboxylase enzyme. And that enzyme also metabolizes dopamine. So if you constantly take five HTP support chronically, you probably want to have a little bit of dopamine tyrosine support as well, because you can create some functional deficiencies long term. So just kind of keep that in mind. Like in my line, we have a product called brain deplete that has a 10 to one balance of tyrosine to serotonin. And if you’re taking a lot of serotonin, it’s probably okay especially if you’re testing it on the organic acid, but just long term, you probably want to throw a little bit of dopamine, whether it’s tyrosine in there to provide some building blocks, that’s excellent out of the gates. And then there’s a couple of really important methyl support that needs to be there, B six and B 12 are very, very important. B six is incredibly necessary for the synthesis of neurotransmitters, we need B six is an important cofactor and so is b 12. b 12 is methylated B 12. Really important for the methylation of these neurotransmitters. Well, we attach a carbon and three hydrogen to it. That’s methylation. Very important. Also, vitamin C is very important because vitamin C tends to be burnt up and overly utilized when there’s a lot of adrenal stress as well. We talked about five HTP, we talked about some potential tyrosine. And then it’s also nice to throw in a little bit of an adaptogen. Because adaptogens help with the stress response, they help with perceived stress. So even if you’re stressed right now, just giving you some support on the adaptogenic herbal side, will change your perception to it. And so things like rhodiola or ashwagandha, or ginseng, or eleuthero are amazing to help kind of or even macca, especially women do very well, macca are very good for stress perception and stress modulation. 

Evan Brand: Yeah, great, great calls. So just to back up what you said, there was a trial done. We’re not fans of drugs, we prefer to try to come at it the natural functional way whenever possible. However, there was a study done that compared antidepressant use, and just in a depressant by itself, compared to antidepressant plus b 12. And 100% of the subjects that got the B 12. And the antidepressant showed at least a 20% improvement with their symptoms compared to the antidepressant alone. So just to tell you one more time, and a depressant plus b 12 20% improvement in the outcome, as opposed to just the antidepressant by itself. And then also Foley, same thing. There’s a paper on Foley, and how that also boost things up. And then I don’t know if you’ve, you’ve played with this one much, but have you seen some of the Selenium extracts? You’ve got some of these saffron and selenium blends like this? Yeah, so it’s pretty cool. I’ll put it in the chat for you. So you can look at this tech sheet, you might have to log in, but I’m gonna send it to you. 

Dr. Justin Marchegiani: Yep, I’ve put those links to the studies. And we’ll put it in the description notes after the show. So you guys can take a peek at it. 

Evan Brand: Yeah, but so just, I just put it for you in the chat. If you want to see, like I said, you may have to log in to see this tech sheet. But this is a cool product. And I’ve used it with some people that were previously on antidepressants, and they got off of it. And many of them reported they felt just as good. And so the Sceletium plant, it’s kind of an indigenous South African plant. Indigenous people used it says for relaxation, stress reduction, calming thirst and hunger prior prior to long hunting hunting trips, which is pretty cool. And it acts like an SSRI. So the Sceletium binds to the serotonin transporters inhibiting the uptake of serotonin from the synapse, resulting in increased serotonin concentration in the synaptic cleft. That’s the same mechanism of prescription SSRIs. So this is a game changer, potentially. And like I said, I’ve had clients that were previously on the pharmaceuticals, and then they did this one, and they like this one much, much better.

Dr. Justin Marchegiani: That’s good. Yeah, there’s a lot of good options. It’s nice to have some herbals, whether it’s adaptogens or the sceletium, whether it’s the saffron and I think in that the important cofactors need to be there B six b 12. You can maybe even throw in some full weight in there because full weight tends to interact. So I tend to have you know, products that will Be six, we’ll have the seratonin have the dopamine support. And then we always like, I think you’re in the same place always having a really good molti there in the background just to make sure all those cofactors are there. And then of course, having a really good solid diet as a foundation that kind of gives you that insurance policy that the building blocks are there, the cofactors are there, and then you can really hit things more therapeutically after. 

Evan Brand: Yep, absolutely. Now, have you played with any of the other testing? You know, we already hit on the test. But there are some companies that do just neurotransmitters Have you ever played with those at all? 

Dr. Justin Marchegiani: Well, the whole idea with some of those is that you may not get a good window, what’s happening in the brain, right. So supposedly, you have the idea one is going to be some kind of like a spinal tap, right, where you really get a window into what’s in the cerebral spinal fluid, which is kind of flowing to the brain, that’s kind of like your ideal, obviously, that’s invasive. And then the urinary metabolites, I think, are pretty good. Because you kind of get a window like, if someone’s buying a whole bunch of food, you kind of get a window by going into their trash what they bought last week, right? It’s kind of like that. So you get a pretty good window of how you’re doing. So if we don’t see a lot of stuff in the trash, or we see too much stuff in the trash, that gives you a window what your body’s utilizing. And so that’s organic acids, we’ll look at with serotonin and we’ll look at five hydroxy and dolo. Last day five HIIA. So that’s helpful to give it give a window into it to know what’s happening. And then we’ll apply some of those nutrients, maybe 100 milligrams of five HTP at a time. And we’ll kind of go out from there. And I like doing it more, you know, at the last half of the day, especially if it’s more calming and relaxing, because some people they may get too tired because of it during the day. So you got to individualize it. And if you’re on a medication, it’s really important if I’m having people that are on meds like SSRI medications, amino acids will help the drugs work better because these drugs work by blocking re uptake ports. And if you’re blocking a rehab, take a port and you’re providing more substrate. Well guess what happens that substrate now is going to increase the symptoms or the potential effects of the drug which can also increase the potential side effects. So I always tell patients, look at the medication that you’re on, make sure you know what the side effects are. And so if we add things in, we look for those side effects to occur. If they do, we go back to the prescriber, and we gently nudge down the dose of the medication under the prescribers controls, we got to look at what those side effects are. That way, if it happens, great, we adjust or we just go slower to so my goal is if we’re going to adjust medication, we’re always doing it from a point of stability, not instability, and we’re always utilizing the prescriber that prescribed it. And if you’re on some of these meds long term, whether it’s an SSRI, or maybe even benzos are the worst, we may need a very, very long term taper, it just really depends. Could be six months up to a year, depending on what the medication benzos tend to be worse, SSRIs tend to be less. And it depends on how long you’ve been on them for Okay, so But either way, we don’t touch medication dosages, unless we have everything in order, we’re stable, and then we have a prescriber that’s involved in the prescription of the medication, monitoring and tapering the dose. 

Evan Brand: Well said and there’s a link between antidepressants and gut bacteria to if you just look up and depressants, microbiome, you can find some studies on this. But we now know that these antidepressants are negatively affecting the gut. And we’re seeing changes with bacteria. And in particular, we’re seeing clostridia and other pathogenic organisms that we test for via stool and urine. We’re seeing these pathogenic bacteria overgrowth. So there is a link now between antidepressants and bacterial overgrowth in the gut. So just keep that in mind. If you’re somebody who’s been on these prescriptions for a period of time you’re having gut issues, maybe you’ve worked through some protocols, whether it’s with us or other practitioners, maybe you’re not to the finish line yet, you know, consider the drug could be a contributing factor, I’m not telling you stop the drug, I’m telling you that it needs to be factored in, and we got to try to counteract what that drug is doing. And we’ve seen cases like that, where clostridia just keeps coming back. And the drug, if the doctor was able to remove it from the protocol, then boom, they were able to get well and stay well.

Dr. Justin Marchegiani: Yeah, totally. I mean, my personal opinion on medications like SSRIs, or drugs like that. The only, you know, real good application, in my opinion, is some kind of a short term where someone may commit suicide or harm themselves. That’s the only I think, you know, valid reason to be on it at all, is for just pure stabilization. And then working with someone with various therapies, whether it’s talk therapy, whether it’s then I think, combining EFT or EMDR, with that to kind of calm everything down and then utilize the diet and nutrients and then get off the medication. The problem with most medications is once you’re on it, you kind of get stuck, and the prescriber doesn’t want to take you off and they’re also not fixing the underlying root issue. So, you know, my general application is if something’s incredibly acute, that may make sense. But outside of that, you want to always try to work on coming off that way responsibly with all the foundational support underneath, and with the prescriber involved. So if anyone’s listening and they’re on a medication like that, and they just want to come off, don’t do that work with the functional medicine doc, and then we’ll also work with your prescriber to get you off because there’s always going to be some kind of a relapse that happens. And we don’t want anyone to be in a position where their neurotransmitters just really go wonky with a major, something they regret. 

Evan Brand: Yep, absolutely. Well, I think that’s all I have to say on it. So if you have any more than let me know, otherwise, we’ll give people some info here where they could reach out if they need help, I know you’ve got some products to mention, I’ve got some too as well. So in your show link in your show notes on the podcast app, you should be able to click there and then boom, check out some of these products. You know, if you’re on drugs, you know, consult with us or consult with your practitioner, how you may work some of these in. 

Dr. Justin Marchegiani: Yeah, the big ones that I use in my line, of course, a good multi multi support pack excellent brain repletes to have that 10 to one ratio of tyrosine to serotonin with some of the cofactors there I’ll also use serotonin with B six. So in my line, serotonin replete or dopa repletes, are going to be the big ones and the dope replate Plus is my bigger l dopa, which is a it’s let’s say, a little bit more down the line in regards to dopamine synthesis, so it can have a better effect on improving dopamine levels. So those are my big ones. We’ll put the links down below. Evan, what are some of the ones that you have in your store that you use with patients? 

Evan Brand: Well, a lot of them I’m ordering through third party, so I don’t have any on my store right now. And we’re moving warehouse. So I don’t have any right this second. But you know, if you’re working clinically with me, I will definitely educate you on those. And then some of the Zimbra and some of those, there’s different professional manufacturers that will use so there’s a couple different brands. But either way you could reach out and we’ll we’ll let you know what we’re going to use. 

Dr. Justin Marchegiani: Yeah, maybe a good idea. You have a category on your website, like say, like maybe neurotransmitters so people are listening to this down the road, maybe look for a category on brain nutrients, or neurotransmitters. And some of those will be there too. I have a category on brain nutrients too. So we’ll try to make it easy for you all to navigate. If you need support, we’ll put links down below. 

Evan Brand: Awesome. If you need help clinically, you can reach out Dr. J works with people worldwide via phone, FaceTime, Skype, however you need to chat. So please reach out to him at JustinHealth.com. And if you need me, Evan Brand, EvanBrand.com is the website. And we love working with this stuff. I mean, we’ve been able to transform our own lives with these products, we’ve been able to transform 1000s of other lives. And so this is really just a sigh of relief, when you can fix these issues. And you can help people take back not only their mood, but take back their life. I mean, when you optimize these things with brain chemistry, you can allow people to become more focused, you can allow them to become more calm, they can sleep better, they become better parents, they become better husband, better wife, better workers, better CEOs, better entrepreneurs. So it’s just incredible what you can do when you optimize this stuff. And so we want to test not guess, figure out what’s going on, look under the hood. And you can help modulate these things. So please reach out if you need help. 

Dr. Justin Marchegiani: Yeah, and if someone’s coming into this, they don’t know where to go. They’re not quite sure where to start, keep it really simple. Start with the food. Start with a good healthy paleo template out of the gates, maximize your ability to break down protein with HCl, good digestive acid enzymes just start there out of the gates because that’s the building block for everything. And then from there, definitely get a practitioner in your corner to really work on all the building blocks, all the supplements support all the other precursor support so you have that good foundation, and then maybe also dive deeper into a lot of the gut, which could be a lot of bottlenecks. If you have chronic digestive issues. That’s gonna be an important part of the equation as well. 

Evan Brand: Totally, totally Well said, well, always fun. I love these brain neurotransmitter episodes. They’re always a blast. I think they’re very helpful, very empowering for people. So please give us a review. We would love it. If you can review Justin’s show on iTunes or my show on iTunes. We really appreciate it. Give us some stars. Let us know what you think. Share it with your friends and family people who are dealing with issues we know that depression anxiety issues are massively increased over the last year. So the thing that we can hope here is that this is a beacon of light to help people know that there is solution to this problem.

Dr. Justin Marchegiani: 100% we’ll put some review links below so you guys don’t have to hunt it down too far to do that. We really appreciate it guys have a phenomenal day. Take care y’all. 

Evan Brand: Take care. Bye bye.

References:

https://justinhealth.com/

https://www.evanbrand.com/

Recommended products:

Brain Replete

Serotonin Replete

Dopa Replete

Dopa Replete Plus

Audio Podcast:

https://justinhealth.libsyn.com/low-serotonin-signs-symptoms-and-natural-solutions-podcast-325

Thyroid Reset Summit | Podcast #218

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

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

Dr. Justin Marchegiani

In this episode, we cover:

03:00    Trauma

06:41    Reverse T-3

14:19    Maca and Hypothyroidism

19:55    Molecular Mimicry

26:28    Iodine and Iodide

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

30:38    Desiccated Thyroid

32:01    Natural Thyroid Glandular

37:37    Nascent Iodine

40:38    Oxalates and Hashimoto’s

44:09    Thyroid Replete or Balance

46:50    Candida Overgrowth and Kale Intolerance

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

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

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

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: -Childhood Experiences score-

Dr. Justin Marchegiani: Yup.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Yup.

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Oh my gosh.

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

Evan Brand: And that’s a mycotoxin?

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

Evan Brand: Oh.

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Yeah.

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

Evan Brand: It won’t be as overwhelming.

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

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

Dr. Justin Marchegiani: Yes.

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

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

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

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

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

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

Evan Brand: Okay.

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

Evan Brand: Okay.

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

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

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

Evan Brand: Yeah.

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

Evan Brand: Yeah.

Dr. Justin Marchegiani: -if you can.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: No way.

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

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

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

Evan Brand: [Laughs]

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

Evan Brand: Wow, she makes it?

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

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

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

Evan Brand: I’ll have to look for it.

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: I did some haddick last night-

Dr. Justin Marchegiani: Mm-hmm.

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

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

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

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

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

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

Evan Brand: Mm-hmm.

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

Evan Brand: Okay.

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

Evan Brand: Oooh.

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

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

Dr. Justin Marchegiani: Mm-hmm.

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

Dr. Justin Marchegiani: Yeah.

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

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

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: 2000, 3000 to sub-500-

Dr. Justin Marchegiani: Yeah.

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

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

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

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

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

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

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

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

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

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

Evan Brand: Oh, okay.

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

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Mm-hmm.

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

Dr. Justin Marchegiani: Yup.

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

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

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

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

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

Dr. Justin Marchegiani: Yup.

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

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

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

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

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

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

Evan Brand: Let me ask you this-

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Yeah.

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

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

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

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

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

Evan Brand: [Crosstalk]

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

Evan Brand: Yeah.

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

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

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

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

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

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: Mm-hmm.

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Go ahead.

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

Dr. Justin Marchegiani: Yeah.

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

Dr. Justin Marchegiani: Yeah.

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

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

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

Dr. Justin Marchegiani: Oh yeah.

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Yup.

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

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

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

Evan Brand: TSH, 1.3.

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

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

Dr. Justin Marchegiani: -Diet.

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

Dr. Justin Marchegiani: Yeah, exactly.

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Excellent.

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

Dr. Justin Marchegiani: Yeah.

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

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

Evan Brand: Take care. Bye-bye.

Dr. Justin Marchegiani: Bye.

References:

https://www.evanbrand.com/

https://justinhealth.com/

https://www.thyroidresetsummit.com/