Role of Functional Medicine in Mental Health | Podcast #326

As an adult, maybe you’re struggling with some of these symptoms yourself, things like anxiety, perhaps depression or mood issues, those types of things. Or many of you have kids with these types of mental health symptoms and problems. Functional Medicine is a form of integrative medicine that focuses on addressing the root causes of a person’s symptoms rather than merely treating the symptoms themselves and, in this case, manage stress. Here are Dr. J and Evan Brand sharing their insights about different approaches for stress reduction. 

Dr. J suggested to pay attention to nutrients first and some natural herbs such as ashwagandha, rhodiola, holy basil, etc. Watch the whole video to know interesting details about functional medicine in mental health.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:22      Foundation of Functional Medicine Needs

8:27      Emotional Stress

14:50    How to deal with Stress

19:08    Alcohol as Stress Reliever

30:43    Importance of Exercise

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

Evan Brand: Doing well, the sky is blue, the weather is amazing. I looked at your forecast for this week too, it’s going to be like 75 and sunny all day, every day. So that’s going to be amazing. We’re inside though, maybe we need to do like outside recordings, maybe need to go like, sit out back in a hammock and record with me. So we don’t miss this weather because then it’s going to be cold. And we’re going to be complaining. But no, but long story short, we were talking pre show about just how everything this year has been kind of crazy. And a lot of people are expressing issues with their mental health, their physical health, their emotional health, it’s affecting our clients, it’s affecting potential clients, people that are reaching out to us that have had businesses closed down or potential job losses and a lot of economic issues that have caused a lot of, you know, mental emotional problems for people. So the idea today was, well, let’s try to cover kind of a, a broad stroke, if you will, of how we could use functional medicine to improve mental health. So let’s dive in.

Dr. Justin Marchegiani: Love it. So off the bat, like we kind of go back to like Maslow’s hierarchy of needs, right? That’s kind of like the first thing. So I always tell patients off the bat, there’s kind of a foundation of functional medicine needs, that’s going to be clean water, sleep, and then clean food. And now we can kind of get in the middle of it in the weeds with the food and kind of getting your macros dialed in and getting all that kind of dialed in. But clean water, clean food and good sleep. And so I always tell patients, the more stressed you are, the more you need to be rested, fed and watered. And the more those things are kind of stable, and that’s like your foundation, the better adaptable you will be at the dealing with stress, adapting to stress. So the health, health and stress adaptation are intimately connected. So the more stressed you are, if you start going towards alcohol, and processed food, and staying up too late and watching too much news, it’s going to get that fear cycle going, you’re not going to have enough rest to recharge your parasympathetic nervous system, you’ll be too much sympathetic dominant, you’ll be leaning on your adrenals leaning more on cortisol leaning more on adrenaline, and it’s going to be harder for you to digest. You’ll be just kind of on the edge every time with your emotions, the smallest thing will set you off, and you won’t have a good solid foundation.

Evan Brand: Yeah, I I think people should really just get rid of the social media apps on their phone. I mean, that was something that I did. I just noticed that if I have the social media apps off my phone, and I have to go to a web browser to check them. It’s much much more inconvenient to do it. So I must I’m much less likely to do it. And also, for me, you have the option of being up speaking to that you hear his little notification sound. Oh, social media-

Dr. Justin Marchegiani: – has turned it off right now. Airplane mode, maybe. 

Evan Brand: It’ll, it will, it’s it’s it, you know, there’s been like trials done on how long it takes you to get focused again. And so what I’ve tried to do is to limit my distractions, I think the world now has become a world full of distractions, mainly because people are trying to solve all the world’s problems on their own meaning, you know, I care about the trees getting cut down in the Amazon. So I’m going to go read about this, and then I care about this, I’m going to go read about that. And then you’re so scatterbrained that you kind of lost your own productivity. So I’m not saying that you need to just, you know, put your head in a hole and turn the world’s problems off in your head like they don’t exist. No, I think it’s just a fine line. And I think most people have lost the line of productivity, because they’re so focused on the issues. And a lot of the day to day decisions you make aren’t going to change the world that much like there’s nothing I could do necessarily right this very second, besides maybe donating some money to some organization to stop cutting trees in the Amazon like it sucks. I don’t like to see, you know, you got all this illegal deforestation going on. But there’s only so much you can do. So you got to find a way to to find a healthy way to absorb the media. And most media is negative. So social media, media news. And a lot of it’s not serving you. That’s the only point I have to make.

Dr. Justin Marchegiani: Yeah, I do think number one, social media is a big one, you kind of have to like, use it, don’t let it use you. Right. So turn off the notifications. Don’t let it kind of be there something that you always go to write, I think deleting it from your phone, or at least maybe on the weekends or periodically, deleting it can be helpful because you’re not going to access it as much on the web browser. I think also people forget that most people use social media as their highlight reel. So they only post great things about their life. People feel bad about it. So I’m very aware about that. And I don’t overly post the highlight reel of my life on there because those things are between me and my family and I don’t need to share it with the whole world every now and then. I’ll get people A glimpse, but it doesn’t need to be there all the time. A lot of people overdo that. And people forget that they’re seeing someone else’s highlight reel and they make it makes their life feel a little bit less than or more inferior. And you got to remember that right? You can’t forget it. That gives you kind of a good perspective and a grounding and and it really just comes back to appreciation. Right, the more you’re grounded in appreciation for what you have that that really shifts that that stress and that sympathetic kind of response of just inadequacy and, and, and, and feeling like your life’s not enough.

Evan Brand: Yeah. And there’s people with it, we know that are incredibly successful in business and wealth and all of that. And these people will go publicly bring up their anxiety and depression. So when you look at someone’s life, and you see all they have it so good, I’m so jealous of this or that car, this house or whatever, a lot of people listening may just shut it down immediately. And they say, Oh, no, I don’t care. I’m not comparing myself. But it’s kind of a subconscious thing. You’re not even really aware that it’s happening. Just look up type in, like Instagram depression, there’s some studies done that it was the most depressing social media. So I don’t want to make it the whole anti social media podcast, but you, you hit on gratitude. And I think that’s really the key. So what I tried to do was like a walking gratitude. It’s very, very helpful. So I’ll just, I’ll take the kids outside, and they’ll just walk, whether it’s in the backyard, whether it’s down the driveway, whether it’s in the you know, by the garage, I’ll just find a place to just walk, walk, walk. And I’m just focusing on the motions of the body just shaking up and down, dude. And I’m just thinking, Man, I’m grateful. I’m so grateful. Look at this beautiful day, look at the sun, look at the blue clouds, or the white clouds with the blue sky. Look at the the contrast, look at the green on the trees. Oh, we’ve got a little bit of yellow coming in on these maples over here. This is gorgeous, Oh, look at that red tree over there. And it’ll really take you out of the fear, it’ll take you out of the worry those repetitive, repetitive thoughts, you know, there’s, and this is not talking to one or two people here on my intake form, which thousands of people have submitted, you and I use a couple different form creation tools. I’ve looked at how many submissions we have. And it’s literally like 95% of people out of these thousands have reported? Yes, they beat themselves up with negative self talk. That’s a question on the intake form. Do you beat yourself up with negative self talk? 95%? Say yes. Now is that because you and I have a population who has symptoms and they want to get better? Or is that indicative of the general population to I would say the general population would be the same?

Dr. Justin Marchegiani: Yeah, I always kind of I heard someone say this a couple of years ago, they said, Imagine, you know all the inner thoughts about yourself, kind of write that down. Okay. And imagine if someone else said those things to you? Would you be friends with that person? Probably not. Right? So it’s, it’s amazing how hard people are regarding the inner dialogue. And I always just kind of inner dialogue comes through your brain, ask yourself, would you be friends with that person? If someone else said that to you? Probably not. So I always just try to say to people, you know, make sure you would be friends with the person that would be saying, the inner thoughts that you’re actually thinking.

Evan Brand: Yeah, that’s a good call, that’s a really good call, well, you can be your best friend or you can be your worst enemy. And I think it’s easy to become your worst enemy. Because I don’t know you, you’re the one who has to look in the mirror. Right? So you’re always going to be the one to blame yourself. But.

Dr. Justin Marchegiani: Yep. And if that happens, what do you do? Right? I mean, I think if you have that inner dialogue that kind of shifts overtly negative to yourself, what do you do in NLP world, you go and you visualize the stop sign, right? You don’t beat yourself up over it, you visualize the stop sign, and then you then you shift into appreciation. Or some folks will have the elastic band on the wrist and they’ll pull it tight, right to create that negative neuro Association, whether it’s a physical, elastic snap, or whether it’s a stop sign coming in, that’s that’s visually cueing you to stop, however you want to do it, and then just kind of refocus your energy in a non shameful way to, to the things that you have that are great, right? Because that stuff needs to be you need to it’s like weeds grow automatically negative thoughts grow automatically. It takes no effort to be a cynic. In today’s world takes no effort. It really takes a lot of effort to be an appreciator and to focus on the things that you have. So just kind of use some of those cues to stop the negative thought and then shift over into the positive thought. Now I always find too, if you’re some people, it just kind of feels good to be negative a little bit where you’re kind of venting over something. And if you feel that way, just do it while tapping on some meridian points, some of the EFT meridian points because I find at least if you’re going to be negative, this at least decreases that sympathetic tone. And then what happens is as that that nervous system kind of calms down a little bit, it’s easier to shift back into that positive perspective. So you can do some of the EFT points chin under the nose. under the eye doubletap, I find it’s more efficient for me.

Evan Brand: And as you’re doing this, and as you’re doing this, you’re you’re kind of talking about the negative thoughts, it could be, oh, I just thought about irritable, yeah.

Dr. Justin Marchegiani: Just just talk about whatever it is, I always like to go into it, assigning it a number. So out of 10, 10 being the worst intensity, where, yeah, you had a five or six or seven. And I try to go into it, taking whatever that number is, I want to cut it in half. So if I’m at a seven, I’m going to cut it down to three, or four, if I’m at a six, I want to cut it down to a three, if I’m at a 10 and want to cut it down below five, I just try to go into it, and have that conversation with myself about whatever that thing is that pissed me off, whatever it is that hey, that difficult patient that that really stressful bill, whatever it is, right. And I just kind of go into it, kind of do a little audit of where you’re at, and then try to get that down until it’s at least half below where it’s at, that kind of puts you back in the driver’s seat. And then it gives you the ability to shift to being positive, because you can’t be positive, it’s harder to be positive when you have that emotional staying at a higher level on that on that object subjective scale I gave you. So if you can cut it in half, that gives you the ability now to downshift from negative into positive to enable just want to make that shift. while they’re at a high level of negative it’s too difficult. That’s Oh, man, doing the EFT can be helpful because one, it gives you permission to be negative, but two, you’re giving your your nervous system, a little bit of a bump to be able to neutralize it.

Evan Brand: That is the the best point you’ve made about the emotional stress piece because this is like taking somebody who’s in the middle of a full blown panic attack and saying, Just chill out. 

Dr. Justin Marchegiani: Just chill out, like just relax, like, be be positive, no, can’t do that. Can’t do that. So this is where like the EMDR. And then you can kind of scatter your eyes around while you do it too. Right. So you can go look at like a clock face and go to 1936. Or you can tap while you’re pretending like you’re looking at different clock numbers with your eyes. And because when you move your eyes that uses different cranial nerves, which uses different parts of the brain, and that kind of the whole goal is you’re kind of scattering that signal. Number one, you’re interrupting the pattern. Number two, it’s kind of like if you’re talking about something you ever had it where someone interrupted you and you’re like, What the hell are they talking about? Right? ever have that? That’s kind of what you’re doing a little bit to your brain and in some of the negative thinking you’re trying to scatter that pattern and make it a little bit harder for your brain to go back to and then you’re like, what, what was I mad about? Oh, yeah, that. And then it makes it easier than shift into positive.

Evan Brand: I just tried to go outside to like, for some reason. Well, duh, I mean, humans were meant to be outside. We’re not meant to be in boxes all day. But you know, if you have a thought that is intrusive, you can just go out, and I’ll take a pair of binoculars, and I’ll just go outside and I’ll just watch the birds. Or I’ll go fill up the bird feeder, put it like a sewage feeder. So it’s like a big chunky like fatty CD type feed. I like to go put that out, watch the woodpeckers come in. And if I’m looking at them, and I’m not thinking about anything, yeah, that’s a that’s a great point. So let’s tie the functional medicine piece into what you said because I think what you said is a really good place to pivot which is you can’t take someone because someone listening who’s just so stressed out right now they’re going to they’re going to listen to you talk about tapping or if they’re watching the video on YouTube. So you tap into right What is this guy doing? He’s friggin tapping his forehead. I’m so pissed. I don’t care what what is this gonna do? That person’s a 10. He can’t he can’t even comprehend getting down to a five right now. So So on the maybe you would call it the herbalist functional medicine side, maybe we come in and give that guy or gal a shot of passionflower. Or maybe we give them a couple hundred milligrams of some pharma gabbeh or maybe a little bit of mother wort or maybe some ashwagandha maybe some Holy basil. Maybe we come in with some B vitamins because you and I know based on looking at thousands and thousands of people on organic acids testing that if you’re really really stressed, you’re going to burn out your bees as in Bravo, your B vitamins are going to be toast we know that. Based on looking at these labs, your neurotransmitters are going to be affected. So you may have low dopamine, you may have low serotonin, which is causing more anxiety, but then the low dopamine is causing a lack of energy and lack of drive. So let’s dive into some of these more functional pieces now.

Dr. Justin Marchegiani: Yeah, so we talked about the mindset stuff. We talked about tools to kind of decrease that sympathetic output and it’s just tapping on meridian points, right acupressure acupuncture points, kind of how energy and nervous energy Nervous System energy flows to the body. It’s just helping that energy flow better whether you call it ci or whether you call it action potential or, or nervous system, nerve flow, whatever you want to say, right? blood flow. It’s all connected, right? It’s all connected, right? So off the bat, we were talking about functional stuff. So when you’re stressed What are important things? Well, blood sugar stability is really important because most people get on a rollercoaster of blood sugar. When they get stressed meaning they’re going they’re overly gravitating towards alcohol, or overly gravitating towards refined sugar, their blood sugar goes up and then crashes down. And then it creates more nervous system stimulation via adrenaline and epinephrine being stimulated. And cortisol being stimulated to bring your blood sugar back up. So I find just keep it really simple, really easy with your meals, you may be more nauseous when you’re overly stressed because stress hormone does cause you to feel nauseous. So this is where you may want to do a soup or a simple smoothie, something really easy where there’s not a lot of digestion, but you’re still getting some proteins and fat in there. Whether it’s some collagen and some coconut milk or just sipping on some bone broth, right, something like that is going to have some good fat protein and it won’t be hard to digest. So if you feel nauseous just still no you should probably be eating but just try to make it something very easy on your tummy. And then think what are some of the nutrients your nervous systems in need when you’re more stressed, so low hanging fruit, B vitamins B complex is going to be very essential. Magnesium is going to be excellent gabbeh l-theanine these are good things that are going to help you relax and wind down having kind of mentioned valerian root or passionflower which are all connected to gabbeh and that kind of inhibitory neurotransmitter that helps you just relax a little bit kind of kind of puts the clutch in gear disengages the the gearbox so you can kind of downshift so to speak.

Evan Brand: Did you ever do Kava when you were down in Austin?

Dr. Justin Marchegiani: Yeah, so I mean, I’ve done I’ve done Kava still. 

Evan Brand: Did you go to the bars though? There’s like a cot. There’s like a cup. 

Dr. Justin Marchegiani: Oh, no, I’ve never I’ve never done it at a bar, but I’ve done it. Um, someone brought it over my house. They got it from Fiji. Before I did, it was relaxing. I like Kava that does a lot of gabbeh too, right?

Evan Brand: Yeah, does I felt weird my throat. I felt like well, am I having a reaction to this? Like it numbs your throat so much. It was a bizarre feeling. Yeah, I’m not recommending it. I’m not recommending it as a as a tool. But it could be it could be a good tool. I just thought I’d bring it up. Because when you mentioned like, Valerian I thought, Man, I remember that one time I drink Kava. I was. It was a weird, almost like an out of body relaxation. And I didn’t feel very grounded. It was kind of like whoa, I’m floating in the room. Kind of kind of interesting. 

Dr. Justin Marchegiani: Yeah, I mean, like I always go to nutrients first. And then I go to my favorite adaptogenic herbs second, so ashwagandha is one of my favorites. Right? ashwagandha rhodiola. Excellent. Excellent x, Holy basil those are kind of like my favorite kind of very relaxed, defying, relaxing tonifying kind of herbs, if you will.

Evan Brand: I like it too relaxefying, Do you get any sort of change in your outlook with holy basil? Because for me, that’s the one that’s most significant. Like I feel like I could take on the world when I get like a, I don’t know five 600 milligram a holy basil. It’s kind of like I am ready for the challenge. It’s a weird because it’s I’m calm. But I’m also energized at the same time. Do you get anything like that? 

Dr. Justin Marchegiani: It hasn’t been on my stack for a while. So right now my big stacks on my desk is going to be ashwagandha I do have some some gabbeh chewables and gabbeh sublingual. I mean, I think if you just took people’s works and took, you know, in their, in their place of work, whatever. And you took away all the candy and you just put like magnesium, and you put gabbeh like Lawson jers. Right. Think about how much of a stress reduction had been people’s works. Right. So much better. Maybe some B vitamins.

Evan Brand: Yeah, I mean, if you and I had brick and mortar places what I would do instead of a little you know how old school like front desk, you’ve got a little glass of like lifesavers and peppermints. And a bunch of garbage. I’d have like pre packaged chewable pharma gabbeh sitting there.

Dr. Justin Marchegiani: Yep. chewable pharma gabbeh, sublingual magnesium, maybe some l-theanine shots, right? keep it really simple. I remember in doctor at school before. For finals, we would like make drinks of like ginseng and holy basil. And we like create these like shot glasses all lined up with herbs where we take it. It was fine. I mean, those are some fun times. But um, yeah, so we just got to think a little bit differently and how you deal with stress, just a different mindset change.

Evan Brand: Yeah, I want to go back to what you said how people get into the alcohol and to the sugar and all of that and the carbohydrates and the blood sugar rollercoaster. I think people don’t understand why that happens. So I just want to give people a brief education of why that’s happening from a, you know, neurotransmitter perspective, that way you feel a little more confident that you can change this and you’re not just a victim to the food. So when we look at urine and you measure these neurotransmitter metabolites, we can see that after a period of stress, especially if somebody has been working with us for several years, we can see that Oh, they went through a divorce. Look what happened to their endorphins, for example, the endorphins got burned out. And with the help of Julia Ross, she has an amazing amino acid therapy chart in her books. You can see that the symptoms of low endorphins start to pop up. So these are the people that cry at the drop of the hat. These are the people that hard on the sleeve real emotionally sensitive. If they crave dark chocolate, they’re going for food to comfort themselves or reward themselves. Those are low endorphin signs, we’ll match up those symptoms to the neurotransmitter report on the oat. And then we’ll come in with a therapeutic nutrient like dl phenylalanine, to rebuild the endorphins. And then within four to six weeks, you can have it the 60% difference in symptoms were these people that were running to the cookie because they were stressed or running to the alcohol at night to relax, they no longer need that now, they may still do it. But they literally don’t have the physiological need to do that. Some people say, I just can’t relax until I have that glass of wine. Once you rebuild the brain chemistry, they literally don’t need it anymore.

Dr. Justin Marchegiani: I mean, if you’re having a stressful day, I mean alcohol Don’t get me wrong is that is a wonderful downer. I mean, it really does help relax people. Now obviously, if you’re going to engage in alcohol, keep it to like a drier champagne, a drier white wine, keep it to a clean alcohol and try to do it after you’ve eaten. So you’re not creating a blood sugar swing, because alcohol can actually lower your blood sugar. And then that creates more cravings and more cravings for junky food, right? So if you’re going to have a glass of alcohol, right, don’t want don’t get drunk. But if you’re going to have a glass, make sure it’s a healthy version, then just try to have some good protein before you have it like so if you go out, for instance, have some oysters, maybe a little bit of seafood, maybe a shrimp cocktail and have a glass of champagne or two or a cabo or Prosecco or something clean, clean, clean alcohol. There’s nothing wrong with that, you know, especially if it’s only if it’s not an everyday kind of thing. I think it’s totally fine. And you know, make sure you’re utilizing some of the nutrients we talked about. So you’re supporting the neurotransmitters as well.

Evan Brand: Yeah, check out our podcast, we did a whole one on the whole biohacking alcohol thing. 

Dr. Justin Marchegiani: Yeah, that’s how-

Evan Brand: So, Sunshine, sunshine is huge. I mean, granted, when you’re in certain parts of the country, you really lose the sun, you really lose it because you get clouds. And, you know, if you’re really high northern latitude, it’s really tough to get sun, I’ve got a lot of clients in Canada, and they just get major, major seasonal depression. And so for those people, like a light therapy box can be helpful. I already know for me personally, it’s affected me like when it gets dark at five 6pm. I mean, I just mentally, I just don’t like it. And so the light therapy box can be very good. A lot of times, you’re going to see those at around 10,000. Lux, that’s a pretty bright, pretty bright light. Of course, nothing is going to beat the sunshine. But if it’s like you’re in Alaska, you literally or, you know, hours of sun per day, whereas before it was 12 hours, and now you’re three hours of sunlight. That’s really tough mentally, so sun can be helpful. I wish tanning beds weren’t so controversial. because years ago, I had a friend who worked at a gym who had a level, I think they called it a level three or level four tanning bed, which was not something that closed on you. It wasn’t like magnetic field balanced. Like I measured it, there was no EMF coming from it. But it was almost like the stage lights, almost like a like a theatrical performance, like a red light up at the top. And you could get a tan, I mean, literally in a couple of sessions. But I did it for mental health. And we know that sunlight in general can really help act as almost like morphine, it can really help modulate these opiate receptors in the brain. I remember coming out of a six or seven minute session, and I was just high on life. I felt so good after that. And I thought, wow, I wish this didn’t have to be so controversial. Because if someone could get access to something like this, if we knew that it wasn’t going to increase risk of skin cancers and such, man, what could it do for all the depressed people out there that have Seasonal Affective issues in the winter?

Dr. Justin Marchegiani: Yeah, I think it just comes down to when you’re dealing with sun, it’s just don’t burn, you know, just just don’t get a burn and you’ll be fine. And that’s different for every single person. And so of course, you know, natural sunlight is going to be ideal. I think it’s gonna be excellent. So that’s a good first step for sure. We talked about some of the B vitamins and things and it gets really essential. I think also, you know, just from a financial standpoint, I think it’s really, really good. People talk about it, just having that six month emergency fund, right, try to have, you know, six months of being able to take care of your family, whether it’s food, living mortgage, just try to really make sure at least three to six months if people had that during COVID. I think there’d be way way, way less financial stress for people. I know, it’s a tough thing to do. But I think it’s something to strive for in regards to financial health is just really look for that six months, three to six month emergency fund. I think you’re smart.

Evan Brand: Yeah. And try to get rid of things that you don’t truly need. I mean, I had several people who say oh, you know this or that about budget, but they’ve got the hundred and $40 a month cable bill and they’ve got the the you know, the subscription to this or that that adds up to hundreds and hundreds of dollars a month. So I think with the reducing subscriptions where you can the emergency fund is smarter than from the food security perspective. Two, I remember months ago, you and I were talking about this it was there was talk about some of these meat processing plants and stuff shutting down and I had literally some of my clients freaking out thinking that they were going to run out of meat and not be able to feed their family. I mean, they were probably just watching too much news about the subject. But that’s why I always recommend everyone have a good chest freezer, you can get him for $100 and go on local harvest or eat wild, or just Google local farms around you, we have a farm that I pay him a little bit extra, but they’ll deliver to the house. And we’ll have literally an entire chest freezer full of amazing grass fed meat at anywhere from six to $10 a pound depending on the cut. And we don’t have to worry about going to Whole Foods where we’re going to get shamed if we don’t want to wear a mask, and then we’re buying their overpriced stuff sitting in the fridge. I’ve got my local farm, you know, bringing pastured meats at a fraction of the cost to my door, throw in the chest freezer, I sleep great at night knowing that if something were to happen to the food supply, my children and my wife and I will be well fed. And then of course well what if the electrical grid? Well, I don’t know. That’s that’s, that’s pretty slim chance. I know, people in California worried about that earlier this year, because of the fires, people were thinking, well, what if I have the chest freezer full of meat? And then the electrical grid goes off? Because California turns off my power generator? You know, hopefully, it’s not a long term thing. But you just got a problem solution problem solution, you can’t just get paralyzed by the problems.

Dr. Justin Marchegiani: Yeah, absolutely. You know, I always talk about it, you got to close the loop, right? You know, you have a problem. When you don’t close the loop. And you think about the solution, and you keep these loops, I call them keeping these loops open. That’s where stress happens when you close the loop. That’s where you feel a lot better, because it’s our problem solution. Problem solution, you’re constantly opening and closing loops all day long. That’s kind of how you want to think about it. So you have maximal you know, stress reduction. So we talked about physiology, right? That’s the foundation because remember, that’s like the this is the vehicle This is a suit, the biochemical suit we have to walk through every day and not everyone’s suit is the same and how we can deal with stress. So if you’re looking coming into this, you know, 20 minutes late, you’re like, Well, what do I focus on, focus on the physiological biochemical suit, because that gives you the ability to adapt. And then from there, you can try to grab one or two things that work best for you. mindsets, really important, dealing with some of these stress can be helpful. Talking about some of the supplements can be helpful. Making sure you’re in a good kind of financial situation can be helpful as well. You know, those are all good kind of strategies out of the gates. Anything else you want to talk about functional medicine wise. So we talked about some of the organic acid testing and looking at neurotransmitters that can be helpful, because I find people that are, you know, let’s say long term stressed out people, we’re going to see a lot of neurotransmitter patterns that are pretty depleted regarding amino acids and dopamine and adrenaline and serotonin. And that may be a longer thing you have to work on replacing with amino acids. So that may not be just a supplement you want to dunk on, they may take a while to work on depleting that, especially, you know, the faster it happens when you work on all the sleep stuff and the diet stuff that gets better, but that the bucket that may need some effort to work on depleting.

Evan Brand: Yeah, the only other functional medicine piece we’re going to be looking into for these like super stress, people’s looking into the gut, we’re going to be looking at gut inflammation. We’re going to be looking at parasites, bacterial overgrowth, all the stuff we normally talk about Candida, because there could be some more functional reasons why someone is going into the cookies, for example, or the alcohol, maybe on a neurotransmitter test, they look okay, but in regards to their gut, maybe they have all these bacterial pathogens are parasitic pathogens that are kind of like begging for some sort of quick burning glucose, right? So we may come in. And I noticed personally just using some Mimosa, I was doing some experiments with not not the orange juice cocktail thing, but actual most of the seed most a tree seed in capsule form. That’s very beneficial for calming down my gut. And I noticed mentally I was calm, just by calming down my gut. So don’t forget about the gut brain access, there is a connection there. And so if you’re having digestive problems now, whether that’s due to stress, or whether it’s due to infections, if you’re having diarrhea or constipation, or stomach cramping or food intolerances, you got to try to address those because it does signal and alert Danger, danger to the brain, meaning if you’re going and eating this allergenic food, irritating the gut that can then irritate your brain and cause issues. So I’ve had some people that have gotten anxious after certain foods, and we know that histamine is a neurotransmitter as well. So if you’re having histamine reactions, even just something like a low histamine diet may be useful to help calm the brain down because of some of the reactions there with histamine. So people think it’s just histamine allergies. No, but it can also affect your brain chemistry. And so you got to focus on that maybe herbal anti histamines or something we would use or some enzymes to help to reduce some of the effectiveness of the histamine on the brain. So I think that’s probably my last piece.

Dr. Justin Marchegiani: Yeah, and those are all valid points. For sure. You know, you talked about histamine, you talked about inflammation, and inflamed brains not going to focus and not going to do as well. So again, inflammation, whether it’s food allergens or deeper gut issues is a big one. Also medical palsy women, you know, lower hormone issues can affect the brain. So try to make sure your hormones are at least at a good stable place because that’s going to help with brain inflammation that’s gonna help with cognitive stuff as well. So everyone’s coming at this from a different place from from a different foundational weakness. So just try to figure out where you’re at and take at least one or two steps, you know, Ford on that. Also exercise can be helpful. So just try to find a couple of movements, simple movements that you can do 510 minutes, that’s going to help really decrease a bunch of stress. So whether it’s a push movement, a pull movement, a set or squat, a bender, a pole, whatever that movement pattern is just try to engage in some of these simple movements, it’s going to really help your mood, it’s going to take a lot of that mental energy and allow you to kind of put it out into that physical movement pattern.

Evan Brand: Oh, 100% Yeah, exercise is key. I should have mentioned it earlier. I mean, I feel amazing after I just do some dumbbells or roll machine or hike in the woods, hike in the field, you know, whatever I could do to move. I mean, that’s in its free, right, it’s free, so and you don’t need any permission to do that. So obviously, if you’re going into a gym and you’re doing the whole mass thing in a gym, maybe that’s not as fun so get outside go somewhere where you know, you have your own space and you don’t have people you know, breathing down your neck, so to speak. But I think with the gut piece, the neurotransmitter piece, the aminos here’s kind of the the summary of today and what’s been going on in the world. A lot of people are just like, hey, things are crazy, I give up. But this is actually the time where you really want to dial things in even more. This is a time where you want to focus even more to keep your body keep your mind keep your your sleep patterns healthy. This is not a time where screw it I’m going to go off the rails and just drink a case of beer. It This isn’t the time to do that a lot of people they’re so stressed they have no other coping mechanism. But I would argue everything you and I’ve been talking and doing and preaching and clinically doing for people. This is kind of like the showdown This is like okay, what did all that work we put in actually do did we were we the last man standing, meaning everyone else got burned out and ended up on you know, anti anxiety medication. And we stayed calm and cool through the whole thing. I think this is the time where you can see all the hard work paying off.

Dr. Justin Marchegiani: 100% I think you’re totally kind of dialed in. Also, one thing I’ve been doing a little bit is a little more meditation and just keep it really simple with breathing. Just focus on breath, you can do kind of a biofeedback device like the Muse that I’ve talked about, we’ll put a link down below for that. That’s one thing I’m experimenting more with. It just kind of gives you that little bit of a thumbs up from a biofeedback standpoint that you’re you’re you’re putting your brain in a pretty good place when you’re meditating. I think it gives people confidence. They’re doing it right. The problem I find with meditation, people are like, Am I doing this right? And there’s just insecurity and what the heck they’re doing. And then that prevents them from being compliant with it. So I think having a extra kind of pat on the back yet you’re doing the right You’re doing good with a some kind of a device that helps whether it’s whether it’s HRV, or the Muse or M wave type of technology, these kind of things I think are helpful to give you the confidence that you’re doing something right.

Evan Brand: Yeah, yeah, the floatation tank is awesome. So doing doing a float would be good. deep tissue massage would be great. calming essential oils would be great Epsom salt baths would be great is anything you can do to downshift. We talked about the shifting phenomenon quite a bit, but-

Dr. Justin Marchegiani: There’s a lot, there’s a lot of options for sure.

Evan Brand: Okay, cool. Well, let’s wrap this thing up. So if people need help, we’re here for you. We always have been and we intend to be kind of on the front lines, helping people with all this stuff. So if you need to reach out to Dr. J. is the website. If you need to reach out to me, is the website and we’re here for you. So don’t give up. Don’t give in. You got to keep pushing forward every day, you still got to put your pants on, you still got to do the thing, whether it’s take care of your kids take care of your wife, your husband take care of career, you still got to move forward. So I know it’s easy to get kind of stuck and like you mentioned I like the idea of the open loops closing the loops. I didn’t get stuck in these open loops, but you got to close the doors. Try to simplify try to you know, minimize decision making focus on the big things and you’re going to be just fine.

Dr. Justin Marchegiani: I love it. Excellent and Well, great podcast today to reach out to Evan, to reach out to me we’re available worldwide. If you want to dive in, look deeper at your physiology, biochemistry, neurotransmitters, gut whatever the root issue is. We’re here to help you guys have a phenomenal day. Click down below for all the important links, guys. Take care. Bye.

Evan Brand: Take care now. Bye bye.


Audio Podcast:

Natural Allergy Solutions | Podcast #225

Allergies are issues caused by an immune system that is hyper-responsive. Stress in the stress bucket, antigens which are foreign compounds, are some of the big causes of the hyper-responsive immune system.

In this episode, learn the things to look at in the stress bucket such as food stress, emotional stress, exercise, too much, too little, infections, environmental antigens like cedar, dander, pollens and other things to help fix these issues in a functional medicine perspective. Answer why it tends to become a non-issue when one is healthy or when inflammation is under control. Also, learn why those little bits of antigens may be enough to tip one over when inflammation is already topped up and antigen or stress bucket is full.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

02:33    Hyper Responsive Immune System and Allergies

10:26    Nutritional Functional Medicine Options for Allergies

15:09    Fungal Infection Solutions

20:05    Quercetin for Mast Cells

28:13    Poor Breathing Solutions


Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani, how you all doing today? Evan Brand, my man, what’s going on, how you doin’?

Evan Brand: Hey man, happy Monday to you. My pink office is gone, so that’s great.

Dr. Justin Marchegiani: Great!

Evan Brand: I’ve now got grey office, and for anybody doing, uh, interior work, they need to just get a hold of you, you’re my interior designer now. You gave me the idea of this good grey color that I have.

Dr. Justin Marchegiani: Yeah, it’s knitting needles grey. We just had my son’s playroom paint to that same color. I just love the greys like that because one, that room, like it’ll go when there’s a little more light or look a little more blue, and then look- look a little more slate or- or dark grey, and then it just kinda blends with everything, it’s- it’s surely Williams number one color of the year like three years ago, and I just- I just have it in a lot of my key rooms.

Evan Brand: Yeah. So, the paint brand I did is Romabio, R-O-M-A-B-I-O. So part of allergy is k- is your indoor environment, you know-

Dr. Justin Marchegiani: Yes.

Evan Brand: -the NPA talks about how dirty indoor air quality is compared to outdoor air quality. So if you’re doing any remodeling, you’re doing any painting in your home, if you’re using garbage products, even some of the stuff labeled as low VOC, it still could contain toxic chemicals, the Romabio is all mineral-based, and so you literally smell nothing. And so, there’s no off gassing, you don’t have to open the windows, you’re not gonna get sick when you put it in especially if you’re chemical sensitive person or if you have allergies, you know, you’re gonna be just fine. And even if you’ve got a garbage paint that you wanna paint over, you can just paint right over with Romabio. So, that would be step 1 for today’s talk on allergies is, optimize your indoor air quality. Humans, we spend way too much time indoors, that’s just what we do now because of our society and we’re connected to computers all day. How could you put a desk outside, yeah, you could but then you might not be able to see the screen. So, I do try to work outside when the weather’s nice and sit in the shade under a covered patio, but most of the time we’re gonna be indoors. So back in the corner there, you see my Molekule Air Purifier, Justin’s got one in his office too. I’ve had great success with it so far. The air in here really does s- smell really fresh. It’s almost like you’re at the beach. It’s just a really, you know, fresh air uh sensation, it’s not an ionizer, you don’t want those, you don’t negative ions being created from your air purifier because what those do, is it actually sticks all the toxins and mold and pet dander, it sticks it to the walls like a magnet, so it- the ionizer takes it out of the air but it sticks it to your wall which you don’t want. And what we’re using is a technology called peco, P-E-C-O which actually destroys the- the pollutants, it destroys the dander, it destroys the mold spores. And that’s a far better situation, uh, in terms of your- your air purification.

Dr. Justin Marchegiani: 100%. So, air is really important. So today’s podcast is on allergies as we allude it to. So, allergies are gonna be an issue when your immune system is hyper responsive, okay? And one of the big things that’s gonna make your immune system more hyper responsive, is gonna be stress in your stress bucket, or an allergy terminology, we call it, antigens. Antigens are like foreign outside compounds. So, anything that’s gonna drive up inflammation, whether it’s foods, like gluten or dairy, or sugar, or aspartame or MSG, uh, grains, these food- they just have more inflammation. Inflammation is gonna drive prostaglandins, right, these are like- these are cosanoid type of uh- co- ho- almost like hormone-like compounds, they can increase things like prostaglandin e2 which is more inflammatory, right? It’s gonna create more histamine, it’s gonna create more swelling and vasodilation, it’s gonna create more congestions, and of course a lot of foods also are very mucus forming too. So we have mucous, we have congestion, we have stagnant lymph, and we’re adding all these inflammation from our food, and then also stress will do it because cortisol is gonna be a- a stress hormone, it’s an anti-inflammatory hormone but it does- it’s very catabolic. So it’s gonna break tissue down. It’s gonna cause constriction. It could- it could- gonna create adrenaline which is gonna cause constriction that’s gonna decrease blood flow and a lot of waste too. And it’s going to- uhm, decrease your sex hormones, which is your ability to heal, repair, recover and be anabolic. So we look at everything, you know, from a functional medicine perspective, we’re looking at our stress bucket, and we’re doing a really good history evaluating food stress, emotional stress, exercise, too much, too little, infections, uhm, and then we’ll also look at environmental antigens like, in Austin, cedar is a big one. Dander, right, various grasses, right? These types of things, pollens, these can go into your stress bucket. Now, the more you’re healthy, the more your inflammation is under the control, the more it becomes a non-issue. But of your inflammation is already topped up, and your antigen/stress bucket is full, those little bit of antigens may be enough to tip you over.

Evan Brand: Yup, well said. And there’s other things that can add into that bucket too. So like bacterial overgrowth which is something that we’re always testing for via stool.

Dr. Justin Marchegiani: Right.

Evan Brand: Uh, we’re looking for signs of leaky gut, so we’re look-

Dr. Justin Marchegiani: Yes.

Evan Brand: -for inflammation in the gut, we’ll look for your secretory IgA level on your stool test-

Dr. Justin Marchegiani: Right.

Evan Brand: -uh, we could even see like some microscopic bleeding, you know, there’s a marker called a colt blood that we look at, and that could be related to major inflammatory issues, or even some type of autoimmune gut condition. So if you’re looking at this and then you combine the diet, if someone is eating a high histamine diet, this is gonna be like alcohol, you know, your wine, your beer, uh, a lot of fermented foods people go crazy with now like sauerkraut and soy sauce and kombucha, those are all gonna be higher histamine. Cured meat, so, a lot of people doing bacon in the paleo community, that’s cool, but if it’s cured, those cured meats could be a problem, and then of course like dried fruit, I see tons of people eating like dried mango slices, that’s real high histamine. So you take your environmental allergies like you’ve got your cedar fever, plus maybe you’ve got some gluten in dairy in there, and then you’re snackin’ on dried mango slices, you probably gonna have some issues.

Dr. Justin Marchegiani: Exactly. So we always wanna look at what- what’s the root underlying issue? We have a hypersensitive immune system, we do a really good audit as a functional medicine doc to figure out all the foods that could be driving it. Okay. I see significant reduction in allergies when we just get the inflammatory foods out. Dairy is a big mucus one, grains are a big one, and then also the hidden inflammation like in the sauces and those kind of things. Now, once we kinda have that looked at and supported, getting the hormones and the cortisol under control is huge. Because the more our cortisol is increased, that can affect our immune system, right? Typically, that can create a hyper responsive immune system and even a- a decreased immune response. But typically, with allergies, we’re seeing a higher immune response especially the TH2 part of the immune- so that- that’s like, we have our TH1 part of our immune system, that’s our cytotoxic immune system, that’s our like our natural killer cells, our helper cells. Think of that as a special forces of our immune system, right? It’s the navy seals, it’s the delta force, it’s the army rangers, it’s the first line of defense in attack. Then we have TH2 part of our immune system, that’s like our humoral, or antibody-based immune response. And these are like the infantry that comes in like a week later. This is the same kind of immune response that when you get a vaccination, you’re trying to stimulate these antibodies on the humoral side, to go and create memory cells, and these memory cells kinda linger in the background and they can go attack things. Now when you have a lot of allergies, a lot of times you can have this hyper TH2, that’s hyper antibody response, and that’s- that’s a big one. So, typically, you know, when you vaccinate, you’re gonna jack that immune response up. So there is some data with, I know the DPT vaccine that one of the side effects is increased allergenicity later on in life, and I think part of it is, just winding up that TH2 part of the immune system. So, we’d look at the foods, we’d look at the stress, we’d look at sleep, right, and then there are additional supplements that we can use to kind of curtail and kind of bump that immune response down. Now, low hanging fruit clinically, I find high levels of allergens, also seems to correlate with low stomach acids. So, I find not being able to digest your food, food sitting in your gut, putrefying and a lot of that because of low HCL, low hydrochloric acid, and low enzymes ’cause HCL and enzymes are brother and sister. We need good acidity; we need good nice high levels of acidity to stimulate our pancreas to make enzymes. So we need HCL, that creates enzyme activity, right? Then we- we make our proteolytic enzymes, our lipolytic enzymes and then we also have bile salt production. And our bile does pull out a lot of junk too. So, we need good bile to bind up a lot of that crap that may be from our environment too. So we have HCL, enzymes, proteolytic – protein digesting, lipolytic – fat digesting, and then our bile salts which helps with fat as well, and does some other junk in there that we wanna release out our stool.

Evan Brand: Yeah, makes sense. Well, people say, “Oh, when I was younger, I didn’t have allergies, but now that I hit age 40, or age 50 or age 60, I have allergies”. We know that as you age, you make less and less stomach acid every year. So sounds like if you wanna battle this, supplementing with enzymes, and then you mentioned the putrefying in the gut, there- there is exactly what we’re talking about with a bacterial overgrowth or a candida overgrowth, or potentially a parasitic infections is that, those infections including H-Pylori are gonna reduce the stomach acid level even more. So, if you just go out, “Okay, Dr. J said enzyme and acids”, you make around buy digestive enzymes and acids and you don’t get better, and that’s because there’s still another layer. There’s still another root cause that hasn’t been addressed that could be the infection piece, or as you mentioned, cortisol, it could be the cortisol, pulling apart the tight junctions in the gut barrier, then that allowed bacterial overgrowth. So if you fix the gut bugs but then you still don’t go upstream to fix cortisol, you’re still gonna end up in the same situation with allergies again. This is not, by the way, a deficiency of antihistamine drugs. You’ve noticed we’ve not talked about drugs. Maybe we should spend just a couple minutes talking about the conventional treatment for allergies, you know, what the ENT doctor is going to do for you in this situation, “Oh, doc, I have allergies”, the- the things they have to offer are- they’re not-

Dr. Justin Marchegiani: Right.

Evan Brand: -root cause.

Dr. Justin Marchegiani: Yeah, let’s just go over one more thing before we dive into the pharmaceutical option, and I think you can learn a lot when we contrast nutritional functional medicine options for allergies and then we can contrast it on the conventional allopathic medicine. You can really see philosophically which path are going down, like this is- there’s a big divide in the road, right? One is, we’re trying to reduce inflammation, modulate the immune system, help with drainage, help with inflammation, help with the gut microbiome, and then the other is, hey let’s- let’s give antihistamines, let’s give corticosteroids, right, let’s give uhm, things that are going to suppress the immune system, versus support, heal, nourish, and drain out. Does that make sense?

Evan Brand: Absolutely, yeah. The decongestants, those things too.

Dr. Justin Marchegiani: Exactly, yeah, the e- essentially anti-histamines, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, one of the big things with the gut is the microbiomes. We talked about the hyper responsive immune system; probiotics have a huge effect at modulating the immune system. So when we have commensal bacterial overgrowth or dysbiotic bacterial overgrowth or infections or H-Pylori, typically we start to see a lot of collateral, not so good bugs starting to accumulate, right? ‘Cause you know, bad people tend to hang together, it’s very rare you just have a solo bad person by themselves, and then can create an immune response that puts us in let’s say not so good direction. So, getting some of the bad guys to dysbiotic, you know not so good stuffs or the infections under control is very helpful, and then also bringing up the beneficial bacteria, lactobacillus, bifidobacter-type of bacteria, if we’re sensitive to that, we may even use more spore biotics, like bacillus, strains, we may avoid a lot of the lactobacillus, K-CI strains, the higher histamine strains if you’re sensitive. So we may look at lower histamine strains, look at, you know, we’d avoid the para-k-ci, the k-ci we may give more spore biotic strains with the bacillus coagulans, ___[12:22] to support the microbiome which does have a modulating effect on the immune system.

Evan Brand: I’ve seen some of the lower histamine probiotics on the market, I think it’s usually unnecessary to have to do some of that specific if you just fix the gut. I’ve rarely had somebody have a problem. With you and I, I mean, we use professional healthcare companies to manufacture our products. And so, the quality is so insanely high, it’s very rare. Maybe like 1 out of a hundred or 1 out of several hundred clients who can’t tolerate our normal, high dose regular probiotic. And that’s because we usually have fixed before we come in and fertilize and add all these probiotics, you and I have already tested, and we’ve already identified and fixed any infections that would potentially be releasing histamine. You know, these different bacteria could be releasing toxins that short of- shooting at the immune system. We’ve already cleared all that out. So, the probiotics are usually tolerated versus, the maybe if you just heard this, and you thought,” Hey, just said enzymes and probiotics, I’m just gonna go buy those two things and think I’m gonna get better”, you might not ’cause you still haven’t gone to the correct order of operations.

Dr. Justin Marchegiani: Correct. So, I would say maybe 1 to 5 percent of my more inflammatory, very- lot of inflammation, lot of the immune dysregulation patients fall into that category, number 1. But like we’d use that, I do find a lot of people that really are reacting to probiotics, they’re throwing a whole bunch of probiotics into a tummy or a microbiome full of dysbiotic, not so good bacteria or even lots of infections. And that’s where you can get a lot of that kind of response. You know, my- my analogy, it’s just like throwing a whole bunch of seeds down, and a weed- oh, and a garden full of weeds, it’s like taking your car to a car wash, and getting it waxed before you get it washed, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s an order of operations and how things kind of our, you know, for best practices so to speak, and it- when we incorporate a functional medicine program, that best practices and that kind of system approach is already built into the logic of what we’re doing.

Evan Brand: Yeah, I mean, it’s kinda like if you just go down the reign of supplement, I only start like pick and choose range of things, like, this is immune, I’m gonna throw it at it, and hope that it sticks, I mean, you might get some limited success with that, you know, people could go out and buy an herb like stinging nettle for example, and they could take stinging nettle, maybe they get some progress, but it still may not be root cause. You wanna talk about that now, maybe some herbs we do use?

Dr. Justin Marchegiani: Yeah. I think we can go there. Is there anything else you wanna highlight on the physiology or the biochems ’cause I- I really want our listeners to understand what’s happening in their body from a physiological biochem perspective, so they get the root, ’cause then when they understand what’s happening, then we have this puzzle piece whether it’s a supplement, or a drug, or a diet, or lifestyle modification, they can see how it plugs in. ‘Cause that way, people get the root cause perspective, versus the palliative, you know, paint over the rust so to speak? Is there anything else you wanna highlight on the biochem or physiology part?

Evan Brand: Yeah, now that you mentioned it, I would just say uhm, fungal infections, of the sinuses could be another problem that most people miss, and especially the ent doctors miss. So people that have lived in an environment where they’ve had high moisture and potentially mold, they may have some type of uh, fungal infection up in the sinus cavity where you can do a- a- a blend of citrus oils, in essential oil format that we put into a sinus irrigator that’s battery powered and you can pump this up into your sinus cavity and don’t actually kill off the colonization that’s happen because, your sinuses are so close to the brain. So if you’ve got a fungal infection up in here, that’s so close to your blood brain barrier. You could be releasing mycotoxins into your sinus cavity up into your brain causing allergic response even if your gut checks out okay. So I would just say make sure you’re addressing both sinus and gut at the same time.

Dr. Justin Marchegiani: I agree. And sometimes, some of these critters, they can hang out in the gut. Now one of the things that I do, especially with my son, ’cause he’s not quite at the age where he can blow his nose really well to get all that, you know, mucus that’s way up here in his frontal cavity out. So, we use the device called the nasaline, and then we use the neti Xlear packets which have xylitol and also so many uh- minerals and sodium bicarbon there. And we’ll suck up about, you know, couple of ounces of that in the nasaline. We’ll mix it up in the- in the solution, then we’ll suck up a couple of ounces, and then we’ll- we’ll inject it in one nostril, then a second or two, a flow coming from the other side where it drains, and then we’ll go to the other side and we’ll push- and I’m not talking the spray, we’re not doing the xylitol spray, we’re actually doing a syringe and nasaline pump, that’s like a big turkey baster, and we’re-

Evan Brand: Yup.

Dr. Justin Marchegiani: -we’re injecting fluid up, and it’s literally flowing out of the other nose for 1 to 2 seconds. When I kinda ring out his nose, and then we do the other side, and have it flow for another second or 2, and that’s going all the way up in the frontal cavities, and may even go down the back of the throat. So if you’re having an annoying post nasal drip, that could be something hanging out way in the back posterior part of the sinus cavity that needs to get flushed out. And the xylitol is great ’cause it will kill some bacteria and potentially even some fungus and then just- and also restoring that good pH up there. So it makes it harder for some of the not so nice stuff to grow, it’s very helpful for sinuses in- or for allergies in the sinus cavity.

Evan Brand: That’s beautiful, and does he tolerate that, is he allow you to do that or is it a pain?

Dr. Justin Marchegiani: Well, here’s the deal. We used to use the bottle, like the Neal med spray bottle or the- or the uhm netty Xlear bottle, but err- one- if you- if you had it at an angle little bit, it- you wouldn’t get optimal pressure-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -so the nasaline allows you to get optimal pressure from any angle ’cause it’s- it’s kind of, you know, in an injection fashion. And then number 2, is you get more flow, you get better pressure. So sometimes with the bottle, there’d be mucus, and we- there wasn’t enough pressure to break it up. So with the nasaline, you can get like 2 to 3 times more pressure, so it breaks it right up and then you can see it fully on the other side and it’s- you get that like sense of like, “Oh my God, that was like way up in your sinus”, and then he can breathe so much better and helps, ’cause, he’s only had one ear infection, and it happened because we couldn’t get snot mucus from up here out. And again, that’ll change as he can blow his nose, right? But when your kids are younger, it helps and if you have sinus issues, it’s awesome too! Totally great. And you may not need the nasaline, you may just be able to do the regular s- you know, regular spray ball that comes with them, but that’s helpful.

Evan Brand: And this is nasaline like N-A-S-

Dr. Justin Marchegiani: A-L-I-N-E. If you go to, and click on recommended products, we have the links there, I’ll have my staff put the links below in the comments section, so if you’re listening to the podcast, or the YouTube video later, you can go and look for those links and we’ll have ’em there for y’all.

Evan Brand: Perfect. Well, I think we talked about a bunch. So, are you ready, do you wanna hit some- some nutrients? Things that can help-

Dr. Justin Marchegiani: Yeah, I wish to. One more thing here, I know, I’m- I’m a little long-winded, so we have our 5 major immune, uhm cells, right? 5 major immune cells, we have- in- in school they’ll teach ya, Never Let Monkeys Eat Bananas – Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils. Okay. Basophils are the big ones we’re worried about with allergies ’cause basophils, outside of the blood, when they go into the tissue, they turn into mast cells, and mast cells produce histamine, and histamine has that vasodilating kind of mucus forming allergy-like effect. And a lot of the medications like Pepcid ac, these 5H2, 5HT2 blockers is antihistamine meds, lot of times they’re working on that response. So, we’re trying to really get that immune system to relax and to chill out into also not over stimulated with stress, and food and poor diet and lifestyle.

Evan Brand: Yup. I think that is important to bring up mast cells, ’cause, yeah, I mean, when you talk about people with mast cell problems, I mean, they’re allergic to anything. Some of those people have to even travel with uh, EpiPens, because if they have some huge mast cell explosion.

Dr. Justin Marchegiani: Exactly, yup. Totally. So, I’ll let you go through everything here Evan.

Evan Brand: Yeah, well, I was gonna say which I was calling like a silly yet, I was calling it coricidin, but it’s really quercetin. Justin’s like, “Dude, it’s quercetin”. So, quercetin, uh it just [crosstalk] but anyway, so, this is- this is a bioflavonoid, and this is very helpful to stabilize mast cells. So, actually, uh, Neil Nathan had a good book on mast cells. And he was talking about how- the number 1 thing he found from a natural nutritional perspective to stabilize mast cells, meaning, if you have a mast cell activation problem where someone is just overreacting to everything like they breathe in cologne, and get a headache, that’s likely a mast cell problem that’s creating a lot of excess histamine in dumping that into the system. So in his book, he discussed using quercetin, and how some people can’t even tolerate a low-dose like 40 milligrams was too much for some people, that’s gonna be a very sensitive person. And most of the time, we can go up to 2, 3, 4, 5 hundred milligrams of quercetin, and then usually there’s other uh bioflavonoids like rutin, R-U-T-I-N that come with it. So, that’s what you and I use a lot. And I would say that’s probably 1 of the top 5 nutrients that you can use, but, don’t just go to Walmart and buy some there. You wanna get a professional quality version because, just ’cause it says, it’s “XYZ” on the label, that doesn’t mean it’s the quality in purity and, if it’s garbage and you bought it at Walgreens pharmacy, it could have a bunch of extra fillers, corn and gluten and who knows what else. It could be in a tablet versus a capsule, versus a powder, so then the absorption in the gut is not as good, ’cause you have low stomach acids. So, you can’t just assume because it’s on the label that it’s gonna work for. So I have to give that a little disclaimer.

Dr. Justin Marchegiani: 100%. Yeah, one thing I wanna highlight, is uhm, reishi mushroom or Ganoderma lucidum is excellent. Rishi is known- I’d one article right here called the suppression of inflammatory and allergic responses by a pharmacologically potent fungus and Ganoderma lucidum or reishi mushroom. And essentially, rishi really helps modulate the immune system but it also helps push up that TH1 immune system. Now, why does that matter? ‘Cause people that may have a lot of allergenic issues, they may have this really high bit of TH2 going on, right? It’s on a see-saw. So it TH2 is high, guess where TH1 sits? So, by- it’s- it’s low, right? Just like with one end of the see-saw, is up, the other end has to be down. So think of the side that’s down is TH1, think of the uhm, which is the side that rishi supports, and think of the allergenic side is over here, on the TH2. So if you bump up this TH1 and guess what you’re doing to that TH2 allergenic immune response? You can kind of bring it back in to benefit.

Evan Brand: Yeah, I’m gonna call on the- I call it rishi, maybe call it rishi [crosstalk]-

Dr. Justin Marchegiani: So- you- we’re pronouncing quercetin differently, and rishi differently. I love it man. [Crosstalk]

Evan Brand: I love it, I mean, I take it almost every day. There’s a couple different-

Dr. Justin Marchegiani: Oh yeah.

Evan Brand: -supplements I take that does have mushrooms in it, so, I- I’m a huge fan and there has been- I mean, they call it the mushroom of immortality, so, I mean, this is something been used in Chinese medicine for thousands of years before Americans picked up on it.

Dr. Justin Marchegiani: Exactly. So let me just read you part of the abstract here. I talk about here, “A number of herbal drugs have been identified in the past that can target inflammatory, cytokines among these Ganoderma lucidum aka rishi, a powerful medicinal mushroom has been found to possess immune-modulating and immune potentiating capabilities, and has been characterized as a wonder herb”. And this article right here, I will put- put the link here below, link here below is this review will focus is on the molecular mechanism and the inflammatory and anti-allergenic reaction this mushroom has especially with allergies. So we’ll put the link below you’re not gonna see the whole thing because a lot of these things are stuck behind paywalls but it just- we- you know I’m just putting it out there because I want people to know there’s a lot of research on some of these compounds and how they can help modulate the immune response. Now I haven’t read the whole article because it’s behind a paywall but I’m gonna guess part of that mechanism and how it’s helping allergies is to that t1 th2 seesaw analogy I just gave y’all.

Evan Brand: Yeah I would say the same thing with the astragalus, you know I love astragalus, I think it’s time of the year we’ve already started to see a couple of ticks on our dog so we’re back in two tick season already and if you do get bit supposedly if you get bit, uh by a tick, and you have astragalus in your system, that may help to prevent the transmission of the Borrelia burgdorferi that causes lyme disease. So, I basically stay on astragalus starting in the spring throughout the rest of the year. But I think that would be a good TH1, TH2 balancer as well for allergy season.

Dr. Justin Marchegiani: Exactly. So we wanna make sure we draw line here, right? The line is, these herbs and nutrients can be used palliatively in the same category that drugs- the drugs are, right? But, if we’re actually fixing the root underlying issues that may create the environment for allergies to form like pet danders in house, mold in the house, poor diet, inflammation, low- you know, not enough stomach acid, poor adrenals. If we don’t fix that, then these issues may not have a root cause supporting benefit. So we draw the line, these are nutrients but they can still be used palliatively as well as to support the root cause. So our goal is to always support the root cause, by addressing these issues we already highlighted, but they can also be used uh, without addressing the root cause as well but they’re always way more effective than synergistic when we- when we’re fixing the diet, the lifestyle, stress that are causing everything to dysfunction to begin with. So I like to draw that line, ’cause most people, they use allergy medications today, without any focus on the root cause. We always wanna delineate and draw that clear line for y’all.

Evan Brand: Yeah, I was pulling up a study here that was talking about prenatal, perinatal, and childhood vitamin D exposure, and their association with childhood allergies, and basically, this uh study discusses, they were measuring vitamin D levels, through different ages of kids. And the lower the vitamin D level throughout pregnancy or through childhood, increases risk of allergies later on. So, long story short, if your pregnant mom listening, make sure your vitamin D levels are up, you know, preferably like 60 to 80, uh, we like to see it, it’s typically in the U.S., it’s gonna be NG over DL. That’s gonna be the uh, the unit. But if you look at your reference range, you wanna be on the higher end of your reference range of vitamin D, that’s an easy one to fix.

Dr. Justin Marchegiani: A hundred percent, yup. So let’s go to the list here, we mentioned vitamin D, and how that modulates the immune system. We talked about medicinal mushrooms, Ganoderma lucum- lucidum or rishi is our favorite herb. If we’re Evan, it’s- how do you say it?

Evan Brand: I say rishi.

Dr. Justin Marchegiani: Rishi, rishi, potato, patata. Probiotics, quercetin is excellent especially with a lot of the- the bioflavonoids, I think you mentioned the histidine, the rutin. Uh, bromelain, which is an enzyme found on pineapple which is great for helping with allergies, stinging nettle is an excellent one. In my line, I’ve a product called aller clear which has a lot of these compounds in it, it has a stinging nettle, it has some of the vitamins C, the bioflavonoid, it has some potassium bicarbonate, these are really good kind of, I say first line natural medicine, functional medicine type of compounds. Anything you wanna add to that Evan?

Evan Brand: Yeah, I would just say make sure you’re working back towards the root cause, so, someone can go buy those supplements, great job, but still make sure you’re looking at your gut, make sure you’re looking at your home environment, do you have new carpet that’s off-gassing toxic chemicals, do you have new paint, did you move into a new apartment, a new condo, a new town home that has all their pollutants in the air that are messing up your sleep at night. So maybe you need to have a high-quality air purifier in your bedroom while you’re sleeping, maybe that’s gonna reduce the stress in your bucket, but you can still do these other things. Just make sure you’re- you’re checking everything else off the list, I don’t want people just taking quercetin and thinking they- they’re gonna be cured.

Dr. Justin Marchegiani: Exactly, 100%. Alright, so let’s continue to roll through some of our other things on our list here. My list, let me pull back up here. Alright, good. So we talked about the medicinal mushrooms, really-really important, we talked about the stinging metal. Uhm, couple other things I wanna highlight, is just poor breathing. A lot of people could have like a deviated septum, and that could require surgery. Some people, it may be more functional based where you can do a specific chiropractic technique called nasal-specific, where they can go up there, and they could put a balloon up and they can- they can kind of balance out those little bones that could be misaligned. So I always recommend the nasal specific chiropractic technique first because that’s- doesn’t require anesthesia, medications, or invasive surgery. So, that’s always better first. And then just making sure you have good posture, right? Making sure your external auditory meatus sits right above your top of your shoulder there, good posture, and then making sure you- the- bones in your neck are moving properly. Soon as you start to go forward head posture, one of the things that starts to happen is your airway starts to close down a bit, okay? The more your airway starts to close down, you start recruiting as you start going more forward, you start recruiting from these intercostal muscles to breathe. So now you’re here, and your breathing from this- your chest muscles, right? So we take a deep breath, if you put a hand on your tummy, and a hand on your chest, you want the bottom hand to be the one primarily moving your chest shouldn’t be. So, you should- when you breathe, [inhales], by chest breath, this is the hand that moves first. No go. If we’re belly breathing/diaphragmatic breathing, [inhales], this is the one that you should be breathing with. A lot of people, they don’t naturally wanna do that ’cause it- make sure tummy look a little bit bigger and everyone wants to have those- that- that beach body. So you see guys walking around like this, that means they’re automatically breathing through their chest which is activating that sympathetic nervous system response, which then will throw off the immune system too if it’s done chronically.

Evan Brand: Yeah, for people who are listening audio, they didn’t see Justin, he was showing the kind a turtle head basically when you’re standing and, if everybody is looking down at their smartphones these days, everybody has that kind of turtle head, head launch forward kinda down and forward, he was saying, that’s gonna be recruiting some of those muscles there in the front of your neck and then he was kind of hunch over at the same time at his shoulders. So he was showing what you want. ‘Cause you wanna be basically your head, you want on top of your shoulders, you don’t want your head in front of your shoulders, he’s saying that’s what’s leading to the more chest breathing, and not the belly breathing. So that’s important, I mean, I’ve noticed, just watching my daughter, that, you know, young children, they’re naturally belly breathers. And as we age and become stressed, we become chest breathers. And chest breathing causes anxiety. You don’t wanna be a chest breather. If you look at somebody having the panic attack, they’re not breathing in their belly, their breathing in their chest.

Dr. Justin Marchegiani: Yeah. I think a lot of people, number 1, they- they don’t wanna look like they’re 5 or 6 months pregnant ’cause they’d really do a deep belly breath. You know, basically, all your organs, all your intestines are going down as your diaphragm is pushing out. Then- and so, make sure you should look a little bit bigger in the tummy but it’s just, you know, it’s just your body trying to get a- a good diaphragmatic breathing, it’s just moving those organs around, that’s all.

Evan Brand: Yeah, who cares? You gotta- you still care what people think, then, you gotta get over that first.

Dr. Justin Marchegiani: Absolutely. Alright, anything else you wanna add on the breathing postural side?

Evan Brand: I think you did good.

Dr. Justin Marchegiani: Okay, cool. Now we already talked about, you know, what these various things could be, right? Pollen, danders, animal dust, mites, right? Uh, things in your fur, right, these kind of things, you know, could be topical things like latex or eating gluten, or anaphylactic things like peanuts, of course, right? And a good air filter will help with some of these ones that are more environmentally based. Now, I- I have one,, there’s a good one there that I like. There’s 2 or 3 brands that I like as well. If you go to, you’ll see couple the ones that I like and then I personally have about all 3 in my house. I know Evan talked about the uhm, uh, what was the one that you have Evan?

Evan Brand: The molekule?

Dr. Justin Marchegiani: The molekule, and I have the molekule as well. Molekule I think is great. One thing I like about the molekule, it’s- looks nice, doesn’t it?

Evan Brand: It does look good. Yeah, I don’t know if you- I don’t know if you have a coupon code. Do you have a coupon for people ’cause if you don’t, I do.

Dr. Justin Marchegiani: Good. Why don’t you put your- let’s do this. If you’re listening here, Evan will put all the- the links and stuff below, if you’re listening to his, and then vice versa for mine. So we’ll put that in the show notes here too.

Evan Brand: Okay. We can save you lot of money. Air purifiers are not the cheapest thing in the world, but they are priceless, I mean, it’s one thing that I would not live in a house, eat, no matter how clean the building materials, I would not live in a house without air purification because-

Dr. Justin Marchegiani: 100%.

Evan Brand: -it’s just- it’s too important especially if you got your kids like Justin and I do.

Dr. Justin Marchegiani: Yup. Sup- super important. So now, we talked about some of the- you know, the causes there, we talked about the biochemistry and the physiology, we talked about some of the conventional things, right? It’s gonna be potential antibiotics, it’s gonna be antihistamines, it’s gonna be uh, immune suppressants, it could even be corticosteroids, or even prednisone if it’s really high, could even be to that degree. [crosstalk]

Evan Brand: Your ENT is not gonna discuss gluten, they’re likely not gonna discuss dairy. I’m sure there’s some out there that may but there probably few and far between. I’m guessing the guy right down the street’s probably not gonna say that to you. And it’s unfortunate, hopefully with podcasts like this, we can turn the tide around. And when you go into an ENT, the first thing you’re gonna say is, what’s your diet, do you eat dairy, uh how often do you eat grains, how much sleep do you have, uhm, do you have brand new carpet that’s off gassing formaldehyde, uh, do you have an air purifier in your bedroom, like, err- you know, hopefully the ENT visits will start to become like this.

Dr. Justin Marchegiani: Exactly. And it’s really hard to do that in the conventional insurance model for sure. [crosstalk]

Evan Brand: …6 minutes or something for an appointment?

Dr. Justin Marchegiani: I know, totally. And we talked about some of the natural compounds that we use, the quercetin, uhm, HCl, or some kind of acidifying agent like apple cider vinegar. We also like a lot of the beneficial probiotics which may be depending upon how sensitive you are as well. And we already talked about- one of the things I like is kidney glandular. Kidney glandular or kidney tissue has an enzyme called DAO, which actually helps metabolize histamine. So, that’s really good. We may do higher dose kidney glandular, get the DAO which will come in there and metabolize the histamine. If you’re sensitive, you may even talk about cutting histamines out, could be citrus, it could be grains, it could be aged meats like Evan talked about, it could even be teasing coffee as well ’cause those- those block the DAO enzyme from working. And we may just add in extra DAO enzyme to help metabolize the histamine as well.

Evan Brand: Yeah. I find low histamine diet help some people but once again, it’s gonna be and maybe the 10% or less-

Dr. Justin Marchegiani: Yup. Hmm-hmm, for sure. Yup. And that’s the thing, when we deal with patients through a functional medicine, you know, we have a lot of experience. So there’s a spectrum in which more patients fall than others, and it’s hard ’cause when people find stuff online, they don’t really have a contact to where they may fit into that category ’cause there an N equals 1. So it’s really important, we wanna plug it in based on our clinical experience which gets us a huge head start.

Evan Brand: Yup.

Dr. Justin Marchegiani: Well, I think we hit everything really good. I think we did really concise job, I think probably one of the more pod- the more concise podcast that’s out there on these topics. ‘Cause we want to make sure you understand the root biochemistry and understand the physiology. That way, you understand concepts, you’re not memorizing random facts.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Root cause information to stick.

Evan Brand: One last story and then we’ll wrap it up. So, I’ve had a major issue with histamine regarding avocados, I was eating avocados like every day, I start to get migraine and headaches from avocados, so I cut them out for 6 weeks while I was working on a gut protocol, and as soon as I fixed my gut, I added avocados back in, and I had no problem.

Dr. Justin Marchegiani: Yup.

Evan Brand: So, go to the nutritionist, then they’ll tell you, “Well, Justin, or Evan, it’s this food, it’s that food. These are the devil. Don’t ever eat avocado”. No, that wasn’t the root cause, the avocado wasn’t the problem, it was my body, I had too many gut infections and other problems creating excess histamine. The avocado just put me over the edge and caused the symptom. So I temporarily removed it, fixed the root cause and then I could add it back in and had no problems. So, you know, these people, they get stuck on a diet because they just went to a nutritionist who put them on like a low histamine diet, but then there’s no other follow-up, there’s nothing after that. It’s just here’s this very restrictive diet, you’re stuck with this forever, the end. And that’s not the way it should be.

Dr. Justin Marchegiani: 100%. Well, hey man, today was a great podcast, if you guys are enjoying it, we’re- we got it on Facebook as well, make sure you subscribe, hit the bell as well. Put comments below, wanna know what you think, wanna get some really good future podcasts ideas from y’all, and I’ll be back personally from my live YouTube Q&A’s later this week, so make sure you’re part of my channel, so you can access that phenomenal content, and make sure you head over to Evan sees patients all over the country as well, he has lots of phenomenal content even outside of the ones that Evan and I produced together. So make sure you subscribe to Evan’s podcast and YouTube channel as well. Evan, anything else you wanna say?

Evan Brand: Thanks for the plug man, and uh, check out justinhealth- justin, and then health,, that’s where you could reach out to him if you wanna do consults, and he has another doc on staff too. So if his availability is crazy, you need to be seen, we can get you in. So, just check out the site, you can find all the resources there.

Dr. Justin Marchegiani: And I look forward to having my book come out, and my thyroid masterclass comin’ out really soon. It’s so hard ’cause my first love to seeing patients and I have to kinda clear my schedule from some- for some patients during certain blocks to get this content out. So, I’m in this little pickle here, just try to finish it up, but it- it’s hard ’cause my first love is seeing patients. So, uhm, doing my best ya’ll, so keep an eye out for the thyroid reset book that’s coming your way along with the masterclass.

Evan Brand: Good job. Keep up the good work.

Dr. Justin Marchegiani: Hey, thanks Evan, you have a great day. We’ll talk soon everyone.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye now.

Evan Brand: Bye.


The Suppression of Inflammatory and Allergic Responses by a Pharmacologically Potent Fungus and Ganoderma Lucidum or Reishi Mushroom

Mast Cell Activation by Neil Nathan

Xlear Rescue Nasal Spray with Xylitol

Improving Gallbladder Function with Functional Medicine | Podcast #216

Digesting fat is so important for one’s hormone growth and for healthy cell membranes as every single cell has a lipid bilayer. If one wants to be a good fat burner on a ketogenic template, it is really important to have great gallbladder function.

In today’s podcast, Evan Brand and Dr. Justin Marchegiani talk about utilizing functional medicine principles and assessment to figure out how one’s gallbladder is doing. Listen as they talk about what can one do about it, the common gallbladder symptoms, root cause solutions, and how can one get better from these symptoms. Stay tuned for more!Evan Brand

Evan Brand

In this episode, we cover:

00:35    What is Gallbladder?

04:47    Consistency of Chewing Foods

08:16    Bile Surgeries

14:18    Autoimmune Issues that Affect Gallbladder

17:28    The 3 F’s of Gallbladder Issues

20:26    Some Advises if Your Gallbladder was Removed

26:32    Comprehensive Stool Test


Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani, welcome to today’s podcast. We’re gonna be talking about utilizing functional medicine principles and assessment to figure out how your gallbladder is doing. Also talking about what we can do about it, what are the gut- what are the common gallbladder symptoms, what are root cause solutions, and how we can get you better. We know, digesting fat is so important for your hormone growth, for healthy cell membranes. Every single cell has a lipid bilayer. And also, if you wanna be a good fat burner on a ketogenic template, it’s a really important we have great gallbladder function. So Evan, welcome to today’s podcast, man!

Evan Brand: Hey man, thanks for having me.

Dr. Justin Marchegiani: Awesome. Well, let’s dive in brother. I’m excited to- to dive in. So, first off, let’s just first dive in just to kinda physiology 101: what is the gallbladder? Why is it even so important? So, off the bat, gallbladder is kinda in this upper right quadrant here just beneath the rib cage, ‘kay? If it’s tender in that area like they’ll do a- a palpation that’s called Murphy sign, uhm, in that area where they’ll look for tender type of gallbladder issue where the gallbladder’s inflamed. But the gallbladder, it- it basically concentrates bile at about a 15 times above than the common hepatic bile duct in the liver wood. So when you’re having your gallbladder removed, that common hepatic bile duct up in the liver just drips bile all the time, it’s not specific, it’s not during a fatty meal, just kinda hits, and you can definitely have some bile acid diarrhea issues. When you have a gallbladder it concentrates that bile 15 times and then allows it to come out and time it, it- it squeezes, it contracts, and s- puts up that bile especially during a fatty meal ’cause you have these hormones in your stomach when that food- when that uhm, kind, that mixed up food in your stomach gets released into the small intestine. Uh, the nice acidity of that stimulates this uhm- neuropeptide called cholecystokinin or CCK for short. And that cause the- the gallbladder to contract and stimulate all these bile release which helps with fat digestion. If we don’t have a gallbladder, we’re not gonna be able to breakdown fat optimally through biliary concentration.

Evan Brand: Yup. So, you’re in to that fast, I’m just gonna repeat it so it gets into some people’s heads.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: So, you say, when your- you put food down the hatch, especially fat, it enters the digestive tract, the body says “Okay, boom. There’s fat in here now, I’m gonna start making CCK”, and that comes from your duodenal, and I believe the jejunal as well, and then- it- to respond to the CCK, then the gallbladder goes “Oop, CCK is in the neighborhood, now I’m gonna release my stored bile because we’ve got fats to take care of”. So then the bile, or they call gall, will start working on these fats and then turning those fats into usable fuel.

Dr. Justin Marchegiani: Yeah, think of emulsification is like you have a greasy pan, and you put a drop of like soap, right, like some- some dish soap like dawn dish soap, and it kinda breaks it up, it emulsifies it. Think of that’s what’s happening if you got this greasy pan in your stomach, which is all the fat in your stomach going into your small intestine, that emulsifies it and allows your body to break it down and absorb it. It goes in these little things that form uhm- a- uh- a- a- a micelle, and that allow it to get into your body and be able to utilize it. Now, going up one kind of marker is hydrochloric acid levels. This is even important, this is more important because hydrochloric acid stimulates, it lowers the pH, and a nice low pH triggers cholecystokinin. So, we also need good pH function, good hydrochloric acid function and then that then, in the small intestine really gets the bile going, and then we also have some enzymes in the pancreas called lipolytic enzymes, lipase enzymes that also help with the pacre- with the- with the gallbladder in the- in the bile digestive process.

Evan Brand: Well, you make a good point, ’cause when we jump into this conversation, if we’ll look at the whole digestive cascade, as a big row of dominos, when you get to CCK and you get to the gallbladder, you’re really talking 3 or 4 dominos down the list but it’s good that you went upstream first to the mouth, where that’s where you’re chewing your food – hopefully you’re chewing your food, you’re not rushing through your meal. That’s why I don’t like things like chipotle, I enjoy the food itself, but it’s all soft, it’s mushy, meat and rice and guacamole, and you can just shove it down the hatch and you really have to chew the stuff. So, if I eat a soft meal, I still try to be very condescend about chewing, chewing, chewing, chewing, tellin’ the digestive system, “Hey, something’s coming down the hit- down the hatch”, but, you make the point about HCL. It’s why it’s so important when we- uh, talking about gallbladder symptoms which we’re getting to in a minute, to look for, and to treat if you have them, H-Pylori, and other infections ’cause, if H-Pylori is reducing your HCL levels, well, you can’t go straight to the gallbladder. I mean, you- you can, you can take bile salts to help it, but you didn’t fix the root cause, it was H-Pylori.

Dr. Justin Marchegiani: Exactly. So, kinda highlighting, we went from the gallbladder. What’s happening at the gallbladder, upstream to HCL, and that- that also activates other enzymes in the stomach called pepsin, and also gets the pancreas producing lipolytic fat breaking down enzymes, and then proteolytic protein breaking down fat enzyme, it’s- it’s very rare that you just have fat by itself, typically fat, protein and cholesterol tend to come together. And then, up one stream above is the chewing part. We wanna make sure we’re chewing our food at least 32 times, that’s about one chew per tooth, right, you have 32 teeth, so think of 32 chews, 32 teeth. And in general, getting your food’s to like an oatmeal like consistency, like- if you’re having a food that’s kind of more predigested like a chipotle meal, you gotta just make sure you at least chew to that good oatmeal-like consistency, and try to be in a relatively stress-free environment because the parasympathetic nervous system is really important for HCL secretion, thus enzyme secretion, and thus, uhm- bile secretion because we need that nice acidity, we need the enzymes, we need the digestive secretion. And for a sympathetic state, all that blood flow is going out extremities, our arms and our feet to run, fight and flee. So, it’s very important that we have good parasympathetic, so good breathing, gratitude, being in a quiet kind of relaxed setting to start our digestive processes.

Evan Brand: You know, I was trying to find some research on this, I am just gonna guess based on the mechanisms we discussed, that people on acid blocking medications probably have more issues with gallbladder. Would that make sense, ’cause let’s say you don’t have H-Pylori infection but you’re on an acid-blocking drug, isn’t that gonna just down-regulate this whole process we’re talking about?

Dr. Justin Marchegiani: Yeah, we need good acidity to trigger that CCK. So, that totally makes sense, right? And then we need- to be able to break down god fats. What are good fats? Well, we have our mono unsaturated fats are gonna be things like olive oil, avocado oil, and then maybe even some nuts and seeds. We have more saturated fats which are gonna be animal products, right? Grass-fed beef, uhm- any of our like, you know, fish, chicken, beef stuff, you’re gonna have omega-3 fats which are on the polyunsaturated category. Omega-3 is more polyunsaturated, and then you also have your saturated coconut oil which I think is your only plant fat that’s saturated, maybe that and palm I think are the only 2 big saturated ones that are plant-based. So, we have our saturated fats, right? Coconut, plant-based fat- coconut, and animal-based fats. We have our mono-unsaturated which typically are gonna be uh- a lot of the olive oil, potentially avocado oil, we have our polyunsaturated, a lot of times which are fish, and then maybe some of the nuts and seeds kind of fit into that monounsaturated category omega-6 kind of category as well. And then we have our uhm- Vitamins-A, D, E and K, “ADEK”, these our fat-soluble vitamins. So if we don’t have good bile-support, we’re not gonna be able to break fat down by the minute which is really good for our uhm thyroid function, it’s good for our skin, right? Higher dose Vitamin-A is great for skin that’s why they use uhm- Accutane which is- is a Vitamin-A analog to shrink the oil cells on the skin, also great for our eyes. Vitamin-D obviously great for our immune system, we make it too from the sun. Vitamin-E is great for our heart, it’s a natural antioxidizing, great for inflammation. Vitamin-K is really good is found in butter fat. It helps get calcium into our bone, right? Vitamin-K2, consider activated- a- activated X by western price, really important nutrients. So, these fat-soluble vitamins, we really need good gallbladder function to absorb them.

Evan Brand: Yeah, and if you don’t have a gallbladder, we’ll get into that in a minute, you know, I was just looking up, uh- reading the bile, the surgeries that people get. When you get into the gallbladder world, gallbladder surgery is just such a huge, huge money maker and it’s done often times in cases where it didn’t have to be done. And I told you we need to get a lady on whose uh, got a specific website about protocols for people with gallstones to try to help give them relief and to save their gallbladder. But another surgery which is crazy to me is called fundo- fundoplication, and it’s what they do to relieve chronic acid reflux. The surgeon tries to recreate your lower esophageal sphincter, by taking the upper portion of your stomach and wrapping it around the lower part of your esophagus and sewing it into place.

Dr. Justin Marchegiani: Wow.

Evan Brand: That just seems insane to me, they call it anti reflux surgery. How many of those people, just have H-Pylori infections that were put on acid blockers, therefore that LAS, that lower esophageal sphincter wasn’t working properly, or maybe they had a mineral deficient or maybe it was a ___[09:18] issue and structurally, that could get adjusted, but instead, they go get their stomach wrapped around their esophagus and sewing together. That’s insane!

Dr. Justin Marchegiani: It really is, and that’s kinda what conventional medicine does. They can go to some extremes to fix things that in my opinion are much more foundational and much more simple. And most of the time I would say 99% of the time, the surgeries aren’t root cause, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: So if we look at the conventional side, we have things like a HIDA scan which is like a nuclear image, they swallow s- solution that’s nuclear, and uhm- they kind see kind of biliary function, right? You want typically a 33 to 40 percent kind of dejection fraction that’s normal, on the gallbladder. So, you can look at that with the HIDA scan, you can even look at, an ultrasound, uhm, to give you a window of the inflammation in the gallbladder. It’s not gonna give you how much uh, bile is flowing to the duct but at least give you- okay it- it- is there- is it stagnant, or just stuffed in there, is it inflamed. You can kind of get that sense as well. A lot of times they’ll do some conventional testing, ’cause if your gallbladder is inflamed, and there’s an immune response, you may see white blood cells uh- on the higher side, right? Uhm, you may also see certain liver enzymes, ALT is a common liver enzyme, AST is another enzyme that can be effective in the skeletal muscle, you can see GGT, think of the “G” in gallbladder, GGT is a big gallbladder enzyme. Bilirubin is a byproduct of red blood cell metabolism that comes out in the gallbladder. With high bilirubin, we may have some- some backed up gallbladder bile issues. And then a- also, I think alkaline phosphatase is another big one that we may see on the higher side. So, we’re gonna see bilirubin on the higher side, alkaline phosphatase on the higher side, and then we’re also gonna see potential HIDA scan issues, that can- those are- HIDA scans more like pathological.

Evan Brand: Yep.

Dr. Justin Marchegiani: There are a lot of people that are in between that may be okay on the ultrasound or maybe okay on the HIDA scan and we can use some of this functional test as well. Uhm, but really important we gotta dig to the root, underlying issue on what’s going on there. And again, AST is more skeletal muscle but there’s some crossover with the liver, ALT is more liver. Think of the “L” in ALT as liver and then the alkaline phosphatate is a big gallbladder one, also a big one for zinc. Alanine transferase or ALT, asphotate transferase, and then alkaline phosphatase for ALP.

Evan Brand: Well, the good thing is, a lot of the blood markers you just mentioned are pretty standard. So, even if you’re not working with the functional medicine practitioner like one of us, you may be able to get your doctor to just run these labs, refer back to this podcast and look and see if you have an elevation. Now, the only problem is, the conventional reference range for blood testing is very bad. So, you may be quote, “normal” by your doctored standards but our reference ranges maybe tighter. So if we start to seal your ALT or your AST enzymes go up, it may not be up enough to flagged. So, that’s why it takes a trained eye to look at these numbers and see, and we’ve seen it time and time again, we get somebody on gallbladder supplements their AST and ALT go down. So, it’s amazing to see, we gave this nutrient, “boom” look at the blood changing just based on this nutrients, it’s really cool. Let’s talk about symptoms now, I think we’ve given a good-

Dr. Justin Marchegiani: Yeah, just to highlight one thing, you just wanna get that CBC done at- which is a complete blood count, and then also a CMP – Comprehensive Metabloc Panel profile, and it’s important, you need to work with a good functional doc because you may be okay in a lot of these areas and you still may have issues, so now what, right? So you don’t wanna just rule it out ’cause some of these testing are good, you wanna look at subjective symptoms, connected to the anatomy, connected to how your stools look, right? If we have fatty stools, blond stools, excessive amount of wipes to clean out your- you know, to clean yourself after going number 2 or just, you get skin marks on the toilet seat, we’re probably not breaking down fat. And again, if you have too much MCT oil in the morning, that can also do a tube instead as a laxative effect. So, you gotta look at it the trend in general, clinical symptoms, subjective symptoms, and then lab symptoms to really make a complete picture of what’s going on.

Evan Brand: That’s a good point ’cause my AST and my ALT on my blood looked perfectly fine. But when I had parasite infections, I had that low right side pain under my rib cage where my gallbladder and liver are. Your gallbladder is kinda tucked in with your liver under there, so if you look down at yourself on your right side up where that rib cage, if you’re having pain there, when I had parasites, I had ton of pain there, my blood looked perfectly fine. So I don’t want, like you said, you don’t wanna give a- a false sense of hope just ’cause your blood looks okay. There may be other functional problems that you’ll find by looking at stool testing for example. But let’s hit- let’s hit-

Dr. Justin Marchegiani: Yes.

Evan Brand: -on these symptoms, because you mentioned some but we needed just go through symptoms here and tell people, “okay, what would you be experiencing?”.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: So, you mentioned, fatty, greasy stools-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: You mentioned it takes a lot of wipes to clean your butt, you mentioned the skid marks in the toilet which if everybody is going on a high-fed diet these days, sure, that may be okay but if you’ve got gallbladder problems to start and then you try to go on to ketogenic diet and you don’t feel well or you don’t lose weight and you’re complaining to your doctor, that may be the part of the problem is gallbladder.

Dr. Justin Marchegiani: 100%. Also, autoimmune issues can affect the gallbladder as well. Gluten’s a big one, it creates those condition called primary biliary- what’s that last?

Evan Brand: I think you call it cholangitis.

Dr. Justin Marchegiani: Yeah, primary biliary cholangitis. I mean, typically just “PBC” for short. But basically you can have some scla- scarring of this uhm- on the- the kind of biliary tubes that go out of the gallbladder, and as well as the- you know, the gut- the liver goes to the gallbladder, the gallbladder kind of comes out together with the pancreas and comes out the sphincter of oddi, or the hepato biliary kind of ampulla, and that- that can kind of scar and it can sclerose, it can kind of have uhm narrowing of the- of that vasculature. Of course, it can back up, and if that backs up, and those enzymes can’t get out you can have pancreatitis as well. But that’s an autoimmune condition where your body is attacking a lot of that tubing that goes up to the gallbladder and maybe even can help with the pancreas, and that can narrow and prevent a lot of that stuff from coming out. So of course, gluten is a big component because that can really activate a lot of au- autoimmunity and you can also have a leaky gut, you can also have a leaky gallbladder which does aggravates more autoimmune attack because things that shouldn’t be out in the bloodstream are out and that exacerbates the immune system going after it.

Evan Brand: Yeah, so let me just read a few sentences on these whole PBC thing ’cause I think this is critical. We know, even just this is just standard you know, medical textbook stuff that says “it’s the most common among women”. And we know that Hashimoto’s is more common in women and men. So it says here, “the cause is not clear but we know it’s more common in people with…” guess what, “…hashimoto’s thyroiditis”.

Dr. Justin Marchegiani: Yes.

Evan Brand: So, it says here, “An autoimmune cause is- is thought possible because more than 95% of people with PBC have certain abnormal antibodies in their blood. These antibodies attack mitochondria. What triggers these attack is unknown…”, of course they say that but it may be exposure to a virus or toxic substance A.K.A. ‘gluten’, maybe dairy, I mean, you and I talk so much auto about- about autoimmunity so I’m glad that your brought this up because, you know, these people may have these symptoms, and they’re not gonna know what’s autoimmune in nature, they may just get the- the knife and say, “Hey, we’ve gotta pull this gallbladder out”. Not necessarily, what if we can shut down this autoimmune attack?

Dr. Justin Marchegiani: 100%. Also, here’s the bigger issue too. Okay, great, the gallbladder is removed, your digestion is now forever altered. I’ve yet to meet a conventional patient of a gallbladder procedure, whether surgeons that “oh, by the way, you’re gonna have to add in HCl, pro- or- lipolytic enzymes and bile salts for the rest of your life”. I’ve never really heard that, at least bile salts seem to be added in. I would say HCl and enzymes too, but I’ve never heard someone do that. Now, your digestion is forever altered, do you think there’s a connection with now you’re not being to breakdown cholesterol optimally ’cause that’s gonna be in the bile, right? The bile is 97% water, then you have some cholesterol, and cholesterol salts as well, and you also have some toxins coming out, that’s why if you have uhm- poor, you know, gallbladder-emptying, then you’re not getting rid of potential toxins that are in there too. So, we gotta be emptying that gallbladder. If we’re not breaking down Vitamin A, D, E, and K, if we’re not breaking down our fat-soluble vitamins, which I just mentioned, if we’re not breaking down cholesterol which is the building block for all of our hormones, do you think we’re gonna have problems ladies, uh- as you get into your 40’s and 50’s, with menopausal issues, perimenopausal issues, PMS, and we know the main connection, it’s kind of a slang but, I’ve heard many uhm- let’s just say general surgeons say it, it’s the 3 ‘F’s’ of gallbladder issues: fat, female and forty. And that’s the time to- late 40’s, early 50’s where hormonal transitions happen, and if you can’t breakdown those nutrients, you are setup for a menopause uh- of “hell”, so to speak.

Evan Brand: Yeah, in terms of side-effects, possible side effects of gallbladder remover- removal, it could be anything from pancreatitis, to increased risk of choline cancer to increased digestive sy- symptoms like heartburn, could be constipation. So, we’ve seen people that- they don’t feel well, after they get the gallbladder removed. And uh, like you said, there’s no surgeon out there saying, “Hey, I’m gonna put you on this comprehensive digestive support protocol, after we remove it”, no, they’re gonna you out with anesthesia, cut that bad boy out, and send you home in a day or 2. Uh, there’s a- a whole lists symptoms here I’m looking at now, symptoms of- uh- symptoms after gallbladder removal. I’ve had women have gallbladder attacks, but they don’t have a gallbladder. You know, it’s like, “well, how the heck does that happen?”. So, you know, the- the- the removal is not the “cure all”. Anything from nausea to gas and bloating, distension, burping, belching, feelings of fullness, heartburn, barrett esophagus, diarrhea, dumping syndrome, weight gain. There’s a whole article here all about post gallbladder removal weight gain happening.

Dr. Justin Marchegiani: And part of the reason why women get targeted so much – I hate to say it – is the estrogen. The estrogen kind of makes things sluggish and slow, it kinda takes- it kinda makes it turn into molasses. So, things really are very sluggish, very viscous, and of course, that can affect gallbladder and bile flow. Women that are on, you know, uh, birth control pills, that’s gonna- in- obviously increase estrogen levels, obviously just being stressed, right? You’re gonna take your progesterone, you’re gonna shoot it downstream to cortisol, and that’s gonna basically cause estrogen dominance there because you’re already starting to lower progesterone in relationship to estrogen. You’re getting estrogen in the environment from the conventional meat products, uh, water, plastics, chemicals, hormones in the meats as well, and then you’re also gonna be just getting it, just from uhm- being a woman, having 10 times more estrogen than a man. So, you’re- you’re already predisposed, and then when you add stress to it, it’s going to exacerbate it uh, big times. So, you really wanna make sure that you’re fixing the- like if you’re having- if you know you have a gallbladder issue, you also need to be going after the- the hormonal issues as well. And then we can dive deeper into the food allergies stuff too, so you gotta go after the hormones, gotta make sure you fixed the estrogen dominance, you gotta make sure you fix the digestive aspects, and then we can go into foods later.

Evan Brand: Well, I’m sure there’s gonna be a ton of people that are just yelling at us right now through they’re podcast app or YouTube or wherever they’re listening to us, and they’re saying, “Well, this is not fair, I already have my gallbladder removed, so what the heck do I do now?”. So, do you wanna address that now or should we talk about that later?

Dr. Justin Marchegiani: Yeah, so, off the bat, the underlying mechanism that was driving that inflammation in the body’s still there. Just the end target, the end uh manifestation of it is removed, but now other tissues may start to, uh, have issues, then also if you don’t fix the underlying uhm, digestive im- impediment which is, your fat-soluble vitamins, your cholesterol, your hormone building blocks are now gonna be thwarted in their digestive processes. So, you have to fix that to prevent compounding hormonal issues, 10, 20, 30 years later, number 1. Uhm, and then so obviously this- so- err- if you’re- if you still have your gallbladder, we wanna keep it by doing a lot of the preventative things. But on the food side, I outlined this in a couple of my gallbladder videos are down in the past. But there’s some common foods that are even uhm- let’s just say paleo-approved, but should probably be looked at- look at removing. So, of course we have the refined sugar in the guts. That’s kind of a no-brainer right here. But, uhm, in order of kind of like uhm, the most likely offender are gonna be eggs.

Evan Brand: Yes.

Dr. Justin Marchegiani: So definitely autoimmune template, cut out the eggs, pork, onions, chicken turkey, milk, coffee, corns, beans, nuts, apples, tomatoes, peas, cabbage, spices, peanuts, fish, rye. I’m gonna link my article that goes into this. So, everyone’s probably like, “Say it again!”, no, I’ll put the link below, don’t worry, take a look at the article, alright? But, I have them in most likely to offend to least. So, if you’re overwhelmed after hearing that like, “What the hell am I gonna eat?”. Just start with the biggest 3 or 5, or look at that list and say, “What are the biggest 3 or 5 that I eat on a daily or weekly basis” and just pull that out. Once we get the inflammation under control, we support HCl, we support enzymes, we support bile salt production, we look at the gut ’cause sometimes there can be infections like H-Pylori and giardia, and of course SIBO in and around that ___[22:31] that can exacerbate everything too. So, we get the infections clear, if we get the acidity and the enzymes dialed in, if we cut out some of the common offending foods, we may be able to start adding some of these foods in overtime. But I find pork’s a big one, eggs are a big one, those are like my- my 2 biggest right there off the bat, and they’re kind of paleo-friendly too.

Evan Brand: Yeah, eggs are huge and people over-eat them and, if you have gallbladder issues, uh- when I interviewed Ann Louise Gittleman, she said the same thing, she said eggs are the biggest offender. I’m like, “Wow, I thought that was just me”, no, it’s- it’s a real thing, and then also onion. I think she said onion are ready-

Dr. Justin Marchegiani: Yes.

Evan Brand: But that was- that was a problem for me when I  had parasites and I would try to do like stir or fry and throw some onion in there, I’d end up with that lower right side stomach pain, I’m like, “What the heck is it”, or if it was I had parasite infections but, the other- the other part of it was the onion. So, yeah, I at least temporarily, like you said going on an autoimmune protocol while you’re working with your practitioner to fix the other underlying causes, you’re gonna be in good shape if you do that.

Dr. Justin Marchegiani: Onions are also a ___[23:28] too. So there could be some underlying SIBO or small intestinal bacterial overgrowth going on as well. So, you gotta look deeper at everything. So, kinda like piggy-backing everything, alright? Women are gonna be the- more bigger offenders ’cause of the hormones, because of the- you know, the pregnancy prevention with the birth-control pill, so you have that, right? So we gotta fix the hormones, fix the hormones, number 2, cut out the foods, at least paleo to autoimmune paleo with those additional 3 to 5 to 8 foods I just mentioned. Get enzymes dialed in, get acids dialed in, and definitely bile salts added in, and if you already had your gallbladder removed, definitely do all 3, and those that up and watch your stools and make sure your stools go floating to sinking, right? Oil and water mix, so if you had the stool, with the whole bunch of undigested fat, and oil and water mix, the stools stay on top of the water, they don’t sink. So, you wanna see the stools sink, and ideally you wanna be able to clean yourself, you know, 3 to 5 wipes on average, and you wanna make sure when you flush, you’re not seeing big skid marks all the time. If you’re doing some MCT oil in your coffee there may be some issues there, too much of that can cause some undigested MCT, so be mindful of that. So, foods, acid, enzyme, bile salts, get the infections cleared, and if you’re a woman, get the estrogen dominance fixed, get the hormones balanced.

Evan Brand: Yup, and, how can you do that from a testing perspective, we mentioned the blood, but I’ll just throw a few other components of this in. Number 1 is the stool test, so we’re always gonna be running a PCR stool panel, or gonna be looking for all this. As you mentioned, we’re gonna look at H-Pylori, we’re gonna look for giardia, we’re gonna look for cryptosporidium, blastocystis hominis, there’s a ton of different bugs, there’s worms, there’s parasites, there’s bacterial overgrowth we look at, there’s candida that we look at, that’s all done with the combination of  stool and urine testing. And on the stool, there’s a couple markers that we can track, obviously, you looking in the toilet is gonna be the best way to track. Well, we like numbers, you know, Justin and I like data. So, when we look at steatocrit, which is a fecal fat marker that usually is expressed as a percentage. I like to see it, you know, 10% or below, we’ll see some clients, they’re 30, 35, 40 percent steatocrit, that means they’re not digesting their fats at all, and they while I’m doing a ketogenic diet and I feel like crap, it’s ’cause they’re not digesting anything.

Dr. Justin Marchegiani: That’s it.

Evan Brand: So, we gotta get that steatocrit down, and how you do that, well, one, clear the bugs too, supplement, and then, what was the other part of my brain? The blood, we talked about the blood, we talked about the stool, oh, the beta glucuronidase. So, beta glucuronidase at enzyme on the stool test we look at, that enzyme gets messed up due to bacterial overgrowth. When we see the enzyme is high, that’s when the estrogen dominance probably becomes more problem- problematic because now, they’re re-circulating the hormones. So, we do some like a calcium d-glucarate or a DIM, or something else, maybe a broccoli seed extract to try to get, or could be probiotics, could just be clearing bugs, taking care of the SIBO, the glucuronidase goes back down, and now all these quote, “estrogen-dominance symptoms” just disappear, and it’s really fun to see that.

Dr. Justin Marchegiani: 100%. So, kinda highlighting the test again, look at your symptoms, if you have pain in the upper right quadrant, under the rib cage, if you have problems breaking down fat, if you’re seeing a lot of your fat, your stool sinking or floating on top, not sinking. If we run a ho- comprehensive stool test and we see a lot of uhm, steatocrit, undigested stool, we see that greater than 10 or 15, whatever that lab marker is right in that area, we got problems, and then we gotta dig in deeper, and this could be the reason why you have hormonal issues too so we have to highlight that. Is there anything else in this topic Evan that you wanna go into that we haven’t gone in deep enough?

Evan Brand: I don’t think so, I would just tell people that if you feel discouraged, or, you know, you’re facing surgical removal of your gallbladder, I’m not saying the gallbladder can always be saved. I have a friend of mine, she’s in her late 50’s, maybe early 60’s at this point, and she was having major, major gallbladder pain, and I told her about taking digestive enzymes, but the pain just continue to grow. So, you know, I said hey, you might have to, you know, go to a doctor and get this checked out. This is very recent, so she did. And her gallbladder function was basically nothing, and she went in and she had to get surgical removal and because of with so much inflamed tissue around her gallbladder they couldn’t do the- the- the uh, laparoscopy, where they just give you a small- a small uh surgical side, they had to really cut her open like 6 to 8 inches, they hadn’t take out the gallbladder, and the surgeon told her, that her gallbladder was so heavy, full of stones that it felt like a concrete block. He said there was no way you were gonna save this gallbladder. So, I think there is a point of no return, where surgical removal does happen, we’re not shaming anybody or making fun of anybody if you got your gallbladder removed, that sucks, like she had to get it out, there was no turning back. And now, you know, she’s got tubes coming out of her stomach to drain her bile until she recovers from the surgery. So, obviously, that’s an extreme case but man, uh, you know, it can- it can get to a point where surgery is the only option but we’re just trying to help you before you get to that point.

Dr. Justin Marchegiani: Yeah, so if we don’t have enough, if you don’t eat good fats, then we don’t have good gallbladder flow, then, what happens is, it’s like not changing the oil. A lot of that bile uhm, and that cholesterol can crystalize. And then overtime those crystals can- can produce more and more crystals. And then imagine these little crystals that are like- a little mini or- miniature-like porcupines. And imagine that gallbladder contracting, it’s like giving a- a big porcupine a nice hug, right? Probably not the best thing. So, that can create a lot of inflammation, and the more little porcupine you’re having your gallbladder, the bigger issue every time you have fat that contracts. And then also, we can have potential pancreatitis because of it ’cause those gallstones can eventually produce, can block the bile flow, and that can stop pancreatic enzymes from flowing into the small intestines. So, that can create more inflammation. So, the more this thing, err- there’s more of this issue, the underlying cause goes unaddressed, the more the inflammation accumulates, accumulates, accumulates, accumulates, there may be a drastic solution of cutting out the gallbladder. Now, I would say, the vast majority of the time, it can be saved. We have to make the food changes, uhm, we also do a lot of gallbladder bile support, we’ll also use things like phosphatidylcholine, we’ll do beet root powder, we’ll do taurine, we’ll do dandelion, we’ll do artichoke, French trees, or herbs that’re designed to help to help one thin out bile flow, they can smooth out the little crystals, so imagine like kinda coming in there and smoothing out all the little porcupine barbs. Uh, that way they aren’t as sharp, and then we can be very careful with our fat consumption, maybe we do the tiniest amount possible. A lot of the coconut fats are easier to process and digest. So, maybe we’ll do more coconut fat, we’ll just do- just the- the largest amount of fat we can handle without issues, we up the enzymes, we up the bile salts, and then we give a lot of those herbs to smooth out the bile flow, thin out the bile, and smooth down the crystals. We’ll even do some- some like extra phosphorus drops to even thin out the bile uhm stones as well.

Evan Brand: Yeah, I do beet powder every day. You know, part of that for my circulation issues dues to all the mold in my body, so- so the beet powder’s been really helping. But, you know, back to my friend, you know, she was, she’s a woman, she’s over age 40, she does have excess weight, you know, she is overweight, she is very sedentary, uh, she did have some familiar health issues as well, you know, any- any family history of uhm- diabetes, other type issues like that can- can increase the risk of gallstones which then increase the risk of these problems, so, if you were to take all of the things you don’t wanna be sedentary, you know, overweight, uh, etc., poor diet, she had all those things against her. So, I’m not gonna- I’m not saying that everyone’s gonna end up like that with her case which is extreme but, you know, I just wanted to point out, hey, sometimes there may need to be a surgical removal. But, we just- we wanna try to prevent that. Statistics I found say there is about uh- 3 quarters of a million surgeries every year for gallbladders.

Dr. Justin Marchegiani: Exactly. Then we kinda talked about, our women- right- our- our fat, 40 and female. The big issue is, estrogen is a big uhm cause of kind of making the- the gall uhm, making the bile more sludgy, so is insulin. So, insulin is also another stimulating factor, this is part about I think where the fat comes in there, because the more weight you have typically is more insulin-resistance, insulin’s that hormone that sticks sugar into the cell, converts it to fat, so if you have more insulin, that’s a greater likelihood of making the bile flow more sludgy. So, if you have high levels of insulin, that’s gonna slow up the bile flow, and then if we have uhm, high levels of estrogen or just estrogen dominance, that’s gonna sludge up the bile flow as well.

Evan Brand: Yup. I’m sure we could keep going on this topic all day but, we should probably wrap it up. Reach out if you do need help, you can go to, and Justin’s summit is coming up very-very darn soon. So, I don’t know when you’re listening to this, if you listen to it in the future, and you already missed out, well, you can purchase his summit, but if you’re listening to it ahead of time, his summit is going live very soon, in two weeks at the first week of March. So, go to Go register for Justin’s event, it’s gonna be awesome, I interviewed him, which I thought was probably one of the best interviews possible, and interviewed me, and I talked about some other stuff that he hadn’t talked about. So make sure-

Dr. Justin Marchegiani: [Crosstalk] …interviews too.

Evan Brand: Thank you, thank you [crosstalk].

Dr. Justin Marchegiani: …for sure.

Evan Brand: So, so go register, uh, it’s- it’s gonna be probably one of the biggest events of the year called Thyroid Reset Summit. So,, go check it out and to run through health talks which is like the apple of summits, they do a great job of putting things on, and there’s, I don’t know what, 30 other experts on there. So-

Dr. Justin Marchegiani: 30 great experts. And also, I’m giving way the first uh- 3 to 4 chapters of my new book coming out, the thyroid reset. That book will be coming out in the next uh, few months here, so, get your free intro copy and then I really appreciate you guys picking up the book as well. Get me up there on the Amazon ranking so we can help more people, I appreciate it. And also, just to finish with this uh, article, here, the uhm conclusion, very important here for gallbladder issues, just to tight home, repeat yourselves a lot because repetitions some other skill, here’s the conclusion, insulin resistance is a risk factor for the incidence of gallbladder sludge and stones during pregnancy and after. And then it says insulin resistance may represent a causal link between obesity, overweight and gallstones. So our big mechanisms here, just kind of- f- coming in full summaries, if you missed the whole entire podcast, if you get this one thing, you got it. High levels of insulin, increased gallbladder sludge. High levels of estrogen, or estrogen-dominance, increased gallbladder sludge. Inflammatory foods, right, that drive insulin and inflammatory foods that are paleo friendly like, pork, like onions, like eggs, like coffee, maybe an issue, and then of course the low HCl levels, uhm, the low-fat diet, uh, all of those things and eating in the stressed out environment, those are gonna be your big 3 or 4, then also infections, giardia, gluten-sensitivity, SIBO, all of those things are gonna drive, probably the big 5 factors. Infections, insulin, estrogen dominance, low HCl enzymes, and then hidden food allergens. Those are your big 5 factors of this gallbladder issue here.

Evan Brand: Yeah, well said. And I love my friend to death but my wife and I were driving in the parking lot the other day, and she’s- and- and then we see our friend who just got her gallbladder taken out, and she’s sitting in the Taco Bell Drive Thru, and I’m just like, “No, that’s exactly what got you in this problem in the first place”. So, the diet is so critical, you can’t skip it.

Dr. Justin Marchegiani: Hundred percent, excellent. And for anyone enjoying this, I’m gonna do another live Q&A here tonight, this at- you know, the very end of the day, probably around 5, 6 o’clock here central time. Make sure you subscribe to the YouTube channel, we do a lot of live Q&A. So, go to If you’re listening to the channel now, make sure you hit that bell, that gives you the notification. So, if you’re on your phone, it’ll pop-up as it ___[35:35] doing a live chat. Even if you’re not around for it, just your little- little question in. So, we do a live Q&A, it’s op-in question, if there’s a topic, keep your question to that topic, if it’s a podcast, we may or may not get to questions ’cause we kinda get in our flow state and uhm, we may just be really focused on our conversation.

Evan Brand: Take care.

Dr. Justin Marchegiani: Hey Evan, you have a good one, take care.

Evan Brand: You too, bye.

Dr. Justin Marchegiani: Bye everyone.




Healing Properties of Reishi, Maitake, and Turkey Tail

By Dr. Justin Marchegiani

When you think of mushrooms, you might think of something you eat. Perhaps you think back to childhood, being told not to touch mushrooms growing outside, as they might be poisonous. You might even think of mushrooms as a drug. Mushrooms can be any and all of these things, but the most fulfilling role of a mushroom might just be the function that it serves as medicine!

History of Mycology

Medicinal mushrooms have been used for centuries for their health-promoting properties. A 4,000-year-old mummy of a Neolithic man was found with Piptoporus betulinus in his medicine kit, a mushroom used for its antibiotic and antiparasitic properties! Both the Egyptians and the Aztecs declared mushrooms the sons of the gods and the flesh of the gods, a plant of immortality. Due to the global presence of mushrooms and their long history of usage, scientists in recent days have begun to study mushrooms in more detail, which has proven our ancestors correct!

Reishi Mushroom

Reishi has been extensively researched for its anti-cancer properties. Reishi, also known as, Ganoderma Lucidum, is the most popular mushroom among Chinese traditional medicinal herbs. The Chinese have been using Reishi for therapeutic treatments for over 2,000 years.

In Asia, people widely use reishi mushroom for cancer and immune-stimulating prescriptions. Reishi is actually one of the highest respected herbal medicines in Asia! Additionally, this mushroom has anti-inflammatory, anti-allergic, anti-viral, antibacterial and antioxidant properties. More benefits of Reishi include:

  •    Inhibits cancer cells from reproducing
  •    Anti-tumor
  •    Reduces the side-effects of radio and chemotherapy.
  •    Stimulates appetite in cancer patients
  •    Lowers cholesterol and enhances metabolism
  •    Purifies blood, hence detoxifies the body resulting in revitalized cells
  •    Improves liver functions and removes free radicals
  •    Dissolves thrombosis: stroke and heart attack prevention
  •    Normalizes polysaccharide and triterpenoids immunity
  •    Enhances the elasticity of blood vessels
  •    Builds up immunity resulting in stronger antibodies

Benefits of Maitake:  

Maitake, also known as Grifola frondosa, is another top-rated mushroom which possesses brilliant natural healing properties. Maitake is a giant mushroom which grows in clusters at the trunk of dead hardwood trees, especially oaks. It can be found growing in the northeastern and Mid-Atlantic states, eastern Canada, Japan, China, and Europe. Though mushrooms are light in weight, some specimens of this mushroom can weigh over fifty pounds!

Maitake is a delicious mushroom which you can consume in multiple ways. It can be added to soups and stews, or drink as a relaxing tea. Maitake is amongst the best solutions for vibrant health and longevity, a true blessing from nature. Some top benefits of this medicinal mushroom include:

  •    Enhances the immune system
  •    Acts as a fantastic anti-tumor
  •    Regulates blood pressure
  •    Helpful in controlling diabetes and cholesterol
  •    Monitors the level of triglycerides
  •    Aids in weight loss
  •    Treats chronic fatigue syndrome

Click here to work with a functional medicine doctor to learn how mushrooms can help you optimize your health!

Turkey Tail

Turkey Tail, or Trametes Versicolor, is an incredibly common mushroom which is native to forests all around the world. This colorful species is generally found growing on logs and tree branches. Aptly named, turkey tail is a fan-like shape, with many layers and rings of striking and contrasting color ranging from tan to blue, cream, and even red, with an appearance similar to the tail of a wild turkey. In fact, the cloud-like image of this mushroom symbolizes longevity, health, and infinity.

Turkey tail is used all around the world for its many wonderful health benefits, which include:

  • Boosts Immune System: Turkey tail acts as a marvelous ally in revitalizing weakened immune systems and assisting the body with fighting off foreign invaders, from HIV infections to the common cold.
  • Protects Against Cancer
    • Possesses Antioxidant Activity: Turkey tail is rich in antioxidants, which slow down the processes of cellular oxidation, making it a great natural supplement for anti-aging and anti-inflammatory properties.
  • Heals the Digestive Tract
  • Possesses Astounding Detox Potential: Turkey tail boosts the liver and provides many detoxification benefits.


Mushrooms have been used for thousands of years all over the world. Mushrooms are a part of a very complex kingdom; they can be poisonous or delicious, intoxicating or healing. By learning more about these three superpower mushrooms, you can join the billions of people who have benefitted from these time-tested natural medicines.

Click here to work with a functional medicine doctor to get to the root problem of your health concerns!

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