Ketosis and Safe Natural Sweeteners | Podcast #210

If you’ve exceeded the pleasure that you’re getting out of pizza, cake, wine and everything else, diets may not just be suitable, as they are temporary.  In order to get that lasting change, you really need to engage in a lifestyle shift.

In today’s podcast, Dr. J. invites Thom King to share his experience and insights that led to his writing of the book “Guy Gone Keto”. Watch as they tackle about the effects of sugar to our body, safe and natural sweeteners, how meat have more nutrition than vegetables and all other good things. Sharing is caring!

Thom King

In this episode, we cover:

00:41    The Springboard of Discipline: Engaging in a Lifestyle Shift

08:23    Healthy Sweeteners

10:56    Effects of Sugar Intake Frequency to Insulin or Blood Sugar

16:57    Allulose, Stevia and Monk Fruit

21:17    Sugar Alcohols

23:04    Benefits of Ketogenic Diet on Thyroid

48:15    Metformin

33:46    Importance of Journaling


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani, welcome back to the podcast. We have Thom King here in the house. He is the author of the book, “Guy Gone Keto”. We’re gonna dive in to some ketosis topics today, we’re gonna talk about natural sweeteners that we can incorporate in. Uh- they aren’t gonna affect our blood sugars much, and we’re gonna just– what– whatever else may come about but, Thom, welcome to the podcast.

Thom King: Dr. J., such pleasure being on here. Thank you for having me and uh– this is truly an honor.

Dr. Justin Marchegiani: Well thank you so much. So, let’s just dive in a little bit and just talk about your book. What inspired you to write this book, “Guy Gone Keto” and– and what are the top 2 or 3 things that you’re hoping for the readers to– to pull out of it?

Thom King: Uhm– well the book was a– the book kind of draw organically so, I had, you know, I– I own a– a food manufacturing business and a– ingredients supply company. And we supply sweeteners to sports nutrition companies, I love those companies, uhm– actually supply and manufacture ketogenic-friendly foods. So, I was in Vegas for trade show and went out with uh– with a customer. And they bought dinner and I way overdid it as usual. Uhm– went back to my room with a– beautiful luxer, and– could not stand to look at myself in the mirror. I was 35 lbs. overweight, I– my blood pressure was like 190/99 and I– I felt like a tremendously huge fraud because I’m catering to the– to that particular industry and not following at all so, at that point, sort of the pai– the pain of my, I guess dishonesty, the pain of my, you know carrying extra weight and being sluggish, and not following any type of discipline, I’ve exceeded the pleasure that I was getting out eating the pizzas and the cake and the wine and everything else, so at that point, I’m like, “Look, I need to make a lifestyle change”, so I really started doing a lot of journaling. And I was doing data collection on my weight, my blood pressure, temperature, I mean, all of the data points that I could find. And– err– and also like, use it as a springboard for discipline, so after about a 6 to 8 months period, I basically had a book on my hand. So, I just took it to it to an editor and, we added a day and it’s really– it’s more about my journey–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –on making a lifestyle change than it is keto. And, so the take home, I would say for your listeners on this, uhm– the points that I wanted to– I– I guess bring up in the book are– it– you can’t actually have a diet like, diets are really temporary–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –solutions.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: In order to get lasting change, you really need to engage in a– in a lifestyle shift.

Dr. Justin Marchegiani: Mm-hmm, mm-hmm.

Thom King: Uhm that’s one thing, and then the second thing is, why does it take to– to make a lifestyle shift and what are those– what are the components of the discipline uhm, you know, that’s required.

Dr. Justin Marchegiani: Very good points. Yeah, I mean, when I work with patients personally, we’re always talking about what’s the template, right? The template kind of gives us the flex– flexibility with our macronutrients, uh– some people may not need a– a keto template. I think most, tend to go better with a– you know a lower carb kind of paleo template so to speak. And typically, when your carbs get low enough your start spitting ketone as an alternative fuel source. And then, there you go, you have the keto diet is kind of off of that so we can adjust macronutrients in– in a bunch of different ways. But I think the commonality that needs to be present in all diet or lifestyle shift is where you need high amount of nu– nutritional density. Lot of nutrients per bite, we need an anti-inflammatory diet, right? Not with the junky omega-6 uhm– fats and the trans fats, and a high sugar stuff, and then we also need low-toxicity organic, you know, low hormones, all those good things. Any thoughts in that?

Thom King: Yeah, a lot– a lot is the definitely coming up for me. Uhm– and so, when you know, when you’re working with your patients, and– you know, you’re [clears throat]– when you say dense micronutrients, I mean, are you referring to– like more– like I would say, uh– like carbohydrates or vegetables, leafy greens, preciferous vegetables, you know, that– you know that have like those micronutrients, and then also you know, the– the fiber. Is that the– is that what you’re talking about in–

Dr. Justin Marchegiani: Yeah.

Thom King: –this nutrition?

Dr. Justin Marchegiani: Yeah, yeah. Absolutely, so, of course like, uhm– vegetables, bone broth, uh– organ meats are incredibly nutrient-dense. If we really look at a lot of the nutrient-density– you know scales that are– that are more out there today, they kind of favor a lot more of the vegetables. But when you’re really lo– and– and they also hinder. They have a negative impact for salts and saturated fat which isn’t really fair because that kind of negates the nutrients that are actually found in an animal products. But once you kind of control for the sodium and for the saturated fat, and you just look at the nutrient, you’d be surprised at how much nutrition’s in like, bacon, or high quality uhm– meat, especially organ meats. It’s pretty insane. Uhm– if you look at the amount of– let’s just say, uhm– nutrition that’s in like, 8 ounces of grass fed meat, you’d had to have 15 cups of kale to equal it. So yeah. So–

Thom King: Wow.

Dr. Justin Marchegiani: –we’re looking at the vegetables, we’re looking at the high quality uh– meats, and even organ meats to a possible, ’cause those are super nutrient-dense.

Thom King: Right. And so, you also mentioned like, anti-inflammatory, like properties of particular food? And, so, I found in uh– you know, in– in a ketogenic lifestyle, particularly uhm– you know, with me, it’s that I’ve been giving a lot of my– I guess fats– some of my fats, put a lot of my proteins from dairy. [Clears throat] you know, whey protein, KCN, and– and stuff like that. What– what are your thoughts on– on dairy and inflammation?

Dr. Justin Marchegiani: Well I think, whey proteins are one of these proteins that tends to be– it’s lowering KC in about 99% KC free and also 99% lactose-free. So most of the negative effects that you’re gonna see in dairy are gonna be in KC and they’re gonna be in lactose, right? You hear lactose intolerance, people can’t break it down. They get bloaty or gassy.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And then KC tends to be the more inflammatory component. So, when you do whey protein, you don’t like get that. Whey proteins are great– are great precursor to glutathione which is just like awesome master antioxidant because the amino acids are so– uhm sulfur-rich. And uhm– you know, I think there’s a lot of like, what’s tonight price talked about, you know, activator X, which is just Vitamin-K2, it’s commonly found in ghee or grass fed butter. So, I think if you’re doing like, those good he– healthy, higher quality dairy thing is better. I think some people tolerate, you know, the milk and the cheese, better is well, especially if it’s raw, unpasteurized, those kind of things. I don’t even do well with that, I get bloaty and gassy. So, I think it’s really individual but if you’re gonna do the dairy, it– you know, you wanna make sure it’s raw, unpasteurized. But I think the– the butter and the ghee tend to be awesome, really good.

Thom King: Interesting. And do you find– do you find that fermented dairy is easier to tolerate?

Dr. Justin Marchegiani: Well I think fermented dairy is gonna be better. But just because you want, you’re gonna have more B-Vitamins and– and more vitamin-K2 and such. I– it just tends to be have more enzymes. Those enzymes are gonna help with the processing of lactose, processing of the KCN. So just kinda like, predigest it a lot for you. So, they– and that’s kind of a benefit, but when I’m dealing with patients like, I’m cutting dairy out initially, but then that’s one of the first things we’ll have back in are gonna be like ghee and then butter. And ghee is just like a more clarified, filtered-out butter. It’s just les K– less KCN, less lactose.

Thom King: Interesting. And then so, don’t you need– you need Vitamin-K2 in order to– to be able to absorb Vitamin– uh– Vitamin-D3, right? Is that right?

Dr. Justin Marchegiani: Yeah but, connect the D3 and then A and then– uhm– Vitamin-K2 is really important. It kind of help escort the calcium into the bone. So, we wanna have healthy, strong bones as well. And then on that note I wanted to highlight uhm– ’cause you’re in– in the– in the sweetener industry, and I know that, you’re kind of like, you’re looking at things like stevia–

Thom King: Right.

Dr. Justin Marchegiani: And you– yeah monk fruit which are really interesting, and I’ve seen a lot of uhm– different videos where people are testing their blood sugar and I’ve seen it not actually go up, I’ve seen it actually drop a bit. What’s been your experience with kind of a healthier sweeteners that are out there?

Thom King: Well, so, I’m like huge on that a collection. And so, part of that data collection is I pull blood continually so–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: I’m trying to see where my blood sugar levels are, I’m trying to see where my ketone levels are. So, and– and plus, since I provide ingredients, you know, to food manufacturers, I always make sure that I’m testing you know some of our sweetening systems and even the compounds we carry on myself. So, like I feel confident when I go in the lab but, you know, that what I’m– what’s going out to the consumer is, you know, is– uh– you know, is healthy or at least they’ve he– healthier options. So–

Dr. Justin Marchegiani: Right.

Thom King: –I’ve– what I’ve done is I’ve– I’ve pull blood sugar, you know, after consuming Aspartame and–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –I’ve pull blood sugar after consuming uh– Sucralose. Uhm– I blood– pull blood sugar levels with stevia and monk fruit. And I’ve found that stevia and monk fruit don’t affect my blood sugar levels whatsoever–

Dr. Justin Marchegiani: Yeah.

Thom King: However, like Aspartame and Sucralose does. And I’m not sure if it’s because of the uh– like dextrose or maltodextrin that they use to, you know–

Dr. Justin Marchegiani: Yes.

Thom King: –to– you know to– to cut it. Or uhm– another theory that I had and I think that this might not be too far off is that, your body– you know, your body recognizes things that are– exist in nature. And you have the ability to metabolize those particular things are recognizes it. And I think when you put something that’s been chemically manufactured like sucralose which is a– chlorinated sugar molecule, uhm– you know, or– or Aspartame which is a modified phenylalanine. You know–

Dr. Justin Marchegiani: Yes.

Thom King: –your body doesn’t recognize those. You know, it’s like, “Hey, this is super sweet, why do I do with this? I don’t know what it is”. So, you do get the– you do get the benefit of calorie abatement. Uhm– but the downside is that your body doesn’t really recognize it and you– it– what’s it say– uh– insulin response. Uh– what the– what are your thoughts on that?

Dr. Justin Marchegiani: Well, I think I’ve seen some of the same date. I’ve known some of the functional medicine docs that have done like, you know, they– on their YouTube page. They said, “Hey, you know, let’s– everyone, let’s a study and let’s test your blood sugar, you know, fasting 1 hour, 2 hours, 3 hours. Let’s compare regular meal then let’s add a little bit of stevia to your coffee or to whatever that drink is, mo– and then monk fruit”. And I’ve seen, you know, it’s not a scientific study, but you know, these studies cost millions of dollar to do–

Thom King: Right.

Dr. Justin Marchegiani: –in a formal setting, so I think this is– this is even better because it is instantaneous.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And I’ve seen people test their blood sugar and then they post their data really showing it didn’t go up, if not, dropped.

Thom King: Hmm…

Dr. Justin Marchegiani: And my– my big concern is I think it’s– I think it’s a viable alternative, and it’s something that I use sparingly.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: The question is, is there like a dose-dependency where you frequently added so much, or maybe there starts to becoming a problem because you are telling your brain sweet. Now in punctuated periods, you know, 20% of the time, 10% of the time, it’s probably okay– do you find if it’s– if it’s frequent all the time that you’re starting to increase insulin or your blood sugar may go up over a longer period of time?

Thom King: Uhm I have not found that to be the case with myself. So–

Dr. Justin Marchegiani: Okay.

Thom King: I actually use bo– uh– we have a proprietary sweetener called KetoseSweet– uh KetoseSweet+. And it’s actually a blend of allulose, uhm– stevia and monk fruit.

Dr. Justin Marchegiani: Allulose is that new sugar alcohol I’m seeing? Couple places do. I wanna hear on that later on. I’ll– I’ll plant the seed now, we’ll– we’ll come back to that. That’s great.

Thom King: Perfect. That’s– that’s ___[12:00] sweeteners, so, you know, and I– wha– I’d noticed this over the past few years, you know when I really, you know, became a– committed to leading a ketogenic lifestyle, that my– uhm– my desire for sweets actually went down quite a bit, and foods that I would normally have eaten before, uh– you know, before I– I started keto, uhm– just don’t– they taste way too sweet to me. Like some of the bars that I used to eat, super sweet. So, I think that your palette shifts uhm– you know when you engage a– uh– a keto diet and you don’t–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –have the desire to– to have the– you know–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –have stevia or monk fruit. As far as like dosage levels go, uhm– I mean, we’ve got scientific papers that we use in conjunction with you know, with a formulation, and we– err– generally suggest that people stay under 5 to 10 grams of– of stevia or monk fruit, uhm on a daily basis. Uhm– and that is a lot– that’s a lot of stevia and a lot of monk fruit. But–

Dr. Justin Marchegiani: Totally.

Thom King: But– you know, at that point ’cause I’ve dosed myself to that level and I’ve dosed myself to a hundred grams of erythritol, I’ve dosed myself to a hundred grams of uh– uh– allulose and so, I mean, I’ve tested blood sugar levels and– you know, also, you know jotted down notes on– uh– you know, like GI effect, because if you have too many like alcohol sugars, it can definitely cause bloating cramping, diarrhea, uhm– which you know, nobody wants.

Dr. Justin Marchegiani: No, that totally make sense. And I’m just curious, so, I like to also see– I’ve seen that as wll with the blood sugars not going up. I really like to see what fasting insulin’s doing. Is insulin for– potentially compensating at any level at all? Is insulin rising even though blood sugar’s dropping? Maybe insulin’s rising to compensate for that? I just precarious, you have any data on that?

Thom King: I don’t have any data on that. I mean, I would certainly collect data on that. Is there– is there a way to test for– for T4 and T3 uhm– like a home kit or something like that without having to go in and pull blood?

Dr. Justin Marchegiani: With T4 and T3, yeah there’s a couple of lab CRT and already in Valley lab’s definitely have them. And insulin I think you— I think you probably just have to just get like a– a ___[14:21] to have that done.

Thom King: Yeah.

Dr. Justin Marchegiani: Go everything in there with– I be curious, but I– I do know that those are gonna be things that typically don’t increase the blood sugar as much. Now one thing I– I do notice though is that some people that may have a negative experience, and I’m seeing just a lot of maltodextrin and corn sugar–

Thom King: Hmm.

Dr. Justin Marchegiani: And some of these sweeteners. What’s the deal with that?

Thom King: Uhm it’s cheap. [Laughs] So, any time you–

Dr. Justin Marchegiani: Does that defeat the purpose though? I mean, people are– are consuming these products to avoid sugar and then you have sugar in it. Which is like, “What?”.

Thom King: Well, I mean, it– it’s that– I think that that’s typical and, you know, in food manufacturing.

Dr. Justin Marchegiani: Yeah.

Thom King: That– you know, [clears throat] there’s– it– it’s tough ’cause it’s the– you know, people are trying to keep an eye on their cost of good sold, right? They’re trying keep high margins and– and the food that they’re selling. And– and maltodextrin and dextrose are so cheap that it’s easy, you know, it’s easy to use that as a– as a uh– as a filler or a bulking agent. So, uhm– you know, when you– when you look at typically like a high-grade sucralose, it’s gonna be 700 times sweeter than sugar. So you can’t really put something 700 times sweeter than sugar into little pocket, uhm– because– it there be a minute such a small amount you wouldn’t be able to actually detect it. So, you do have to use in those particular situations bulking agents. And so for larger, you know– uh manufacturers that don’t have, you know a contingency of consumers, uhm– you know that lean into natural uhm– they’re not even gonna question, you know, maltodextrin. But–

Dr. Justin Marchegiani: Right.

Thom King: ___[16:02] getting to your– to the point of– yeah, it’s completely counter– counter productive and counterintuitive to add back sugar into something [laughs] you’re trying to cut the sugar out. Well, so, yeah, it’s ab– absolutely 100%.

Dr. Justin Marchegiani: It seems like on a liquid, you’re probably have more ability to– to manipulate that because it’s a liquid, right? You can use a glycerin or some kind of liquid carrier that– you know, you don’t need a certain– a– a bulking if you’re using liquid drops. So, I’m just curious, uhm– what’s the alternative if you are trying to– to get it in a powder. Which are company using what have they found to be better.

Thom King: Uhm– we use lots of different, you know, uh– uh different sweeteners and different sweetening systems depending on what uh– you know, depending on the– the functionality in the outcome that the customers looking for like–

Dr. Justin Marchegiani: Can’t we rate down the ingredients in your keto-sweet product?

Thom King: Sure. So, uh– we have a product called a KetoSweet+ and it is– it’s allulose, stevia and monk fruit. And we have it both in a powder form, and we have it also in a liquid.

Dr. Justin Marchegiani: Is there a bulking agent with though with that at all?

Thom King: That’s the allulose. So, we usually–

Dr. Justin Marchegiani: Oh.

Thom King: The allulose is the bulking agent ’cause allulose is only about 70% of sweetened sugar. So–

Dr. Justin Marchegiani: I see.

Thom King: — in order to get to parity with sugar, we add stevia and then we add monk fruit as well. And so what we found is that, the combination of stevia and monk fruit actually mask each other’s off notes. Uhm– which is–

Dr. Justin Marchegiani: Aaahh.

Thom King: –super interesting. And then, you know, adding those two high intensity sweeteners to allulose which is 70% is sweetened sugar brings it to parity. So, our liquid– our liquid– KetoSweet+, I’d say you can compare it to like DE-42 high fructose corn syrup, or like–

Dr. Justin Marchegiani: Yeah.

Thom King: –any of like kerol or syrup that you would like, you know at the store. Uhm– and then, the– the powders just– very-very similar to sugar. Uhm– it’s not a sugar alcohol, it’s actually considered– still considered a saccharide, uhm–

Dr. Justin Marchegiani: Okay.

Thom King: So, think fermentation. So basically–

Dr. Justin Marchegiani: Yes.

Thom King: Uh– allulose exist in nature in small amounts.

Dr. Justin Marchegiani: Yes.

Thom King: It’s been considered a rare sugar.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: And so, basically, take a– uh– fructose molecule and you treat it with an enzyme. So think fermentation.

Dr. Justin Marchegiani: Yup.

Thom King: And then, metabolite after that is a rare sugar called allulose. So– in allulose, your– you know, your– your body recognize it, recognizes it because it exist in nature. But your– because it’s been– you know, because it’s been enzymatically treated, your body is unable to metabolize it. So, it just basically goes through urine and feces and doesn’t affect blood sugar levels or uh– ketones. And what I have found is it actually drops your blood sugar levels slightly. Uhm– and I think it’s because of the enzymes that are used to– to manufacture that. Uhm– the beauty of the allulose, is its functionality. So, it participates in mallard which is the interaction of proteins and sugar that causes uhm– or creates a ___[19:13]–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: So you’re using it in the baking process when you are making cookies or a cake, you’re not gonna get something that’s like brick, you are actually gonna get something–

Dr. Justin Marchegiani: Right.

Thom King: –that’s you know, crispy on the outside, fluffy and moist, you know, in the middle. So, it has that functionality and, I mean, to me, this is gonna be most definitely a– a game changer.

Dr. Justin Marchegiani: So, this– this allulose– and I have a couple of dark chocolates too that I– I do consume that are very low sugar that have allulose as this kind of sugar substitute. So I am seeing that catch on. And allulose is not in the same family, it’s like a paleo like– like xylitol or erythritol–

Thom King: Yeah.

Dr. Justin Marchegiani: –this is a– a polysaccharide you’re saying?

Thom King: It is. So, it’s actually a– [crosstalk]

Dr. Justin Marchegiani: Yeah?

Thom King: It– well, it’s actually a monosaccharide.

Dr. Justin Marchegiani: Monosaccharide is in the sugar?

Thom King: Yeah, but it’s not– but it– yeah, it’s definitely not at all like– like an alcohol sugar like xylitol, or maltitol or any of those–

Dr. Justin Marchegiani: And you don’t get any bloating if you consume too much?

Thom King: Uhm– I’ve dosed myself to a hundred grams, which is like err– like, 4 times which you, you know, you should be taking in, probably even more than that. And what I noticed is that, I had– it created some gas but it didn’t create like cramping or laxation. Uhm, I think that whether was happening is a level of fermentation. So, there’s probably some, you know, some bacteria in my gut that’s metabolizing it and–

Dr. Justin Marchegiani: Yeah.

Thom King: –off-gassing, but it wasn’t anything serious. And a hundred grams of that is a lot, like you have to force yourself to get it at your body.

Dr. Justin Marchegiani: Yeah, that’s like 3 and a half ounces, that’s– that’s a decent depth for sure.

Thom King: It is. And so, at that point, I would say don’t exceed that. I would say if you’re going to use allulose or something like that, uhm– you know, not to exceed maybe 15 or 20 grams.

Dr. Justin Marchegiani: Okay. Let– it makes a lot of sense. Uhm– anything else you wanted to highlight regarding other sweeteners? Is this the only major sweetener you have, or do you have any others like, what’s your opinion on like the birch bark xylitol? Any other opinions on the sugar alcohols, anything else you carry similar to that?

Thom King: Yeah, we carry all of the sugar alcohols, we carry xylitol, we carry–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –uh erythritol, and I mean, right now, erythritol is probably our biggest seller like we have an erythritol stevia blend, and we are able to process it in a natural powder so it dissolves into solution better, uhm– you know, companies that manufacture bars that are sort of extruded process, are able to use that sweetener, you know, ’cause it– it does dissolve uh– easier, so, in my opinion, like– so I have worked quite a bit with paleo’s, uhm– paleo’s have a tendency to increase water activity in the lower intestine.

Dr. Justin Marchegiani: Yeah.

Thom King: Uhm– which is– which can lead to bloating, cramping, diarrhea, uhm– xylitol I find, I mean, when you start talking about the m– maltitols of the world.

Dr. Justin Marchegiani: Yes.

Thom King: Maltitols of the world, the laxation effect that those had is pretty extreme.

Dr. Justin Marchegiani: Right.

Thom King: And I would say away from those unless you have really doped up the tolerance to sugar alcohols. Uhm– xylitol is a little less, but still pretty intense. If you over consume xylitol, you’ll definitely get a laxation effect. And I would say that the least, the– the sugar alcohol that has the least amount of– of uhm– of GI impact is gonna be erythritol.

Dr. Justin Marchegiani: Okay.

Thom King: And I think I would still recommend that people stay under 15 grams of erythritol per day.

Dr. Justin Marchegiani: Mm-hmm. Yeah, I think the big issue with a lot of these a m– m– mo– most are gonna come from uh– GMO corn. So, you could potentially get that round up– or that– that– that glyphosate pesticide uhm– potential trace in there as well which is common with a lot of the corn processing.

Thom King: Right.

Dr. Justin Marchegiani: Like the birch park, tends to be a little bit more of uhm– let’s just say the unadulterated form.

Thom King: Right, yeah. And we– you know, we– we have very– every one of our raw ingredients that comes in, uh– third party tested. So, and I mean, if you guys are– like any of your audience are gonna do business with, you know, with a ingredient company, you should actually 100% demand third party testing and see evidence of a thrid party testing. And part of our third-party testing is to test for like a GMO protein indicator. So, we’re always looking at, you know, we don’t anything in-house that’s GMO at all.

Dr. Justin Marchegiani: Interesting. I’m just curious, what are you finding in the– I mean, I’m not saying you guys did this but what have you found in the past when you started testing these things, did you find any of the round-up residue, did you find any lead or metals or mycotoxins that kinda– can you give us some of the bad stuff you found, in the past?

Thom King: [Laughs] Those are awesome questions. Uhm– and that is why we started doing third party testing. So, uhm– you know, I would say 10 years ago, when we just started getting into third party testing, we would find crazy, like shovel handle, uh– glove, like all sorts of adulteration in the products that we are getting.

Dr. Justin Marchegiani: Hold on, I wanna make sure I heard that. So, like, meaning like, particulate of a shovel handle? Particulate?

Thom King: No, I mean a shovel handle.

Dr. Justin Marchegiani: Like an actual piece of it in there?

Thom King: Yeah. And–

Dr. Justin Marchegiani: So, okay– I think the whole handle, you mean?

Thom King: No, probably 68 inches of the shovel handle.

Dr. Justin Marchegiani: Oh, my gosh! How does that happen? Like it’s crazy.

Thom King: I have no idea, or in the glove, like we found the glove, and–

Dr. Justin Marchegiani: Okay, got it.

Thom King: –so, I mean, a lot of these things– you– I mean– we– we do visual testing, so every– you know, all the raw– and this is back in the day. And we– we you know, we would– obviously not use those particular ___[24:51] after that, but anything that we bring in now goes into QC’s cluster. And we– you know, and we send it out for third party testing which test for heavy metals. Uh– test for Coliform, you know, various like yeast–

Dr. Justin Marchegiani: Yeah, bacteria.

Thom King: Or– uh– pe– uh– petrochemicals, uh– GMO protein indicators. So– we– we tested all that way, and I would say that our current blenders that we have in place, we don’t generally run into issues with them, uhm– I like to also add that everything that comes in and goes out of here runs through a metal detector. Uhm– you know, so, we– you know, we’re able to– to pull anything out that maybe the smallest piece of uh– of metal that, you know, got into it.

Dr. Justin Marchegiani: Yeah.

Thom King: But, uhm– when we– so when we start vetting new ingredient suppliers, I mean it’s a pretty– it’s a pretty rigorous uh– uh– task for them, you know, they have to give us all of their documents, their organic search, we send it off for third party testing, uhm– we will bring in, you know we could just bring a load from them, and then all of that gets tested. So, uhm– I wish more companies did that, because we’ve had products coming through our warehouse once we send ’em to third party, boom, they’re out of our warehouse and it’s like, no, this isn’t what we ordered. So, everything has to fall within a spec. And I would– it was really highly encourage, your– your listeners, to– I mean, and I know that they’re probably are getting a lot of their supplements through you and you’ve already vetted those companies, well I would say, oh, my God, like, I would say that, we’re just sweeteners. So, this is like, not a big deal but when you start looking at companies that are selling supplements and they’ve got a lot of compounds going in there, it– absolutely everything should be third party tested because I know in the supplement industry, 75% of the supplements out there don’t even contain any active compounds.

Dr. Justin Marchegiani: I agree. And this is a problem and that we test all of our– raw ingredients independently and I found increases in lead and some of these–

Thom King: Oh yeah.

Dr. Justin Marchegiani: –raw material back, and that can happen, of course, you know, you just over time find out who the best ones are–

Thom King: Right.

Dr. Justin Marchegiani: –where the qualities at. And then so you are also testing for like, round-up and or GMO type of contamination as well?

Thom King: Yeah, and I mean, in petrochemicals and heavy metals. So we test–

Dr. Justin Marchegiani: Oh.

Thom King: –for cadmium and lead, and, I mean, we’ve had products come in specifically from China which is kind of interesting, uhm– you know, that are showing up super high in cadmium and lead.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: So, we do– I do a ton of formulation for companies. So companies will send us their product then in order for us to push it through our queue– our-our RND, uhm– we’ve gotta have ___[27:35] and then we also get that third party tested. And I found that, there’s a lot of P-Protein, uhm that is out of China that is super high in lead. And–

Dr. Justin Marchegiani: Oh.

Thom King: –I think it’s just because of the amount of the petrochemicals that get better in the air and then settle out into the soils. So, uhm–

Dr. Justin Marchegiani: Yes.

Thom King: Yeah, so we test– we test for– yeah, we test for all of those things–

Dr. Justin Marchegiani: Totally

Thom King: Uhm– you know, and– occasionally we find something but– at the more rigorous our– our testing has become, the more we are able to weed up the suppliers that are unscrupulous.

Dr. Justin Marchegiani: Yeah, very good. Now we talked a little bit earlier about in some of the benefits of being ketogenic earlier on the thyroid. I wanna just kinda peg you back to that because you are asking me some questions in the pre-interview like, you know, who’s gonna benefit from the ketogenic diet on– on the thyroid side? And this is a question I get a lot because you have some data– uhm, people saying, “Well, I– my thyroid gets worse or weaker on a ketogenic template and some gets better”, and I think a lot of it has to do with how insulin-resistant, how numb someone’s cells are to insulin. So the more numb you are to insulin, your body has to compensate by making more insulin to overcome that numbness. And I think that’s the big issue and kind of the physiological imbalance that’s driving a lot of issues with people’s heath and thyroid, and finding healthier sweeteners like you mentioned, getting the carbs down can really dese– uh– really increase the sensitivity, meaning it lowers the insulin–

Thom King: Mm-hmm.

Dr. Justin Marchegiani: –and that allows thyroid conversion to happen better because insulin’s a big blocker of thyroid conversion if it’s too– too high. Just answer that question.

Thom King: Right, yeah. And I mean, I found that with my– with myself. So, I was carrying about 35 lbs of extra– uh– of extra weight. And I mean I was definitely insulin– uh– resistant. And so, I did show a depleted T4, uhm– you know, when I started, and then that T4 leveled out. Uhm– but I’m not sure like on a– real long-term basis, uhm– how the thyroid will be affected, I mean, I test– like I do a batch test and–

Dr. Justin Marchegiani: Yeah.

Thom King: –and like I do full blood panel batch test and then I also uhm– do stool sample once a month–

Dr. Justin Marchegiani: Yup.

Thom King: –to track my microbiome.

Dr. Justin Marchegiani: Okay.

Thom King: So, yeah, I’m like, really– so I’ve really found some interesting stuff in this data collection that I’ve– have done. But I found that the ketogenic diet really did help my insulin resistance so I became more– more sensitive but you know, another– I– I would have like a question I guess, have– have you do you have any experience with uh– berberine with your patients?

Dr. Justin Marchegiani: Yeah, I mean, I use berberine a couple different ways. Uhm– with some patients it’s typically used in my SIBO-clearing programs where we’ll try to knock down SIBO or bacterial overgrowth.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And this– a bunch of different berberines, Goldenseal, ___[30:29], Barberry, you know, those kind of things. Obviously, yeah, berberine HCL. Uhm– but berberine’s also a really good insulin-sensitizing compound. It can really help lower your blood sugar, and– and lower your insulin levels. So there’s some really good benefits there as well.

Thom King: Right, ’cause I added that as a supplement and I almost wonder if that was, you know, if that really helped me become more uh– you know, more sensili– sensitive to uh– to insulin. And another thing too, is I’d like to hear your thoughts on– on Metformin.

Dr. Justin Marchegiani: Yeah, I think uhm– berberine kind of works similar, in a similar way it helps us uh– on the insulin sensitizing side. Metformin ‘s gonna work more by decreasing like the glucose absorption in the gut, and then it also kind of shuts down gluconeogenesis in the liver. Uhm– part of that decrease in the glucose absorption though, it can also decrease the absorption of B-12. So, if you’re on Metformin or Glucophage, you really wanna be on some supplemental B-12 on top of it. Uhm– and then, you know Metaformin’s relatively natural like the extract from Metaformin comes from the French Lilac flower, so it’s–

Thom King: Mm-hmm.

Dr. Justin Marchegiani: –it’s kind of on the natural side, uhm– but I tend to like be more impartial for like the Berberines and the other more nutrient-based insulin-sensitizing compounds. But if people are on it, you know, you just gotta make sure the B-12’s dialed in there too.

Thom King: Interesting. And do you feel like getting a B– uh– B-12 supplement with it or just increasing the amount of like– of– of uh– like organ meat would– would suffice?

Dr. Justin Marchegiani: I would just be a– I just make sure you’re on at least a good Malt tea with some extra B-12 on top of a really good diet.

Thom King: Interesting.

Dr. Justin Marchegiani: A– a– and again you can monitor that with you functional medicine doc like, you know, I like methylmalonic acids are really good tests to look at to assess your B-12 levels. Whien methylmalonic acid goes high, that actually means lower B-12, right? Methylmalonic acid gets metabolized to succinic acid. And so you need B-12 to make this conversion happen. So if there’s not enough B-12, methylmalonic go– acid goes up, if you don’t have that B-12 that convert it. So, let’s ___[32:31] if people are gonna be on it, you wanna be careful because, you know, lo– low B-12 can cause, you know, alzheimer’s dementia-like symptoms.

Thom King: Interesting. And then so, do you find like with your patients, that– that taking– taking these vitamins and supplements orally and/or do you feel like there’s greater efficacy in IV’s?

Dr. Justin Marchegiani: Well the– I mean, I think IV’s are good, the problem is they’re impractical for people to do daily, that’s the only issue.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: Just because uhm– you know, people got a work, they don’t have, you know, 30 or 40 minutes to get drip in there, and that can be more expensive but–

Thom King: Right.

Dr. Justin Marchegiani: –uh– Iv’s here, they I think can be really good but, ideally you want good food and supplements are those easier take–

Thom King: Defenitely.

Dr. Justin Marchegiani: And that’s the big benefit. If I see patients that do a lot of gut issues then we will go on the– s– the sublingual B-12 side, and that can really help too because it can kind of get more of the absorption via the oral mucosal kind of buccal tissue versus the gut, and that can help too.

Thom King: Wow, awesome. [Laughs]

Dr. Justin Marchegiani: And then I’m just curious–

Thom King: Yeah.

Dr. Justin Marchegiani: What other– like what other key things, you know, you wrote the book, Gu– uh– uh– “Guy Gone Keto”, and you also–

Thom King: Great.

Dr. Justin Marchegiani: –come up some of these great sweeteners. What other cool tools are out there that you found kinda as– in your transition to a healthier diet, and making a lot of these health thing you think really impacted you?

Thom King: I would have to save the th– the thing or modality that had the greatest impact or what I found was the– the– the– lent itself to the success that I had was probably journaling. So, you know, that is– w– you know– and being mindful. So, when– when I get up in the morning, one of the first things I do, grab a cup of coffee, sit down and I start to journal, and you know, I journal with real intentions of things I wanna manifest. Uhm– you know, I do some data collection like my weight and blood pressure. Uhm– so, I think journaling was really-really-really huge. And really taking time to do that first thing in the morning sets the– sets the stage for your day. And then within that, I incorporated what I called “My Arrow of Power”.

Dr. Justin Marchegiani: Yup.

Thom King: Uhm– journaling, run, cycling, you know, I do try, and then you know, every other day, I do yoga and then I finish out my workout with a meditation. Uhm– and I think that those real things can actually helped me the most.

Dr. Justin Marchegiani: That’s really good to hear, that’s excellent. That sounds like something like a little Tony Robins kind of morning progress. That’s what it sound like.

Thom King: [Laughs] I’m totally influenced by Tony Robins.

Dr. Justin Marchegiani: That’s cool. And then I’m just curious too, just kind of piggyback on a couple things, where do you guys source your Allitol from the mean like– not like what company but like, wh– what’s the raw ingredient it comes from?

Thom King: You mean the allulose?

Dr. Justin Marchegiani: Yeah, I’m sorry, Allulose. I said Allitol– Allulose. Great.

Thom King: I don’t know but that’s a weird interesting compound. That’s not like the– the mix of– [laughs] of– erythritol and allulose.

Dr. Justin Marchegiani: Exactly, exactly, totally.

Thom King: Uhm– so, we– so I’ve been working woth allulose for the past five years and part of it was so new, uhm that the supply chain really wasn’t there.

Dr. Justin Marchegiani: Yeah.

Thom King: And we weren’t really able to verify stuff, so we won’t add– we won’t add something as an ingredient unless we’re– unless we’re 100% confident that the supply chain is solid, and also reliable like everything is– that arrives is within spec. So, the– the allulose, you know, we’ve got 3 different suppliers, and all three of those suppliers uhm– are using non-GMO uhm– corn fructose uh– substrate to– to enzymatically create the allulose.

Dr. Justin Marchegiani: Got it. So it’s corn fructose but it’s GMO-free and– and ___[36:11].

Thom King: Great.

Dr. Justin Marchegiani: Are they able to separate the– the sugar from the protein component pretty well?

Thom King: I think so, I mean– ’cause when we third party test, we’re not showing any proteins. Uhm–

Dr. Justin Marchegiani: Oh good.

Thom King: So, I mean I– I– I don’t have any reason to believe that there’s any problems with the– the– with them separating it. I know that they use like what’s called resin– resin column uh- filtration. So it pulls out like any of the pure– the– the impurities of– so– yeah, I mean we’ve been working with it for a while, and we third party test it and we haven’t found any– you know, any proteins in it to indicate that there’s, the– you know, the genetically modified uh– corn was used in that process.

Dr. Justin Marchegiani: So someone was gluten-sensitive and one of the ___[36:55] out, you’d feel like it would be filtered enough, it wouldn’t be a problem for them?

Thom King: Uhm- well, we’re also uh– allergen free– uh– facility, so we always test for– we test for gu– uh– you know, gluten? Uhm– and absolutely the allulose is gluten-free.

Dr. Justin Marchegiani: Good. And if they were sensitive to corn, like the corn protein like the zein protein, you feel like it’d be– it’d be filtered enough for there wouldn’t be an allerenic reaction to it?

Thom King: Yeah, I do, well, ’cause we test for proteins and there’s no proteins– there’s no proteins left in there, so I would– I would feel confident thst, uhm– yeah, that, that people, they are sensitive to that but not, you know, be affected by it.

Dr. Justin Marchegiani: Very cool. Well, we’re gonna have to put some links down below where people can find the KetoSweet+ formula–

Thom King: Oh.

Dr. Justin Marchegiani: Anything else Thom you wanted to highlight for the listeners here?

Thom King: Uhm– no, not really. You– we were the– the questions you asked worked totally through, and I appreciate that.

Dr. Justin Marchegiani: I appreciate you comin’s on. Anything else you wanna leave to listeners with for just– how– how they can find more about you and more about your products too?

Thom King: Uhm– well if you want to get a copy of the book, and we also have uh– we released a line of ketogenic uh– condiments like ketchup, barbecue, sauce–

Dr. Justin Marchegiani: Oh, cool.

Thom King: And– teriyaki sauce. And so, if you just go to guygoneketo, you can find all of that.

Dr. Justin Marchegiani: Right.

Thom King: Uhm– you can reach me through that too. Uhmm– all of the social medias under this Thom King, T-H-O-M, K-I-N-G. Uhm– reach out to me if you ever got– if you ever have questions. If they want to buy the KetoSweet+, I think kwe– the KetosSweet+ is available on the guygoneketo site. It’s also available on, that’s S-T-E-V-I-A “dot com” that’s we have all of our compounds on there available for retail. And if they wanna see what kind of madness we’re up to in the– in our lab, they can go to and follow us on linkedIn and you can see some of the craziness that goes on in our lab, things we’re inventing.

Dr. Justin Marchegiani: Very cool. And is it possible the coke with the KetosSweet+?

Thom King: Oh, absolutely, yeah. So, it does– it does actually participate in maillard at lower temperature, meaning that uhm– like with sucrose or table sugar, you– you’d probably about a hundred and forty-five–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –to a hundred and fifty-five as when it starts to caramelized, and you’re gonna noticed that you’re gonna get that a little sooner with the uh–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –with allulose, probably in the 130 to 135 range.

Dr. Justin Marchegiani: Mm-hmm, mm-hmm.

Thom King: So, probably wanna bake it and cook at little lower temperature for a little– e– extended period of time.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: But then, you know, other than that, yeah, you can– cook and bake just like you would for a sugar.

Dr. Justin Marchegiani: Awesome Thom, well, thanks for all the great information here today, appreciate it. And you have a phenomenal day.

Thom King: Thanks, you too Dr. J., thanks for having me on.

Dr. Justin Marchegiani: Thank you. Bye now.

Thom King: You’re welcome.


Low Dose Naltrexone and More | Podcast #185

Welcome to today’s podcast with Dr. Justin and Dr. Sajad Zalzala, a famous family doctor! Find out more about their discussion of the biochemistry and mechanisms Dr. Z learned when he was in medical school to get the extra buffer between conventional and functional medicine. Learn about the relationship of the allopathic medicine and functional medicine through drugs and diseases, like Diabetes, and about the different anti-aging pathways as they discuss more and dig deep into the Low-dose Naltrexone issue.

Watch as they discuss the right supplements and diets to restore health and wellness of patients of all ages.

Dr. Sajad Zalzala

Dr. Sajad Zalzal

In this episode, we cover:

01:39   Integrated/Holistic Medicine and Conventional Medicine

17:51   Metformin

21:47   The Three Anti-Aging Pathways

30:54   Opioid Crisis

47:15   Cannabis




Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani in the house. Welcome back to Beyond Wellness Radio. We have Dr. Sajad uh— Zalzala, Dr. Z for short. Dr. Z, welcome to the show!

Dr. Sajad Zalzala: Thanks for having me, Justin.

Dr. Justin Marchegiani: Well, let’s dig in today. So, you’re a family medicine practitioner. You’re a medical doctor and you kind of made your journey over to the functional medicine world. And, it’s always interesting because when you go from the medical doctor realm, you put so much time, so much work into understanding the allopathic side of medicine.

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: And, to come over on to [stutters] Let’s call it the— the uh— the— the good side, right?

Dr. Sajad Zalzala: Uhuh— Uhuh—

Dr. Justin Marchegiani: Walk me through that journey. How did that happen? Did you get disenchanted with conventional medicine? What happened in your life to then cause you to come over unto the uh— to the light, so to speak?

Dr. Sajad Zalzala: Sure. Actually, for me, it happened early on, uhm— right— right in medical school. So, actually, started out my uh— my career after high school uh— as Computer Science major. I— I— First, I don’t want to do anything with medicine uh— but I changed my mind, uhm— you know— a few years into my studies. That’s Computer Science, actually gravitated more towards a customer service helping people rather than, you know, technology.

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: So, I— I decided, you know, I’m wasting my time with computers and I decided I wanted to go. I— I wanted to be a doctor instead. Uh— So, I kind of switched gears and uh— you know— applied for medical school. I was fortunate to get in. I almost dropped out after the— after the first year of medical school. Uhm— Me— Studying was a lot harder than I thought it’d be, you know. I didn’t have the skills that I— that I needed uh— to uh— you know, to make it through. And, I almost dropped out actually. Uhm— But, what saved me was actually, in my introduction, is Integrated Medicine.or Holistic Medicine. At the time, it wasn’t you know— Functional Medicine is still one of those terms that wasn’t quite used yet, uhm— but I think, at that  time, Integrated medicine was— was the term that was mostly used. Uhm— But the reason I almost dropped out of medical school is because there I was a bit disconnected by what we are learning from the biochemical pathway physiological perspective of what we were learning from the therapeutics perspective. Uhm— You know, it just— it just— It seems like our class—  our class is completely ignored. Everything you could do from a diet, nutritional, you know, lifestyle perspective uhm— to— to help— to help a patient and focus specifically on drugs and surgery, and that was pretty much it. Uhm—

Dr. Justin Marchegiani: Totally. And— And again, I kind of little tongue-in-cheek, put a little jab at the…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …allopathic uh—

Dr. Sajad Zalzala: [laughs]

Dr. Justin Marchegiani: …medicine community. But, Allopathic Medicine is phenomenal at Acute Traumatic Care…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …where the underlying cause isn’t an issue, right? You got in a car accident….

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …the underlying cause is already isolated. It was the car accident ot the trip and fall, right?

Dr. Sajad Zalzala: Hmm—

Dr. Justin Marchegiani: Chronic Medicine or Chronic Degenerative conditions, there’s an underlying cause that’s— that’s still not addressed that if you just…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …use medications, we’re not covering it up. We— We’re covering it up. We’re not getting to the root cause. So—

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: You had this mindset where it was allopathic and then you shifted over because in family medicine, you’re just constantly prescribing drugs for symptoms…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …and not getting to the root cause, correct?

Dr. Sajad Zalzala: Exactly. Exactly. I mean, I think— I think, conventional medicine and all kind of [incomprehensible] medicine is kind of a victim of its own success. BUt, a hundred years ago, I mean, uh— you know, Penicillin was  a big thing. You know, surgeries, surgical techniques were a big thing. And so, they were curi— you know— Allopathic practitioners are curing diseases and kneeling patients uhm— for things that were thought to be incurable. But— But in our— in our day and age, where most people are not dying of infections, where people are not dying of, you know, uh— you know, slivers in their feet and things like that, uh— you know, it— [stutters] they’re trying to take that— the success from a hundred years ago, and trying to— and trying to put it into our— our modern uhm— maladies, and it— it just— it just fails, terribly, because it completely ignores so many things in our biochemical and [stutters] uh— and uh— physiology.

Dr. Justin Marchegiani: Yeah. We’ve come a long way because water is cleaner, right? WE have good water purification process. Maybe we still leave some Fluoride and Chlorine in there but that’s another podcast.

Dr. Sajad Zalzala: [makes a sound]

Dr. Justin Marchegiani: We have, you know, clean— We have food storage systems like refrigerator so we can keep food fresher and such. Uh— Obviously, we do have the pesticide component. We do have indoor plumbing. These kind of things have decreased a lot of the infections, but then now we have all these Chronic Degenerative uh— things that are occuring, like heart disease…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …and Cancer at much higher rates. Was there a personal kind of impact with— Did you have a health challenge that kind of pulled you over from conventional medicine into functional medicine?

Dr. Sajad Zalzala: Not until later. I mean, I was a big fan of uh— Integrated Medicine, right? Kind of right from the start that I heard about it. Uhm— But later on I uh— you know— So, I’ve always had a challenge with my weight. I— I was a— I was a big kid back when there weren’t really many big kids.

Dr. Justin Marchegiani: [laughs] Right. Right.

Dr. Sajad Zalzala: Uh— [laughs] So learning about Integrated Medicine function has allowed me to kind of help me control that, and I still struggle with it. Uh— You know, if anybody’s— If anybody’s struggle with their weight, they kind of know what their doctor…

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: …you know, what I’m talking about. Uhm— But uh— you know, I uh— I learned to clean up my diet. You know, I learned that the uh— food pyramid was completely uh— bogus. Uh— And— And— And— And that— You know, I— I went Gluten-free back in 2011. And even though I’m not a strict as I want to be but uh— but I— I— I still think it’s a big component of— of— of where I’m at today in terms of my health. Uh— [crosstalk] And it— And it shows— Yeah. It shows just the power uh— of— of— of— of just simple things like that.

Dr. Justin Marchegiani: [breathes in]

Dr. Sajad Zalzala: Uhm— That— That just means your medicine’s fully ignores, or they actually try to— try to convince you otherwise. Uh— Like, there was a story and uh— uhm— how people who are Gluten-free are at high risk of having Arsenic poisoning. Uhm— We got to kind of read between the lines and say, “Well, it’s not— It’s not because you’re Gluten-free. It’s because you’re eating so much rice.” [laughs]

Dr. Justin Marchegiani: Exactly. You’re into [incomprehensible] but like—

Dr. Sajad Zalzala: And it has lights saying, “Gluten-free you know— Gluten-free uh— diets are linked to Arsenic toxicity, you know.” So, there’s still be this big war being waged between— you know, between the— the— the natural health community and the— and the conventional allopathic community.

Dr. Justin Marchegiani: A hundred percent, and that’s the problem. A lot of conventional medicine has a lot of confounding variables that aren’t really laid out there. That’s great that you’re able to break that down. And I’m just curious too because I found with a lot of medical doctors there’s like— There’s a sense of arrogance that like, “You know what, I’m in medical school. I’m a medical doctor. Ther— The medical school’s only gonna teach me what is important, and if I didn’t learn it in medical school, it must not be important.” How were you able to turn that part of your brain off and realize you weren’t getting the whole story, this wasn’t it?

Dr. Sajad Zalzala: Well, I guess that for me, because I was fortunate enough to learn about Integrated Medicine early on. Actually, learning about it, functionally, they’re medicine. Listen to Dr. Jeffrey Bland. [crosstalk] I listened to…

Dr. Justin Marchegiani: [crosstalk] Uh— Yeah. Got it.

Dr. Sajad Zalzala: …his— his clinical updates. You know, attending the uh— the— some of the IFM and the Integrated Medicine Conference. It actually helped me learn the allopathic part a lot— a lot more uh— effectively, uh— because— It’s ‘cause it opened— o— opened m— my eyes a lot more. So— So when I learn the allopathic stuff uh— you know, always in the back of my mind’s like, “This is not how it actually treat a patient.” You know, I had a Hypertensive patient. I would not actually actually start them on antihypertensives, you know. I fix their lifestyle first. But—

Dr. Justin Marchegiani: Right!

Dr. Sajad Zalzala: But…

Dr. Justin Marchegiani: Right!

Dr. Sajad Zalzala: …I know the mechanism is action for the medications and I know that the test is asking for this therapy. So— So I always l had a kind of [stutters] I had to act almost like a split personality in some ways where I needed to know what I need to— to think like the allopathic people wanted me to think like they have allopathic educators wanted me to think like. They also had this thing where I knew there was a different way to do it. Uhm— So— So I would— It was never a sense of betrayal as the only real sense of— of betrayal is was the fact that they— that they really didn’t teach any of these other therapies in medical school. Uh— And every time I ask my professor uh— about it like— like— like you’ve learn about a pathway or something like that. What— What couldn’t you— Couldn’t you change that pathway using, for example, you know, Turmeric to— to reduce inflammation rather than some drug or something like that. Or— Or— Or something like that, and then— and then the professor would kind of stare at me. It was like, “Whoah! Hah! Maybe you could? But we don’t have any large randomized controlled trials…

Dr. Justin Marchegiani: Hah!

Dr. Sajad Zalzala: …to  prove that. Uh— So, you know, with this kind of like, you know, move along. You just— just— just— just learn what we want to learn.

Dr. Justin Marchegiani: It’s like, “Of course, you’re not, because you can’t patent some herb— you know, that the mother nature created.” And then, if any drug company spent billion dollars getting it through Phase III Clinical trials, uhm— they wouldn’t have unlimited rights to it…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …so they would never recoup their money. So, of course, that’s never gonna happen, right?

Dr. Sajad Zalzala: Yeah. Wha— I mean, Functional Medicine is gaining steam uhm— into the mainstream. I mean, you have the Cleveland Clinic. They have a Functional Medicine department. Uhm— You know, you have— you have other major universities and hospital systems kind of down…

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: …board. Uhm— I don’t know if— if the— these programs will ever be as effective as we need them to be ‘cause a lot of times they’re kind of padded with uh— “fluff” for lack of better term. Uhm—

Dr. Justin Marchegiani: Totally.

Dr. Sajad Zalzala: But like for example, I mean, not to knock on any hospital systems but, you know, a lot of times it’s, “Oh! Come check out our uh— Holistic Medicine department,” and basically, just Yoga classes. Not the…

Dr. Justin Marchegiani: That’s it.

Dr. Sajad Zalzala: …knot kind Yoga. Yeah. Not the knot kind of Yoga. I mean, Yoga’s a great therapy but— but— but to think that— to think that— that— that, you know, by sprinkle in a little Yoga in a— in a hospital that you call it now Holistic Hospital. You know, I— I think— I think those just uh— uh— uh— whitewashing— whitewashing the whole thing.

Dr. Justin Marchegiani: Oh! I— I totally agree. And I’ve said— I’ve got it on records a few times, I don’t think you’re gonna see— and I could be all wrong. I don’t think you’re gonna see the Functional Medicine at Cleveland Clinical really, truly be what it needs to be. I think it will be water down to some degree…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …and the reason why I say it is because you’re gonna have tens of millions of dollars invested into a Cancer Wing at Cleveland Clinical Clinic. You’re gonna have tens of millions of dollars invested into a— into a Heart Disease Wing.

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: If you bring Functional Medicine treatment and care into that hospital, that sucks profit and revenue…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …out of those other wings.

Dr. Sajad Zalzala: Mm—

Dr. Justin Marchegiani: I mean, they’re CEOs. Just look at the— you know, the bottom dollar

Dr. Sajad Zalzala:

Dr. Justin Marchegiani: , and they’re gonna be like, “Hey! You know, this one thing is doing okay but, you know, it’s stealing a whole…”

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …”bunch of revenue from what keeps the clinic afloat.” And, there’s a lot of money in Cancer and Heart Disease and Chronic Disease like Diabetes. And, don’t get me wrong, a just— There’s not gonna be the ROI on dr— on supplementation and lifestyle counseling because these aren’t patentable things.

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: That’s the [inaudible]—

Dr. Sajad Zalzala: Yeah, exactly and absolutely. And then, unfortunately, I think until the healthcare bubble bursts and people realize that— you know, that [stutters] those insane to pay for, you know, 50,000 dollars a year for a therapy that just covers up the symptoms. Until that happens. Uh— Yeah. I think— I think we’re kind of stuck with it, unless— unless patients take— take control of their own health and try to kind of seek out their own therapy.

Dr. Justin Marchegiani: Oh! Totally. Like—

Dr. Sajad Zalzala: Mm—

Dr. Justin Marchegiani: I mean, for instance, uhm— my wife and I had a child at the end of the last summer, and he’s doing phenomenal. But, like a lot of children, as you know, as a family uh— practitioner, is had a— a slight like heart murmur, which a lot of times in— in the child and I— and I think can be totally normal. So, we were just like, “Alright. So, well let’s just get it evaluated.” Uhm— Kind of fast forward to the end, his heart was totally fine…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …but we get the bill back…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …and it was like 3,000 dollars…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …for an hour of the doctor’s time. I mean, they…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …did like a little uhm— They did a little, I want to say, a ultrasound test.

Dr. Sajad Zalzala: Yeah, Echocardiogram. Yeah.

Dr. Justin Marchegiani: And uh— And then, one other type of test. But those 2,500 dollars, the insurance ended up paying everything but three hundred bucks. But, I’m…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …like, “Wait a minute! Lie, if I just went to the— to the Cardiovascular doctor and was like…

Dr. Sajad Zalzala: Uhuh—

Dr. Justin Marchegiani: …out here, 300 bucks. Just— Just give me what I need from the service perspective…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …we could have just cut out all that whole insurance industry.

Dr. Sajad Zalzala: Right. Right. Right. I know, absolutely. Absolutely. Absolutely. Yeah, I mean— I mean, uh— the direct— direct care and— and self-pay is becoming much more uh— popular as— as copays and deductibles go up. Uh— I mean, I have an incredibly high, you know, deductible on my— on my family’s plan. And I do everything I can to try to stay out of the— of of the healthcare system. You know, I’m fortunate that I have access to the healthcare system uh— you know in the— in ways that I learn other people don’t but— but— but you know, people are smart about it. I think they can also kind of— you know, uh— work with their doctor, their— the- work with their health provider to kind of uh— keep people much more affordable. Uh— And [crosstalk] then— Then, when— Then, when you’re dealing with the insurance and everything’s inside it like uh—

Dr. Justin Marchegiani: One hundred percent, and that’s the issue— is that I’m paying a whole bunch of money for like a high-deductible insurance, where, in the end, I could had just paid that person cash. You know, I think…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …having an insurance is great for high-deductible stuff. You get in the car accident. [crosstalk] Something really—

Dr. Sajad Zalzala: [incomprehensible] Yeah.

Dr. Justin Marchegiani: Something really expensive that’s gonna happen and you may need care…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …or hospitalization, that’s where I think it’s good. But I think everything else, having an HSA or Flex Spending…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …and then, going with the doctor— ‘Cause with me— I’m not sure how it is in your practice but it’s just me. I have a couple of people that help on the administrative side. I don’t spend all this money on billers and staff and overhead. So, number one, I get more of what I g— what I charge…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …and I could charge less than most people because of the situation, right?

Dr. Sajad Zalzala: Yeah, absolutely. [crosstalk] Absolutely. Yeah. That’s why I started this. I w— You know, I’m— In the pre— pre-recorded session, I was speak— talking to you more about why I started this online clinic. Uh— It’s— It’s because by— by doing online, by a long-gauged access, a patient— you know, a— a practitioner directly— It brings down the costs.

Dr. Justin Marchegiani: Huge.

Dr. Sajad Zalzala: There’s also convenient factors as well. I mean, uhm— you know—

Dr. Justin Marchegiani: Don’t commute?

Dr. Sajad Zalzala: You don’t commute, right? You don’t—

Dr. Justin Marchegiani: Wait in the office?

Dr. Sajad Zalzala: Yeah. You don’t have to take a half a day off of your work schedule to go— you know— to go— to go sit— to go sit in a waiting room. And you know you just— you necessarily have to uh— uh— you know [stutters] You could potentially uh— book— book outside of the uh— you know, regular business hours. Uh— Because, usually, practitioners on the other end are, you know— they have a little more flexibility as well. So, it’s— it’s better for the practitioner and— and for the patient.

Dr. Justin Marchegiani: That’s great. And, Dr. Z, what’s your website? So, people listening, if they want to reach out to you and get support, how can they uh—

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …can hold you?

Dr. Sajad Zalzala: Yeah. So— So, the uh— The online clinic I run is called the Uhm—

Dr. Justin Marchegiani: Love that name.

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: We’ll put the uhm— the link right below so if you guys are listening to it and you’re driving and doing something and you can’t access it. Just click below in the description and you’ll find that in there.

Dr. Sajad Zalzala: Sure. Sure. I mean, uh— [stutters] my goal for that clinic is to just try to help as many patients as possible by— by allowing them access to a uh— functional medicine glider. Uhm— One of a— One of the challenges with— with uh— a non-medical functional provider is— you know, the some— some of them faces as— Some— Sometimes, patients need medication uh— uh— to try to, you know, to try to get rid of certain…

Dr. Justin Marchegiani: Stabilize

Dr. Sajad Zalzala: …issues. Exactly. For example, if somebody has like a— has like heavily Yeast infected because of a Yeast Overgrowth— you know, sometimes, you need some kind of solinized standards. Herbs don’t always work as well as it should. Uh— We’re taking probiotics, so that’s kind of a— a situation where, you know, you— you need a medical doctor kind of in the background there to kind of order that. Order blood tests. You know, a lot— a lot of tests and things like that are not— I mean, you’re not able to access directly. Uh— So, I work together with these— with these uh— health coaches or these, well— uh— they’re— they’re functional medicine providers, I call them…

Dr. Justin Marchegiani: Yeah. [crosstalk] It could be a practitioner or another…

Dr. Sajad Zalzala: A practitioner, exactly.

Dr. Justin Marchegiani: …non-prescribing physician like myself.

Dr. Sajad Zalzala: Exactly. So, I kind of collaborate with these— with these non— with these non- uh— prescribing uhm— a non-medical— non-MV uh— uh— p— practitioners. They kind of get the best of both— get the best of both worlds to the patient. I mean, they— they have…

Dr. Justin Marchegiani: Okay.

Dr. Sajad Zalzala: …fantastic educations and experience in functional medicine. And then, when I need that support and supervision from a medical doctor, I’m licensed in 35 states, uhm— So, that allows me kind of broad access to— to pretty much, you know, 90% of the audience that’s listening to you in the United States. Uh— So— So that— That’s kind of my vision for that. YOu know, it’s still fairly recent in terms of its uh— launch. Uhm— You know, we’re still accepting patients. Uh— And— And— And we hope to— We hope that it’ll grow as time goes on if people know more about it.

Dr. Justin Marchegiani: Awesome, Dr. Z. So let’s dig in a little bit deeper here. So, number one, we have like— you know, you talked about like the biochemistry and the mechanisms when you were in medical school. You would dive in, you would understand what the mechanism is. You would try to get kind of your head wrapped around how the drug works for that mechanism. But then, you would say, “Okay. Well, how can we plug in a natural intervention to help support that?” Is that correct?

Dr. Sajad Zalzala: Exactly. Exactly. Again, that’s kind of where— where I listened to Jeff Bland and other— uh— other people like him; really made a big difference in my education.

Dr. Justin Marchegiani: Okay. Well, I’m gonna lay one thing out and then, let’s kind of play a game and just go back and forth here. That way, I think people can— can understand both mindsets. So, we have High Blood Pressure, right?

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: Those are the— I mean, we have the big medications for it. Are gonna be like Hydrochlorothiazide…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …like a water pill. We have Angiotensin-converting enzyme…

Dr. Sajad Zalzala: Uuh—

Dr. Justin Marchegiani: …drowse [inaudible] blockers, right?

Dr. Sajad Zalzala: Right. Right

Dr. Justin Marchegiani: So— So, I look at it as, “Okay. Well, number one, we can help water retention by…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …just helping with Insulin resistance ‘cause Insulin…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …process water retention.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: We have— We have uhm— the Angiotensin-converting enzyme medications, where we can just support the adrenal function.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: We can get inflammation in the body down…

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: …which will help decrease vessel constriction.

Dr. Sajad Zalzala: Mm—

Dr. Justin Marchegiani: Things like Curcumin or— or Ginger or Fish oil will help relax kind of the— the inflammation there. Then also, things like Magnesium, which…

Dr. Sajad Zalzala: Magnesium…

Dr. Justin Marchegiani: …[crosstalk] helps in natural beta-blocker for the heart too.

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: So, that’s kind of— That’s like…

Dr. Sajad Zalzala: Ome— Omega-3 is so kind of the— the— the flexibility in the arteries and in our— in our blood as well. Uhm— You know, just staying away from inflammatory foods. I mean— I mean a lot of times uh— the— the Circulatory System is so inflamed because of the junk that we feed ourselves. [laughs] Uhm— you know, uh— Yeah, you— you could bring down the blood pressure fairly— fairly quickly by just going on a— you know, super clean— super clean diet. And, I’ve seen that happen uh— you know, quite often. 

Dr. Justin Marchegiani: That’s great. I want to see. Do you have another uh— another drug? Can you cut another mechanism that you can lay out and then just kind of compare and contrast the allopathic versus the functional med uh— mindset like I just did?

Dr. Sajad Zalzala: Uh, well, you know, uhm— Diabetes, for example, that’s a big one. Uhm—

Dr. Justin Marchegiani: Excellent.

Dr. Sajad Zalzala: So— Yeah. Yeah. So, I mean, the number one— the number one prescribed drug is Metformin, and actually, I like that drug. I don’t want to knock it. Uh— And uh— the reason I think it works so well ‘cause it’s actually an extract with uh— I believe it’s the French Lilac or the German Lilac. French lilac…

Dr. Justin Marchegiani: Yep.

Dr. Sajad Zalzala: …I believe.

Dr. Justin Marchegiani: Okay.

Dr. Sajad Zalzala: I think that’s why it’s so powerful. You know, in fact— in fact, every since I started prescribing it just for its anti-aging properties. Uhm— But if you want to go— you know, if you’re purest, and you want to go like completely, you know, natural with that, even though— even though Metformin’s pretty close to that, uh— Berberine is another uh— way you could do it. Uhm— So— So Metformin for those who may not know. Uh— Is this— It works really well because it uhm— uhm— it helps the Insulin receptors work better, uhm— and then also, blocks excess uh— accumulation of sugar storage in the liver. Uhm— So uh— you know— excess creation of sugar in the liver as well. So— So, it really works really well. Uhm— But of course, you know, any— any supplement or medication or anything that should you take externally is only gonna work so far— you know, uh— if— if— if you don’t— You have to make changes to your lifestyle and diet. I mean, I tell patients I’m a big fan of what’s called the Paleo Diet, uhm— you know, like a modified Paleo diet. You know—

Dr. Justin Marchegiani: [crosstalk] Paleo, like Paleo template. Yeah

Dr. Sajad Zalzala: Yeah, exactly. What people try to eat as closely as their ancestors do.

Dr. Justin Marchegiani: Love it.

Dr. Sajad Zalzala: Uhm— [stutters] And that seems to work the best for a wide variety of people. Uhm— You know, they were the largest variety of people. I mean— I mean, there’s some individuality. I mean— I mean, people from Europe may be different from people from Asia and there might be little bit of uh— that kind of tweaking that you need to be there, but I just like the concept that when I think— I think got to be with that Yeast. So— So, anybody— anybody who comes in my office at sessions comes from Diabetes. First thing I do is I make sure that they get on a Pa— Low-carb— Low Starch Paleo Diet. Uh— And then, Metformin’s usually I’ll start with Like, if they want to go uh— they want to go [inaudible] I’ll be with a Berberine. Uhm— But then, from there, I mean, if— if you’re talking about the Insulin sensitivity, you put them on things like Chromium uhm— because, you know— Because Chromium’s important for the uh— for the receptors, Insulin receptors.

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: Uhm— You got to put in mind something— s— a good quality B Complex because all those— you know, all the B vitamins are— are— are needed to help process the Carbohydrates. And a lot of people are deficient on those just— just because of the process foods. Uhm—

Dr. Justin Marchegiani: Yup.

Dr. Sajad Zalzala: The Magnesium’s another thing uh— [stutters] that a patient’s on. Uhm— You know, uh— anything with bitter, like bitter Melon, Dandelion— anything that tastes bitter, they said they have substances in that help kind of control a blood sugar as well. Uh— I mean, there’s so many things you can do. Uhm— One medication I do not use for d— Diabetics is a Glyburide or the Sulfonylurea medication.

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: Uh— I stay. I stay away far those as possible.

Dr. Justin Marchegiani: Why is that?

Dr. Sajad Zalzala: The reason because uhm— if I— I find it actually helps accelerate Diabetes because what it’s— It kind of forces the pancreas to release more Insulin.

Dr. Justin Marchegiani: Stimulates more Insulin.

Dr. Sajad Zalzala: Exactly. Exactly. And the last thing you want as a Type II Diabetic is more Insulin, uhm— because it burns the pancreas out faster and it’s kind of a faster path down that cliff to you after [incomprehensible] eating Insulin injections. Uhm—

Dr. Justin Marchegiani: Exactly.

Dr. Sajad Zalzala: So—

Dr. Justin Marchegiani: That makes sense. [crosstalk] So, I just want to break that down for the listeners, right? What you’re saying is we have this pathway of Insulin resistance that happens. We have this drug Metformin, which is the— the French Lilac you mentioned, which decreases some Glucose absorption in the— in the gut. It decreases some of the Gluconeogenesis, which means producing sugar from the liver. Also, I think— I mean, you didn’t highlight, but I just want to see. Do you also give some extra B12 to prevent any uh— Anemia issues from the Metformin and Low B12 connection?

Dr. Sajad Zalzala: Oh, yeah! Anybody I’m informing, I always have their B12 level periodically, and— and I encourage them. B12, well that’s part of the B Complex that I tell my Diabetics to take.

Dr. Justin Marchegiani: Got it. So, that’s there. And again, conventional medicine, they’re not touching the diet. They’re typically recommending the food pyramid, which has…

Dr. Sajad Zalzala: Yes.

Dr. Justin Marchegiani: …more grains, more inflammation, higher blood sugar via Cortisol and just Carbohydrates that they’re consuming. And then, you know, typically, it’s the Sulfonylurea medications and then, eventually, they’re on to full on Insulin.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: And I know, just giving more Insulin to cover up all that sugar. So, you’re actually trying to get to the root issue…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …which is the diet and the lifestyle change. You may use a medication, which I do think Metformin is— is a better medication. And again, I think a lot of the anti-aging benefit just come from the fact that we’re getting Insulin down…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …too, right?

Dr. Sajad Zalzala: Right. Well, there are other— There are other uh— anti-aging properties in that formulated system.

Dr. Justin Marchegiani: let’s hear it. I’m curious.

Dr. Sajad Zalzala: Yeah. yeah. So— So there’s three anti-aging pathways. There’s a kind of..

Dr. Justin Marchegiani: Cool.

Dr. Sajad Zalzala: [incomprehensible] Sirtuin gene. Three major ones that we know about and there i— there may be more. So, you’ve got these Sirtuin genes. Uh—

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: let’s talk about that. So, you’ve got the uh— the AMPK, uh— A-M-P-K…

Dr. Justin Marchegiani: Yep.

Dr. Sajad Zalzala: …and you’ve got the MTOR. Uhm—

Dr. Justin Marchegiani: Yes.

Dr. Sajad Zalzala: You know, if anybody’s read anything about red wine and Resveratrol, they’ll know about the Sirtuin genes, originally discovered by a— you know, a guy— a brilliant uh— scientist out of a Harvard Medical School back about— about 20 years ago. He discovered that the— that— that from Yeast on up, we have these genes called the Sirtuin genes. Uhm— And— And he found that— that in— that in uh— many organisms, we can actually stimulate the Sirtuin genes by taking the Resveratrol. Now, they spent millions of dollars trying to find Resveratrol derivatives to work in humans. Unfortunately, it never panned out. Uhm— Now, Dr.— His name is Dr. David Sinclair. He’s back in the lab and he’ looking at a substance called NAD or NADH. It’s a derivative of— of uhm— Niacin. Uhm— Uh— Don’t ask me what NAD or NADH is for it’s really long.

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: You can look it up. But— But we’ve ignored NAD for a long time. You know, remember from your high school Biology class, uhm— N— you know, NAD was just kind of one of those things that’s just part of the Krebs cycle. We took it for— We took it for granted. You know, we always thought that the end goal is ATP, and we need ATP. But you need N— NAD to make it. We’re also…

Dr. Justin Marchegiani: [crosstalk] It’s a reducing agent, right? NAD’s main job is to— is to grab electrons.

Dr. Sajad Zalzala: Exactly. Exactly. And— And uh— You know, you need a certain number. I can’t remember if I’m at how many but you need a certain number of NAD to make a certain amount of ATP. But as you get older, the— the number of ATP— the number of NAD available to us is— is— is less and less. In fact, there’s this a— well, a study show that at a time you’re 50, you’re down about half as many as much— as much NAD uh— production as— as— as a young healthy adult does. Uh— And that’s— that’s the part of— that’s the problem why the Resveratrol in humans doesn’t seem to work. It’s because of that lack of NAD. Once you get the NAD levels up, then everything works better. And there are— There are some research on some substances that help to help do that. Uhm—

Dr. Justin Marchegiani: So, let’s break that down. So, what pathway was that again that you just mentioned that the— the Resveratrol was with?

Dr. Sajad Zalzala: The Sirtuin. The humans have a— seven—

Dr. Justin Marchegiani: Sirtuin?

Dr. Sajad Zalzala: …seven Sirtuins. Yes—

Dr. Justin Marchegiani: Is that similar to the— to the nerve pathways?

Dr. Sajad Zalzala: Uh— nerve— nerve— uh—

Dr. Justin Marchegiani:  Cell Resveratrol does a lot with the nerve pathways. Resveratrol, Green tre— Green tea— those kind of things.

Dr. Sajad Zalzala: I believe they are [crosstalk] related. I believe they are related. I have to…

Dr. Justin Marchegiani: It must be.

Dr. Sajad Zalzala: …go back to my biochemistry books to— to see how they’re related. Uhm—

Dr. Justin Marchegiani: [crosstalk] So, the first one’s the Sir path. Go ahead. Yes.

Dr. Sajad Zalzala: The Sir path, or the Sirtuin…

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: …Fluid path, but you need enough NAD in order— in order to— to actually put those certain pathways to— to be activated. And uh— there’s a lot of sc— there’s a lot of research going on in subs— substances to help boost NAD levels. Uhm— The one that’s available right now as a supplement form is called Nicotinamide Riboside or NR. Uhm— It’s kind of costly, but it’s— It’s well— well worth it. Uhm— Uhm— The uh— I find if used in combination with other uhm— Mitochondrial Support uh— supplements that actually works a lot better than by itself, uhm—

Dr. Justin Marchegiani: And then, additional B vitamins would also help with the NAD as well?

Dr. Sajad Zalzala: Uh— Yeah. B— Again, because you got to remember that Krebs cycle.

Dr. Justin Marchegiani: Z— Yeah.

Dr. Sajad Zalzala: With B vitamins involved…

Dr. Justin Marchegiani: Nicotine.

Dr. Sajad Zalzala: …and all that— Exactly. All in that— Well, maybe…

Dr. Justin Marchegiani: FAD as well.

Dr. Sajad Zalzala: …if NAD is— NAD is— is derived from— made from uh— a Niacin or B3 vitamin.

Dr. Justin Marchegiani: Yes.

Dr. Sajad Zalzala: Uhm— So— So, if I don’t have enough NAD, the Sirtuin genes don’t work. So— So, you need— you need both, like Resveratrol to sti— help stimulate the uh— the— the Sirtuin. But you need in that, you know, NAD boosters to help boost it to kind of work more. So kind of fuel, the fuel for the certain uh— proteins. The other two pathways, the uhm— the MTOR and the AMPK— those can be stimulated by things like Intermittent Fasting or fasting.

Dr. Justin Marchegiani: MTOR.

Dr. Sajad Zalzala: Yeah, exactly. Exactly. But also—

Dr. Justin Marchegiani: Also, coffee too, right?

Dr. Sajad Zalzala: Uh—

Dr. Justin Marchegiani: Can coffee help with the MTOR?

Dr. Sajad Zalzala: The— There’s a lot of things that we’re learning about that can help…

Dr. Justin Marchegiani: Yes.

Dr. Sajad Zalzala: …that can now boost MTOR. I’m not— I don’t— I don’t know as much about the studies for coffee but I— I wouldn’t be surprised. I mean— I mean, coffee’s got a lot of things in it, uh— Polyphenols and things like that. Uhm— But— But like I say, it can stimulate those pathways by uh— fasting— fasting, uh— Metformin. Also— Also stimulates those— those pathways well. Uhm—

Dr. Justin Marchegiani: Now, is it primarily doing it through the Insulin sensitivity. Is that how it’s doing it? Or is there another [crosstalk] pathway?

Dr. Sajad Zalzala: No, I think— I think there’s something else to it. I think there’s…

Dr. Justin Marchegiani: Okay.

Dr. Sajad Zalzala: …something else to it. Uh— I don’t exactly how it’s stimulating it, uh— but uh— but you know, when you do— you know, gene arrays and things like that, uh— you know, working analysis, it seems to be uh— uh— you know, stimulating those two pathways uh— for— for the positive. Uh— And that’s why there s— there seem to be more and more traction in getting Metformin. People who are not even Diabetic, you know, Pre-Diabetics, or eve people who just you know, who— who— who just had a little extra trouble losing weight, it seems to be very effective. Uhm— [stutters] And when you add it to a Paleo Type Diet. It just kind of adds that one more layer of—

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: …of benefit to it. Uhm— So— So, I— I commonly prescribe Intermittent Fasting for my patients. Uhm— And basically, what that is, is you know, you stop eating at like 6:00 o’clock at night. And then, you kind of skip breakfast. You know, I know that’s kind of blasphemy for a lot of nutrition stuff but yeah. You skip breakfast and then you don’t need until you know as— as long as you can go. So, usually it’s about, you know, 10:00 o’clock, noon, so that gives you a good uh— you know, 12-16 hours, where— where your kind of uh— kind of fasting for that period and you’re letting your Digestive tract uh— rest. And your turning on these— these house— housekeeping genes.

Dr. Justin Marchegiani: Yeah. And there’s a 16 by 8 where it’s your having that 16-hour fast [crosstalk] and 8-hour eat window, or an 18 by 6. And if anyone has adrenal issues or blood sugar issues, one thing you can even just think about doing is even a 12 by 12.

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: What you may stop eating at 7:00 PM, and then— or let’s say 8:00 PM but then you’re up at 7:30 the next day and you don’t have breakfast ‘til 8:00. And…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …that can give you 12-hour window too.

Dr. Sajad Zalzala: Right. Right. Read…

Dr. Justin Marchegiani: If you’re having between.

Dr. Sajad Zalzala: The longer you can go without food, the— the more likely you are to turn on these housekeeping genes. Uhm— The effect is at the M— the MTOR, the AMPK, uh— some of the other— some of the other genes as well. Uh— And— And— And, you know, there’s also a way to do it is called a calorie restriction, but uhm— [stutters] the people who are brave enough to do the TruCalorie restriction. Uh— I— I’ve heard— I’ve heard— I’ve heard that they’re miserable because they just don’t have enough vitality to, you know, they don’t have calor— enough calories in the diet to sustain vitality. Uh—

Dr. Justin Marchegiani: A hundred percent.

Dr. Sajad Zalzala: Again, they— they— they may end up living a little bit longer than the rest of us but, you know, I— you know, I think there are— there ae so many other ways to kind of accomplish that same goal without— without— without that uh— hit to your vitality.

Dr. Justin Marchegiani: Yeah. The problem is I’ll— i— if we’re talking— You know, people talk about nutrition and then use calories a lot, but calorie’s just a form of energy.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: It’s a measurement of heat. Really, calories in our world are gonna be attached to nutrients.

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani: So, if we’re talking low calorie, we’re also talking a low nutrient diet, and our— our metabolic system to need nutrients.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: So, it’s not good to shorten the nutrients…

Dr. Sajad Zalzala: All right. Right.

Dr. Justin Marchegiani: …but if you can get the nutrients in but use the fasting window…

Dr. Sajad Zalzala: Uhmhm— Uhmhm—

Dr. Justin Marchegiani: …to still turn on some of that biochemistry that— that has that effect, then you get the best of both worlds.

Dr. Sajad Zalzala: Sure. Sure. Well, what I was referring to is this fad that I think [stutters] that uhm— that came about maybe 20 year ago— 20 years ago, around the same time the discovery of Sirtuin genes, where they— where they took monkeys, for example, and I put them. You know, they did— they didn’t calorie restrict it. Uhm— And yeah. I mean, the monkey was calorie restricted. You know, he was lean. He lived longer without diseases but i— people said he looked miserable. Uhm— They— I think, they— they start losing fertility in things like that just because your body just can’t— you can’t— the body just can’t function on— on such a reduced calorie. And by reduced, I mean, take— take your basal calorie requirement so for me, it would be somewhere around, you know, 2,000 or 2,200 calories, and cut that by 30 percent. And sustain that. That’s really hard to do. Uhm— the people who do it— I don’t know if there’s anybody left [laughs] that was still doing it. Uhm— But— But the p— But there was a society, the Calorie Restriction Society, back like 10-15 years ago. Uh— I don’t know if anybody’s still part of that or not. But, people who do it— I mean, you got to be really strict about it. Uh— And then, you have to be really careful talking about the nutrients. You have to be really careful to get all your nutrients in and that condensed in that lower calorie. I’m not a proponent of calorie restriction. I think there are other ways to do it. I think the Intermittent Fasting will get you most of the benefits. Uhm— Intermittent— Intermittent Fasting— well, you don’t do it everyday. You may..

Dr. Justin Marchegiani: Yes.

Dr. Sajad Zalzala: …do Intermittent Fasting maybe four days out of the week. Uhm— And then that— that’s what I— that’s what I…

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: … currently do.And, if there’s a better way— you know, If somebody comes on and mention there’s a better way to do it. You know, I looked at research. I looked at some data behind it [stutters] and I adopt uhm— and I kind of adopt that posture and try it out with myself and see.

Dr. Justin Marchegiani: I think that’s great. I think there’s some really good benefits there. So, really interesting. You broke down those pathways and how uh— Metformin and maybe [stutters] functional medicine practitioner looks at Diabetes or Insulin Resistance. Let’s look at pain. Let’s look at like the enzyme…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …pathways. There was the enzyme that kind of works on those sick low oxygenates…

Dr. Sajad Zalzala: Uhmhm— Uhmhm—

Dr. Justin Marchegiani: …pathways. Let’s break that down. What’s the mindset, allopathic versus on the functional medicine there?

Dr. Sajad Zalzala: Yeah. So, I mean, uhm— you know— Pain— Pain is actually a very good topic because, you know, ev— everyday we’re hearing about, “We’re kind of in Opioid crisis. People are over— overdoing Opioid.” But just— just— just a little aside on that— I mean— I mean, I think an addiction, in general, was on the wise. Not just a medication addiction, I think— I think people using pain medication, because— because addiction is just such a big thing now, and a lot of it has to do with the but— you know, the— the— you know, the neurotransmitters and brain being s— so out of whack for— for all sorts of reason. Uh— You know, depleted nutrients, uh— Uhuh—

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: Just— Just the Chronic stress. Uh— Now, you have cell phones— you know, and the cell phone kind of teaches you how to— how to— how to be addicted. You know, every little minute you’re looking at it, and you know, you’re like that little monkey who— who— who oppress the— who oppress the Dopamine stimulation until they die. Uhm— [clears throat] And so— So, I think, you know, pain is a big thing but we also have to kind of look at— have to look at the addiction uhm— all part of it as well. But, to answer your question, uh— yes. So— So, you know, in the conventional allopathic, if somebody comes to you with some kind of Tendonitis or inflammation somewhere, you know, the first thing you reach for is Ibuprofen, you know, Naproxen, uhm— you know, uh— Celecox— Celecoxib— things like that. Uh— And those— Those uh— uh— blocks the action of the COX-2, uhm— but not without— but not without side effects. Uhm— You know, stomach— stomach issues is big. Uhm— You know, if you’re using the occasional Advil— you know, it’s Ibuprofen. It’s— It’s probably okay but— but, you know, people who are around it all the time, it seems to set them up for things like leaky gut, uhm— dysbiosis, uh— and those can really set you up for even— ironically, for even more inflammation down the line. Uhm—

Dr. Justin Marchegiani: So, basically, the enzymes that those medications block, those enzymes are really important for Hepato— b— basically, repairing the liver, repairing the gut lining…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …helping the heart to be healthy. So, you’re blocking one enzyme…

Dr. Sajad Zalzala: Uhmhm— Uhmhm—

Dr. Justin Marchegiani: …that creates this inflammatory compound called Prostaglandin 2, right?

Dr. Sajad Zalzala: Uhmhm— Exactly.

Dr. Justin Marchegiani: But then, on the other side of the fence, it’s decreasing the repair of the heart, the gut and the liver, right?

Dr. Sajad Zalzala: Exactly. Exactly. I mean, there— there are much more effective ways and much less an— much, much less dangerous ways of doing it. Uh— You know, something simple as Turmeric and I…

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: …believe there’s enough Turmeric now, but there’s so many other uh— alternatives out there, but you know Boswellia, uh— Devil’s Claw uhm— you know— you know, Ginger, Celery seed. There’s— There’s [stutters] There’s very— There’s very nice combinations out there as well. I kind of combine all those and kind of in proper ratios. And they have almost none of the side effects you’ll get and the inflammatories uhm— uhm— but again, I mean— I mean, they— they may work you know, if you’re in a pinch, but— but I wo— I— Again, I always recommend trying to figure out why. That— That’s what functional medicine is all about. Why? Why doesn’t the inflammation [inaudible] Why do they have pain? Pain is a symptom. The— There’s something wrong, uhm— and— and you have to try keep— keep— keep peeling the onion, so to speak. You got— you got to keep— keep going to the next layer until— until you figure out why and what therapeutic you need to kind of get in there and fix that pathway. That’s done right.

Dr. Justin Marchegiani: And, you know, those medications, those NSAIDs, they work really good. And they do [crosstalk] really do have, I think acutely, you know, a day or two…

Dr. Sajad Zalzala: Yeah, exactly.

Dr. Justin Marchegiani: …or let’s say you broke uh— you broke a bone or you had a surgery or something. I think they w— they work great, or maybe, you know…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …worst case if it doesn’t happen too often, maybe you drank too much the night before, right? But, we want those longer term— Wha— Wha— One, we want diet and lifestyle strategy [crosstalk] to that keep the inflammation down. But, number two, we want natural strategies that we can use more frequently…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …and not have to rely on the big guns, right?

Dr. Sajad Zalzala: Exactly. Exactly. I mean— I mean, I’m not— I’m all— I’m all for, you know, taking an Aspirin or an Advil when you— you know, you got [stutters] you did something you shouldn’t have and [laughs] now you’re gonna pay. You reach one that’s fine, but a long-term use, no. I mean, like you mentioned heart— heart issues uh— you know, raises your blood pressure. Uh— you know, it’s really hard on the kidneys and the liver. Uh— So— So, there’s really no— there’s no good reason. Now, unfortunately, the alternative out there has been the Opioids.

Dr. Justin Marchegiani: Yes. That’s the big hit. Big deal.

Dr. Sajad Zalzala: Yeah. And— And then, that’s— you know, that’s been devastating people in so many different ways. Uhm— You know, uh— the— the chronic activation of the Opioid receptors. Uhm— So— So, first of all Opioid receptors are seem to be everywhere in Nevada. And— And this is a good segue into LDN Low-Dose Naltrexone. Uh—

Dr. Justin Marchegiani: Yes. Perfect.

Dr. Sajad Zalzala: L— LD— Yeah. Opiate Receptors are almost everywhere in your body. You know, when we— when you reach for Tylenol 3 or Percocet or Vicodin, you know, that’s stimulating the Opiate receptors in the brain and the spinal cord to try to reduce the pain. Uhm— But, it’s also blocking the Opiate receptors in our Immune System, in our Pituitary gland, and all [stutters] the Gluteal cells in our brain. You know, they’re— they’re everywhere and— and we’re learning more and more about how important these are. And, that’s why you’ll often see people who are in chronic pain medication, uh— chronic Opioid medications. Uhm— The testosterone’s in the tank. If they’re female, their hormones are all in a whack. Uhm— Uh— You know, [stutters] it just kind of seems to decimate the uh— decimate the uh— the— the Endocrine System body, uh— and in the end will all sorts of— well, long-term— long-term effects. And to make things worse, they stop working after. Uh— And that— And that’s why you get tolerance, and tolerance eventually leads to addiction, where you need more and more and more of it, to get the same effect. Uhm— ‘Cause— ‘Cause eventually, the body starts to  downregulate the Opiate receptors. They’re stimulated way— stimulated way too much. The body downregulates to them uh— them and— and— and you just— you just don’t have any Opiate receptors left now.

Dr. Justin Marchegiani: So, it’s basically like Insulin resistance but with your OPR receptors?

Dr. Sajad Zalzala: Yes. you can think of it like—

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: …just like that. I mean, it’s— it’s probably slightly different but yeah. Exactly. So if— So, I— I think— I mean, I don’t— I don’t have any data to prove this but I think the same reasons why all of us are becoming Insulin resistance is the same reason why we’re all becoming Opiate resistance. Now by the way, we make our own Opioids. They’re called Endorphins. You know, uh— they ru— they runner’s high [stutters] and that high that they get when they— when they— when they, you know, exercise. That’s because of release of Endorphins. Uhm— And so— And so, by becoming like Endorphin or Opiate Resistant, we’re actually blunting that— that natural response we get to— to uh— to let go natural Endorphins. And the— And that— And that can have a lot of consequences as well.

Dr. Justin Marchegiani: One hundred percent. And that again, it’s like when you come up and your resistant and then you come back down, I mean, the side effects of coming off Opioids are…

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: …tremendous.

Dr. Sajad Zalzala: Right.

Dr. Justin Marchegiani:  And, my big concern is chronic inflammation— You go from NSAIDs, unaddressed, you go to Opioids…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …and the problem is, the more stressed you are and the more inflamed you are— I’ve never found a stressed, a chronically stressed or inflamed person that didn’t have a bad diet, and they didn’t have also a bad gut. And the problem is…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …you mentioned it earlier, beta-Endorphins are natural pain-relieving compound…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …but beta-Endorphin is a 19— uh— I mean, 19 the— 19 amino acids to make beta-Endorphins. So, if we have bad digestion…

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: …we’re not gonna be able to break down those proteins and make our natural…

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: …beta-Endorphins as well.

Dr. Sajad Zalzala: Right. Right. So you have— So you have a production issue but also a receptor issue.

Dr. Justin Marchegiani: Yes.

Dr. Sajad Zalzala: Uh— One way— Now— Now I mentioned that the Opiate receptors are on Immune System as well.

Dr. Justin Marchegiani: Uhmhm—

Dr. Sajad Zalzala: Uh— And— And— And we’re learning more about— more and more about— about the importance of them. We haven’t fully fleshed out the exact amounts, but it seems like people who have Immune System issues, like Rheumatoid arthritis, uh— Fibromyalgia, uhm— you know, Gout, uh— Sorry, not Gout, Psoriasis— things like that, uhm— they— they seem to have a uh— they seem to have a lack of these— was— of these Opioid receptors. And, uhm— uh— And that’s kind of where the— the idea of using Naltrexone comes in play. Uhm— So, Naltrexone, for those who don’t know uh— was originally uh— uhm— approved back in the— in the 80’s or 90’s for— for alcoholism uhm— but at— at the 50-milligram dose, and it’s still used. There’s a lot of— There’s a lot of addiction centers that use uh— Naltrexone uh— to help— to help alcoho— alcoholics stay away from alcohol. Uhm— However, there’s a doctor— I think his name was Dr. Bihari. He— He— He found out, kind of by accident, that- that people who are taking Naltrexone, uhm— they seem— they seem to have a positive effect on the Immune System. Uhm— And so, you know, they play around the dose to try to hear out what the— the optimal dose was, and it turned out the lower the dose the better, up to— up to a point, obviously.

Dr. Justin Marchegiani: So, we’re talking like 2-4 milligram-ish?

Dr. Sajad Zalzala: Yeah. Yes. So, 2 – 4½ — 4½, initially the highest that I’d go. So, the reason it’s called Low-Dose Naltrexone because we’re not using it at pharmacological 15 milligrams. We’re using it more of the physiological, maybe homeopathic— uh— you know, 2 milligram to— to 4 ½ milligrams. Uhm— In fact, I think it’s such a powerful therapy. You know, obviously it doesn’t work by itself. I need to kind of address the other issues, but sometimes, you know, it— it— by itself, I’ve— I’ve seen it work— wonder drug. So, I uh— I have this— I have this web service that everyone— It’s called the, uhm— uh— where uh— you know, a lot of people doing a lot of reading on, and on the end it’s got a lot of— it’s got a lot of uh— you know, coverage on Facebook pages and other news groups, and things like that. Uhm— And— And, if you want to know where they can go to— to get a prescription, a lot of times, the last evac and the family doctor, and the Doc kind of specializes ahead and say, “Well, you’re not alcoholic, why do you need Nal— Naltrexone?” Uh- It’s because, you know, most allopathic doctors have no idea that you can use Naltrexone this way. Uhm— So, I created this website called, where patients can request the uh— descriptive directed consultation, and I evaluate them for prescription for the LDN. It has to be from compounding pharmacy, and there’s several good ones around the country. Uhm— So, that— that’s kind of another site service that I offer as well, uhm— becau— because— because it’s such— I think it’s such a powerful therapy. Uh— The number one reason that I prescribe it is for Fibromyalgia. Uhm— The number two reason is autoimmune conditions of all sorts: MS, Rheumatoid arthritis, Psoriasis— things like that. Uhm— But there’s been more and more a— uh— research on it for— for psychiatric conditions as well. Again, going back to those Opioid receptors and Glial cell which can help— help control the information in the brain, we think that Anxiety depressionism is inflammation in the brain, so if you can do— do anything to reduce that inflammation, uh— it— it seems to help uhm— So, uh— uh— so— so— The way it works, uhm— The mechanism of action for the low-dose Naltrexone, is that you— you— you temporarily block the opioid receptors.

Dr. Justin Marchegiani: Receptors, right?

Dr. Sajad Zalzala: Exactly. And then, uh— but only for a short time and only for a small amount. And so, over time, you actually end up with more Opioid receptor. And it— And it changes gene expressions and things like that to positive, and that help balances the Immune System. It doesn’t activate— It doesn’t overactivate the Immune System. It doesn’t suppress the Immune System either, but it brings it back into a balance. And that’s why it’s also used for things like uhm— uh— infections. In fact— In fact, some of the early work on— on LDL was for HIV, uhm— but a lot of times— you know, people— what people requested for to help fight off uh— you know, uh— Lyme disease, uh— Chronic Epstein Barr Virus infection, uh— thing— things of that nature.

Dr. Justin Marchegiani: That’s great. So, basically, what’s happening is, we have a mild blocking of that…

Dr. Sajad Zalzala: Hmhm—

Dr. Justin Marchegiani: …Opiate receptor site, and then, there’s some compounds that are produced to help modulate the Immune System help that, the T-regulatory cells, to kind of balance out that…

Dr. Sajad Zalzala: Exactly.

Dr. Justin Marchegiani: …ones. But of course, you’re looking at is, “Okay. Here’s like a palliative thing we can do to just kind of help with the Immune System.

Dr. Sajad Zalzala: Uhmhm—

Dr. Justin Marchegiani: You may also be working on the Insulin Resistance, the inflammation.

Dr. Sajad Zalzala: Right. Right.

Dr. Justin Marchegiani: Maybe, Vitamin D is profound as well. So, you may be looking at a bunch of other things, but then, plugging that in as an additional palliative support.

Dr. Sajad Zalzala: Sure.

Dr. Justin Marchegiani: Is that correct?

Dr. Sajad Zalzala: Exactly. Exactly. And, I have uh— about— about half of patients that asked me for— for the prescription are already working with a holistic practitioner and greater practitioners such as yourself, uh— but, you know, who may not have prescribing powers. And it is uh— it is a “prescription only” medication protocol. Uh—

Dr. Justin Marchegiani: I think it’s important because I think a lot of Docs, they— they may say, “Hey. Here’s this natural thing. They prescribe it but they don’t do all the other things that I consider…

Dr. Sajad Zalzala: Right. Exactly.

Dr. Justin Marchegiani: …follow-up upstreams. So, I think it’s important that you’re setting the table upstream, but then you’re also working downstream, too.

Dr. Sajad Zalzala: Exactly. So, anybody that I do a consultation on for the LDN— uh— LDN prescription, I make sure they’re— they’re working with somebody or I put them in touch with somebody before I create. Uh—

Dr. Justin Marchegiani: Oh, that’s great.

Dr. Sajad Zalzala: Yeah.

Dr. Justin Marchegiani: So, I’m just curious. If someone like is addicted to— to— to Fentanyl or Oxycodone or whatever too, can you just list out the— these uhm— these Opiate medications?

Dr. Sajad Zalzala: Yeah. So—

Dr. Justin Marchegiani: Fentanyl, [crosstalk] we have Oxycodone, Percocet—

Dr. Sajad Zalzala: [incomprehensible] found in patches. Oxycodone is found in Percocet. Percocet is a mix…

Dr. Justin Marchegiani: Yeah

Dr. Sajad Zalzala: …of Oxycodone and Acetaminophen [inaudible]. Yeah. You’ve got the Vicodin, which is Hydro— Hydrocodone mixed with Tylenol. Uh— We have Norco. It’s very similar— It’s similar. We have Codeine, which is very weak uh— uhm— uh— Opioid medication. It— It’s converted to Morphine. Uh— Morphine is the— is the original. I mean, that’s what they— that’s what they extract from the Opium, uh— the Opium uh—

Dr. Justin Marchegiani: Right.

Dr. Sajad Zalzala: …poppy plant. Uhm— And uh— uuh— And so—

Dr. Justin Marchegiani: And— And then, with Heroin— Heroin’s also a derivative of that too, right?

Dr. Sajad Zalzala: E— Exactly. Exactly. Uh— The another derivative that is Dilaudid or Hydromorphone.

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: It’s about four or five times stronger than uhm— [stutters] than Morphine. Uhm— And so, when we— when we look at these medications, how much somebody’s on, we always look at what’s called a Mor— Morphine equivalent dose.

Dr. Justin Marchegiani: Hmhm—

Dr. Sajad Zalzala: Because like— It’s like at a Morphine the original molecule and all these other Opioids are kind of uh— derivatives. Uhm— Now, outside of these consen— you know, hard Opioids, there are some synthetic Opioids. Uh— Tramadol is one of them.

Dr. Justin Marchegiani: Yup.

Dr. Sajad Zalzala: Uhm— And one of the newer ones on the market is called Nucynta. Uhm— And— And they— They work by [stutters] they activate the Opioid receptor, but not as strongly as Morphine and their derivatives. But, they also have other— other effect to them. Uhm— Patients tend not to tolerate them as well as— [stutters] as a pure Opioid medications because they have like uh— effects on uhm— uuh— the— the effects on Serotonin and Dopamine and things like that the patient just can’t tolerate sometimes.

Dr. Justin Marchegiani: A couple of quick questions. Is Oxycodone and Oxycontin the same thing?

Dr. Sajad Zalzala: Uh— Oxycodone is kind of a generic. Oxycontin, it would be as a brand name. Uh—

Dr. Justin Marchegiani: Brand name.

Dr. Sajad Zalzala: Yeah. And Oxycontin is— is supposed to be an extended-release but uuhm— uh— but that’s actually been replaced by Oxymill, uhm— uh— because too many people were just kind of breaking the tablets, and you know sniffi— I don’t want to give…

Dr. Justin Marchegiani: Right.

Dr. Sajad Zalzala: …anybody ideas [crosstalk] for sniffing.

Dr. Justin Marchegiani: Right. No.

Dr. Sajad Zalzala: That’s a— [laughs]

Dr. Justin Marchegiani: It’s already out there.

Dr. Sajad Zalzala: [laughs] Yeah, exactly. Chewing them, uh— you know— thing— things like that they’re doing just to get that high. Because, again— you know, [stutters] once you get a little bit of that high, you’re always for a next time. You just have to take higher and higher doses to get that high. Uh—

Dr. Justin Marchegiani: So, with Oxy and Hydrocodone, which one’s stronger?

Dr. Sajad Zalzala: Uh— I believe the Ox—

Dr. Justin Marchegiani: The Oxy?

Dr. Sajad Zalzala: Yeah. The Oxycodone, I believe is— is slightly stronger than the Hydrocodone, uh— which is about on par. Uhm— But— But because these are kind of all derivatives of Morphine, I mean, different ones have different— have different uh— reactions uh— in patients. UHm— Like for example, some people say that uh— Oxycodone uhm— doesn’t— doesn’t cause constipation as much as Morphine. Uhm— uh— you know, I— [stutters] I pre— prescribe in my clinic but— but I— I am— I try as much as possible to get patients off of them as much as possible. Actually, I— I don’t prescribe them myself. I have a lot of patients who come to me in my— my practice in Ontario, uh— who— who were on them. And— And it’s just a lot of work uh— to think— to get patients off— off of these Opioids. Uhm—

Dr. Justin Marchegiani: And, do you have a taper? Like, do you have a protocol in which you— you’re tapering off a certain percent over a certain time  or is it just totally customized?

Dr. Sajad Zalzala: Uhm— It’s kind of customized depending on— you know— how long the patient is on it. Uh— I mean, the guidelines say, I think uh— no— no more than ten to 20 percent for a month. Uhm— I find that actually quite aggressive. Sometimes, you have to bring it down just a smidge each— [crosstalk] each month.

Dr. Justin Marchegiani: So, maybe like— maybe like five percent a month is— is reasonable?

Dr. Sajad Zalzala: Yeah. Yeah. And that [stutters] the challenge is that the dose— the dosing seems to be uhm— tsp— is not— is not uhh— l— like, for example, uh— Oxy— Oxycodone comes in, you know, fives and tens. Uh-huh— say…

Dr. Justin Marchegiani: Right.

Dr. Sajad Zalzala: ..gonna create it. Uh— You know [stutters] and kind of find uh— in between. Uhm— There’s also, you know, co— There’s also the uh—  the ant— the agonist— antagonists like uh— Methadone and Suboxone. Uh— Those are a lot more…

Dr. Justin Marchegiani: Right.

Dr. Sajad Zalzala: …popular uhm— but— but— you know, they have some of the same properties as— as your Opioid medications. But— But if you take too much, it kind of blunts the high. Uhm—

Dr. Justin Marchegiani: Do you have any experience with the herb Kratom to help people get off the Oxys?

Dr. Sajad Zalzala: I’ve heard a lot about that. [laughs] Uhm— But I had not— I don’t have any person— I’ve had— I’ve had several patients ask me one, uh— but I haven’t— I— I— I don’t— I don’t know any reliable sources uh— or safe sources so I don’t — I don’t recommend it. Uhm— I’d have to do more— more reading research and I should get— get more feedback from patient before I can make any recommendation. However…

Dr. Justin Marchegiani: [crosstalk] Yeah. For good things to be better.

Dr. Sajad Zalzala: Yeah. However, to— to kind of segue to another topic we’re about— w— w— we’re talking about on the pre-recording— How— How much time do we have by the way?

Dr. Justin Marchegiani: Uhm— We have— We have about f— five or ten minutes left.

Dr. Sajad Zalzala: Oh, okay.

Dr. Justin Marchegiani: How much do you need?

Dr. Sajad Zalzala: Yes. So, just real quick. So, I was completely against, you know, uh— Cannabis. You know, probably…

Dr. Justin Marchegiani: Oh, yeah.

Dr. Sajad Zalzala: …for five years. Oh, yeah. So, I’m completely against it. You know, when— when I had patients come up to me about Cannabis— medical Cannabis, ‘cause— cause it’s legal here in Ontario and several other states. I was like, “You know, okay. The— These— you know, these patients are just kind of find uh— a legal way to get high.” But then, uh— you know— But then I had a medical student with me rotating one day and he’s like, “Doc, you got to— you got to check out the OCBD.” You know, and then— and— and you know, which is a— which is a component of Cannabis. Uhm— It’s Cannabidiol. It’s so— It’s so— so Cannabis, the plant. I mean— I mean, we— we’ve taken it from nature and we’ve kind of hybridized it, and things like that, that [stutters] a lot— a lot of times the recreational one is much higher THC than what we find in nature. Uhm— And so— so a lot of people who— who were looking for— uh— Cannabis as a recreation, will look for the high THC. Uhm— And— ANd THC has some psychoactive properties. It— It can have some therapeu—

Dr. Justin Marchegiani: It will get you high, basically.

Dr. Sajad Zalzala: Exactly. Exactly. But it can help with people with…

Dr. Justin Marchegiani: In the munchies.

Dr. Sajad Zalzala: Exactly. Exactly. It can help in to a limited extent people who have like Anxiety issues, PTSD— things like this. So, there is a place for a little bit of THC.

Dr. Justin Marchegiani: Yeah.

Dr. Sajad Zalzala: Uhm— However, one of the components that I’ve been impressed with the CBD Cannabidiol.

Dr. Justin Marchegiani: Mm—

Dr. Sajad Zalzala: And that— that seems to have a lot of anti-inflammatory effects. In fact, there seems to be specific Endocannabinoid receptors in our— in our— in our selves, in our bodies. Uh— We’re not— We’re not quite sure what they’re there for. Uh— because we haven’t, I don’t— T— To date, I mean, I haven’t— I haven’t seen the news and greatest research of date. There’s nothing in our body that— that stimulates these Endocannabinoid receptors. It’s just but— but these Cannibal [stutters] these uh— these Cannabis extracts do. Uhm— And— And they have a lot of a pos— positive effects on our— on our inflammation on Immune System. Uhm— When I— When I prescribed a CBD Oil, I almost always prescribe it with the highest CBD concentration available. Somewhere…

Dr. Justin Marchegiani: 2 THC

Dr. Sajad Zalzala: …about 20 percent. Exactly. THC— I try to keep THC to a minimum. Uhm— Uh— And— [stutters] And I’ve have patients who h— who have milder, the— they seem to get better on it. I’ve had a co— a couple patients with seizure disorder. Uh— It doesn’t work for everybody with seizures but— but it does seem to— it does seem to help in a couple patients I have..

Dr. Justin Marchegiani: And is that working with the Opiate receptor site? Would you do that in conjunction with LDN or you’re choosing one path or the other to start?

Dr. Sajad Zalzala: Well, they’re separate paths.

Dr. Justin Marchegiani: Okay.

Dr. Sajad Zalzala: So— So, you—

Dr. Justin Marchegiani: But the CBD, it’s still hitting the Opiate receptor though, a little bit, isn’t it?

Dr. Sajad Zalzala: Uuhm— Not— I could say, the— the— the making reaction seems to be this— this uh— uh— uh— Endocannabinoid receptors

Dr. Justin Marchegiani: Okay.

Dr. Sajad Zalzala: Uhm— And— And it’s— And it’s separate. I mean, there are— there are people— Uh— There— There may be some cross— cross-reactivity there, but I think— I think it’s uh— fairly minimal from— for what I know. Uh— And so, there are people routinely on CBD and LDN, and it doesn’t seem to be any reaction. Uhm— Now, if somebody’s on CBD and they want to try LDN, I usually just add precaution and start them on a lower dose than they normally would. Uhm— And then— And then teper them up more slowly.

Dr. Justin Marchegiani: Mm—

Dr. Sajad Zalzala: But— But you know, I’ve had a lot of people using successfully the other, and I see they’re kind of synergistic. Uhm— So, I’ve come around the last couple years on Cannabis. I mean, I— I still think it shouldn’t be used recreationally. Uhm— And I don’t think it’s worth it. I— I think there are just too many— too many problems with using it frequently. But— But if you can get the me— medicinal aspects out of it, uhm— then— then I think— I think it actually [stutters] has the potential of being a— a great uh— adjunct thera— therapeutic to— to all the others that we talked about.

Dr. Justin Marchegiani: So, with the CBD, you’re not getting maybe the slower reaction time, or the munchies or maybe any of the maybe the lower motivation or uhm— memory issues. It’s— It’s more just helping modulate, has some anti-Anxiety stuff to it. It has to be Endocannanib— the Endocannabinoid receptor activation which helps with the Immune System. THC though— I— I do hear it does has some really good pain benefits and some…

Dr. Sajad Zalzala: It does.

Dr. Justin Marchegiani: …anti-nausea stuff, if there’s maybe some chronic pain or some Cancer stuff happening. Is that true too?

Dr. Sajad Zalzala: It does, absolutely. Absolutely. I mean, because I’m not a pain doctor, uh— when— when somebody requests uh— Cannabis, medical Cannabis for pain, there is a Cannabis Pain Medical Clinic here— here in town that I refer them to. Uhm— But— But my gu— But I’m— Uh— I’m much more comfortable prescribing them the low THC because, you get— you get into a lot less legal trouble that way. [laughs] When you start dealing with, you know, THC products then, you know, there’s— there’s uhm— special courses the doctors are expected to go through, and I just haven’t had— I just haven’t had the time t— to do those yet. So, I don’t feel comfortable playing around with THC so much. But CBD I, you know, I haven’t seen any problems with it so far. It certainly doesn’t seem to affect the— the— the cognition, right?

Dr. Justin Marchegiani: And if someone does CBD— If someone does use the CBD, can they— can they work while they do it? Can they drive while they do it?

Dr. Sajad Zalzala: Yes. As far as I know. I mean, as far as I know, I hadn’t seen any way [incomprehensible] with it. Uhm— In fact, a lot of the products in the states now uhm— the— they kind of get around— get around the whole legality should by using Hemp— Hemp-derived CBD. And— And uh— there are farmers that uh— that— that grow uh— uhm— uh— specifically, bred Hemp products that had almost no THC and high CBD. They don’t— Technically , Hemp is still legal in the U.S. It’s not grown in the U.S. It’s grown in Canada. [laughs] Uuh—

Dr. Justin Marchegiani: Mm—

Dr. Sajad Zalzala: But— But— But, you know, Hemp— Hemp— Hemp products. I mean, you can buy Hemp seeds. You can buy uh— uh— you know, cereal with Hemp in it if you like. You can buy Hemp oil. Uhm— But— But— But like I kind of get to get around the— the legality of uh— using Cannabis uh in Marijuana. Uh— A lo— A lot of— A lot of the CBD products over-the-counter, on the market or [inaudible]. Yeah. And [stutters] I don’t think that’s any problem. Uhm— uh— I— You know, the— they seem to work— they seem to work just as well, whether you get it from Hemp or from— from the regular, you know, uh— Cannabis.

Dr. Justin Marchegiani: Amazing. Really great information, and Doc— Dr. Z is licensed in over 35 states here in United States as well. He’s also uh— in Canada too. So, if you’re on both sides of the fence there, feel free and reach out to him.

Dr. Sajad Zalzala: Yeah,

Dr. Justin Marchegiani: rootcauses— plural— So, feel free…

Dr. Sajad Zalzala: Yes.

Dr. Justin Marchegiani: …and reach out to Dr. Z. He may really help provide that extra buffer between the conventional medicine and functional medicine bridge that a lot of people need. Dr. Z, thank you so much Is there anything else you wanted to share with the listeners today?

Dr. Sajad Zalzala: Well, the only, I think, was that LDN Direct if anybody want to be uh— you know— want where is just in a minute. If they’re working with practitioner but they want to try the LDN, uhm— you know, I’d— I’d be more than happy to try to help them. Uh— So, it’s LDNdirectcom. Uh— And— And uh— And then, a lo— a lot of times people don’t have a practitioner to work with, and I refer them to my Root Causes Clinic or to a local practitioner such as yourself.

Dr. Justin Marchegiani: Dr. Z, thank you so much for the information. It’s refreshing getting both sides of the fence there. Have a phenomenal day. We’ll talk soon.

Dr. Sajad Zalzala: Thank you.

Dr. Justin Marchegiani: Thank you.





Dr. Bernard Bihari, Low Dose Naltrexone Pioneer

Dr. David Sinclair, Resveratrol, NAD, and NADH






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.