How to Deal With Stress and Feeling Overwhelmed? | Podcast #376

Connections between the brain and gut abound, which can be seen in the dysfunctions that often unite them. Many neurological and mood disorders often have enteric manifestations, GI disorders may present with neurological and psychiatric symptoms, and psychological stress may adversely impact microbiome balance and GI function.

Dr. J and Evan Brand discuss that consideration of the bidirectional relationship of the gut-brain axis will inform individual treatment strategies. Managing external stress-related factors while optimizing gut health may jointly address some chronic health conditions. Specifically, personalized therapeutic strategies that combine stress transformation approaches with gut health interventions, such as functional testing, nutrition, and natural supplements, may help to optimize gut function and bolster related body systems. Learn more about supporting the microbiome and its effect on overall health when you subscribe to this channel!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
0:46 – Stress
6:41 – Brain Chemistry
7:51 – Water Filtration and Organic Foods
13:56 – Cortisol Patterns
23:13 – Stress and Hormones
30:00 – Testing and Functional Strategies


https://youtube.com/live/zJccNb1lT3M

Dr. Justin Marchegiani: And we are live. It’s doctor J here in the house with Evan Brand. Really excited. We are back doing our live podcast. Really excited to be back in the saddle. Evan, how we doing, man? What’s going on? 

Evan Brand: Oh, doing really well. I’m excited to talk about stress. My wife, she woke up this morning.Which is like my jaws tight was like grinding my teeth last night and maybe you need to talk about that today. So I thought, OK, everyone is stressed, there’s a lot on everyone’s plate, but it’s really how you respond to it that really determines whether it makes you and you become someone and something and you get success out of your stress. Or do you just get frazzled and burned out and you resort to alcohol and tobacco and other addictions, chocolate and wine and whatever else to cope with that? And I think there’s a lot healthier coping mechanisms or stress for burnout, for feelings of overwhelm. And you and I have done this for years clinically. We’ve helped people through the toughest of cases. You and I have taken the huge load on our shoulders of, you know, trying to be the helper, be the healer with someone that’s struggling. And that’s a lot, that’s a heavy toll on us. So there’s things that you and I do personally. And then there’s things that you and I do clinically and then we’ve got some studies to kind of verify you know, what we’re seeing.

Dr. Justin Marchegiani: 100% So when I look at stress.You have the actual stress issue, like whatever that stress issue is, right? And so feeling anxious or feeling stressed about an issue is a good thing, right? Part of the reason that is there is to get you motivated to get off your butt to solve the problem. So I always look at the issue and I’m like. Right. Why do I feel stressed? Usually there’s you haven’t closed the loop yet. I call it closing the loops. Problem, right? You take action to resolve the problem, the problem goes away. That’s the closed loop, right? And so you have a lot of people with open loops. Meaning they have a problem out there and they just haven’t even figured out the solution. So when it comes to being healthy and having good neurotransmitters, good adrenal function, good healthy diet and lifestyle habits, good anti-inflammatory type of environment, nutrient dense foods coming in. Good nutrition, your ability to process one that stressor when it hits you, it’s not gonna hit you as hard. It’s not gonna knock you off your pedestal to you’re going to be able to adapt and you’re going to be able to think clearly and troubleshoot whatever the issue is. And so I always look at a problem. I said OK, got it, how do I close the loop on that, what’s the action item to execute? That so I always just kind of get clear, have a list. What are the things I can do and set in motion to resolve the issue. I think it’s really important if you just dust it away. The healthiest adrenal glands eventually is gonna eat away at you because you haven’t closed the loop. So always think about closing the loop on your issues #2 get healthier so these things don’t bug you as much, right? If you have good levels of B6, good levels of magnesium, you’re sleeping adequately, you have good blood sugar stability, Good amino acids. It’s gonna allow you to be able to process it. You’re not gonna activate that fight or flight part of your nervous system. That shuts down the frontal cortex and activates the reptilian brain stem part of the brain that’s all about fight or flee, fight or flee, fight or flee. And so the more you can keep this kind of reptilian brain from being activated, and then you can use that frontal cortex, you’ll be able to sit back, become troubleshoot the issue and close the loop.

Evan Brand: And this is hard if you’ve got toxins, if you’ve got lyme, different infections. I mean we’ve seen in the literature that certain infections and toxins. Basically, decrease the blood flow to that front part of the brain. So you become a monkey. You do become primitive as you mentioned. This reptile brain kicks in and you can’t make good decisions and you certainly can’t comprehend the future. You get stuck living in the day, the hour, the minute with that stress and when you say close the loop, I think that resonates for a lot of people, but many people are afraid to close the loop because this means that they have to end a friendship that’s toxic. They have to end a marriage that’s failing. They have to, you know, fire someone that they don’t like. They have to quit their job because they have a bad boss. So.You know, closing the loop sounds so simple, but this could be a huge roadblock. You know, for people, and I’ve seen it, where you’ve got a woman eating perfectly. She’s doing amazing with her supplements. But for example, here’s the case study. She’s in an open relationship and she’s miserable and she hates it. And she’s jealous and her husband’s with these other women and she doesn’t want him to be. And so there’s issues there. I don’t freaking care how much ashwagandha this lady pops. She’s not going to supplement out of this situation. That’s intense. And there is a place for closing the loop. And you can’t supplement your way out of a situation like that. 

Dr. Justin Marchegiani: Yeah. In relationship, it’s always good to have healthy boundaries, right? It’s like good fences make good neighbors, right? Having good emotional boundaries and how were relationship operates, right? If your families asking 10 times of you, then, then you, then ten times of you, then they help you on the backside, right, this kind of Arctic give and take that. So you always have to have clear boundaries. I think that’s a really, really important one. There’s an awesome book out there. Um, by Henry Cloud called boundaries. That’s a really good woman. I see patients in relationships. They may not even be a relationship with their spouse. It could be a relationship with family or friends where they’re just kind of a parasitic element of people asking many multiples from that person. Then that person’s providing back and there should always be a give and take. Right. I always tell patients like when you play catch, I throw the ball, you throw the ball, right. Emotionally, there’s a give and a take and it’s back and forth and it’s equal. When I start throwing the ball, you don’t throw it back. I run back over, get the ball, come back, throw it again, that, that, that’s, that’s you know very depleting, right? You missed the give and take, and so you gotta make sure your good, healthy boundaries are there. Also, with relationships, it’s always better to try to restructure. Kind of reboundify the relationship, then just exit. I think exiting a lot of relationships is just, uh, it’s an easy way out. It’s, you know, you just go somewhere and end your and go on to your life. I think it’s always better to see if you can repair or give people an opportunity to repair and get on the same page and see what happens from there. But either way, right, you have all these emotional issues. Get healthy. If you’re afraid to deal with these issues right now, put them on the back burner. No, you have to deal with them. Adjust your expectations of healing and try to get healthier so then you have better energy, better focused, better calmness to address whatever the problem is. 

Evan Brand: This is great advice and it’s uncomfortable and there are situations that are going to be intense, but I would encourage you just to go face first with those now if you have trouble making eye contact with these people. Some of that’s related to brain chemistry too. I see a lot of people that when they get in a stressful situation.They just shut down. They look down, they look away. They can’t face the person and therefore they can’t fully express themselves. That’s usually tied into low GABA, and so we can’t measure GABA on the organic acids. But we can measure serotonin, we can measure dopamine, we can measure endorphins. So before you and I go into a few of these studies and solutions, you know, let’s just give a little back story on some of this. And so, you know, when I had gut infections down in Texas, I had tons of anxiety. It wasn’t me, it was not my personality. It was the gut bugs. And when we looked in my brain chemistry, my serotonin was low. My dopamine was low. I had issues to fully get myself motivated. I still push through, but I didn’t wake up necessarily with that spark like I wanted, and so I know personally and you and I have seen it 1000 plus times clinically the low brain chemistry problem, it’s epidemic and it’s only gotten worse even in the last 10 years. You and I have been looking at these labs. 

Dr. Justin Marchegiani: 100%. And so again, there are some people that have been on board here with us for years listening and they’re super advanced. And so just kind of out of the gate, we’re going to just give a brief overview of foundational things. OK. So first thing out of the gate is an appointment my phone because I just changed my whole house water filtration here, and Evan and I were talking about it earlier today. So check this out. I’m gonna hold up my phone. So you can see here.The clean one on the left, that’s a brand new filter. And that all the way up to the webcam. 

Evan Brand: We can hardly see. Go closer. Yeah. 

Dr. Justin Marchegiani: So the one on the left, right, the white one. That’s the new one.That’s the one that was in there for the last three months. I mean that is just nasty, dirty and gross that again that sense. That’s a post filter. So it went through a massive pre filter, went through the huge carbon based filter and then went through that afterwards. And it was dirty. It is nasty. I actually have it over on my on my bar countertop over there. So pretty pretty freaking gross. So, what does that mean? It means, prioritize good clean filtered water. If you don’t have a high water filter water filter system, we’ll put some links down below to the ones that we personally use, but in general, at least get a good quality glass water Topo Chico, Cheryl Steiner, a Perrier, a mountain valley one out of a good glass model was gonna be excellent during the day and then I definitely recommend getting a whole house water filter once you’re in a in a place where you can do it. Some people may be in an apartment, then maybe a temporary housing. You can always get an under the counter filter. There are even some temporary ones that actually go on top but still filter water out pretty well. But that’s pretty nasty. And so 70% of your body’s water in regards to all the liquids. So you need good clean filtered water without all the junky chemicals. Maybe drugs, maybe pesticide runoff? Bull run off, who knows. So the first thing is kind of get your water right. Comments there, Evan?

Evan Brand: Yeah, I mean, this is important because when you’re stressed, you’re gonna be dehydrated. You’re burning through everything. You’re burning through hydration, you’re burning through B vitamins. You and are looking at papers on B vitamins and magnesium for helping with stress. So we know that when you’re burning the candle, and most people in the modern world are.You need good water and the tap water. You can look up EWG and put in your zip code. It’s scary. I mean, almost every single city has insane high levels of trihalomethanes which are carcinogenic as you mentioned pesticide residue, pharmaceutical drugs like heart medications, beta blockers, anti anxiety, antidepressant medications. You know what’s scary? There are studies now being done on bays, some of these inland bodies of water. And there was one down, I think it was in Florida near Miami. Biscayne Bay is one of these most famous bays. They have an issue now where all of the fish. I’ll see if I can pull it up.They now have drugs in them. And it’s because of the runoff from people. So let me pull this up because this is.This is pretty crazy. This was, this actually came out over the summer this year. And I think it’s pretty shocking and most people don’t have a clue. 

Dr. Justin Marchegiani: Yeah, there was that famous study on atrazine up at UC Berkeley showing the frogs were essentially having reproductive organ issues like a major. I think they were almost becoming like asexual and their sex organs were like switching some kind of weird dynamic what’s happening. Based on the hormone, like disrupting compounds in these pesticides. And that was atrazine. 

Evan Brand: Did you, did this pull up my screen here? Oh yeah, the screen share, I’m going to share with you. 

Dr. Justin Marchegiani: Go ahead. 

Evan Brand: Alright, yeah. So here it is. Pharmaceutical drugs showing up in fish from South Florida waters. Yeah, so it’s Biscayne Bay and I know you’ve got 2.5 million Miami residents and a lot of those people are on pharmaceutical drugs and then they’re peeing that out and then some of that runoff is ending up in the water supply and then that runs off into the Bay and then the fish then accumulate those drugs. So they did a three-year study.They found the Valium. They found antibiotics. They found blood pressure medication in the blood and tissue of bone fish. One fish showed 17 different drugs. So here you are thinking you’re getting your fish clean. I’m gonna eat fresh fish. It’s like well. You know you’re looking at antidepressant treatment, medication, narcotics, pain relievers. That’s insane. Now they’re saying good news is that this is a catch and release species. But, what about the other fish that people are eating? So move. I don’t know. Just tuna fish. 

Dr. Justin Marchegiani: Absolutely. So I mean, getting your water clean, getting your food quality clean, organic food. Here’s the atrazine study. And they were talking about it here at UC Berkeley Press release back in 2002. But it was April 16th in the National Academy of Sciences, UC Berkeley, essentially what happened here, the frogs were developing, they were becoming hermaphrodite. They were heading both sex organs. So you could see testes here, ovaries, ovaries, and you could see abnormal gonads and male exposure to this type of frog.The frogs have become hermaphrodites. Both male and female due to the hormonal exposure. So you can see because the atrazine environment basically an uncontrolled experiment this would be no atrazine free environment talking about because herbicides been used for 40 years of 80 countries. It’s effect on sexual development and male frogs could be one of many factors in the global decline of amphibians. So crazy, right? Now we’re talking about lowest levels of 0.1 part per billion. So this is real. So that’s why I’m saying out of the gate, easiest thing out of the gate. Clean water, good water filter, organic food, organic food. And then outside of that, right then we could talk about blood sugar, stability, at least a pound worth of protein at every meal. I think it’s a really good making sure you have good fats that aren’t all pufa-based fats. Seed, nut oil based fats, refined vegetable oils, you know keeping it good healthy saturated fats, coconut oil, avocado, olive, you know cold press. You know most of your good quality fats coming from more stable.Had accelerated fat sources. This is great. And then after that you just adjust the carbs for your activity level and kind of your metabolic type, meaning do you need to lose weight? Are you kind of a skinnier person? Are you really active right? The more active and the more at an optimal weight you are, the more carbohydrates you can handle. So you got to adjust it. It’s not a one-size-fits-all on that. 

Evan Brand: Let’s transition. Talk about cortisol. Yeah. This is important for stress. When people think stress, most people think cortisol and you and I’ve run so many of these, probably more than anybody, I pulled up my screen. If you want to pull it up. This is a Dutch panel. That you and I run on almost everyone in regards to hormonal health and what you’re looking for is really the health of the cortisol pattern. So you can see here this particular female, she was absolutely exhausted. You could see for people on audio, you’re missing out, but you could go back to. Uh Justin Health YouTube channel and you can watch this video if you’re listening on the audio and you want to see the the the some of the screen shares. But you want to basically charge your smartphone battery first thing in the morning, get a full charge and that full charge last throughout the day, but in this case this woman, her cortisol pattern was completely shut. She was below range the entire day except for night time. She perked up just a little bit, and that could have been like maybe she was on her phone, she was watching a horror movie or a scary TV show or something an artificially boosted her cortisol. But this is the real issues. So no matter how clean your water is, if your cortisol pattern looks like this, you’re gonna be absolutely exhausted and you were gonna deal with stress terribly. You’re not going to deal with stress. How many people are you seeing like this now versus maybe 5 Years ago, do you feel like it’s becoming more common or no? 

Dr. Justin Marchegiani: Yeah, I mean it’s, it’s always tough because we’re, I’m seeing a large percent of the population that are have chronic health issues, right. So I’m always gonna get that, that slice that’s going to be significant. But yeah this type of pattern is, is a big deal, right, because not only is this a sign of you being chronically stressed and depleted, but this is a reverse cortisol rhythm, so you’re gonna be tired during the day and it’s gonna be harder for you to relax at night and recharge. So it makes it really difficult to get that good regenerative sleep wake cycle going. And so these are the people that have.Hard time sleeping at night and getting and reestablishing those good healthy lifestyle patterns that should be in place. That’s what makes it really tough. One thing if you’re just tired, but you can work on getting sleep and and recharging if we can’t. And then also this person, I guarantee you there’s there’s stress handling capacities gonna be at Max, so they’re just gonna like flip out on their kids, flip out on their friends at the simplest thing, or they’ll just be an overwhelmed and they’ll just be in flight constantly ignoring and sweeping all their problems under the rug because they jerked their capacity so low. 

Evan Brand: Yeah, and I know this particular female here was incredibly histamine intolerant. Someone in the comments said, let’s talk about histamine. So there is a component to that. And in her case, she was sensitive to everything, chemicals, fragrances, EMF food. So this was a, you know a pretty sick middle-aged woman, but I mean everything was completely crashed here and so you and I wanted to talk about some of the herbs. Now if we jump right into one of these papers on. What’s called Magnolia and Phellodendron? This is a blend, actually. And it’s usually under the patented name Relora. Some of the professional products you and I use contain Relora. Now. This is a good option for reducing stress and anxiety, but the problem is you really don’t just want to start taking supplements without the clinical data because if you look back at that woman and the cortisol pattern is completely crashed, if we were to go to something like Relora, I would say this is not an appropriate thing to use because if you look at the results of the study of supplementing Relora for four weeks, the salivary cortisol was18% lower in the Relora group. So what that means is they saw less stress, less tension, less depression, way less anger, less fatigue, less confusion, and a higher mood. But would you say in her case that’s not appropriate because she was so crashed already. We don’t want an 18% reduction in cortisol. 

Dr. Justin Marchegiani: Now the question is what type of people were in that group, because a lot of these adaptogens, if someones low like ashwagandha for instance. There’s studies on Ashwagandha on helping to lower cortisol as well as increased cortisol. So I would say that the adaptogens are probably not like a drug where they’re gonna suppress. If someone’s already low, they’re probably gonna more help that HPA access kind of adapt. Now there are certain adaptogens like ginseng or licorice that may be more stimulatory even if someone’s high, it may still over stimulate. So you gotta be careful with over stimulating ones, but usually ones.like holy basil Holy basil, Magnolia, Ashwagandha tend to be more adaptogenic, so I’d be curious about that. What that sample size was? Were they kind of higher cortisol people? If they were higher cortisol people, then that would totally make sense that the herb was working to kind of bring things back into balance. Does it say it all in that study? 

Evan Brand: We assess salivary cortisol and psychological mood in 56 subjects, 35 women, 25 or 35 men, 20 21 women. They were screened for moderate stress, so that would have been interesting if they would have came in and did a cortisol panel on all these people and showed the before and after, but that’s OK because you and I have seen this a lot clinically and as you described, we’d like to just give the nutrients to let the body do what it needs to do. Meaning we’re not coming in with Cortef necessarily and cranking her up. We’re giving HPA access support and the body can figure this out on its own in many many cases. 

Dr. Justin Marchegiani: And the fact that a lot of these symptoms improved. It’s probably not a low cortisol person making their cortisol lower because that those symptoms would get worse, right? They would actually, you know, they wouldn’t be improving, right. So the fact that they’re coming down, there’s probably an improvement. So imagine these people had higher cortisol patterns.To begin with. And that would make sense. But that’s why we don’t even go all in on just any herb, right? Or making these diet changes. We’re getting the inflammation down. We’re increasing nutrient density. We’re also providing all the cofactors to help your adrenals function better, whether it’s vitamin C, whether it’s pantothenic acid B5, whether it’s B6, I have one study in here talking about B6 and Magnesium actually works better than magnesium alone. And part of that is unique cofactors for these nutrients to work better. And a lot of your brain chemicals actually have cofactors for a lot of these conversions of serotonin and Dopamine and norepinephrine to happen, you need a lot of cofactors. And then we can kind of go more into the category of like, well, if your diets crummy and you’re eating a lot of sugar or inflammatory foods, you can actually deplete those pull factors more. Or if you have mold exposure, you may deplete, you may be depleting your B vitamins in your in your in your folate and your B12 and your B6 for methylation purposes. Because that mold exposure is revving up those methylation pathways, you may be utilizing more of your acetylation and glucuronidation pathways for glutathione and acetyl cysteine right. You’re sulfur aminos may be depleted as well and also chronic stress does deplete sulfur because you need sulfur to actually activate dopamine to norepinephrine. And so when you look at those pathways, the more stressed you get, you will actually deplete sulfur and when you don’t have enough sulfur if you have mold exposure coming in.You see how you have a toxin on this side and then you have stress over here and you’re kind of burning that candle at both ends.

Evan Brand: Yeah.Let’s hit Ashwagandha. And then I like B vitamin magnesium when it’s pretty interesting. So ashwagandha, we hear a lot about it. I’d say it’s probably the most popular adaptogenic herb. I mean, you see it in grocery stores now at the checkout counter, I’ve seen Ashwagandha gummies and Ashwagandha pills, which I think in general is good, I have seen at the high dose and I have seen chronic usage in some people. It gives them a little bit of flatness where they just don’t have as much emotions. I’ve just seen, if you look on Reddit, there’s several threads if you type in like ashwagandha at Hedonia, this is basically just the loss of pleasure in life. So there’s some people that are reporting either high dose or long term use of ashwagandha. They just sort of become numb. So I think you need to watch out for that. But in general, you and I are cycling on and off of these things and we’re rotating. Now out of protocols and not necessarily, always in isolation. Just for a couple months, if they have excessive fatigue, maybe we’re adding in some rhodiola, so we’ll look at that in a minute too. But the Long story short is many, many papers on Ashwagandha. This is just one. But you’re always gonna see an anti anxiety activity and you’re always gonna see anti stress. It’s going to improve symptoms of depression and insomnia and it’s going to help primarily by modulating the HPA access and also the sympathetic adrenal medullary axis, as well as GABAnergic and serotonergic pathways, meaning that it may help boost GABA, which calms you down. It may help boost serotonin, which helps you become less irritable, less anxious, and you may sleep better.

Dr. Justin Marchegiani: 100%. I just swallow some Gabba and some glycine right now, some amino acids that also help with stress. Love, Mike. 

Evan Brand: I took some right before. Yeah, right before we jumped on. I told you about those gummies and my wife. And so I had a couple. It was like Ashwagandha, Rhodiola I think it might have been some Maca too, but, so that was good. So here’s another paper on ashwagandha. This was a randomized double-blind placebo-controlled, which is the best, the best type that you want. And they said, compared to placebo, significant reduction in what they’re calling the Hamilton Anxiety rating scale. So significant reduction in that. In a near significant reduction and the depression, anxiety and stress scale. Also reductions in morning cortisol testosterone levels increased in males. So you and I didn’t mention that but. Stress.Those surprise stress is going to negatively affect your hormones too. Stress is going to reduce testosterone. That’s going to affect your sex drive. So when you see that Viagra is being passed out like candy, now you wonder what all’s going into the stress is a big component.

Dr. Justin Marchegiani: Yeah, we just saw a major study come out last month looking at the effectiveness of antidepressants. And they’re showed to be, you know, no long term benefit with a lot of these antidepressants. I think that was a Lancet study out of the UK and so we kind of look at a lot of the antidepressants, we look at the mechanism that’s happening there. You know, we know there’s data on things like tryptophan and five HTP and B6 helping. So there’s definitely like, there definitely is like a depletion theory where people are chronically stressed and then as they are stressed, they do deplete their serotonin, they deplete their dopamine. We see that in organic acid test. But the medications for that are blocking these reuptake ports, trying to accumulate more serotonin in between the synapses may not be the right school of thought. And there are a lot of doctors and people and pharmacologists looking in the direction of just brain inflammation. And so everything we do in functional medicine is about reducing inflammation. So when we give this nutrient with this herb we’re doing so many things in the background, diet and lifestyle wise to reduce inflammation. There’s so many variables we’re moving so it’s so hard in functional medicine world to do a double-blind placebo control trial because in those trials you have to typically control a variable or two at once. If you control 10 variables at once, 12 variables, there’s just too many things moving in one Direction to know which one was the deal breaker and like in this one, study over here. I’ll show you. Where they look at tyrosine supplementation. And or stress for cognitive demands. I’m going to pull this trial up here. So this is interesting right here. And this is kind of why we like to test and not guess, right, assessing over guessing. So they looked at dopamine, tyrosine which is a building block for dopamine, right. It goes, it goes phenylalanine and tyrosine and then it goes L DOPA dopamine and then under stressed dopamine can get converted to norepinephrine.Then you actually use a lot of sulfur. From dopamine to norepinephrine. But they talked over here that the potential of using TYR supplementation to treat clinical disorder seems limited and benefits. But then it talks about down here tyrosine does seem to effectively enhance cognitive performance particularly in short term stressful and/or cognitively demanding situations, we conclude tyrosine is an effective enhancer of cognitive function, but only when neurotransmitter function is intact and dopamine or norepinephrine is temporary or depleted. So if we have some functional deficiencies and we may see that based on a stress profile or you know functionally, we may see it on a cortisol rhythm test and we may see it with an organic acid panel, looking at vanilmandelate, looking at Homovanillate and we may see some of these markers either go overly high or overly low, which shows that there’s some significant depletion going on here. And so you can see that this the nutrient tyrosine tend to work better when people actually had a depletion. 

Evan Brand: Well, you made me think of something and we’ve probably talked about this before, but how crazy is it to think about trying to do a proper, supposedly double-blind placebo-controlled study? Because, think of Sally who woke up and had a GMO Gluten bagel with vegetable oil. Instead of real butter for breakfast, she takes the antidepressant. Or she takes the herb and they’ve got Johnny over here who had a grass fed rib eye for breakfast and he took the same medication. They’re going to get totally freaking different results. So you and I were talking about this before we hit record, but it’s so hard to actually look at and appreciate a study that’s going to give you that outcome because like what time do they go to bed? Are they all going to bed at 10:00 PM or Sally staying up till 2:00 AM? No wonder she didn’t get relief from the antidepressant or the antidepressant herb or whatever. So it’s like, my God, when you really break apart using the functional medicine lens, you break apart the sleep, the stress, the diet, the family relationships, like how many of those people are going through a divorce during the study? Those are the seven people that didn’t get relief from depression, right? So it’s very difficult. And I think that’s why you and I can look at these studies and there’s other people that will talk about studies on podcast, but the reality is when you have the clinical experience that would, that’s what makes the difference because we’re coaching people through some of the lifestyle measures, the sleep, the nutrition, the water, we’re not just throwing the herb and saying good luck. It’s just not going to be that effective. 

Dr. Justin Marchegiani: Yeah. And also like we just mentioned earlier. We got a test, right? We don’t wanna guess, we want to assess. And This is why someone may have, you know, no experience with this supplement and say it’s it’s joke it’s it’s snake oil and someone’s like no i had a really great experience because there’s one you may Had a really great experience because there’s one you may not need that nutrient as much if you need something more than someone else, right? Then you may have a better benefit, but also a lot of nutrients work synergistically, right? So this one study looks at magnesium with B6 and they found that this study that, right here, many civilizations regard subjects with severe extreme stress study provides clinical support for the greater benefit of magnesium combined with B6. So both groups did well. They had a magnesium group and a magnesium with B6 and they found the magnesium with B6 actually did better and so a lot of nutrients are synergistic. I mean, I think anyone, most people will benefit from magnesium just because a large percent of the population are depleted in it. Our food supply becomes less and less on it. It’s one of those core nutrients it’s hard to get enough of. So I think it can’t hurt to ever take some of these core nutrients, but a lot of these nutrients are synergistic and so magnesium is very important for stress and relaxation. But B6 also helps with, it’s an important cofactor for all of your brain chemicals to work. Very important cofactor and it helps a lot of your neurotransmitters like serotonin and GABA and dopamine and adrenaline all work and convert in the brain. So it’s important that you can’t just ever rely on one nutrient, you got to look at the whole thing and it’s always better to assess versus guests too.

Evan Brand: Yeah, and when you click on the podcast and it says helping with stress or feeling overwhelmed, you may think of us talking about meditation and float tanks and scheduling massages and getting manicures and pedicures.And take it a vacation and taking Fridays off and hugging your kids more and having more sex. All those things are great too. But we’re really trying to get geeky here with you guys, because most people that come to us, as you mentioned, they’ve already been to 5 10-15 20. They done the massage and they’ve been through the talk therapy and they’ve been to so many other practitioners. They need the nitty gritty granular stuff like this. It’s really going to get them better. So if you guys are listening for the lifestyle stuff, we try to integrate that and that is important, but ultimately most people are doing a lot of that, and they’ve tried and they’re still suffering. Let me pull something up on Rhodiola. This is pretty cool. I told you years ago how Rhodiola changed my life. And this is a paper that just concludes that Rhodiola is a very effective potent herb for treating mild to moderate depression. And we’re talking in six weeks. So this is not a long thing. Like people think it’s gonna take years and years and years.I’m not saying that if you’ve got mold, you won’t still be depressed. If you’ve got Lyme, you’re still going to be depressed like that. That can happen. But what if I can just give you a tool, which is gonna boost you. Let’s say it reduces your depression by 30%, enough for you to get back into the gym. And now you’re exercising. Now you get the natural endorphin boost, and then you feel more confidence. Now you go on a date with this woman you’ve been wanting to go on a date with, and now you have more fun and oxytocin cause your bonding. But at this this whole snowball effect happened all because I just gave you this herb to pull you out of a dark place. So that’s really what we’re trying to do.

 

Dr. Justin Marchegiani: Absolutely. So we talked about some of the Earth, some of the nutrients, some of our big favorite ones. Of course, movement is going to be helpful. Again, you got to figure out where your level is. If you’re chronically inflamed, movement maybe too much, too stressful and puts you in a more catabolic place because you’re breaking down tissue. Figure out where you’re at if you’re at a good place.You can lift some weights, do a little bit of interval sprinting, whether it’s a walks, walk, run, walk, Sprint, you can do a rower. We like rowers because of, you know, the extension and also there’s less impact on the joint. So if you’re already inflamed, you’re not going to create more inflammation. You can start with some bands or some gentle lifting of weights to kinda you know find that 8 to 12 you know rep 8 to 12 you know, Rep movement, that’s going to give you a good muscle breakdown, give you a little soreness. That’s good. You know, getting 10,000 steps today, these are all simple strategies. Strategies. We don’t have to overthink it. You don’t need to super crazy customized plan out of the gates. Just get some good movement. Make sure you’re, you have good form. If you’re not sure, you can always start with walking or yoga or something more gentle and you can always check out some YouTube videos and do some band work or some cable work or I like the new tonal that’s another good at home device for lifting is really good so you know just get get enough movement in there to get your muscles a little bit sore.

Evan Brand: Yeah, absolutely. I’ve got my roll machine right here. I just try to put it on this heavy of a setting as I feel confident with it’s not gonna injure me where I can still go. And I almost use it like a sprinting device. I don’t necessarily just go slow and steady, I try to just kind of sharp relatively fast. Kind of like a Sprint row movement and I tell you it, it can be depleting, but man, I’ve heard many people talk about this, like when you want to get out of your mind with your ruminating, if you’re worried, if you’re thinking negative, you’re going through all these bad things in your life and bad symptoms and all. I’m so, you do these pity parties for yourself when you’re exercising physically. It almost shuts that brain off completely to where you could just focus on like how hard this exercise, how hard this movement is. 

Dr. Justin Marchegiani: 100% great 100% now outside of the gates here right? There could be some hidden issues that were not addressing and you have to see a good functional medicine provider over there could be you may need to look at your adrenals. Your adrenals could be more depleted like that patient Evan just show where they have significant kind of reverse cortisol pattern. It’s good to know your adrenal pattern because if you have chronic issues, you want to know, hey, this is where I’m at one it gives you a timeline of how long it may take to heal that person may look at look like a 6 to 12 month journey on that. Also it gives you the ability to have, you know, realistic expectations, good timeline, also something like that. We’d probably wanna do a retest on someone that’s that out of balance to make sure they’re back in balance, but also want to look at hidden stressors that could be behind that, whether it’s mold, whether it’s pests, whether it’s, you know, toxicity issues that aren’t being addressed. Whether it’s gut issues we talked about, a lot of these nutrients have to get eaten, so for our diets poor there’s a problem. But also what if it’s good now but we’re not breaking down and absorbing it? That’s where we’d have to do deeper testing on the functional medicine side to see how you’re doing digestive wise with HCL and enzymes. See if there’s any gut bug issues.And then we can also do other intracellular nutrient tasks for their organic acids or nutrients, look at other kind of intercellular nutrients. So there could be some other hidden stressors going on there. I always say just kind of start from the ground and work your way up, start with the low hanging fruit. Keep it simple because that provides a good foundation anyway, but you know if you have chronic issues, you definitely want to reach out to someone like Evan evanbrand.com or someone like myself,Doctor J justinhealth.com for the deeper issues and we’ll put links down below so y’all can reach out. Evan, anything else you want to add before we wrap things up?

Evan Brand: Yeah, I think for people that are, in a short term, acute stress, they have to travel for a wedding. They’re maybe going on a honeymoon. Sounds fun, could be stressful. Travel, new food, new water supply, their new parents. They’ve got small children, those are situations where you may come in, not small children cause those are long term stress, you and I can attest to that but you know, honeymoon, you know, new marriage, whatever. So, so those acute stressors, you could probably do some of these formulas whether it’s Tongkat or Magnolia or Ashwagandha,Rhodiola, holy Basil, there’s many, many options. Extra magnesium, B6, GABA, taurine and acetone. These things are great, but if you have been stressed and feeling overwhelmed for 1,2,3,5,10,20,25 years and beyond, you really don’t just want to go try to get rhodiola and get your way out of it. It’s not going to happen. I’ve tried. I took so many supplements when I was sick and it helped me to stay alive and it helped me to continue to work and be up on my feet but.I knew that ultimately I was missing something, and it wasn’t until I really cleared the parasite, cleared the H pylori, my energy started to come up like I was on Rhodiola while I had parasites.I was still tired. I was less tired, but I was still tired. And I think the problem is like naturopathic medicine. So naturopaths specifically, they may come in and instead of, you know, quartet for cortisol, they give you licorice and ashwagandha, which is great, but then it stops there. So you really have to ask the question why? Why did I get myself into this? How did I get into this? Was this the bad relationship? The moldy apartment? The college dorm? That got me sick? And I think people need to just ask why a few more times. So, like, I’m tired. OK, here’s rhodiola. But it could be.  Hey, I’m tired. Well, why are you tired? Well, because I’m stressed. Why are you stressed? Because I’m in a bad relationship. OK? So we need to work on that. And if people keep asking why, usually you’re going to uncover some stuff. And I just encourage people, don’t be afraid, to look in those dark spots. Don’t, don’t be afraid to look in those corners where there’s some cobwebs of things that you’ve been emotionally shoving away, as you mentioned, dusting in a way or putting it under the carpet. Yeah, eventually those things are going to weigh you down. 

Dr. Justin Marchegiani: Yeah, someone in the chat talked about a Epstein barr virus kind of plummeting their energy recently. Well, when it comes to Epstein Barr and some of these viruses like Epstein-barr said cytomegalovirus, it’s very rarely the virus just comes out of blue, comes out of the blue and just knocks you on your pot, right. Usually there’s some level of depletion going on and it’s the straw that breaks the camel’s back and so. There’s different supports we can do to address viral issues, whether it’s silver or Monolaurin or Rishi, right? Different herbs and nutrients cats claw. But you’ve got to look at how did your body, how did your immune system become so compromised and susceptible to it. And you tend to have to work backwards and fix all of those issues that led up to this point. It’s very rarely something just coming out of the blue and doing all of it. It’s usually a level of susceptibility that you incurred and then this virus came in. So you have to really address everything, never just one thing.

Evan Brand: Yeah, I’ve seen that too, and I’ve seen it with a lot of things that are probably still controversial on YouTube, but we’ve seen things that people put in their bodies that all of a sudden reactivate Epstein Barr and other problems. We’ve seen this in celebrities, we’ve seen this in clients. So yeah.

Dr. Justin Marchegiani: Absolutely. But guys, we want to give you actionable information. A lot of people out there, it’s just like sales, sales, sales, market, market leave you kind of hanging. I want everyone to kind of listen and be like, all right, here’s some foundational things. When we’re talking and doing a long podcast, it’s super easy to get overwhelmed. So just pick one or two things, execute, execute, execute action, action, action. And then if you’re feeling a little bit overwhelmed that you want to take next steps, you have Evan and I for resources. It’s all about educating. It’s all about empowerment. So we’ll put links down below where you guys can reach out and work on taking the next steps. But worst case, just continue to take action. We’re here to help.

Evan Brand: Absolutely. So go take a bath, do your lavender, your Epsom salt and all that. Get your mind right. But then ultimately you gotta figure out what’s under the hood.

Dr. Justin Marchegiani: Love it. Very good. Evan, wait. Great chatting with you man. Glad we’re back in the saddle.

Evan Brand: You too. Take it easy. Talk to you soon, brother. Take care everyone. Bye now. 

Dr. Justin Marchegiani: Bye y’all.


References:

https://justinhealth.com/

https://drjabanmoore.com/

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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

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


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

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: 100%

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

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

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

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

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

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

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

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

Evan Brand: Yeah. It does. And I know

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Yep. You got it. 

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

Dr. Justin Marchegiani: Not yet. Not yet. 

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

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

 

Dirty Cure for Depression (No Really, It’s Dirt!)

By Dr. Justin Marchegiani

Rates of depression have been skyrocketing. Teen depression rates leaped by more than 60% over the course of only three years. As a society, our mental and physical health is seriously declining. While feeling unhappiness, dissatisfaction or loneliness every so often is completely normal; prolonged periods of these negative feelings takes a real toll on our lives.

Question: When was the last time you got dirty?

No, really, when did you last go outside and bury your feet in the ground or pick veggies straight from the garden?

We live sterile lives indoors. Hand sanitizer and antibacterial soap are never more than a few steps away, and we clean our homes with germ-killing sprays and sanitizers. But what would you say if I told you that research conducted in recent years has revealed that the bacteria and microbes in dirt can aid in enhancing your immune system and boosting your mood?! Let’s further explore the mental and physical benefits of getting dirty.

Dirt Throughout Time

Studies show that children who reside on farms have a significant reduction in allergies, asthma, and gut-associated ailments when compared to children who grow in more sterile environments. This is recognized as “the Farm-Effect,” which links low microorganism exposure to a high vulnerability for developing allergies by limiting the natural progress of our immune system.

If you think about it, it makes sense. For hundreds of thousands of years, we have coexisted with bacteria and microbes and lived lives outdoors. Babies crawl, which in paleolithic times, would have meant spending a lot of time in the dirt! (Plus, babies have a knack for sticking things in their mouth.) Throughout the course of time, until recent times that is, tiny humans had constant daily access to the dirt and all sorts of other microorganisms that boost the immune system and influence gut bacteria. We all require little dirt in our existing lives.

Dirt, Soil Microbes, and Depression

Soil microbes such as Mycobacterium vaccae have been studied for their serotonin-boosting and anti-depressant effects on the brain. Serotonin deficiency has been linked to mood issues including anxiety, depression, obsessive-compulsive disorder.

In a study conducted on lung cancer patients, the patients were injected with Mycobacterium vaccae, afterward reporting less anxiety and an enhanced quality of life.

Click here to work with a functional medicine doctor for help boosting your mood, naturally!

Ready to Get Dirty?

The microorganisms living in our natural environment have positive effects on our mood, immune system, and more! Below are some of the other top reasons to go outside and connect with nature:

  • Reduced blood pressure
  • Lowered anxiety
  • Boosted cognitive function: Being outside engages your senses. Your brain gets a boost as it works to problem-solve and memorize your environment.
  • Reduced rheumatoid arthritis symptoms
  • Anti-inflammatory effects
  • If you’re playing outside in the dirt, the sunlight is helping you manufacture Vitamin D, and regulates your circadian rhythm, which means better sleep!
  • Children who spend more time playing outside are more courageous, energetic, and imaginative!

Human Microbiome

The growing body of research on the human microbiome continually points to the impact of microbes on our long-standing health. Despite being invisible to the naked eye, millions of microscopic bacteria and microbes exist on your skin and in your gut. These bacteria have vital roles in everything from controlling your mood, to the development of diseases like arthritis and diabetes.

Outdoors as a Cure for Depression

Science knows that microbes in the natural world play a vital role in our health. Several antibiotics (like penicillin) are manufactured from the microbes that originate in the dirt.

The majority of the healthy bacteria our bodies benefit from are found in soil. Children flourish when they are allowed to play outside, but us grownups can get some fun nature time too! Gardening is a hobby that keeps on giving. Reap all the benefits of spending time outside in the sun, fresh air, and dirt. Plus, if you grow organic berries yourself, you can eat them fresh from the garden (without washing) knowing they’re safe and more health-packed than anything you’d buy on the shelf at the grocery store.

As the paleo diet and lifestyle movement carries on, researchers are beginning to take a look at re-establishing the relationship between humans and the earth. Research is ongoing, and the antidepressant effects of getting outside back up what gardeners have been saying for years: gardening is better than therapy and good for the soul!

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

References:

  1. http://www.nbcnews.com/id/18082129/ns/health-livescience/t/soil-bacteria-can-boost-immune-system/
  2. https://www.ncbi.nlm.nih.gov/pubmed/22892709
  3. https://upliftconnect.com/science-finds-soil-help-depression/
  4. https://www.livescience.com/7270-depressed-play-dirt.html
  5. https://www.sciencedirect.com/science/article/pii/S2095809917301492
  6. https://qz.com/993258/dirt-has-a-microbiome-and-it-may-double-as-an-antidepressant/
  7. https://www.everydayhealth.com/depression/major-depression-rates-surge/

Biome Building: Rebuilding the Microbiome

Biome Building: Rebuilding the Microbiome

 

By Dr. Justin Marchegiani

Have you ever felt butterflies in your stomach when you’re feeling nervous? Have you ever felt a sense of dread, like your stomach’s dropping, when receiving bad news? Ever had a “gut feeling” about a person? This is because the human body has a “second brain” that we are just starting to learn about. This second brain’s location? The gut.

WHAT IS THE HUMAN MICROBIOME

Biome Building: Rebuilding the Microbiome

The 2-pound community of microbes living in and on our bodies is called the microbiome. These microbes seriously outnumber our human cells; we have about 10x as many outside organisms within our bodies than we do human cells.

The vast majority of our microbiome is located in our digestive systems, which is where we also find our second brain. Or more scientifically, the enteric nervous system. There are neurons embedded in the walls of our gut, which measures nine meters from esophagus to anus.

Scientists have discovered that ~90% of the fibers in the vagus nerve carry information from the gut to the brain, and not from the brain downwards! Breakthroughs in science are being made on how the trillions of bacteria in our gut— the microbiome— communicate with the neurons in our gut lining.

The microbiome is responsible for more than you might realize. From controlling how many calories you extract from food and causing cravings, to impacting our mood and whether we suffer from allergies. If we learn how to get our gut bacteria in check, we can use this to our advantage to control how fast our metabolism works, boost our energy, prevent disease (up to 90% of all diseases can be traced back to the gut/microbiome), and extract more nutrients from our food.

WHAT DISEASES ARE CONNECTED TO THE MICROBIOME

What Diseases are connected to microbiome

Your gut houses 70% of your immune system. If you don’t have a healthy gut balance, your immune system will be severely affected. To read in depth about the three main types of bacteria that determine the health of the gut: beneficial, commensal, and pathogenic, check out our article on gut bacteria.

Poor gut health is tied to many health concerns and diseases. Autoimmune diseases such as arthritis and IBS, cognitive decline (Alzheimer’s, dementia), asthma, allergies, autoimmunity, fatigue and brain fog, parasite infections, fungal overgrowth, infertility, type 1 diabetes, gluten sensitivity, mood disorders (anxiety, depression), learning disabilities (ADHD), and small intestinal bacterial overgrowth (SIBO), just to name a few.

Preliminary findings show that in our day and age, our microbiomes are becoming increasingly unbalanced due to the dietary shift towards processed foods (which contain all sorts of pesticides, artificial food additives, artificial sweeteners and food coloring, MSG, and unlabeled genetically engineered ingredients), more C-section deliveries (going through the birth canal exposes newborns to vital microorganisms which “seed” the gut), increased antibiotics use (whose stated purpose is to (negatively) affect microbial life- killing both the bad and the good).

As you can see, a healthy gut community is crucial to your health, but modern conveniences have limited diversity within our gut flora, negatively affecting our health. Luckily for us, there are many changes we can make to take control of our microbiome and nurture a healthy community within.

Click here to work with a functional medicine doctor to get your gut in great health!

REBUILDING THE MICROBIOME

Rebuilding the Microbiome

The Microbiome Diet: Eating to support immunity and lower inflammation:

It’s critical to lower inflammation and support gut health. An elimination diet (cutting out certain foods that irritate your body or that don’t promote your health) is a great way to go about supporting a healthy gut. Paleo and autoimmune diets are two great starting points. Clean meats, clean fats, non starchy vegetables, and low-sugar/low-glycemic fruits are safe choices.

Foods to eliminate are the common culprits of inflammation, digestion issues, and brain fog. These include sugars, nightshades, nuts/seeds, dairy, and eggs.

Microbiome Diet

Start adding back foods after it’s been at least 4 weeks and your symptomatic improvement has plateaued for at least 1 week. The basic structure of food reintroduction is to start with one very small serving (one scoop, one teaspoon, etc.) and increase the serving size over that three- to four-day period, seeing if we can tolerate it. We want to start food reintroduction with eggs, then nuts and seeds, dairy next, then nightshades, and lastly FODMAPS (click here for Dr. J’s guide to FODMAP).

Watch Dr J’s video, where he talks more in depth about his food elimination diet recommendations: Autoimmune Elimination Diets Can Help Improve Leaky Gut and Inflammation.

Other ways to establish a strong microbiome:

Limit your sugar intake. Sugar feeds the bad bacteria in your gut. About one hundred years ago, each person was consuming an average of 3–4 pounds of sugar per year; now it’s about 150 pounds.

Get in your probiotics and prebiotics. Fermented foods such as sauerkraut and kimchi are great sources of probiotics, while dandelion greens and plantains offer plenty of prebiotics.

Microbiome Diet - Bone Broth

Drink bone broth. Bone broth supports a healthy gut lining and provides a cornucopia of vitamins and minerals for your bones, as well as collagen for your joints, skin, and hair.

Avoid antibiotics. Antibiotics don’t discriminate, they eliminate both bad and good gut bacteria, which leaves you with a defenseless immune system and at a higher risk for infections and inflammation.

Listen to your gut (and nurture it to optimal health!). Leaky gut allows foods and unwanted bacteria in the intestinal tract to slip into the bloodstream. This can put stress on the immune system and is the main cause of autoimmune disease for most people.

Get dirty! We evolved in the dirty outdoor world, and our modern disposition towards all that is sterile deprives us of a plethora of the microbes the world has to offer us! Backyard soil actually contains bacteria that can produce serotonin in our systems, acting as a natural antidepressant!

TAKEAWAY

Fostering a healthy microbiome comes naturally when we listen to our bodies and take care of ourselves. A clean diet and dirty lifestyle are two keys to success! Roll around with a dog in the dirt, pay attention to what foods work for you and which give you issues, and don’t be afraid to ask for help if you are unsure.

Biome Building

Sources:

https://justinhealth.com/autoimmune-elimination-diets-can-help-improve-leaky-gut-and-inflammation/
https://www.scientificamerican.com/article/gut-feelings-the-second-brain-in-our-gastrointestinal-systems-excerpt/
https://www.drweil.com/health-wellness/body-mind-spirit/gastrointestinal/love-me-love-my-microbiome/
https://draxe.com/microbiome/
http://www.marksdailyapple.com/16-things-that-affect-your-gut-bacteria/
https://chriskresser.com/the-microbiota-and-bone-health-yet-another-reason-to-protect-your-gut/
https://chriskresser.com/do-gut-microbes-control-your-food-cravings/
http://drjockers.com/6-steps-to-rebuild-gut-flora-metabolism/
https://www.scientificamerican.com/article/gut-second-brain/
https://justinhealth.com/good-bad-gut-bacteria/
http://www.amnh.org/explore/science-topics/health-and-our-microbiome/meet-your-microbiome
http://www.paleoplan.com/2014/03-30/asian-ground-beef-veggie-lettuce-wraps/


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.