The Nuts and Bolts of Your Mitochondria – How to Enhance Mitochondrial Function | Podcast #349

Have you ever thought about what powers are inside your body? In this video, Dr. J and Evan talk about mitochondria and how to boost them.

When we talk about your body’s powers, the easy answer is nutrients, of course! Our body transforms those nutrients into energy, and it’s that energy that boosts the cells in our body. All types of cells have small generators called mitochondria that, in many ways, are their sources for life. Mitochondria are the only part of the cell where our basic life requirements — food and air — are combined to make energy in a process known as the Krebs cycle.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00:      Introduction
1:30:      The role of creatine in mitochondria
6:34:      Energy pathways
14:47:    Cell Danger Response
16:07:    Citric Acid Cycle

Dr. Justin Marchegiani: Mitochondrial function, your mitochondria, little the powerhouses in your cell and they help generate ATP which is the cellular currency of energy so to speak. And we’re going to talk about natural ways to improve mitochondrial function, Evan, and how we doing today, man.

Evan Brand: Doing really well. I think first, let’s dive into some of the big assaults that we have as a modern society on mitochondria. And that could be anything from viruses, bacteria, parasites, gut infections, pesticides, herbicides, heavy metals, plastics, phthalate’s, the BPA, the BPS, flame retardants, nonstick chemicals, car exhaust, air pollution. That I miss any I mean.

Dr. Justin Marchegiani:  Like you hit a lot of I would say being sedentary. There’s a lot of mitochondria in your muscles. And if you don’t do enough, you’ll put enough force to those muscles, they will atrophy. And so just not doing enough about creating enough stimulus on your body. That could definitely we can and decrease your mitochondria in your muscles. So, I would say, sedentary and in active resistance through your muscles.

Evan Brand: OK, OK that’s a good point.  That’s a good point. So, you’re saying that, like, just in general, you have to have some level of physical stimulation physical activity to keep the mitochondria working. I guess it’s kind of like an old car that you’ve sat there…

Dr. Justin Marchegiani: All your muscles at least. Yeah, ’cause if you decrease, you know your muscle levels via just atrophy due to lack of use. Yeah, your muscles will shrink absolutely and that’s your mitochondria will shrink for.

Evan Brand:  Sure, what about creatine? Do you know anything about the role of creatine in mitochondria? ’cause I know when I’m taking creatine, I just I feel stronger? Obviously, there’s creatine’s used a lot in like bodybuilding world, but there’s gotta be a mitochondrial mechanism there because I’ll tell you I feel like. I can lift, you know, at least a good 1020 pounds heavier on particular exercises with creatine in my system.

Dr. Justin Marchegiani:  Yeah, me crazy definitely has an effect on growth hormone and improving growth hormone stuff that will help with muscle. Creatine is like instant energy for the muscle. So, it’s it’s there. It’s ready to be used right away in that first 10 seconds or five, five to 10 seconds of muscle use or like explosion movement through that muscle. So, that definitely plays a role in muscle. I’m not sure how it plugs in 100%. I see ’cause really you know with ATP right in the mitochondrial function? If you look inside the mitochondria you have glycolysis and then you have the electron transport chain. Or I’m sorry, you have the Krebs cycle citric acid cycle and that plugs into the electron transport chain. So, glycolysis that’s going to be utilizing the carbohydrate in the muscle right glycogen in the muscle. Fast immediate source. I think creating plugs into that top part. And then you have the Krebs cycle citric acid cycle, where B vitamins, magnesium. All these different things kind of plug into that and with that. With the citric acid or Kreb cycle, that didn’t mean the same thing. Essentially, they’re grabbing hydrogens, right? So, there it’s it’s a reducing agent, so it’s just grabbing reproduce. Reduction is a gain in electrons and so you have NAD goes around. Then it grabs NADH so you get 3 NADH and I think 1FADH2 so you have FADH. And it grabs another hydrogen and that becomes FADH2, and so it’s grabbing all these hydrogens. And then it’s essentially bringing those hydrogens downstream into the electron transport. Jane and Beta fatty acid oxidation there and so yeah, I think you generate was at 36 to 39 ATP through the Krebs cycle and the electron transport chain.

Evan Brand: Unless you’re in like chronic fatigue stayed, this cell danger response, and I think you’re spitting out something low like 2 maybe 3 ATP. I’ve read about this cell danger response. They just call it HDR in the literature, but it talks about how. The cell danger response, could be initiated by trauma or a car wreck or even mold exposure or tick-borne illnesses, or viruses. There’s a lot of you know, Epstein Barr. You’ll see the link between like mono and chronic fatigue. It said that these people are in this state of just a low power output, or even if you have the nutrients, you’re just not generating the ATP with some I don’t know if it was Caitlyn or somebody that you and I had looked into where there was a talk on this about. How the w the the ATP was literally in the single digits. The low single-digit output in some of these states. So, the message here is that for people that have chronic fatigue, you got to realize there is a mitochondrial component to this. Why don’t we talk about testing a little bit? The main thing that you and I are going to look at is going to be the organic acids. I know there are some other tests out there. I’ll admit I’ve had clients send them to me such as the mito swab. I’ve not run the model swab. Personally, I don’t know enough about it to speak on it much, but I’ll just say that it does exist. I believe it is a a mouth swab and it’s probably looking at just a couple generic markers in the saliva. But we like to use the organic acids test because, as you mentioned, there’s the Krebs cycle metabolites on there. We can look into the supinate or what some people call succinic acid. You’ve got the malic acid. You’ve got fumarate. There are other markers on there, and we we see when people have talks and exposure. Like I said in the beginning, the heavy metals, the mold, the pesticides will see those. Mitochondrial markers go up. And the higher the numbers go, generally, the more tired someone is because that indicates more damage to that Krebs cycle. So, the oh is huge, and then obviously we’ll look at stool too. Now the stool test you don’t measure like the stool tests we’re running. You’re not measuring mitochondrial function, but I look at it in a roundabout way. Meaning if you have all these gut infections producing toxins that could be damaging mitochondria as well, so we know that when we clear the gut out, we see the mitochondrial function improve.

Dr. Justin Marchegiani: 100%. Yep 110%. I want to just put something on screens. People can see it here I guess is really helpful.

Evan Brand: Have you seen or heard about that my to swab before? Have you seen anybody send you those?

Dr. Justin Marchegiani: I have, I’ve ran up. Fulham, it’s kind of a binary test. It gives you a result my the issue I have it’s not a lot of actionable information. It’s like OK, you know there’s some issues there, but then now what’s, what’s the remedy that you’re going to plug in from a diet lifestyle supplement? Toxin reduction execution right? What’s the next step on it? So that’s the problem with some. Of those tests, I always. Look and I always ask well what’s the corrective action based on the test showing uses a concern.

Evan Brand: Yeah, yeah

Dr. Justin Marchegiani: That makes sense.

Evan Brand: That’s the problem with a lot of them like I’ve seen a lot of these stool testing companies. Same thing there’s like so much data. Well, this percent of this bacteria and this percent of that. It’s like, what do I do with that? Is that an infection? Is that not an infection? So you and I’ve seen the same problem in other categories of health tests do.

Dr. Justin Marchegiani: 100%. I want to show a couple things on screen here? Just so it’s crystal. Where the mitochondria is and how all these different energy pathways plug in, I think it’s important I’m going to pull it up here on screen in just a second so people can see it.

Evan Brand: Yeah, people listening on audio, they’re going to be lost. So just look up Doctor Justin YouTube page and you’ll be able to view some of this stuff. Some stuff, like mitochondria, gets a bit geeky. The the main thing here is toxins are a big factor in damaging this cycle and you gotta get toxins out. Reduce exposure where you can and we can run actually chemical test on your current too so we could talk about that in a minute.


Dr. Justin Marchegiani: Absolutely, and so if you look here right. Do you have the mitochondria right here. Some middle part, the mitochondri. The outer part is the cytosol.  So, from what I understand, like creatine is going to plug more into the cytosol and glycolysis, OK, but then you’re going to see you get about two ATP which is adenosine triphosphate. And this gets broken down into ADP and you get energy right? And so, you have glycolysis which generates a little bit of ATP 2. And creatine to plug more on the outside then that goes into your mitochondria. Now you have the Krebs cycle and the electron transport chain electron transport chains part of also the beta fatty acid oxidation. That’s how you burn fat for fuel. OK, so Krebs cycle that churns around twice, and essentially what you’re doing is you’re gathering NAD and FADH2. NAD&FADH are grabbing hydrogen so and a design to grab a hydrogen making NAD. HFADH is going to grab a hydrogen, making FADH2, so I think you’re going to grab it’s like two or three. NADH is, and then one FADH2. And all those hydrogens then go into the electron transport chain here and this is where you generate most of your ATP. And again, what comes out, oxygen comes and this is why, if you’re like anemic right? And you’re not carrying oxygen. Well, that’s why you’re going to get tired and this is going to have an effect on your thyroid and your adrenals because the mitochondria is important for energy at all levels. And so if we have anemic issues or were inflamed because inflammation is going to make it harder to carry oxygen all. And also nutrition, because this electron transport chain, when we run the organic acid test, we can look at citrate, malate, fumarate, succinate. These are important metabolic essentially inputs into the Krebs cycle that correlate with certain nutrients like amino acids, alpha-lipoic acid, magnesium B vitamins, and so we can get a window on how this. Krebs Cycle was functioning based on the organic acid testing at some of those compounds and then all sister connotate citrate, right? These are really important, and then electron transport chain we can get a window into things like carnitine and Co Q10 ’cause they also play a major role in the electron transport chain. So we get a good window with how the mitochondrial function functioning by looking at the B vitamins and looking at a lot of these nutrients and so essentially things that can impair this. As you mentioned, pesticides. Heavy metals, mold toxins, antibiotics, and all these things have a negative impact. But that’s kind of how things look, so we have. Glycolysis is the first part that then goes into the mitochondria, and then we have Krebs cycle and electron transport chains. These are the big three. If you can kind of zoom out and see how it looks and how it makes sense. That should hopefully make more sense, so on that front. Any question that, Evan?

Evan Brand:  Well people listening to that. They’re going to be like wow, this sounds like a really crazy rare problem, right? This must be just rare. This must be like a one in million case and I would say. Not going to say 99. I would say 90% of the people we work with. I see some level of mitochondrial dysfunction or damage either on the chemical profile test, so that’s something I alluded to earlier. We can run chemicals so we can look at gasoline. We can look at xylene. We can look at phthalates, all sorts of organophosphates. 24D is a major herbicide. I still see people at Lowe’s and Home Depot in the Garden Isle buying grass seed. That’s called weed and feed, weed and feed is a grass seed mixed with three different types of herbicides. It’s 24D, I believe it’s dicamba and glyphosate. Wait, I could have mixed one of those up, but either way, it’s three different chemicals, very toxic substances mixed with grass seed, and that’s like people just buy it and they don’t think anything of the term weed and feed. That means you’re going to be killing all the good stuff in your soil and poisoning yourself at the same time. It’s just not smart. So this mitochondrial thing. My point was, this is not rare, like when you show that image and people see that like. Oh no, that’s not happening to me. It’s like it happens every day, all day. I had mitochondrial damage, my latest test shows our mitochondria are much, much better, but I had significant mitochondrial damage from my mold exposure.

Dr. Justin Marchegiani: Very interesting, I want to highlight one thing here so you can see creatine does primarily exist here in the cytosol, right? So if we zoom out, right cytosol is outside of the mitochondria, right? Right glucose, pyruvate here, so just so you guys can highlight here, creatine does go from the cytosol and it can go into the mitochondria. So, we did talk about creatine. It does primarily happen more in the cytosol outside the mitochondria, and it can go in via this. Mi-CRT kind of transport. Compound, so yeah, so creatine is a compound that we talked about that goes outside but can also go inside the mitochondria. To yeah Doctor Neil Nathan.

Evan Brand: That’s awesome! Doctor Neil Nathan did a huge thing for 155-page slide show that people can look up just called the Cell Danger Response. It’s very complex stuff. There’s going to be maybe a few geeky on that. People want to dive into that, but for your average person there’s not much takeaways built into that. But if you want to look into more of like the biochemistry side of it, then then you could look at it. But I think the big summary is it’s all. It’s all the Chemicals, and this is a relatively new problem I mean we face now over 80,000 chemicals are in the environment. Depending on what number you read, there’s only a small amount of those that are even tested. You’ll see stuff in Europe like oh Europe has banned these chemicals and makeup and personal care products, but the US was very far behind. And if you look at the environmental working group, they have a water testing report. You can look at and you can plug in your zip code. I mean just the amount of trihalomethanes’s pesticide herbicide residue pharmaceutical drugs that are in the municipal tap supply in your city are massive and you’re getting hit with this all the time. If you go to a restaurant and you eat rice, what do you think they make that rice with? They make it with tap water so you’re getting exposed to it that way too, which is why if I go out to eat, I don’t really do rice that often anyway. But if I do it, It’s going to be at home with good, clean filtered water.

Dr. Justin Marchegiani: I like it. Anything else you want to say on that, so obviously get the toxin exposure. Super important hydration obviously really important to anything else you want to say on that?

Evan Brand: Yeah, you hit you hit the the Co Q10. You mentioned some of the markers we’re going to look at on the oak test, so we will use those. We have a formula. I believe you’ve got 1/2 mines called my to boost. It’s essentially like a multi for the mitochondria with all the Co Q10, ribose, carnitine B vitamins. So, when we see mitochondrial dysfunction, we can supplement that and we tell people this is a band-aid for your mitochondria. This is not some of it is the root cause, right? If you just are simply low and depleted in Co Q10, one could argue supplementing Co Q 10 is the root cause, but in reality it was usually. Oh here we go. Let me see if I can share this slide with you. Mainly it was the the toxins that led to this so let. Me share my screen really quick.

Dr. Justin Marchegiani: And there is going to be because we do make Co Q10 on our own via the mevalonic acid pathway. And of course, as you get older, just like stomach acid, you’re gonna make less of it and so there there could just be a depletion based on age as well.

Evan Brand: Does that show up at all on your side? The video is that screen share show.

Dr. Justin Marchegiani: Try again.

There’s like a little bell there. Let me let me pop it up again. How about that, yes? Oh yeah, let me let.

Dr. Justin Marchegiani: Me highlight it, go ahead.

Evan Brand: Yeah, there we go. So, this is this is kind of what I was alluding to, and many many other people may have different ways to look at this, but this is from Neil Nathan. He had a great paper on this cell danger response and it just shows at the top here. Basically, everything I already mentioned like a flame. Heavy metals, pesticides, infection, so that would include viral issues as well. Mass cells, NK killer cells, cytokines, the microbiome. All these issues here are what really breaks this role. You know, the one of these is the final straw that breaks the camel’s back and then you end up in this what’s called the cell danger response phase. And then that’s where you get the issues with the mitochondria down regular. So there’s more in that. Like I said, it’s 155 pages. It’s like you got to be, you got to be, you know, have your bulletproof coffee before you look through that.

Dr. Justin Marchegiani:  No, that makes a lot of sense, so your kind of really focusing on the toxicity and how that negatively impacts it. I want to just kind of tie in the dietary component. Why is food so important to enhancing the mitochondria? Let me let me break that down for a second here. This is important. OK, so this is really important. We talked about like Kreb cycle right? And so like this is our zoom out right? What’s happening here? We have glycolysis, Krebs cycle, electron transport chain outside of the mitochondria with the cytosol inside. Now check this out. This is a good one. This is from textbook of functional medicine, so. We have fats, carbs and proteins. These are our primary nutrients where everything comes from right. Fast could be coconut oil, grass fed butter could be fats from. Uhm, grass fed meat right? Our carbs can be vegetables, fruit, starch and our proteins could be protein powder or it could be animal protein, right? All of these essentially shuttled downstream. Fats get carried into the mitochondria via carnitine, so if you go into any biochemistry textbook, it’s called the carnitine. Shuttle right. Every medical doctor, doctorate level person would studied this at a graduate level. I studied as well now in the textbook of I think that guidance Physiology, but there’s another textbook of biochemistry that’s common at the graduate level. You know what the rate limiting amino acids to make carnitine are. It’s methionine and lysine and so really important.

Dr. Justin Marchegiani: Guess what some of the rate limiting amino acids are in a vegetarian diet.

Evan Brand:  Oh yeah, well.

Dr. Justin Marchegiani: Medallion Leisinger actually very deficient in vegetarian diets, and so this whole process of a carnitine shuttle here that helps bring carnitine converts it into acetyl Co A. So then the actual it can get inside the mitochondria. And run through the citric acid cycle again. That’s the same thing as Krebs Cycle. They have multiple names. In medicine for the same thing, it’s just meant to confuse people. So citric acid cycle or the Krebs cycle.  This is how we get fat inside the mitochondria is via carnitine. So very important, right so if we zoom out. Here, we have energy out here, fat. We get it inside via the carnitine shuttle. Super important there and then you see carbs. Right glucose, other sugars. We go pyruvate to lactate and we need guess what B vitamin? So if we’re putting in lots and lots of refined processed sugar and we’re insulin resistant, we can actually deplete B vitamins. And we can actually deplete a lot of magnesium and other nutrients downstream. So, this is really important. Too much carbs, too much sugar, especially if you’re insulin resistance and you’re putting on weight due to too much carbs. That’s going to be a problem, and you’re going to deplete nutrients now. Then we have proteins, amino acids. These all get converted downstream. We also need B itamin to support that now the difference is if you’re eating high quality protein. Guess what? You’re getting good quality B vitamins in that. Protein if you’re doing a lot of refined processed sugar, guess what? You’re not getting vitamins and nutrients with it. So carbohydrates, it’s possible to eat a lot of empty carbs that are actually going to deplete your nutrient levels. Protein not as much if it’s grass fed and organic right now, really, you’re taking all these nutrients, fats, carbs and proteins. You’re converting them into acetyl Co A. OK, you’re converting it to acetyl Co A and again we spit off beta-hydroxybutyrate what’s that? That’s a ketone now this is important. If we keep our carbs in check we can use ketones for fuel, so this is a really important fuel source or people that are going to be lower carb because we’re going to be more keto adapted. We’re going to be able to use that and then you can see here that acetyl Co A. Runs around the Krebs cycle. Twice we go 2 turns. Guess what, we need cysteine amino acid iron really important. So if you’re a female you have heavy bleeding your estrogen dominant you heavy bleeding that’s in effect energy magnesium manganese B vitamins lipoic acid magnesium B vitamins B vitamins tyrosine phenylalanine aspartate, glycine, histidine, arginine, proline. Glycine, valine methionine, right? These are all amino acids over here. So, we need amino acids to run these systems. We need B vitamins. We need magnesium and then of course, once we pump these things around, here’s our NADH and then our FADH should be there somewhere as well. So here NADH, it may not. They may just be oversimplifying it not showing it. But we have NADH here. We should have an FADH2 coming in. This all goes right into. Guess what? This is the electron transport chain and base. Yeah, fatty acid oxidation right there, right? This is now now hydroxymethyl Glutarate. This is Co Q10. This is where Co Q10 comes in and this is where it runs through the electron transport chain and burning fat for fuel and we generate our 36 to 38 ATP from all these three sources 1-2 and three and so that’s what’s happening in your mitochondria. So just to kind of highlight macro nutrients, fats, protein, carbs, very important two, don’t junk it up with all the toxins that you mentioned. And then of course, making sure we. Can breakdown protein. Make sure we’re getting enough iron making. Sure, we’re not. Anemic right? All of those things kind of flow into allowing all these pathways to to work optimally.

Evan Brand: That’s amazing, I love the breakdown to that. The visual super helpful. So just to clarify a little bit. So for women out there, you’re saying that if having heavy ministration, they have low iron. It’s not just the the low iron that we assume is creating like a low oxygenation, you’re you’re showing here. The low iron is literally creating a mitochondrial deficit.

Dr. Justin Marchegiani: Correct. You’re not getting the oxygen in right? If we go back to here, right? Mitochondria, what do we need to get into the mitochondria? Oxygen, what’s one of the big carrying capacities for oxygen in the body? Hemoglobin and then iron affects hemoglobin in red blood cells, right? Hemoglobin is part of the red blood cell carrying capacity and we need the iron to really keep the hemoglobin levels up so we can carry enough oxygen.

Evan Brand: Wow, so there’s why you’re tired.

Dr. Justin Marchegiani: Could be. Yet, one and then of course all of the other nutrients play a role. Not enough of the amino acids. The only issue with this graph, any biochemists that are looking on? I think the only thing that’s missing is really the FADH2, so it should. So, all these things, they’re just reducing compounds. Really, the whole goal of this Kreb cycle to run is just grabbing hydrogens. And then once we grab these hydrogens, Uhm, these things get cleaved off, and then it generates ATP. What’s happening there? And all these things like hydroxymethyl iterate. These are right. These are all driven through Co, Q10, right? We need Co Q10 to make that happen.

Evan Brand: Now for people like supplementing ketones, if you go back up to the top there, you can basically kind of inject your own spark plug into the cycle, I guess right? If you’re taking exogenous ketones, what is that doing in relationship to this whole cycle?

Dr. Justin Marchegiani: It’s giving you more beta hydroxybutyrate. The problem is your body is going to primarily want to use that when insulin levels are lower, so you have to keep your insulin levels and check. If not, you’re not setting your Physiology up to want to burn that. If you’re probably, gonna pee it out more like more than likely versus burn it. Cause typically, your body has an enzyme called hormone sensitive light pace where it wants to break down fat and convert more of these ketones. Hormone-sensitive light base is inverse with insulin. So hire your hormone-sensitive light pace is you need lower insulin to make that happen.

Evan Brand: So the lady who eats the donut and then goes to the store and buys her exogenous ketones, she’s wasting her.

Dr. Justin Marchegiani: Probably not as good. There may be some mild benefits that you get cognitively just ’cause your brain has some additional fuel to run on. If people brains are insulin resistant, they may have a lot of sugar from that doughnut, but the cells in their brain maybe so numb. To it that they may not be able to access it so some ketones could be helpful, but in the end, you want to fix the insulin resistance if you’re going to do it. Try doing both. Don’t just do the ketones. Try to do both that you can.

Evan Brand: And you can make your own ketones too. For free.

Dr. Justin Marchegiani: Yeah, yeah, that’s how you’re doing that you keep in your insulin in check. And you’re going to start. Making your own. 100%.

Evan Brand: Yeah, cool.

Dr. Justin Marchegiani: Cool, that was awesome. Very cool guys. I hope you guys enjoyed today’s podcast. We’re trying to be a little bit more visual; you know. Go into some hard hard science Y stuff, but you know just kind of zoom out. Like what’s the take home right? The take home is don’t put junkie toxins and that screw up your mitochondria right? Antibiotics, I mean antibiotics? You know if if you have an acute infection that’s not resolving, you know you gotta do what you gotta do, right? You have an acute pneumonia. You gotta do what you gotta do. Talk to your doctor about it. Just don’t go to antibiotics all the time as your first line defense. Try to do some. More natural things to fix it #2 you know, try to be aware of mold in your environment. Make sure you’re not. Getting exposed to pesticides. Chemicals heavy metals. Make sure you’re doing your best to hydrate right. We need water to make this whole thing work too. I would say after that make sure you have your macronutrient style, then good quality protein fats and carbohydrates. Organic sources dial in your carbs so you’re not insulin resistant and make sure your inflammation is good. Inflammation helps with oxygenation and blood flow. Then after that we can look at using supplemental nutrients in my line and Evans line we have mito supports products mine is mito synergy. Evans is my toe. Boots will put links down below. Those products have a lot of these nutrients. It’s going to have the ribose to creatine the carnitine, the B vitamin. Since it’s going to have the Co Q10, it’s going to have actually Kreb cycle intermediary compounds like fumarate malate, succinate. All those different nutrients or run those pathways better. Of course, that all sits on top of a solid diet. Don’t take supplements if you’re going to eat crap, eat really great and then say OK now I’m going to work on enhancing it. And again, we can run testing on organic. Message to look at some of these intermediary nutrients, like citrate to connotate succinate bloomer, a mallet we can actually test them, which is pretty cool.

Evan Brand: Yeah, the testing is the best part because you you know if you actually need it. I can tell you the average person has mitochondrial problem, so in general, could you just take this? I kind of call it a multi for the mitochondria. Could you just take that test? You know like a guess and check you could, but we like to see the data and obviously my biggest thing is looking for mold colonization. Candida overgrowth clostridia. Some of these gut infections and how that affects your brain chemistry too. So when you do the oh, you really are getting the best bang for your buck in terms of testing. Like if you could only do one test out there, I think the oh it would. Probably be the number one most.

Dr. Justin Marchegiani: Important 110%. Anything else you want to say?

Evan Brand: If people need help, they can reach out to you worldwide or me worldwide. Doctor J at justinhealthcom me Evan at and we would love to chat with you about your symptoms, your goals and we’ll tell you for your good fit for care, so please feel free to reach out. Look forward to helping you.

Dr. Justin Marchegiani: Foot and get adjusted. Help calm here and then you guys have any questions, comments or concerns. Put him down below. Let us know. Kind of what you’re doing. What’s working that really helps us out as well. Very cool. Alright guys, well you guys have a phenomenal day here and we’ll. Be in touch. Take care of y’all.

Evan Brand: Sounds good.

Dr. Justin Marchegiani: Alright Bye bye.


Audio Podcast:

Recommended products:

Mito Synergy

Mito Boost

Deluxe Mold Test Kit

GPL Mycotox

Genova Organix Comprehensive Profile

Genova NutrEval FMV


How to Address Your Fatigue and Gut Symptoms via Organic Acid Testing | Podcast #328

Hey, guys! In this video, Dr. J and Evan talk about addressing gut symptoms via organic acid testing. To start with, Organic acid testing (OAT) became very popular amongst functional medicine doctors and dietitians. It is a urine-based test that gives essential information about the functioning of various bodily systems and to identify possible nutrient deficiencies, gut dysbiosis, and more. 

Organic acid testing may be beneficial for people whose symptoms have not yet describe through other stool tests, blood work, or urinary hormone tests. It helps give an immense understanding of nutrient deficiencies, mitochondrial function, neurotransmitter metabolism, detoxification abilities, antioxidant status, and gut health, which trained and experienced clinicians can utilize to dive deeper. 

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:07     Organic Acid Testing, Gut Issues

5:17     Candida, Oxolates

10:27   How Lab Results are Interpreted

17:14   Metabolism, Energy Production

24:35   Neurotransmitters

26:06   Detoxes

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Dr. Justin Marchegiani: And we are alive. It’s Dr. Justin Marchegiani in the house with Evan Brand. Today we are going to be talking about organic acid testing organic acids are wonderful technology that we use with almost all patients to really look under the metabolic hood to see what is going on whether it’s functional metabolic issues, deficiencies, certain nutrient deficiencies, gut imbalances, detoxification problems, methylation issues, we weren’t able to kind of peel back the onion, so to speak and look deeper under the hood. Evan, how are we doing today man?

Evan Brand: Doing really good excited to dive in! You know, I can say this with confidence, because I’ve actually spoke to the lab about this that you and I, personally, between us clinically, we are in the top five of practitioners worldwide running the most organic acids testing.

Dr. Justin Marchegiani: Wow, isn’t that cool? I didn’t even know that. I knew I knew we were up there. But that’s really cool to hear.

Evan Brand: Yeah. So So what does that mean? Well, that just means that we’ve looked at so many of these that we can really get good at what we’re doing. And most importantly, we can help you the listener figure out exactly how your symptoms are linked in to a particular body system dysfunction. So we’re going to talk today about how the gut, you can find information about the gut via urine. And we talked about stool testing a lot. But in some cases, the urine is actually a little bit better for investigating the gut, which is pretty interesting. So we’ll dive into that we’re going to talk about energy markers and how your energy and fatigue levels can be tied in also. And the mood category, we’re going to get into possibly depression, anxiety, and how that could be tied in or even OCD behavior, depression, winter depression, and then we’re going to get into nutritional markers. And I mean, there’s just so much information from one cup of tea, it’s like magic.

Dr. Justin Marchegiani: Yeah, we can get a lot. And again, when we’re looking at gut issues, I always tell patients, we’re always going to look at a gut test, like a good high quality gut tasks. You know, there’s a couple of tests that we use, but once the genetic test that looks at the gut microbiome infections, h pylori, bacterial overgrowth, inflammation, markers, digestion, markers, immune markers, so we’ll always want to look at a comprehensive gut test to see what’s going on. But it’s nice to look at the organic acids, because sometimes, most of the time, I would say they kind of correlate where we see some kind of bacterial overgrowth, or a fungal overgrowth, it will a lot of times say it on there, I do find the organic acids do pick up fungal overgrowth far more often than stool test to a lot of times, if you’re looking at under the threshold level of fungal stuff, we do see a lot of fungal stuff. It’s not at the positive level. But if we see it there at all, you know, we typically consider it a problem. And then third, you know, we may not see total congruence, like there may say gut issues on an organic acid test, but not on a gut test. And guess what, if we just see it anywhere once, then that’s enough for us to kind of move forward on it. We don’t need total agreement. It’s just an extra check. It’s an extra net to catch anything that could be missing. And of course, we get deeper look in what’s happening nutritionally methylation, B vitamins, sulfur metabolism, detoxification, mitochondrial functions, we really get a good window at what’s happening underneath the hood. 

Evan Brand: Yeah, I want to show you this three year old, if you’ll let me share my screen, I tried to click on it, it says you got to enable it for me. But I’ve got a three year old little girl as a client who has been to conventional doctors, and she can’t get help. And the pediatrician, of course, is just saying, Hey, you know, possibly do some vitamin D. And that’s really it. Okay, now I can share. So let me pull this up here. Can you see that? 

Dr. Justin Marchegiani: Yes, I can. 

Evan Brand: Okay, good. So the people watching too, if you’re listening via audio, I encourage you check out Dr. Justin’s Justin Health YouTube channel. If you’re listening and you want to see the visual here, we’re going to try to make sure that those doing audio only still get the gist of it. But really, what we’re trying to find here are high markers. That’s when you really see problems. And you can see for this little girl, this is keep in mind this a three year old little girl. And the parents said that the girl is literally addicted to sugar, and she refuses to eat anything else. And she has a ton of symptoms, skin, mood, gut behavior, just all kinds of stuff and look at this tartaric acid, which is an indication of Aspergillus, growing in our gut, we want less than 3.9. She’s 147. I think this is the highest I’ve ever seen. And sadly, it’s an a child. And then of course, arabba knows you and I’ve talked about that being the gas that Candida produces, we want less than 56. She’s off the charts at 226. So right there really high, that’s really high. This is the amazing thing in five seconds of us looking at this page, we know this person’s already colonized for mold, and they were in a moldy house in Texas had major mold exposure. And when now we know that she’s got a major Candida problem. So even if we just had that data and just pursued those two points, we would get a hell of a hell of a lot more results than what you would get if you went to the pediatrician and said, Hey, I think she’s got a problem. They’re not going to know anything about these tests or these markers.

Dr. Justin Marchegiani: Plus in the conventional medical world, I mean, frankly, you know, candida that doesn’t really exist to people like that right. Conventional medical doctors at They’re very rarely saying, hey Candida is a problem. Usually it’s one of those things. They just say, Oh, yeah, that’s just kind of what natural medicine thinks everything is. The problem is candida, but not necessarily. But if we have objective markers that show it, it’s good to really know that and conventional medicine isn’t typically doing testing that sensitive enough to really pick it up.

Evan Brand: Yeah, and I know you run a lot of the Genova panels. And the reason that I use the Great Plains is just because I like to run the combo a lot when I, you know, I’ve kind of attracted a lot of moldy people. And so we like to run the mycotoxin combo test. So one cup of tea, and we get two labs. So that’s why I do the the Great Plains, but the rest of page one was okay, she didn’t show any major bacterial overgrowth, he was starting to creep up there on one of these markers. But overall, it was decent. Let’s move on. Let’s look at this is where all the fatigue is coming from. They said that this kid is just exhausted. And then they described it as poor tone, where she literally just lays on the floor all the time. Justin, I don’t know if you’ve ever even seen anything this high. I mean, look at these oxalates 677 off the charts. We know Candida is a piece of it, but man, and then look at the I call it succinic. But I think it’s actually pronounced succinic.

Dr. Justin Marchegiani: So succinic, yeah, and just so you know, oxalates a lot of times, especially in a kid, it’s probably not like, I would never tell a mom like oh my gosh, like most green vegetables have oxalates in it. So I wouldn’t be telling any mom like oh my gosh, you need to avoid green vegetables. Unless there was some kind of oxalate crystal issue in regards to kidney or significant muscle or join issues. I would just think that, hey, those oxalates are probably high because of the candida, candida that can really increase oxalate production and decrease oxalate synthesis. So I would lean more on the Candida being the oxalate problem.

Evan Brand: And I think this is huge, because you have some unnamed people writing books and fearmongering people about oxalates. And now you have people paranoid vegetables, like you just mentioned, you’ve got people that are like cutting vegetables out because they’re worried about the oxalates. But you and I’ve seen personally and clinically hundreds and hundreds of point reductions in the oxalic acid just by treating the Candida so Yeah, I would agree that when we know she’s not eating vegetables, so we know that that’s not where it’s coming from.

Dr. Justin Marchegiani: Yeah. And so we know if they have a Candida issue and they have a whole bunch of sweet cravings, you know, exactly. They’re not eating a whole bunch of vegetables. That’s not the issue. They’re, you know, a whole bunch of crap. And we don’t want to give them any more ammo to let their that their kiddo eat crap, right. So we want to definitely get some good nutrition in there, more than likely most of the oxalate issues are going to be from the Candida. Now again, some of the exceptions may be if we have vulvodynia, excessive joint pain from oxalate crystals, crystals, maybe kidney stones, or really kidney pain issues, that could be something really clinically significant. If not, we’re not going to worry about the oxalates, we’re going to think of that more as an effect than a cause the cause really being Candida and the effect being more of the oxalates as the cause. So I always when I’m looking at these labs of patients, I always have them in their head, draw a line one sides, cause one size effect affects we watch and monitor causes we treat and work on supporting. And so it’s easy for people to look at an effect think that is the cause and treat the effect. And then a lot of times the result won’t be as good or you do things that aren’t necessary, like cut out foods that may be really healthy for your kid.

Evan Brand: Totally Yes, same thing for the citric acid here on 29. For those listening, we’re looking at these little triangles, basically, the higher the number goes down in general, the more of a problem or dysfunction we have. And we want citric acid, maybe somewhere around 200 would be moderate. This poor little girl is off the charts almost at 1300. And we know citric acid will go high with Candida and fungal overgrowth in general. But all this succinic acid and malic acid oxic glutaric, these things are off the chart. So this just indicates an insane amount of mitochondrial dysfunction. And that’s, that’s why this girl is literally so exhausted. She can’t go to school, the parents can hardly get her out of bed. And she’s three years old. I mean, you know, my daughter, she’s four now, but when she was three, I mean, she bounces out of bed and she’s just running, running, running, going and putting her bird feeders up. I mean, this kid wakes up with energy. So you can just see, these symptoms that kids face in the parents is think gold. They’re just, like bored, or they’re just tired, but they don’t think Wow, she could have a ton of mitochondrial damage.

Dr. Justin Marchegiani: 100% Yep. 100%. So looking at a bunch of these things here. I think we hit a lot of good things out of the gates. Let me just keep on rolling here. So actually, do you want to hit a little a couple more things? I’m going to show some of my organic acid testing to the second. 

Evan Brand: Let me do to show this one page here. So some of the nutritional markers are gonna get, we’re gonna see here that she was very deficient in riboflavin. The higher it goes actually the more deficient and then of course vitamin C is in Charlie is just completely toast. And then we’ve got some other markers ammonia excess and some gi bacteria markers, but overall, the main things I wanted to hit were just massive mitochondrial damage, massive colonization of mold and Candida. So don’t think that just because your kid is young That means they can’t, they don’t have permission to be sick. I mean, I started treating my daughter when she was two because she had parasites. And so I just, I feel bad because you know, these kids, when they’re really young like this, they may not be able to express all of their pains and their symptoms. But hopefully there’s enough whether it’s skin or mood or behavior or, or sleeping issues, that there’s enough justification for the parents to reach out, run the labs, and then we can really show them on paper, what their kids just can’t verbalize.

Dr. Justin Marchegiani: 100% I think it’s really good points. Now, just to kind of give people a little understanding how we interpret how we look at some of the labs pretty simple. So we want some of the markers here on the labs to be in the middle distribution. So if you look at my screen here, can you see my screen? 

Evan Brand: Perfect. 

Dr. Justin Marchegiani: Okay, good. Excellent. And I just make sure that you can see me as well along with that. Okay. So in general, we want these markers to be somewhat in the second to fourth quintile distribution, when they go on the extreme high or low, we always get a little bit concerned. And we get more concerned if it’s near a red area. So there are some of these markers are two tailed meaning, let’s say number seven citrate, where there’s a red on the left and the right, and some are one tail there say most are one tailed, like adipate subarray, [inaudible] where there’s only a red to the right, does that make sense to tail means read on both sides, one tail means read on one side. And of course, if markers are low, and we’re closer to a read that matters more, so we want them to be somewhat distribution in the middle extreme highs or lows are more concerning, especially if they’re grouped together now. So in this section here, fatty acid metabolism, we see them on the lower side, not as big of a deal, because this is only one tail. But we do keep that in mind. We look in the carbohydrate metabolism, you see you’re in the middle here without lactate, which is one of the more important markers, beta hydroxy butyrate, being higher isn’t that big of a deal. That’s a ketone. That’s a ketone. It’s not that big of a deal. lactate is a marker for co q 10. Typically, and pyruvate is a marker typically for B vitamins and B complex as well. So this being a little bit low, less than detectable limit isn’t that big of a deal, as long as you don’t have a whole bunch of them there. But we do keep an eye on it. And I always tell patients chronically high organic acids, that’s like a demand issue. So it’s like you’re making a million bucks a year, but spending $2 million a year you have a lot of income coming in, but your demand for that money for those resources is high. So functionally, we’re still in debt, right? And when we’re chronically low, especially in areas where there where it’s two tailed and red, that’s a sign that there’s a depletion issue depletion, it’s like you’re making 10,000 bucks a year. But spending 100, right, you’re making a lot less, right. There’s not a lot coming in, but but you’re still spending more than you’re making, right? So both in the end, you’re in debt. Okay, that’s kind of the analogy I give. And I always tell patients, well, what’s the root cause? Like? No, we always want to be focused on the root cause we may be doing palliative support. People can feel better in the moment, but we always want to get to the root cause support now, with organic acids pretty simple. First is going to be diet, and it could be a macro issue, and or micro issue, meaning if someone’s eating that looks like a healthy diet, but it’s not organic. Well, it may be significantly deficient in certain nutrients, right. If you look at Joel Salatin runs polyface farm, he found he sent his organic eggs to the lab, and they looked at the amount of full weight that was in his organic eggs, it was 20 times more fully in his organic eggs than the typical conventional storebought eggs. So organic matters. It’s not just pesticides, pesticides is important. It’s a big part, but it’s also nutrition. So of course, eating organic makes a bigger difference, food quality makes a big difference. And then number two is going to be absorption absorption can be affected by gut microbiome issues, parasites, fungal overgrowth, bacterial overgrowth, it could be affected by low stomach acid and enzymes and bile salt levels. It can also be affected by food allergies, chronic food allergens, or chronic inflammation in the intestines, can can drive it to number three, just general stress. Stress can be categorized as physical stress, right? you’re exercising too hard. Maybe you’re too sedentary, maybe you’re not getting enough sleep, maybe your emotional stress is off the charts. And that’s throwing off your cortisol and your adrenals and your hormones. Stress plays a big role. Number four is toxicity, toxicity primarily from pesticides, heavy metals, mold, toxins, pesticides, heavy metal mold, toxins are biggies. And then number five is genetic. Genetic can mean hey, you just need more magnesium, you need more amino acids, you need more B vitamins than the average person just for who you are. Could be an mthfr issue. You need good high quality full eight, that cheap folic acid stuff is not cutting it. You need more methylated B vitamins. So genetically, there could be just some imbalances in regards to what your biochemical needs. I think Roger Williams wrote a book called biochemical individuality talking about people’s need for certain nutrients can be exponentially higher than someone else’s. And so those are kind of the big five things out of the gate. Any comments on that, Evan?

Evan Brand: Yeah. So one thing I think it’s important to point out is people get really caught up in the DNA and the genetic testing and I’m cool with So I’m cool with it. But I just want to highlight something you said here, which is that we’re really going to be looking more at the downstream effect of any of those genetic predispositions here correct meaning, let’s say that there is a genetic predisposition to needing some more foliage or some B vitamins upstream, but then that manifests downstream, we’re gonna see it here, we’re going to see the citric acid cycle, we may see some things off of this carbohydrate metabolism section. So what I’m saying is not that the genetic stuff is useless, but that you and I are going to see the result of those genetic issues here. Is that correct? And the you might not need that genetic data, because you’re going to be looking here at what the actual body has. Is that true?

Dr. Justin Marchegiani: 100% Yep. 110%.

Evan Brand: Because you send us the snips, right, well, I’ve got this snip or this genetic This or this genetic that, but I really would prefer to look at the organic acids, maybe in addition to but if I’m without the genetic information, I still feel confident in what we’re going to do and the results we can achieve with just the test alone.

Dr. Justin Marchegiani: Yeah, here’s one image. I’ll put it on screen. These are two twins here called Otto and Iwa, can you see it? Yep. These are exact twins. Okay, so one engaged in you know, lifting weights eating better the other one? Not? I mean, you can see, look at the difference. Fuller hair for muscles, right? It’s same DNA. Remember, twins have the exact same DNA. Right? So this is important. So we know our genetics can change. The reason why I don’t like the genetic tests as much as because you could have you could have someone being an alcoholic eating terribly. Someone totally changing their life and and eating incredibly healthily. And guess what? The DNA looks exactly the same. So it kind of it’s a snapshot in time. It’s not functional does not change based on your your lifestyle decisions. And so you can see here we know, right, this is the same DNA here. This is the these are two German twins, like 1969. Same DNA. Look at the difference. 

Evan Brand: Okay, yeah, people on audio people on audio listening, he’s showing a picture of these guys, they’re twins, you can see same height, same looks everything. But then the guy, one guy is, who knows, maybe 130 pounds, the other guy’s like 170, and just ripped shredded muscles.

Dr. Justin Marchegiani: Yep. And so basically, it’s the epi genetics. It’s it’s the functional progress that we’re looking at. So just kind of put that there. And again, anyone listening, we’re trying to do enough of a good job describing what’s happening. So if you’re in your car drive and just kind of listen to us, if not, we’ll put a link right below to the YouTube video. So if you guys want to engage in the video, feel free. Let me go back to the organic acids, though. So we talked about fatty acid metabolism, carb metabolism, energy production. So we’d like this to be somewhat in the middle seven through 14 is a bunch of these organic acids here. The names don’t necessarily matter. citrate, Sr connotates, ISO citrate alpha ketoglutarate, succinate, Fumarate analyte, hydroxy, [inaudible] doesn’t matter, right, that’s just just focus on what it means these typically correlate with nutrients like B vitamins and CO, q, 10, and chromium, chromium and arginine and cysteine, and B complex and manganese and magnesium and lipoic acid. So when we see deviations high or low, especially a whole section, higher low, that tells us those nutrients are going to be burnt up depleted. And it just gives us a window, what’s happening. And we got to look at it in correlation to someone’s lifestyle, how good their diet is, how crappy their absorption is all that matters. I always try to look at the top the patient’s top two or three symptoms, I try to correlate it to the, to the systems that may not be functioning optimally based on the organic acids. And then I support based on that, because there’s a lot of things you could support at all times. At the back page, they’ll typically give you a whole bunch of things that were to recommend here. I ignore that. Because because there’s a clinical art to this. And we’re doing a lot of different things. At the same time. We’re not just like running this test. I’m just saying here, take the supplements, we’re really trying to look at the whole big picture.

Evan Brand: Okay, I kind of skipped over some of the importance of the neurotransmitters in the beginning. I mentioned we’re gonna hit some brain chemistry stuff, depression, and some mood issues. Cool.

Dr. Justin Marchegiani: Depending on how bad your gut health is. Ideally, if we’re doing some kind of a really good high quality methylated B 12. Or [inaudible] or hydroxyl and or some kind of something sublingual, usually we can not necessarily need it if we’re doing the high enough of a dose and or sublingual. But if someone maybe has really bad Crohn’s or ulcerative colitis and bloods coming out of their stool, and we see markers on their differentials, you know, hi MC, ah, Hi mctv Hi, MC, hc, and or high methylmalonic acid, we may want to just do a one off injection to bias time, but most of the time, it’s not necessary. Because when patients come in to see us, we’re doing all kinds of diet changes and lifestyle changes a month before these tests even come in. So then the time they get these tests in usually we’ve calmed down most of any acute issues to begin with. Does that make sense? 

Evan Brand: It does. Yeah, I just see a lot of these pop up IV clinics going around and people they’re paying a really pretty penny for some of these injectable B vitamins versus some of the pricing that you and I offer on some of the our professional methylated sublingual nutrients, it’s maybe a quarter of the cost, if not half the cost. And you don’t have to get an injection. You don’t have to travel to a clinic and sit in the chair. You can do it at home and you can fix it. So yeah, I would agree with you.

Dr. Justin Marchegiani: Yeah, I would say depending on how acute The issue is, maybe that may dictate. And also if you’re acutely sick, that may help kind of as a palliative thing, but in general, it’s not practical from a day in day out standpoint. And then we have our neurotransmitter. So vanel, Mandalay and Homo vandelay. They’re kind of they’re two, they’re two sides of the same sword so vandal Mandalay, it’s a marker for adrenaline, home of analytes, a marker for dopamine. Now in the in the neurotransmitter synthesis pathway, it goes phenyl alanine tyrosine tyrosine l dopa l dopa epinephrine norepinephrine. So what does that mean? It means home of anolyte will eventually home of anolyte looks at dopamine, right? So dopamine will eventually go downstream to adrenaline. It’s the next step in the cascade if there is stress going on. So when you support adrenaline, you’re also support a dopamine, when you support dopamine, you’re also supporting adrenaline. And you may not have both of these out of balance. So in this case, this person is having more of an adrenaline issue. Now, by supporting the adrenaline we will be supporting dopamine. But if you have a chronic adrenaline issue, you will eventually be depleting dopamine, because it just comes from it. It’s the precursor, your fan, Amanda lates, the post cursor, dopamine or Homo ventilates, the precursor? Does that make sense? 

Evan Brand: So let me say it in another way, you’re going to see a depletion of your endorphins before you see a depletion of dopamine.

Dr. Justin Marchegiani: Oh, no, you could see both, you could see a dopamine issue before endorphin. That’s gonna be all based on genetics. But if you only see one issue going on, it’s just a matter of time before that second issue kicks in.

Evan Brand: I’d say 75 80% of the time, you are seeing both at the same time lower.

Dr. Justin Marchegiani: So think of it as like this, you have two credit cards, right? You’re only in debt on one credit card. Well, if you keep up your spending habits, it’s just a matter of time before you’re in debt on both credit cards. Does that make sense? Okay, just like that, and then five hydroxy. And these are all metabolites. So these organic acids, they’re metabolites of amino acids. And these metabolites give us a window into certain nutrients. And so as long as you have an understanding on what the nutrients are and what the area is, the actual organic acid doesn’t necessarily matter that much, FYI.

Evan Brand: I think I think of it and kind of refer to it as like the fingerprint of what’s going on or maybe the ash in the bonfire, you can see the evidence of what’s happened. You’re just kind of analyzing the ash and looking at the fingerprints.

Dr. Justin Marchegiani: Yeah, patients usually think of it as like gas in the gas tank. Is it higher? Is it low? I’m like, Nope, it’s RPMs and the engine RPMs is overly overly high or really low or really high demand overly low on the on the stimulation.

Evan Brand: Scroll down to that detox marker. I want to see what you can tell us about that one there that-

Dr. Justin Marchegiani: Let me just finished the neurotransmitters real fast. So five hydroxy acid that’s a serotonin marker. So serotonin plays roles in motility, mood, sleep, happiness. Another big one kind of urinate plays a really important role would be six right B six helps with the synthesis of all these nutrients. All these neurotransmitters and of course, kind of urinates brother or sister is anther urinate so this person has high xanthine Made in high kind of urinate. So we know there’s definitely a B six problem. And B six plays a really important role in neurotransmitters. So if you’re just thinking, Oh, I’m going to just take some tyrosine or phenyl. alanine, yeah, probably not the best, okay? Because you need the other nutrients there. And then also picolinate chronically low is a big sign of low amino acids and if we have low amino acids, it could be a catabolic stress issue. You’re just burning up a lot because you’re you’re a lot of Khattab catabolic stress, cortisol imbalances, hyper adrenal stuff, it could also be, you’re not getting enough protein, you’re not eating enough vegetarian V and not eating enough or you’re not digesting enough, it could be all of the above. And then we have our oxidative stress. Oxidation is losing electrons when you lose electrons. And you don’t have enough antioxidants like vitamin C, or a or E or good antioxidants like curcumin or resveratrol. Those help donate electrons. And if we are donating electrons, when we lose them, we can create free radical damage and that can chip away at our DNA and cause our DNA to age rapidly. Any questions on that last part? 

Evan Brand: No, we’re good. Let’s run into the detoxes part.

Dr. Justin Marchegiani: Yeah, so this person right here is very depleted detoxification. So the most important markers here are these two, or these two tailed markers at the bottom, pirate, glutamate and sulfate. Very important, they all correlate with Bluetooth ion. So when I see low sulfate and low pirate glutamate that almost always means a glue to phi on depletion. So the big neurotransmitters here are n acetylcysteine, cysteine, taurine, glutamine refining, right? glycine, they all play a very important role in making our tripeptide most powerful antioxidant glutathione.

Evan Brand: Let me pose a question to you that some people will have at this section is they’re going to say okay, you mentioned gluta found depletion. So are you saying that there was a toxin issue, maybe a mold toxin that depleted the glutathione and or you’re saying that you may not even have the raw materials necessary to synthesize Bluetooth ion, right. So it could be a two pronged issue, it could be a depletion of glutathione due to toxins, plus the inability to make it is that what you’re saying? This could show?

Dr. Justin Marchegiani: Yes, so it could be one more variable so one, it could be a combination of exposure to toxins that are stressing out that pathway to you’re not getting enough good exposure to sulfur amino acids. Three, it could be not, you’re not digesting your protein well, right. And for when you get stressed part of the whole catecholamine adrenaline noradrenaline pathway require sulfur requires sulfur to help with that conversion and metabolism of healthy, healthy neurotransmitters. So you actually need sulfur on the neurotransmitter. So if you’re chronically stressed, you could also deplete sulfur that way,

Evan Brand: So each each your broccoli, folks as long as you can tolerate it.

Dr. Justin Marchegiani: Well, more importantly, yes, there’s a lot of sulfur there. But more importantly, like your animal protein, like you’re gonna get a lot of sulfur in there. But from an amino acid from a bulk amino acid standpoint, you’re going to get way more sulfur in protein from a caloric standpoint, as a percentage as a percentage of the food, you’re going to get a lot of sulfur and broccoli, but this is just low calorie, right. So you get more from a caloric standpoint with high quality animal products, or honestly, whey protein or college and proteins. Excellent, too, for that, too.

Evan Brand: Yeah, that’s what I was gonna say if somebody is listening, and they either maybe were previously vegetarian or couldn’t get back into the meats, maybe they were having issues digesting meats, we’ve got some really good like grass fed ways or some collagen hydrolyzed beef proteins. Those work amazing.

Dr. Justin Marchegiani: Yeah, or even just free form amino acids that are kind of been fermented that still are pretty balanced, they can, they can help get the needle moving on that. And then this to methyl hippuric can also be elevated due to xylene. And xylene can be in drinking water could be smoking, inhalation, vehicle exhaust, now, a different different nail polish those xylenes one of those things that could be an issue up there as well. It’s possible it’d be put on the list. I mean, most people we’re trying to educate them on healthy products, how you know, good water filtration, good, hygienic products. And then if we look down here below, this is gut bacteria. Now this person only has one elevated gut bacterial metabolite. And I tell patients like what we’re looking at here like this is typically bad bugs, usually more on the gram negative side. It’s not telling us what the bugs are. Could it be h pylori, could it be klebsiella? citrobacter? Could it be prepatellar morganella. It can be all those things. Right? Pseudomonas, it could be it’s just looking at the exhaust. So it’s like, okay, a car was was had their engine on they were in the garage, they left you show up to the house, you open the garage, I feel like there’s some exhaust in here. Like you may not be able to know Oh, that’s a four. That’s a Chevy. that’s a that’s a Toyota, you may not be able to know what car it is, but you can know Okay, something was in here. Does that make sense? And so it just tells us Okay, we got some exhaust of some bad bugs here. And we probably got to work on it. And now if we have the stool test, we can no okay. Yeah, well, you also test the positive for Pseudomonas and klebsiella and H. pylori. So that’s probably what that’s correlating with. I had a patient last week had a lot of bugs and he Laurie, and there wasn’t much elevated at all, I think this is the test. This is the person that had a lot of other big bigger bugs. And that can happen. I tell him, you, we don’t need both tests to confirm most of the time they do. And then I’d say most of the time, the organic acids, picks up the de arabba, Anatol, this picks up the the fungal overgrowth before the GI map or the stool test. So it’s good to have both, that’s a really good marker. And then a lot of times the if we see a lot of bacterial overgrowth here, that a lot of times would correlate maybe with a SIBO breath test where we do a lactulose. And we and we blow into it for three hours afterwards. A lot of times, we’ll see a correlation on that as well.

Evan Brand: Yeah, yeah, well said. And I think you made a great point here, which is that sometimes you’re not going to get the smoking gun on this test, the stool may come in and provide better data and vice versa. Rarely, the Candida shows up on the stool, though the the oat test is always going to be better for Candida at least 98% of the time. 

Dr. Justin Marchegiani: Well, 100%. Now also, with induction, this may also give us a window into bio output, as well as poor protein digestion. So induction issues, you know, usually more purified protein work on HCl, of course, I’m always working on HCl Anyway, I’m just giving you a little bit more of an insight. Usually, with the lactate being on the higher side, that almost always means there’s a lot of extra probiotics in the system. So they may be taking a lot of lactobacillus or bifidobacterium. And usually these patients may get more bloated to those kinds of probiotics. And usually that’s common with SIBO. So we see a lot of the lactate, that can mean there’s other already taking a lot of probiotics, and then that may be a problem. And they may want to switch to a spore based probiotic or even just no probiotics, and maybe even a a low fodmap diet out of the gates. You know, those are different things just clinically, I noticed over the years. And again, when we look at this, we’re taking into account the patient’s adrenal tests, what’s happening with their thyroid? What’s happening with their their gut functioning, what’s happening with their lifestyle? Have they had their had they had mercury fillings removed? Has there been any mold exposure? What’s their diet? Like? What’s their digestion? Like? Are they pooping everyday, we’re looking at the whole picture. So some people may look at this test totally in isolation, not good. You really want to connect it to everything else that’s going on? 

Evan Brand: Yep. 

Dr. Justin Marchegiani: Anything else you want to highlight there Evan?

Evan Brand: If you haven’t had your organic acids test, reach out, let’s get it done. Let’s see what’s going on. This is an amazing test. If I only had like desert island situation, I only had one test to run, I’d honestly probably pick this one, wouldn’t you? Or what would you pick?

Dr. Justin Marchegiani: I would because you do get a window, what’s happening with the adrenals a little bit you do get a window, what’s happening with the mitochondria. And then you also get a little bit of a window in regards to what’s happening in the gut and detoxification. So you get a window of a lot of different things. And I love it with kids. Because, you know, kids don’t want to get their needle, get a needle in their arm, right. And so it’s really nice. This is a urine based test if you want to avoid getting a blood draw. It’s a really easy test to do out of the gate. So I do like that.

Evan Brand: Also. And it’s at home too, right? So if you got people that are elderly, or just you know, paranoid to go out, for example, in the public and go into a lab, hey, you do it at home, you get it back. I mean, how convenient does it get?

Dr. Justin Marchegiani: Yeah, and then also with this test, you got to be careful if you’re chronically low protein. This is running it off of creatine. So if creatine is too low, which is a protein metabolite, you could get some, some false readings on the on the lower side. So you got to make sure there’s a protein in the system. And so if you’re dealing with someone who doesn’t eat much protein at all, you know, we’ll typically throw in some freeform amino acids for a couple of weeks ahead of time. That way, those systems at least have the substrate to move metabolically, if you will.

Evan Brand: Yeah. Great pointing out.

Dr. Justin Marchegiani: Anything else you want to say, Evan?

Evan Brand: I don’t think so we’ll give the links to people. If you enjoyed this, please let us know. I know this was kind of fast, and maybe a little overwhelming, because we’re breaking down. But for us, this is something we do all day every day. And of course, for your unique situation. We’re going to talk you through what’s going on what you need to do, how to fix it. But give us some feedback. So like I said, if you’re on Justin’s YouTube channel, right in the comments, do you like these video versions, because a lot of times you and I are just riffing on stuff. But if people like the videos, we’ve got so much stuff that we can uncover. We’ve got literally 1000s of case studies, we can start reviewing, if you want to see before and after, like, Hey, here’s a protocol we implemented. And you know, we’re not going to give exact dosing and say, Tell it tell you to do it, but we could run you through what we do, if you like it. So let us know because we really need the feedback to help guide the show.

Dr. Justin Marchegiani: Yeah, and also, we’re trying to be different than other people that are talking about these topics, because they’re not in the trenches. So we’re in the trenches. So, you know, our kind of unique proposition for y’all is that we do this every day, and we want to provide valuable information that’s actually actionable. And is it’s real, it’s something that we’re in that this is the patient from last week that I’m talking about here, right? And so we’re trying to provide actionable information and if you see this and you kind of get a little bit overwhelmed, it’s okay, it’s normal to feel overwhelmed. We review 1000s of these tests, it takes a couple you know dozen to kind of get your get your, your feet wet, so to speak. So just an FYI, if you get overwhelmed, not a big deal. If you work with us as patients, you know, we typically go over these things a couple of times and then usually patients have questions a month or two later after the test. We always go back. Part of being a great clinician is you have to be a great teacher. So if anyone feels overwhelmed with it, don’t worry, we tend to take these things, boil them down, make sure you have the key action components. As long as you have the action items, that’s the most important thing. And if you want to reach out to someone like myself or you can reach out to Evan. Evan has the same philosophy you got to have a heart of a teacher. And then Justin Health myself, Dr. J at There’s links there for you guys to click. If you enjoyed it, let us know. If you want to dive in deeper. Let us know if you want to support us in any way you can always purchase any of the labs or supplementation from our website. It goes to help fund this show and make it all possible. Evan, anything else you want to say?

Evan Brand: I don’t think so. You covered it. And please subscribe if you’re not already, you know, I looked at our statistics and a lot of people that listen, they’re not subscribed, so make sure you hit subscribe. I think with no ads and all killer, no filler content. This is a much more listenable podcast, I tried to listen to a couple health podcasts the other day. And there was like an ad in the beginning that was like five minutes. And then there’s like right in the middle of the conversation. There’s like another ad and then like an ad at the end. I mean, I think people take us for granted with our adlis shows I might have to start doing ads just to you know, tell us Hey, didn’t you miss the ad free days?

Dr. Justin Marchegiani: I know man to do that with the switch. So if you enjoy it, let us know and support us down below. Alright Devin phenomenal chatting with you today. We’ll be back next week everyone share, thumbs up comment-


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Improving Mitochondrial Function | Podcast #222

Today’s episode talks about mitochondrial health. Listen as Dr. Justin and Dr. Tim, a doctorate of Physical Therapy (DPT), a nutritional biochemist and functional endocrinologist engage in an informative discussion about improving the mitochondria, ways to protect the DNA on the mitochondrial side from oxidative stress and damage and importance of Superoxide Dismutase (SOD).

Watch the video and answer the questions about genetic markers that we need to look at to gleam a predisposition of having mitochondrial stress or dysfunction, learn the effects of glutathione deficiency and superoxide dismutase, and many more!

Dr. Tim Jackson


In this episode, we cover:

00:17    Genetic Markers

01:42    Ways to Protect DNA from Oxidative Stress and Damage

09:55    Carnitine

15:31    Three Pronged Approach: Repair, Protect and Fuel

29:06    Glutathione S-transferase Mu


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani. Today, we have Dr. Tim Jackson in the house, we are doing a podcast on mitochondrial health, how to improve your mitochondria. Dr. Tim, welcome to the podcast my man!

Dr. Tim Jackson: Dr. Justin, thanks for having me. It’s always a pleasure.

Dr. Justin Marchegiani: Very good. Well, what’s going on there? We were talking about some genetic test, uhm, pre-called with one of my patients, you gave me some good feedback, I appreciate that. Let’s dive in to some genetic markers that we can look at to maybe gleam a predisposition for having some mitochondrial stress or dysfunction. What would those be?

Dr. Tim Jackson: Yeah. So, uh, looking at superoxide dismutase or SOD-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -polymorphisms, uh, along with polymorphisms in the glutathione pathway, whether it’s uh, GSTN uhm or GPX, uh because both glutathione and Superoxide Dismutase are the two bodyguards that sit in front of your mitochondria. Uhm, our nuclear DNA is protected by histones and so is not as susceptible to oxidative damage.

Dr. Justin Marchegiani: And what are histones?

Dr. Tim Jackson: Histones are just proteins uhm, that help, uh, kinda coil up uh-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -the DNA, and uh, organize it and also protect it. Uh, and mitochondrial DNA uh, does not have those, so it’s kind of sitting out uh-

Dr. Justin Marchegiani: Aah…

Dr. Tim Jackson: -alone by itself. And if you’re deficient in glutathione and superoxide dismutase, then uh, it’s much easier for the mitochondria to become damaged.

Dr. Justin Marchegiani: So regular DNAs has histones which protect that coil up around the DNA, but mitochondrial DNA does not have histones that make it more vulnerable, is that correct?

Dr. Tim Jackson: Right.

Dr. Justin Marchegiani: Ok, got it. So, what does that mean? What can we do to protect our DNA on the mitochondrial side, uhm, form oxidative stress and damage?

Dr. Tim Jackson: Well, obviously, you know, looking at things like stealth infections, mold, dysbiosis, blood sugar imbalances, all of those uhm, will create inflammation and ultimately stress the mitochondria-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -uh but in order to, you know, protect it and upregulate the SOD compound or superoxide dismutase and glutathione, uh, we can use things that upregulate NRF2. And NRF2 is just uh ce- cellular control switch, uhm that is responsible for detoxifying, uh, certain compounds-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -but also upregulating your antioxidant, your endogenous antioxidant production. So if we can do things that control many different reactions-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -that’s a lot better than going, you know, tip-for-tat, trying to uhm, you know, correct imbalances.

Dr. Justin Marchegiani: Okay, got it. So let’s repeat those nutrients. So, obviously, superoxide dismutase is a- is a big one, and where can we get that supplementally?

Dr. Tim Jackson: So, there are several companies that have uh, SOD, uhm, in the capsule or tablet. Uh, I haven’t seen any good data on how terrible it is, uhm, so, I try to do things that will upregulate it upstream, uhm, instead of just uh, you know, trying to absorb even in the uh- and optimally helping gut, I don’t know how will absorb SOD would be. Uh, but if you upregulate NRF2, and things- plenty of things can do that. Uh, but one that’s specific to the mitochondria is molecular-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -hydrogen. And molecular hydrogen- what makes it so unique, is that it’s-

Dr. Justin Marchegiani: Hmm.

Dr. Tim Jackson: -really tiny. So it can get to where we need it to go, which is in the mitochondria.

Dr. Justin Marchegiani: Got it.

Dr. Tim Jackson: It- it helps to stab in the nasty- really nasty free radical called peroxynitrite.

Dr. Justin Marchegiani: Yes.

Dr. Tim Jackson: And not only that, it stimulates the production and creation of new mitochondria, which the only other things to do that are exercise and PQQ.

Dr. Justin Marchegiani: Excellent, very good. What about fasting? How much does fasting have an impact on the mitochondria?

Dr. Tim Jackson: Uh, it has a tremendous impact uhm, in terms of upregulating, you know, autophagy, cleaning the cells-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -uh, that sort of thing. Uh, the only thing I would caution with fasting is that, you know, if someone’s HPA, thyroid, gut, vanadyl axis [crosstalk], and uh, you fast, then that may in fact worsen their metabolism and metabolic rate.

Dr. Justin Marchegiani: And that’s a thing. I see a lot of people with adrenal issues and also thyroid issues, and they may even have some blood sugar stuff, and they’re hearing all the rage of fasting that people getting lots of benefits but that may actually exacerbate their issues, right, it can increase the HPA-TA, or, you know, increase that stress and it can even potentially lower thyroid hormone more by increasing reversed T3.

Dr. Tim Jackson: Right, yeah, absolutely. And uh, lot of times, you know, you can develop hypothyroid symptoms-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -uhm, adrenal insufficiency-

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: -and/or cortisol resistance.

Dr. Justin Marchegiani: Totally. Good. So, we have- you mentioned- was that the molecular hydrogen you mentioned- you mentioned the superoxide dismutase, correct? Uh-

Dr. Tim Jackson: Yeah.

Dr. Justin Marchegiani: Err- what about various compounds like resveratrol or curcumin, what do you think about them? How do they do with the mitochondria?

Dr. Tim Jackson: So, curcumin works on uh, control switch called NF-kappa-beta. And basically, uh, you know, genes generally aren’t turned completely on or off, it’s more-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -like adjusting the volume on your stereo. And so, curcumin helps downregulate NF-kappa-beta-

Dr. Justin Marchegiani: Got it.

Dr. Tim Jackson: -and that results in less inflammatory markers which is-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -cytokines-

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: -uh, TNF-alpha, ___[05:48]. And so, curcumin, uh, works, uh, on several levels. It upregulates glutathione by up to 600%-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -uh, it downregulates NF-kappa-beta, so-

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: -you’re not giving the inflammatory stress. And that’s also has some antimicrobial properties. And, uh, not to get too far off topic but certain viruses can get- retroviruses can get stuck in the mitochondria. And if- if you have a patient, or if you’re someone who- you’ve been taking a lot of CoQ10, you’ve been taking lot of carnitine, you might even have done IV-NAD, and you didn’t felt benefit, then it means your mitochondria are damaged and we need to repair them. Uhm, and you tell me when you want me to go into the three pronged approach of how to heal the mitochondria.

Dr. Justin Marchegiani: That’s great, excellent. So is there anythi- other supplements you can- you can highlight before we dive into that? What about resveratrol? People have talked about that. What’s your take on resveratrol?

Dr. Tim Jackson: Yeah, uhm- it- it’s not very absorbed, uhm-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -by most companies. Uhm, you know, even if you add uh-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -___[07:01] to it, or black pepper. Uh there was a company that had transdermal resveratrol-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -but I think the vinyl FDH shut them down. Uhm but I think there are a few products out there uhm, that have liposomal resveratrol.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: And so, you know, that would be better absorbed, for sure. Uhm, but yeah, I mean, it works on multiple levels, it can help, you know, with hormone metabolism, uhm, and free radical stress-

Dr. Justin Marchegiani: Hmm.

Dr. Tim Jackson: -anti-aging, so many things.

Dr. Justin Marchegiani: Very cool. Any other supplements you wanna highlight, kinda low-hanging fruit nutrients, you wanna make note of?

Dr. Tim Jackson: Uhm- B- well, I would say, you know, L-carnitine, or Acetylcarnitine.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: Uhm, you know, if you had certain polymorphisms, you might not be able to carry fatty acids into the mitochondria-

Dr. Justin Marchegiani: Mmm.

Dr. Tim Jackson: -where they get burned for energy-

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: -what we call beta-oxidation.

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: And so Acetylcarnitine is like an uber for fatty acids-

Dr. Justin Marchegiani: American shuttle.

Dr. Tim Jackson: Yeah. Exactly. And so, you know, that’s a supplement that uhm, helps mitochondrial health, helps improve metabolism, uhm it can help burn fat, uhm, energy production, etc. So, yeah, I would say that- that’s definitely low-hanging fruit. Uhm, and then, you know, the molecular hydrogen, you’re not to harp on that too much but it- it does so many different things. Uhm-

Dr. Justin Marchegiani: How do you get the molecular hydrogen? I know you mentioned Cindy Crawford has a skin-care line with those compounds in it. I know you mentioned there’s a molecular hydrogen machine that you’ve been supporting and using for a while.

Dr. Tim Jackson: Yeah.

Dr. Justin Marchegiani: How we can get more molecular hydrogen into our body?

Dr. Tim Jackson: So, uh, the company trusii, T-R-U-S-I-I, uh, there’s many companies offering molecular hydrogen machines. But this company, uhm, they have a- a really great machine, uhm depending on how much you’ll wanna spend, uhm you just add reverse osmosis or ___[09:08] as water. And it’s- uhm, add some molecular hydrogen to it, uhm, so you don’t have to keep buying out the supplement, you know, every month. It’s a better alternative investment in my opinion. Uhm, the more expensive machine also contains a nasal cannula-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -so you can breathe that in, uhm, and molecular hydrogen. So the highest concentration of mitochondria is in our nervous system.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: The second co- highest concentration is in our heart. Uhm, and so, by improving uh, mitochondrial function, we can improve brain health, brain fog, fatigue, uhm, you know, difficulty concentrating, and also, uhm, have better for fusion to our tissues, because we have better cardiac output.

Dr. Justin Marchegiani: Oh, interesting, very good. Awesome. Uh, one thing I wanted to highlight too, you were talking about carnitine a minute ago. Carnitine is important because there’s key amino acids you need to make it. Methionine and lysine are really important ones, and a lot of those amino acids are missing in vegetarian type diets. So if you’re not eating animal products, we are not getting supplemental amino acids while being vegetarian, it may be hard- you’d be missing some of those key nutrients that are important for making carnitine. [Crosstalk]

Dr. Tim Jackson: Yeah. I mean, absolutely. And the process of methylation, uh, which is you know, collection of a hundred and- or almost 200 different uh reactions in the body. Uh, helps reduce CoQ10 and the L-carnitine. And so if you’re deficient in B12 or methyl folate, or your methylation cycles disrupted because of uh heavy metals or environmental pollutants, then you won’t create as much endogenous uhm L-carnitine and CoQ10.

Dr. Justin Marchegiani: Interesting. And can you talk more about methylation. So, a methyl group is a carbon in 3 hydrogen. So essentially hen we methylate, we’re just binding those compounds, uhm, to whatever that reaction is, whether it’s neurotransmitters or B-Vitamins. Can you talk kinda more about it like, what does that really- what’s really happening kinda at a biochemical level inside of our cells when we’re methylating and- and where does this happen?

Dr. Tim Jackson: Uh, so it happens uhm, and all the cells in the body and it involves no just B12 and methyl folate but all the other B-Vitamins, as well as-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -mineral cofactors such as magnesium and zinc. Uhm, and-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -you know, you probably heard of supplements like TMG or DMG-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -uhm, those are-

Dr. Justin Marchegiani: [Crosstalk]

Dr. Tim Jackson: -yeah those are major methyl burners uhm that have been shown to improve cognitive function. Uhm, but methylation is responsible for everything from detoxification, to producing glutathione to uh, producing certain immune cells, the CD4, CD8, T-helper, T-suppressor cells. Uhm, and also, metabolism of your estrogens. So-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -if you’re not methylating your estrogens, you tend to recycle or reabsorb them. And uh, you know, methylation can get turned off, uh, independent of any polymorphisms, you know. But if you have polymorphisms and uh methylation or MTHFR, then that certainly uhm, you know tells us that you at some point, you know, in the right context, need both B12 and methyl folate along with the other B-Vitamins.

Dr. Justin Marchegiani: And so what’s happening in the body? These nutrients are- are- they’re affecting obviously brain chemicals or affecting detoxification like, what’s happening? Like, just to keep it simple.

Dr. Tim Jackson: Yeah, so, basically adding a methyl group, uhm, helps with the creation of glutathione, but you’re also getting neurotransmitters like ___[12:54]

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -to turn into dopamine, produce.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: Uh, there’s a condition called cerebral folate deficiency, where uh, due to certain antibodies, uhm, you might have uh, enough, uhm methylfolate or folinic acid in your cells but it might not be in the cerebral spinal fluid.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: And uhm there are a couple labs I think that test for it now, it used to be mostly research-based, uhm but those people to need higher doses of methylfolate-

Dr. Justin Marchegiani: Mm-hmm.


Dr. Tim Jackson: Uhm with the other thing with uh B12 is that it needs a- a transporter, a mover. So, lithium orotate, the trace mineral, not the psychotropic drug but, it helps uhm transport vitamin B12.

Dr. Justin Marchegiani: Oh, very cool. I know you mentioned that on- on our last podcast we did together. That’s very good. So we have this carbon-hydrogens, then we need all these nutrients, trimethylglycine or- or HCL, essentially betaines gonna have a lot of that in there. Our methylating B-Vitamins like B6, B9, B12, ideally, we’re having uhm folate, not folic acid, we’re having methylated or LMTHF folate, we also may be doing choline like B1, like riboflavin, thiamine, nycine as well.

Dr. Tim Jackson: Yeah. So, uhm all the B’s, biotin, etc., uhm all need to be there for the methylation cycle to occur. Uhm, and, you know, you could- there are many polymorphisms that we won’t give into that can affect the methylation cycle outside of MTHFR. Uhm, so, you know, it’s really ab- about the environment and the terrain that determines whether these-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -polymorphisms expressed or not.

Dr. Justin Marchegiani: Very cool. Alright, so let’s go dive into your 3-prong approach. So, what does that look like and- and how do you apply that clinically with your patients?

Dr. Tim Jackson: Yeah. So, basically, err, we’ve been taught that you know, okay, give more CoQ10, give more carnitine.

Dr. Justin Marchegiani: Yep.

Dr. Tim Jackson: And let- let’s say you have a ferrari, and the transmission’s out. Putting more gasoline in the gas tank is not gonna help the-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -transmission. And that’s what you’re doing when you’re just giving CoQ10 or carnitine. And that’s okay uh, but you have to adjust the other aspects and one of them we mentioned earlier, and that’s uh, protecting the mitochondria. How do we protect them? We make sure we have adequate glutathione, reduced glutathione, not oxidized glutathione, and uh optimal levels of SOD or superoxide dismutase.

Dr. Justin Marchegiani: Interesting. Okay, got it.

Dr. Tim Jackson: And so, the 3-pronged approach is protect the mitochondria, the antioxidants, provide mitochondrial fuel, you know with L-carnitine, CoQ10 etc.-

Dr. Justin Marchegiani: PQQ.

Dr. Tim Jackson: PQQ, NAD, uh nicotine ___[15:47]-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: -a- all those things. And then the 3rd of uh aspect or 3rd uhm, prong of the approach is to repair the mitochondrial membranes. And so those get damaged from inflammation, and also certain pesticides and petrochemicals, and uhm, you can use different supplements uhm that have high doses of phospholipids, uhm, ___[16:14] in them to help remodel the mitochondria, and uh, you know, it’s been studied in patients with chronic fatigue syndrome, uhm to help the mitochondria for sure-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -uhm, so the 3 pronged approach, just to summarize is, protect the mitochondria with glutathione superoxide dismutase, repair the mitochondrial membranes with uhm NT factor energy, or uhm, uh group of phospholipids that are gonna rehab or rehabilitate mitochondrial membrane, and then provide mitochondrial fuel via CoQ10, carnitine, PQQ, NAD, etc.

Dr. Justin Marchegiani: Got it. So, repair, protect, and fuel. So, protection is glutathione, antioxidants. Would curcumin also fall into that category too?

Dr. Tim Jackson: Curcumin, uhm helps to upregulate glutathione-

Dr. Justin Marchegiani: So I guess it could right ’cause glutathione’s uh antioxidant. So, would it kinda have some protection qualities, right?

Dr. Tim Jackson: Yeah, absolutely. And because it lowers uh inflammatory markers-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -uh that’s gonna put less oxygenated stress on the mitochondria-

Dr. Justin Marchegiani: Good. Excellent-

Dr. Tim Jackson: -and-

Dr. Justin Marchegiani: -so that’s the protection. Then on the fuel, that’s like B-Vitamins, CoQ10, carnitine, PQQ and then with- with like the niagen or the- the nicotinamide compounds fit into that category?

Dr. Tim Jackson: Uh they- uh could uh potentially but I think of them more as uh mitochondrial fuel.

Dr. Justin Marchegiani: Oh that’s more- yeah, fuel, that’s in- in that fuel, yup. Correct?

Dr. Tim Jackson: Yeah. And so, uhm you know, the- they can definitely help and you know, in the clinic we’d use uh IV-NAD, it’s great for uh drug detox-

Dr. Justin Marchegiani: It burns though doesn’t it?

Dr. Tim Jackson: Uh, it should be between a 6- and 8-hour drip, and you have to do it 10 days consecutively, you can’t miss a day. Uhm, and that can help for example people who’d take in the antibiotics that fall under the 4-Quinolone-

Dr. Justin Marchegiani: Oh yeah.

Dr. Tim Jackson: [Crosstalk]

Dr. Justin Marchegiani: Lot of damage.

Dr. Tim Jackson: Yeah, lot of damage. So, IV-NAD, coupled with the NT factor energy, uhm can help the mitochondria for sure.

Dr. Justin Marchegiani: And then on the- so you have the repair side which is like a lot of the- so we have the protect which is lot of the antioxidants, the fuel is more of the nutrients we just mentioned, the NAD, the B-Vitamins and CoQ10, carnitine. And then repair, it was- it was- I’m sorry, protect, fuel and then repair. And the repair is gonna be more glutathione, and a more sulfur amino, correct?

Dr. Tim Jackson: So the repairs are gonna be more of the NT factor energy, the phospholipid complex-

Dr. Justin Marchegiani: Phospholipids. Okay, and then how-

Dr. Tim Jackson: Yeah.

Dr. Justin Marchegiani: What does that mean supplement wise? What supplements would you look for, and then what foods, what good phospholipids can we eat in our diet- consume in our diet that will help?

Dr. Tim Jackson: Uh, well so, uh anything uh, like sunflower, lecithin, as a supplement-

Dr. Justin Marchegiani: Got it.

Dr. Tim Jackson: -to the health but, there’s actually a product called uh NT-factor energy-

Dr. Justin Marchegiani: Mmm.

Dr. Tim Jackson: Uhm, ___[19:15] helped developed it. And uh certain, you know, chemicals and pesticides can get lodged into the mitochondria. And according to him, uh the NT-factor energy can take up to a year that can help displace some of these chemicals from the mitochondria.

Dr. Justin Marchegiani: Very good, excellent. I love that! I mean, really good. Protect, fuel and then repair. And that makes a lot of sense. And then how are you applying this with your patients? So if someone comes into your clinic, are you just starting with diet and lifestyle changes first, uh what lab test are you doing, how does this plug into your clinical model when you work with patients?

Dr. Tim Jackson: Yeah, so, I mean, their- uh, actually the U.K. has some really good mitochondrial testing because of the work of Dr. Sarah Myhill. Uhm and I think the lab is called RED Labs. Uh, but it- you can measure various markers here, you know-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -cerum, CoQ10-  [crosstalk], pyruvate, lactate, etc. Uh you can look at fatty acid markers on an organic acids test-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: -if they’re high, that means they’re not-

Dr. Justin Marchegiani: [Crosstalk]

Dr. Tim Jackson: Yeah. They’re not- yes, not being transported into the into the mitochondria, you might need some L-carnitine. And the difference between L-carnitine and acetyl carnitine – acetyl carnitine can cross the blood brain barrier. And so it can work on neurotransmitters as well as uh mitochondrial health.

Dr. Justin Marchegiani: And then carnitine’s- like L-carnitine is more downstream, right?

Dr. Tim Jackson: Yeah. Mm-hmm.

Dr. Justin Marchegiani: So you would use that to improve the carnitine shuttle and to help improve fatty acid oxidation and energy burning from fat, right?

Dr. Tim Jackson: Yeah. And then kids, on the spectrum who have low muscle tone, uhm, you know we definitely use uh lot of carnitine, CoQ10, you know, the gold standard in traditional uhm mitochondrial uh disorders is the muscle biopsy. But you know, traditional medicine does a great job of finding things if aren’t there on the extreme here, or extreme here, but most of the world exist on this continuum. And just because you’re on that continuum doesn’t mean you don’t have it- an issue for it to be corrected.

Dr. Justin Marchegiani: And we can also use carnitine too to help modulate thyroid hormones too, I mean, if you’re on the hyper side or on the grave’s or hyper side, carnitine is some really great modulatory effects, and also with the lithium orotate as well. So, 2 interesting mitochondrial compounds but also help with modulating high thyroid function.

Dr. Tim Jackson: Mm-hmm- mm-hmm. Absolutely. Definitely.

Dr. Justin Marchegiani: Alright, to continue walking everyone through your kind of how you would, you know, work up a patient and incorporate this 3-pronged approach.

Dr. Tim Jackson: So basically, the more systems that are involved in someone’s symptom presentation, the more you should take uh mitochondrial dysfunction. And, you know, mitochondria- by making the mitochondria work better, everything in your body will work better.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: Now off-air we were talking about uh, you know, the different, uh Kindle Store that I trained with an Austin Texas, you know he calls-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -an mitochondrial bucket.

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: And so, let’s say you start uh today working on healing your mitochondria, you’re not gonna notice all the benefit that you will 6 months down the road. Uh the first system that goes offline when the mitochondria are dysfunctional, is the nervous system. So, brain fog, fatigue, memory issues, etc. And that’s one reason why the IV NAD issues for drug rehab because it helps kind of rehabilitate the brain and so those cravings for the drugs and withdrawals go down dramatically.

Dr. Justin Marchegiani: And what did you learn specifically from Kindle when you were down in Austin?

Dr. Tim Jackson: Uh methylation, you know, at that time back in 2012, you know, it was all uh checking bile titers, and using uh anti barrels, uh, and liquid boron for uhm cerebral folate deficiency, uhm, and the mitochondria at the time he wasn’t as comprehensive uh with it, uhm but now he’s gotten more so.

Dr. Justin Marchegiani: Oh, interesting. Alright, next. What else?

Dr. Tim Jackson: Uhm, so, you know, outside of the 3-pronged approach, the way, you know, that I uhm look at the mitochondria and- and work with someone uhm with mitochondrial issues is to uh, you know, again, upregulate glutathione. Some people may not be able to tolerate glutathione the beginning-

Dr. Justin Marchegiani: And then what happens? If that is the case and they can’t even handle sulfur amino acids like methionine or cysteine or NAC or taurine or- I don’t- m- maybe they had little taurine but what would you do? How would you incorporate those aminos which are tapered in, would you incorporate binders, what would you do?

Dr. Tim Jackson: So, I would look at the potential for SIBO, and the production of hydrogen sulfide gas. Uhm, I’d seen that happen a lot, uhm, you can also- Amy Yasko has a list of, you know, foods that are really high in sulfur, uhm, and so I would, you know, you might want go in a low sulfur diet for a period of time. Uhm, but basically, uhm using uh, like the ___[24:32]-

Dr. Justin Marchegiani: Yeah molybdenum? Mm-hmm?

Dr. Tim Jackson: Molybdenum, yeah. That uh will help that CBS polymorphism work as well.

Dr. Justin Marchegiani: Nice.

Dr. Tim Jackson: And or facilitate that enzyme working better. Uh, so someone can’t tolerate glutathione, uhm, you know, we use it uh, in lower doses, uh or we’ll back off completely, open the drainage pathways to the body, make sure the biles are moving, we’re supporting the kidneys and liver and lymphatic system, and then out again.

Dr. Justin Marchegiani: So, what does that mean? Because obviously, I mean you need glutathione to detoxify it- it’s a great antioxidant, right, it’s a great protector of our uhm, our mitochondria. So, obviously we need it. So why does that mean like, do we have to just decrease it, doesn’t that decrease our mitochondria’s ability to be protected because it doesn’t have the histones, right? So what happens? I mean, is it- is it kind of a short-term kind of mindset?

Dr. Tim Jackson: Well, yes. it’s short term mindset for sure because you now- you definitely need it, but in people who are really toxic, uhm their elimination pathways are compromised, then, you know, they’re not gonna be able to tolerate it. And-

Dr. Justin Marchegiani: So- so the reactions are because we’re mobilizing too much crap? Or too much toxin essentially?

Dr. Tim Jackson: Typically, yes.

Dr. Justin Marchegiani: And so when you try to upregulate like the lymph, are we giving like certain gentle herbs that may upregulate the lymph or the detox just to kinda generally allow things to to flow better and not get excited, do we add in binders? What does that look like?

Dr. Tim Jackson: Drainage remedies- I use drainage remedies uhm, to support the lymphatic system. You can use things like coke root- red root-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -uhm, but also, you know, vibration plate, chi machines, mini rebounders to get the lymphatic system moving, dry skin brushing, uhm drainage remedies for sure for the kidneys, liver, uhm and lymphatic system.

Dr. Justin Marchegiani: Yeah. ___[26:25] is great, I’ve used it on my wife uh before she had a- almost little bit of mastitis, breastfeeding and that works really well, it really opens things up, I love ___[26:33], that’s great.

Dr. Tim Jackson: Yeah.

Dr. Justin Marchegiani: It’s very good. Yeah, so, in general, Amy Yasko has the low sulfur diet, we’ll put the links in for the Amy Yasko diet. So we kinda keep some of the sulfur down, we made you what some breath testing to look at hydrogen sulfide, and- and why would that be a problem? What’s happening with that SIBO or that hydrogen sulfide overgrowth that is affecting glutathione or making us more s- uh- sensitive to sulfur amino acids?

Dr. Tim Jackson: Well, uh, hydrogen sulfide is a mitochondrial inhibitor.

Dr. Justin Marchegiani: Aah.

Dr. Tim Jackson: And, so it basically puts the body in a state of torpor, or energy conservation. So-

Dr. Justin Marchegiani: Great! Torker?

Dr. Tim Jackson: Torpor. T-O-R-P-O-R. So like-

Dr. Justin Marchegiani: Oh, okay. Yeah.

Dr. Tim Jackson: Uh, yeah. And that was the way I was you know, described to me but uh, you know, you can lower body temperature-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: -decreased energy production-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: -cause major brain fog, uh, as far as the breath testing goes, it can be helpful but 25% of the time you get a false negative.

Dr. Justin Marchegiani: So you wanna do conventional stool- or you wanna do some more cutting stool testing to look for bacteria overgrowth?

Dr. Tim Jackson: That uhm- on the organic acids test, I think it’s 21 hydroxyphenyl acetate-

Dr. Justin Marchegiani: Yeah.

Dr. Tim Jackson: Uh that’s the marker that can be indicative of SIBO, uhm you know, if you see that, uhm, and-

Dr. Justin Marchegiani: Phenyl acetate is interesting ’cause that’s also an oxidative stress marker too.

Dr. Tim Jackson: Right. Right.

Dr. Justin Marchegiani: Interesting.

Dr. Tim Jackson: And uhm, yes, so, the uh, SIBO. If you had concentration for any period of time or extended period of time, the only way SIBO can develop is when there is a lack of peristalsis or decreased peristalsis-

Dr. Justin Marchegiani: Right.

Dr. Tim Jackson: -so you get a migration of the bacteria that belong in the large intestines, moving up to the small intestines which should be relatively sterile. And so uhm, you know, err- you wanna correct the large intestines, you wanna optimize stomach acid, uhm, bile production, digestive enzymes and uh, you know, you can use herbs or antibiotics to treat the SIBO, but if you don’t improve peristalsis, it’s just gonna keep coming back.

Dr. Justin Marchegiani: Interesting. Now there are a lot of patients that are doing a lot of DNA testing these days for 23 of May, what are the big DNA Markers you would look at to say, hey there may be a mitochondrial issue, or even maybe an issue with detoxifying? What would you look at genetically, what are the top 3 or 5 things you would look at and highlight and say, “Hey this- this may lead you into faking there’s an issue”?

Dr. Tim Jackson: So GSTM, uh, for glutathione.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: Uhm, you know, we can measure uh glutathione levels. Uhm, it’s best to measure the reduced-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -uhm to oxidize ratio ’cause some people can’t recycle glutathione. Uhm, but glutathio- any polymorphisms in the glutathione pathway, that’s gonna affect detoxification, uhm, and on mitochondria, uhm, and polymorphisms and the superoxide dismutase pathway. Uh, that’s gonna affect it, uh, polymorphism called endufs, uh N-D-U-F-S, uhm that affects uhm fatty acid transport-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -into mitochondria. Uhm there’s one called ACAT, A-C-A-T, and that can affect the conversion of protein, and fats into Acetyl-CoA, and so that’s a great limiting step in energy production.

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: And so, uhm Vitamin B1, uhm, can be helpful in facilitating uhm or bypassing that polymorphism in particular-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: -uhm, and then there is one called SLC, there’s a whole family of them. SLC uh 16-A1, uhm and there are others uhm but it has- those also had to do with fatty acid transport, uhm and so, you know, that’s where you could look at uh blood or seer models of L-carnitine.

Dr. Justin Marchegiani: Would MTHFR fit into this or COMT fit into this at all?

Dr. Tim Jackson: Uh it would it in the sense that MTHFR affects the levels of CoQ10 and carnitine-

Dr. Justin Marchegiani: [Crosstalk] lower levels so you gotta make sure those are higher?

Dr. Tim Jackson: Right.

Dr. Justin Marchegiani: COMT, how does that affecting things?

Dr. Tim Jackson: So COMT uhm basically uh it affects- so it can create uh elevated uh catecholamines, and that can create a stress response in the body, and uhm, you know, long term sympathetic dominant stress response will turn the mitochondria.

Dr. Justin Marchegiani: Can that also deplete dopamine too?

Dr. Tim Jackson: Yeah. Uhm, and so, well what it does is, people with COMT, they don’t metabolize it as quickly depending on the exact COMT uhm, but dopamine, norepinephrine epinephrine tend to be higher, uhm, and usually norepinephrine epinephrine are more of an issue, uh, but yeah, it can uh for sure affect uh the mitochondria indirectly through that mechanism.

Dr. Justin Marchegiani: Great. So let’s re-summarize that, we have our COMT and our MTHFR, right? Now you mentioned the endoxin and the B- B1 importantly, with the MTHFR you me can- you mentioned the carnitine and the CoQ10-

Dr. Tim Jackson: Mm-hmm.

Dr. Justin Marchegiani: With the COMT we’re working on what decreasing sympathetic stress, breathing, not over exercising, good- good food, is there anything you’d want or also highlight to help reduce COMT?

Dr. Tim Jackson: Uh, making sure that uh you check your estrogen levels-

Dr. Justin Marchegiani: Okay.

Dr. Tim Jackson: -uhm, and man, you know, checking estradiol, and women checking-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: -E1, E2, and E3-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: Uhm, and measuring that compared to progesterone, uhm, but that can uh, certainly affect uhm or be product of COMT.

Dr. Justin Marchegiani: Great. And then the other 3 again? The first 3 that you mentioned, I wanted- just make sure we have a good summary.

Dr. Tim Jackson: So the ACAT, A-C-A-T-

Dr. Justin Marchegiani: Mm-hmm.

Dr. Tim Jackson: Uh, affects uhm the production of Acetyl-CoA which is the first step in the Krebs cycle-

Dr. Justin Marchegiani: Krebs cycle, yup.

Dr. Tim Jackson: -and so vitamin B1, thiamine can be used for that-

Dr. Justin Marchegiani: Okay.

Dr. Tim Jackson: Uhm, other polymorphisms like ___[33:03], uh FADS, uh those affect uh an SLC, affect the transportation of fatty acid into the mitochondria-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: And so extra carnitine may be needed-

Dr. Justin Marchegiani: Yup.

Dr. Tim Jackson: Uhm and then the polymorphisms that you know may interfere with protection of the mitochondria are GSTN or any polymorphisms in the glutathione pathway, along with uh SOD polymorphisms-

Dr. Justin Marchegiani: Very good.

Dr. Tim Jackson: -and you know, to upregulate those, uhm we can use again molecular hydrogen, we can use uhm things like ___[33:42] glutathione or uh liposomal glutathione as well.

Dr. Justin Marchegiani: If someone wants to learn more about interpreting these genetic tests, do you have a- a resource or reference that you like to go to?

Dr. Tim Jackson: I wish I had a comprehensive uh resource that I can tell you to go to that cover them all, uh unfortunately I don’t. Uhm I mean, there might be someone somewhere, you know there are new apps coming out all the time, and all they’re doing you know, it might save- this is oh, a neurotransmitter profile, this is a hormone profile, they’re just reporting those polymorphisms that affect that particular area of the body, it’s not a separate test.

Dr. Justin Marchegiani: Got it. Is there one source you could point us to?

Dr. Tim Jackson: Uhm,, I helped them design their report, uhm I’ve done a- if you google my name Dr. Tim Jackson I’ve done a ton of articles, interviews, podcasts, summits on methylation MTHFR, uhm so that should be a lot of free content available if you google my name.

Dr. Justin Marchegiani: Excellent. Dr. Tim if listeners wanna find more about you and wanna work with you, what’s your website? How can they reach out?

Dr. Tim Jackson: healyourbody.O-R-G, so, or my email, I know it’s long, but it’s drtim- D-R-T-I-M-0-7-29-81, and you know-

Dr. Justin Marchegiani: Oh my God, we gotta shorten that up to like or whatever [chuckles]-

Dr. Tim Jackson: I know.

Dr. Justin Marchegiani: We gotta shorten that up. Alright, we’ll put the links below so if you don’t- if you don’t recall and don’t remember Dr. Tim’s info, we’ll put it below so it’s a one-click option for you all. Dr. Tim, it’s been awesome. We had 2 other podcasts for Dr. Ji- Dr. Tim, so feel free and go back and review those podcasts, great uhm treasure trove of information. Dr. Tim, thank you so much for being a part of the podcast. And you have a phenomenal day.

Dr. Tim Jackson: Thank you Dr. Justin, you the same.

Dr. Justin Marchegiani: Thanks doc!


Organic Acid Testing Review – Uncover Your Metabolic Road Blocks

Organic Acid Testing Review

By Dr. Justin Marchegiani

Organic acids are made by your metabolism. They come from amino acids or proteins essentially. They can give us a window underneath the hood what’s happening with B vitamins, with methylation, with detox, with neurotransmitters, mitochondrial function, how you’re generating energy from proteins, fats, and carbohydrates, etc. Watch this video and learn more what are the five big root cause of organic acids.

Today’s video’s going to be on organic acid testing. We’re going to dive in deep to a patient’s lab. Also, we’re going to go over organic acids- how to look at them, testing-wise and what they actually mean from the inside out.

Organic Acids

So off the bat, organic acids are made by your metabolism. They come from amino acids or proteins, essentially. They can give us a window deeper under the hood of what’s happening with B vitamins, with methylation, with detox, with neurotransmitters, mitochondrial function, how you’re generating energy from proteins, fats and carbohydrates, neurotransmitters, oxidative stress. It even can look on fungus and bacterial overgrowth. So it gives us a good window of what’s happening underneath the hood.

Now, we will look at tests. Actually look at the summary of abnormal findings and go through what everything means.

Why organic acids go out of balance?

  1. Poor diet
  2. Malabsorption
  3. Stress
  4. Toxicity
  5. Genetic (MTHFR)

Out-of-Balance Organic Acids

Poor diet

This can be poor macronutrients, proteins, you’re on a low-fat diet, a very high amount of carbohydrates with insulin resistant or could be just poor quality of food. Lots of toxins, chemicals, inflammatory food as well. So make sure that your diet is on  point.


This could be low stomach acid or enzymes. You could have infections infections like SIBO or bacteria or parasitic infections, and could even be food allergies as well. Including sensitivity followed by leaky gut, etc.


This could be emotional stress such as relationship, financial issues, family, friends issues, work issues. It can also be too much exercise, very high amount of physical exercise or even too little. And it also could be sleep – poor sleep. Sleep really helps recharge and reinvigorate you for the next day and repair also.


Toxins whether it’s from round up or pesticides, glyphosate, heavy metals and environmental stressors like mold or mycotoxins or even EMF.


There is an MTHFR, SNP issue or just need certain higher levels of other nutrients like magnesium or B6. Everyone’s a little bit different.

So now knowing that, let’s dig in. So off the bat, you can see this patient’s lab test a lot of things are popping up. Issue with fatty acids, issues with carbohydrate, energy. The big thing off the bat is amino acids,amino acids, amino acids. Carnitine’s actually made from methionine and lysine free-form aminos, tyrosine neurotransmitter issues.


Some issues with amino acids seen on lab tests

Issues with Amino Acids in Lab TestsThis means that neurotransmitters are more burnt out. And the big thing I’m seeing is stress and/or malabsorption. When you see amino acids like this go crazy off the chart, that’s definitely an issue – lower brain amino acids and obviously, gut issues.

In this patient, we have other lab tests in this patient but there’s infections present as well, which is setting up for that area number two which is the malabsorption issue. We’re seeing nutrients not quite present at optimal levels and just the pattern we’re seeing really tells us a strong  malabsorption going on. Persons diet’s already good, pretty good. Malabsorption is definitely present and with that, stress definitely becomes an issue. Also, sleep and all that we are working on that with the adrenals in diet and lifestyle;but malabsorption is definitely present.

So let’s go look at the nitty-gritty of the lab testing here. We like the patient to be somewhere between the top part of the first and the bottom part of the fourth. This is what I call the sweet spot that we like right in the middle. This is like the field-goal post we want to kick the ball right through for that field goal. When organic acids go high or low, there’s essentially imbalances in those intervention or companion nutrients.

Demand or Depletion Issue

You can see the Carnitine for the Ethyl Manolate. You can see that Mandelate, the companion nutrients, Tyrosine. So if these organic acids go high or low, it means either a demand or depletion issue. So when organic acids go high, there’s a massive demand issue. That means the body needs that nutrient at a higher amount than what is present.

So my analogy to the patients and that’s like you’re making $1 million a year but you’re spending $2 million a year. You’re making a lot of money but you are spending too much. Your budget needs to get rained in. That’s the big five things we talked about earlier. And then on the depletion side of now your organic acids are low. That’s typically from chronic stress of those big five issues, more chronic longer-term issue. It’s like you’re making $1000 a year, but you’re spending 10,000. One, you’re not making that much to begin with. Number two, you’re spending way more than what you’re making, anyway. So it’s going to be impossible to get ahead.

So we have to work on getting to the big five of why that is the case. When you see organic acids high or low, they mean different things, but low is more depleted; high is more demand. They both mean that those intervention nutrients need to be supported and addressed. And obviously, the underlying big five stressors need to be looked at- which in this case, is definitely going to be malabsorption and stress.

Low Amino Acids

You can see this person here, a little bit high in the Ethyl Malonate, which we talked about – means Carnitine, we saw the L – lactate. So you can see if we draw a sweet spot here, we’re very low in this area. And that’s another marker for amino acids. So the amino acids are very low and you can see some of these are two-tailed, some are one. So if you were to do like a Beta Hydroxy Butyrate, well there’s no left area that’s low. But if you go down below, under energy production, there’s definitely red on the right and left of Citrate, Cis-Aconitate and Isocitrate.

So that means we have two-tailed here and only one tail below. That matters is that we have, let’s say Malate is low, that’s important to know. But it’s more important that if Isocitrate is low because it’s actually a red area. It’s two-tailed, there’s a high and a low versus just a high.

So on that note, we can see with the above that’s amino acids, lower amino acids. You can see the mitochondria. Here’s our sweet spot. If we only have two organic acids in the sweet spot, we definitely have these two were low, but these three above are more important because there is no red area to the left down there.

Uncover your metabolic roadblock by CLICKING HERE 

Low B Vitamins

But we can see the mitochondria and how we’re generating energy is severely depleted and again this one of this patient’s chief issues is fatigue and you can see five areas in the bad left area and you can see three are very low. So definitely a depleted mitochondria, for sure. B vitamins, nothing’s flagged high but you can see we’re definitely in the low area. We’re definitely in that first quintile, and if you go back here, you can see B complex vitamins are part of what’s needed to drive the citric acid, Krebs cycle, warrior mitochondria. Essentially all the same name here for this.

So B vitamins definitely in the lower side. Methylation, a little bit in the lower side. I get more concerned when these go higher with Methylmalonate goes higher, it means we’re depleting a lot of B-12. When B12 isn’t present, Methylmalonate goes high. So it’s definitely part of this sequelae of this low B vitamin symptomatology we’re seeing. Lower energy means lower B vitamins.

Low Vanilmandelate

Neurotransmitters, you can see this person is low in Vanilmandelate, which means lower adrenaline. Lower adrenaline so their ability to regulate stress and adapt to stress is going to be thwarted and maybe some anxiety too, pretty possible or inability to focus When you have not enough adrenaline or dopamine, you typically lose that ability to focus longer and the time there. Homovanilate, 5-Hydroxyindoleacetate, that’s serotonin and dopamine, those are okay. Kyunurenate, it’s a little bit low. It’s a marker for B6, Quinolinate and Picolinate are markers for brain inflammation. Look okay but definitely the adrenaline markers are lower. Oxidative stress look pretty good. I’m fine with these being low because, you know, less oxidative stress, stress or internal rusting.

Low Detox

Detox, you can see, very much on the low side and again this didn’t even get flagged on the summary page of this. It’s important because if you’re just getting this test on your own, you’re like, “fine detox look no problems”- wrong. There is a massive polar shift to the left, which tells me there’s a severe depletion, remember. Lower organic acids depletion on the left section. Sulfate, the only one in the middle. This is sitting right on the fence of being low. Right on the fence being low gets flagged at 28. That’s 29- that’s a big marker for sulfur amino acids and glutathione precursors. So definitely an issue. They’re having a harder time to bring those nutrients on board to make the glutathione and to make all the phase 2 and phase 1, literally toxifying support.

High Indican

And in gut bacteria, it’s got one that’s high down here and the one that’s borderline. Indican is on the higher side that means not quite digesting protein well. Inability to digest proteins in putrefaction happening and just higher amounts of bad bacteria. And as you can see here this is what gets flagged when it’s 5% in the top 5%-1.41 It gets into the red .73, 1.41 and reach the top 5% of the reference range. Top 5% in this patient here. 1.84. So we don’t just look at it when it’s high, that’s very high. A lot of gut bacteria dysbiosis and some putrefaction  are happening, meaning not quite digesting protein. And that makes sense because when we go back to the protein on the summary page, a lot of amino acids were low and then yeast and fungus looked okay.



So if we go back here to the summary page, high and low organic acids mean something. We already talked about that. Depletion on the low-end demand in the high-end. The big five tend to be the driving factors why this go out of balance. Diet, malabsorption stress, sleep, toxicity and genetics. Genetics being MTHFR, and we’ll see that with high amounts of Methylmalonate and/or formiminoglutamate but again, this is a quick video just to give you some insight of how we’re looking at how we’re interpreting this test. And we put this test together to look at body system three and we have to look at the other two body systems, and maybe even blood work. And obviously, a full diet and lifestyle review so we can get a complete picture of what’s happening under your metabolic.

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Improve your energy by boosting your mitochondria – Podcast #67

Dr. Justin Marchegiani and Evan Brand discuss about the mitochondria and about energy in-depth in this podcast. Get the full explanation on how energy is generated in the body and how you can get more energy. For people who have chronic fatigue, discover how you can manage your symptoms and find out how you can improve your mitochondrial function.

MitochondriaLearn more about the various nutrients needed to boost energy when you listen to this interview. If you’re in the mood to geek out, here’s your chance to get a concise overview on how the citric acid/Kreb cycle works. Also find out what is the best test to take to look at how compounds are being produced and the nutrients needed to produce them.

In this episode, topics include:

00:41   about the mitochondria and energy

2:46   citric acid/Kreb cycle

09:52   electron transport chain

11:24   supplement for energy production

21:54   action steps








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Dr. Justin Marchegiani:  Hey, it’s Dr. J here.  Evan, how’s your Friday going?

Evan Brand:  My Friday is going great.  It’s a beautiful day.  There’s a festival coming in town that I’m gonna be–

Dr. Justin Marchegiani:  Excellent.

Evan Brand:  Gonna be at this weekend meeting up with people.  It’s gonna be fun, man.  I’m gonna get out from behind the computer screen a little bit.

Dr. Justin Marchegiani:  That’s great.  I’m actually flying up to Boston this weekend.  Pretty excited about that.  I have family up there and going to a wedding.  So it’ll be a really great weekend in Boston.

Evan Brand:  Nice.  Yeah, it’s a–fall, it’s probably kicking in there by now.

Dr. Justin Marchegiani:  I know, the foliage, all that good stuff.  Love it.

Evan Brand:  Great.

Dr. Justin Marchegiani:  So we talked kinda pre-show that we were gonna chat about the mitochondria.  I’m getting ready to do an excellent YouTube video on it today and it’s kinda fresh in my brain so I wanted to kinda talk about the mitochondria and we’ll kinda talk about energy as well because the mitochondria is really the powerhouse of your cell.  Your body creates about 36 ATPs and ATPs are like the currency of your cells, how your cells generate energy.  And when people have energy issues, it typically comes from 1 out of 3 ends of the triangle of energy and that is adrenals, thyroid, and mitochondria.  And yes, they’re all connected.  Because typically if you have some level of adrenal dysfunction, there’s probably some level of thyroid dysfunction.  There’s probably some level of mitochondrial dysfunction especially if we’re having some type of gut issue because we need certain nutrients to run our mitochondria.  And again, we’re gonna attach my YouTube video that I’ll be doing later on today because I’m gonna through it and break it down in a more nerdy fashion.  But you’re gonna see there are certain parts of what’s called the Kreb cycle or the citric acid cycle and carbohydrates, proteins, and fats all feed into this cycle, and this compound called acetyl-CoA is produced.  And acetyl-CoA, again we need carnitine to help with the fats and brings the fats into the mitochondria, we need certain B vitamins and alpha-lipoic acid to help bring the proteins and the carbs and convert that into acetyl-CoA in the mitochondria.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I’ll take a breath there so you can–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Break it down more.

Evan Brand:  Yeah, yeah, take a breath.  Well, so a lot of people that have chronic fatigue, they may get some type of prescription or who knows what for chronic fatigue but if target improving the mitochondrial function, you’ll often a–I wouldn’t say a complete removal but you’ll definitely see lot of regression with those chronic fatigue symptoms, so maybe we’ll get into why mitochondria gets so messed up anyway and then talk about–well, I at least wanna talk about, you know, the ways to boost them and support them.

Dr. Justin Marchegiani:  Got it.  So yeah, regarding the mitochondria, right?  I mean, it’s gonna crank out–it‘s gonna run 2 times a round, and you’re gonna see this whole citric acid cycle–that’s what we kinda talk about regarding the mitochondria, right?  This whole citric acid/Kreb cycle, this is really where you’re mitochondria is generating lots of ATP, lots of energy, and there are various nutrients that are needed.  So just to kinda open a diagram on the video there, but citrate, cis-aconitate, isocitrate, alpha-ketoglutarate, succinyl-CoA, succinate, fumarate, malate, and even oxaloacetate.  Big, big words but these are various compounds that get produced in this Kreb cycle and we can actually run tests.  One of my favorite tests to look at energy production in the mitochondria is an organic acid test and I use the organics tests primarily by Genova and it gives us a window into how all of these compounds are being produced and the nutrients that are needed to produce them.  So, because this is a really good window, and when we’re dealing with patients that have fatigue issues, one of the things we’ll see is sometimes we’ll see the thyroid in a pretty good place, not bad.  We’ll see the adrenal levels low and we’ll see the mitochondrial levels pretty good.  That’s gonna be a primary adrenal patient when it comes to fatigue.  We may see it the other way around with the thyroid being low and the adrenal and the mitochondria being okay, and that’s a primary thyroid patient.  And we may see it just the mitochondria on the lower end while the thyroid and the adrenals are doing okay.  Most of the time it’s a combination of 2 or 3, and sometimes we really have to support all 2 or 3 systems at the same time to make a major, major difference in the amount of energy and fatigue that’s there.

Evan Brand:  Let’s talk about mitochondrial toxicity.  What are the things that are causing people to have impaired energy levels and messed mitochondria?  I mean, I know a lot of different drugs, I mean, antibiotics and things like that affect mitochondria but would you say the environmental toxins, I mean, can you say any toxin that we would generally talk about is negatively gonna impact mitochondrial function also?

Dr. Justin Marchegiani:  Yeah, toxicity across the board is definitely going to affect mitochondrial function.  Pharmaceutical drugs are notorious for affecting mitochondrial function.  Blood sugar because a lot of the nutrients, if you look at how the pathway, how the citric acid cycle runs and the ATP that’s produced, you’re gonna see at certain parts of the cycle, certain amino acids are needed, like leucine and isoleucine and glutamine and his–histidine and arginine and proline and all these amino acids, tyrosine, aspirate, and all these different amino acids are needed to run the Kreb cycle.  B vitamins, iron, if you’re anemic; magnesium, alpha-lipoic acid, these are, you know, cysteine, sulfur amino acids.  So I’m not trying to nerd up but I’m just trying to emphasize on the fact that nutrients are required for this Kreb cycle to run.  So if we have a malabsorption occurring, that’s gonna affect our body’s ability to absorb the nutrients we’re taking in to actually run the Kreb cycle.  If we have exposure to–to toxins, that will put stress on the Kreb cycle.  Remember it takes nutrients to detoxify as well.  So if you look at your cytochrome P4 oxidase pathways phase 1 and phase 2, you’re gonna see a lot of sulfur amino acids, a lot of minerals like selenium, like manganese, magnesium, zinc, a lot of minerals and nutrients and vitamins, and antioxidants are needed to detoxify.  So if you put more toxins in your body and your body needs to put nutrients into running these pathways, well, that means there’s gonna be less nutrients to run your Kreb cycle and your mitochondrias are gonna have less ATP and less energy.  Does that make sense?

Evan Brand:  That’s–yeah, it’s a great that you mentioned.  I’m gonna restate it just to make sure it goes into the brain and sinks in.  It takes more nutrients slash or in parenthesis energy to deal with toxins.  So removing your toxic load is gonna be essential.  I just pulled up a page here from Texas A&M University, Different Toxins That Affect Mitochondria, and this is another reason to stick to an organic diet whenever possible because these herbicides, insecticides, and fungicides are gonna prevent the passing of electrons to the proteins that carry electrons to it’s got the big list here of all these different toxins that are in conventionally raised foods, you know, the different fungicides and herbicides, insecticides, so obviously, cyanide.  All these–it’s a huge list.  If you just look up toxins that affect mitochondria, there’s so, so many but definitely I think that’s the good starting point for people.  It always comes back to this good foundation of the organic chemical-free diet and then we build on top of that with all these other extra geeky nutrients that we like to add in and boost you–your mitochondria up even more.

Dr. Justin Marchegiani:  Exactly.  So if anyone’s listening to this and getting geeked out or getting a little overwhelmed, it doesn’t matter.  Just take all, everything I’ve just mentioned and throw it away, an organic diet is gonna be foundational, right?  Good nutrients, low toxins, anti-inflammatory.  That’s gonna bet he foundation.  Now on top of that, we wanna make sure we’re not consuming too much sugar especially refined sugar because if you’re taking in a whole bunch of sugar which doesn’t contain nutrients, well, it actually takes nutrients to run these pathways.  So if we’re getting a whole bunch of food that doesn’t actually have nutrients in it, you see how we’re actually creating a nutrient debt, meaning it’s costing more money or more energy to run these systems than what’s actually coming in.  It’s like we are charging more on our credit cards than we’re making that month on income, and I call this nutrient debt.  So we wanna make sure you’re not going into nutrient debt regarding poor food choices and we wanna make sure we’re not going into nutrient debt by exposing ourselves to toxins and increasing the amount of requirements for nutrition that our body needs.

Evan Brand:  Yup, I wanted to go over some of the chronic conditions that have their origin and mitochondrial dysfunction.  Obviously, this stuff is available online but since you’re listening you want to, let me save you some trouble here–Alzheimer’s, Parkinson’s, diabetes, hypertension, heart disease, osteoporosis, cancer, and the big one for us, autoimmune disease.  So all of these dysfunctions plays a role in premature aging as well.  So I mean, this is the–this is pretty deep stuff, man.  This is going to the root of the body.

Dr. Justin Marchegiani:  Yeah, 100%.  So when we look at our mitochondrias, right?  We look at our mitochondria, we have main–we have two main ways that we create a whole bunch of energy in the mitochondria.  We have the–the citric acid cycle or the Kreb cycle, right?  Same thing.  The next thing is the electron transport chain.  So if you look at that, you know, we make about 34 to 38 units of ATP in our mitochondria.  So you’re gonna see ATPs gonna come from the citric acid cycle, the Kreb cycle.  It’s gonna come from the electron transport chain primarily and then outside of the mitochondria we have energy in the form of glucose.  So glucose can be helpful for short burst energy, so getting some good healthy carbs in there.  But you can see a lot of the energy comes from inside the mitochondria that may not even be glucose-dependent because you know in the video we’ve already talked about in the video I’m doing, acetyl-CoA is that first raw material for the Kreb cycle and that comes from fats, proteins, and carbs.  So we really wanna dial in our mitochondrial nutrients, so a Paleo template with the right macronutrients for your daily requirements is gonna be essential for providing that acetyl-CoA, that first building block, and then if you’re eating organic and nutrient-rich foods and you’re getting, let’s say, an organic acid test done so you can know what nutrients you’re missing, then we can customize and make sure you have all of the nutrients and foundational support to move that Kreb cycle around and pump out ATP which is gonna be the–the currency of our for energy.

Evan Brand:  Great.  Yeah, when I first hear mitochondria, just because I’ve–was into the bodybuilding world for a while, I always think of D-ribose.  I don’t know what comes to mind for you but I always think of ribose as kind of the big supplement for energy production.

Dr. Justin Marchegiani:  Yeah, I think of like alpha-lipoic acid and carnitine.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  I think of those quite frequently.  Again, these nutrients like carnitine for instance.  This is from my biochemical textbook in doctorate school that said, “Carnitine is a compound that’s created primarily with the amino acids methionine and lysine, which are deficient in a vegetarian diet,” and it talked about the fact that vegetarians could be deficient in L-carnitine which is important because we need L-carnitine to perform the carnitine shuttle, which the carnitine shuttle is nothing more than out body bringing fat into the mitochondria and burning it for fuel.  So the analogy I give my patients, it’s like the old time steam trains with the coal.  We’re just shoveling that coal into the furnace to be combusted and create steam and move the pistons.  And that coal is like fat and the shovel is like the carnitine.  So the carnitine shuttle is like the carnitine shovel.  It’s shoveling that coal into the furnace to create the energy to move those pistons around and–and the real world body language is to move that Kreb cycle around where we can generate ATP and then we can also generate ATP in the form of the Kreb cycle–I’m sorry, in the form of the electron transport chain as well.  So we have the electron transport chain and the Kr–and then the Kreb cycle where we’re really creating a lot of our ATP and the ATP is the currency in which our body has–uses this energy.  It’s–it’s how our cells use.  It’s kind of the transactions in which our cells create energy.  We create it in our economy with dollar bills and things like that and credit cards.  They do it with ATP.  So we really wanna make sure our mitochondrias are maximizing its economic or ATP output.

Evan Brand:  So you’re telling me a vegetarian diet is not a good idea.

Dr. Justin Marchegiani:  Again for some people they can pull it off and they can do really good.  But if you have higher protein requirements and higher fat requirements, again most vegetarians tend to be on the lower fat side.  The smarter ones will do coconut oil and MCT and avocado and they’ll do vegetarian DHA via algae.  The smart ones will do that.  But it’s so much easier just eating healthy animal products and getting your nutrients that way.

Evan Brand:  It sure is.  I couldn’t do it the other way you just said.  That sounds miserable.

Dr. Justin Marchegiani:  And again, most people that have a hard time or that feel better on a vegetarian diet, because you know a lot of cancer institutes and cancer places like the Gerson Institute for instance.  They require–they do a lot of vegetarian, a lot of juicing and I personally feel they get great results doing that off the bat because many of these cancer patients, their guts are so screwed up whereas it’s just really juicing vegetables and getting a lot of your nutrients that way because it’s already broken down.  It’s ready to go.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  But I think we gotta work on fixing the guts.  If you look at evolution, there aren’t many places in the world that didn’t rely on some level of animal products.  So if you’re having a hard time dealing with the animal products, it’s either one, a food allergen or number two, there’s some type of digestive issue combination of low enzymes, low stomach acid, and/or a gut bug or dysbiosis that’s really preventing you from maximizing the digestive nutrients from these animal products.

Evan Brand:  Yeah, and I mean it is a mild chore if you will to cook and things like that but I feel like it’s even more of a struggle for people that are trying to maintain a vegan or even a vegetarian diet than if they would just get in some good animal protein because they’re always trying to fill in the gaps of these things that they’re missing out if they just had some good quality animal protein in their diet.

Dr. Justin Marchegiani:  Yeah and it’s something like 25% of the energy that you take in via a lot of these animal proteins, it takes that much minimum 25% just to even break it down and digest it.  So eating animal proteins and fats and such can be very intensive, can deplete and can require a lot of energy.  So if you’re sick and chronically ill, I mean, definitely utilizing broths, bone broths and soups, where you’re really breaking things down, maximizing chewing, maximizing enzymes so we can break it down better, and even using free form amino acids.  Aminos that are already broken down can be really helpful because now the body doesn’t have to go under all the extra energy required to free up these amino acids because protein are nothing more than pearl necklaces and then the individual pearls are the aminos.  So imagine every time you wanna break down that necklace, you gotta rip it apart and that can take energy.  And if you’re already fatigued, that may just be enough to push you over the top.  So in my chronically ill patients, we’ll see on an organic acid test, isocitrate, cis-aconitate, and citrate on the lower end and we’ll know and we’ll give them extra free form amino acids to help.  We’ll even see things like hair issues or nail issues and skin issues, and we may give them some extra free form aminos just to make it easier so the body has some extra building blocks in the meantime.

Evan Brand:  Yeah, I have a good success story about bone broth I wanna tell.

Dr. Justin Marchegiani:  Go ahead.

Evan Brand:  It’s not in a human patient, but in a feline patient.  So Hannah and I, my wife, were looking for a house this past weekend and we were kind of out in the country, we’re looking for a piece of land with a house, things like that.  And we come across this little dry creek bed and I hear a “meow” and I’m, “Huh?  That’s weird.”  And I look over and sure enough, there’s a little kitten laying in the dried up creek bed, looks like it can’t move, looks like it has a broken leg, and so I’m like, “Oh, crap.  I can’t just leave this guy here now that I’ve seen him.  I’m involved.”

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So I go check him out and I’m, you know, making sure he’s not gonna bite me or hurt me or anything like that and I pick him up and he’s acting really weird.  He’s super skinny, malnourished, things like that.  So long story short, we check out the house and you know, we leave him until we come out and he’s still here.  So we take him home and we’re calling all the animal shelters, trying to get him checked out.  They’re all closed for the weekend.  This was–I guess it was last Friday and so we’re like, “Crap, what do we do?”  So we end up taking him to this vet, spent like 200 bucks on him, get him deflead.  He was infested with fleas.  They trimmed up his hair.  He had a bunch of mattes in his hair and things like that.  Just rough shave, rough shave.  So we bring him home and he’s not eating anything and he’s not drinking anything and I’m like, “Man.”  The only thing that I could think to do because he had a fever, too.  So he had like a 104 fever which is high for cats, just like humans and he wouldn’t eat.  So I’m like, “Man, if I couldn’t eat, what would I do?”  And I was, “Huh.”  You know, I would do like an organic chicken and wild rice soup or something.  So I’m like, “Well, I’m not gonna give him that.”  But I had some bone broth in the–in the pantry.  The Pacific little cute little bone broth cardboard box, super convenient.  So I poured a little bit of that into a bowl and the second I put that bowl down in front of him, he just starts licking and slurping up the entire bowl of bone broth.  And then he just passes out and starts purring and goes asleep in my lap.  I mean, it was just awesome to see.  He knew right there, this is some good stuff.  He got some energy now.  I was kinda happy with him, just being a lazy cat in my lap, but now he’s been sipping on bone broth basically this entire week, and now he has so much energy that he’s just running around the house chasing my ankles, biting my ankles, chasing the dogs.  So now he’s got too much energy.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  But anyway, that’s my bone broth cat rescue story.

Dr. Justin Marchegiani:  Crazy.  Well, we feed our cats a little bit of cod liver oil.  We’ll even put in probiotics.  I tried to do all grain-free stuff as biologically appropriate as possible.  I think that’s, you know, it’s–I see how animals are treated today and the quality of food they eat.  It’s–it’s devastating.  If people knew the quality of food they are feeding their pets, they would probably think twice.

Evan Brand:  Yeah, I know.  Do you ever give your cats like raw–like raw meat of any kind?  I’ve heard about that.

Dr. Justin Marchegiani:  I really try, it just becomes–they just, you know, they really have a stand-off with me.  And they’re like, “Nope.  We’re not gonna eat.”  And I’m just, “Oh!”  So I try to go with some type of, you know, fish or tuna or beef that’s, you know, human-grade, even organic, something that I could potentially eat.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  And just really good quality biologically appropriate dry food as their kind of staple.

Evan Brand:  Yeah, cool.  A little bit off subject, but on the subject of energy nonetheless.  So–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I’ve seen the results first hand with bone broth and myself and definitely a lot of people that I’ve given bone broth as a recommendation for their gut healing protocol.

Dr. Justin Marchegiani:  Yeah, that’s great.  And I just wanted to just walk everyone through one more time, right?  We have glycolysis, that’s where we take glucose when we create energy out of glucose.  That happens outside of your mitochondria.  In the mitochondria, we have the Kreb cycle or the citric acid cycle.  They’re the same thing.  We crank out ATP, alright.  In that process, our Kreb cycle produces these things called NADH and FADH2, and those gather up hydrogens.  And those hydrogens then get tossed over to the electron transport chain and we generate more ATP, about 30 to 34 units and about 2 to 6 units on the Kreb cycle.  So all of these ATP come out of the mitochondria.  About 32 to 38, depending on who you read or listen to, Ned or Gross, and that’s the energy that comes out of mitochondria.  So we have the outside part of the mitochondria, which is glycolysis.  That’s glucose energy.  Inside we have the Kreb cycle and the electron transport chain.  So a lot of the nutrients and a lot of the things that I mentioned today had to do more with the Kreb cycle and this is important.  So we–we gotta realize proteins, B vitamins, alpha-lipoic acid, carnitine, right?  These are really important nutrients to help run the cycle and we can deplete nutrients with stress, with poor blood sugar, and with toxicity issues.  So if we can maximize all those things by having good quality food, being careful with the refined sugar and avoiding toxicity and giving your body what it needs, that’s kind of like the–the first kind of foundational step to mind your mitochondria if you will.

Evan Brand:  Good stuff.  Shall we talk about action steps or what’s next in–in your brain over there?

Dr. Justin Marchegiani:  Yeah, why don’t you kind of throw out a couple of action steps that they–the patients and the people listening can start with?

Evan Brand:  Well, you know, I’m a–a supplement nerd.  I’ve been working at a supplement company.  I’m a little bit biased and I always like to go to the supportive nutrients once again assuming the diet’s figured and straightened out.  Assuming that stress is managed.  People are using sensory deprivation tanks or they’re going out in nature.  They’re doing something to balance out the sympathetic and parasympathetic.  If all that’s done, then I really like to use even creatine is really helpful.  I’ve got energy benefits from creatine.  You most of the time, you hear it as a supplement only for bodybuilder and guys wanting to get big and things like that, but I found creatine really helpful.  You’ve already mentioned the alpha-lipoic acid.  I’ve used that not standalone.  I’ve used that in combination type products and then I’ve also used some of the PQQ.  I’ve used some of that just for experimentation purposes.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  So those are just some things that I’ve experimented with that I’ve noticed great benefit in terms of energy.  I obviously like to use a good vitamin B12, a methylated cobalamin B12.  You can even get that one now, I think, it’s–what is it–the L-MTHF–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  B12.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  That’s a good one, too.  So I guess those are kind of my go-to choices, getting a good quality B vitamin in.  Sometimes a B complex but it’s tough to find one that doesn’t make people’s pee turn gold and they’re just in that overdose of B vitamin range.

Dr. Justin Marchegiani:  Exactly.  I would say next for me on top of that, magnesium is really important for the Kreb cycle.  It has over 300 enzymatic reactions in the body or magnesium dependent.  B12 is really important so a lot of vegetarians that may not get enough absorbable B12, right?  You can get–

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Analogs of B12 via the plants but they don’t have the same effect.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So if you’re getting an anemia from a B12 or an iron, that can affect the Kreb cycle and how your body creates energy.  So any anemia that can either be a B12 anemia or a iron-based anemia, that’s really important.  Next is B6.  B6 is really important for the brain for converting neurotransmitters but it’s also important for the Kreb cycle and then CoQ10, right?  One of the things that you’re Kreb cycle does is the mevalonic acid pathway in which, you know, CoQ10 is made.  It’s made from cholesterol and it’s a by-product of the ATP in the Kreb cycle.  So CoQ10 is very important.  Even things like malic acid, succinic acid–these are important Kreb cycle intermediaries.  I already mentioned creatine, D-ribose, a really important Kreb cycle nutrient, L-carnitine.  So depending on what organic acids, we’ll use some broad-spectrum mitochondria support, that’s number one.  And then number two is we’ll actually use specific high-doses of L-carnitine and CoQ10 on top of that and we may even add in alpha-lipoic acid especially if we see extra blood sugar issues on top of it.

Evan Brand:  Yeah, and talk about CoQ10 a little bit.  There’s a big variance in quality.

Dr. Justin Marchegiani:  Yeah, I mean with CoQ10, right?  It’s like anything else.  It’s like well, meat’s meat, well, know you can get meat from McDonald’s or you can get meat from your grass-fed farmer.  Two totally different things and it’s amazing how most vegetarians and vegans just want a lot meat into one category but heck, we would never lump vegetables in one category.  We wouldn’t say, “Hey, the–the roundup ready, you know, vegetable that’s sprayed with thousands of pounds of pesticides a year is the same as the organic one in your backyard, right?  That’s just crazy but we do that with meat all the time.  So, what was your question again?  I just got up my own little tangent there.

Evan Brand:  The question was talking about CoQ10, why you need a good–

Dr. Justin Marchegiani:  Oh, yes.

Evan Brand:  A good activated version or bio-available version if you will.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Obviously for magnesium, all that stuff, too.  Because people may–people still, like when I get the supplement list from people like, “What are you currently taking?” during the initial paperwork, I’ll still see magnesium oxide on there and it’s like, “That’s a 4% absorption rate.”  So that’s garbage.

Dr. Justin Marchegiani:  It is.

Evan Brand:  And that’s the same thing that you’ll get with some of these low quality CoQ10’s that people will go to Walgreen’s and just pick off the shelf because they heard in an article or in a podcast like this that it’s good.  So they go out and they just get the standard thing and the standard thing is not gonna cut it.

Dr. Justin Marchegiani:  Yeah, I mean, I see a lot of the–I see a lot of the CoQ10 like in the cheaper stores like the Walgreen’s and the Costco and such.  I’ll see the price of the CoQ10 and I know what the supplement companies but these things at cost from the major manufacturers like the–the manufacturing at cost price is more than what they’re selling at retail in some of these box stores.

Evan Brand:  Geez.

Dr. Justin Marchegiani:  So it’s just impossible to get quality when you’re, you know, buying that cheap.  So again, we try to use maximal absorption, you know, lowest amount of additives.  There’s some benefit to reduce.  There’s some benefit to non-reduce, meaning ubiquinone or ubiquinol.  Ubiquinol is the reduced form.  Ubiquinone is the non-reduced form.  Just the differences in gain in electron.  The reduced form has a gain of a electron in there.  Again, the research is spotty.  This–it doesn’t support as much in the reduced side.  It’s a little more expensive.  So I just tend to use the regular ubiquinone with some people.  But as they get older, there’s some research saying that maybe the ubiquinol is better, but I typically go with the ubiquinone at about a hundred to 300 milligrams per day.

Evan Brand:  DO you take CoQ10 yourself?

Dr. Justin Marchegiani:  I take a broad-spectrum mitochondrial support that does have anywhere between 100 to 200 milligrams per day.  So I do get at least a hundred to 150 in per day.

Evan Brand:  Uh-hmm.  When I–I told you about all the–the stuff with my Grandma, it’ll be a long story to say on here but I brought up to the cardiologist, I said, “Hey, I–you know, I’m looking to get–do you guys have any CoQ10 on hand that you can get pumping into her ASAP?”  And he said, “It hasn’t even been proven in studies to work.”  So, you know, I think CoQ10 is kinda like the vitamin E where everybody got all, “Yeah, vitamin E, vitamin E.”  And he just completely dismissed the value of CoQ10.  I forgot to tell you about that.

Dr. Justin Marchegiani:  Oh, really?

Evan Brand:  Off air.  But it was just like, “Dude, really?”  It’s like I can pull up my mobile PubMed app right now and show you studies of CoQ10.  But maybe there weren’t studies in 1970 or whenever he graduated.  You know what I mean?  So it’s just kinda like, get with the times.

Dr. Justin Marchegiani:  It’s tough because in research you can almost find something that says anything you want.

Evan Brand:   Yeah.

Dr. Justin Marchegiani:  So if this guy is, you know, anti-functional medicine or anti-nutrition and wants to just lean more on the conventional side, he could find stuff that says what he wants.  Again, we could probably rip apart the study and maybe see well, the CoQ10 didn’t have the highest quality.  Maybe the–the amount wasn’t therapeutic enough.  We can rip apart from that perspective.  But he just looks at it and says, “Well, CoQ10–the abstract conclusion said it wasn’t effective for heart failure or heart issues.”

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  And, you know, we know that there’s other confounding variables that may have been affecting that.  The amount, the quality, and there are other studies that do say there’s an issue.  And clinically, we know that patients that need CoQ10 when we added in, they do better and they feel better.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And what more clinically do you need?  I mean–I mean, how much money, how much time, how many years do we need to spend for something to be a part of the mainstream?  It won’t be a part of the mainstream.  The research says that when something actually enters the research, it’s in the research and it’s like, it’s there.  It takes to about 20 years for that to become part of the mainstream.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I mean, my God, if you’re waiting for definitive things in research to–to become a part of a mainstream, I mean, you’re gonna be waiting for decades.  And if you’re like 20 or 30 now, I mean, you may be 60 or 70 and retired before you could ever get the official benefit.

Evan Brand:  Right, that’s insane, yeah and I–I’m glad you brought up the, you know, the clinical side of things.  If I see that it’s gonna work, I’m gonna continue using it.  And you and I both isolate things and we tweak all these different variables and it works.  There’s no doubt about it so I–I’m glad we got to hash that out because it’s crazy to always have to have something in writing that’s signed in blood that says, “Yes, this is guaranteed to work.”  I mean, if I see it working outside of, you know, some double blind placebo, I mean, I’m a big fan of those, but they’re not necessary if I see it working in the day-to-day life.

Dr. Justin Marchegiani:  Oh, my gosh, like I heard a doctor recently say that, well, talking about diet and cancer, that dietary changes have not been shown to help cancer, right?  It’s like, “Oh, my God, are you kidding me?”  It’s like is it that hard to understand that sugar in your diet feeds cancer cells?  I mean, we only have a test called a PET scan that involves giving someone radioactive glucose so we can see where that glucose goes because we know the tumors take it up.  It’s like is that hard–is that hard to bre–is it that hard to bridge the gap over that glucose feeds, excessive sugar feeds cancer, or that if we have man-made carcinogenic compounds in the form of pesticides and plastics that are known to be carcinogenic, that if we take those in our diet, that that could affect and grow cancer cells in our body?  I mean, is it that–that far-fetched?  So it’s really difficult because like you gotta look at yourself.  You gotta clinically look and see what works for you, use functional testing, try it, see how it feels because essentially all research really comes from and is initiated first by clinical research.  Like it’s a clinical observation, a doctor sees it, a patient benefits and goes, “Hey, let’s create a study, let’s do this,” and then we finally see the benefit years later in a clinic study and then it has to be repeated many, many times and then maybe 20 or 30 years later, we can actually say, “Hey, this actually does that.”  But there’s so many years we have to wait and clinical research, the clinical observation is where it all starts from.  So try to get a lot of your information from the clinical side and then you’ll yourself 30 years having to miss out on the benefit.

Evan Brand:  Totally.  Great way to sum that up, man.

Dr. Justin Marchegiani:  So action item right now, all the diet and lifestyle stuff we already mentioned. If you wanna take it to the next level, get an organic acid test.  You can reach out from Evan or to Evan or to myself, JustInHealth or NotJustPaleo and we can get a test ordered for you.  We can customize a program based on that test.  I just ran two tests from two different companies side by side and I’m looking forward to doing a video reviewing that and how I did on my organic acid test.  I think everyone’s, you know, like, “Hmm.  I wonder if he’s really practicing what he preaches.”  And I’m gonna show you how good or bad my test was.  You’ll have to tune in and see.

Evan Brand:  Yeah, I’m–I’m curious to see, too, because it sounds like I’m gonna be switching companies as well.

Dr. Justin Marchegiani:  Yeah, I’ll give you a little sneak preview.  My organics have been getting better over the last year or two, so I’m excited and I’ve added some additional mitochondrial support and I definitely feel the improvement and again, like the diet’s the foundation.  This is kinda like the frosting on the cake to take it to the next level if you will.

Evan Brand:  Yeah, and this is a whole new other podcast, but since I’ve just–I–I’ve really enjoyed this and this has been really fun.  I really love stacking the mitochondrial support with adaptogens.

Dr. Justin Marchegiani:  Love it.

Evan Brand:   I mean, it just takes it to a whole another level.

Dr. Justin Marchegiani:  Love it.

Evan Brand:  So–

Dr. Justin Marchegiani:    Absolutely.  Well, if anyone’s listening to this and wanna get to the next level then you know where to reach out and again, if you guys are liking the actual real clinical info, go over to iTunes.  Click below either on the YouTube video or on the iTunes podcast app, and get–let us–have a review, give us a review, let us know how we’re doing, give us some feedback.  If you have any show recommendations, let us know what you want to hear.  We’re here to produce really great information that will really help empower our, you know, the culture, the–the country here.  We really wanna put information out there and get people back, taking control of their health.

Evan Brand:  Definitely.  And yeah, go write a review.  This show is gonna be on my show and on Dr. J’s as well.  Write a review for his show on iTunes.  Yes, it takes a few minutes, but you have a few minutes because you just spent X amount of minutes listening to this.  So go on, click the Write A Review button tab.  You have to actually add some stars, add in some words.  Just do it.  It’s–it’s so helpful for us.  It keeps us up in the top of the charts to where all of the multilevel marketing schemes and other people that were “competing with” that they fall to the bottom and that we rise with the truth, and you know, the–the real way to get to the bottom of–of health and happiness.

Dr. Justin Marchegiani:  Awesome.  I love it, Evan.  We’ll end on that.  That’s the perfect ending point.

Evan Brand:  Alright, man.

Dr. Justin Marchegiani:  Have a good day!

Evan Brand:  You, too.  Bye.

Dr. Justin Marchegiani:  Bye.








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.