The Top 5 Reasons Why Your Estrogen Levels are High – Men & Women!

Let’s talk about the top 5 reasons why your estrogen levels are high. We’re going to break them down today.


First, let’s look at the 3 major kinds of estrogens: E1 or estrone, E2 or estradiol, and E3 or estriol. In a woman’s regular cycle, it’s usually estradiol we’re talking about. When you start shifting to more menopausal and the ovary stops working, you start getting more estriol. The adrenals help in kick in a lot of DHEA and you make more estriol. Estradiol is more of the growth factor type of estrogen and estriol is a weaker estrogen.

Click here if you need to consult with a functional medicine doctor to learn more about estrogen and your hormones.


  1. PLASTICS. You’ll get it when the plastic is warm like in a microwave or out of a plastic water bottle especially if it’s in the car and the sun is hitting it or it’s outside. That’s why you want a good stainless steel or glass water bottle if you’re going to go outside or leaving it in the sun. The microwave heat and the radiation is going to cause a big release of plastic chemicals there, the xenoestrogens. One of the big ones are the phthalates but also BPA. There are other types of BPAs that are new which are supposedly safe but there are still estrogen-like compounds there as well. These plastics can affect women and men as well. Men are actually going to be more affected by them because men aren’t used to having estrogen in their environment and getting a whole bunch is going to be a problem.
  2. PESTICIDES. These tend to have an estrogenic quality to them and if you’re eating foods that are not organic, you’re definitely going to be getting organochlorines and various pesticides in your environment.
  3. PHYTOESTROGENS. These are found in soy. For example, I had a vegan-vegetarian patient. We ran a Dutch sex hormone panel on her and her estradiol was through the roof and really high. Phytoestrogens can be a big one, so soy may be a problem. With vegan-vegetarian, there’s a lot of phony protein consumption like fake meat kind of stuff such as the Beyond burger where there are a lot of soy and estrogen-like compounds in there. There are also hormones in meat. You have to make sure you get antibiotic-free, hormone-free, and ideally organic and pasture-fed or if you’re on the Whole Foods scale, step 4 or step 5 is ideal. Step 2 is at least pretty good. Organic means no pesticides, no hormones, and also the food they’re eating has no pesticides or hormones, too.
  4. HIGH LEVELS OF INSULIN. Too much carbs drive high levels of insulin because insulin responds to a high level of blood sugar. The blood sugars in your bloodstream go up and your pancreas comes in. The beta cells make a bunch of insulin to bring it down and bring it into the cellar and converted to fat. So, high levels of insulin upregulate an enzyme in men called aromatase that converts testosterone, the male hormones, to estrogen which becomes a problem. Now, in women, a similar thing happens but it’s the exact opposite or the big switch. Their estrogen is converted to testosterone. So, women can actually get more androgen-like issues which results in weight gain, acne, hair growth, and sometimes you can see some libido enhancements on that. So, that’s the difference between men and women.
  5. POOR GUT HEALTH. In the gut, we make healthy good bacteria in our gut that help us absorb a lot of nutrients. A good healthy gut function helps us break down protein for good HDL levels and good enzyme levels. We need these to break down protein into amino acids which are really important for helping us to detoxify. So, detoxification helps us to excrete estrogens that we’re getting exposed to in our environments such as the pesticides, plastic, or something that you don’t even know you’re getting exposed to. Good healthy detoxification will help your body eliminate that, so that’s a good backup plan.Also, if we have a lot of dysbiosis, SIBO and bacterial overgrowth, we can make a lot of what’s called beta-glucuronidase. This is an enzyme that’s made by bad bacteria and it makes it harder to detoxify estrogen. The beta-glucuronidase takes conjugated estrogens and binds it to a protein that helps us excrete it out the body. It takes that protein and it pulls it apart. It takes the handcuffs off that protein, so that allows that estrogen that’s been deconjugated to go back into the body in the general circulation. So, if we have gut issues, that could be a major concern.


We need things like cysteine, glycine, glutamine, sulfur amino acids, and things that help us methylate like B12, B6, and folate. So, these nutrients we have to get them in our diet via a good diet. We need to be able to break down and absorb those nutrients, so we need good digestion to get those things in there.

So, in general, we’ve got to make sure we have a good gut bacteria balance. Even fungal overgrowth can cause problems and H. pylori that can lower stomach acid and make it harder to break down nutrition on one side and then it can create this bacterial overgrowth enzyme that makes it hard to detoxify estrogen. These are really important components. If you have any issues with estrogen, you’ve got to look there.

Now, we may want to do things to help detoxify like make lifestyle changes, food changes, pesticide changes, make the changes in regards to plastics, and make in in regards to your diet, your glycemic load, and your gut. That’s a good first step to get to the bottom. There are also different things we may do to help upregulate detoxification to help get that estrogen. It may be activated charcoal or various soluble fibers. It could be things like bentonite clay. We could use things like DIM or Calcium D-Glucarate or glutathione, sulfur amino acids, and vitamin C. They’re all helpful in different situations. We would recommend them based on what’s happening but at least make the diet and lifestyle changes out of the gates.

If you want to find out the root cause of what’s happening, click this link where you can schedule a chat with me!

Top 5 Causes of Bloating – Functional Medicine Solutions & Mold Bloating Connection | Podcast #282

Hello, everyone! In today’s podcast, Dr. J talks about bloating and its connections with mold, low stomach acid, bacterial overgrowth, h. pylori, fungal overgrowth/candida and parasite infections. Mold and mycotoxins may also play a role in causing sympathetic and adrenal stress that could affect digestion. Food allergens and too much-processed carbohydrates may also feed bad bacteria that could contribute to bloating and gas. The cause of your bloating might not be what you think it is. And how does mold fit in this puzzle? Dr. Justin Marchegiani is drawing a line between the root cause and palliative solutions. We’re also looking at more natural solutions to help treat and relieve your bloating. Of course, very important is the root cause and checking back to that so everything connects and encourages better digestion and less bloating. We’re talking about the tests we conduct to help get down to the root of your bloating, chronic vs. acute bloat, and the next steps. Let’s ditch the discomfort of bloating!

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

01:06 Lab Testing, Root Cause and Palliative Solutions

9:55 Mold Exposure

15:33 Digestive Support, Infections, and Fungal Overgrowth

17:21 H. pylori and Mold Connection

25:19 Working with Functional Medicine Practitioners

28:02 Best Practices’ List



Dr. Justin Marchegiani:  Hey, guys.  It’s Dr. Justin Marchegiani here with Evan Brand.  Today, we are gonna be chatting about functional medicine solutions for bloating.  Really excited to get to the root cause.  Evan, how was your weekend, man?  What’s going on?

Evan Brand:  Oh, not too much.  It was very good.  I’m excited to dive in to this topic.  I figured we would divert from the coronavirus.  We’ve done, I don’t know, hours and hours and hours and hours of content on that and what we’re still seeing clinically is that people still have issues outside of that, being concerned with that, and one issue that’s popping up pretty much every single day and that could be because we focus so much on helping improve gut health in people is the issue of bloating, and people will come in with the sort of preconceived ideas of what’s going on.  They’ll say, “Oh, I have bacterial overgrowth or I have this or I have that. I have parasites.”  And that’s what they think is going on but in a lot of cases, and this is why you and I focus so much on doing advanced lab testing, in many cases the people wrong.  What they thought was wrong with them is not what’s wrong with them and then we find a different solution.  So why don’t we dive straight in to the testing?  Maybe talk about some of the tools that we use to investigate these issues and then we could dive in to maybe the specific things that we are seeing that are these triggers or root causes.

Dr. Justin Marchegiani:  Absolutely! So when we look at root cause, we always want to draw a line between root cause and then palliative solutions that may help symptomatically.  We always want to draw a line, right? And of course, there’s palliative solutions that are more conventional-based, right?  Whether it’s like bloating, whether Gas-X or some type of drug to address, Imodium or something else on the tummy side that’s gonna just manage symptoms on the drug side, right?  And then there are even more natural things that do the same like activated charcoal, right?  And then there are some things that are more palliative but may connect into the root cause like digestive support, like enzymes and acids.  As part of a lot of bloating issues, there tends to be some kind of a gut infection or gut stressor followed by low stomach acid, low enzymes, low bile salts.  So there are some palliative things we may throw into the mix that may help support and allow us to feel better but they are also part of the root cause.  So we—we want to always plug in solutions but also make sure we are checking back to the root cause so we’re not—we’re making sure that everything connects.  Palliative, root cause, and they all want to connect and ideally, we’re choosing root cause stuff that’s gonna be more—more natural that’s in alignment with what your body needs for good digestion to begin with.

Evan Brand:  Well said and there could be a lot of overlap between the palliative stuff and the root cause stuff like the enzymes, great example.  So testing-wise, what are we looking at?  How are we identifying the root causes of bloating?  Number one is stool test.  We do a DNA stool test on pretty much every single person.  Unless they’ve already had something run and it was very good or recent testing from a previous practitioner or doctor, then we may use that but in most cases, we’re looking at a DNA sample to try to figure out what’s going on and not only what’s going on, but what specific species of bacteria, what specific pathogens like worms, what specific parasites, what’s the gut inflammation look like, what’s the gut barrier look like, what about H. pylori, is that going on?  Because if enzymes make you feel better or enzymes making you feel better because you have an H. pylori infection that’s—

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Suppressing stomach acid, so I would say stool test is probably the best but not always the best place to start testing-wise.  What would you say?

Dr. Justin Marchegiani:   Absolutely! So I mean, there’s just—we look at underlying physiology, right?  You can tell a lot by underlying physiology with symptoms.  The difference is a good functional medicine doctor is gonna look at the symptoms and go upstream to the body systems that may not be functioning optimally.  So if I’m seeing indigestion, I’m thinking okay, maybe we don’t quite have enough enzymes and acidity to activate our digestive support, right?  Because we need nice low acidity, right?  Low acidity is like a pH of like 1-1/2, 2-1/2, that helps activate enzymes and the acidity also helps then trigger bile release once that chyme goes into the small intestine, and it also triggers more pancreatic enzyme release whether it’s lipase or protease.  These are enzymes that break down protein or fat, so we need that acidity.  Also, acidity makes it harder for bacteria to grow.  So think of acidity as like the—it’s like the Clorox bleach on the dirty picnic table, right?  It just really kinda cleans things up and makes it really hard for a lot of the not so nice guys to grow.  So we know that’s kind of a foundational tenet and that’s always good to look at that.  Now, we have other outside things like emotional stressors and any type of emotional stressor or any type of stressor plays into the adrenals.  Because when we activate the adrenals, we’re either surging cortisol or adrenaline, right?  One is from the outside of the adrenal gland, right?  The cortex, that’s cortisol.  One is from the medulla, the inner part of the adrenal gland.  Either the inner half or inner third and that’s gonna be surging a lot more adrenaline, right?  Both are intimately connected, right?  Adrenaline gets to the scene first.  Cortisol follows by about 20 minutes, okay?  And these are gonna activate a fight or flight sympathetic nervous system response and that nervous system response will take blood flow and shunt it away from the intestines and bring it to the arms, hands, and feet, so we can run, fight, and flee.  So if we have emotional stress and it’s unresolved, or we are putting our body in stress from food allergens or from eating on the go or not chewing our food up well enough, we’re just consuming a lot of toxins in our food, whether it’s mold or pesticides or chemicals, that could be activating that fight or flight response.  So that’s why looking at the adrenals can be helpful because if we have this chronic digestive stress, that could be stressing out the adrenals and a lot of people that focus on digestion in the functional medicine world, they don’t ever bridge the gap between digestion and hormones, and they really come full circle.

Evan Brand:  Yup, so that’s your answer.  Your answer is what will the next test—my question was what was the next test you would say is important for investigating bloating?  So your answer would be adrenals.

Dr. Justin Marchegiani:  The adrenals would be a really important part because the fight or flight, the sympathetic nervous system is helpful.  Now again, this is gonna be more on the chronic element.  This is like a chronic issue, right?  If this is more of an acute problem, the adrenals may be at play but they may not be a big piece in that person’s healing recovery.  But it’s always good to look at because the problem with stress, people associate stress like when you say emotional stress or stress, you’re thinking like family, kids, finances, work, right?  The problem is if you have an underlying Giardia infection or H. pylori infection, even though you are on beach totally relaxing, you know, drinking Mai Tais, you are still gonna have stress in your body that could be activating a little mini sympathetic nervous system response because of the infections.  So that’s why the gut stuff, if it’s chronic it can be under the surface and you may not even be perceptible what’s happening.

Evan Brand:  Yup, and that was my case.  I mean, I had Giardia and other infections, my adrenal test looked terrible.

Dr. Justin Marchegiani:  You had three amigos, right?  You had three amigos, right?

Evan Brand:  Yeah, it was the H. pylori, the Giardia, the Crypto and when I ran an adrenal profile, I didn’t feel stressed, right?  I was taking a lot of adaptogenic herbs, so maybe that was helping but if somebody said, “Are you stressed?”  I’m like, “Nah, not really.”  But when you looked at my adrenal profile, my system was clearly stressed.  I’m glad you pointed that out that even though you don’t “feel stressed” or you think your life is fine or “Oh, my kids are great.  My husband’s wonderful.”  It’s like, okay, cool but that doesn’t matter actually.  You could have plenty of co-adrenal stress and have nothing going wrong in your life at all but that—let’s take this a step further.  So you mentioned the cortisol release and all of that, so what is that actually doing to affect the gut?  Well, the cortisol, it’s catabolic.  It eats things away, so you know, you’ll read or hear about people who go run a marathon and then they’ll have diarrhea.  That cortisol just tears apart the gut barrier.  So I’m sure there’s other mechanisms involved but to me that’s one that comes to mind.

Dr. Justin Marchegiani:  Yeah, also you can look at post-marathon and then look at immune system deficiency.  You’ll see chronically low or at least, you know, for a few days to a few weeks on the low IgA side, from long-distance aerobic exercise.  So you could be over-exercising or just doing too much aerobic, and that could be really compromising your immune system, right?  So that could be playing a big role as well.  So like you mentioned, chronic cortisol can rip up that gut lining and then the more that gut lining is ripped up, greater chance of food allergens.  So then now if you’re consuming, you know, questionable foods, there’s a greater chance that you may start reacting to those foods as well.

Evan Brand:  Here’s the funny thing.  I’m thinking out loud.  So in terms of like Buzzwork–Buzzfeed type titles, you know, I kinda brought this up to you before he hit record.  I’m like, hey, let’s do something on like top 5 causes of bloating.  But the funny thing is when you’re a practitioner, it’s really tough to just go, number one, number two, because as you see, you and I are—we’re connecting all of these dots.  So we could end up coming up with more of like 20 different mechanisms leading to the bloating whereas people, when they go to click on an article or something, they want it to just be one, two, three, four, five.  But when you really do functional medicine and you see this stuff clinically, it just does not work like a one, two, three, four, five.  It’s not like car where it’s like—okay, it’s a bad carburetor.  Remove the carburetor.  No, it’s like, okay, you got the adrenal stress from the gut bug you picked up and then that’s affecting the gut barrier and then you’re training Crossfit four days a week.  That’s affecting it.  So it’s really difficult to just go bang, bang, bang.  So we’re hoping to zoom in but also help you wrap your head around the whole picture of this.

Dr. Justin Marchegiani:  Yeah, it’s really tough, right?  Like let’s go look at your situation, Evan, if you don’t mind. So—

Evan Brand:  Sure.

Dr. Justin Marchegiani:  You know, you had some blood sugar issues, right?  You also had three major gut infections—Giardia, Crypto, H. pylori—three amigos.  You also had some potential tick bite stuff, right?  And then we also had some chronic mold exposure.  So it’s like—like if you just went and saw the mold specialist, you’d still be sick.  You know what I mean?

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Because it’s like it’s not just about grabbing the mold.  Now, the mold was important but you know, we also worked on blood sugar and made sure you were getting enough food, made sure you were digesting your food, you started gaining weight, you supported the adrenals, cleared out the infections.  Then we saw there’s all those chronic molds.  Let’s work on the mold stuff.  You also, in between there, you know, address some of the cavitation stress that may or may not had been a big issue.  By the way, do you think the cavitations were a big underlying issue with your health issue?  Do you think it was just kind of a side thing for everything?

Evan Brand:  It’s tough to say because the heart palpitations that I had for years, I mean when I was living down in Austin, I was 20 lbs lighter than I am now. So—

Dr. Justin Marchegiani:  I know.  You were really skinny.

Evan Brand:  Yeah. So I put a lot of weight back on, thank the Lord, and my wife did, too.  Here’s the interesting thing.  We thought that she was skinny due to breastfeeding, you know, because she had been lower weight than she was when she was in high school and we thought that it was just breastfeeding all the time but no, it was probably the mold exposure because when we got her on binders, her weight restored back to normal.  So to answer the question about the cavitations, I mean, you know, I was having heart palpitations almost every single evening.  I’d sit down on the couch and then, oh my God, you know, the heart palp and then as soon as I got—that night of the cavitation procedure when they cleaned everything out, that was the first night I didn’t have heart palpitations for I don’t know, at least a year.  So it stopped that immediately.  My blood pressure—

Dr. Justin Marchegiani:  The question becomes like well because you were already in pretty good shape before that, what if—what if the mold was addressed before that?  Would the heart palpitations even be an issue?  Would the cavitations even been able to cause a heart issue?  Does that make sense?

Evan Brand:  I don’t know.  Well, it’s hard to say.  Yeah—

Dr. Justin Marchegiani:  And the reason why I’m bringing this up is because I have a lot of patients come in and no one has, you know, very little people have unlimited resources, so like, where do we start?  And when you have like big picture, when people say like mold or like cavitations or heavy metals, like they’re thinking a lot of money is gonna be thrown out those resources, so our job is to be like, well, how do we prioritize that?  How do we get the best results, you know, for the least amount of money.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s really the tricky thing because when you go to like myopic practitioners that are the cavitation person or the mold person or the Lyme person, it’s very hard to get a—or the gut person, it’s very hard to get a holistic perspective because you know what they’re gonna be doing.  You’re seeing that person.  That’s what they’re gonna do.  That’s their stick.

Evan Brand:  Yeah, and the truth is that my blood pressure issues, I have having these weird blood pressure spikes, those mostly resolved but the mold exposure—another re-exposure to mold didn’t happen for a couple of years after that and then the blood pressure issues came back.  So, did it temporarily fix some sort of orthostatic hypertension-type stuff and some hypoglycemia stuff?  Maybe but you know, it was—you have to travel, so the expensive travel plus $5,000 for the procedure.  So, you could have bought a lot of binders for $5000 bucks.  That’s a lot of charcoal.

Dr. Justin Marchegiani:   Or, you know, home remediation stuff but you know, just kind of setting the tone for people that are listening.  Being a patient myself, right?  And helping to fix myself and you as well, and working together, it’s really overwhelming.  But I just want listeners to know that if they wanna find someone like you or like me who had been through this and have the mind’s eye and focus on prioritizing and really figuring out what are the first steps and doing things in an order of operation, I think that makes it less overwhelming and that also plays into the whole stress because if you’re doing a treatment plan that’s gonna be so expensive or so segmented like, oh, we’re gonna do this and then that, then it becomes a little bit convoluted and hard to jump on board because you feel like it’s gonna take so much out of you to get going.

Evan Brand:  True.  True.  Yeah, I’m glad you brought that up and I would say that every step along the way that you’ve had in your health journey, every step along the way I have had in my health journey taught us a lesson.  Maybe it wasn’t the secret sauce, right?  But let’s say it got me 10% better.  That 10% better was what I needed to regain the weight that I lost from my parasite infections and then getting the exposure and then using detox solutions, you know, that got me maybe 50% better and then using immune-supportive herbs and antimicrobial herbs, that gave me 10%, 15%.  So, I think what you’re saying in so many words is that many people come in kinda thinking that they have a need for silver bullet if you will and it’s kinda like, “Hey, Dr. J or Evan, I think I have got this parasite and that’s wrecking me.”  And then we do all the labs and we see there’s no parasite.  We see it’s actually a huge candida problem or it’s a huge nutrient deficiency or major gut inflammation or something that.  And so we focus on that and then they’re 80% better.  Then we kinda go back and we’re like, “Hey, remember how you thought it was parasites? Well, look, the 80% progress you’ve made by pursuing this and that instead.  So, back to the bloating conversation, when we’re looking at somebody that comes in and it’s like the major complaint like bloating, what is really interesting is when you unpack all of it.  There’s actually more coming along with it.  So, it could be like, yeah, bloating is the uncomfortable part but then you look at the bowel habits and then you look at the disturbed sleep and the teeth grinding and then you look at the skin rashes.

Dr. Justin Marchegiani:  Yes.

Evan Brand:  And then you look at the dark circles under the eyes and then you look at the 20 lbs of weight gain with doing nothing, and then you start looking at thyroid labs and then as mentioned, adrenals.  So, I guess my point here is that, it’s okay and good to have a one primary complaint, but it’s very rare for it to exist like that.

Dr. Justin Marchegiani:  Yeah, exactly. Yup, 100%.  So, we wanna prioritize everything.  So we look at digestive support.  We may look at infections.  We may also wanna look at fungal overgrowth.  Now, a lot of times fungal overgrowth may come with the stool testing but sometimes that can be missed.  So we’re gonna look at clinical symptoms like fungal toenails or tinea versicolor rash or chronic yeast issues or chronic jock itch, or those kinda things, right?  Maybe chronic dandruff.  We’ll look at that.  We may also run organic acid testing that will look at D-arabinitol or oxalic acid.  Things that may give us a window of fungal metabolites in the urine, and then we may also run a breath test, too, to get a little bit more of a window of what’s happening with other dysbiotic bacteria and we may even see imbalances and commensal bacteria which is normal gut bacteria.  So, a lot of times that always come at the end because if you have imbalances with infections that will always or could drive commensal bacteria, normal flora out of balance.  So, we also want to prioritize things on that note and of course, the diet is gonna be a foundation.  So coming off, we may typically lean more on the Paleo side.  We may cook more of the fibers down.  We may lean more on the lower FODMAPS, lower fermentable carbohydrates especially if there’s more bloating or gas because those fermentable sugars even in healthy vegetables like garlic and onions could drive a lot of these problems, and people tend to like lean into the fact that like, “Oh, I have SIBO.  I have this infection.”  But sometimes, like in Evan’s situation.  Evan had three major parasites and so it’s really good to have you kind of your mind’s eye wrapped around it because if you only thought he had H. pylori and then address H. pylori, and the problem still persisted, you’ll be like going insane.  You’ll be thinking like, “What’s going on?”   So, it’s good to really have that holistic perspective and address everything systematically.  It just gives you the better chance that you’re gonna fix things, you know, a lot sooner than later.

Evan Brand:  Yeah, and you and I haven’t talked about this but I’ve kinda come up with this theory that H. pylori is—and some of these infections are really like a secondary infection due to like a primary mold exposure.  So, I remember being a kid playing in my grandmother’s basement that had flooded on many occasions, they—all they did was turn on a couple of box fans and it took several weeks to dry out.  I guarantee I had H. pylori and parasite issues for many, many years.  You know, I had gut issues as long as I could back into my childhood.  I just wonder because you and I have talked about this idea of like commensal bacteria and there’s this argument, right?  That H. pylori could—you could co-exist with H. pylori and that it shouldn’t cause any problems, but why is it getting so out of control, so out of balance?  Now, granting my diet was terrible as a kid and all of that, but what if the immune-suppressive aspects of mold toxin weaken the immunity so that I wasn’t able to fight off candida?  I wasn’t able to fight off H. pylori and that’s what allowed those infections to thrive and take over.

Dr. Justin Marchegiani:  Exactly, and I think a lot of the argument is more at the level, like maybe there can be a tiny bit of H. pylori present but when it hits a certain threshold, right?  Then there’s a greater chance that it can cause a problem, right?  And then of course, the more food allergies you’re consuming that are gonna inflame the gut, now that maybe makes it cause a problem, and then if you have enough decrease in stomach acid and enzymes from the H. pylori, that can cause a problem, too.  I mean, we know Dr. Marshall who got the Nobel prize for discovering H. pylori, I mean, he thought it was crazy.  He had to give himself H. pylori to see that it caused ulcers and infections or it can, right?  So, we know there’s a connection with it.  So, kinda my issue is let’s lower the infections, fix everything else, and a lot of times people get better and get better much faster.  Now, the problem with a lot of people in a lot of medical approaches to an infection is the antibiotics just a drop a bomb down there and they may not get the infection and they may create rebound fungal overgrowth and disrupt the immune response, so a lot of times you can get sicker from antibiotics with some of these chronic gut issues.  So, you really have to be addressing the problem holistically.

Evan Brand:  Yeah, well said.  So, I mean, if you go to a conventional doctor and you do get diagnosed with H. pylori, the first problem is the testing is really bad in the conventional world and so a lot of times, they’ll miss the infection but if they did find the H. pylori, they’ll do triple or quadruple therapy, 3 or 4 antibiotics at the same time, often multiple rounds of that due to the antibiotic resistance.

Dr. Justin Marchegiani:  Correct.

Evan Brand:  And then as you mentioned, now you’ve got even more–let’s say you came in with bloating as we talked about but you went the conventional rabbit hole, and then now you’ve got the yeast problem and then you feel got even more bloating there.  So, you know, I would never do this study but it would be very interesting to see, to test this theory if you take 10 people that have high H. pylori that also have high mold toxin that we know is suppressing the immune system in various ways, what would happen if you just focused on a mold detox protocol?  Would the immune system gain the upper hand on the H. pylori to get it back in balance?  I would never test that, right?  We’re always gonna do both at the same time, use antimicrobials and use detox support at the same time, but it’d be interesting to test this theory of it being an “opportunistic bacteria” that in theory—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You could shut it down if the immune system was strong enough.

Dr. Justin Marchegiani:  Yeah, and then kinda my theory, if I am gonna address any mold toxins initially while doing other foundational stuff, I mean, my general theory is don’t push, don’t dump too many toxins right away.  If I’m gonna do anything I may just gently nudge in some binders or some gentle lymph support but I’d probably spend more of my time and effort fixing the home if there’s an acute exposure on where those infections, where the mold may be coming from.  What’s your take on that and how your peer does that?

Evan Brand:  The home is always part of the investigation.  So if you see that there’s like high levels that show up, and people are like, “Why—why are you going a tangent about this?”  Well, it is a huge gut issue.  If you just look up Dr. Ritchie Shoemaker, he is the guy who has been working on these issues for 25 years, tons of people manifest only as gut symptoms.  So that’s just the disclaimer but if we see that something shows up on the urine, then we’re gonna go the house to try to match up the species and see, okay, because you’re growing Aspergillus in your gut, you know, you can see it on the organic acids now, at least on Great Plains they’ve got on the first page, they have certain markers that are tied in to Aspergillus.  So you can kinda see, hey, you’ve got mold colonization and then we’ll try to look and see if it matches up to the house at all and in some cases, it doesn’t at all.  It’s like the house has Fusarium but the gut has Aspergillus, so yeah, the house could be a problem but it looks like it’s more you internally.  You’re more of a factory or manufacturing plant, so then we’ll just throw in some silver or something else to try to knock that internal colonization down, and then still working on the other stuff.  It’s rarely a number one priority as you mentioned.  It’s like, hey, here’s a little binders.  Here’s some antifungals that also will happen to kill the candida overgrowth that you have and plus these other herbs that we mix it with are antimicrobials, so that’ll knock down some of the bacterial stuff you have.  So it ends up being like a 3 in 1 combo and assuming the constitution of the person is strong enough, but maybe we need extra liver or adrenal support, they usually do fine.

Dr. Justin Marchegiani:  Yeah, I always pause going after mold right away.  I just find that well, if there’s a lot of symptoms or we have a lot of house symptoms, right?  Any visible mold, tell-tale sign, any chronic humidity in the home, tell-tale sign.  If we see things tend a little bit moist on the wall, right?  We can get a moisture meter.  We can detect some of that stuff.  History of leaks, those kinda things, then we’ll definitely just do a simple house test.  Because the thing about a house test is, if you got 5 people in the house, then all 5 benefit from that test, so it’s kinda like a 5 in 1.  So, I definitely like the house testing because it definitely gives you your best bang for your buck, number one and then we’ll typically remediate or address some of those things or if we don’t see any big red flags, we’ll just maybe get a higher quality air filter.  So, we’ll do a lot of the Austin Air stuff which is a great one because of the zeolite and the activated charcoal and so either for Austin Air or  Evan has his site as well—, store button.  If you guys wanna get a high-quality air filter that we personally use with patients and ourselves, that’s a great option.  And then for me, I tend to always pause that stuff because I can see major benefits a lot of times without that but we’ll kinda put it on that treatment plan on that path.  I like to get gut stuff fixed first because a lot of times the body will dump a lot of mold via the hepatobiliary system.  Hence, Shoemaker and a lot of these protocols binding up stuff that comes from the liver and gallbladder, right?  So that’s kinda my approach to it and that dovetails with bloating because if we have digestive issues, you really wanna make sure.  People don’t think their digestion could be affecting detox, right?  They kinda think of those as compartmentalized things but if we have digestive issues, it could easily be impacting detoxification, so whether it’s metals or mold or just general pesticides from conventional food, all those could play a role and your digestive issues could be affecting that.

Evan Brand:  Yeah and here’s the funny thing.  You know, you and I had thousand plus cases under our belts before we even became educated about mold.  So it does pop up into our conversation a lot and a lot of people come to us and ask us these questions and we’ve done some really great interviews about this but the funny thing is we were getting people better before you and I knew anything about it.  So, I do want to focus on or at least point that out.  Now, I think it’s just helping us to add an extra puzzle piece to the puzzle.  Because there are certain cases where resolving the gut issues, like the parasites and the bacterial stuff, you’ll look at the gut report, right?  We’ll have side by side.  Oh, great!  We cleared out the infections but we still have these symptoms—the brain fog, the dizziness, the sleep issues, right?  So now we know, hey, that other puzzle piece could be this because we did clear out the gut infections.  But I would agree with you and argue maybe what 80%, 90% of the time, you could resolve those type of symptoms—the bloating and such, just from the gut issues, the liver, the gallbladder support alone.

Dr. Justin Marchegiani:  I get scared for my patients or any patient that comes in and is going to see just a Lyme practitioner or just a mold practitioner.  I get really scared if they have not done the foundation because with practitioners like that that are so myopically focused, anytime they’re treating the Lyme or treating the mold and they have a negative issue, it’s that it has to be die off and that means we’re on the right track.  So it becomes this kind of vicious cycle where their—by them feeling worse, it supports them continuing to do that thing which them feeling worse may mean it’s the wrong thing or it’s too fast or it’s not in the right order, and a lot of times those protocols can be very expensive especially if you see a Lyme practitioner that does antibiotics and you are on antibiotics for years.  That can be scary or if you are looking at a home remediation and you don’t know how to do it the right way, and you’re looking at tens of thousands of dollars on a home remediation.  That could be scary, tool.  So you really wanna be able to hit things in the most sequential way possible and the biggest knowledge understated that I have dealt with the last year or two with you and me on our mold side is really how to fix some of these mold issues with our homes as cost-effective as possible.

Evan Brand:  Yeah, I wish I have my $10,000 back.  I was just desperate.

Dr. Justin Marchegiani:  –therapy.

Evan Brand:  Yeah, for the enzymes.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  You know, I was sick.  I was symptomatic.  I didn’t feel well.  My daughter had stomachaches.  My wife wasn’t sleeping well.  You know, and we were looking up holistic solutions.  We didn’t have time to fully do the research and figure out what we know now and here we go dropping 10 grand, and my situation was no better and even in some cases, it was a little worse and so, I don’t wanna turn this into the mold podcast but just pointing out the fact—

Dr. Justin Marchegiani:  Yeah, it’s connected for sure.

Evan Brand:  That yeah, yeah, it is.  But the fact that you could pursue rabbit holes like that and be no better off, right?  Symptomatically, I was just as sick as before and that 10 grand could have used for several years worth of adrenal support and liver support and gallbladders and binders and all the stuff I really needed but I was desperate to fix the house because to me that was kind of the blame but I also had some internal gut digestive stuff going as well.  So, I guess the point really here is that you wanna make sure you have all the puzzle pieces and try to work with the practitioner who can be zoom in and zoom out, and that’s what we try to be really good at.  We try to be really good at making sure that if we do need to hyperfocus we’ve got the skills and tools to do that.  We’re gonna use this specific protocol, this many times a day for this many weeks to address this infection.  However, we may also need to zoom out and get your house in better shape and get your spouse in better shape in case they are re-infecting you and we’re also gonna help with those pieces, too.

Dr. Justin Marchegiani:  Exactly.  So, just kinda recapping for people listening.  When I work with a patient, when Evan works with a patient, we kinda have like our best practices’ list and we really make sure we hit things.  So, of course, we are removing the bad foods, we’re dialing in the diet, and of course, that could be more nuance that just a really good whole food Paleo template.  There can be other foods like we mentioned FODMAPS on other sides, chewing our foods, cooking foods, those things.  Number two is replace.  Replacing enzymes and acids, maybe bile salts.  That’s important.  Sometimes other things need to be addressed like prokinetics and such.  Third R is repairing the adrenals, repairing the hormones, repairing the gut lining, partly because of the sympathetic stress that may be driven by the hormones and how that can affect digestion and gut lining.  Fourth R, removing the infections and this could be parasitic.  This could be H. pylori.  It could be bacterial overgrowth.  It could be SIFO or small intestinal fungal overgrowth.  There could be even, we could throw mold toxins in with that as well.  And then the fifth R will be repopulate, reinoculate good bacteria.  Sixth R, re-test and sometimes you’d come back with a new infection, that can happen, and that’s frustrating.  So there’s a kinda an order of operations and again, there may be a certain deviation and certain ways we go deeper based on our experience, but that’s just a general framework at how we’ll dive in deep, so we don’t miss anything.

Evan Brand:  Yeah, it took my daughter three rounds.  You know, we’ve done—

Dr. Justin Marchegiani:  Right.

Evan Brand:  Like five stool tests on her and she’s not even 4 years old yet.  You know, she showed up with one bug, knocked it out, re-test it.  New bug, got rid of it then H. pylori showed up and then candida, knocked those down.  I mean, it’s crazy so it can be a little bit of whack-a-mole and that just comes with the territory.  It took me several rounds, too.  You know, we kinda joke about the gut being like an onion having different layers of infections.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  But it does appear that they do kinda come out in layers.  It’s, you know, is it possible that H. pylori with that little tail structure you see in the microscopic images?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Is it possible it’s burrowed deeper in the intestinal wall and it comes out later?  I don’t know.  It’s tough but we just—

Dr. Justin Marchegiani:  It’s hard to say.  It’s hard because with kids, too, you can’t quite hit it as hard either, you know.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  But yeah, that’s why—and again, that situation is pretty rare to go that many times.  I mean, that’s more in the extreme but it happens, you know.  We always wanna be upfront with people.

Evan Brand:  Kids are barefoot.  They’re out playing in the creek, playing in the dirt, you know.  So it’s kinda like—

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  How your kids are.

Dr. Justin Marchegiani:  Kids are a little magnet for critters, right?  I mean, we kinda know that.  They—

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Fall down.  They have no problem picking up dirt, putting it in their mouth, the whole nine yards.  So yeah, I get that.  Is there anything else, Evan, you wanna leave the audience with today?

Evan Brand:  I would just say get a good—get a good workup on yourself.  Could you just go to Whole Foods and go buy a bottle of oregano oil off the shelf because you read some blog that said that oregano oil kills fungus and that may be the cause of your bloating?  That might work, but is it the full piece?  Is it the full picture?  Are you gonna take it forever and then you kill the good bacteria and then you’ve got a more imbalanced gut than you did before?  Maybe.  So, my advice would just be get a good workup.  Try to have a practitioner on your side that’s gonna be able to look at all the pieces, not just zoom in on one tiny piece of the puzzle—

Dr. Justin Marchegiani:  Correct.

Evan Brand:  And convince you that’s everything and if you do want to reach out to us, we are those people.  I mean, we do look at the full picture.  So, Justin’s website is  He is available worldwide for consults via phone, Facetime, Skype, Zoom, whatever you gotta do to connect, and my website is evanbrand.  Same thing.  We both work across the world.  So we are very blessed, very grateful to be in the opportunity to help you, so thanks for tuning in.

Dr. Justin Marchegiani:  And then if you’re listening here, 99% of the people we don’t get the chance to even see in person or you know, over the phone or such.  So if you feel like you could benefit or your family could benefit, you know, share this information.  At least it’s gonna get people moving in the right direction, taking a couple of good action steps, and then put your comments below.  We really wanna know what your experience is, what has helped with you, etc.  What were some of the missing lynchpins to help your care and also a thumbs up and a share.  We would really appreciate it.  Alright, Evan.  It was a phenomenal chat, man.  You take care.

Evan Brand:  You take care.  Buh-bye.

Dr. Justin Marchegiani: Bye.

Products Mentioned:

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Audio Podcast:

SIBO Can Cause Histamine Intolerance, Here’s How. | Podcast #268

For today’s podcast, we’re focusing on SIBO, gut infections and more histamine issues, and how SIBO can cause histamine intolerance. Last podcast about histamine went well last week, so today we’re going deeper into these topics. Check out this podcast with Evan Brand.


Dr. Justin Marchegiani


Dr. Justin Marchegiani

In this episode, we cover:

1:43 Histamine, symptoms and solutions

8:21 Diet recommendations

15:20 Fat Consumption

17:07 Gallbladder issues

22:10 Solutions

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

Evan Brand: Hey, man, Happy Monday. I’m doing really well. 

Dr. Justin Marchegiani: Happy Monday to you as well. I know we chatted, kind of in our pregame interview, we chatted about what we’re going to talk about and we kind of chatted about histamine, histamine went really good last week, we see a lot of patients with potential histamine sensitivity. And the histamine a lot of times may not be– a little reverb there. histamine may not be a root cause of the issue. It may just be a symptom of other issues going on in the gut. We always kind of keep that in mind. A lot of people. You know, if you don’t have a lot of experience, clinically, it’s easy to think that histamine is the root cause. And then you feel like you have all these food restrictions and you’re not sure what next steps to do and that’s tough. So we’re going to be focusing on SIBO we can even expand that to gut infections, and histamine issues. So I’m really excited for today’s topic.

Evan Brand: Yeah, you made a great point right from the gate which is people that are focusing on The nutrition piece too much or focusing on maybe some of the supplemental things correct. Many people discuss DAO, which is something I’m experimenting with just to play with it and see how it works. DAO is the enzyme in your body that naturally helps to grade histamine. But as you have infections and stress and toxins, you are either unable to produce less, I mean, we’re not 100% confident with the mechanism, you may produce less or maybe is less effective. So people will do a DAO supplement say, Oh, well, I feel better. I’m not having these food reactions, and they’ll just stop there. But this is where we’re starting now at the end of that rope, and then we’re taking you to the whole next level, because if you stop there, you’re just you haven’t addressed what’s actually going on.

Dr. Justin Marchegiani: Exactly. So in general, histamine is a neurotransmitter made from histidine. It’s designed to help with the inflammatory response. It’s designed to vaser dilate open up the blood flow of the blood vessels so you have better blood flow, which helps with an inflammatory response. So you bumpy your elbow, right, you bump your head there’s a histamine response that helps vaser dilate helps migrate a lot of those white blood cells into that area kind of helps promote healing. The problem is acute acutely and acute situation not that big of a deal because it happens and then your body recovers. We’re more talking about a chronic kind of low grade inflammation or low grade histamine issue where you’re chronically swollen, you’re chronically inflamed. You may have a lot of chronic histamine symptoms, this could be headaches, it could be flushing, right, that chronic red and flushing symptoms. It could be nausea, it could be hives, right, those kind of wheels are you to carry a hives and the skin could be fatigue, it could be brain fog could be just kind of chronic low grade swelling could be allergic shiners under the eyes with a lot of lymphatic pooling in the face. So it’s good to keep an eye on these symptoms as they could be part of what’s going on. And then of course, there’s a lot of medication that are typically treating these things, whether it’s Xurtak or [inaudible] or Pepcid AC, different medications. The problem with a lot of the medications, they tend to have more side effects, whether it’s fatigue or brain fog. And a lot of people, they just get knocked out when they take a lot of these medications. So they’re kind of stuck because their performance and ability to function at work, if they’re doing hard work are dealing with their kids, they’re going to be pretty much a zombie or zonked out for a lot of them. So we want to really get to the root cause of why these symptoms are present. And a lot of times the guts going to be a big role because a lot of chronic inflammation is going to be at the gut level, whether it’s inflammation from food that you’re dealing with, whether it’s gluten or dairy, and or other histamine foods, right fermented foods or age meats or citrus or avocados, or it could be from a deeper infection that sets you up to be more sensitive, right. If you have SIBO or bacterial overgrowth, or other infections, it’s going to potentially make it harder for you to digest food, the harder it is for you to digest food, the greater chance that you’re going to develop food allergens. And also the more inflammation in your gut, the greater chance that you’re going to have gut permeability. So the more permeable your gut is, the more these foods have a way of getting into the bloodstream, the more your immune system sees them and an undigested state increases the chance that we’re going to make antibodies for those foods. And then also just the fact that we have other bacteria that may be slipping into the bloodstream. These compounds are lippo polysaccharides these can also go and create histamine issues. They can also go to the up to the brain hit and hit a lot of brain fog and mood issues. So there’s a lot of like dominoes they get hit. His to me maybe one of those dominoes, but there’s a lot of dominoes that get me hit. And then you have a lot of symptoms happening from it. And then the question is you have to kind of corral all these symptoms in to a root cause of like, what’s the next step but it gets very, really overwhelming.

Evan Brand: Yeah, I want to go back to the symptoms real quick. Something that’s really interesting is the fact that you could have issues with your sleep, you know, trouble falling asleep or even dizziness. You know, I noticed when I went low histamine with my diet, some of this Kind of disequilibrium, dizziness stuff that I was having that I thought was mold exposure, or possibly co infections I bartonella. I noticed when I went lower histamine, it got better, like my head got more clear and then I was able to go to sleep better. So this is kind of why you mentioned some people do the anti histamines and then they get knocked out. You know, I think part of the reason that some people’s nervous systems are so revved up is excess histamine, but here they are taking melatonin. Now, that may help or passionflower or, you know, we’d like to use like, Mother Ward or Valerian or Thean or Skullcap there’s a ton of good sleep options, but you may be missing the boat so those herbs are fine. Those are much safer than a sleep drug which are extremely hard to get people off of. But this the the sleep herbs may not be the root cause it may be histamine. So you could try going with a lower histamine diet during the meantime, that’s something we may recommend you do is go lower histamine while we’re working on labs are waiting on labs. And then if we find that just by lowering histamine in the diet, All the sudden, you have less blood pressure problems, you fall asleep easier, you’re not flushing, you’re not having the nasal congestion, you’ve got rid of headaches, maybe your energy’s better, well, then that’s a great clue that we’re onto something. But we don’t want to get you stuck on low histamine forever. I just don’t think that’s a way to live. So that’s when we’re going to go into these gut infections. So you mentioned bacterial overgrowth, and how we’re going to be looking at that as with stool and urine. So, Justin, I run honor, no problem between us both probably thousands of labs per year. And I would say, Now, granted, we’re a little bit biased, right? Because people that come to us have already been to many practitioners, and so they often are going to have real problems. But I would say 90% of people we look at are going to have some sort of a bacterial overgrowth problem that’s leading to these issues.

Dr. Justin Marchegiani: 100%. So histamine, it’s an important first step to look at and kind of know the histamine foods. We’ve already talked about some of the foods last time And we I think there’s a handout up there from last time as well from last week. So take a look at last week’s podcast. Try to put some of those links down below so you can access them but more common histamine foods are going to be ones that are rich in probiotics fermented foods. And that’s tough because people are following the Paleo template or following Weston a price or understand the benefits of probiotics and fermented foods. That’s kind of a curveball. And a lot of people kind of walk into this and they’re like, wait a minute, that’s supposed to be good for you. Yeah, it should be good for you. But for some people, it may be a problem with histamine and if they have SIBO it could be a problem as well. I call it probiotic intolerance. And that’s very possible. That’s what’s happening. Next are going to be your citrus foods, your age meats. Of course, a lot of paleo foods are going to be on that list. So if you’re just going paleo you cut about half of them out anyway, just by default.

Evan Brand: You know what got me in trouble though? coconut aminos I love- 

Dr. Justin Marchegiani: Yeah, and amino acids are pretty high.

Evan Brand: Super high. And I was for I was, you know, there’s basically fermented coconut blossom nectars what it is, but of course The longer things ferment the higher the histamine so I was making my steaks and marinated steak and then maybe even add a little extra coconut aminos during the cooking process. Yes. And I was going too crazy with it. So I’m taking a break from coconut aminos that’s something that gets heavily used and abused and healthy foods because people are trying to ditch soy sauce for example.

Dr. Justin Marchegiani: Exactly. And that’s a good first step. And if you don’t have a histamine issue, that’s a really good first step. But if you do and you have some symptoms, like we mentioned earlier, then you know what, where to look. But in general, regarding histamine, we want to keep those foods down. So I mentioned some of the avocados, the tomatoes, the egg plan. So if you’re cutting out night shades, you may get that out. By default, avocados are kind of a curveball, right? Because that’s a really good fat. We also have the age meat, so try not to let meat sit around longer than a day or two, or even meats that tend to be preserved, whether it’s jerky or, or bacon are those kind of things. And then of course we have your probiotic foods and then our citrus So those can be curveballs. And then obviously teas and coffee, and britisher teas are the big one teas and energy drinks. That’s a DAO inhibitor. So they’re not really high in histamine, but they inhibit that enzyme DAO that helps break down histamine. So, you know, keep that in the back of our mind. So in general, the more information we– go ahead, yeah.

Evan Brand: I was just gonna say one thing about drinks. I’ve had some people that go on to like a CVO like these natural stevia sodas, where you’re doing carbonated water and a lot of time there’s added citric acid to those. And so there’s a lot of citric acid added to some of those drinks and I’ve had people drink those and then all sudden they flush out and so just cutting the drink out with the citric acid that could be something that kind of created some type of either a mast cell response or a histamine response. So that’s just one other one other potential cause and it’s tough because if you’re eating like if you’re drinking a carbonated drink and you’re doing a steak with coconut aminos, and then you’ve got your sauerkraut or kimchi on your plate with your whole grass fed dairy, it’s tough to know what you’re actually responding to. So sometimes you really have to just keep a food journal and go really simple where you just drink that carbonated drink for 15 minutes and then wait, see if you get a response and then move on to the next food item and the next food item. Hopefully, the average person it’s not that tricky, but for some it can be.

Dr. Justin Marchegiani: 100%. And of course, we already mentioned the kombucha, there’s some higher sugar ones, there’s some lower sugar ones. If you’re probiotic intolerant, that’d probably be something you want to pull out for at least a couple of weeks to a month and see kind of where you sit after after the fact. It’s got to make sure that we’re fixing digestion. We have enough HCl and hydrochloric acid and enzymes and good digestive support. Foods not being digested appropriately are going to create stress and inflammation in the gut. And then we got to look deeper at you know, making sure the common food allergens are out because a lot of times regular food allergens like you get from grains or dairy, or lentils or the goons, those can create similar symptoms of histamine and the question is welcome Is there a histamine response to these foods from an inflammatory perspective as possible, right? Because the more you create inflammation, we know that histamine is a part of the inflammatory response. It’s it. It’s part responsible for the vaser dilation that happens. So it’s possible that inflammation from other foods that aren’t necessarily histamine sensitive foods could potentially drive histamine symptoms, we have to keep that in the back of our mind. And this is why it’s so hard because you’re like, wait a minute, this foods not a high histamine food, yet I’m having high histamine symptoms, how do I connect the dots and that’s how it’s all from inflammation. inflammation is the first domino and there’s many different Domino pastor trails that could take based on inflammation being present. Now, the hidden sources of inflammation are things that we don’t really see or we’re not aware of like low stomach acid low enzymes are not necessarily aware of that we may be aware of the fact Hey, I take hydrochloric acid, I feel better, I have less bloating and less gas and more regular or I do a SIBO test, I treat my SIBO and my motility My histamine symptoms improve after the fact that’s also another thing that can create awareness, but you may not be aware of it unless someone helps guide you in the process and does some testing as well.

Evan Brand: Yeah, and I’m not going to say that all the time it happens to older people, we’re talking 40 50 60 70 80. But in general, I think it’s going to be more common for someone who is older because they’re going to make less stomach acid just due to age. Now we have seen kids and teenagers that have a lot of skin issues and gut issues, and I was one of those teenagers. And that’s because my diet was terrible, right? So you’ll still get younger, younger people that have these histamine intolerance issues, mainly because their guts been wrecked by antibiotics or they just had a bad diet to begin with. But if we’re just saying, as you mentioned, some of these dominoes that fall, one of the dominoes that falls with age is just HCl, so you become at a higher risk of getting bacterial overgrowth because now you don’t have enough acid to neutralize what you get exposed to from your foods. 

Dr. Justin Marchegiani: 100% And again, I think part of it As you get older, there’s a natural drop in hydrochloric acid and enzymes as you get older. So there’s that. So I think age does play a role because of stomach acid dropping. And we need stomach acid to activate our enzymes and we need stomach acid to activate our bile salts. And we know bile has natural antibacterial effects. So the less bile you have, the more easy it is for bad bacteria to grow. So if we have good stomach acid, that’s going to provide an anti microbial environment meaning harder for bad critters to grow. And then with good HCl we also produce better bile salts. bile salts have that good acid byproduct that keeps bacteria down as well. That’s why you see a lot of people that have SIBO they’re also typically taking bile salts to help with one the environment but also to being able to break down fats really, really important. 

Evan Brand: So how about people with had a gallbladder it sounds like they would be brain risk for this problem, then?

Dr. Justin Marchegiani: Well, they have to be on bile support for life now. Because what’s happened is that don’t really have a gallbladder anymore. They’re common hepatic bile doc and the liver is now the gallbladder. And so it doesn’t hold bile. Like the gallbladder concentrates bile like 15 to 20 x. And then it contracts and punctuates to release a bile at the right time, ie you have a fatty meal. Do you have a hormone that’s produced or a neurotransmitter kind of peptide called coli sista kinda, and that triggers the gallbladder to contract, it releases all this stored bile that’s been concentrated. And that bile can now come in and hit that fat and digest it and emulsify it. The problem is, you don’t have that punctuated release, because the gallbladder is gone. So it just kind of drips, it just drips drip strips, like a leaky faucet all day long. And then you don’t have the concentration of it. So it’s kind of a little bit more watered down. It’s a little bit weaker, and you don’t have the concentrated release at time of that fat being ingested. So that’s the problem.

Evan Brand: Yeah, well, you know, conventional doctors don’t educate people on this when they go into a potential gallbladder removal surgery. They’ll just say, Yeah, you’re Liver still is going to make some bio for you, but they don’t talk about that concentration factor and how it’s literally, you know, that’s like taking a, you know, a little fairy dust of some HCl and throwing it in and hoping it works. It’s not a therapeutic amount that’s going to come without that gallbladder, I mean, no still going to survive, right? I mean, there’s tons of people living but it’s just they’re not thriving.

Dr. Justin Marchegiani: Well, what tends to happen after that is to cover up a lot of those symptoms. conventional medicine says, Well, you have to be careful of your fat consumption. Well, yeah, you do because you don’t have the same level of bio output, but you need good fat, you need fat soluble vitamins A, D, and K, your long chain omega three fatty acids are really important for your health. So you’re not getting good fats. That’s a bad thing. I mean, we’ve seen with the obesity epidemic over the last hundred years, the last 30 or so years, fat consumption has dropped significantly and weights gone up. So it’s not really a fat issue based on the correlation. It’s really a carbohydrate issue. Maybe a trans fat issue, maybe an excess refined junkie vegetable oil issue but good healthy fats are not part of the play. And if we now affect our digestion when we can’t absorb those things, well every membrane in our body has good fats in them. So we need healthy fats to make our cell membranes. We need vitamin A, which is a fat soluble vitamin for our thyroid receptor sites. We need fish oil for inflammation. That’s our long chain omega threes. We need cholesterol which tends to come trapped in with animal fat for our hormones for our brain mass. So all this stuff is so important for healthy hormones. healthy body healthy brain

Evan Brand: Yep, absolutely. And there’s no education on that. It’s just Yep, you gotta gallbladders gotta come out and then that’s it. And then they don’t have here’s the interesting thing that the surgeon and then the doctors and such they don’t deal with the collateral damage. They just kind of got it out and move on. So then they end up coming to us. Hey, look, here’s this list of 20 symptoms I developed after gallbladder removal surgery. not to get too distracted from our from our topic, but this is all related because it could have been connecting a histamine problem could have been what led up to this and then it could have, you know, continued after the removal.

Dr. Justin Marchegiani: And I’ve done some articles and podcasts on gallbladder issues in the past and there are some common paleo foods that could be a gallbladder issue as well. Porks one of them, especially Bacon is also a histamine overlap there. So is I think sauerkraut as well, onions. There’s a bunch of paleo foods that like, you know, on the surface, you’re like, wait a man, these are pretty healthy foods. But if you have a gallbladder issue, it could be a driving factor and yes, some of these foods overlap with histamines. So take a look at just go to my site just type in gallbladder and you’ll find those articles and videos there for y’all.

Evan Brand: Perfect. So we hit on the the SIBO, we often discuss that SIFO small intestinal fungal overgrowth is very commonly occurring at the same time. And so that’s where once we get the proper lab testing, looking at stool and urine primarily, we’re going to be finding the answers that We need to start resolving this. As we mentioned, you may be using extra enzymes and acids. Maybe you’re using histamine degrading enzyme supplementally to try do yeah, you’re using that as a band aid knowing that you’re working backwards. And then once we come in with herbs to address, which is the, the opposite of the conventional neomycin, die flu can Neistat and kind of protocol, we’re going to come in with herbs instead, and then eventually retest and then of course watch symptom improvement at the same time. But with retesting labs, with watching symptom improvement, may be doing those band aids you can reverse this issue.

Dr. Justin Marchegiani: Yeah, we need to calm down the inflammation in the gut because those mast cells are what’s making a lot of histamine right. So your basal fills are in your blood when those basal fills go into the tissue goes into the gut lining there, they’re all become mast cells. And mass cells are what produces histamine and imagine this, you know, this mass cells sitting here, the longer we’re not exposing ourselves to inflammatory food, that mass cells like swelling up because it’s used to having a reserve Now that reserves is kind of like, kind of in gorging itself bigger and bigger and then now you eat some food that’s kind of off your food recommendation, then you get this massive flood of histamine. And when you feel like even worse, and this is what happened with someone’s on a good diet for a while, and then they go off the wagon. They’re like, Holy smokes, I got hit by a bus. What happened? I thought I was doing really good. Why have I not become more adaptable at these foods? Well, it takes some time. And then a lot of times these mast cells are just sitting there in the short run, filling up with histamine waiting for you to just go off your diet.

Evan Brand: Yeah, what about alcohol? Do you have anything to say about that? Because I had a woman who’d been off alcohol for a long time. We kind of discussed Hey, you probably shouldn’t do it. your gut barriers toast and she went to some work party and had two drinks and then she emailed me the next day Oh my god, I’m so miserable. Alcohol has never done this to me before. Granted, she was on a protocol. So some of the herbs mixing with alcohol is not smart, but just from a avoid leaky gut perspective and then going back to it, she seemed like she got worse than alcohol used to make her feel. Do you have any insight on that?

Dr. Justin Marchegiani: Yeah, so I always tell patients like don’t add any alcohol and until we have a level of clarity, a level of improvement. So then if we add an alcohol and we go backwards, we know that the alcohol brought us backwards that way. We’re not feeling crappy. And then we’re putting alcohol in there. And maybe the alcohol is what’s holding us back from getting better. And we don’t know it, right, because we always felt crappy to begin with. Yeah, so kind of get clean first. So then when you get dirty again, you know, okay, I know what clean feels like. There’s something that changed here. So regarding alcohol, there’s different quality of alcohol. So you could have like a mixed drink with a whole bunch of sugar in it, you know, that’s going to cause a whole bunch of problems just because of the sugar and the crap that’s in there. And obviously, there’s like different wines that may have pesticides or sulfates or potential gluten in there. A lot of wines are contaminated because there’s a lot of flour that lines the barrel the wines. So hard alcohol is going to be your cleanest and keeping the sugar content if you do a mixed drink, and then also like a champagne or a dry white wine will kind of be your next step up, right, the dry or whites or the dryer kind of champagne is going to have less sugar, it’s going to have less potential irritants. So you kind of start with the fruit, the kinds of alcohol that will have the less additives and inflammation compounds, and then kind of work your way back. And that wave, it just gives you the chance to have in the least issues now there are some cultures where they just have less da o to hang out with in your in their in their guts in their bloodstream. So they’re going to react to alcohol, they’ll get like a facial flush. You see this in a lot of Asian cultures because they don’t quite make as much do. So they’ll take that Pepsi they see a lot of times and that blocks that histamine response. So a lot of cultures may just have less histamine issues. You see it with Asians and alcohol, they get very flush, so you just got to know where you’re at, and then just try to choose an alcohol that’s gonna have the least possible chance of a reaction. And then you can always do some activated charcoal. In between to kind of help with that, too.

Evan Brand: Yep, that’s good advice. Anything else you think we should say about testing or herbs or things we’re doing to work on this issue?

Dr. Justin Marchegiani: Well, there’s different herbs that we’re going to recommend depending on if we’re methane dominant SIBO or hydrogen dominant SIBO, and a lot of times people have the right to have more than one issue going on at once. So, you could have SIBO and a parasite infection, you could have SIBO and H. pylori, you could have SIBO and SIFO and SIFO is nothing more than a fungal overgrowth. It could be Candida, various different yeast, mainly the main ones, Candida, but you could have all of these things going on together. It may not just be SIBO, you have the right to have more than one issue. People get fixated. They’re like, I know it’s Candida. I know it’s a worm. I know it’s this and it may be but it may be that and a whole bunch of other things. So keep your mind open to all the different stressors that could be going on at the same time.

Evan Brand: Well, the funny thing is to maybe the person’s right and they did have a parasite or they did have Candida, but we may find something even higher up on the priority list and that like if I see, you know, okra toxin levels we know okra toxin and other mold toxins we know those damage that go if I see those things off the chart and I look at dizziness and they can’t sleep and they got heart palpitations and all these other symptoms that don’t sound like SIBO. We might go after that first and SIBO  and histamine and all that may be secondary and tertiary problems. So that’s another fun and important reason that we do multiple tests on people is because if you come in and you’re like, hey, Dr. J, I know it’s SIBO just run the SIBO test. He’s gonna say, No, I really think we need to also look at this and this and that. And that’s not just because we like to run labs. It’s because we like to have data so that when our puzzle pieces are on the table, we can make a more complete picture, as opposed to trying to identify your problem and make a protocol based on one little piece if we don’t, I mean, if we’re using the just one little puzzle piece, it’s just not you know, your success rate may be hindered.

Dr. Justin Marchegiani: 100 & 10%, and I think it’s, it’s really important to kind of keep that in the back of your mind. That could be a lot of different things happening. And like you mentioned earlier, an important component is the history. Hey, do you live in a house where there was recent water damage? When you’re in your home, and you leave for a period of time? Do you feel better? Have you rectified the water damage? How did you do it? Is there any visible mold in your home? So these are really important questions to know. And sometimes I’ll see in my history, I’ll see patients Yeah, there’s water damage, and they didn’t really do much to address it. And they really feel foggy in the home. They feel better when they’re outside, getting fresh air. These are important signs and symptoms. A lot of times you’ll see more neurological things like you mentioned, Evan, whether it’s brain fog, or just spaceyness or headaches. And again, we’re looking for that timing in regards to a flood or there could be even a chronic issue where there’s just high humidity in the home. And that’s where doing some of the mold testing for the home is ideal. The multitasking for the home is great because if you have you know, five people in the house We get a positive Mold Test. Well, we know that that could be affecting all five people. So it’s good to know that.

Evan Brand: Yeah, absolutely. I had a building I went into when I was in Florida. And I literally got flushed. After entering the building. I had like a reaction to the building. I started to feel off, I was just like, Whoa, this is not a good building. And I look up at the ceiling and there’s water spots, water stains, all over the ceiling. I was like, Oh my god, and this is not. Oh, Evan, you’re crazy. This is placebo. You looked at the ceiling, and then you convince yourself you felt bad. No, I felt bad before I even saw the ceiling. This was on the way, walking out of the building, I look up and see all the water stain. So most people are not that sensitive, and most know are not that in tune to their situation to know, hey, I’ve been in this building for an hour and every time I am in this particular building, for example, like college students, they’ll say when I go to this one classroom, I can’t focus I get brain fog. I get really tired. Maybe the subject is boring and they don’t like the teacher but it could be the building, particularly Making them bad. So I’ve had some college students I work with where I’ll just tell them, hey, try to sit in a different part of that room. Or if it’s a big auditorium, move to a different corner where maybe you’re closer to a door where you get fresh air and see if you feel better. And yeah, obviously, this is a more like, nuanced small percentage of the population, but it does happen. And I want people to know, they’re not crazy. This is a real phenomenon you may be experiencing.

Dr. Justin Marchegiani: Yeah, and the nice thing about it is you should be able to figure out some correlation from this, because you’re in that building, you’re out, you’re in your home, you’re out, maybe you’re walking around all day. So hopefully, you can notice a correlation there. Like you mentioned earlier, everyone’s not going to be that level of sensitive, right? There’s different genetic variation, obviously, depending on how long you’ve been exposed to something and how much is it already in your cells in your fat in your body already can make you more sensitive. So with some of your mycotoxin testing, which will do a lot of urinary testing for mold, will see some of these things and we if we do a urinary test for mold, we have to also challenge it. So we’re going to be using glutathione for at least a couple of days ahead of time. Just because if your detoxification pathways are a little bit weak, or let’s say the molds overwhelm your system, you may have lower glutathione. Anyway, so it may be harder to push the mold out to begin with. So you have to keep that in the back of your head. That’s why we test the home first. Because if we have a high level of mold in the home, we don’t see a lot coming out in the urine. Well, it’s really important that we provoke that and just give you enough detoxification support to at least get a window and how much is coming out in your year and that way, we have a baseline. So as we treat over 369 months, we can come back and see if those levels are dropping.

Evan Brand: Yeah, infrared sauna is great too. For that you can measure a lot of higher increased levels after sauna so somebody can’t tolerate glutathione and for some reason you could do a sauna, and also fasting which is pretty interesting. That’s why a lot of the samples we do in the first thing in the morning because fasting can help excrete some of these toxins too. So we could obviously dive more into that on another show. My mood levels are almost gone. I had okra toxin level of 195 you want it below four.

Dr. Justin Marchegiani: Fasting, though, with fasting, you only can do that really acutely, though. That’s like a short term thing. It’s not a long term strategy, right?

Evan Brand: Yeah, yeah, I’m just talking overnight fasting, but maybe, you know, like intermittent fasting. Maybe in between those meals, you are exceeding a little more and flushing a little more toxin out.

Dr. Justin Marchegiani: God. Okay, so you were saying okra toxin. Go ahead.

Evan Brand: Sorry. Yeah, yeah, that’s okay. I think the reference range was below four is optimal. And I started out at a 195. And here we are talking almost exactly one year later, and my levels are down to a 15. So-

Dr. Justin Marchegiani: 195 to 15. So it’s like, 98% 95% reduction.

Evan Brand: Yeah, it’s a lot but it took a year and that’s hardcore work. That’s conventional and prescription binders that sauna, that’s extreme avoidance. That’s liver lymphatics. I mean, that’s a lot of work. So I just want to end this by putting a realistic timeframe in people’s heads, you know, when they have a reaction They take a Benadryl and they feel better in half an hour. You know, they’re really happy about that, or when they have a headache and they take an Advil, they feel better in 30 minutes, that’s great. But with these issues here, we’re talking reversing potentially 10 20 30 40 50 years of toxins and damaged gut barriers and overgrowth and antibiotic usage and all that crap. So, you know, when we tell somebody, hey, six months to a year timeline, I think that’s extremely short when you factor all that in.

Dr. Justin Marchegiani: 110%. Man, I like it. I think you’re on the right track. with that. I think we’re on the right track with today’s chat, trying to connect the SIBO component, trying to also connect the different gut components that connect the SIBO. And then also I think the mole and we need to do our own little show on mold and histamine. Maybe next week, we’ll come back and do more than his mean, it gets really important. I think it’s a big issue. And the problem is a lot of people have multiple issues at the same time, and this is where it’s really hard. We want to glom onto one thing we want this one, hey, we want to have this one label. This is my issue, it’s kind of easy to wrap your head around that. But it could be a lot of different issues. So everyone that’s listening, keep your mind open to their being lost at problems at the same time. And also, if you’re overwhelmed, this is where it’s good to reach out to a practitioner like Evan., or myself Dr. J. if you want to dive in deeper, kind of get your arms wrapped around it with some objective lab testing. So we actually know what is happening underneath the hood, so to speak. Yeah. And anything else you want to add today, man?

Evan Brand: No, I just want to give people a little bit of boost of hope and encouragement. Just say hey, look, as you mentioned, there may be layers to this, but you can peel back the layers you can you can get better, no matter how long you’ve suffered. You can you can you can keep that in mind.

Dr. Justin Marchegiani: Yeah, and your story is great with the mold because you really had some pretty debilitating symptoms. And mold one of those things. It’s like if you don’t know what’s there, man, it’s like, you’re just in it in an environment where there’s just toxins all around you and you don’t even see it and it’s a slow creep and the time symptoms start really in their head, it’s been going on for years. That’s the problem.

Evan Brand: Yeah, I got to give a shout out to our mutual friend, Dr. Jack Wolfson, for telling me that it was mold. I didn’t want to believe it. But I was talking to him and said, Hey, I was waking up dizzy. This is weird blood pressures going all over the place. And he writes back in all caps, one word mold. And that started at all.

Dr. Justin Marchegiani: Yeah, and the thing is, I mean, I’ll give credit to Jack. I think that’s us right on there. The problem is, there are a lot of let’s just say, mold, myopic doctors, where everything’s mold, right? Everything’s mold. And that’s a problem too, because it may not be so the differences with you, you got this feedback from Dr. Jack you tested your home, guess what? Really high mold, you tested your urine, you provoked it really high mold. So we had some objective data to kind of support us. So we weren’t kind of flying blind. So I think you did the right thing. And for people that are listening to this and think it’s mold, get that testing done first so you can be more confident. And then more importantly, because you’ve gone through the whole mediation process that’s even more overwhelming. And that’s where you want to work with an expert because You can feel like you have to spend six figures to get your home remediated. And that’s not the case. You can do it for way, way cheaper. And it can be, let’s just say a process that isn’t as bad as it thinks. Or if you feel like it is based on what you see online and everything. 

Evan Brand: Yeah. And into Jack’s defense, you know, he is he works on hearts. You know, he’s not a mold doctor, but his wife was really sick. Yes, last few years from mold. So luckily, he had had first hand experience. So he thought, hey, this sounds kind of weird, and at least had enough in the trenches experience with his own wife to know, hey, that might be it. So very interesting how it all turns out, I think it’s one of the biggest hidden epidemics going on.

Dr. Justin Marchegiani: Yep. I see the whole mole thing and the Lyme thing as well. Anytime there’s some kind of a weird neurological symptom. people throw that out there. And it could be right but get the whole thing worked up. I mean, the thing with Evan Evan had three different other infections to begin with. So you had I think giardhia blast on h pylori. 

Evan Brand: Crypto. Yeah. 

Dr. Justin Marchegiani: Crypto, Giardhia, H pylori, right. So now just kind of for everyone listening so they can have insight, Evan had already addressed those issues ahead of time. And he gotten a little bit better, but there was still something holding him back. So if Evan just myopically focused on the mold and didn’t get rid of those infections, he may not have the same level of improvement. So there’s kind of an order of operations and how we want to hit this. And because you had three series, I mean, each one of those infections individually is kind of a big deal. The fact that you had all three going on at the same time, I call it the three amigos. It’s definitely going to be a major stressor on your body, and then you throw in the mold and the adrenal stress and then potentially blood sugar issues. Yeah. So you had a whole host of things that we were able to kind of sequence up and have it all makes sense.

Evan Brand: Yeah. And we’re talking we’re talking over a four to five year period, you know, those gun reactions were cleared out almost five years before the mold protocol. And that’s not due to that that’s not the way that necessarily I wanted it or that that we wanted it to happen. It’s just the way it happened. That was you The exposures came later. And so not everything could be perfectly sequenced and care but it’s just a matter of peeling back the layers you can to get some level of improvement. And that quality of life hopefully will continue to motivate you and allow you to pursue other layers of healing.

Dr. Justin Marchegiani: Well, the nice thing with us is we’re getting better because we’re also treating ourselves and thousands of patients so because of that, it’s not just like you know, textbook information, it’s real world actual results kind of driving treatment, driving protocols, driving kind of our perspective on what the next steps are for patient so it allows your treatment allowed me to get better at this and allow you to get other patients better so we just continue to grow like that which is excellent.

Evan Brand: Yeah, it’s a very, very, very cool place to operate.

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

Evan Brand: That’s it. mentioned the links again, you can reach out to Justin, Dr. J, at my website’s We both offer intro console where you can book 15 20 minutes, you can chat about your symptoms and goals. See if you’re good Fit for care if so, we’d love to help you. We’re very grateful to be in this position. So we honor it and we’ll be back next week.

Dr. Justin Marchegiani: Excellent. You guys have a phenomenal day. Look forward to checking in soon. Take care y’all. Bye now. See ya.


Audio Podcast:

Resistant Starch to Improve Your Gut Health

By Dr. Justin Marchegiani

What is Resistant Starch?

When we hear the word “starch,” a lot of us think of unhealthy carbohydrate-heavy foods. But not all starches are created equally. Resistant starch works differently than processed carbs like pizza and pasta–resistant starch passes through the body without spiking blood sugar without even knocking you out of ketosis!

Resistant starch isn’t completely broken down and absorbed by the body–it passes through undigested which allows you to consume resistant starch without getting thrown out of ketosis and without having blood sugar spikes that come with other starches. Research shows that resistant starch actually stabilizes blood sugar and also acts as a prebiotic to promote healthy gut bacteria.

Types of Resistant Starches

There are two main sources of resistant starches that I recommend: unripened banana flour, and cooled potato flour. Potato flour is technically a nightshade, which can exacerbate some people’s autoimmune conditions. It’s the alpha-solanine component of the potato that tends to be the problem. If you have an autoimmune condition, try banana flour or plantain flour first. While I personally have used both, I prefer unripened banana flour because I have an autoimmune thyroid condition. Some of my patients do better with the potato flour so you may want to experiment and see which one works best for you.

What Are the Benefits of Resistant Starch?

The goal of using resistant starch is to feed the beneficial bacteria in our small intestine. Many patients that I work with need to do a keto diet or a lower carbohydrate diet to help address and correct blood-sugar imbalances.

Typically, a lower-carbohydrate, higher-fat diet like the keto diet can be a great tool in helping to stabilize the blood sugar. Lowering carb intake also helps take stress off the adrenals/pancreas, thus stabilizing the up and down flows of blood sugar. While this diet can be very beneficial for most people, some research shows that going low-carb can reduce certain good bacteria from our gut population.

Adding resistant starches can help feed and promote the growth of beneficial bacteria in our gut by producing butyric acid—the same fat as butter, essentially. This helps to keep our small intestine more acidic and prevent SIBO (Small Intestinal Bacterial Overgrowth) from coming up from the colon into the small intestine. Butyric acid has also been shown to lower inflammation and fight off cancer cells!

Some people may get a little bit constipated due to the shifts in bacteria on a low-carbohydrate diet. This can be resolved by upping vegetables intake (nonresistant starch polysaccharides) and adding in resistant starch in the two forms mentioned above.

Resistant starch is also used for weight loss as it promotes satiety–which makes you feel fuller for longer–and can prevent cravings. Additionally, further studies have shown that resistant starch can improve insulin sensitivity in subjects with the metabolic syndrome.

Are you having symptoms of a gut problem? Click here to work with a functional medicine doctor to get to the root cause.

How to Use Resistant Starch to Improve Gut Health

Typically, I start with about one teaspoon of resistant starch and work my way up to about two tablespoons. I continue to double my dose until the magic two-tablespoons dosage has been reached. If you have any issues with the resistant starch (excessive gas, bloating, belching, or flatulence), simply cut the dose in half until you find the correct dose for you.

Clinical Pearl: Resistant Starch as a Tool

Resistant starch can be used as a diagnostic tool to assess if you may potentially have SIBO (small intestinal bacterial overgrowth).

SIBO is when the bacteria from our large intestine is moving back up to the small intestine. If you take a little bit of resistant starch and have any exacerbation of symptoms, like bloating, gas, bent-over pain, or excessive flatulence–that’s a sign that you more than likely have SIBO. 

SIBO can be diagnosed with expensive lab testing, which sometimes may be needed—but I recommend trying resistant starches first to see how they work for you.

Resistant Starch May Not Fix Your Gut

The goal of resistant starch is to act like a prebiotic which feeds the beneficial bacteria in your gut while increasing butyrate. The elevated levels of butyrate also make the gut environment more inhospitable, essentially creating a better environment for good bacteria to live in and a very inhospitable environment for bad bacteria to live in.

For some people with SIBO and other more serious gut issues, you may need to do more than just use resistant starch. We would start by looking for any infections and pathogens in the gut which need to be removed first.

What To Do Next?

Are you are having chronic gut issues (leaky gut syndrome), fatigue, low thyroid symptoms, and weight gain?

If you are looking to get some answers, running some specific functional medicine tests may be the only way. Most chronic health issues tend to get worse over time if they are left untreated, and the conventional medical options tend to cause more problems in the long run.

Click here to work with a functional medicine doctor to get to the root cause of your health problems.


IBS Might Be Connected To Your SIBO (Small Intestinal Bacterial Overgrowth) | Podcast #257

Between 3 percent and 20 percent of Americans experience irritable bowel syndrome (IBS) symptoms. The condition affects more women than men. People are most likely to get the condition in their late teens to early 40s. IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhea or constipation) or having a different kind of stool (thin, hard, or soft and liquid).

Today’s podcast is all about IBS, a common disorder that affects the large intestine. We are going to dive in deeper on how is SIBO connected to IBS, symptoms, the root cause and a lot more. Read up more about Dr. Justin’s podcast with Evan Brand.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:12 What is IBS

9:47 Fodmap diet, histamine IBS connection

24:01 Hydro Colon Therapy

31:09 Antibiotics

33:56 Biofilms


Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house. Hope everyone is doing phenomenal. today’s podcast is going to be on the SIBO IBS connection we’re going to dive in to IBS and is it connected to SIBO lot of symptoms there will try to look upstream inside out and get to the root cause of this. Evan, how are you doing today, man?

Evan Brand: I’m doing wonderful. I was diagnosed with IBS. And can you remember what year it was several years ago by a conventional doctor who did nothing but look at me and palpate my stomach and prescribed me an acid blocking medication and then said, Yep, you’ve got IBS and that was it. So it’s just crazy. How many people get diagnosed with IBS? I should try to pull up some numbers on this and see, but I would say most people are undiagnosed because they’re suffering, right? They’re having diarrhea or constipation or bloating or gas and they just don’t go to the doctor, they just take an over the counter this or that and move on with themselves.

Dr. Justin Marchegiani: Exactly, exactly. And IBS is a, a disease a diagnosis of exclusion, meaning you rule out a lot of the more Inflammatory Bowel issues, Crohn’s, ulcerative colitis, a lot of those symptoms being like extreme weight loss. you rule out all of the inflammation markers, like high amounts of calprotectin blood in the stool, whether it’s from inflammation in your colon, small intestine, or ulcerations in the stomach, right. So you’re ruling out all of the big, big, big, big issues, okay, rectal bleeding, extreme weight loss, extreme vomiting, extreme abdominal pain, those kind of things are going to be the big things that we’re going to be ruling out. And then of course, we have you know, more of the in between symptoms where we have Yeah, we have constipation. We have some loose stool and diarrhea. We have some nausea, but there’s not a lot of inflammation present. There’s not a lot of us no calprotectin we may run like a colonoscopy or sigmoidoscopy, we’re looking at the end of the colon and seeing no real signs of inflammation, or bleeding, a run a CT or an X scan an X ray scan and see what’s going on there. But we’re ruling out like the strong pathological issues, but we still may have a lot of symptoms that I mentioned earlier. And so once we’ve done that, then you kind of fit the criteria of IBS. Now, the question is, what’s the root cause? And I’ve seen many, many times we have one study right here, saying that IBS, is connected to seabone can be caused by SIBO between one and 40% of the time. This isn’t a study by the journal gutten liver in March 2017. We’ll put the link below on that. So we know there’s a strong association up to 40%. And so we know there’s a strong association when we have IBS. There’s two major kinds of IBS. Keep it bluntly, we have IBS D which is diarrhea, IBS. IBS C which is going to be IBS for this digestive issues. But there’s more on the constipation the slow motility side. And the faster high motility side.

Evan Brand: Here’s the interesting thing, the route of, I guess the diagnosis of exclusion, you mentioned, a lot of people don’t even get to go that route because the doctor throws them the drug and sends them on their way. I mean, you talked about the optimal scenario where you get all the proper scans, you get your calprotectin looked at, you can measure your Secretory IgA and look at your gut barrier. But that often doesn’t get done. Often. It takes multiple complaints, it takes multiple visits. Sometimes, emergency room visits are required because people are in they have to be in so much pain and misery for the conventional doctor to listen enough to then give them the proper referral. So I just want to point out what you said is that all these things are great, but a lot of times it doesn’t happen that way in the conventional we always do that in the functional world. Looking into the testing but that’s not the first step for most people. And that’s just the sad truth. And I don’t know if it’s a cost saving measure. I don’t know if it’s the insurance companies don’t want to go straight to send you over to a gastro doc for deeper analysis. I don’t know why. But I never got referred over until I had major complaints. And even when I got referred over the gastro doc didn’t even do a full workup. It was just a quick seven minute visit.

Dr. Justin Marchegiani: Exactly. So when they’re looking at these things, they’re just trying to rule out the more serious Irritable Bowel Disease type of symptoms. Right. Once that’s been ruled out, you can still have a whole bunch of nausea and spasms and diarrhea and constipation, then obviously, headaches and fatigue and mood issues can resolve, especially if you’re not digesting and absorbing a lot of your nutrition. You may have a lot more symptoms, and you’re going to be typically left with just a few medication choices. So the big ones are going to be things that help with the diarrhea, various anti diarrheal or antispasmodic medications, okay, and then you’ll have laxatives to help with the constipation to slowly side of the stool moving. That could be various laxatives that could be Metamucil or fiber supplements. And then of course with some of the diarrhea things antispasmodic medications tend to be used and then also a lot of times, antidepressants because we know serotonin plays a huge role in the gut on motility. So conventional medicines using a lot of antidepressants, whether they’re tricep like antidepressants, the older ones from the 80s or SSRIs are also use. And then of course, there’s the pain, right? It could be a pain in the intestine, then pains are going to be used, whether it’s like gabapentin or something else like that. They’re giving medications on the pain side. So these are the big ones that are going to be used. It’s kind of cookbook, right? It’s okay fast tools, slow stools, pain, right? pain medications, and then sometimes they’ll give pro kinetics for you know, your food setting in there so long. And then of course, the antidepressants. Those are the big for families and medication. So walk me through how does any of that fix the root cause it doesn’t, right, the mindset is we’re going to just manage the symptoms and hope that things don’t get worse over time. And we know that with entropy and inertia, things always tend to go downhill over time. Not better if we don’t get to the root cause if we ignore the root cause.

Evan Brand: Did you mention acid blocking drugs? Those are often thrown a lot.

Dr. Justin Marchegiani: Yeah. Yeah, I mean, if that’s symptoms present, I mean, those are typical symptoms for IBS in general, but if we have IBS, and GERD combined, yeah, acid blockers would definitely be used. Pro kinetics, along with that to pro kinetics are just things that help with the motility and the migrating motor complex to keep food moving through the intestine. So yeah, you may see that as well. Yeah, there’s a lot of different scenarios where other let’s say diagnoses or symptom presentations could overlap for sure.

Evan Brand: Okay, so I just want to briefly dive into some of the other symptoms or things that could be happening outside of the gut. So like the mood issues that can happen we’ve done stuff on this before and we’ll continue to talk about the gut bacteria and the the the mindset so anxiety issues, depression issues, insomnia, irritability, there’s a lot of other emotional things that people may not even recognize are from the gut. I mean, and this is coming from somebody who I suffered with depression for a long time of my life. And once I cleared up my gut, it was if the clouds over my head lifted, so I just want to point that out that, hey, if you’re suffering, emotionally, it may also be your gut. So you have to start in my opinion, you have to start they’re going to the mental health counselor may be necessary to but for me, the game changer was getting my gut cleared out my energy, my mood just went insanely, insanely good after that.

Dr. Justin Marchegiani: Exactly. And then what’s happening there physiologically or biochemically what’s happening is when we have unresolved emotional stress, and it could be subconscious stuff where we may need to use techniques that help address things subconsciously, it could be just conscious stress, what we need to just have kind of write out the big issues and and create some kind of an action plan that we could execute to get to the problem on it. Whatever it is, if it’s work or relationship or financial stuff, whatever it is, that’s going to activate our fight or flight and sympathetic nervous system and the sympathetic nervous system interplays with the adrenal and that makes stress hormones to help us deal with that stress, whether it’s adrenaline or cortisol, and cortisol and adrenaline long term is very catabolic, so it’s going to help, it’s going to actually break down our neurotransmitters so we’ll have less neurotransmitters that can then affect motility. We know that antidepressants are used for motility. So we know if we actually deplete our own natural antidepressants that we make naturally serotonin don’t mean we may have less of it to help with motility number one, the more fight or flight we get into the more we can actually break down our gut barrier. High levels of cortisol can break down IGA. I did a video that’s out this morning, you can take a look at it on histamine intolerance, and in that study, there was an article talking about cortisol impacting IGA and the immune response and can cause more histamine when you’re stressed. So you could have high amounts of histamine, which a lot of histamine symptoms overlap with IBS. So it could be skin stuff. It could be headaches, it could be fatigue, brain fog stuff, you know, and a lot of the histamine issues overlap because when you have inflammation in the gut, and you have a lot of cortisol stress, you may be making more histamine and the gut bacteria has a huge impact on the kind of histamine you have. And we know that dysbiotic bacteria and or SIBO, which is bad bacteria from the colon migrating up into the small intestine can have a major impact on histamine. And on all the other symptoms. We just talked about mood, nausea, depression, anxiety, and then of course, your typical IBS symptoms, constipation, diarrhea, stomach pain, etc.

Evan Brand: Yeah, well said. So you may come in with the diet, right? We may use the diet as a modifying tool, you know, something like a low fodmap diet may help, right because you’re trying to reduce the things that are fermenting in the gut, and possibly feeding the bad guys, but that’s where a lot of people stop is they end up with some diet protocol like a SIBO diet or an IBS diet. And and that’s it and they don’t go any further. So they may be able to manage it. But that’s still not the full root cause what would you say about the diet piece? And the involvement?

Dr. Justin Marchegiani: Yeah, so a lot of people they come in, they may already be on a standard American diet, and then they’re like, oh, okay, I’m going to make some diet changes. And they may still have issues and and the problem is a lot of fodmaps are fermentable carbohydrates or healthy foods. So why do people start scratching their head because they’re like, wait a minute, I’m already cutting a lot of crap out but I still don’t feel good. Or hey, like, I’m following this Weston a price thing where they’re telling me to eat lots of fermented foods. Why do I feel worse, and this can happen because a lot of those foods are very fermentable. So the bacteria in your gut feeds on a lot of the carbohydrates in those foods. Those carbohydrates being from fructose oligo, die in moto and poly, all these different kinds of carbohydrates or sugars that are naturally in these foods, healthy foods, but the bacteria will feed off of them.

Evan Brand: Let’s talk fugit just so people like okay, what is he talking about? like apples, pears, those are common fruits that are five.

Dr. Justin Marchegiani: Yes, right. Yeah, yeah, those will have. So there’s a really good handout that you can look at, I’ll post my handout underneath. But these are different carbohydrates. So frictions are going to be high and fruits only go and die in mono and poly sat and poly, poly alcohol. These are going to be in different types of vegetables and foods. Now there’s an app that you can get on your phone called fodmap, A to Z and it will tell you exactly which one of those fo de ma ma p ma PS in there, the different types of carbohydrates are in each food. I have a generalized handout that I’ll put below that has all the different ones in there. And so you know, but the big thing is you just want to cut them out. And the goal is that you’re starving out some of these critters by not giving them the fermentable fertilizer so they can grow. You can starve them out. And that can be a good first step that makes sense.

Evan Brand: Yeah, kombucha has an issue too I remember I had a woman who she had extremely high levels of [inaudible] her organic acids test indicating she had a ton of Candida overgrowth, she had toenail fungus. She had even fungus on her on her skin like a fungal infection on the skin. This lady was drinking five kombuchas a day. Now, granted, that’s an extreme case, most of you listening are probably not drinking five kombuchas a day. But that just goes to show you can have too much of a good thing in the fermentable food category. And some people get crazy with it. They’re eating sauerkraut every day, I just don’t think that’s necessary.

Dr. Justin Marchegiani: Exactly. So a little bit goes a long way. But if we if we have what I call probiotic intolerance, meaning foods that have good natural probiotics, and it caused problems, there’s probably SIBO going on, and there may even be an overlap with histamine issues. Because fermentable foods also have a high amount of histamine. So so many different conditions overlap, and it’s really, really confusing because you have to have a root cause perspective, because when you go to the root cause and you’re up here, lots of things emanate down below various symptoms, various others diagnoses and all a diagnosis is it’s just a way of taking a whole bunch of symptoms and throwing them in one bucket. The problem is different buckets have overlap as well total, whether you have like a mass cell issue, that’s one bucket, but then that may overlap with IBS. And then a lot of IBS symptoms, of course, overlap with Crohn’s or ulcerative colitis or microscopic lattice, but they don’t quite have as many of the inflammation signs. So there’s a lot of different characteristics and you have to, if you can go upstream is only a few root causes up here. So you get much less overwhelmed when you go up, right? You go essentially inside out, above, below, above, below, inside out. So you always go in to fix the outward manifestations and symptoms.

Evan Brand: Yeah, well said about the histamine IBS connection. I don’t think most people pick up on that they, they go on like a low histamine diet, but they’re doing it for what they think are histamine problems, but really, that’s the same thing as IBS problems. So the diarrhea could be a histamine thing. It could be a SIBO thing. So you really have to tease apart all these things. So how do you how do you tease this apart? You know, how do you approach these different buckets and then go up to the top what’s at the top.

Dr. Justin Marchegiani: You need a good functional medicine provider that can help guide you because it’s really confusing. And unless you’ve walked that path before, it’s easy to get to glom onto one thing, and then get overwhelmed. That’s number one, and it happens all the time. And then number two, you can go down the path where you’re kind of stuck on a whole bunch of medications that are managing issues, but then you’re like, you know, you’re just trying to like, you’re crumbling and you’re trying to hold everything up with duct tape, and it’s, it’s stressful. So the first thing is you got to get the diet component under control. So we have to look at cutting out fodmaps maybe cutting out autoimmune foods, we have to really pre digest and cook everything very well so we can digest it better. Right? Think of cooking as pre digestion. So kind of wrap your head Okay, cooking is precious, and a lot of people will think oh raw, so good. While raw may be okay for some people that have great digestion, but if you don’t have good digestion, so a lot of fiber in there that could be hard on your gut, it could be a lot more fermentable fiber in there. Also, the fact that you just tell me has to work harder and if you have less hydrochloric acid less enzymes, which we know according to many studies show that SIBO patients have less acid. They’re [inaudible] low stomach acid. We know stomach acids, an important trigger to make enzymes as well. So if we have low stomach acid, we have low enzyme issues. And then of course, if we’re eating when we’re stressed, or we’re not chewing our food up well enough, we’re just going to not break those foods down. And then those foods are sitting in our guts, and it’s a stress to break it down. So number one is choose good foods. But number two is pre digest them with really good cooking methods and in mastication just chewing it up.

Evan Brand: Well, yeah, when I had gut bugs, I was trying to eat salad and it was a waste of time. I was not digesting leafy greens at all. So I just gave up on eating salad and that’s why a lot of people end up going with a more meat based diet and I’ve seen so many people, there’s a lot of like famous YouTubers and other people who were raw vegans. And they end up getting off of that because they’re just like, hey, it destroyed me. I couldn’t digest anything. I was malnourished.

Dr. Justin Marchegiani: And some people they go to the extreme of going full carnivore, which is definitely low fodmap to, which does great, but some don’t have to go to that extreme. And some people they actually feel worse too, because protein and fats are also hard to digest as well. So sometimes there’s less anti nutrients and there’s less fiber, there’s less fermentation, and that’s enough to allow them to feel better and heal others they can handle some of those foods, they just have to be more autoimmune or moral low fodmap. And they really have to be working on the cooking methods and of course, the next step is going to be supplementation. So we may work on adding natural prokinetics, things to help with motility. We may add in hydrochloric acid and enzymes, you may add an anti inflammatory support for the gut lining, whether it’s dgl or like in my line, we use gi restore which is a healing nutrient for the gut lining. You have different things as well and your line as well. But we may we may come up with a plan based on how the person is presenting and things that have already helped or haven’t helped.

Evan Brand: Yeah, so it could be some herbal antihistamines to you kind of hit on the IBS histamine connection. So part of what we do is teasing apart when to do what? So if we’re trying to get someone’s got dialed in, they may be so miserable that we first have to use herbal antihistamines to try to calm things down. Let’s use the example of somebody who every single food they eat, they have a food reaction there. They say I have food sensitivities, and we say to what they say to everything, and we say, okay, and that’s where we can come in with maybe herbal antihistamines that you can take during the day to try to help regulate that massell reaction. You can look at the acid and enzymes, possibly possibly probiotics, but usually that’s like phase two. Usually phase one is more of us trying to manage the symptoms, get the proper information via the lab testing that we could talk about, and then make the game plan and usually the game plan is going to have to involve some combination of anti parasitic antifungal and or antimicrobial herbs and often we combine those together.

Dr. Justin Marchegiani: Exactly and then pre digesting the food by cooking it well is going to be helpful. We can do a crock pot, which is great for pre digesting foods and making more soup and stew like foods. The only problem with the crockpot is foods can accumulate more histamine there so if you’re not feeling good with crock pot foods, we may need to progress more to an Insta pot or pressure cooker. And a pressure cooker is great because it cooks the food faster so there’s less time for histamine to develop and of course an Insta pots even better because that’s going to be a hybrid pressure cooker and a crockpot combined. You just have to make sure with a with a crock pot with an Insta pot you’re very present when you cook it so you have to make sure you release that steam valve before you open it up and you’ll have an explosion so I always recommend like you put it way away from the shelf. Make sure kids don’t touch it. Make sure everyone knows like you do not touch it. Have one person deal with it. Someone comes in and wants to grab a snack bite of something, you’re going to have an explosion. So just make sure you’re very aware of that. And you have one person managing it, put it away, make sure the kids are out of the room and make sure that the vent is vented and that little little kitaen in the middle drops all the way down. So you know that that thing is cool when you’re when you’re opening it up. And I even recommend get like a fireproof blanket, put it over it and then turn it. Those things are-

Evan Brand: Yeah, they’re insanely hot. Good point about the-

Dr. Justin Marchegiani: Just gotta be careful because some women or even myself and I’m in the kitchen, you’re just like you’re doing 10 things at once and you may just go right to it and not think so you just really got to be very present when you’re using an Instapot. Okay, this is how you gotta do it. And you got to be very, very careful.

Evan Brand: Yeah, they’re incredibly hot and powerful for sure. I’m so glad you brought up the the histamine issue with the crock pot because you know bone broth is all the rage everybody’s drinking bone broth. We measure their gut barrier, guess what their gut barrier still toast drinking a gallon of bone broth a day did nothing for you and a lot of these people if they’re missing making their own bone broth because they don’t want to pay the price of somebody else to make it for them. People are saying that they’re letting it in the crock pot for 12 hours or 15 or 20 or 25 hours. That is a ton of time for histamine to build up. So I’m not saying stop doing bone broth, but I’m kinda saying that because I’ve had people that were actually having histamine reactions. They didn’t know it was linked to the bone broth. They get these weird rashes on their face or on their skin. They get a headache. They have no clue why. And I’d say well, when you get a headache Oh, it’s always in the morning. Oh, well, what do you do for breakfast? Oh, I drink a cup of bone broth in the morning. Ah, take out the bone broth, no more headache.

Dr. Justin Marchegiani: And again, my rep my opinion on this is bone broth for most people will probably be fine. So if you have negative symptoms, after taking it, like Evan said, then you probably want to pull it out for a period of time and really look at getting the histamine out just for a period of time and just I just call it being histamine conscious, right? Look at the high histamine food list and really pull out all the ones that you are consuming the most and just kind of watch and wait, but if you’re consuming has to mean are you you’re consuming bone broth and you feel relatively good with it. Continue doing it. I have no problem with that.

Evan Brand: Yeah, sorry, I’m not trying to, to label a small population as the whole population, because you’re right. That’s not that’s not everyone. But there are some super sensitive people listening that may hear that little nugget and apply and be like, Oh, yeah, I wasn’t so different. I didn’t know it. But hopefully you’re not in that category. Hopefully, you’re in, you can do as much bone broth as you want.

Dr. Justin Marchegiani: And this is the hard part because there’s so many caveats, right? There’s so many exceptions, you know, if and, but, and that’s why you really need a good provider to work with that can help you navigate because there’s so many exceptions to the rule, and we can’t be absolute in our generalizations here. So take everything with a grain of salt for sure. And if you’re working with someone that’s individualizing approach, there may be an exception to it. So that’s really good to note. So outside of that, I think the food components really big I mean, I’ve have my six our approach, which you kind of follow something similar as well, where we’re removing the bad foods or replacing the enzymes second or repairing the gut lining under the hormones. The hormones are the X Factor. People forget about this. I already highlighted how cortisol and stress and the sympathetic nervous system can affect digestion, but it also affects histamine. It affects the gut barrier. It affects the immune response. So the hormones are a big component. People come in there. There’s a lot of, let’s say, guts, functional medicine, doctors online, and they’re so myopic to the gut. They just everything else blows away and I can’t tell you how many people I’ve seen that they’re menopausal women that have ridiculously low hormones that are affecting their gut as well. They have low thyroid, which are that affects their motility, hey, that’s a sign of SIBO and IBS, right. Also people that have poor adrenal function, they don’t have enough cortisol to deal with the inflammation in their gut either. So you got to look at the hormones that gets overlooked all the time. And then I’ve personally then of course, removing the infections which there can be different kinds of infections and you you got to know that it may not just be SIBO, your SIBO they also have an H pylori connection which may also have a fungal overgrowth. SIBO and SIFO, there may be like you said, everyone we had I think that the three amigos, right, I think we had blasto giardi and H. pylori. So it was a-

Evan Brand: Crypto always you always mix up the blasto in crypto currency.

Dr. Justin Marchegiani: So, so crypto giardi and H pylori.

Evan Brand: Equal equally terrible.

Dr. Justin Marchegiani: Yeah, crypto grd. which is which is worse? I mean, crypto is probably worse than x file, then blasto.

Evan Brand: Yeah, my gut was a mess. I was not I was not healthy man. I was malnourished for sure.

Dr. Justin Marchegiani: Hundred percent, one hundred percent, or anything else you want to add to that list?

Evan Brand: The testing aspect, you kind of hit upon what we’re doing, but not in too much detail. So we’ll just kind of briefly cover that is primarily stool testing is going to give us a lot of the answers, of course, but as you mentioned here, you’ve got to get the other puzzle pieces. So you may need to run that cortisol panel, you may need to run that thyroid panel. So we may have to send you out to blood to get blood work because, as you mentioned, you could have someone with a gut motility problem that is not gut related. And how crazy is that? That it could be a thyroid problem causing your gut problem. Most people find that connection.

Dr. Justin Marchegiani: It can it definitely can for sure. And I have a couple of questions that popped in in regards to doing hydro colon therapy is that helpful? My opinion about hydro colon therapy, it’s an extreme way to move the bowels. So if there’s an extreme constipation, that may be a good way to start to kind of get things moving. But in general is a lot of things that happen in the colon, where we reabsorb electrolytes and things like that. So I don’t really want to disrupt a lot of that day in day out. So I much rather use natural things to kind of move the bowels if we have to do colon hydrotherapy acutely fine, but long term, we want more natural strategies that fix it and of course, fixing the bacterial or the infection stressor that could be screwing up motility is obviously root cause so there’s a lot of natural things that I consider to be non root cause like that, not root cause, but it’s palliative, and it may support it may be better than a lot of the medications or surgeries but we still have to have our eye towards the root cause and more sustainable everyday Things that are less invasive.

Evan Brand: Yep. Well said if I may mention the whole vitamin D connection we wanted to hit on this a bit.

Dr. Justin Marchegiani: Oh, yes.

Evan Brand: So there is a paper that had come out. Just a couple of weeks ago, October 2019, which was a study on ultraviolet B UVB light, which you get from sunlight exposure, and you could buy like UVB lamps, I’m sure. And the paper looked at the implications of low vitamin D. And at the end of it here, it just talks about how seasonal fluctuations in the composition of the gut microbiome are found and this is due to the different levels of UVB light. So basically summertime, a lot of people say they feel better during summertime. Part of the reason is if you’re getting more sunlight, you’re actually helping to regulate your gut bacteria and they found that the IBD flare ups were super common and linked to vitamin D deficiency. It says here, due to the gut dysbiosis associated with low vitamin D they go on and on. But that’s the sparknotes is that low vitamin D equals gut dysbiosis equals irritable bowel.

Dr. Justin Marchegiani: Yep vitamin D can have a big implication I think also vitamin D has a big connection with the serotonin receptor sites and we know serotonin has a big connection with what motility so I think it’s all connected right i think vitamin D then connects to serotonin. serotonin connects to motility. And if we’re not moving our bowels adequately, then you know you can start to have bacteria accumulating right because low and slow motility can definitely cause bacterial overgrowth, right that food sitting in your gut fermenting longer. So, when we look at SIBO, we primarily have hydrogen dominancy about or methane dominant SIBO, and those symptoms tend to correlate methane, constipation, hydrogen diarrhea, and sometimes we can have a combination of two. That’s the general correlation. So, the testing that we would do with that as a lactulose breath test, and that’s going to look more at small intestine overgrowth. We also have glucose breath test which you can look more at the upper stomach, there’s the urea blood, the urea breath, which is more of a newer test kind of an experimental phases. But essentially you’re blowing into a tube baseline, slamming down a 50, to 75 gram thing of lactulose, which is a large sugar molecule that does not get digested and absorbed, but gets fed to the bacteria. And when the bacteria starts to eat it, it starts spitting off gases. And the sooner in that three hours, so you get baseline below, slam down some lactulose below every 20 minutes for three hours. So the rule of thumb is, it should take the lactulose about two hours to get into the colon. So typically, at two hours, you’ll see this double peak accumulate. And that’s a sign that that the lactulose is hit the bacteria in the colon. So the mindset is, if we start seeing spikes in gases, right, methane greater than three are definitely great of intense concern hydrogen greater than 15 combined greater than 20 definitely concern, we start seeing spikes in these methane and hydrogen gases, then we know the bacteria, especially if it happens before two hours. We know the bacteria are gobbling it up. And there’s more bacteria because more bacteria equals more gases. So lower gases, lower bacteria, more bacteria, more gases, of course, hydrogen based bacteria, more hydrogen, but no bacteria, more methane. And on the GI map, we can actually they’re testing now various methane bacteria, so you can see some of that on the GI map.

Evan Brand: I like that. Yeah, I was gonna ask you now that that’s on there. How do you how do you correlate that? Or do you do a breath test and you’re going to run stool? Is it just in certain situations, or can you infer from the stool Now that may cause you not to run the the breath?

Dr. Justin Marchegiani: So we know a lot of the bacteria that we test on the GI map? We know if it’s connected to SIBO. So, we already know like things like Pseudomonas and klebsiella and citrobacter Prevotella and Morgenella are already connected to SIBO. Now, do we know without a doubt that this bacteria is in your small intestine? No, I mean, it’s like, it’s like you have a toothpaste tube. And then you have a little bit of toothpaste in the middle, and then you squeeze it all out and then you try to infer after you squeeze it all out where in the toothpaste thing it was, it’s hard to know that right? You need a biopsy where you go in there and you either grab it in that part of the testing, or you do the breath test where you can infer based on the time where it’s at. Outside of that. I just say that you’re you’re making a diagnosis, a functional assessment of, hey, you have a general dysbiosis. And based on the research, we know that this the bacteria that’s high in your test is associated with SIBO. And then we can also try cutting out some foods and seeing what happens. Number two is a strong history or a lot of symptoms. We may run a breath test alongside of it, it just depends. I typically don’t recommend a ton of testing. If we can do functional assessments and we see improvements and we see functional assessments approving it, then that gives us enough ammo to say this is an issue. The patient is already getting better. That’s the most important thing.

Evan Brand: Yeah. Well said Because see, a lot of people get caught up on that, like, What? Where are the bacteria? What’s the location? Do I have SIBO or not? And it’s like, well, you’ve got Pseudomonas Aeruginosa over growing. It’s probably in your small intestine based on your symptoms. let’s address the Pseudomonas. And if your symptoms get better, it was probably in the small intestine. That’s kind of how I approach it. I don’t often run breath testing.

Dr. Justin Marchegiani: And you can also make some diet changes, too. And so yeah, cutting out the fodmaps, like I mentioned, or those kind of things, they can give you a pretty good window into it.

Evan Brand: Yep. So So yeah, we try to only do things that we see are going to help us create a clinical outcome. And in a lot of cases, my opinion, you tell me if yours is different, my opinion, the SIBO breath test doesn’t add too much more to the picture. If we get a really, really good stool analysis.

Dr. Justin Marchegiani: If we get a good soil analysis, and we already make changes on the diet and the lifestyle and supplement side and we already see things that they give us a clinical indication of what direction we’re heading in for sure I hundred percent agree with that. Yeah. Okay.

Evan Brand: Well, I think that’s all I needed to say that I don’t have anything else on this topic at the time, but I hope it’s been helpful for people.

Dr. Justin Marchegiani: I think it’s been really, really good and of course, antibiotics can be helpful, but more specific ones that are using the SIBO are going to be the Neomycin and or the Rifaximin or Sifaxon, those are antibiotics tend to stay more in the gut and don’t go systemic. Of course, our natural bias is towards the antimicrobials. There have been studies that compared the effectiveness of the antibiotics with antimicrobials and the the natural ademma chrome os have come up better in some situations. That being said, Every now and then someone does better with antibiotics, but clinically, I found most people do very good with herbs. And they tend to do really well because of the E flux pumps, the natural antimicrobials inhibit the flux pumps, which is essentially let’s just say you’re you’re in a canoe and what you start taking on water okay, the flux pumps are essentially you in the canoe bailing the water back into the into the lake, right? That’s the flux pumps. So think about it. If we have a bacteria we want to kill, we want that water to accumulate in that canoe and sink the person or sink the bacteria. So the flux pumps prevent that canoe from sinking. So the herbs tenant act like someone coming in and taking away that person’s bucket and then they can’t bail out the water and then the canoe or the bacteria takes on water faster and sinks. So you have some really good benefits with the herbals with the flux pumps and then also the biofilms are another component so the biofilms are like protective shields that the bacteria use from being killed so things like ginger or silver and or graphics or systemic enzymes can be very helpful for essentially taking away that the Spartans shield so to speak and making them more vulnerable to the herbals.

Evan Brand: Yeah, Serapeptidase did a wonder for me as soon as I started on that I had a massive massive sinus drainage and I wasn’t even someone who felt like I had any sinus issues at all, but once I started doing that, and combining with antimicrobial antifungal herbs, I mean it was literally me achieve he was literally me peeling back the onion and hitting a new layer of infections, which is why sometimes on the retest, we’ll see new bugs show up and people say well, why wasn’t this on the first test? We did? Well, probably because it was hiding and we pulled it out of hiding.

Dr. Justin Marchegiani: Exactly any patients that are listening you know, they always see my ginger tea recipe or me talking about using ginger tea. Why? Well wonder ginger tea helps with inflammation. It helps with motility but also it helps with biofilms. So I like to use things that have multifactorial benefit and it’s cheap right helps them the digestive side helps in the motility side and helps on the biofilm side beautiful in reducing inflammation too.

Evan Brand: Beautiful. We could do a whole show on biofilm, I think but yeah, it’s definitely definitely part of this puzzle.

Dr. Justin Marchegiani: 100% I did a video on biofilms. We’ll put that we’ll put that in the reference below that a few years back, so that’ll be a good reference for y’all. Silver is also a great biofilm Buster as well. So my line, we use GI Clear three, which is a nano silver. And then of course, we just make the homemade ginger tea. And I have a video on that too well, so we got a lot of stuff with the references. And if you want to add anything for your video, and we’ll add stuff there too. That’s perfect. Cool. All right. Any other questions from the listeners feel free to chime in? Again, we’re one of the only podcasts out there where we try to really talk about real life experience with patients. You know, we’ve had experiences over the last decade with thousands of patients. And then we take questions live because we don’t need to prep for this stuff where this is things that we do every day. So you don’t prep for the for the book that you read to your kid at night because because you you know the language so well. We know the functional medicine language and we’re happy to be able to engage with y’all on that. Let me see what we have for questions here. All right. How do you treat patients from a distance so we have labs that we can order anywhere in the country. Or even the world. And then number two, we can always engage face to face via FaceTime or Skype or zoom. And then of course, we can make diet changes. We have a lot of handouts and video support, we just engage via phone or Skype or video works great. IBS constipation and frequent urination and a tingling sensation to my testicles and anus and the doctor didn’t know what it was any ideas, hard to say. I mean, there could be some aggravation of your your lower single nerves if you’re knowing that pudendal area is irritated, there could be a disc issue potentially that could be a sciatic potential issue with that s one s two s three nerve root could be affected. So it’s hard to say what’s going on there. I mean, people that ride bikes or things like that that area can be a compressed people that have sciatic issues or sit too much could be compressed. So I need to have a little bit more info but of course, if there’s digestion issues, fixing that would also be helpful using all the things we talked about today. Evan?

Evan Brand: Gosh that was great. I have nothing else to say except, you know, you could run some testing but that doesn’t sound like a parasitic type issue. I agree with you. It sounds more nerve related.

Dr. Justin Marchegiani: Exactly. And how to get rid of colon pain that’s caused by chia seeds. Well, first thing if you’re having a lot of colon or digestive pain, let’s cut out the chia seeds. Let’s cut it out for a period of time, see how we do. Excellent. And then another question here that’s on topic is the SIBO always come with pain. No. And this is weird. A lot of times SIBO may not even come with digestive issues. It may come with brain fog, it may come with fatigue, it may come with depression. And they come with symptoms not associated with digestion. And this is the hard part where people that go to their conventional medical doctor, or even a lot of functional med doctors there, hey, if you don’t have these gut symptoms, we’re not going to run these gut tests, right? People become very symptom oriented in regards to what testing they’re recommending. And that can be a big mistake, and people can fall through the cracks.

Evan Brand: Oh, yeah. Well said anxiety too I’ve had a lot of people with anxiety, and they don’t have gut symptoms, and then we get their stool test back. I’m like, are you sure you don’t have any gut symptoms? Like how do you have this many infections and you have no gut symptoms. It’s always amazing. I don’t know if it’s just a disconnect. If it’s a, they’re used to it. They don’t know what their gut should feel like, you know, they’re used to their stomach being bloated all the time. And then we do a protocol and it’s flat and like, Oh, I guess I was bloated. I didn’t know that. Yeah, that’s a great point.

Dr. Justin Marchegiani: Yeah. And then a patient writes in what if you have gas when you’re taking sulfur based amino acid. So if you’re having a lot of gas, when you’re taking sulfur based amino acids, you just back off the dose and just gently taper it up. And I’d probably take it with food. So it mixes in with the sulfur amino acids of my animal products, animal products, and just kind of taper it up from there and go slow and get to a level where you feel comfortable. It’s great that we had all the major questions here so far. Anything else you want to add, Evan?

Evan Brand: No I’m glad we have some questions, it’s helpful to dive into the real life experience. So if people have questions ahead of time or in the future, you know, feel free to reach out to us on our websites, you know Justin Health Wellness Clinic on Facebook, Instagram as well, you know, look us up, follow us connect with us that way too because a lot of what we do is kind of a thankless job you know, we’re connecting with, you know, hundreds of thousands of people per year but rarely do we have people actually reach out and give us an actual like, hey, I want you to cover this or this or this topic, y’all kind of just sit there and wait which is fine, but we would like the interaction to so feel free to reach out and ask us questions will answer them.

Dr. Justin Marchegiani: We appreciate it. Also, someone wrote in Yeah, our intestines are our essentially our GI tract is our first brain for sure. there’s what’s called the enteric nervous system and there’s just as many nerves in our in our gut and our GI tract as there are in our brain, right and our brain is essentially our central nervous system that’s brain the spinal cord. Peripheral nervous system is the spinal cord out to the extremities. And then of course, we have the enteric nervous system, just as many neurons in the gut, as in the spine and brain, so that’s really important. So of course, having digestive issues can affect your mood just as having issues in your brain can affect your mood. Your second brain, which is your gut, is so important. And of course, that’s where all the building blocks from your gut go to your brain anyway, so all the nutrients and amino acids that make your brain chemicals come from your gut so of course, you have your own enteric nervous system there but you have all the building blocks that come from there too. So really, really important.

Evan Brand: Yeah, just treating your brain is not the answer.

Dr. Justin Marchegiani: It could be part of it and some people it may be all of it but most people it’s going to be a combination of the two. Yeah, yeah. And this is where you need that skilled experience so feel free and you want to reach out to Evan,, Evan works with thousands of patients all over the world and then myself at and we appreciate you guys clicking below and write us a review as well as go into iTunes., Appreciate it y’all. You guys have a phenomenal day. Take care.

Evan Brand: Take care. Bye bye

Dr. Justin Marchegiani: Bye.


Audio Podcast:


SIBO, Yeast Overgrowth, Mood Issues & More – Podcast #169

Your gut affects your health in a variety of ways, and it’s not just about digestion. The health status of your gut can influence the immune system, your weight, and even your mood! In today’s part-podcast and part-Q&A video, let’s join Dr. Justin Marchegiani and Evan Brand as they talk about gut health and how it affects us as a whole.

Watch and listen as they discuss topics like Small Intestinal Bacterial Overgrowth (SIBO), yeast or fungal overgrowth, weight gain and weight loss, and even the link between your gut and your mood swings. So many people are diagnosed with SIBO, in fact, Dr. Justin says that almost 90% of his patients are suffering from this condition. Learn how to manage your gut health by taking the right supplements, eating the right foods, and preventing issues from wreaking havoc on your overall health. Watch this video for more info!

Dr. Justin Marchegiani

In this episode, we cover:

02:30   SIFO is Definitely an Issue

05:20   Conventional Treatment of Candida and SIBO

07:19   Urinary Tract Infection

10:00   Treating UTI by Just Hitting the Gut.

21:36   Top herbs for Candida Overgrowth


Dr. Justin Marchegiani: Dr. J here in the house, with Evan Brand. We’re gonna do a live Q and A call. We may talk about some topics near and dear to us, what’s trending. And then if you guys want to come in on the side and ask any questions, feel free. We are here to serve. Evan, what’s cooking, man?

Evan Brand: Hey. Uh— not too much is cooking but I’m drinking some apple cider vinegar drink. Good old Bragg’s uh— with some cinnamons. So, that’s good. This is a good— like tummy tonic, and there’s a small amount of sugar in here but— Hey, I’ve got Stevia extract in here, some ACV, some little bit of apple juice. I could probably make this myself, but it’s so convenient for two bucks to go buy one of these and just have a nice little tonic.

Dr. Justin Marchegiani: I know. Totally. Just that convenience aspect is really nice. I like the lime one. The lime one’s really good, too. IIt’s only sweetened with Stevia.

Evan Brand: Oh, that one doesn’t have sugar.

Dr. Justin Marchegiani: Yeah. That one’s a good one.

Evan Brand: Oh. Yeah. I didn’t know that…

Dr. Justin Marchegiani: Love it.

Evan Brand: existed.  

Dr. Justin Marchegiani: Wow, man.

Evan Brand: Well, I did an interview uh—

Dr. Justin Marchegiani: Now you know.

Evan Brand: I did an interview this morning uh— with my— for my summit, and it was all about SIFO, so I figured maybe we could chat about that, like Small Intestinal Fungal Overgrowth are what we’re seeing. You know SIBO is such like a hot topic, but people aren’t really talking about SIFO, and you and you and I are seeing so many people every week. I’d say, it’s what— 90 percent of the people have yeast overgrowth?

Dr. Justin Marchegiani: Yeah. I think, when we look at yeast, for instance. You know, we do a typical SIBO test, which looks at Methane and Hydrogen gases, which are— you know— You give a sugar s— solution via lactulose to the per— person, and that sugar’s indigestible to the body, except certain bacteria that are dysbiotic. And when those bacteria eat that lactulose solution, they spit off Methane of Hydrogen gases, depending on wha— what bacteria they are. And that Hydrogen can either disrupt and cause diarrhea or increase motility, or can cause decrease motility via Methane, so— Of course, we see it with various gases indirectly. We don’t know the exact bacteria, but we know that those gases are there because the exhaust created by it. It’s kind of like, you don’t know a car’s in the garage if it’s not there, but if you smell the exhaust that it left a minute ago, you can kind of tell, right? So, it’s kind of like that. And of course, people can have— or patients can have symptoms in their gut via fungal overgrowth. And, symptoms can overlap pretty well, so you may have a fungal overgrowth or something else happening and you may think it’s a small intestinal bacterial growth. You may come back on the test with nothing in that area, but we may do some other testing that shows a fungal overgrowth is present.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, SIFO’s definitely an issue.

Evan Brand: Yeah. So let’s— let’s go through symptoms a bit. What if somebody know if— or expect that they have SIBO or SIFO? There’s gonna be the bloating, could be fatigue, could be anxiety, could be brain fog, uh— could be food cravings, sugar cravings could be possible. Uh— I mentioned the mood issues, like anxiety, because most people don’t think about it, gut being a cause of anxiety. But it is. And when I had gut issues, I had anxiety. I lost weight. I had brain fog. I had fatigue. It’s all because of my infections.

Dr. Justin Marchegiani: Hundred percent. And a lot of people who have gut issues, right? They’re gonna have a lot of mood issues or energy issues too. It’s very rare that someone only has gut issues. Like, they could have diarrhea, bloating or gas, or indigestion, or GERD, or acid reflux, or gastroparesis with their food, just sits in your tummy for a long time. But it’s very possible that you could just have mood issues, uh— brain fog— With fungus, it’s common to have joint pain. It’s common to have brain fog. It’s even common to have anxiety too. Uhm— the yeast, kind of metabolic products in the gut, uhm— when they metabolize, they can spit off acetaldehyde. Acetaldehyde can then create a compound called salsolinol. Salsolinol can create apoptosis in the midbrain, where it— it can actually kill off some of the uhm— substantia nigra cells that produce dopamine— s, of course, you know, chronic yeast issues, severe yeast issues, but could potentially create more neurological issues due to all the toxic by-products.

Evan Brand: That’s a trip. Now, I know saccharomyces boulardii. We talked about it. We use it for the saccharomyces could do two things, maybe you colla— collaborate on this a bit for the saccharomyces as one, gonna help to crowd out the yeast, but can also kill the toxins that Candida’s producing. Can you speak on that? Do you know what I’m talking about?

Dr. Justin Marchegiani: Yeah. I mean, yeast, Candida can also produce [stutters]— As a by-product, they’re gonna produce mycotoxins, right? And these toxic by-products can disrupt digestion. Uhm— they’re also— you know, acetaldehydes, a stressor that’s produced by the Candida that I mentioned earlier. And Candida’s one type of yeast. You know, they’r— you can have, you know, the Rhodotorula species that— that the cal— Candida albicans, as the Candida of everyone refers to. You have the Geotrichum candidum. You have uhm— these species as well. So, of course these things can cause similar symptoms as SIBO and they can create toxic low because of the how it disrupts toxicity, how it disrupts uhm— digestion. You need nutrients to run our detox pathways. It can create this mycotoxins, which then have to be processed by our detoxification system as well. And of course, it can stress out the immune system because 80 percent of our immune cells live in our gut and it can create more permeability with the gut, i.e., leaky gut, which then gets the immune system fired up. Which is kind of like leaving the uhm— the faucet on in your guest bedroom that you never go into, and your water bill’s sky high that month.

Evan Brand: Yep. Well said. So, let’s talk about treatment a bit. I mean, some of the options that we use, conventional docs. Maybe let’s chat about that first. I mean, we always go straight to the functional medicine piece and assume that people understand that. But I don’t think many people understand what and how poorly conventional medicine treats Candida and bacterial overgrowth type issues.

Dr. Justin Marchegiani: Well, most of the time, conventional medicine’s gonna, you know, typically laugh at your face when you talk about Candida. And unless you have— number one, you have some type of skin-oriented rash, like a tinea versicolor, some kind of seborrheic dermatitis. That’s apparent on the skin, right? It’s like, it’s there. You can see it. It’s apparent they’ll recommend some type of antifungal cream, and they won’t ever look deeper in the gut, which tends to be the root of where it comes from. Or there’s like a vaginal yeast infection or there’s some kind of thrush, where there’s a white coating around your mouth or tongue. So, unless you have those two or three things, for the most part it’s not gonna be picked up. And the Candida like we mentioned can create a whole host of issues: fatigue, mood— It can create things that are none digestive. It can create things that are digestive. I already mentioned. And if you’re going to your conventional medical doctor, it’s typically not gonna be picked up. We can even see it via antibodies, too. So, sometimes people will do a stool test but we’;; actually see the candida via the antibodies. It’s hard to pick up so, we’ll always use clinical symptoms too. Oh, the other one was a fungal tell— fungal toenail.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Like the yellow kind of thickened discolored toenail. That’d be the— the fourth one. [crosstalk] Mouth, nose—

Evan Brand: What about on the fingers, too? I’ve seen people with like a ye— a yellow nail, where it’s like…

Dr. Justin Marchegiani: It’s the same.

Evan Brand: …falling off.

Dr. Justin Marchegiani: It’s the same thing, right? Toenail and fingernail is the same kind of thing.

Evan Brand: Yeah. Okay.

Dr. Justin Marchegiani: Mp— that thickened type of fungal things we see on the nails, on the skin, Uhm— typically, on the mouth, and then typically, vaginal. And let’s say number five would be kind of like a uhm— seborrheic dermatitis, or like a cradle cap, or like a dandruff. It’s kind of in that same fungal category. So, five big ones: hair, mouth, vaginal, skin, nails…

Evan Brand: Got it.

Dr. Justin Marchegiani: …toe or finger.

Evan Brand: Yeah. So, let’s talk about UTIs for a bit. Now, when you hear about a Urinary Tract Infection, a lot of times, this is affecting women. Is that bacteria plus Candida [crosstalk] at the same time?

Dr. Justin Marchegiani: Typically— It depends. Typically, it’s gonna be bacteria. The— the number one way you can figure it out is typically bacterial vaginosis. We’ll have kind of a fishy odor to it. So, it’s gonna a little bit fishy, in women. No, it’s like— okay, it’s apparent something’s going on down there. Yeast infection, typically is not gonna smell like that. It may smell a little bit yeasty, almost like a buri kind of smell, but it’s not gonna have that kind of fishy odor smell. That’s the number one. Both are gonna have discharge. [crosstalk] Both are gonna have discharge, typically like you know, kind of a cottage cheesy kind of fim. Uhm— you know— We’re getting pretty graphic here but hey, this is— this is what we do, all week long. So, of course, that’s the big way. And then, typically, the UTIs can affect primarily the urinary tract, right? Bacterial vaginosis involves more the Gardnerella bacteria. Uh— the UTI is more gonna be the E. coli bacteria. And then, of course, yeast is gonna be more like your Candida albicans kind of thing. So, of course, like if it’s a UTI, you know, you tend to feel it. It tends to hurt more when you pee. A little bit of pain or stinginess when you pee; bacterial vaginosis, probably not as much. Maybe just itchy. And the big— you know, dividing factor would probably be the odor, as how you would know.

Evan Brand: Okay. And then [inaudible]—

Dr. Justin Marchegiani: Of course, you can get a culture. You can get a culture, right? You go see your doctor. They may do a culture, but in terms of treatment for bacterial vaginosis, we may do kind of an herbal formula, mixed with apple cider vinegar. And we make it like a douche applicator and flush that area out for a week or two. And then, we may throw some probiotics in, internally via the mouth and intervaginally to help shift the pH. Typically, getting more acidic pH makes it harder for that bacteria to grow. Obviously cutting out the refined sugar and the junk of your food, too. With yeast, similar thing. We have some Boric acid or suppositories that we’ll use. The help will also get the probiotics going. Cut out the refined sugar. And then for UTI stuff, we’ll typically use some Silver. We can use some D-Mannose powder. We can use Uva Ursi herbs. Uhm— we can do apple cider vinegar, lemon juice. These are all really good things that we can do to help acidify the p— acidify the urinary tract. Also we can do cranberry juice extract, unsweetened organic. We can also do some organic cranberry pills as well. That has a big shift on the pH in the urinary tract, which then starts to starve them out because they— they tend to not live as well in that nice acidic environment. They tend to grow more in an alkaline environment.

Evan Brand: So, let me ask you this. Could you successfully treat a UTI just by hitting the gut?

Dr. Justin Marchegiani: Uhm— you could. Uhm— again, like some of the things we’d want to do is to want to make sure we have some of those herbal metabolites make their way out the vaginal, you know. I mean, typically UTI it’s gonna go out, right? It’s gonna head some and go out, and so the urinary tract will be hit. The question is, “Will the vaginal area be hit.”  Obviously, for peeing it out, it’s not gonna be hit. It’s close in that area, but more than likely it’s not gonna hit it. That’s where you need some kind of an herbal douche formula to topically get in there. Same thing with the yeast. So, yeast, you kind of want to top like in there with a suppository. BV get in there uhm— with a— a flushing type of herbal mechanism, and just make sure you’re not pregnant, right? ‘Cause the— there could be some abortifactant uhm— mechanism there if it’s getting too close— you know, up the vaginal canal. And then, uhm— number three is the UTI that we could do internally, and we could flush out that way.

Evan Brand: So, could you go— I mean are there like professional grade herbal douche blends, or is that something you’ve got to piece together yourselves? Like, does the store-bought version exist?

Dr. Justin Marchegiani: Yeah. I have one that I use that works really well. It’s good to call herbal douche formula, and that we should choose an applicator when we mix— mix it with some apple cider vinegar, like the instruction’s say, and we flush one— one or two times a day. [crosstalk] I’ve got to shift the diet. I’ve got to shift the diet. Typically, it should do a— a really good probiotic intervaginally, as well, that kind of help shift the pH and shift the microbiome there.

Evan Brand: Is there a brand for that?

Dr. Justin Marchegiani: Yeah. I like one by Wise Woman Herbals.

Evan Brand: Okay.

Dr. Justin Marchegiani: [inaudible] … for the herbal douche formula, and then the probiotics will typically do, you know, my Probio Flora or will do a Woman’s formula. But typically, the Probio Flora is enough as well.

Evan Brand: Cool. Okay.

Dr. Justin Marchegiani: Probio Flora too is uhm— the Phage in there really helps kill uh— E.coli too. So, if it’s any UTI stuff going on too, that could also help with that too.

Evan Brand: I’m gonna bookmark that. That’s really really cool. And this— I feel like the douche is something good where if you’ve got like a resistant infection or something that just keeps coming back. Sounds like that would be a good thing to add in.

Dr. Justin Marchegiani: Yeah. And then, typically though, even if we ever— let’s say, we do topically hit that area, we still want to make sure we systemically treat things too. Like, we would topically hit something ‘cause you want a faster results.

Evan Brand: Right.

Dr. Justin Marchegiani: Like, let’s say, there was a fungal nail, right? And maybe really hard to get rid of that fungus on that nail if we just hit it to the gut. So, we kind of want to hit it from both ends. So, we kind of want to put that critter between a rock and a hard place. Make it so it has nowhere to go.

Evan Brand: So, do you add apple cider vinegar, too. That’s— I know it comes [crosstalk] west.

Dr. Justin Marchegiani: Yeah. We’d add it to it.

Evan Brand: Okay.

Dr. Justin Marchegiani: Make it says like add six ounces of apple cider vinegar or something. If you read the jo— instructions on how to mix it.

Evan Brand: ‘Cause like in ingredients, it says it’s in a base of ACV. So, I was just curious.

Dr. Justin Marchegiani: Can you read the in— Can you read the instructions?

Evan Brand: Yeah. It says, “Add one tablespoon of concentrate per six ounces of warm water.”

Dr. Justin Marchegiani:Per warm water?

Evan Brand: Yeah.

Dr. Justin Marchegiani: Got it. Yeah. So then it’s the warm water then. So, the apple cider vinegar’s already in it. SO, we will just add that to the warm water.

Evan Brand: That’s really cool, man. I learned something new everyday.

Dr. Justin Marchegiani: That’s it.

Evan Brand: Wow. Well, thanks. [crosstalk] Let’s look at some questions and see what we’ve got here, digestively. Uh— Evie ask you a question, “Dr. J, I’ve been taking your Digestive Supreme and HCL. They’re helping a lot. Thanks. Is it okay to take for a long time or should I stop after some time?

Dr. Justin Marchegiani: So, typically, if there was an infection, we want to get rid of the infection and then we can taper it down. And then, the rest is gonna be based upon you. So, if you’re under a lot of stress during the day, you know, then we may want to take it during stressful period. If you’re eating food that’s maybe a little bit questionable, we want to save it for that. So, get rid of the infections. Get rid of the internal stress that’s causing the issue. You know, as long as your diet’s on track and the stressful environment is kind of under control or you’re not hydrating so much during the meal, then I think it’d be okay to reduce the consistency on that, for sure.

Evan Brand: And I— I— I’ll throw my two cents in.

Dr. Justin Marchegiani: Yes.

Evan Brand: I cycle on and off enzymes, personally.So, I just got my Stool testback. I showed up with some gut bacteria, showed up with the cyclospora parasite. So, needless to say, I’m back on enzyme ‘cause I’m clearing out these infections because the last thing you want is undigested food particles feeding the bugs. Like Justin mentioned, if you’ve got an infection, something that— like H.pylori could be suppressing stomach acid. You know, that’s undigested food that’s going straight to the bad guys. So…

Dr. Justin Marchegiani: Yeah. And I noticed myself. I was just having a— like uh— looser stools for the last few weeks only after coffee, and it was just— typically, was a different consistency. So, I just start on. I used to hit my GI Clear 4 and Para 1 up, and I noticed that it did start to solidify again even after coffee. So, I’m gonna be doing the GI Map Test at the end of this month…

Evan Brand: Good.

Dr. Justin Marchegiani: …and see what at.

Evan Brand: Well let’s go through your results when they come.

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’d be a fun show.

Dr. Justin Marchegiani: Yeah. I’m excited. Then also uhm— I saw your test last night. I saw the increased steatocrit on yours…

Evan Brand: I know.

Dr. Justin Marchegiani: …and the increased beta-glucuronidase. So, definitely hitting it with the antimicrobial herbal stuff, maybe adding in some extra bile salts or lipase in there too would also help.

Evan Brand: Yeah. I appreciate it. I’m gonna uh— I’m gonna do that, and then also, I’m gonna add in some milk thistle too. Try to get that glucuronidase down.

Dr. Justin Marchegiani: Yep.

Evan Brand: No probiotics can do it, but I think I rather probably do both.

Dr. Justin Marchegiani: Well, yeah. I mean, glucuronidase is gonna be— if you kill the bacteria, that— that will go down, too.  

Evan Brand: Okay. That’s cool.

Dr. Justin Marchegiani: You can just throw in some extra charcoal to help bind that up too.

Evan Brand: Okay. Also, uhm— we’ll have to chat but uhm— where we’re getting our Para 1. There’s also a binder that they’ve got, which is like a Fulvic acid – Charcoal mix.

Dr. Justin Marchegiani: Yeah. I’ve seen that . I think that’s good too. Uhm— I find that— you know, the charcoal’s still really good as well. So, you could do either one [crosstalk] then. I like the charcoal.

Evan Brand: Yeah. And the charcoal’s so cheap.

Dr. Justin Marchegiani: That’s the thing. The charcoal’s just a little bit more cost-effective, that’s why I like it.

Evan Brand: Yeah. You can’t beat it. Okay, [crosstalk] cool.

Dr. Justin Marchegiani: And it’s still great. I mean, it’s still— you know, you can use it for alcohol— I had— my Patriot’s play yesterday, my Tom Brady. They’re just freaking awesome, man. He used to go— and— you know, he is just like the perfect— like practitioner spokesperson for natural medicine. I mean, what he does, what his diet, and he eats basically a Paleo Autoimmune Template for the most part. He’s trying to keep inflammation down.

Evan Brand: Yep.

Dr. Justin Marchegiani: And uh— you know, he trains in a way that to support pliability and muscle length, and then which we’ll have to uhm— try to get his trainer on, man. I got to get him on…

Evan Brand: Good.

Dr. Justin Marchegiani: …and speak to him. I know. We’re gonna work on that. But yeah, he’s a perfect practitioner of all these stuff. But uhm— in regards to—- where was I going? So, we just talked about?

Evan Brand: I think you were talking about—

Dr. Justin Marchegiani: Oh, yes! I’m sorry. So, I had a nice glass or two of champagne yesterday.

Evan Brand: Oh.

Dr. Justin Marchegiani: So, I hit up some activated charcoal, and I hit up some Sulfur amino acids, and I feel phenomenal. No issues. Then, of course, I have a nice glass of mineral water in between drinks that prevents any— you know uhm— the antidiuretic hormone that’s being reduced. So, all the peeing that happen from alcohol, prevents any of those minerals from being washed out. So, that’s my little tip there.

Evan Brand: That’s cool. Uh— anybody uh— listening, watching, add your comments. We’re gonna go through these. We’ll try to answer as many that are on topic as we can. So, add your comments now. So, we’ll go through it now.

Dr. Justin Marchegiani: Yes. And we’ll hit the ones that are on topic— is— is first. And then also, give us a share, give us a like, give us a thumbs up. We appreciate it, guys. Help us grow so we can help more people like you. Your benefitting right now. Don’t keep it all to you. Let it get out there. We appreciate it.

Evan Brand: Absolutely. Uh— what’s our time on? How much time we got left with these questions?

Dr. Justin Marchegiani: We— we got five minutes. Let’s roll for it.

Evan Brand: Okay. Alright. So, we’ve got one here from Jeff. Uh— he says that he’s been taking the GI Clear 1, 2 and 5. Two caps a week for H. pylori. Yesterday was his birthday. He’s been so sick; nausea, headaches, panic attacks. How should I take the herbs on an empty tummy?

Dr. Justin Marchegiani: So, number one, I‘m imagining that because it was your birthday, you may have gone off the—

Evan Brand: Oh, oh.

Dr. Justin Marchegiani: …of the rings there, Jeff, maybe with some extra birthday type of uh— surprises or things like that. So, there could be that. Uh— number one, if we’re having some sensitivities, we need to come off the herb for three to five days, get back to base line, add them a ginger tea, and then ratchet up one capsule per day on each herbal product. If you hit the wall, meaning you start to have those nausea or negative symptoms, you  back off. Get super stable before you go to the next. And of course, if you’re having issues, take it with food, because the food kind of prevents a buffer. So, those herbs aren’t sitting up against an irritated gastric mucosa, add in the ginger and then we should probably throw in some activated charcoal in between breakfast and lunch away from food and lunch and dinner away from food. That will maximize absorption of any of the— the toxins. But dial in the dose. Don’t be a hero and push it too high and too fast. Take it with food. Take a couple of days off. And then, add it back in.

Evan Brand: Yep. Good advice. Now, the question here. Dr. J, I’ve been following your advice but not perfectly. I’ve had long term constipation, GERD, gastritis, H. pylori, bloating, abdominal distention, cramping. How can I help myself? I’ll answer this one.

Dr. Justin Marchegiani: Yes.

Evan Brand: If you don’t mind.

Dr. Justin Marchegiani: You got it. Do it.

Evan Brand: Uh— You’ve got to get tested. I know you said, “I’ve been following…

Dr. Justin Marchegiani: Uhmmn—

Evan Brand: “… meaning you’ve probably been watching Dr. J’s videos, maybe some of the stuff that we’re doing together like this. But if you’ve knocked out the testing done, then you’ve— you’ve got uh— you’ve got to do that. If you say H. pylori— if it’s still there, you’re gonna have these symptoms. So, you’ve got to get some functional medicine testing. You can reach out. Get that done. And, we’ve got to fix the bugs. You’re never gonna fix constipation if you’ve got bacterial overgrowth ‘cause those gases are gonna change the intestinal motility time. Bloating; same thing. That could be yeast, fungus, bacteria, H. pylori. We know that’s why you’ve got the GERD, because that’s suppressing your stomach acid. You’re gonna have heartburn because your body’s not gonna allow the undigested food to go down. So, get tested and then we can use herbs to fix this.  

Dr. Justin Marchegiani: One hundred percent!

Evan Brand: Uh— let’s keep going here. We’ve got another [crosstalk] question from Kitty. Uh— She’s taking the beef protein powder. That makes her constipated so she take HCL and pepsin even though it’s a powder.

Dr. Justin Marchegiani: I would say, you could try it, and see what happens. If it doesn’t work, there could be something in it that you’re allergic to so I would try a Collagen protein that’s in a peptide form and see if that shifts or changes it. ‘Cause that’s gonna be in a more broken down assimilated form. [crosstalk] So, try it. Try more enzymes and HCL, and see what happens first. And then try just a really clean— like— you know, my TRUCOLLAGEN. Try something in a collagen peptide form…

Evan Brand: Yeah.

Dr. Justin Marchegiani: …and see if that fixes it. And then, let us know.

Evan Brand: Good advice. Another question, “Hi, Dr. J. I’d like to ask you uh— how to detox from heavy metals toxins, parasites, etc., naturally?” We’ve done a ton of shows on this. We’ll continue to probably hit this topic, but just searched or search the YouTube channel here for those ti— uh— those titles, and you’re gonna find some stuff. But that— that could be an hours and hours and hours conversation.

Dr. Justin Marchegiani: Totally. Yep. Absolutely.

Evan Brand: Samuel. Want to read that one?

Dr. Justin Marchegiani: Yeah. “Is it possible to overpopulate with good bacteria using probiotics? And if so, what steps do you take to balance?” So, number one, we can see it with patients that tend to have like digestive issues or SIBO. We see an excessive amount of D-lactate, which can be caused by throwing a whole bunch of Lactobacillus in with the whole bunch of dysbiotic bacteria. So, we can see that. So, number one, make sure we’re starting from a blank canvas, not a canvass full of messiness from the start. Uhm— number two, probiotics tend to be transient. They’re not gonna stay around longer than a month or so. So, they are transient. So— Number one, a good steady dose of them is gonna be fine. So, you know, two to four capsules I think is a reasonable amount, like with my Probio Flora. And I think, you know, some couple sources of fermented foods that you want to throw in a weekly, whether it’s a lower sugar Kombucha, fermented pickles, sauerkrauts, uhm— those are all good standard options that you can kind of add in. And, I think, as long as your digestive symptoms are under control and you’re infection-free, I would not worry about it. If you’re having a lot of blow or gas because of probiotics, you probably have to look a little deeper and see what’s happening with the dysbiosis or other infections.

Evan Brand: Yep. One more questions right next to that. You want to hit that one too?

Dr. Justin Marchegiani: Top herbs for Candida overgrowth?

Evan Brand: Yep.

Dr. Justin Marchegiani: Oil Oregano, Berberines, Silver, not really an herb but it’s still something that we use, uh— Clove, Wild Indigo, grapefruit seed extract; I would say those are a couple, right there. Anything you want to add?

Evan Brand: Yeah. I’d like to add olive—

Dr. Justin Marchegiani: Anything like a medicine?

Evan Brand: Yeah. Olive leaf.

Dr. Justin Marchegiani: Olive leaf, yep.

Evan Brand: Uhm— the monolaurin, the lauric acid…

Dr. Justin Marchegiani: Monolaurin, lauric acid, yep.

Evan Brand: Uh— I would also say— I mean, we’ve got so many formulas. I would just say to look at our— look at our GI formulas. Justin’s got several custom formulas I do as well. You could check our sites,, We’ve got many. And these herbs in isolation can work— can work pretty good, but we’ve really like to focus on the synergistic effective herbs together.

Dr. Justin Marchegiani: Yeah. like, for instance, Berberines, and Artemisia. If you look at Stephen Buhner’s book, he talks about the synergistic effect that you have with those herbs together. So, like one and one equals ten, not two. So, combining some of these herbs, they have to work phenomenal.

Evan Brand: Yeah, uh— you want to hit Tammy’s question?

Dr. Justin Marchegiani: Yeah. “I got stomach pain when I take Proteolytic enzymes. What does that mean? I had H. pylori and stomach ulcers twice in the past. So, number one, I’d make sure you’re not taking the enzymes on an empty stomach. I’ll take them in the middle of the meal. Okay? Number two, I would just see that, you know, if you didn’t take the enzymes, would you also have stomach pain? Or is it— Is the enzymes the only variable factor? And if you have a lot of stomach ulcers and those kind of things, number one, we need a support and start adding some healing and soothing herbs. Potentially, lower the dose and make the food more liquid or predigested in kind of like a crock pot type of format. So, the food is easier to process. Nothing raw. Even if it’s like, raw broccoli or like raw Paleo veggies, that may still be too much. So, I would look at crock pot liquid form, healing-soothing herbs and amino acids. Kind of what’s in my GI Restore. Uhm— add every variable in one at a time so that way you know. You get the foods dialed in, right? You get, you know, the type of food and the cooking process dialed in. You add some soothing herbs. You do the enzymes. You start with the very low dose. You work it up. You isolate. You do one of each variable, one at a time. So, you know what’s going on.

Evan Brand: Yep. And I would like to add. Make sure that you’re infection-free. You said you had H. pylori and stomach ulcers twice in the past. Uh— gastroenterology is very very very uh— inaccurate. Some of their testing. You can have false…

Dr. Justin Marchegiani: Yeah.

Evan Brand: …negative [crosstalk] in every week though. Just get retested. Make sure you’re free and clear. Make sure there’s no other infections or that H. pylori plus vitamins factors, which is something we test for. Make sure that that’s not there.

Dr. Justin Marchegiani: And again, here’s the deal, too. If you’re having issues potentially with food or enzymes, then you sure as heck gonna have issues with herbs to knock out the infection. So, work on the first three R’s first: removing the bad foods, replacing enzymes and acids to the right dosage, taken the right way, healing-soothing nutrients and adrenal support. So, adrenals, ginger tea, amino acids, healing-soothing herbs, and then, make the food really palatable so it’s easy to process.

Evan Brand: Uh— Great. Great advice. Angel, “Do you recommend diet to Diatomaceous Earth for Candida?

Dr. Justin Marchegiani: I think it’s great to help uhm— with the killing and binding effect that’s good at worms. Uh— I use it to kill ants in my backyard when I see them. Uh— Diatomaceous Earth has a high amount of Silica in it and it basically dehydrates the uhm— the exoskeleton of the— the insects. So, it’s a great non-toxic thing. You can also swallow it too so it can— it can dehydrate the worms, too, and kill them.

Evan Brand: That’s neat. Now, question from Narine, “You two are awesome.” Thank you, Narine. Where do you guys practice? So Justin, uh—

Dr. Justin Marchegiani: Everywhere, in the ether.

Evan Brand: Yeah, everywhere. Justin lives in Texas. I live in Kentucky. But, we are 100 percent via phone and Skype consults. That’s it. Uh— Riley, “ How long should you take the GI Restore 4 with probiotics after a parasite killing protocol?

Dr. Justin Marchegiani: Uh— typically, combination— typically, if we’re looking at it objectively ‘til calprotectin goes down, which is an inflammatory uh— protein that’s produced by the gut when there’s inflammation, and/or ‘til you’re infection-free. So, for infection-free, then we really want to see that calprotectin go down, and ideally, that correlates with symptoms and improving in the gut mucosa just becoming better and feeling better.

Evan Brand: I would say, generally, though, the given number— I tried to get people to run…

Dr. Justin Marchegiani: Two  to four months.

Evan Brand: …[inaudible] models.

Dr. Justin Marchegiani: Yep. I think two to four months on average. I know Riley’s case in particular. You know, he’s had issues with H. pylori in the past. So, there could be just some— some thinning gastric mucosa, that’s just more sensitive, and we just need to make sure that infections crossed off our list. And then start the timer, you know, two to four months from when that infection is gone.

Evan Brand: Okay.

Dr. Justin Marchegiani: Kind of thing—

Evan Brand: That’s good. That’s good. Uh— Addy asks, “ Do we  recommend Grapeseed extract for Candida?” Yes. We use it [crosstalk] in our formulas. It can help.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: Uhm— uh— another question here. “Thoughts on prebiotics supplements?” I think it’s our last question uh— that we have time for. “Do we need prebiotics if we have lots of vegetables in the diet?”

Dr. Justin Marchegiani: I think you can throw in some resistant starch either some unripened banana flour or a little bit of a cool potato flour. I think that’s great. Throw in a protein shake. Uhm— we typi— and I think my Probio Flora, and maybe your probiotic, there’s a little bit of Inulin or Chicory root, which can be helpful. Uhm— but in general, some of that starchy carbohydrate, and it can start with the very small amount, can be helpful. And take a look at my videos on resistant starch for more info on that.

Evan Brand: Oh, good. Good. Good. Good. Glad you got a video there. Well, that’s all we got time for, question-wise. I think we hit most of them, though. Unless there were some off-topic. But, we hope this was helpful. Make sure you guys hit Subscribe if you’re not subscribed to the channel. Go ahead. Hit subscribe right now, because you’ll get notified. Make sure you hit the bell too, ‘cause we—

Dr. Justin Marchegiani: Hit the bell!

Evan Brand: …we’re back [inaudible]…

Dr. Justin Marchegiani: Everyone’s like, “Hey, Dr. J, like when are you gonna be live?” So, we’re gonna try to let you know a day ahead of time. But if you hit the bell, It’s gonna pop-up on your YouTube app, on your computer or phone. It’s gonna say, “Dr. J and Evan are live.” And then, you’re gonna know.

Evan Brand: Generally speaking though, you guys should expect us here every Monday at anywhere between 11:30 and 12:00 Eastern.

Dr. Justin Marchegiani: Yeah. That’s the general kind of gist and I’ll be online typically 9:30 to 10:00 CST, which is 10:30 to 11:00 EST on Fridays, for our FAQ for you all.

Evan Brand: So, s— you know, go ahead and stalk us here. Subscribe, hit the bell and we’ll be back for more content very soon. If you have…

Dr. Justin Marchegiani: Oh, one last question here.

Evan Brand: Yeah.

Dr. Justin Marchegiani: One last question. “Can you overdo with herbs?” Yeah, you can, Charlotte. So, just make sure if you’re— people thata are sensitive, they kind of already know it, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: They have issues with Vitamin C and issue with probiotics or issues with HCL, and it’s like— these are patients like we got to take our kid gloves and put them on ‘cause we got to go. Everything has to be very slow and very gentle. And it’s not that you’re— you’re weak or have— you know— It’s not anything— It’s not a negative on you. It’s just your system, where it’s at. So, if we go a little bit slower, it helps. It’s kind of like, you want to take a cold shower, get in the shower. Get it on warm and then just inch the dial a little bit co— you know, to the cold direction. And then, before you know it, in three to five minutes, you’re in a cold shower. And it wasn’t that difficult. So, if we have to, we can go slow. Of course, working on ginger tea and soothing nutrients to get the gut lining more tonifying, relaxing things, adrenal support. And then we can inch into the herbs as well. So, for sure. Absolutely.

Evan Brand: Oh, I’m gonna advise, two cents…

Dr. Justin Marchegiani: Yes.

Evan Brand: …because you made some word adrenal. Yeah. If your adrenals are weak, you gut protocol is going to be much more uh— heavy hitting on you. So, if— if you’re working on with a practitioner and you guys are just looking at the gut, make sure you’re asking questions about thyroid and adrenals and hormones. Because, you know, Justin and I are utilizing a Three Body System Approach, which is adrenals, gut, thyroid detoxification. Things like that.And if all these other pillars aren’t there, and you’re just hitting one avenue really hard, you’re gonna crash out. So, make sure those other— other pillars are involved. Otherwise, the progress will not be as well. And I could explain why you’re not handling the herbs as much.

Dr. Justin Marchegiani: And it’s human nature. Once people find out they have a critter in them, they’re like, “Get rid of it! Oh, my gosh! This is awful.” And I— I get it. So, normal reaction, but we have to make sure the bigger picture is we don’t to get reinfected. The bigger picture is we don’t want to feel worse either. So, there’s this a sequence in which we have to do. And it takes a little bit of trust because the normal reaction is, “Get rid of it now.” “Get rid of it yesterday,” right?

Evan Brand: Yeah. For sure.

Dr. Justin Marchegiani: Okay. Awesome. Well, great call. Slam that bell. Give us a share. We appreciate everyone watching. And hope everyone’s health takes one notch in the right direction today. [crosstalk] Appreciate it all.

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye, Evan.

Evan Brand: Bye.


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Optimizing Your Functional Medicine Gut Program – Dr. J Podcast #164

In today’s video, Dr. Justin Marchegiani and Evan Brand discuss the topic of creating a functional medicine toolbox for your gut health. Learn about the natural ways to modify your diet, improve your digestion, and promote your overall gut health. Watch and listen as they reveal some of the tools in the trade.

Discover some protocols that help aid problems with gut fungus, yeast overgrowth and infection, gut bacteria issues and parasites in your digestive system. Learn about the different steps to take on how to ensure you’re taking the right path for better gut health. Also, stay tuned for more information about how to further catch some knowledge bombs from this functional medicine duo.Optimizing Your Functional Medicine Gut Program

In this episode, we cover:

03:30   Looking at the Food

04:23   Digestive Support

06:10   Silver in the Killing Phase

09:47   Probiotics and Antibiotic Therapy

13:48   Retest




Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. Evan Brand, what’s going on, man? How are things?

Evan Brand: Happy Monday. Life is good. The sun’s gone, though. That’s sad. This time of the year just— gonna start that gray sky, so I’m kind of jealous. I’m sure it’s sunny in Texas right now.

Dr. Justin Marchegiani: It’s a little cloudy out here today, but I was actually in Lake Austin yesterday, water skiing. I got a new suit. It’s about a three-four millimeter kind of thickness suit, so it’s great. I go in the water, doing pretty good. I’ve got some little booties, too, that are neo-printed, and some gloves. The worst thing was the week before. I didn’t have the gloves— is you really— you know— ‘cause when you’re squeezing really hard, right? You kind of squeeze a lot of that blood out, right? You kind of like— you know, white knuckled, so to speak. You don’t have a lot of blood, so your hands get really cold with the air. So those new gloves made a huge difference

Evan Brand: Well, that’s awesome.

Dr. Justin Marchegiani: Yeah. How’re things going on with you?

Evan Brand: Things were good. You know, the baby’s running around and keeping me busy. She basically stole half of my lunch. She took all my carrots and almost stolen my peas, so that’s a lot of fun. You know, tweaking her diet. We just actually ran a GI Map on her. So, we’ll make it to Stool Test back. We’ll have to uhh— chat about what’s on there— Actually, no! I take that back. We got the results. She had Klebsiella on there. So, that’s pretty interesting.

Dr. Justin Marchegiani: Awesome, dude. I got my dog, Butter, here on the YouTube if you guys want to see her. Butter (kisses the dog). We love good healthy fats, that’s why we named her Butter. Uhm— but yeah— so, we’re in the same place. Aden’s doing really good, breastfeeding like crazy. He’s starting to sleep a little bit more, so we’re really excited about that. Really happy your daughter’s going good, too.

Evan Brand: What do you think about the Klebsiella with her? I mean, we’re using some herbs already. It’s like, at her age it makes you wonder. Did she pick up Klebsiella from somewhere? Did she have it? Was that passed through the placenta? I mean, it makes you wonder, her being that young.

Dr. Justin Marchegiani: Yeah. I mean, I would say off the bat, uhm— probably something from your wife? From you guys? And, I would utilize some probiotics and, maybe, one oil of Oregano Capsule a day, or something like that, or maybe decent to help. Keep it really low, though. [crosstalk] But use more probiotics. Anything else?

Evan Brand: We’re doing that tincture, I was telling you about, that’s got the uh—

Dr. Justin Marchegiani: Yeah.

Evan Brand: … I think it’s got the…

Dr. Justin Marchegiani: Yeah. [crosstalk] good one [silence]. That’s a great one. I like that.

Evan Brand: [inaudible] …worked it out. But anyhow— So, I’m sure we can do a whole podcast on that, but I figured, today, you and I should chat about creating a protocol. You know, if you’re trying to create a functional medicine toolbox for gut health, what would that look like? In that could involve things that could help with fungus, yeast, bacteria and parasites. We’ve hit on parasites and— you know, the influence of thyroid health and adrenal health. And we’ve hit on the link between parasites and leaky gut, and leaky gut and autoimmunity. So now, I feel like it’d be good for us to— you know, reveal some of the tools of the trade, which you’ve already mention one, which is the Oregano. So maybe let’s go into the order of operations first. Let’s talk about what comes first, like in this whole Functional Medicine approach. ‘Cause some people, they think probiotics are just be used anytime. And prebiotics, you can just throw them in. But really, there’s a— there’s a Science and there’s an order to herbs. Probiotics may not be the first thing that you should look at for an adult.   

Dr. Justin Marchegiani: Yeah, I know. I uh— I hundred percent agree with that. So, first things first is looking at the foods. If we have certain foods that are more offending and more inflammatory, that’s gonna potentially create the— the breeding ground on which bacteria can overgrow. There’s lots of different bacteria that can grow, so— I mean, we have more of our pathogenic type or Klebsiella, or Proteus, or Citrobacter, rella— or Morganella. These are our dysbiotic bacteria, not so good. They produce toxins in our body. They can eat up B vitamins. They can prevent our good bacteria from producing nutrition. So, of course, we want to make sure those things are under control. We will look at the foods first. Keep the inflammatory foods down. I think, potentially, in your daughter’s situation. They may have been some foods, they may have been slipping in some, like kind of pseudo-Paleo foods, potentially. [crosstalk] What food were you slipping in for her?

Evan Brand: Well, so we were doing the rice flour.

Dr. Justin Marchegiani: Rice flour? [crosstalk] Yep.

Evan Brand: Rice flour and also, there was some Tapioca starch and some of these like dried veggie snacks. They had Tapioca in there. So I’m thinking because, remember, I showed you that she had a small rash into her eye.

Dr. Justin Marchegiani: [inaudible] … improving?

Evan Brand: It’s gone.

Dr. Justin Marchegiani: And what food change did you make?

Evan Brand: The rice flour. We took it out.

Dr. Justin Marchegiani: I think there’s a gluten-sensitivity component there. So, I think [crosstalk] once you get that better, the gut bacteria will get better. So then, once that’s better, you know, looking at digestive support— so if they’re kiddos— I mean, you know, what can you do? So, typically, we’ll do like uhm— We’ll do some enzyme wafers that are really easy to chew and taste pretty good, for the little kiddos, they can eat.

Evan Brand: Is there any good brands?  ‘Cause I looked at some, and it looked like a lot of them had fructose in there, added.

Dr. Justin Marchegiani: Yeah. I mean, I like the Vitalzym’s chewables.

Evan Brand: Okay.

Dr. Justin Marchegiani: That’s a pretty good one. If they can swallow a pill, Then we’d  maybe have them do an HCL enzyme combo if they can get a pill. If they can’t, I’ll do a wafer.

Evan Brand: Ah— okay.

Dr. Justin Marchegiani: I would do that, and uhm— just really making sure they chew their food up really well. Uh— and then— you know, just cutting out the inflammatory food. So that would be my first two steps right there. And, I would even maybe do a smoothie for one meal a day and really just add some extra aminos, add some extra nutrients in there. So, it kind of gives her digestive system a break for at least one meal.

Evan Brand: That’s a genius idea. Did you know that the Vitalzym chewable has the DPP4 in there. So that would be great [crosstalk] if there is a cross-contamination issue going on.

Dr. Justin Marchegiani: Yeah. And that would be helpful. And the chewable— those taste pretty decent, too. Had a couple of kids— Yeah— fed them a couple dozen at least the last few years, do well with those. So, I like those, a lot. And then the next step is, you know, the Killing Phase. We kind of talked about, you know, the foods. We talked about enzyme support. Maybe we add them some gut-healing nutrients. Maybe we add them some collagen peptides. Maybe we add them some L-Glutamine to keep it really simple for the kiddos. Maybe we just put that in our morning shake. A couple of blueberries or berries, maybe a nice scoop of collagen or pea protein to keep it more hypoallergenic, maybe some coconut milk or MCT for some extra good fats, maybe we add some extra L-Glutamine— or like in my Lyme, we use like a GI Restore, some extra healing, soothing mucilaginous herbs, like Aloes, Slippery Elm, DGL Licorice; all very healthy and soothing. And then maybe we start the killing in a month or two later. We could start even with just like a teaspoon of Silver. Right? Twice a day, for your daughter who’s younger, right? Something very, very small. Maybe do one oil of Oregano Pearl, once a day. And over [crosstalk] Yeah.

Evan Brand: Talk more about the Silver. I mean, there’s antimicrobial benefits. I believe there’s antiparasitic benefits, possibly.

Dr. Justin Marchegiani: Yeah. I mean, Silver is proven to help with biofilms. They’re actually— My mom’s still a surgical nurse. She’s been a surgical nurse for like 45 years, and she has even— The last couple of years, they are actually adding in a Silver wrap. So, when they do like a total hip or a total knee, they’re actually wrapping the whole joint with this like Aluminum-foil-like thing, but it’s Silver. And they wrapped the joint before they closed it in that, uhm— to prevent, basically uhm— bac— antibiotic or just some bacteria coming from coming in.

Evan Brand: And that stays in?

Dr. Justin Marchegiani: No, it dissolves.

Evan Brand: Oh, it dissolves. [crosstalk] That’s cool.

Dr. Justin Marchegiani: It’s kind of like a cellophane thing that kind of dissolves. They do it— this one called Seprafilm. They put over like— you know, they do a surgery to prevent scar tissues. So, it’s similar to that. It’s kind of like a cellophane-thin kind of thing they wrap. Not sure of it’s up against the joint directly or if it’s around the fascia and the skin. I’m not sure about that. But it’s definitely enclosed around that joint for sure, to help with the biofilms and the resistant bacteria. Conventional medicine’s getting on board. And they have to, because they have a lot of problems with antibiotic-resistant bacteria. So, they kind of have to.

Evan Brand: Yeah, the C. diff, the MRSA. I’ve even heard of antifungal-resistant. Like this species of Candida diflucan and these other prescriptions aren’t working for even the yeast anymore. They’re— The yeast are evolving and getting too smart. Luckily, in our toolbox, we’re not using pharmaceuticals. We’re using herbs. And in this case, you know, if we’re talking about Candida, you mentioned the silver— We can use Silver against Candida, too. The Oregano can be against Candida. The garlic can be another good choice.

Dr. Justin Marchegiani: Yup, exactly. And there’s some liquid garlic options that we could always give her, too, as well. And then we could do some of the oil of Oregano. I like them ‘cause they’re smaller in pearl. So, like in my GI Clear 5 line, we have that, where we use the emulsified 75 percent Carvacrol extract, so it’s very potent. And it’s a pretty small uh— pearl, so typically, that’s easier to get down. And you can do that with the kiddo. You can do the Silver like I mentioned. And then we could always do some liquid garlic. So, those will be like kind of my options for kids that really had a hard time with pills, off the bat.

Evan Brand: Let’s chat about some statistics. I’ve seen kids as young as one, two, three, four years old, and they have infections, parasites, bacterial problems, a lot of Candida problems. ‘Cause the kids were unfortunately exposed to antibiotics early on, and now they’ve got a massive systemic yeast overgrowth.

Dr. Justin Marchegiani: Yeah. So, of course, anytime you have to use antibiotics. ‘Cause there may be sometimes— you know, you’re scared as a mom or dad, right? You’re like, “Oh my gosh! She’s getting out of control.” Number one, like have some things in your medicine cabinet like the Silver. You know, you could do even some ginger capsules is good, or some higher-dosed ginger tea if you can’t get that downward. It’s gonna be great. Of course, keeping the sugar out. But if we uhm— had to come at it with some probiotics during the killing, we can always add in some probiotics, some powder probiotics, and some saccharomyces boulardii. And we can put it in— in their drink, right? We can get them to have a nice little smoothie. We that in there. Or we could just mix it in, maybe their Kombucha or something. Or we could just come up with some kind of a drink they like and put it in there. That could be some really good options during the killing, and of course, we would do it after for at least one or two months.

Evan Brand: So, what do you think about Probiotics. I mean, some of the training I’ve seen and some of the protocols recommend probiotics during a killing phase and then some protocols don’t recommend probiotics. I mean, it— like—

Dr. Justin Marchegiani: It depends. There is some research showing that probiotics during antibiotic therapy can actually be beneficial. And again, most conventional antibiotic therapies don’t go longer than two weeks. So, I’m not that worried about it ‘cause we’re gonna be giving probiotics afterwards for at least two months. So, I’m not worried about if we want to go do it for two weeks. Do the probiotics while we do the antibiotics. I’m okay with it, especially if you have digestive issues. And let’s say the probiotics really helped and they’re soothing. Maybe they help keep you regular. Maybe you have a history of a lot of rebound yeast overgrowths ‘cause of post antibiotic therapy in the past, then I would. If you don’t, then I would just wait until afterwards. I don’t think you can go wrong if you do. Some people, they have histories of just antibiotics or let’s just say probiotics causing a lot of bloating and gas. And if that’s the case, and I’d probably wait. Yeah. May use some different strains. May use some coil or spore-like strains, or just doing it after the antibiotics. A lot of that flora’s gonna be knocked down. So, maybe the probiotics are more tolerable after that as well.

Evan Brand: And the same thing would apply for just straight herbs. If you were just doing straight herbal protocol. Sometimes, you’re gonna use probiotics during the killing. Sometimes, you’re not. Or you’re always using.

Dr. Justin Marchegiani: Uh— I only use probiotics during the killing, if we’re on a repeat protocol, like if we retested and we have new infections or other factions, just because I want to prevent any rebound overgrowth from happening

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just kind of where you knock them out of the floor down. You even knocked the good stuff back, but we all know, if you do weeding in  the garden, you never have to go back and purposefully plant weeds, right? Weeds automatically grow.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, it’s kind of like that. We’re just kind of throwing down extra seeds during the process to take up the space that maybe those weeds would take. So, it’s kind of like a preventative thing, as well as— It can have benefits with inflammation and it can have benefits with regularity and motility as well.

Evan Brand: That’s good advise. And also, too. You and I see the Beta-glucuronidase enzyme on the Stool Test that we’re running. And if that enzyme is elevated, that could mean your recirculating your toxins and hormones and drugs and stuff like that. And one good way that we can get Beta-glucuronidase back down into normal range is probiotics. So, I love that you bring up [inaudible]—

Dr. Justin Marchegiani: Also— We can also use phages, too. Phages have some really good beneficial effects at knocking down that bacteria. And then, you know, depending on how regular you are, we can even slide in some activated charcoal, too. Some activated charcoal or some like Modified Citrus Pectin, trying to act like a little sponge and soak up a lot of the crap that are maybe sitting around your gut from all that bacteria.

Evan Brand: When would you make the call on that? Would that be like if you have a ton of bacterial infections plus parasites, they could try to treat five or six things at once? Like what if it was just H. pylori? Are you gonna hit the charcoal or not?

Dr. Justin Marchegiani: Depends on the person’s resilience. If they have a lot of fatigue, and they have a history of being more sensitive, or they have a history of lots of antibiotics and like they tell me like— you have like, in the past, antibiotics have really wiped me out, or I’m just really tired or if in fatigue, then maybe I would add in preventatively. I they’re pretty— like if energy’s pretty decent, then I would say, “Let’s wait and see.”

Evan Brand: Yep. .

Dr. Justin Marchegiani: …wait and see. But it’s something that’s always there, you know. Kind of undecked so to speak. So if we need to go, we can go to it. Of course, then one of the first things we can do is ginger tea, ‘cause ginger really helps the lymphatic systems. It’s very anti-inflammatory. Keeps things moving. It’s also a biofilm buster, too, so it helps— it actually helps the uhm— antibiotics work better. There were studies using Silver and ginger and they found that when they used the Silver and ginger, the antibiotics actually work better. So, I tell patients, if you need to use the antibiotic, use the ginger and Silver with it. And then, you can even add in the probiotics to prevent any rebound overgrowth. That way, you get the best of both worlds.

Evan Brand: Nice. That is awesome. And then, uh— I guess the last step in our toolbox— you know, we’re talking protocol, would be another test. Because, once you go through the— you talk us through the process, removing bad foods, replacing enzymes, repairing the gut…

Dr. Justin Marchegiani: Hmmn— hmmn.

Evan Brand: [inaudible] …infections re-inoculating probiotics. Then the last step in this whole protocol is the test itself. Retest and make sure [crosstalk] all the stuff we implemented was successful.

Dr. Justin Marchegiani: Hundred percent, yeah. So, if we have a specific infection we’re going after, we definitely want to put in their crosshairs, we want to aim at it. And then we want to go look to that scope again and make sure we actually hit it right. That’s kind of where that lab test retest would come in. Sometimes, if it’s just insignificant smaller amounts of yeast or smaller amounts of bacteria, and there’s not any major stuff— there’s no H. pylori, there’s no like significant bacterial overgrowth, there’s significant fungal overgrowth or any parasites, then we’ll just based it off of symptomatic relief?

Evan Brand: Yup.

Dr. Justin Marchegiani: Is there anything significant, then I want to make sure that we retest for sure.

Evan Brand: Yeah. It’s a great point. People ask it all the time. You know— “Should I retest?” “Do I really need to retest?” Maybe. But if you feel amazing, maybe we can assume. And your hair’s better, and your skin’s better, and your nails are better— like for me, I noticed when I thought my infections were gone because my weight loss stopped. Like, my weight stabilized, but I still did the retest, ‘caused I had the Giardia, Crypto, H. pylori, Pseudomonas, Candida— I had all of it. That was just too much for me to not spend the money on the retest.

Dr. Justin Marchegiani: Yeah. I wouldn’t give you the choice for those kinds of infections. But let’s say you had just a little bit of like yeast, or you had just a little bit of Citrobacter. It wasn’t off the charts and you didn’t have really awful symptoms, then I would probably say, “Hey, if you feel and improvement, that’s good.”

Evan Brand: Yeah.

Dr. Justin Marchegiani: I would say, “Let’s just keep you in the loop to retest once a year.”  

Evan Brand: So, people say, “Well, how would I know if I’m feeling good Dr. J? “ That would be things like what? If your brains working? Your…

Dr. Justin Marchegiani: Yes. [crosstalk] Everytime I— I chat with the patient, we always go over wins, challenges and corrections, diet, lifestyle, review, supplement review. So, of course, wins and challenges, what’s moving in the right direction at each appointment and what’s moving in the wrong direction. And of course, we have our baseline audit in the beginning. Patient comes in day one. Do patient exam. I got bloating. I had gas. I have diarrhea. We follow up. Make diet changes, lifestyle changes, supplement changes, how much better, what are our wins. “Oh, well. Bloating is down; 80 percent. Diarrhea is down; 90 percent.” And we continue to follow that all the way down. So each time we chat, we’re always checking in. We’re keeping our pulse on everything. I want to know exactly what we’re at, so to speak.

Evan Brand: Yep, well said. So, if those symptoms are still there, maybe the hair’s better but you still got the gas bloating. Well, could still be some yeast or bacteria going on there. Is that safe to say?

Dr. Justin Marchegiani: Yeah. And if we’re running— Let’s say, we’re running like our GI Map or our 401H and it’s looking relatively clean, then the next place we’re gonna go is the Breath Test. We’re gonna go Breath Test next ‘cause then, there may be some bacteria on there we not necessarily are picking up. And the Breath Test is kind of more of uh— a broad general spectrum because it’s looking more of the gases that bacteria is producing. So, not necessarily the bacteria, but it just tells us that there are bacteria there, producing gases if you will.

Evan Brand: How about the [crosstalk] organic acid?

Dr. Justin Marchegiani: The analogy is this, right? The analogy is this. You’re on top of the water. Is someone under the water swimming? Well, how do you know if you can’t see him? Well, you look for bubbles coming up, right? So, think of the gas that comes back on the Breath Test is like looking for bubbles on the surface trying to see if someone’s in the water.

Evan Brand: So, may I ask you this, too. What if someone’s like, “Aaaah! I don’t want to do SIBO Testing.” What about just coming in and giving some Broad Spectrum Antimicrobial Support— maybe we throw in some of the SIlver or some of the garlic?

Dr. Justin Marchegiani: Yeah. It depends. I mean, typically, when I’m recommending SIBO Testing, people are having more severe issues and the issues have been more chronic, and they’re just more motivated to get answers. So, it just depends, right? The more intense the symptoms are and the more chronic some thing’s been, people typically wanted to know what’s real. They want to be able to put their finger on it, so to speak. So I, typically, will recommend that. Uhm— if they said let’s just try it first, then I can get more to agree that, “Hey. if we didn’t get it to improve, then Round two.” “I don’t want to retest” I’ll try to get that negotiation moving.

Evan Brand: Yeah. So, long story short, you know— we try to base everything on labs cause if you don’t test, you’ve guessed. And we try to minimize guessing and checking ‘cause a lot of practitioners do that. We’re just not huge fans of guessing because you spend more money in the long run and the clinical outcome is not as good. Then that comes back on us. “Hey. Why didn’t it work?” “Well, ‘cause we’re shooting into the dark.”

Dr. Justin Marchegiani: . Well, also like. Let’s say, we come back. Let’s say, we did a Breath Test, right? And let’s say, hypothetically, the person was at a hundred for Hydrogen and 50 for Methane, okay? And then let’s say, we did a protocol. And let’s say those gases cut in half but they were still symptomatic. Well, does it kind of— Isn’t it nice to know that you had 50 percent improvement on some of those gases and that you’re moving in the right direction? Like, imagine you had a map, right? And— like Google map, right? And they only told you, you are on the right path once you got there.

Evan Brand: [laughs]

Dr. Justin Marchegiani: Well, don’t you have to want a confirmation that you’re moving in the right direction, right?

Evan Brand: Yep.

Dr. Justin Marchegiani: That’s kind of how I look at it. And the more complex and the more severe someone is, the more I like that because it gives me confidence as the doctor, that we’re doing the right stuff. But the patient is doing really well and some of the things and some of the things are really working well, then sometimes uh— I’ll let that one slide. But, I’ll let them know as a caveat that if— if we go in the wrong direction that’s gonna be our Plan B. And also I want to let people know what our Plan B is, just so they don’t think like, “Uh! Well, uhm— That’s all I got. I’m a one-trick pony,” Right? So, I want to let them know we got second options and third options, so to speak.

Evan Brand: Have you used a BioHealth? I know they’ve got a SIBO. I know they talked about a lot.

Dr. Justin Marchegiani: That’s the panel I use. I use the 900 SIBO Breath Test. .

Evan Brand: Oh, okay. That’s the best one.

Dr. Justin Marchegiani: I like it. It’s a three-hour.

Evan Brand: Okay.

Dr. Justin Marchegiani: It’s a three-hour test, and that’s nice to see the three-hour because you can get that whole window and you can see where it transitions at two hours to three, which is nice.

Evan Brand: Awesome. And then, what do you want to see on there? I mean, does that kind of like an adrenal profile where you’re gonna have a reference range?

Dr. Justin Marchegiani: Hmm— Yeah. We want to see Methane three or below, and we want to see Hydrogen 15 and below. Below 15, ideally.

Evan Brand: And— and— So, let me ask you this. If you have an overgrowth of good guys, you know, on the GI Map, sometimes, we’ll see the beneficial bacteria show up high. People always target these bad bacteria, but it— you can’t have too much of a good thing. If you have too many good guys, could that also show up and trigger those?

Dr. Justin Marchegiani: Well, if we’re running an Organic Acid Test, we would look at the lactate being elevated and if we saw that there, most people are gonna know because they’re gonna feel more bloated and gassy with probiotics. They’re gonna feel it. They’re gonna be more probiotic intolerant. So, we’re gonna know that, alright? There’s gonna be— you know, We’re gonna have specific symptoms that we’ll be able to see clinically. And then I would just be using more spore-based probiotics, instead.

Evan Brand: Okay.

Dr. Justin Marchegiani: That I’ll probably use Saccharomyces boulardii and spore-based probiotics. First is— you know, like in my line, we used like the Probioflor, which is like bifidobacteria lactobacillus. The unique thing about my Lyme is we have the Phagen. So, the phage does have some antibacterial effects and it comes from a non-dairy culture. So, a lot of people can tolerate mine. But if you’re just doing a run on the milk probiotics, and there’s no phage and— and there’s dairy in there, potentially, then there may be a problem.

Evan Brand: Yep. Yep. Well said. I think that’s it. I think we killed that one fast, but very effective. Were there any pieces to the whole protocol talk you wanted to mention?

Dr. Justin Marchegiani: I think we hit it pretty good, man. I think we’re really on the right track. Let me just see if we got any questions. I have kept my uh— question window down. I apologize for ignoring everyone.

Evan Brand: Let me see.

Dr. Justin Marchegiani: We got—  Oh, then we do now some questions. Let me see what’s going on here guys.

Evan Brand: Uh, Waled said that he hopes that we talk about Lyme disease treatment. Maybe we can do a whole podcast on that. I mean, Justin and I are continuing to learn more about the different protocols. There’s many protocols for Lyme.

Dr. Justin Marchegiani: I think a lot of people with Lyme are overtreated though. I think there’s a sequence that you have to go and work through. Like if you have a cute Lyme and you came back with uh— a bull’s eye rash, or you got any tick bite and then some symptoms follow right away, definitely go after that right away. But if it’s a chronic kind of thing, you need to get everything worked through. You need to get all your hormones work through, digestion worked through, diet and lifestyle worked through, worked through all the gut stuff, worked through the detox, and then get to the Lyme later. Uhm— so, a lot of people I find, I think, are misdiagnosed. Their immune system’s so screwed up ‘cause of other things, and then they’re seeing some Lyme come back, because, of course, everything’s gonna come back. Their immune system is down, right? It’s like, you open  your house up, and you got— you know, you come home one day, and there’s ten homeless people laying in the kitchen. Of course! Your house is wide open, right? [crosstalk] So, think of that as kind of like your gut when your immune system’s super low.

Evan Brand: Yep, well said. And, you know, the thing with the Lyme, antibiotics are very, very, very overused. And if you read some of the work that Steven Buhner’s put out. He’s got multiple books on this subject about antibiotics. Unfortunately, in many, many cases, for chronic Lyme, they just don’t work. And he’s seen a lot of people get sicker from the antibiotic. So, herbs, luckily Lyme and these other bacteria, they are still susceptible and allowed to be killed from herbs. Antibiotics— it’s not working.

Dr. Justin Marchegiani: And this is really important, too. This kind of dovetails with today’s podcast. If we do a whole bunch of killing, where does that all go? Well, it typically will and get dumped in via the hepatobiliary system and then obviously, some of the killing will happen in the gut. And then, what if our motility is not good? What if our digestion is not good? Well, it’s gonna back you up even more and you’re gonna reabsorb more of those toxins, right? So, that’s why we really want to make sure things are moving, digestion is doing good, our motility is doing good, our immune system is better. And then we have things that really help with uhm— coagulation, meaning, we’re keeping things moving. We’re not letting them— things get like static and coagulated and sticky and stuck. We want to keep it flowing.

Evan Brand: Yeah, well said. I mean, I think we may— maybe oversimplified the protocol talk, but part of that is just making sure that you’re not constipated. I mean, pretty simple, if you create all the garbage but you never take the trash out, that’s not good. You’re gonna have an overflow.

Dr. Justin Marchegiani: Totally. Totally. So, couple other questions here. Thanks Monmon for sharing the live show on your Twitter. I really appreciate it. Question for me. How old I am? I am almost 34.

Evan Brand: Nice.

Dr. Justin Marchegiani: Almost 34. Uh— Suggestions for root canals? I would uhm— do your best to try to read Ramiel Nagel’s book. I would do oil pulling and I would do your best to try to avoid it. See natural doctor. If you have to get it, get a full extraction. There is new research or new therapies coming [crosstalk] Stem cell therapy as well. I posted a video on my YouTube and my Facebook channel about it today. Take a look at that,— I should say,, or click on the the facebook link. I don’t know what the topic is. I came in late. Okay— So, Pheochromocytoma. I think that’s a tumor on the kidney that produces excess aldosterone. I’m going back to like doctorate school physiology class. I think that’s the aldosterone-producing tumor. So, I mean, all the stuff we would do for cancer: Ketogenic diet, uhm— toxicity, coffee enemes, crucumin— all of that. I’ll let you hit the rest of them. Go ahead.

Evan Brand: Yeah. Let’s see what else we’ve got. Uh— Tessa. Wanting to know about starting Iodine, what to do to get started. Uh— Dr. Korosin talks about Iodine a lot in the aspect that many people are doing it, but if they have thyroid antibodies, it’s making the situation worse. So my advice would be get your thyroid panel run. Look for the antibodies first ‘cause you could if you have [incomprehensible], you could make yourself worse if you go start pumping a bunch of Iodine. And uh— Korosin’s got a bunch of literature he link’s, too about that conversation.

Dr. Justin Marchegiani: Keep the Selenium in there, two to four hundred micrograms. And once you’re stable, if you want to play around with some Iodine, hundred and fifty micrograms to start at one drop or one hun— 150 microgram dose, you know, per week, installing increase. They just make sure the B vitamins, the vitamin C, the Selenium, the Magnesium, and the Zinc are all in with it. And also, stay tuned for my Thyroid Reset Plan book that will be coming out in the next six months.

Evan Brand: Oooh!

Dr. Justin Marchegiani: It’s [inaudible] … draft for the first half of the book, just the other day, so I’m really excited about it.

Evan Brand: Congratulations.

Dr. Justin Marchegiani: Yeah. Thank you.

Evan Brand: Alright. Let’s keep going. Uh— Home remedies for flu and what to eat everyday to avoid s—

Dr. Justin Marchegiani: Uh— Remedy. Last week’s podcast. We did a whole podcast on it. Also I did a whole blog post: “What to do when you get sick” Part 1, Part 2. Part 1’s on the diet and lifestyle. Part 2 is in the supplements. So, that answers your questions right there.

Evan Brand: Man, Justin is killing it today. All great. Another question. Is it necessary to take HPA Access Support during a Kill Phase if you’re in Stage 1 or 2? I would say, it depends on your constitution. I think Justin would agree and…

Dr. Justin Marchegiani: Yup.

Evan Brand: … depends on your sleep, your stress level, how many hours are you working, how much rest are you getting. Are you working or are you off from working? What’s your circadian rhythm look like? Are you travelling? What’s going on? Like, what’s in that stress bucket?

Dr. Justin Marchegiani: I would say yes. It’s always gonna be good. And then depending on how much stress would be what we’d— what specific herbs we would recommend.

Evan Brand: Oh, we take adaptogens everyday, so we’re gonna say yes always.

Dr. Justin Marchegiani: Yes. I got some Ashwagandha here. So today, I’m crushing the Ashwagandha Supreme, right here. Absolutely. I’m gonna hit two right up now. I love it. It helps with my mood. It helps with sleep. It helps with energy. I find two. I can take it before bed if I— I get like disturbed or like stressed out, because— I don’t know. I watch the news or uhm— just something happens. Like, I just got some project. I got to do some deadline. Taking that really helps kind of curtail the Cortisol rush at night, along with uhm— some GABA and Magnesium, too.

Evan Brand: Yeah. I’ve been hitting Ashwagandha, the Reishi, the Motherwort, the Ziziphus, Albizia, the GABA, Chewable PharmaGABAs. I love them. Those were all good choices. “Hello, Dr. J and Evan. How much probiotics  are appropriate for a two-year old after antibiotic treatment for Bronchitis. If you’re looking into those infant strains that we’re using, some of the infant probiotics, typically— if we’re talking powders, it ends up being about…

Dr. Justin Marchegiani: Quarter teaspoon, right?

Evan Brand: … about quarter to a half teaspoon per day…

Dr. Justin Marchegiani: Yup.

Evan Brand: … for my daughter. We’re doing that currently. And she’s a little less than two years old but we just put it into her drink of water, and she just sips on it all day.

Dr. Justin Marchegiani: Yeah, and then for us, like my son Aden, I’m just like basically tipping my finger a little bit and some— Like I dump some probiotics on like the uhm— the container, and I’ll just kind of slip my finger and I’ll just touch it. And then I’ll apply it to his gums. Or like, we’ll put it on my wife’s breast, where like my child will feed from and just apply it there. And then, when he feeds, he gets the probiotics that way. So, you can do either way, if [crosstalk] they’re still not doing solids.

Evan Brand: That’s a good idea.

Dr. Justin Marchegiani: The infant’s strain’s great. That’s really what you want, I think, up to age four. [pauses] Yeah, up to age four, like that’s when you want to be just doing the infant’s strains.

Evan Brand: Uh— Tessa gave us some more follow-up about the Iodine question. She does not have a thyroid and has grave disease. Would that change your—

Dr. Justin Marchegiani: So, Dr. Wright has a protocol for graves where he does really a high amount of Iodine to basically overload the Iodine symport system, and then downregulate uhm- hormone Iodine or let’s just say thyroid hormone production. There’s that protocol. What’s out there? Dr. Wright’s— Jonathan Wright’s Protocol. I personally— and again, you need to be working with the clinician with this. Graves, it’s really serious. I mean, all of these conditions, I don’t recommend just doing Dr. Google. Like, we’re giving a lot of good information, which is great. But you really want to be working with someone in applying it. But for hypothyroid graves, we’re doing L-Carnitine, we’re doing Melissa and Lemon Balm, okay? Blue Flag— We’re also gonna be doing Lithium Orotate. Okay. And of course, an autoimmune Paleo type of template. I did multiple patients over two hands full that I had taken them out of grave-like states, so to speak.

Evan Brand: What’s the Lithium doing?

Dr. Justin Marchegiani: Well, Lithium has an effect on modulating the thyroid hormones.

Evan Brand: Oh, wow! That’s cool.

Dr. Justin Marchegiani:  Yeah. Lithium Orotate, we— I typically just uh— a formula used with the combination of Melissa or Lemon Balm and Blue Flag, and a couple of other herbs in there that are really helpful. The Carnitine, the Lithium; that’s gonna be great. And of course, you know, we added some Selenium, too, to help with the antibodies.

Evan Brand: Nice. Nice. Great. Great follow-up there. Very— Very good. Uh— does oil pulling really help? Yeah. It does. We’ve used uh— oil pulling ourselves. Both of us have, but there’s some— there’s some cool things you can do with it too. And there’s actually some testing you can do to look for all these different infections, like Hidden Cavitation infections. In the oil pulling, there’s some cool literature on like Silver and coconut, and all that, helping with like oral bad guys.

Dr. Justin Marchegiani: Absolutely. Vitamin K, too, is gonna be excellent for root canal stuff. Of course, collagen. Your teeth’s gonna be— have protein as well. So, good collagen peptides is gonna be excellent as well.

Evan Brand: Uh— last question here from Roslyn. “My SIBO test results are Methane 60+, Hydrogen 20; probiotics do not agree with me.

Dr. Justin Marchegiani: Yeah. Imagine, Roslyn. Are you also constipated, too? Can chime in there? Methane— typically, he put in a Methane diameter and a more constipated Hydrogen, dominate more diarrhea. You’re still positive on the Hydrogen, too. So you may have a— you may also alternate with the two. So, if you can Chime in there fast and let us know what your motility is like, I can answer you more specifically.

Evan Brand: Yeah. And we’ve used that ___[30:51] Formula. It’s got some of the Quebracho extract in there, which can help drop Methane.

Dr. Justin Marchegiani: Quebracho. [crosstalk] Love it.

Evan Brand: Quebracho. Sounds like a part here something. I don’t know.

Dr. Justin Marchegiani: I love it. It’s great.

Evan Brand: Like if— If Roslyn doesn’t get back to us, then we’ll just assume that if Probiotics are not agreeing and Methane’s that high.

Dr. Justin Marchegiani: So, of course, you know, if let’s say she is more constipated, then we would do things like ginger and natural prokinetics to keep things moving. We use ginger tea. Uh— maybe some of the Iberogast formula to keep things moving. Another support I used, called MotilPro, which is excellent. And then, we work on knocking down that bacteria. We probably hold off some of the probiotics if it makes it worse. But we’d make sure things are moving. Maybe even some uhm— Magnesium citrate to keep things moving too.

Evan Brand: Yep. Good advice. Vitamin C, too. You could pump by, what? Two to five grams or so. Vitamins C. That should be enough to move the bowels.

Dr. Justin Marchegiani: Probably a little higher than that, but yeah. I mean, I think, two maybe a little light, but definitely five to eight, five to nine will probably move it for sure.

Evan Brand: Okay, cool. Uhm— more more question here. Why can’t my eyes handle bright light? It could be due to the adrenals.

Dr. Justin Marchegiani: Adrenals, yup. Hundred percent.

Evan Brand: Typically, weak uh— weak adrenals, so definitely get your adrenals tested and looked at some of the adaptogens to help handle bright light. Like the people, you know, especially the women who come out of the grocery store. The first thing they do is pop down those sunglasses on and they just can’t live without them. That tells me adrenal problems.

Dr. Justin Marchegiani: Yeah. I agree. Hundred percent. Alright, cool. I think we answered almost everything. Would spore probiotics Just Thrive be enough to repopulate to the  gut after the Kill phase or should you rotate the— I would rotate other strains. I’m not familiar with Just Thrive. I’m a big fan of MegaSporeBiotic. We have it on our site,, under Gut Section. We’ll put the links in the Show Notes. I like that one. There are a couple of others that are out there that are really good. I know uhm— Primal Defense by Garden of Life is a decent one. I like the MegaSpore, though.

Evan Brand: Yep. Cool.

Dr. Justin Marchegiani: And then, Sue says, “My—” ‘Kay. So, I don’t know. Yeah, so that’s about the Pheocytochroma. Not sure if you have. That’s a tumor. So, you’d really want to get that uhm— resolved there with your doctor. But you’ve got to go on  like anti-cancer protocol for that. Uhm— hope that helped guys. Any other questions, comments, or concerns, Evan?

Evan Brand: I think that’s it for today. If people want to reach out. Schedule a consult with you. Check out Justin’s site, You can book a consult with him. If you like to book a consult with me, either of us, we’re happy to help you. You can just check us out; is me. And make sure you subscribe to the YouTube channel here. We’re what? Thirty three plus thousand so— [crosstalk] Let’s get Justin up to fifty grand, you guys. and then a hundred, and then a million. So, subscribe, subscribe, subscribe, and share, because sharing is caring. And Education is the first step to greatness. How can you approach this stuff if you have no clue. You can’t. You got to learn, and then you can apply.

Dr. Justin Marchegiani: Absolutely. And just so everyone know, if you’re listening to us on YouTube. You know, we have the conversation and the video kind of going back and forth, so you can see our ugly mugs. But we also have the podcast link, and we are recording our podcast in super high audio quality. So, if you want to upgrade the audio, feel free and subscribe to our podcast channels. Again, we’ll have them in the show notes if you listen to Evan or I. We have the upgraded audio for you and that’s only been the last month or so. So, we’re really trying to up our game, guys. We want to make sure you get the best information at the highest quality on your fingertips.

Evan Brand: Yeah, so that’s on iTunes. So, look up Justin Marchegiani, or just type in Beyond Wellness on your iTunes or podcast app. And you can subscribe there. Cool thing I’ll tell about, Justin, iTunes just released a Podcast Analytic so now we can check and see our people actually paying full attention for the full episode or is everybody stopped listening after 20 minutes. Now we can see the drop-offs. That’s pretty neat. And then, for my show, it— just type in my name, Evan Brand, and you’ll find it.

Dr. Justin Marchegiani: Absolutely. I think if you go to, there’ll be a link for your podcast. If you go to or, there’ll be a link there for the podcast. Click it. It will bring you to the button where you can subscribe. And then, we’ll make sure you get updates as soon as you can. And then also, if you’re listening on YouTube, smash the bell. YouTube’s doing some funny things you’re not gonna get the notifications if you are subscribed. So, hit subscribed and then smash the bell right next to it. That way, you’ll get all the notifications. And we’re gonna try to continue dropping lots of knowledge bombs. Let us know. Give us some comments below the channel if you’re listening on YouTube about this. We want to hear some of your concerns. We’re gonna work on responding on them a little more. And also, we want to get more feedback on what you guys want to talk about. So, let us know. We really want to engage you and bring more information. You know, our goal is to help, you know, ten million people. So, you know, we’re doing in the thousands range right now. We want to help more. So, allow us to help you by figuring out what your needs are and let us help you fulfill it, okay?

Evan Brand: Amen. We’ll see you guys after Christmas. So, I hope it’s good for everyone.

Dr. Justin Marchegiani: Yeah. Merry Christmas to everyone. Happy holidays, too. And hope you guys have a happy healthy New Year. And check out our hacking the holidays podcast. Lots of good solutions there so you guys can kick butt, stay healthy and not get sick throughout the holidays.

Evan Brand: Amen, brother.

Dr. Justin Marchegiani: Hey, Evan. great chat with you, man. You take care and Merry Christmas.

Evan Brand: Take care. Merry Christmas. See you.

Dr. Justin Marchegiani: Take care. Bye now.

Evan Brand: See yah.


Jonathan Wright’s Protocol by Dr. Jonathan Wright

Steven Harrod Buhner

Functional medicine solutions for SIBO (Small Intestinal Bacterial Overgrowth) – Podcast #98

Dr. Justin Marchegiani and Evan Brand dig into a lot of the things that you need to know about SIBO — the causes, lab tests and treatments available for small intestinal bacterial overgrowth.

SIBO - small intestinal bacterial overgrowthLearn to differentiate SIBO from other digestive issues and/or infections when you listen to this podcast interview. Get to know about symptoms and lab tests to confirm SIBO as well as the functional medicine approach that will pave the way to gut healing. Find out the root cause of your gut problems and not just focus on the issue of SIBO so you can get effective treatment immediately. 

In this episode, topics include:

3:57   What is SIBO?

6:59   Testing for SIBO

10:27   Causes of SIBO

12:13   Autoimmune Paleo Diet/Specific Carbohydrate Diet/Low FODMAP

26:10   Treatment with supplements












Dr. Justin Marchegiani:  Evan Brand, it’s Dr. Justin here, man! Happy little Monday! What’s going on for you?

Evan Brand:  Hey, thank you! Well, this baby is coming apparently. That’s what’s coming.

Dr. Justin Marchegiani:  It’s exciting. I know we talked about it on Friday. You were getting close, still not quite there yet but you’re almost coming down the hill on this one.

Evan Brand:  By the time this show goes out, the baby will be here.

Dr. Justin Marchegiani:  Super exciting!

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And this is gonna be a Paleo baby, right?

Evan Brand:  Yes, absolutely.

Dr. Justin Marchegiani:  Nice. So do you have a Paleo baby name set up yet?

Evan Brand:  Su—Summer.

Dr. Justin Marchegiani:  Oh, is that the name?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Oh, awesome! That’s great!

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Very cool. I know, if it was like a—a last minute kinda judgment call. That’s cool.

Evan Brand:  Thanks, man.

Dr. Justin Marchegiani:  Perfect and it—it’s almost, it’s not quite officially summer yet, June 21st, right?

Evan Brand:  By the time this show goes out, it probably will be June 21st.

Dr. Justin Marchegiani:  It probably will be. Yeah, actually it will be past that. I guess it’ll probably come out in late June. So that’s great. Awesome timing. Good to hear.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Any other updates on your end here?

Evan Brand:  Everything’s great. Just seemed to be plucking away at any road blocks that have been in my health journey and—and other’s journeys. So I think every week you and I chatting about a new topic is really empowering people. I’m continuing to get good feedbacks, some new 5 star reviews on this show for iTunes, so everybody seems to be liking the direction that we’ve gone with these—with these episodes. So it’s always good to have the feedback.

Dr. Justin Marchegiani:  Love it. Love it. Any good treatment cases last week that you wanna share?

Evan Brand:  Last week, let’s see. I’ll look at the calendar and that will help me to refresh my brain. Yeah, actually I do have a good one. So a guy is actually a rocket engineer. He builds rockets for shooting up satellites and spaceships–

Dr. Justin Marchegiani:  Yup. Uh-hmm.

Evan Brand:  Into outer space and his brain is not working as well as it should be.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  So immediately upon starting to work with him, I got the Neuro Synergy product to him, which is several different brain vitamins and I got an email this morning and that said that his brain is starting to work better. So within less than a week, changes in cognitive function, that’s pretty insane. So the huperzine and some of the other brain-boosting nutrients that I’m using with him is very effective. So I think sometimes we don’t have to wait for people to have their lab test results. We can just immediately throw some nutrients their way that we know they’’ll benefit from that might help them and can’t hurt them, so to give them that motivation because you and I like to get people at least 5-10% better each month and if we can get you started on some nutrients while you’re waiting for your labs, then that’s gonna be great.

Dr. Justin Marchegiani:  100%! Same here with me. I mean, we have lots of autoimmune patients that come in every single week. We make simple dietary changes like transitioning to an autoimmune and/or throwing in a low FODMAP eating plan and we see remarkable changes and then we just add just simple things, like getting extra nutrients in through a good high-quality multivitamin. Getting better digestive support on board there, helping to support the hormones and the adrenals or diagnosing any underlying thyroid imbalances and getting rid of infection. It’s amazing just what type of healing capacity the body has when you just remove those roadblocks.

Evan Brand:  Absolutely! My sleep’s been better than it has in probably 5 or 10 years. So who knows how long I had my gut issues going on? Like seriously. Every day I wake up, I’m like, “Wow! I was sleeping deep.” It’s just mind-blowing.

Dr. Justin Marchegiani:  Well, you’re gonna need that sleep with this new girl on the way here so–

Evan Brand:  Tell me about it!

Dr. Justin Marchegiani:  You’re gonna need efficient sleep.

Evan Brand:  I know.

Dr. Justin Marchegiani:  Great. Well, we talked pre-show that we were gonna address some topics of SIBO today, and then we’ve kinda interlaced or intermingled SIBO in other topics that we’ve addressed on parasite infections and probiotics and other types of digestive issues, but today this is gonna be a podcast just focused on SIBO and—and what SIBO is essentially and just to kind of give the abbreviation here, SIBO stands for small intestinal bacterial overgrowth and to keep it really simple is that we have a lot of the bacteria from the large intestine kinda creeping its way back into the small intestine. In a nutshell, that is what SIBO is. It’s basically bacteria from the colon kinda being in the wrong spot in the intestinal tract typically making its way back towards the small intestine. I’ve done a lot of videos on this. I know you have done some stuff, too. So go to or and Google just SIBO and you get a lot more info on this. But essentially we have that ileocecal valve that kind of is the capacitor that restricts entry from the small intestine to the large and it starts to open up and we start to have this bacteria creeping back into the small intestinal tract.

Evan Brand:  Yeah, so looking at some of the research, the latest statistic I found here is that in terms of like irritable bowel syndrome, you know, SIBO is one of the most common causes of IBS, so it certainly could have been a factor for me with my IBS struggle. It says here up to 84% of IBS cases have been linked to SIBO. So if you’ve been told by the conventional doctor, if you go in and you have some of the constipation, diarrhea, bloating, abdominal pain, all the other symptoms that can happen. You go to the gastroenterologist that you probably get referred to, they’ll just say you have IBS. It might be SIBO and that’s certainly what I’ve seen and definitely you’ve talked about it all the time. You see it every single week how many people are dealing with this. So it’s—what would you say? 6/10, 7/10 people that are presenting with gut symptoms actually have SIBO?

Dr. Justin Marchegiani:  Yeah, I mean a lot of people that are coming in with digestive issues more than likely have SIBO. The question is, is SIBO the root issue? So we know a lot of the SIBO symptoms are abdominal pain, discomfort, bloating, diarrhea, constipation, gas bloating, etc. And a lot of people that have gluten issue or other infections like H. pylori or parasitic infections or fungal overgrowths which may not be considered SIBO per se, but they tend to mimic a lot of those small intestinal bacterial overgrowth symptoms, so we wanna rule those out because I consider the deeper infections upstream issues and I can consider the lot of the SIBO stuff downstream. Now it’s not to say that SIBO isn’t a contributing factor. It’s not to say that we don’t have to address the SIBO because a lot of the herbs that we use to knock out the higher up infections can be sensitive to a lot of the SIBO type of overgrowth that we see anyway. So in other words, SIBO is important. Most of the people we always wanna rule out the upstream stuff first. I typically don’t ever go to your typical SIBO breath test to evaluate SIBO until we’ve ruled out the deeper infections because if we have H. pylori, if we have a parasitic infection like Giardia, Crypto or Blasto, it makes sense that the collateral damage of SIBO, that bacterial overgrowth will be there.

Evan Brand:  So you’re saying it’s not even worth it technically if you just go straight to the typical hydrogen-methane test at this point. We need to really look at running the comprehensive stool panels first with people presenting with these symptoms because that’s gonna give us the most bang for our buck in terms of identifying underlying causes and if you go in and treat SIBO but you haven’t removed the infections and people will still struggle, right?

Dr. Justin Marchegiani:  I see that a lot. I’ve seen a lot of patients that have come from other functional medicine doctors that just specialize in SIBO–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And have only had their SIBO treated per se and they may use the—the conventional SIBO antibiotics which are like rifaximin or neomycin, a 10- to 14-day kind of dose of that, typically 500 to 1000mg b.i.d., it depends on what the doctor prescribes on that. So I’ve seen that and then they still come in with symptoms and then we’ll test and then they have Blasto—Crypto or Blasto, and H. pylori. So I think SIBO is important to assess and we’ll talk about how we can assess that but we wanna rule out the upstream. I always upstream to downstream.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  What could cause the most collateral damage to the least, that’s kind of how I assess things. It’s pretty conservative that way we’re not doing 100 tests at once. You know, we can start with 1 or 2 tests, focus on the gut, cross those off our list and then go downstream to a SIBO assessment. Now there’s typically 2 for the most part. There’s the more invasive sample where they’re going into the intestinal tract via endoscopy, right? Through the mouth down the esophagus and doing some kind of a sample to look at that—get a—a sample of that bacterial issue, that’s one way. That’s like the most, like the gold standard, because then you know, okay, I’m getting this sample of this bacterial overgrowth sample and it’s coming from the small intestine and we know and we can confirm that shouldn’t be there. It’s an overgrowth. That’s like sample #1 or measure #1 but it’s pretty invasive.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Typically don’t do that unless someone’s very, very sick and it’s typically done by the conventional doctor ahead of time. In a less invasive way, it’s what’s called a small intestinal bacterial overgrowth breath test, where they give a sample of lactulose or sometimes if we’re looking at the upper small intestine, the upper stomach I should say, they’ll—they’ll give a sample of glucose, but typically lactulose because it takes about 100-120 minutes, about 2 hours or so to get down into that lower small intestinal tract, you know, by that duodenum and ileum area, that part of the intestine, and then we can see elevation in certain gases, whether it’s elevation in methane, whether it’s an elevation in hydrogen or we’re looking at a—a combination of methane and hydrogen together, and that’s typically what we’re looking at and we’ll see things, a greater than increase in methane above 3, some will say is an issue and could be indicative or SIBO, some say above 15–

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  Typically if we’re looking at a combination of methane and hydrogen, somewhere between 15-20 is gonna be positive. Again, some of the test will have these ranges on it like if you look at the National College of Naturopathic Medicine, they’ll have their ranges. Commonwealth Labs will have some ranges, too. I think there’s another lab called ARO Labs, their another one that has–

Evan Brand:  I don’t know–

Dr. Justin Marchegiani:  SIBO as well.

Evan Brand:  I don’t know if you saw BioHealth doing SIBO now. They just released it.

Dr. Justin Marchegiani:  Oh, I didn’t see that one.

Evan Brand:  Last week.

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

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And it’s breath testing?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Oh, that’s great. I’ll have to–

Evan Brand:  Yeah, I’ll–

Dr. Justin Marchegiani:  Subscribe to that test.

Evan Brand:  Yeah, I’ll send you—I’ll send you the clinician sheet about it here. And let’s talk about some of the other causes, too. So you talked about parasitic infections, like if there is an infection in the gut, that could definitely cause SIBO because of the damage that’s gonna be done and you talked about the diet a little bit, too, you know, in terms of like patients doing a lot better with a low FODMAP diet. So if we see like a lot of carbs, sugars, fructose, that’s gonna be an issue. If they were on PPIs before. What are those—what are the common brand names of the PPIs? Is it like a Prevacix, what is it called?

Dr. Justin Marchegiani:  Yeah, you have Prevacid. You have omniprazole.

Evan Brand:  Prevacid.

Dr. Justin Marchegiani:  With the generic.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  You have Nexium. You have Prilosec.

Evan Brand:  Which are all over-the-counter at this point? They almost all used to be prescription. I guess now the patents are up so people can do and destroy their gut with these things by just jumping on a strong PPI like that. Candida, a lot of times if you have candida, you’ll have SIBO at the same time.

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  If you went through antibiotics. Let’s say that you’ve got like bronchitis or you got some type of sickness and the doctor threw you on a round of antibiotics. That can really be a good—a good trigger for SIBO and I’ll see that a lot and that’s one of my intake questions is, have you gone through a round of antibiotics recently? And a lot of people say, “Yes.” And so we don’t necessarily have to go straight into the SIBO test like you say. If we get the stool panel run or the organic acids, so we can see like infections and candida overgrowth, a lot of times the treatment for that is gonna overlap and start working at getting rid of the SIBO in a way, right? If we’re using some of these natural antimicrobials and herbs and say oregano, garlic, things like that, we may knock out the SIBO just as a by-product of getting rid of a parasite or bacterial infection.

Dr. Justin Marchegiani:  Exactly. So when we look at that, the fore of the first dietary changes we’ll do is that I always typically start with an autoimmune diet because a lot of the symptoms of inflammation can be a lot of SIBO symptoms. So cutting out things like nuts and seeds, and—and nightshade vegetables and even eggs, just off the bat, get them to a baseline autoimmune kind of diet is—is a good place to start. And then from there what we typically do is we assess. We’ll reevaluate a few weeks later to see how we’re doing. We’ll probably add some hydrochloric acid and enzymes in because a lot of patients that have these issues, they’ll have—they’ll have a history of being on PPIs like I mentioned, these acid-blocking medications. These acid-blocking medications create further deficiencies in nutrients, such as various minerals like magnesium, selenium, zinc, and we need some of these nutrients for healthy thyroid, adrenal relaxation, and even to make hydrochloric acid. So you can see once you have one of these underlying issues, they can tend to compound the problem and make it worse and worse over time. So then people continue to get worse over time and they tend to go back and lean on those medications that cause a problem in the first place. So then you got this rabbit chasing its tail around, and the problem gets worse and worse over time.

Evan Brand:  Yup. That makes perfect sense. So just in terms of the diet piece, I often hear of like this Specific Carbohydrate Diet which in a way I would say the autoimmune Paleo diet’s pretty close to the SCD, wouldn’t you?

Dr. Justin Marchegiani:  Autoimmune Paleo Diet is pretty close to the SCD, yeah. So the SCD, when we look at the SCD, there’s one out there by Allison Siebecker that’s an SCD and a—a SIBO one, a low FODMAP when that’s combined. So in my member’s area, my patients have access to this where we’ll sometimes give the SCD in conjunction with the low FODMAP so the—the SCD is called the Specific Carbohydrate Diet. And what’s different about the SCD is it’s various phases of introducing foods. Typically foods start off, they’re really simple. It’s just meats and maybe some carrots off the bat. Everything’s peeled and even cooked pretty well or even mashed so there’s no outer coating. It’s low in salicylates, low in phenols. So you have your meats. You have basically your carrots and then the next phase you may start to add in a couple more vegetables and maybe a little bit of apple or pear sauce and then you go up to—to level 2 and level 3 and level 4 and you gradually introduce more and more foods. Now if you’re following a straight SCD or Specific Carbohydrate Diet, that may still have some FODMAPs in it. So we gotta be careful. So we may put a combination of an Autoimmune/SCD and low FODMAP together. It really just depends on what the person’s history is. If they have a—an underlying ulcerative colitis or Crohn’s issue. We typically go autoimmune in conjunction with low FODMAP, in conjunction with kind of a low salicylate, low phenol, SCD approach. Because some foods like potatoes are technically low in FODMAPs.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Same with tomatoes as well, right? Same with eggs. But people that have autoimmune stuff, they may be sensitive to those things. Even nuts are supposedly okay on a low FODMAP, right? Sometimes, alright, if you look at Allison Siebecker’s they’re considered to be okay, but if you look at other low FODMAP diets, nuts are not acceptable and also nuts are not acceptable if you are on an Autoimmune Diet. So we get a little bit more strict on how we approach things, just because I have, you know, hundreds of data points of patients doing well on this approach. So it’s really tough off a bat. It’s not meant for a forever thing, but it’s meant to just kind of cross our T’s, dot our I’s, find out what foods we’re sensitive to, cut out some of the inflammation and significantly reduce a lot of the bloating and gas and a lot of those constipation and diarrhea, SIBO symptoms as we get the person better.

Evan Brand:  Yeah, and lot of people if they’ve suffered long enough, they’re open to that and they’re willing to do that but if—if some people they haven’t gone strict with the—the diet, it may feel like we’re taking a lot of good stuff away from you, but this is gonna help to speed up your process of you getting better because if we’re relying just on one treatment whether it’s the herbs or some of the other botanicals, you can get better but it may take longer. So like Justin’s saying here, if we’re improving the diet and stacking that on top of the good lifestyle, getting the good sleep, all the other factors still are important, that’s just gonna make sure that you get better faster, and that’s the question that we often ask is how quickly do you wanna get better? And that will determine, you know, how deep or how intense we can go with stacking all of these on top of one another, and maintaining a normal life that’s pretty free of symptoms overall.

Dr. Justin Marchegiani:  Exactly. Yup, exactly, 100%. So regarding some of the testing I mentioned, the glucose testing, to look more in the upper small intestine—on the upper stomach tract. Lactulose is typically, you know, the—the best one so to speak because of the slow breakdown of the lactulose. Again, if we have some type of gastroparesis or some type of significant motility issue, it may take longer for that lactulose to get down there and that we may see an issue with that being delayed on the breath test. Like if we’re only doing a two-hour breath test, right? Like the Genova one, but it takes 3 hours to get down there, we may miss that infection, right’? So some people will actually have them wait an extra hour than start the test at the first hour in and then we can get a good window of that, so and it’s also if faster motility, then it may go too fast, so you gotta have to kinda weigh those, weight the odds of—of both of those different testing there. And then also I did a whole video on how to do some of these tests, alright, like what the data says and what we’re looking at but I kinda mentioned some of the things, greater than 3 on the methane and 15-20 is—tends to the point that we wanna look at for hydrogen and/or methane. Typically 20 or above combined hydrogen-methane is positive, 15 or above for hydrogen, and again that can change from test to test, so I did a deeper video on that and how to interpret it.

Evan Brand:  Great. Yeah, and so it looks like—looks like BioHealth is gonna be a better solution than the Genova, looks like there’s 3—it’s a 3-hour test here with 10 breath samples. So I think this might be the new gold standard for us.

Dr. Justin Marchegiani:  Oh, I like that. That’s great. I’m gonna have to order one and get access to that ASAP. Yeah, I see, May 23rd. It just came out. That’s phenomenal.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Very cool. So regarding testing we already talked about kinda my philosophy looking at the upstream infections, that’s important. And there’s a lot of people out there, a few people out there I can think of off the bat that are—are not in favor of adrenal testing. Now I understand where these people are coming from, these clinicians. I don’t necessarily agree, because I think people have significant inflammation on their backs and on their bodies, and they have a very difficult time regulating it. And when we see someone that has decent adrenals but has gut symptoms, that matters versus someone that has very impaired adrenals, and what I mean by impaired, let’s say a flat adrenal rhythm, or let’s say a reverse cortisol rhythm and/or very low depleted sex hormones. Now some of these clinicians are basing these off of symptoms but I can tell you many times that I get surprised every now and then and now that I’m doing the 201 by BioHealth and the newer Dutch testing, you’d be surprised how often you get surprised with some of these people’s clinical presentations. And sometimes when I see that, then I got to the thyroid and it’s really the thyroid that’s really the—the weak link in the chain. So I’m a big fan of looking at the adrenals because it gives me the ability to look at what that patient’s capacity for regulating inflammation and stresses and also gives me a window into their sex hormone outputs so how fast they can heal and also how dysregulated is their cortisol rhythm. Alright, the Whitehall study found that the closer that morning cortisol is to that night time cortisol, an increased risk of cancer even greater than cigarette smoking. So cortisol rhythm to me is important and it also gives patients when they come in with a real crappy rhythm or a very low sex hormones, it gives them a bull’s eye to shoot for. So it really creates a significant level of compliance because that patient knows they got a test in 6 months that they’re studying for so to speak, and by studying I mean going all the diet and lifestyle things and being compliant with the treatment because then we can follow-up and see how we’re doing and then we can have a real specific treatment. So to a lot of those doctors out there, I think they’re—they’re missing the boat a little bit and I think they would get better patient compliance and I think they’d be surprised that some patients are probably slipping through the cracks because their adrenals are terrible and that would allow them to provide a better prognosis on where they’re going based on their patient’s inability to regulate stress and inflammation.

Evan Brand:  Absolutely. Yeah, that’s a great point and that ties into the gut. People may think, well, why are you talking about adrenals? But this whole adrenal cascade, this is going to affect the gut, so—which we may have talked about briefly in another episode, if you’re unable to regulate your inflammation because you do have adrenal issues then that’s gonna leave you more susceptible to the gut. So if you’re only focusing on the gut and what a lot of practitioners do, I—I mainly think for marketing purposes is to kind of pigeon-hole themselves into being say a SIBO specialist or a gut specialist but you honestly can’t get people better 100% if you are a specialist. Is that a safe statement to make because if you’re only focusing on SIBO and you’re just killing off all of these bacteria but yet they have wrecked adrenals a leaky gut situation is still there because they have say high cortisol all day, you can’t get someone ultimately better. That seems like they’ll just spin their wheels.

Dr. Justin Marchegiani:  Yeah, I think it’s great to be able to market to the public as you specialize in this area, but I think it’s important that you still, you know, flex your holistic muscles that yeah, even though I specialize in here, I still connect in the adrenals. I still connect in the gut.

Evan Brand:  Right.

Dr. Justin Marchegiani:  I still connect in the detoxification issues along with it, so even though we’re really focused on this one issue, we are not myopically focused where everything else becomes non-existent in our periphery.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  So I think–

Evan Brand:  That’s well-said.

Dr. Justin Marchegiani:  I think that’s really important because that’s where conventional medicine’s kinda gone wrong, where the cardiologist only knows about the heart and doesn’t know about the hormones and vice-versa for the endocrinologist and the gastrointestinal doctor, right? But we know how important all of those things are connected.

Evan Brand:  Yup, absolutely. I had another thought and I think I lost it. It was about—oh, just in—in terms of SIBO, you know, I’ve already kind of said this so I may be repeating myself but basically if someone is just throwing themselves on the antibiotics or the herbal antibiotics, you may spin your wheels and you were talking about how the—the importance of adrenal testing even for gut issues. Last week, I had a female in her 60s, I—if I would have guessed, I know you and I kind of put things in our head, “Oh I think this person’s gonna show up like this.” I would have guessed that she was flat-lined with her cortisol, however, she had a sum of over 60. Her cortisol sum was insanely high and her cortisol rhythm was insanely high, yet she had tons of fatigue yet had some anxiety in the evening. So I thought, “Oh, maybe we’d see an elevation in the evening.” No, her cortisol was just off the charts, the highest I’ve ever seen ever. And now I found that out and I wouldn’t have been able to start working on the fatigue if I would have thrown her on something stimulating like licorice, I would have created a disaster for that woman. She would have felt worse. So without that piece, it’s really scary to—to jump on a program.

Dr. Justin Marchegiani:  Exactly and the big thing we’re trying to do in functional medicine is we’re trying to use objective lab testing to really drive compliance because patients have been told already that have come and seen us that it’s all on their head and they need something to show, “Hey, this is a window under the hood of what’s happening with your physiology, your hormones, and your biochemistry. It’s real.” And then now from that, we’re gonna re-test in a certain amount of time, so the pressure’s on you to be compliant so then they know “Hey, we’re gonna be making these changes and we’re gonna be re-testing,” so they’re gotta do their part. And then also and make sure that we are—we aren’t guessing, we are assessing. Because I get surprised every now and then. So I think some people are missing the boat on that from a clinical standpoint. I understand why they do it because they’re hyperfocused on—on cost and such. And I get it, if someone, you know, has significant financial issues and they don’t wanna do a certain test, but my issue is you wait 2 or 3 months and they’re not quite feeling where they want to, almost everyone regrets not running that test 2 or 3 months ago, right?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It’s never—I mean maybe you may start getting better and you’re like great, it worked out, but if you don’t feel better in that couple of months, then you’re gonna really wish you did that test because then you have a little more confidence in what direction you’re moving forward with regarding your treatment for your SIBO issues.

Evan Brand:  Yeah, and that’s sort of like if you’re buying something really cheaply, like say you just buy a little piece that may fit the job for a tool that you needed at home, but then that screwdriver breaks, now you have to go buy another screwdriver and then that one breaks, and then eventually you’re like, “You know what, I’m gonna buy a screwdriver with a lifetime warranty.” It’s just gonna last you a lot better, but yet you’ve spent double or triple because you’ve been trying to only use an incomplete puzzle I guess is what I’m saying.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Like if we try to focus on, “Oh, let’s just look at adrenals,” then that’s what—what I did in the beginning because I was just trying to just prioritize things for people and now I’ve come to the conclusion and you have a long time ago, this conclusion, we really don’t want to just look at this one piece. We really have to try to get this full puzzle upfront with someone because then we’re delaying the success that they get and then they blame us but it’s—we don’t have the data, so we can’t work without the data.

Dr. Justin Marchegiani:  Exactly. So I always tell patients, the longer you’ve been sick, the more sick you are and the faster you wanna get better, it’s better to pull a couple more labs out so we have a—a more complete picture. The shorter you’ve been sick, the better you feel, and the less motivated you are to get better, then we can start with just like something like one test.

Evan Brand:  Right.

Dr. Justin Marchegiani:  But I always tell patients, it’s better to do something over nothing because then we can start moving forward versus you know, sliding backwards.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So a couple more things on the SIBO, a couple of the herbs that—that I formulated and use. I use a couple in my practice. One is called GI Clear One and one is called GI Clear Six. They each have some various herbs I use that have some high amounts of berberines or Artemisia compounds in there, cloves, Java Brucea, wild indigo, just various herbs that had shown to be very sensitive to killing some of the gut bacterial overgrowth, okay? That’s number one. There is some other ones out. There’s been studies looking at the antibiotics, the Neomycin or the—the rifaximin and rifaximin is the same thing as Xifaxan, FYI. And then the combination of the—the neomycin with the—the herbs. So looking at just the antibiotics and then looking at just the herbs, there’s been some studies showing that herbs actually work better. Now when in doubt, if you’re gonna just say, “Well, I wanna go the antibiotics,” still go with the herbs because the herbs have a really good effect at knocking out biofilms, too, and some of the antibiotics won’t touch the biofilms, that’s number one. And then number two, people need a longer dose of these antibiotics and people that do long-dose antibiotics can wipe out a lot of their beneficial flora so combining it if they are with the anti—with the herbs are gonna be beneficial because herbs are shown to be just better clinically taking it over the long period, safer, less side effects than a lot of the antibiotics would. And you have couple 10,000-year history with these herbs being used by various tribes and cultures to help with infections and parasite stuff and like wormwood and with malaria, and like mastika on the island of Chios in Greece for all kinds of different issues with the H. pylori and other issues. So it’s nice to use the herbs. I’m biased towards the herbs because of their safety, because of their long-term history and because of our ability to use it long-term and the ability to affect things like efflux pumps, which are kind of the bacterial way of bailing water out of sinking ship. So imagine antibiotics coming in and the—the ship bailing, and those antibiotics back into the intestinal tract creating more bacterial overgrowth because it’s knocking out a lot of the good stuff. So those efflux pumps get affected more by the—the herbs and they also affect some of the biofilm, which are like the protective shields that these infections use to protect themselves from getting killed.

Evan Brand:  Yeah, I’ve seen a few studies about enteric-coated peppermint oil as well.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  And I used that when I suffering a lot with IBS. I wasn’t into the herbs, so I didn’t know enough about the herbs at that point. So I was using the peppermint oil and I had great success and that’s something I’ve given to my dad, too. He’s had a lot of issues with his gut and it has been incredibly helpful. It’s hard to find a clear piece of research that says whether you would be able to use the enteric-coated peppermint oil specifically for treatment of SIBO, like if you can knock it out by itself, what do you think? Maybe in a—in a low overgrowth situation, it could give you some antimicrobial benefit but I think you’re probably gonna need a bit more of a well-rounded approach by adding in the herbs on top of that.

Dr. Justin Marchegiani:  Yeah, I mean, typically I would never rely just on one herb by itself.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  I would do a combination of a couple. If you look at my GI Clear One and GI Clear Six, we do that in those products. In my GI Clear Five, that’s the pure emulsified oil of oregano; we’ll hit that up really hard as well and then we’ll even use my GI Clear Three which is silver and that’s a really good biofilm buster, and then we always like to throw in ginger because there’s a lot of research on ginger busting out biofilms, too. So we do a combination of different things and we’ll even interject the low FODMAP diet and sometimes we’ll even start eating a little bit of FODMAPs while we’re doing the killing because it’s kinda like putting cheese on a mousetrap for the so-called mouse, i.e. the bacteria to come out of hiding. When it comes out—BOOM! We’ll use those herbs and really knock them down to size.

Evan Brand:  That’s great! That’s really interesting concept there.

Dr. Justin Marchegiani:  And look at your situation, right? You would have what I would consider to have a—be a lot of SIBO symptoms. Like if you went to one of these SIBO docs that are out there, the first thing they would have had you done was SIBO testing–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Without a doubt. But look, what came back on a stool culture, right? We’re talking an actual, you know, under the microscope, you know, stain/culture diagnosis. You came back with Giardia and Crypto, correct?

Evan Brand:  Correct.

Dr. Justin Marchegiani:  Yup. If you did a breath test, you would have came back and they would have been just all 100% myopically focused on the gases. “Oh, those methane and hydrogen are high, we gotta knock them down.” But if you looked upstream, you’d see you’ve had 2 major infections that would have been missed.

Evan Brand:  Yup, I know. And I—I would have suffered. Maybe depending on how heavy hitting the treatment would have been for the SIBO. If it was a very heavy hitting treatment, tons of garlic, tons of the oregano, the berberine–

Dr. Justin Marchegiani:  They have may have got it by accident, right?

Evan Brand:  Exactly. But I wouldn’t have known and what if I—let’s just say, what if I did the SIBO treatment for a shorter duration than necessary to get rid of the parasites then my symptoms would have come back and then I would have been well, that didn’t work, why not?

Dr. Justin Marchegiani:  Right?

Evan Brand:  So–

Dr. Justin Marchegiani:  Especially a lot of these SIBO infections aren’t known to be as contagious like these parasite infections. These parasite infections can be fecal-oral, can be spread by intimacy wherein not quite as much as with the—the general SIBO stuff, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Because the SIBO really is a whole bunch of different bacteria that are just overgrown so to speak. So–

Evan Brand:  Right.

Dr. Justin Marchegiani:  We—we wouldn’t think of that as being like a—a contamination or potential, you know, thing that can be vectored per se, but when we deal with infections, H. pylori, to—kind of be added in there, we have a different perspective on the—you know, the spouses and the partners that could be affected in there and contaminated with.

Evan Brand:  Yup. And so I think that’s a pretty good overview. We talked about the testing, getting the full panel run, making sure you’re getting some stool testing run with your practitioner, making sure you’re getting some adrenal testing to see how much is this cortisol issue—how much is that contributing to your leaky gut, making you more susceptible to pick up bacterial and yeast overgrowths and parasite infections. And then we talked about some of the herbs and then combining those for the synergy. We talked about the diet in terms of watching out for the FODMAPs potentially doing like an SCD or an Autoimmune Paleo Diet for the time being then re-introducing things, seeing how you feel. Is that—is that the 4 pillars? Is there any other missing piece?

Dr. Justin Marchegiani:  Yeah, for the most part. Let me just go through it at my head. We have the 5R’s. So we’re removing all the bad foods, right? This could be but not limited to autoimmune foods–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  SCD, low—low, cutting out the higher phenols and salicylates. Cutting out the FODMAPs and potentially even cutting out histamines. The more messed up someone’s gut is, the more they have to be diligent and vigilant on their diet in the beginning. So some of these things may have to be removed. Next R would be the replacing. Replacing enzymes and acids to really help with the breakdown of these foods. Third R would be repair. Repairing the gut lining and/or adding in, repairing nutrients to reduce inflammation. So we may add in some specific strands of probiotics to help with the inflammation and the repair side. And also the adrenal piece, right? Helping to regulate inflammation better so we can put out the fire in our gut and we also know the adrenals are important for IgA production. Very low cortisol will affect IgA. So the repair involves potential probiotics, potential anti-inflammatory nutrients, and potential adrenal support. Fourth R is removing the infections, anywhere from the parasite to the—to the bacterial issue, to the fungal overgrowth to the SIBO, and the fifth R is gonna be reinoculation where we really focus on the probiotics even through it’s not a forever kind of thing. It still has an effect of receding at least for a month at a time and then the last piece after those 5 R’s are completed are retesting, making sure there’s no lingering infections that come to the surface.

Evan Brand:  Nice.

Dr. Justin Marchegiani:  That’s–

Evan Brand:   Well said.

Dr. Justin Marchegiani:  Yeah, that’s the overview.

Evan Brand:  And—and I like how you painted out—you painted out the order of operations there and you did not say probiotics first. I think you and I discussed the female patient I had where she went to the naturopath, threw her on like a heavy—heavy dose of the soil-based probiotics and she blew up like a balloon, felt awful, tons of symptoms. Wrong order, wrong treatment.

Dr. Justin Marchegiani:  Yeah and also if we’re gonna do specific kind of probiotics, I’m a bigger fan with my sensitive gut patients to use the one called Megaspore.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  It’s typically a Bacillus clausii, subtilis, coagulans bacillus kind of spore-like strain. It tends to be more sensitive to people that are what I call probiotic-intolerant. They get a lot of gassiness and bloating and digestive symptoms from probiotics.

Evan Brand:  Yeah, she—she felt horrible and I was so glad to finally see in the flesh just because treatment sounds good, you just talked about the 5 R’s, you can’t just go straight to number 5. You have to do 1, 2, 3, 4, 5.

Dr. Justin Marchegiani:  Most people wanna go to number 5 or number 4 because it’s sexy, right? Oh, probiotics and this!

Evan Brand:  It is.

Dr. Justin Marchegiani:  It’s just sexy.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  But number 1 off the bat, before they even, we have the 5 R’s, is gonna be get some testing done, right? Ideally, once you’ve—let’s say you tried cutting the FODMAPs out and you’re done AIP, great! If you’re getting results, good. I strongly encourage you at some point to dig in and get some testing done, right? That’s where looking at the body systems would be super helpful, organic acids testing and/or adrenal and/or gut testing will be helpful. The more symptoms, we may dig in to thyroid stuff. That way we get a complete picture. Now the worse thing you wanna be dong is guessing and then having all these things happening where you’re starting to get worse over time and you don’t know and you get—start getting scared and you’re like, “Well, what do I do next?“ Having the testing is super helpful and having a clinician that’s been there a couple thousand times really gives you a lot of confidence because, you know, if I’m climbing Mt. Everest and something happens, I wanna have a—a Sherpa or someone with me that’s—that’s been up that mountain dozens of times that knows the ins and outs.

Evan Brand:  Absolutely, yeah. That’s a great point.

Dr. Justin Marchegiani:  Any other comments on that? So we have the testing. We talked about the SIBO testing. We talked about the breath testing and just to kinda correlate symptoms, increase in methane gas can typically mean constipation, increase in hydrogen typically means diarrhea. We can have both. We can be alternating. So it’s to be able to coin some of those symptoms, right? Either diarrhea or constipation or some of the gases. It may hold true, it may not. And then we talked about the—the different testing, either the endoscopy sample. We talked about the breath testing. We talked about the actual gut testing as well, looking for the parasites. And then we talked about the periphery testing, either the adrenals or deeper organic acids testing to look downstream.

Evan Brand:  Yeah, but say the only thing I would add to that is don’t be alarmed necessarily. This is a good conversation to have with your specific practitioner, but don’t be alarmed if things do get a little bit worse before they get better, especially if there’s like a parasite like I was dealing with. Things got a little bit worse before they got better. So don’t assume that it’s just gonna be–

Dr. Justin Marchegiani:  Yes.

Evan Brand:  A—a miracle solution. There may be this readjustment period that you’re gonna have to work through, a couple of speed bumps along the way but that can be normal to have an exacerbation of symptoms before they get better. And that’s—and that may be okay–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  But you need to talk with your practitioner to make sure.

Dr. Justin Marchegiani:  Yeah and a good—some good references on the mainstream for this article here or this podcast would be Dr Pimentel out of the Cedars-Sinai over—over at California, Los Angeles there. Also Allison Siebecker and Dr Sandberg-Lewis out of NCNM, over at National College of Naturopathic Medicine. Those are some good resources and references on the whole SIBO thing here outside of you wanna kind of dig in to nitty-gritty, those are some good places to look.

Evan Brand:  Good stuff.

Dr. Justin Marchegiani:  Any other questions, Evan? Or comments or concerns?

Evan Brand:  Not—not for today.

Dr. Justin Marchegiani:  Like it, man! Well, go out and get sick people well and I’ll do the same.

Evan Brand:  Amen!

Dr. Justin Marchegiani:  Have a good one and best of luck with Summer coming into the world.

Evan Brand:  Oh, thank you.

Dr. Justin Marchegiani:  Take care, Evan.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.

Detoxification Issues – Mary Vance – Podcast #19

In this podcast, Dr. Justin and Mary Vance, a holistic nutritionist and wellness coach talked about the importance of functional nutrition and how by determining and addressing the underlying causes of one’s disease rather than simply dealing with it symptomatically can greatly provide relief and make a huge difference in one’s health.

Learn the proper approach to detox and how proteins and amino acids play a vital role in making our detoxification channels run properly.  Also find out what the top three stressors in our detox system and how to avoid it.  Discover the different herbs for detox as well as the healing benefits of essential oils.


In this episode we cover:

06:25   SIBO

09:33   3 Weeks To Vitality

14:18   3 Detox Stressors

19:28   Detoxification pathways

25:12   Herbs for detoxification

43:17   Resistance Starch

43:17   Essential Oils Benefits








Justin Marchegiani:  Welcome back to Beyond Wellness Radio.  This is Dr. Justin Marchegiani here.  Baris Harvey will not be here today but we have an awesome guest in our studio, Mary Vance, NC.  Mary is a Certified Nutritional Consultant in Bauman College.  She has also gone through Dr. Daniel Kalish’s Functional Medicine program.  And Mary has worked with patients; I want to say, for the last five to ten years, Mary?

Mary Vance:  It’s actually been almost 10 years now.  I finished school in 2006.  I started kind of mentoring and working with people, around 2005-ish, so almost 10 years, yes.

Justin Marchegiani:  Wow.  That’s great.

Mary Vance:  Yes.

Justin Marchegiani:  Well, I would love for you to be able to share your story, kind of how you got into the health field with our listeners.

Mary Vance:  Sure.  And you can read kind of a more detailed information on my site which is

Justin Marchegiani:  Okay.

Mary Vance:  But the short story is that I grew up an animal lover and was raising and training show horses and dogs.  And I attended some animal rights workshops and learned about the really deplorable conditions behind factory farming.  And that really horrified me so I became a vegetarian.  And I was about fifteen and I lived essentially on rice and ramen noodles and I became severely anemic.

Justin Marchegiani:  Oh, man.

Mary Vance:  Yes, right.  (Laughs)

Justin Marchegiani:  (Laughs)

Mary Vance:  I mean they were delicious but I became really severely anemic.  And that was kind of the first connection I made that, “Wow! What you eat really dictates the status of your health.”  So you know now, since you and I are working with clients and patients all the time it is kind of a no-brainer for us.  But I think a lot of people still do not really make that connection.  And so that is how it really hit home for me and I started really studying how to be a healthy vegetarian.

Justin Marchegiani:  Yes.

Mary Vance:  You know, if there is such a thing.  And I just read everything that I can get my hands on.  I was really interested in the connection between nutrition and health.  But then of course, I was eating a lot of soy and thought that I was super healthy because I was a vegetarian.

Justin Marchegiani:  Right.

Mary Vance:  And all of the processed soy food obviously kind of messed up my hormones and thyroid.  And that is when I really kind of started pursuing this as a career.   Went back to school and got my education and training and then you know just learned how to rebalance my hormones on my own.  And it all kind of took off from there.

Justin Marchegiani:  Wow! That is great.  Now because you mentioned animals I am going to go into it.  I got a scratch from my cat maybe four days ago and it is kind of swollen up.  And I have done some research it’s a bartonella infection.

Mary Vance:  Oh, wow!

Justin Marchegiani:  I am actually treating it right now with some herbs, with silver, with noni, with neem, cordyceps, a couple of herbal formulas and its actually going down really nicely.  So I may get to avoid the antibiotics.  I am keeping my fingers crossed.  I want to keep my gut flora as healthy as possible.

Mary Vance:  Yes.

Justin Marchegiani:  I know you have the experience working with a lot of people with gut infections.  And I am just curious, people that have animals, do you see a lot of people that are around animals come up with infections?

Mary Vance:  Now that is really an interesting question because one of my closest friend is a naturalist and works with tons of animals and his was the worst parasite test I ever saw.  (Laughs)

Justin Marchegiani:  Gosh.

Mary Vance:  Riddled with stuff and have a lot of GI issues.  And yes, actually one of the more common thing I see and I know you do too is really H. pylori.  And then if you test one person, if they have a partner you always want to run a test on the partner.  And 9 times out of 10, the partner comes up with it, too.  So aside from animals, the moral of the story is check your partners as well.  (Laughs)

Justin Marchegiani:  Oh, absolutely.  My cat gave my fiancée cryptosporidium infection.

Mary Vance:  Oh my gosh!

Justin Marchegiani:  I know.  And speaking of cats, are you familiar with toxoplasmosis?

Mary Vance:  Oh yes.  Yes.

Justin Marchegiani:  So that is an infection that literally changes the person’s brain chemistry to like, I think to actually like urine, like the cat urine.

Mary Vance:  Oh, my God!

Justin Marchegiani:  Isn’t that crazy that it can like change your urges and kind of desires around something like that?  Isn’t that crazy?

Mary Vance:  That is really scary.  I think pigeons carry that, too.

Justin Marchegiani:  Yes, yes exactly.  So when you deal with these people that have chronic infections, what is the best way to do it?  Do you find going out knocking out the infection right away tend to be the best thing or is there some type of foundation that has to be worked on with these patients before they get to the infections?

Mary Vance:  Well, that is a really good question, too.  And as you know, kind of my favorite repeatable mantra that I tell everyone is that there is never a one-size-fits all approach to any of this stuff.  So if anyone comes to you and they have a bunch of different gut infections or pathogenic infections or parasites going on, I mean sometimes if they are also super toxic, you know when their liver is not working properly because they are super overwhelmed with all the toxins that are admitted due to these gut infections and they are not digesting well and that creates kind of a toxic environment.  And then if you give them herbs or even sometimes the antibiotics or whatever if they have a really severe infection and that can overwhelm their detox system.  And overwhelm them to the point where they would crash and feel incredibly ill.  

Justin Marchegiani:  Right.

Mary Vance:  And if their adrenals are not supported, it is really important to make sure that whoever you are working with has the detox channels working properly and they are not super stressed out and their adrenals are kind of working before you can really knock out a lot of the GITs.  And make sure that their diet is pretty stable, too.  Don’t you find that common in your practice, too?  

Justin Marchegiani:  Yes.  I mean, I find that a lot of people for instance a lot of toxins are eliminated via the hepatobiliary channel system.  So if your gut is backed up then when your liver and gallbladder dump all these stuff up you are just going to reabsorb it.

Mary Vance:  Totally.

Justin Marchegiani:  So definitely making sure like digestion is there, transit time is there.  Getting rid of the dysbiosis and SIBO.

Mary Vance:  Oh yes.

Justin Marchegiani:  That is like, I find that really important.

Mary Vance:  Yes, SIBO is so funny because all of a sudden you hear about SIBO everywhere and its only years ago no one was really talking about it.

Justin Marchegiani:  Yes.

Mary Vance:  And now it’s… I mean I see it’s a really common cause of constipation and almost everyone I am working with that has GI problems have the tendency towards constipation.  And of course that makes, you know, detox issues much worse if you are backed up but SIBO is really huge right now.  I see a lot of those cases.

Justin Marchegiani:  And what is your opinion with SIBO?  Because I find with some patients that it is just SIBO that is causing the problem.  And then you have other patients where SIBO is kind of a sign of a deeper infection that is like underneath.

Mary Vance:  Oh, yes.

Justin Marchegiani:  And that is kind of like making the outer environment in the gut like more, you know, dysbiotic, if you will.  So what is your take?  Are you seeing more of just SIBO being the problem or SIBO and other infections?

Mary Vance:  Well, I find that with candida most often.

Justin Marchegiani:  Yes.

Mary Vance:  You know.  If you always see yeast as kind of a secondary infection to other stuff.

Justin Marchegiani:  Yes, candida.

Mary Vance:  And it seems that way with SIBO as well.  Because yes, obviously the gut terrain is totally altered with these infections and then it causes the secondary infections to crop up.  But it is kind of baffling to me right now.  I don’t know if you have come across this but I will have people that go to their doctors get breath tests for SIBO and they come back negative but they still have all the signs.  And then they start eating you know, according to FODMAP and kind of addressing that, they feel better.

Justin Marchegiani:  Yes.

Mary Vance:  So I wonder what do you think about the accuracy of those breath tests? 

Justin Marchegiani:  Oh, basically we are on the exact same page.  I tell my patients, one if we see it in the stool test that is great.  But if they see any resolution of going on a Low FODMAP diet and their gas and bloating improves that is diagnostic to me.

Mary Vance:  Oh yes.

Justin Marchegiani:  And then also if adding in a little bit of resistant starch makes the problem worse, I tell them it is like throwing a rock in the beehive and that is diagnostic for SIBO in my ballgame as well.  Because some of these tests can be expensive so we can do objective/subjective testing.  When we add these things and then we see if symptoms go one way or the other.  That can be huge at moving forward and knowing that we have this issue.

Mary Vance:  Yes.  So do you just use the Metametrix tests to see if there’s an overgrowth of good bacteria and that is how you use stool testing to diagnose SIBO?

Justin Marchegiani:  Yes, like that or like if you are doing a 401H from BioHealth you will see like Enterobacter or you will see Citrobacter and things like that up in the abundance of the gut bacteria.  So you can see it that way, too.

Mary Vance:  Yes, yes.

Justin Marchegiani:  And then, you know, sometimes just any breath test and you will see it more of an H. pylori.  But I have just been doing the PODMAP thing and I think it is really diagnostic for patients.

Mary Vance:  Yes, I think so too.  Yes exactly.  If that works right away off the bat it kind of save some people money if they cannot afford a stool test right away.

Justin Marchegiani:  Yes.  And right now you are doing a lot of stuff with detox.  I think you have an e-book and a specific product on your website that you are really kind of putting out there right now.  Can you tell us more about that detoxification product?

Mary Vance:  Yes, so I wrote a book called “Three Weeks To Vitality” and my main goal for writing this book is that one of my colleagues when I used to teach detox workshops which are really fun.  And we would do them right before spring and right before fall because those are kind of the ideal times according to Traditional Chinese Medicine.  That is when the liver and the large intestines are the most active and the weather is warm and those are the best times to detox.  But one of my main things in teaching these workshops and I noticed was that people were doing just these crazy fad cleanses that are really unhealthy.  And using or drinking all kinds of stuff and doing the Master Cleanse for 3 weeks and you know, some people can feel great doing some juice fasting.  But again, if you have underlying hypoglycemia or some other type of issues going on then that can again be really kind of dangerous.  And a lot of people have ended up in the hospital from doing the Master Cleanse because it severely alters their electrolyte level.  So I kind of wanted to educate people on just using food and herbs for safe holistic detoxification and that is kind of the basis for my book.  It gives you a three-week plan.  And week one is the pre-cleanse where you are kind of cleaning up your diet and getting rid of all the junk like gluten and dairy and potential food allergens, soy foods.   

Justin Marchegiani:  Yes.

Mary Vance:  The other benefit of it aside from all the education that I kind of provide and the guidelines on this 21-day program is that it is also a great way to test yourself for food allergies. You know, by eliminating potential allergenic foods for a period of time and then adding them back in at the end.  You can tell you know if you start to get symptoms that you might have food allergy issues going on.  And the same thing with coffee and alcohol.  A lot of people are drinking coffee every morning and drinking wine at night and they do not realize the impact that it has until they get rid of it.  And then you know it helps them really identify which habits are not serving them well.

Justin Marchegiani:  Yes, I think you said some really important things there.  Now you talked about detoxification.  So you are kind of eliminating a lot of the environmental stuff, a lot of the dietary stressors that are coming in your body, is that correct?

Mary Vance:  Yes for sure.  Because our environment is so toxic these days it is really scary.   You know a lot of people say, “Oh, our liver is our own natural detoxifier.”  And you will hear naysayers basically saying you do not need to do detox because your liver does that for you.  But obviously we are bombarded with so many toxins.  And like what we have been talking about if your gut is now working properly, if there are other factors going on.  We have those endogenous toxins, internal and then external.  So just by getting rid of all of the junky stuff that you are eating for 21 days and really eat… There are foods that you can eat to support your liver and herbs you can take.  You know, kind of healing elixirs you can drink to really support liver detox.  So yes, definitely what you are intaking day to day is really important for that but also just kind of making over your life.  That is kind of a whole holistic model, right?  Is that we identify not only just what we are eating but our lifestyle, stress and sleep and all these other factors involved, too.  And kind of look at what are some toxic patterns in your life that are not serving you well.  That is kind of the true path for healing is really looking at all the factors and not just focusing on just diet or just protocol.

Justin Marchegiani:  Right.

Mary Vance:  But they are addressing all those factors for health.

Justin Marchegiani:  Right.  And I think a lot of cleanses out there they miss the internal toxins.  You said endotoxins or internal toxins.  Endogenous was the work you used.

Mary Vance:  Yes.

Justin Marchegiani:  And I think it is really important because a lot of infections like for instance we have H. pylori or bacterial issues we are going to see endotoxin which is hepatotoxic.

Mary Vance:  Oh yes.

Justin Marchegiani:  We see a compound known as lithocholic acid which is produced by SIBO.  We see mycotoxins which are produced by fungus. For instance, if we like to do this awesome cleanse and we get all of these nice nutrients and herbs, if we do not get rid of these infections though we are not really getting to the root.  Is that correct?  Is that what I am hearing you say?

Mary Vance:  Yes, totally.  And obviously this cleanse is just designed for people to be able to do this at home.  But I do get a lot of emails from people that say, “Yes, I felt better by cleaning out my diet but is still do not feel great.”  You know, then that is a sign that there is still something going on that you have to test for.  So yes, that was a major issue.  People have adrenal fatigue and they are not going to totally get better until you really resolve some of these underlying, other factors that might be going on that are a huge stress on the body.    

Justin Marchegiani:  So what do you think are the three habits, out of your experience with thousands of patients what are the three biggest habits that are putting stress on our detoxification systems?

Mary Vance:  Well, the biggest one I think and that you would probably agree with I would not say necessarily for the detox system, in general.

Justin Marchegiani:  Yes.

Mary Vance: But one of the biggest things that people do not realize and just a factor of our health is sleep.  I mean, we are still programmed in our society that if we sleep 8 to 10 hours at night that we are lazy and we are not productive.  I was just reading an article the other day that said our ancestors were sleeping 10 to 12 sometimes more hours at night.  And we gradually whittled that down.  And that is one of the gateway first wrongs in the ladder for stress which causes inflammation which then you are kind of off and running.  That is how the disease state begins.   

Justin Marchegiani:  Got it.

Mary Vance:  So sleeping is a huge one.  And then for detox, a lot of it are really focusing on cleaning up your products.  Things that you are slathering on your skin and chemical-filled cleaning products that you are inhaling when you are cleaning your house.  There are just so many chemicals that are used in our lives day to day.  And cleaning all that stuff, just remember anything that you are rubbing on your skin is absorbed and has to be detoxed.  And that includes on your food, pesticides that you are eating or herbicides from non-organic produce and factory farm meat.  Those have a huge impact.  And then of course, people are just like popping pain relievers and drinking alcohol and using over the counter drugs.  And all of those kind of really add up. And your body has this total load threshold and when that is exceeded then these toxins back up in your system and that is when problems start.   

Justin Marchegiani:  Yes, those are really, really good points.  Now on top of that you have talked about the Master Cleanse.  I think you were dropping a serious big knowledge bomb back there.  Like that is like blasphemy in the detox world.  Can you go more into the Master Cleanse, if you will?  And just talk about kind of what your take on in this?

Mary Vance:  Yes. The Master Cleanse is very polarizing.  Some people are like they get super upset if you talk about leaving out the Master Cleanse.   

Justin Marchegiani:  Oh yes.

Mary Vance:  But the idea that you drink this lemon water which in and of itself hot water with lemon can be a great detoxifying agent.

Justin Marchegiani:  Yes.

Mary Vance:  How it like stimulates peristalsis and it really does kind of help bile production.

Justin Marchegiani:  Yes, it is very alkaline, too.  Right?  Alkalinizing.

Mary Vance:  It is very alkalinizing, yes.

Justin Marchegiani:  Yes.

Mary Vance:  So this Master Cleanse they drink that and cayenne pepper which can be thermogenic and help boost fat burning.

Justin Marchegiani:  Yes.

Mary Vance:  And increase circulation.  And maple syrup and sometimes Epson salt or something, I do not even know.

Justin Marchegiani:  Yes.

Mary Vance:  But you know if you are drinking this 6 -7 times a day, again like I was saying earlier, if you have underlying health issues you are not aware of or if you have a tendency to hypoglycemia, I mean you are going to really crash and burn.  And people are doing this mostly in my experience when I work with clients and taught these workshops, it is not that people really care so much about being healthier or cleansing their liver.  Specifically, they just want to lose weight.

Justin Marchegiani:  Exactly.

Mary Vance:  So you are really going to lose weight but you are mostly losing muscle mass.  You are not burning fat when you are doing the Master Cleanse.  It can really have detrimental effects on some.  And people would be like “Oh, but, I felt amazing!”  And I think that is kind of a false sense of your body’s being stressed out and you are kind of running on adrenalin for a few days and then you just crash.

Justin Marchegiani:  Yes, it is very addicting to be running on adrenalin, like it feels good.

Mary Vance:  Oh yes, yes totally.  Yes those are some scary stuff.  And some of these cleanses that people are buying on the store they have like really harsh laxative stimulant herbs.

Justin Marchegiani:  Yes.

Mary Vance:  So there is pooping all the time and they are like, “Oh, I am cleansing, I am on the toilet all day.  But really that is not focusing on liver support at all.  You are just pooping a lot.

Justin Marchegiani:  Right, right.  And I find with my patients or just people in general, the main benefit that people get from doing a Master Cleanse is they are cutting out food allergens but there is no protein in their diet.

Mary Vance:  Oh yes.  Exactly, yes.

Justin Marchegiani:  Like they are just getting a total break from eggs, beef, and chicken.  Even foods that are like Paleo but they are just getting a break from it and their immune system kind of like de-stresses, right?

Mary Vance:  Yes, that is really an excellent point.  And a lot of people if they are feeling really poorly going into it and they are having lots of digestive issues then yes, and that is where people get confused, too.  Is that it is hard for them to determine if they have food allergy or if they are just not digesting food that they are eating well because their digestive system is not working and they are not producing enough enzymes or hydrochloric acid.

Justin Marchegiani:  Yes.

Mary Vance:  And then they remove all those foods or they remove all food and they are like, “Oh, I feel amazing!”  It is probably like you said they are removing allergens or foods that they are not digesting well.

Justin Marchegiani:  Yes, that is really a good point.  And also I want you touch upon our cytochrome P450 oxidase pathways.  Phase 1, phase 2, some people say phase 3.  I want you to touch upon that because if I remember correctly from school, it takes protein and amino acids to run those pathways.  So you look at the Master Cleanse you are like wait a minute!  There is no amino acids coming in so how does that actually run our detoxification?  So can you go down and talk about our detoxification pathways?

Mary Vance:  I am really glad you brought that up actually because I think I even mentioned that on my website.  Is that when people are just doing this kind of raw vegan cleanses or whatever like you said, your body synthesizes these potent detoxifier.   And you know these detoxifying agents like glutathione for instance break by it through protein.  By breaking down protein and through amino acids and then the liver synthesizes these really potent N‑acetyl-cysteine and glutathione specifically antioxidants that it uses to boost detoxification.  And if you are deficient in those, you are not going to be detoxing.  And that is why a lot of these combination herbal products or nutrients they contain a lot of these amino acids and glutathione, N‑acetyl-cysteine specifically.  And so many people are deficient in those because again if they are vegetarians, and they are not eating much protein or they are not digesting or breaking down these proteins…

Justin Marchegiani:  Right.

Mary Vance:  Then that is one way that you are shortchanging your liver and you are not getting your full detox capacity met. 

Justin Marchegiani:  That is really important.  And I want to just underline one thing you said for the listeners.  Glutathione, our master antioxidant made from proteins, cysteine, glutamine and glycine.  So I think that is really, really important.  So in your detoxification program, do you have some type of general detoxification support that is amino acid based to help push that phase 1 and phase 2 pathways?

Mary Vance:  Oh yes, totally.  So I give people options.  They can remove the food that I suggest and you know there’s protein involved and then if they want to use the supplements, there are a lot of great functional food, the kind of smoothie mixes out there that can be used for detox programs.  And a lot of them, you know, we are talking about heavy metals earlier.  So a lot of them can help chelate some heavy metals out of the body.  They are from any of these companies but you know we use like Designs for Health.  And some of these companies, they have already put together packets that have antioxidants and the herbs in them and then the vitamins and minerals you need for detox and the amino acids.

Justin Marchegiani:  Right.

Mary Vance:  Designs for Health have one of those called Amino-D-Tox which is full of amino acids.

Justin Marchegiani:  Yes.

Mary Vance:  So it is really easy to find a great deal of detox support packets that you can use alongside your cleanse.   And that is when you are really kind of, you know, the food part is great to address of course but if you are also doing the supplemental support and getting fiber and making sure that you are pooping regularly then you have kind of the full spectrum in place there.

Justin Marchegiani:  A very interesting.  So if I am a patient and I want to work with you and want to do a really good cleanse.  Let us say, that my diet is already good.  How would we work together doing this cleanse?  How do we move forward?

Mary Vance:  Yes.  Well, again if you are working with me or a practitioner then you can really personalize it based on what your particular health concerns are.  And sometimes, I know you use the Organix Profile probably in your practice from Metametrix.  And these are really cool test because it gives you an idea exactly if your detox pathways are congested, you know, it will tell you specifically what imbalances you have.  So sometimes, I will recommend that to see exactly what is going on or working with them in terms of any deficiencies or that test can kind of reveal if you have SIBO issues or some gut stuff going on.  Because a lot of times, people think they want to do detox because they are like, “Oh, I am tired and I am bloated, etc.”  But really they need more specialized gut work and maybe do the gut works first and then the detox.  So it really, you know, again kind of depends on the person.  And then you can recommend any testing that might reveal some underlying issues going on and then kind of really personalize it based on what they need.     

Justin Marchegiani:  Got it.  So you have like your general support and then you might customize it based off some lab testing as well to see kind of what pathways maybe are not working.  Is that what you are saying?

Mary Vance:  Yes, exactly.  Or if I kind of flag them as being a potential digestive case then, I recommend some stool testing alongside the Organix Profile and see exactly what is going on and then maybe the detox is not the place to start.  Maybe back up a little bit farther down the road until you clean up the gut or maybe they need some detox and then clean up the gut, you know.  It really depends on what is going on.  

Justin Marchegiani:  Yes, yes.  And just for the listeners at home, organic acid testing is the new cutting edge testing that involves looking at these metabolites in our body.  And essentially if we have metabolite A it gets converted to metabolites B, we know there are certain nutrients that are required to help make that A to B conversion.  And if we see a whole lot of A and a small amount of B then we are basically indirectly knowing that the nutrients that convert A to B are low.  And so we are able to come in there. We can look at all the different pathways that our body needs to detoxify and we can really customize things.  And that is kind of what Mary is talking about how she customizes her detoxification programs.

Mary Vance:  Yes, I love that test.  It is really cool.

Justin Marchegiani:  Yes, yes.  So talk to me about some of your favorite herbs to use when you detoxify patients. 

Mary Vance:  There are a lot of combinations out there.  There are tinctures as well.   And sometimes, if someone is not digesting food well then liquid herbal tinctures are the way to go.  But you will see combination herbal formulas with like Oregon Grape root and milk thistle.

Justin Marchegiani:  Right.

Mary Vance:  Of course, those are really great antioxidants and have some liver healing capacity.  Those two are my favorite.  Then you will find like burdock root or ginger sometimes. But what is interesting is some of those herbs are kind of more liver protective and liver regenerative and some of them actually help the cleansing process.  And it helps to actually strengthen detox.  So a lot of people are just buying milk thistle because they have heard that they are great for detox but milk thistle is actually the best detox support.  It is incredibly good in healing for the liver.  But if you combine it with some of these other herbs then you get kind of the liver protective, regenerative and the detoxing herbs.

Justin Marchegiani:  Hmmm, very interesting.  So I am going to switch gears a little bit away from detoxification.

Mary Vance:  Uh-hum. 

Justin Marchegiani:  Now because you worked with so many patients, tell me about the three biggest mistakes most patients, let us say they are Paleo literate.  Let us say that they already know about Paleo.  They already studied it or maybe are already doing some Paleo things like cutting gluten out of their diets and such.  What are the three biggest mistakes you are seeing with patients?

Mary Vance:  Oh, this is a good one.  This is a fun topic.  Well, number one, like I have said earlier, it is always sleep.

Justin Marchegiani:  Yes.

Mary Vance:  It is so incredibly rare that I find someone who is either sleeping well or sleeping enough or has good sleeping habits.  And my podcast partner Caitlin “Grass Fed Girl” and I have done several podcast just on sleep alone and good sleep hygiene.  And you know people are sleeping with their IPhones next to their head and sleeping with their Wi-Fi routers next to their heads and the TV on.  And you know, there are street noise and their rooms are not dark for their staying up too late, etc.  And that really alters your circadian rhythm and alters your adrenal function and it affects your cortisol levels.  We are just now reading a lot about how lack of sleep can really contribute to weight gain and causes a lot of hormone imbalance.  So that is a huge one.  And people, you still tell them, “Listen, you really have to work on sleep.” And they still do not believe you.  And then some people are really relieved and finally like, “Wow! Okay, great!  I have permission to get more sleep.  But the other big one, especially with the Paleo community, this is really, really common.  I get this a lot with women especially.  It seems to be really more predominantly women.  But they will say, “Oh my neighbor lost 50 pounds in Paleo.  I have gained 20 pounds.  What is going on?        

Justin Marchegiani:  Oh, yes, I hear that a lot.

Mary Vance:  Yes.  And then they are completely baffled because they have read all the amazing testimonials for Paleo online and how it is a panacea, it cures everything, or GI issues, too.  I get that a lot.  But often times again, like I was saying earlier, there is never a one-size-fits-all approach.  So your neighbor’s Paleo diet is not going to be your Paleo Diet.  And often times they are just eating too much of a particular macronutrient for them.  They are eating tons of meat or maybe too much fat for their particular physiology.  Or if they are not digesting it well that can be another issue.  And I still tell people you know, I mean you need a lot of plant.  And obviously there are exceptions to that.  Again, sometimes too much fiber can be irritating to people if they have gut problems.

Justin Marchegiani:  Uh-hum.

Mary Vance:  But it is usually, in their cross fitting, they are working out really intensely and that can be an issue, too.  If they have hormonal imbalances and severe adrenal fatigue and they are cross fitting themselves to death then you are going to have some weight loss resistance issues, too.  So sometimes people are not exercising, sometimes they are exercising too much.  They are not sleeping enough.  Or they might be eating Paleo but they have not adjusted their particular macronutrient ratio.  Though they are eating super low carb, you know, they are not getting enough carbohydrates and that can actually affect hormone balance especially for women.  Like I was saying, women have really delicate endocrine system.

Justin Marchegiani:  Uh-hum.

Mary Vance:  So if they are eating way too low carbs and that can prevent weight loss and contributes to some hormonal imbalances, too.  Especially, it is seemingly thyroid related.

Justin Marchegiani:  Yes.  Then talk to be about going too low carb.  Now how are you customizing the macronutrients?  Because I would see some people that they do really well doing low carb.

Mary Vance:  Yes. 

Justin Marchegiani:  But others don’t.  So how are you customizing that?  How are looking into adjusting it?

Mary Vance:  Well, yes.  Another thing that is kind of hot right now as everyone wants to try is ketogenic diet.  And again, that seems to work really well with people who have like 50 or more pounds of weight to lose.  And that is as you know is kind of low protein and high fat and really low carb.

Justin Marchegiani:  Yes.

Mary Vance:  But it is kind of a pain but it is really important information for everyone to track exactly what they are eating everyday and get their macronutrient ratio break down and see, “Okay, well I am only getting 10% of my calories from carbohydrates and that is really low.”  That might be too low for some people.  So it is really kind of takes all the fun out of eating basically to have to like count your carbs and track your percentages of how much protein, fat and carbs you are getting.   But I have people do that at least for a little while just to get a ballpark.  But most people I think for weight loss tend to do well with under a 100 grams of carbohydrates and then again it totally depends on the person. And if they are working to resolve some hormonal imbalances or other issues going on and then again with the ketogenic diet that everyone is kind of hopping on that bandwagon right now.  Like I said, for some reason it seems like people who have not very much weight to lose do not do well on that.  It can really make them feel poorly and people with a lot of weight to lose seem to do well.  What has been your experience with that working with people?

Justin Marchegiani:  Yes.  I mean, I see men always tend to do very well.

Mary Vance:  Yes. 

Justin Marchegiani:  And then some women will come in and they won’t do as well and there’s typically an underlying thyroid or female hormone issue that tends to, need to be addressed.

Mary Vance:  Yes. 

Justin Marchegiani:  And then also, I think people get the wrong mindset.   They are under the impression that all right, “Well, we are going to lose weight because then we get healthy.”

Mary Vance:  Oh yes. 

Justin Marchegiani:  And I think, I think the causality is reversed, is you get healthy then you lose weight.  And women they just have these beautiful, intricate cycle that is kind of like a symphony that is up then down.  For men, just constant, a straight line like an eeehhh, that is a straight hormone line throughout them hormonally.

Mary Vance:  Laughs. 

Justin Marchegiani:  And then the women have the symphony going on.  So you just take off one instrument out of the symphony or time it up wrong that symphony just sounds like noise.  Or like men just have this fog horn going the whole month.

Mary Vance:  Laughs 

Justin Marchegiani:  So definitely that is one of the big things I see, the hormones.

Mary Vance:  Yes, that is a really great point, too.  Because as you know, I know you specialize and work with Hashimoto’s and hypothyroid cases. 

Justin Marchegiani:  Yes.

Mary Vance:  Another thing that really gets me is that I will ask every woman who is either struggling with weight loss or I suspect hormonal imbalance, “when did you have blood work done?”  And then they will always say, “Oh my lab work is normal.  My lab work is normal.”  But you look at the lab work and there’s a huge range for your TSH which is what doctors use to primarily diagnose.

Justin Marchegiani:  Yes.

Mary Vance:  And let us say their TSH is 4 and you know that is not flagged as abnormal on the lab test.  And as you know, there is an ideal range and then there is this huge range in the lab test.   So you get a lot of people who are like kind of they are flying into the radar and they have T4, T3, TSH imbalances going on.  And that is when you want to do the more sophisticated panels and sometimes that is what some people do.  (Laughs)   

Justin Marchegiani:  Yes.  Yes, and you want to scratch your head even more because you can take a blood test on the East Coast and your TSH is 5 and you are considered normal because 5.5 is the normal for the East Coast.  And then you go to the West Coast and then it is 4.5 and now you are suddenly hypothyroid.  So I say the easiest cure for hypothyroid is just a plane flight, you know?

Mary Vance:  (Laughs)

Justin Marchegiani:  Just go to from the West Coast to the East Coast.  (Laughs)

Mary Vance:  That is pretty awesome.  And the worst thing is then they give you Synthroid and send you on your way.  And then those were the other people that I got.  They would say, “I have been taking Synthroid and absolutely nothing has happened to me.  I do not feel any better but my lab work is great.”  It is either a Hashimoto situation going on, and then it is not your thyroid’s fault, you know.  It an immune system issue.

Justin Marchegiani:  Right.

Mary Vance:  I do not want to talk about leaving out our conventional medical system because obviously it has its strengths.  But that is the one thing that gets me.  I have these people that are so frustrated working with endocrinologists and they never ask them how they are feeling.  They just look at their lab work and send them on their way.  And then people are still feeling really poorly and you know they have autoimmune issues then they are told, “Oh, if you have autoimmune it is still the same treatment,” you know?

Justin Marchegiani:  Right.  Right.  And then like the assumption that we can look at a brain hormone, i.e. TSH.

Mary Vance:  Yes. 

Justin Marchegiani:  And then we can make this general assumption that this is the same thing as thyroid hormone.  Well, we can just test thyroid hormone and we can be very accurate that way.  We can look at T3 and T4 free and total but we will just look at the brain hormone and we will base everything off of that one test, even though it is totally indirect.

Mary Vance:  Yes, exactly, exactly.  And then I have a lot of people too, they will have a full thyroid panel at hand and it say that have their antibodies are really high which indicates Hashimoto’s and no one has told them that.

Justin Marchegiani:  Yes.

Mary Vance:  No, my endocrinologist never said anything and my doctor never said anything.  I do not know what you are talking about.  You know they have been walking around with Hashimoto’s then it is not being addressed and then it is just, you know, kind of backward.

Justin Marchegiani:  Yes, and I think it is really important for anyone listening.  Like the training that I have had, the training that you have had, this is not training that is available to people in the conventional mainstream medical school setting.  You really have to go outside, kind of the conventional scope.  You have to go study from doctors that have been in the trenches for decades.  And you take classes with people that are already doing this.  It is not something that is in the conventional setting.  So I think a lot of people just think, “Oh, well my doctor went to this medical school or that medical school.”  These things are not being taught.  It is so cutting edge and for the most part, anything the doctor is learning in medical school is about 20 to 30 years old.  It is very outdated.  Most of what a doctor learns is clinical or in their residency but I think that is an important assumption that people really need to readjust that.

Mary Vance:  Yes.  Those are really good points.  They only have maybe one section that they need to require for nutrition.  And so your endocrinologist is never going to ask you what you are eating.  And many times your doctor is not either.  Or they have such ancient information about what you should be eating for health and there is still kind of the low-fat dogma and exercise more and eat less fat or whatever they are saying. 

Justin Marchegiani:  Yes.

Mary Vance:  But yes, I mean that is why this holistic health community and alternative medicine is really, you know, our whole goal here is to find the root cause as well and not just keep treating symptoms.

Justin Marchegiani:  Yes.  And I spoke with a Stanford physician recently.  You know, Stanford is probably in the top 10 for medical schools in the US.  It is pretty renowned.  And I asked her about her nutrition training while in school.  And she had to take I think a two credit class and it was online.  And you did not even have to show up.  You could just take the test at the end.  That was your nutrition class.

Mary Vance:  I know. 

Justin Marchegiani:  And I am like, “Oh my gosh! Like how can this doctor who just studies to know and at the end takes the test, how are they going to have the same kind of knowledge that when you spend thousands of hours I imagine in your nutrition program over at the school you went to?  How can they compare?

Mary Vance:  Well, and the other thing that I just do not understand is people really, I mean disease just does not, I mean in the majority of cases, right?  And the majority of cases disease does not just kind of spontaneously occur, you know.

Justin Marchegiani:  Yes.

Mary Vance:  There are a thousand factors that go into this and the biggest one I think, one of the biggest ones is what you are eating and what you are putting in your mouth everyday.  And that is going to also impact your stress level and inflammation.  And we know that stress and inflammation are kind of the first parts of imbalance that occur. 

Justin Marchegiani:  Yes.

Mary Vance:  You know, I do not understand why we are still going along and that connection is not really being addressed in the conventional medical world?  

Justin Marchegiani:  Well, I know hundreds of people are finding your website, reading your blogs and checking out your podcasts and buying your products so people are I think slowly changing.

Mary Vance:  Yes. 

Justin Marchegiani:  It is just a matter of time before they see five-ten doctors and you know, it is all in their heads.  Or if their hormones are out of balance here some birth control pills.  Or here is an antidepressant or it is you are just getting older.  Don’t you love that one?

Mary Vance:  Oh, my gosh! 

Justin Marchegiani:  You are just getting older.

Mary Vance:  Oh, I know you I am sure get tons of people who, I feel so bad for these people.  They have been through the ringer with like GI doctors, and endoscopies, even colonoscopies, and they have had biopsies and they say, “Yes, they just gave me an IBS diagnosis because they cannot find anything wrong with me.”     

Justin Marchegiani:  Yes.

Mary Vance:  And then they send them on their way and the reason that they need that diagnosis just so they can prescribe drugs.  And obviously the drugs are not necessarily going to heal the disease.

Justin Marchegiani:  Right.

Mary Vance:  Or the underlying cause but at least the person will be able to function.  And obviously there is something going on.  And that is what they will say, “Well, maybe you should consider an antidepressant.”

Justin Marchegiani:  Yes.  Exactly and I was watching House, MD.  I am just starting the show.  The show has been on for like 10 years but I got Netflix

Mary Vance:  Yes. 

Justin Marchegiani:  And I get to go through, you know, like just back-to-back-to-back.  You are going to go on like your weekend binge of whatever show you are checking out.

Mary Vance:  Yes. 

Justin Marchegiani:  But in that show, it’s the epitome because one, there was like two really cool things that happened.  If you have not seen the episode, spoiler alert but the girl that has brain issue, it’s a parasite!  Oh, my gosh!  I could not believe it because conventional medicine, you know, their parasites only exist in the third world.  So it was a parasite and it fixed her.  But number two, the other guy that comes that is having all the problems, the fatigue, the soreness.  And he is like, “Oh, it is fibromyalgia, it is chronic fatigue.”  Well, he goes out and he gets these M&M’s, you know like candies that did not have like any, you know, they are just kind of bland looking.  Put them in a bottle and just said it was medication and said here you go.

Mary Vance:  Laughs. 

Justin Marchegiani:  So basically, the message is: if your fatigued, if you are in pain, you are tired; it is all in your head.

Mary Vance:  In your head. 

Justin Marchegiani:  And then at the very end he comes back wanting a prescription refilled, basically proving that he is right.  It is all in our heads.  But if you go on the scientific literature, like low thyroid, adrenal fatigue and gut infections can cause chronic fatigue and fibromyalgia.   So it kind of supports exactly what you are saying.

Mary Vance:  Oh, yes.  And our system is kind of a disease-based model and not preventive-based model.  So those are the people that are flying into the radar because they have these subclinical imbalances or things going on that are not serious enough to prescribe drugs for, be detected and then that is how actual, real more serious diseases take hold if you do not kind of focus on these little underlying imbalances first.

Justin Marchegiani:  Yes.  I totally agree.  Can you tell me more about like who is your ideal patient?  Like who are the people that are coming to see you from all over the world?

Mary Vance: I specialize in Women’s’ Health and hormone balance so I see a lot of digestive cases.  And I do like those cases because those like I was describing that person who has been to five different gastroenterologists and had so many of her tests done and still do not feel better.  Because even making a few dietary changes right away will give them relief while you are kind of working on healing the other stuff.  So a lot of digestive wellness.  And then like you, a lot of immune cases, Hashimoto’s, hypothyroid.  Those are all really satisfying cases to work with because people just feel so much better.  And just educating them about what is going on with them that nobody has told them about and then giving then a good protocol or trying an autoimmune diet.  So it is mostly fertility, women’s health and hormones and digestive wellness.  And of course the detox piece, too.  

Justin Marchegiani:  Got it.   And you mentioned a lot of digestive issues with these female patients.  What percent of the people that are having these infections even have digestive symptoms?

Mary Vance:  Oh, gosh!  That is scary.  If you know that there are, when you run these profiles, or they do not really realize that what they are having are kind of nagging issues that they would not even necessarily, or they can cut normal.  You know, they think they are kind of burping a lot or feeling bloated at the end of the day.  But these food allergy symptoms and digestive issues manifest as different, you know, just being tired all the time can definitely indicate a GI problem as well.  It totally depends on the person, you know?

Justin Marchegiani:  Yes.

Mary Vance:  So there is a lot to answer your question.

Justin Marchegiani:  Right.

Mary Vance:  Yes, there is a lot of people that do not really have serious GI issues, you know but there is something going on in there and they are not aware of it until you run a test.

Justin Marchegiani:  Hmm, hmm, very interesting.  And what is your experience with resistance starch been like?  That is kind of like a big hoopla in the Paleo community.

Mary Vance:  Yes. 

Justin Marchegiani:  So what is your experience?

Mary Vance:  That has really kind of taken off.    

Justin Marchegiani:  Yes.

Mary Vance:  And I have just started sort of researching it and reading about it.  But, obviously, you know, the resistance starches resist digestion.   

Justin Marchegiani:  Right.

Mary Vance:  So you know, I think that the people are jumping on that bandwagon because it improves insulin sensitivity, it can lower blood sugar levels.  But I am kind of just starting to do more research on that and I think it can be really useful in a lot of people.  So what have you seen?

Justin Marchegiani:  Yes.  I mean, I think for me, it has been diagnostic for picking up SIBO.

Mary Vance:  Yes, yes. 

Justin Marchegiani:  I think some people do really well because they can increase butyric acid in the gut.   And butyric acid is really beneficial at lowering the pH and preventing bad bacteria from growing, especially people that are on lower carbohydrate diets.

Mary Vance:  Uh-humm.    

Justin Marchegiani:  There are these certain bacteria called Eubacterium rectale or Roseburia bacteria.  And when you go low carb these things get like really obliterated.  But if you do a little bit of resistant starch even while you keep a low carb diet you can keep that beneficial bacteria up.  So I think there are a lot of good benefits especially if you are someone that goes super low carb and you may get constipated.  In my opinion, that is the reason why people may get constipated on low carbs.  Even if they are not on the veggies and/or that bacteria starts shifting in your colon.

Mary Vance:  Yes, yes.  And I know that people are kind of using raw potato starch. 

Justin Marchegiani:  Yes.

Mary Vance:  I definitely think that using it for diagnostic tool is really valuable for SIBO.  But again as we were talking earlier I guess off air about people are going to their doctors and getting tests for this stuff that are not showing up until you either run more sophisticated stool profiles or you are kind of doing these little experiment with their diet and that is helping and it is really going to start to show up.

Justin Marchegiani:  Yes.  And you like potato starch over like plantains or over banana starch?  What is your take on those?

Mary Vance:  Potato starch can actually kind of mess with certain people. 

Justin Marchegiani:  Uh-humm.

Mary Vance:  And so I do not really use that one.  I know that it is kind of a popular one and people are using Bob’s Red Mill, I think. 

Justin Marchegiani:  Yes.

Mary Vance:  Potato starch.  Yes I am more inclined to use kind of the ones you suggest and necessarily that would be my go to. But I know with a lot of the articles I read, that is one of the main ones that is recommended.  What do you see with that?   

Justin Marchegiani:  Yes.  I have seen the same.  Anyone who has autoimmune I always just default to the banana or plantain.

Mary Vance:  Oh yes, because that has some irritants for autoimmune issues, yes. 

Justin Marchegiani:  Yes. I mean you get the alpha-solanine in the potato but some people are like, “Oh, but it makes us better.”  I am like, “All right, well as long as you are not autoimmune then we can try it.”  So I always recommend getting both and see which you gravitate towards.

Mary Vance:  Uh-humm. 

Justin Marchegiani:  I gravitate towards the plantain now or the unripen banana for sure.

Mary Vance:  Yes, and they are also delicious.  (Laughs)  

Justin Marchegiani:  Yes.  You can just mix it in with your shake, too.

Mary Vance:  Yes, yes. 

Justin Marchegiani:  Yes.  That’s cool.

Mary Vance:  Yes.

Justin Marchegiani:  Well, tell me about, this maybe like a little bit off topic or it maybe a little difficult for you to pull up the information.  Tell me about your most popular blog post.  Because I know you are a big blogger in the…

Mary Vance:  Uh-humm.    

Justin Marchegiani:  So what is like the things that the people there coming at, what are they looking up?

Mary Vance:  So probably the biggest post, the two biggest posts I can think of, well three, (Laughs) the biggest one is on adrenal fatigue.   

Justin Marchegiani:  Ah, yes.

Mary Vance:  Kind of healing a hormone imbalance.  And I think I even started off even in that post saying that you know most doctors won’t even address, you know, if people go to their physicians and say, their primary care doctors and say, “God I am so tired, you know.”    

Justin Marchegiani:  Yes.

Mary Vance:  That is not even really recognized by the conventional medical system at all.   That is a huge post.  Then treating candida.  You know, yeast overgrowth.  I got tons of hits on that blog post.  And then just 10 really easy daily detox tips.  Because after you, let us say, you have done all this work and you have cleaned up your gut and you got your liver detox pathways running smoothly again and you want to make sure, that is another huge question that I get asked.  How do I make sure my hormone levels do not tank again?

Justin Marchegiani:  Right.

Mary Vance:  Well, there are daily lifestyle habits that you can do to, just daily detox like dry skin brushing or we were talking about like the hot water with lemon.

Justin Marchegiani:  Yes.

Mary Vance:  Or including liver friendly foods, sitting in a sauna.  You know, exercise, sweating.  There are tons of ways that you can support your liver daily.  And also if you are working on healing hypothyroidism or hormone imbalances, you know just making sure that your lifestyle factors are in place in the most critical factor.  You can be doing everything right with taking your supplements everyday and eating but if you are staying up all night and chugging coffee and your stress levels up to the roof, you are not going to get well.     

Justin Marchegiani:  Right, right.  And on your site, you talked a lot about essential oil.  I know you like the Young Living Essential Oil company.  Can you tell me more about kind of like your take on essential oils?  Like the biggest three things that you would use them with in your life.

Mary Vance:  Yes.  You know while we were speaking earlier when you are talking about your cat scratch infection.  The Thieves Oil… (Laughs)

Justin Marchegiani:  Thieves, yes, yes.  Actually I have doTerra so I would do on guard.  But yes.

Mary Vance:  Yes.  And you can put that actually directly on it, too.  But I really love using essential oils.  My main caution that I tell people though is that I think that people are using a lot of these oils internally.  And you need to be kind of careful with how you are using them internally because we are still not sure exactly.  You know, there is a lot of evidence that peppermint, which is one of my favorites.  You are asking me about my favorites, peppermint is one of my favorites because it is really uplifting and cooling and it can relieve headaches pretty instantly and it can be very soothing for IBS type people.  Then there is evidence though because it is killing off certain gut bacteria.  And then if someone has SIBO for instance and they have an overgrowth of… That is what SIBO is basically bacteria in the wrong place and overgrowth of what is not considered bad bacteria.  It is just in the wrong place and there is too much of it and it can kill some of that off.  And so we do not know necessarily if it is killing off good gut flora.  So there is a lot of debate out there actually whether or not oils are safe to ingest.  And I think there are several that you can ingest safely.  But I do caution people about, you know you cannot take all these oils internally.  But I am a really big fan of some of these blends.  I have been really kind of focusing on the meditation practice and there are a lot of them that have specific oils in them to help deepen the meditation practice.  There is one that Young Living has the grounding blends and Believe.  And they have like balsam in them and different kinds of frankincense, especially.

Justin Marchegiani: Yes.

Mary Vance:  So I like those blends.  And I love peppermint and lemon oil that can be good for detox.  And I do, I love frankincense and myrrh, too because those are really great for your skin.  So it is super fun to dabble with and I think that diffusing then and inhaling them it can really provide a lot of stress relief for people.  And like I said, using them alongside kind of yoga or meditation practice because they smell nice and they make you feel good.    

Justin Marchegiani:  Yes.  What is your take on Valor?  You like Valor?

Mary Vance:  Oh Yes.  I love that one.  But Valor is also super popular.  I think they run out of it all the time.  People use that for kind of self-esteem and confidence and again it smelled awesome.  But I heard a lot of people who use that to reduce anxiety. And so yes, I think that they can be really good.  We reviewed this kind of like amazing testimonials about essential oil all the time.   I think that they can be a really good kind of lifestyle habit to help people when they are kind of working on healing.  And they are natural.

Justin Marchegiani:  Yes.

Mary Vance:  They are all plant based. 

Justin Marchegiani:  Oh yes.  Absolutely.

Mary Vance:  Yes.  They are really strong and they work pretty well.

Justin Marchegiani:  Very cool.  So is there anything else that you would like the listeners to know about you or anything on your radar screen that is really important to you right now?

Mary Vance:  Well, I would just say, you know if anyone wants to go to my website like you said,, there are tons of resources on there. And I actually recently written about my meditation practice and what I have kind of done to start help maybe get focused and grounded and centered.  And there are all my popular post listed and you can download my e-book.  So yes, I got it all in there and poke around.  It is not only just nutrition articles.  It is obviously, you know, with this holistic model like I was saying, it is lifestyle, wellness, sleep, stress, exercise, emotional well-being and there are recipes and just articles about nutrition on there, too.

Justin Marchegiani:  Very cool.  Her name is Mary Vance.  You can find her at  Feel free and check out her detox program.  Also if you need coaching, she is available as well.  And also Mary has a podcast called HealthNuts podcast.  They are on sabbatical right now while her counterpart finishes her book.

Mary Vance:  Laughs 

Justin Marchegiani:  But feel free to check out lots of great old episodes of really good interviews and check out the Facebook, twitter, LinkedIn and all the good channels there.  Thank you so much, Mary for coming on the show.

Mary Vance:  Yes.  Thanks so much for having me, Justin.  It is always fun to chat about these stuff.

Justin Marchegiani:  Absolutely.  Take care.

Mary Vance:  Okay, bye, bye.

Justin Marchegiani:  Bye.

How to Heal Your Gut Steve Wright Podcast #16


Dr. Justin and Dr. Baris interviewed health coach Steve Wright, co-founder of the SCD Lifestyle which is a community of health experts dedicated to help people heal their guts and take responsibility for their health and body.    

In this podcast, discover what SCD or Specific Carbohydrate Diet and how to use it to help restore one’s gut health.  Learn the healthier way of dealing with constipation without using Psyllium husk.  Understand why the functional medicine approach to treating patients is much more effective and beneficial than the insurance based approach to treatment.  Also find out about the common gut infections and key lab testings to accurately detect them.


In this episode we cover:

05:44   SCD versus GAPS Diet

14:07   Psyllium Husk and Constipation

31:20   Functional Medicine Model vs. Insurance Model

35:50   Key and Foundational Lab Testings

45:16   Other Clinical Markers for Infections

48:14   SIBO







Baris Harvey:  Welcome to another awesome episode of Beyond Wellness Radio.  In today’s episode we are interviewing Steve Wright of  Steve is a health practitioner.   He is also known as a poop specialist in our space.

Dr. Justin Marchegiani:  Laughs

Baris Harvey:  He struggled with severe IBS and digestive problems and now helps other people fix their guts.  So, how is it going today, Steve?

Steve Wright:  Great man.  Thanks for having me on.

Baris Harvey:  Yes, it is awesome to have you.  How is it going today, Dr. Justin?

Dr. Justin Marchegiani:  It is going great Baris.  I am really excited for today’s podcast.

Baris Harvey:  Yes definitely.  So Steve, I gave a little quick introduction but for the people out there who do not know about you.  Could you give us a little background about your story?  I know one thing that I like, we actually just did an interview with Garrett and he had a different, like an engineering background and you also did some electrical engineering in the past.  Can you tell me about your background and how you got led into this health space?

Steve Wright:  Yes, definitely.  And that is actually what I tend to call myself, as a digestive engineer or a health engineer.  I have in the past few years worked with people one-on-one but I have recently stopped doing that.   So I guess I am no longer officially any sort of practitioner.  It is sort of everybody’s story of how you ended up in the space.  I had an issue and no one in the modern medicine system was giving me any relief at all.  Not even a small amount.  And so my background from college was electrical engineering and I think what engineering in college does teach you is, it teaches you to be okay with really complex problems and problems that has unknown parts of them.  And so once I really realized that food was a big thing in my digestive issues.  I had a really, really bad IBS with gas and bloating that was like so bad it would make me want to cry.  But then when I farted I would feel so good but it would smell so bad.

Dr. Justin Marchegiani:  Laughs

Baris Harvey:  Laughs

Steve Wright:  It was like those kinds of farts that nobody wants to claim, like you are afraid that something died in you.

Dr. Justin Marchegiani:  Laughs

Steve Wright:  (Laughs) So, it was a very diabolical problem everything I had to eat.  I had all kinds of other symptoms that was just my big pain.  I had cystic acne.  I was 30 pounds overweight, used to be 60 pounds overweight and all these different issues.  And one of my good friend Jordan, my business partner now, he was celiac and he was getting help from gluten-free and a practitioner put him on a Specific Carbohydrate Diet and he stated getting better.  And so in a moment of fury and just tears and “upset-ness” I called him one day and he convinced me to give it a shot.  And in 3 days into changing my diet my gas and bloating was gone.  And so at that point it was when I felt empowered.  And suddenly I had started to take a little bit of responsibility for my own health and not outsource it to cure everything.   And so between kind of being angry and really sick that kind of led me to like sort of own my training and as far as problem solving goes and take responsibility.  And so it has been a 5-6 year process now of, “Okay well, that feels better but how much more energy could I have?  Can I have clearer skin?  You know, could I go from a very strict diet that works very well to a diverse diet that is like 80-20?  You know, can I do a sprint triathlon?  Can I go backpacking for multiple days up in the Rocky Mountains?   And just kind of every layer to sort of getting my health back to levels I never thought existed.  And then each time I find something that works I try to turn around and educate the public about it or create some sort of program to allow people to do it cheaper, better and faster.

Baris Harvey:  Definitely, that sounds good.  That is a good overall view of what happened.  And I like the fact that you had to go on a strict diet because of how much healing you needed in the past but also where now you probably can be a little bit more lenient and not so strict on your diet.  Do you still have to be pretty precise?  Do you notice like a definite change when you eat like maybe the wrong foods?  Or is your body a little bit more shall I say resilient to that now?

Steve Wright:   I definitely have a much more resilient health perspective at this point or health level at this point.  I mean I can eat gluten for like a meal or two.  Anything more than that my skin will like instantly begin to breakout and I will feel some fogginess in my brain sometimes as well.  So I still have sensitivity to some types of foods.  And in general, I eat all whole foods, typically.  If I do go out, I am going out to the best restaurants eating very much it is like Paleo with some Weston A. Price sort of mixed in.  So I will eat legumes like once a week properly prepared.  Obviously, I would eat high quality dairies from time to time.  But in general, 85-90% of my template diet is meats, fruits, vegetables and healthy fats.  You know, that type of thing.

Dr. Justin Marchegiani:  That is awesome. That is awesome.  So Steve, this is Justin here.  A couple of questions for you on the SCD diet.  I have used that diet with my patients quite frequently especially the ones that have colitis or Crohn’s disease, etc.  And I also use the GAPS diet or the into phase diet for GAPS.  And I am just curious, when you are working with patients, how would you apply the SCD versus GAPS and when would you choose one over the other?

Steve Wright:   Great question.  So essentially, what we use at SCD lifestyle and what I would use with people is basically the best of both worlds.  So in my opinion, the Specific Carbohydrate Diet as it was written by Dr. Sidney Hass or as it was written by Elaine Gottschall in her very popular book “Breaking the Vicious Cycle” is incomplete.   And the work of Dr. Natasha Campbell McBride has done with the GAPS diet again, all of these people are amazing and they helped saved my life.  So this is not a sort of walking on them.  We need to continue to further the ability to help people.  And so both diets by themselves and silos have disadvantages.  And they do not seem to produce consistent results for the majority of people who tried them.  They seem to maybe only serve 60% or 70% or something like that.

Baris Harvey:  Steve, real quick, I think some listeners might not know kind of the overall, what is, before you kind of go into what you do with clients, could you go to a quick brief overview of what the SCD lifestyle or the SCD diet kind of consist of?  And also what the general basis of a GAPS diet is?

Steve Wright:   Sure.  Sure, yes.  And that is a great point.  We should probably define what we are talking about. 

Baris Harvey:   Yes definitely.

Steve Wright:   Great, great point Baris.  Yes, so the Specific Carbohydrate Diet started in the literature in the 1920’s.    Essentially the diet as it was written through those various evolutions I just mentioned, is a diet that is processed food free, additive free, grain free and polysaccharide or disaccharide free even though that is a little bit of a debate right now if you get into the minutiae.  But essentially, what is allowed on Specific Carbohydrate Diet are properly prepared legumes, some fermented dairies such as cheese or homemade yogurts.  Meat, fruits, vegetables, nuts all of those types of things.  And there are specific, for instance, Elaine Gottschall chose to not include seaweed and multiple other specific parts of fruits that have polysaccharides.  And the basis for that is just that when your gut is really messed up, you cannot breakdown those carbohydrates chains and actually absorbs them and end up feeding bacteria or feeding the gut dysbiosis that might have already be going on.  So, Dr. Natasha Campbell McBride saw the golden SCD and took that and made it as the underlying foundation of GAPS.  And what she did was she essentially innovated on top of it to really help her autistic son.  And so she removed dairy from it because a lot of people have dairy allergies and totally understand that.  She also added in juicing.  She added in like some specific probiotic recommendations.  She did come up with like a lengthy Intro Diet whereas SCD has sort of an initial phase diet like 3 or 5 days whereas the GAPS intro phase can be much longer.    And so both of them have a lot of merit and they help a lot of people.  And I think Dr. Natasha Campbell McBride totally hit on something that we also abide by at SCD lifestyle which is that dairy is very reactive.  And we personally tell everyone no dairy for 30 days.  You know, always be testing it.  And then if you do happen to be okay with dairy, I think it is a really powerful food group that you should not completely exclude.  And so that is one of my sort of beefs with the GAPS diet.  As far as like how do we use either one?  It is a great question.  So, essentially, it comes down to I think creating your own custom diet.  And both diets could get you there.  Might be for GAPS really is that the juicing can be overtaxing if you are already learning how to cook and how to shop again, how to clean up.  And so if you want to add on top of that another layer of juicing, those are more skills and more money where the bang for the buck only seems to be there for a certain set of people who have really bad detoxification issues.  And for other people who have like SIBO, that is small intestinal bacterial overgrowth or other really bad gut dysbiosis the apple juicing can really affect them.  And if you have someone who switches diets in the first week or two and all they do is feel worse they are not going to stick with it.  And so once again I am not against juicing.  I just think it is something that you add later as you begin to jump into this lifestyle.  So basically my overall thing is start with meat, fruits, and vegetables.  Cook everything.  And we have like phasing charts over at but I am kind of staying away from actually like the cruciferous family in the beginning because those can be hard to breakdown because it has a little bit more complex molecules and fibers in those.  And really just starting from a cooking standpoint.   The GAPS intro can be like no fruits and vegetables.  And I think that works for some people but in general from a satiety standpoint and from the ability to stick to a diet, I think there needs to be some sort of compromise there.  And so that is kind of what we are trying to do at SCD Lifestyle.  It was like we saw these people failing in multiple ways and we are like, “Okay, let us just take the best practices and sort of begin to coach people through that.”

Dr. Justin Marchegiani:   Awesome.  Those are some great points, Steve.  So looking at the SCD and looking at GAPS, one thing I noticed on the GAPS side is the big emphasis in bone broths.  I do not quite see that on the SCD side.  So I just wanted to kind of figure out how you apply, how you use bone broths.  And just one layer on top of that is I kind of want you to go into FODMAPS.   Because I know even in the GAPS intro they still talk about adding in broccoli and cauliflower and even onions at some points.  And I see in the intro diet they even mention apple cider and things like that in one and two and then avocado I think in phase two or three.  So I want to get your take just to rehash that on when you apply broths and do you ever take FODMAPS 100% out of the equation?  And you probably even want to go into what FODMAPS are, too.

Steve Wright:  Yes, yes that is a lot of stuff to unpack there but great questions, Justin.  So let us start with the bone broth.  Yes, bone broth can be like this amazing human food and I do think it should be very much a part of a healthy person’s or a person who can digest it very much a part of their life.  You know, hopefully having it on a weekly basis if not a more often basis.  Now you know some people love it every day.  And I think it is a great food for that.  So I love the fact that the GAPS diet really elevates bone broths and talked about it a lot because it does seem to be like a needle mover for a lot of people.  And so I think we have to always keep our eyes on the different needle movers because you know something like maybe supplement x is really good for your health but it is maybe not going to like really cause massive change in a month or something like that whereas bone broth could have a potential to do that.  So my thoughts are we typically add it in a little bit later after the first 30 days or so and always looking out for fat malabsorption.  Because there are a lot of IBD people for instance or people who are still misdiagnosed or undiagnosed who have just a really wrecked gut and bone broth for them is like death soup.  Like drinking it just makes them want to cry.  So I think it is worthwhile to let people know that if you cannot tolerate a lot of fatty foods or anything like that, where you have like some really bad gut dysbiosis, sometimes it is better to wait four to eight weeks before you begin to slowly introduce bone broths.  And then the same thing could be said for probiotic foods.  You know GAPS is really, really big on probiotic foods and I love that as well.  But again there are the really, really sick people who need to have a gradual introduction into all of these things.  Like for instance, my business partner Jordan, he had to start with the one strain of sauerkraut per day for like months.  It took him like two or three months to get up to like two or three spoonful or forkfuls of it.    And so that is where I think that first three days is really key for just keeping it really simple and trying to keep the diversity a little high with fruits and vegetables.  But also as you mentioned you know watching out for FODMAPS.  So FODMAPS you know, is a fascinating diet out of Australia.  And I think it is a really cool new take on foods and how they impact us and how the gut flora is impacted from them.  In general, I think a 30,000 foot view, my experience with FODMAPS is that the more intolerant you are to FODMAPS foods the more damaged and the more destroyed your gut is.  And so removing them if you are intolerant to them in the beginning can be sort of like a life changer.  Like your quality of life can immediately go way up.  However, I do not think there are classes of foods that you want to keep out forever.  Like you mentioned, onions and broccoli and cauliflower, these are very powerful great foods.

Dr. Justin Marchegiani:   Yes.  Right.

Steve Wright:  That we should use later on in a very healthy diet.  But I think sometimes for those people, they will just have to heal their gut a little bit longer before they can reintroduce those.

Dr. Justin Marchegiani:   Excellent points.

Baris Harvey:  Yes.  That makes a lot of sense.  So it is basically a certain level of making sure that you are healthy enough or you take like a more therapeutic approach where maybe you have to kind of babysit, be kind of delicate on what foods you introduced until that gut is kind of cleaned up and now you can actually take some of the nutrients out of these other foods that might be harder to digest.

Steve Wright:  Yes, I mean let’s face it.  The diet that you should be following is like for me is the Steve diet, it’s the Baris diet, it’s the Justin diet.  And your gut flora, my gut flora, our epigenetics, all these things are different.  And they are also different depending on where you are in your health in your life.  So in the beginning, you might have to get a very restrictive diet.  But do not label food just good or bad.  Just label them good for me right now or not good for me right now and based on whether you can digest them or not digest them.

Baris Harvey:  Uh-hmm.  Definitely that sounds good.  So you are just talking about how some people have a problem digesting fats.  And it is funny because we also talked about how people can have problems with breaking down the carbohydrates and often times when people are backed up and have constipation.  I know a lot of people they really like to bulk up with like psyllium husk or just pack a bunch of fiber in order to get things moving along.  But I like how you have a little bit of a different perspective.  Could you for the listeners out there who might have some constipation issues and they are just trying to stack up on psyllium husk, can you give some other advice on how they can maybe helped with their constipation issues?

Steve Wright:  Yes, so I guess my counter perspective is that fiber from whole foods is really the kind of fiber you want.  And supplementing with psyllium husk is basically you would try to do the same thing if this analogy makes sense to you this is what you would be doing with psyllium husk.  So let us say, since we are talking about poop, you take a big dump and you clog your toilet.  And you go to flush and yet nothing happens.   Would you pour out more toilet paper and start shoving it in the toilet to make that…

Baris Harvey:  Yes, it would make everything worse.

Steve Wright:  Right, right.  So that is sort of the same thing with psyllium husk.  It is sort of like a plugged toilet in a way.  Would you dump a bunch more of poop basically into your system hoping that it is just going to unclog it?  With some people it works in the short run.  Myself, when how much you will actually experience it is that it is either going to make a bunch of bloating and really hurt or it might work for a week or so.  And then also you will notice you need more, and more and more.  And through this process you might actually be damaging your colon just because you are creating so much feces.  So my take on that is it is not an amount of poop problem that constipated people have, it is the inability to get rid of it.  So there is an evacuation problem going on and not a lack of poop to get rid of.

Baris Harvey:  Uh-hmm.

Steve Wright:  There are lots of ways that we could do this without using psyllium husk and some of the herbal laxatives and enemas and things like that.  And that is through substances that either help with peristalsis which are the waves that actually move the food through your stomach and then obviously get rid of your stool.  And then there are also substances like vitamin C and magnesium which are nutrients that your body could absorb and could help you in that regard.  But when you overdose on them or begin to sort of micro-overdose on them they will actually draw some water into your digestive tract and sort of begin to help move things along or soften the stool and kind of get it along.  So, I really prefer the sort of short term interventions with vitamin C and magnesium and typically magnesium glycinate or citrate.  And then long term thinking about what is going on in here?  Why is peristalsis not happening?   Do you need more probiotics or more fiber from whole foods and begin to try to get to the root cause of why you are constipated in the first place.

Dr. Justin Marchegiani:  Excellent points.  Great points, Steve.  Now I work with a lot of patients and I find gut infections are strongly at play.  Lots of different parasites issues, whether bacterial issues, H. pylori, chronic, fungal overgrowth, SIBO.  And a lot of these infections they produced toxins, right?  So we know endotoxins or lipopolysaccharides. These are produced from a lot of the gram negative bacteria and these can disrupt a lot of those peristaltic waves or kind of like if you would get the last bit of your toothpaste out of your toothpaste you kind of roll it up.  That is kind of how your intestine works.  So can you talk about how kind of in your role working with patients being a clinician, how these infections really kind of muck things up, if you will?

Steve Wright:   So just to clarify, I do not have a medical license or anything.  So I was just a health coach.

Dr. Justin Marchegiani:  Uh-hmm.

Steve Wright:   Yes GI infections are extremely prevalent.  And people are not getting this message or are not hearing this message.  If you sort of  poll the community and I am not sure what percentage you saw, Justin but like Dr. Tom O’Bryan sees 70 to 80% of every person who walks into his clinic whether they are complaining about GI issues or not have a gut infection.  I have heard Dr. Lauren Noel talked about around 80% as well.

Dr. Justin Marchegiani:  I agree.

Steve Wright:   Okay cool.  Yes.

Dr. Justin Marchegiani:  Totally agree.

Steve Wright:   And that is what we pretty much saw, too.  It is 80-90% for the people that we are working with.  So it is a really high percentage.  And so, yes exactly those infections do a lot of damage.  Number one, they could shut down the peristalsis waves.  Number two, all those toxins are definitely causing inflammation and probably leading to leaky gut.  And it is really the root cause especially constipation.  Like constipation to me is like a huge massive red flag that there is probably some sort of infection that you want to go and get tested for.

Dr. Justin Marchegiani:  Yes.  That is great.  And I also have a site called and I talk a lot about thyroid issues.  And I see on your blog here today, you did a blog on, “Is your thyroid destroying your gut function?”  Could you touch base on the thyroid gut connection, Steve?

Steve Wright:   Yes sure.  I am sure you have mentioned this before but every cell in your body needs thyroid hormones. They need at least T3 to function.  And so the thyroid is extremely important.  And if you look in the research, there is a high prevalence of thyroid disorders and inflammatory bowel disease, celiac disease and thyroid disorders are very high.  And so it is kind of fascinating to think that there is a gut issue that is diagnosed and then typically or at least you have a much more increased risk of ending up with some sort of thyroid autoimmune disease as well.  And I think a lot of what is going on here is you have a couple of things.  Number one, is that if there is not enough thyroid hormone ending up in your gut cells the peristalsis waves, this is shown in research, the peristalsis waves will be either slowed down or the strength of them, their ability to sort of squeeze out like what you are talking about the toothpaste, will be diminished as well.  And that is just because the cells are not getting enough of the hormone signals to do the job that they are supposed to do.  Now if you are hyperthyroid instead of hypothyroid then you could be causing like diarrhea or something like that.  And you know that the really cool research that is coming out that I am really pumped about now that I would be writing more about in the coming weeks, is that they are now showing that maybe up to 20%.  And this is really new stuff.  But all we really know is that the gut flora plays a big role in the conversion from T4 to T3.  I know this is not perfect science but I think it is easiest to remember T4 is sort of the inactive form or thyroid hormone, more of storage part of the thyroid hormone.

Dr. Justin Marchegiani:  Right.

Steve Wright:   And T3 is the one that everybody wants majority of the time.  And so the gut flora helps with not only the conversion of the T4 to T3 but they also store some of the T3.  So if you have a disrupted gut flora you might have, you know, poor conversion.  And then that is going to feed the signal back to begin to make more thyroid hormone and it can continue this bad feedback loops and really begin to cause a bunch of issues.  And conversely, maybe you are eating an SCD diet or a GAPS diet.  You have gotten rid of your gut infection but you are still having to rely on magnesium or vitamin C to have bowel movements when it could be just that you needed some sort of thyroid support or some work up there to actually begin to restore full function to the gut.  Does that make sense?  I do not know if I was talking all around that article.

Dr. Justin Marchegiani:  Yes absolutely.

Baris Harvey:  Yes, I know that sounds awesome.  I mean like a simple way to think about it and it is so awesome how complex yet amazing our bodies are.  When you see something like hypothyroidism and then slowing down the intestines.  And we know like our thyroid is like our master metabolism kind of gland.  And then we see like, “Oh, if you have hyperthyroid you might have diarrhea.”  And it is kind of like your body telling you like things are hypermobile, it is speeding up.  There is something going wrong.  Or if the inverse is happening through your body and it is kind of obviously telling you something.  And often times it is just so common that we kind of ignore those signals.

Steve Wright:   I mean, I think that is just part of like every system in the body.  Like functional medicine, like everything is just connected to everything.  And so it could be that the gut is messing up in the HPA axis where the thyroid adjusts itself or it could be the other way.  And so I think what you said there is perfect.  Really a lot of this is about becoming aware of our bodies again.  And I know one of the ways in which I got sick was essentially and it is no fault of anybody’s but sounds like humans we get like a manual that says this is how you should relate to your body.  And this is what a perfect poop is.  And this is what a perfect thyroid is, right?  We do not get that.   And typically the process of getting that is through getting back into our bodies and realizing what we are putting in, what we are consuming and then talking to other people who have like a very robust, resilient health: how did they feel?  Like what did they do?  And if you can’t do what they do then you are like, “Oh, interesting.  I wonder why that is?”

Baris Harvey:  Yeah definitely.  So I want to slightly transition.   I was actually on a call.  Somebody called and they are talking about a client going to their doctor after you know they tested these gut panels.  And it is funny because we talked about the infections and parasites and usually people think like unless you are swimming in some dirty water in Thailand, we do not get parasites or infections or things like that in America.  But they also had leaky gut and they went to their doctors and their doctors said well it is not real, right?  It is not a real thing.  I am not going to treat anything like that.   Could you answer this question?  For us, we kind of know this but is leaky gut real?  And how have you seen that in your practice?

Steve Wright:   Yes, this is such a profoundly simple question.  What is real is what is real to us individually.   So in that doctor’s point of view, leaky gut is not real to him.  I do not know what his basis of medicine is or how he functions in this world.  I am not here to judge him.  But let us say for instance, you just went to PubMed which is, and for people to know, that is a big search engine for all the research that is going on in the medical community.  If you type in intestinal permeability which is the medical term for leaky gut; leaky is kind of like the slang term.  You will find well over 10,000 research papers that reference it.  So I do not know, maybe things become real for that doctor at 100,000 references or 12,000, I am not sure.  But what is true is that since the 1980’s, papers have been published since we realized how the gut actually begins to function is through cells that become more permeable depending on the conditions that are present in the body and outside of the body.  And so this is a known fact now that there is such a thing as a permeable gut and that is actually how the gut cells function.  The problem is that this is just beginning to be taught in medical schools and as most people know your average family practitioner and even most gastroenterologists and people like these, they got into school a long time ago.  And to be honest they are not interested in learning new ideas.  They are just interested in going through a yearly conference or two and brushing up on the paradigm that they bought and paid for and work really hard to get.  So I think at this point, the patients out there have to decide whether or not they believe it is real.  If they believe it is real then it is time to fire your doctor and find someone who believes the same thing you believe.  I mean if you believe that you should pay your taxes and your accountant says do not pay your taxes you will probably fire that accountant and go to one that believe what you believe.

Dr. Justin Marchegiani:  Right.

Steve Wright:  So the same thing applies to medicine.  Doctors are there to serve you.  And that is not how it always had been portrayed but that is really how the world works.  When you buy a consultant they are there to help you.  So if your consultant is not acting in a way you wish they would it is time to fire them.

Baris Harvey:  Awesome.

Dr. Justin Marchegiani:  Awesome points, yes.  And Steve just so you know, 10, 842 for intestinal permeability on PubMed right now as we speak.

Steve Wright:   That is so awesome.  It is creeping up.

Dr. Justin Marchegiani:  I know.

Steve Wright:   It is going to get to 11,000 real soon.

Dr. Justin Marchegiani:  (Laughs) I know.  Right.  So, you kind of touching back on the doctor’s paradigm and being a physician myself and working with lots of patients you come to the resolution that what you are learning in school and what you are learning in textbooks is about 20 to 30 years old.  So to be on top of things and to really help your patients, you have to be studying what is clinically working now.  Talking to other doctors, going to cutting edge conferences where you are learning the application of what is happening now.  What are the best tests?  What are the best things we can use supplementally?  Diet wise, lifestyle wise to fix these things.  And also we have to step outside the insurance model because a 5-minute doctor’s visit is not going to be enough to get the information to teach our patients.  So you can talk about kind of the functional medicine model versus the insurance model?

Steve Wright:   Yes. Sure.  So, I love analogies, right?  So I think this is how the insurance model works.  It is much like the public school system.  So if people can think about the public schools system.  They probably thought about that more than the insurance model.  But the teacher and the doctor are the same role.  So in the public school model, the teacher is told exactly what they must teach.  They have exams that their students are measured on.  If they do not get their students through that certain grade then they could be fired.  They get specific kinds of pencils.  They get specific textbooks regardless of what they want to teach.  They are told how they have to teach and what exactly the takeaways are.  Well, that is the exact same thing that is happening in the medicine world.  So I really do not fault the doctors.  I do think that obviously, like you Justin, like you decided that you are going to do something different.  And you have decided to take more responsibility, more investment into your profession.  And there are teachers; they are stand up teachers who do the exact same thing.  They buy their own markers.  They buy their own stuff.  But that takes a really special person.  And so if you want to subsist inside either system you have to realize the standard of care that is practiced there.  And so in the insurance model, the insurance companies dictate exactly how these doctors have to function.  And if they do not follow what the insurance companies said with step one it can go so far as the medical review board could remove their license.

Dr. Justin Marchegiani:  Wow!

Steve Wright:  So their license is what they paid hundreds of thousands of dollars and eight to ten years of their life to get.  So they are stuck in a really, really rock and a hard place position here.  And so that is where you almost have to step outside of the system and go over to this non-insurance based model where a lot of the functional medicine practitioners practice.  And I think there is another distinction there that we should make which is that, I think the insurance model is really built around symptoms care.  It is about solving the immediate pain but no time is spent on why are you in pain or how did you get here.  Whereas in the functional medicine model, which is typically outside of this insurance model so that physicians like yourself can actually spend 30 minutes, an hour, more time than that.  You actually have time in your day to probably research the tough cases and figure out the newest and best models or reach out to world class practitioners who are doing something different that no one has heard of yet to help these people.  And that model is really about why is this happening in your body.  Because you might have acne and depression and a little bit of constipation and you knee might hurt a little bit.  But in the insurance based model you are probably going to have a physician for each one of those things.  You are going to have a dermatologist.  You are going to have a neurologist.  You are going to have a gastroenterologist and you probably will have some sort of an orthopedic surgeon or something on your team.  And none of these people talk to each other.  And then in the functional medicine model, you can go and see someone and they will be like, “Oh, actually all that stuff is related back to… Oh, looks like your gut and your hormones are off.”

Dr. Justin Marchegiani:  Laughs

Baris Harvey:  Uh-hmm.

Steve Wright:   And so if we fix both of those all that stuff will go away.  And so I think that is also a big distinction between those two models.  One model is silo and specialty focused and the other model is like wait, everything is related.  It is all of the system.  And so if I treat something over here it is going to affect something else over here.

Dr. Justin Marchegiani:  Absolutely.  And I am constantly learning and I found the SCD Lifestyle phasing chart through you guys, through your site and I have been using that for my patients for the last year.  And that is where they worked wonders.  I appreciate that.  You know, that contribution you made.

Steve Wright:   Oh, thank you so much.  Yes.  Really and this is probably both of you guys just kind of thought, I just want to create this stuff, you know.  I am in this for myself as well as for everybody else.  But I really want to create tools and blog posts that I wish I would have had 7 years ago.  Because it is inexcusable that more people do not know about these stuff.  So that is kind of like a rule that I have about what products and what things you put on the market.  What blog posts we publish.   If this would not serve me 7 years ago we are not going to do it.

Dr. Justin Marchegiani:   Love it, I love it.  And right now, there are a lot of people out there that are trying to get answers, right?  They are trying the diet stuff and they are also curious about functional medicine lab testing.  So I know there are a lot of ways that you can spend a lot of money on lab testing and maybe not accomplish a whole bunch.  So there are certain tests out there that may not get you the underlying cause of what’s driving things.  So, what would you think are the key foundational lab testings that you would recommend?  And again there are exceptions to every rule.  Like a lot of times people think that food allergy testing is a waste but for some people it may be beneficial.  What tests do you think are key and foundational to addressing maybe chronic gut and/or fatigue issues?

Steve Wright:   Yes, yes that is great.  And you are right.  Everything that we talked about in the world there is an outlier.  So from my point of view, again kind of like if you take sort of my engineering mindset, how do we get the most bang for our buck?  And what are the biggest needle movers regarding diet?  And we can apply this for test, too.  And so when it comes to test, I think the first thing is getting a good handle on a salivary adrenal panel, like adrenal stress index is what they are called, for your hormones.  Because we talked about thyroid earlier in this podcast but with a lot of people who are just learning or do not know about it yet, is that as long as you do not have an autoimmune condition with the thyroid a lot of it could be handled just through fixing your adrenal glands.   And then a lot of sort of other sex hormone issues can be taken cared of if you really get those guys working properly and the feedback loop is working properly.  So I think number one, you know working with a physician who can screen you for autoimmune markers.  That is really a needle mover test.  And some people do that through like Cyrex Labs.  Other people can do that through blood testing.  I think those are really big needle mover test because if you find that that is huge in this whole grand scheme of things and what you are going to eat and what you should go after.  I think the salivary index BioHealth is the trusted lab that I like.  I tried a lot of labs out there and I have run panels.  Do you agree?

Dr. Justin Marchegiani:  I agree.  Like a 100% agree.

Baris Harvey:  Uh-hmm.

Steve Wright:   Okay great.  I have run panels and I am not going to name any other labs but almost every other big labs you have ever heard of I run side by side panels and BioHealth always seems to line up with symptomology for people and so that is what I trust for the salivary or hormone stuff.  And then the next big thing is the GI infections test or two.  So here is a fascinating nugget that is not only fascinating but extremely frustrating.  We did over 400 case studies where we have people doing a BioHealth 41H which is a stool test for infections versus other labs stool test.  So we just essentially said this is the model of what we do.  If you want to work with us because of what we have seen you have to do these two tests.  And that means basically double the money.  And we found somewhere around 70% of the time roughly, you know give or take 10% they were off.   And there was one test that caught some bugs, that made sense and the BioHealth did not or the BioHealth caught them and the other test did not.   And so that is a really frustrating but it is a very interesting point which is that you want a practitioner who not only uses sort of the same base testing but also sees a lot of these tests because tests are not perfect.  There is nothing about any medical testing out there that is perfect.  Even cholesterol testing is very imperfect.   And so you need a practitioner that understands the subtleties and the limitations of testing.  So when it comes down to needle mover test, I would definitely go with a BioHealth salivary panel at least the 41H from BioHealth and then combine that with maybe another one out there Genova or Doctor’s Data or something like that or another trusted lab.  And then however your doctor prefers to screen for autoimmunity.

Baris Harvey:  Awesome.  I know you mentioned the false negatives with kind of the GI testing.  I know you might not treat in a specific way if you do not find anything.  But are you still going to kind of go about it the same if somebody is having a lot of symptoms of infection and you are not finding anything.  Or you still might do some kind of protocol that is still geared that way just in case it was a false negative? 

Steve Wright:   Yes, yes definitely.  I definitely talked to people about that in the past.  And I know a lot of high, really respected coach or medicine practitioners do the same thing.  And the issue with that is that you do not know.  You have to then use a sort of like a broad protocol.  You cannot target a specific type of bug for instance if it was H. pylori versus SIBO those are two different programs.   Every one of those infections has a specific protocol that works really well for it.  If you get a false negative but you still think that there is an infection there I think it is still worthwhile at that point to use some sort of broad spectrum based protocol and then follow-up with testing again.  So just because you have one false negative, here’s a crazy story for you guys.  So I have low stomach acids since I started this whole journey.  It was one of the first things that I have figured out and nobody was talking about.  And I am like, “Oh, my gosh!  If I take Betaine HCl like I would start to have these amazing poops.  I don’t burp anymore.  And I do not have indigestion anymore.  It was just an amazing thing.  And so ever since and that was like 7 years ago, I am like Googling and trying to figure out like what causes low stomach acids to be low or to be suppressed.  And you know there are a lot of different things but the main one out there is typically is H. pylori.  And so for years, I am like, “I have H. pylori I know I have it.”  But I have like two and a half years’ worth of tests that are negative, negative, negative.  No H. pylori.  And so we have never treated it because there was never anything there.  And we are talking about all kinds of different labs, all kinds of different ways of testing.  But as I got healthier and healthier, I did another stool test and then eventually I did get a positive for H. pylori.  And treated it and now I do not need any sort of stomach acid boosting support unless I am under a really bad stressful situation.  So the moral of the story here is number one, tests in and of themselves just done once are almost worthless.  You need to continue to do testing overtime.  And there are conditions such as crypt hyperplasia which may have been happening in my case or there is maybe this idea in my head, this theory that as you begin to solve a root problem, as I began to increase my immune system through fixing hormone dysregulation all of a sudden that infection became active enough to actually finding it on the test.   And so I really think it is a fallacy to think that you can test once and figure this all out.

Justin Marchegiani:  Yes.  That is a great point.  And I recommend lab testing just for preventative medicine maintenance just once a year.  At least a gut test even if you are healthy.  I know when I met my fiancée for instance, she had 15 years of IBS issues going to the ER, being scoped many times.  And when I first treated her she had a blastocystis hominis infection.  We removed that infection half of the pain gone.  Then we tested again H. pylori, then it is cryptosporidium, then it was a worm infection, then it was Giardia.  It was 7 or 8 infections layered in the crypt.   So if all of our listeners can just open the palm of their hand, think of the fingers as like the villi and then where the finger gaps meet the palm of the hand, that is like where the crypts are.  And these infections get burrowed up in there.  So based on your experience Steve, what do you think are the most common and most virulent strong infections that you see out there are?

Steve Wright:   Well, I just want to echo exactly the advice that you just gave, Justin.  I do the exact same thing.  I actually just ordered a $2500 worth of preventative testing.

Dr. Justin Marchegiani:   Nice.

Steve Wright:   I do it every year.  And that is part of my budget.  That is part of how I look at health care and taking responsibility for my health these days.  I have a catastrophic health insurance policy.  But then I also have that deductible covered in savings.  But every year, I budget two to three thousand dollars’ worth of preventative testing just to make sure I am on the right track.  Because if I can catch this stuff I will never even use that deductible unless it’s some sort of an acute problem that happens through sports or accident or something like that.

Dr. Justin Marchegiani:  Love it.

Steve Wright:   So I could not echo that enough.

Dr. Justin Marchegiani:  Love it.

Steve Wright:   So back to common infections.  So I would say like out of the 600 or so case examples I can poll from blastocystis hominis as a huge one.  See what else, H. pylori was another really, really common one.  Entamoeba coli is another really common.   I would say those three are probably the most common that I saw on a regular basis along with SIBO.  Excuse me, I should definitely throw small intestinal bacterial overgrowth in there because that is super common.

Dr. Justin Marchegiani:  Yes, yes.  And then when you are looking at patients because I have the same thing where sometimes the lab work does not come out positive, you know, like what are you going to do?  What are the clinical markers and signs that you may look to say, “Well, there are still something wrong.”  Maybe they have cut out FODMAPS and they have an improvement.   What are the other clinical markers would you look at outside of just lab testing?

Steve Wright:   Yes, I would look at number one, any gas or bloating at all is an indication to me that there is likely low stomach acid plus some sort of overgrowth.  Those are really big red flags for either or both conditions because they sort of feed each other.  I would guess like, okay so if you are using supplements that physically alter the way in which the intestines work that would be things like digestive enzymes, Betaine HCl, ox bile, vitamin C, magnesium if you want.  So like the first three are more about like stopping diarrhea or helping constipation.  And magnesium, vitamin C, laxatives things that improve constipation.  If you are not having perfect poops on a really healthy diet like a whole foods diet or like any of the diets we have talked so far you are still having loose stools or constipated tools that is all we really need right there.  The other thing is if there are any autoimmune markers at all I am automatically thinking GI infection and yes I would say any autoimmunity, any sort of GI distress at all.  And then lastly like, if things just seem complex, like you have been sick for a really long time, then typically I am assuming you have multiple areas of your body that have been down regulated overtime and part of that is just going to be the gut.  So maybe it was not always the gut.  Maybe it started with some thyroid and adrenal stress and then you have lost your immunity and then you just picked up a gut infection.  So now you are presenting as chronic fatigue or multiple chemical sensitivity or fibromyalgia.  And you know, for instance, fibromyalgia.  Essentially 70% of people with fibromyalgia have SIBO.  So any of these sort of complex syndromes and undiagnosed problems like IBS immediately I am thinking this person has a high, high chance of having a gut infection of some type.

Dr. Justin Marchegiani:  Uh-hmm.

Baris Harvey:  Yes definitely.  That makes a lot of sense.  And real briefly, I know we are coming close to the end of our episode but if you can go over because I know SIBO is really a big issue that is starting to pop up a lot more now.  For those of our listeners who are not too familiar with it.  I know Dr. Justin you recently did a video on SIBO.

Dr. Justin Marchegiani:  Uh-hmm.

Baris Harvey:   Could you go a little bit more into SIBO and just talk about how you might get this overgrowth and kind of like what is a little bit behind the mechanisms and maybe some ideas on how you get rid of it as well?

Steve Wright:  Yes sure.  So small intestinal bacterial overgrowth is essentially you are having too much bacteria in the small intestine.  It could be beneficial strains bacteria, could be just neutral bacteria or even bad bacteria that have overgrown.  Essentially what has happened is most of your bacterial growth should be in the large intestines not in the small and somehow you now have a colony in the small intestine that is essentially producing a lot of gas.  They are just being bacteria.  Bacteria very, very simple.  I mean they eat and they give up a by-product.  But the symptoms that it causes are very intense and can be very debilitating depending on the level of the overgrowth and the length of time.  So the ways in which you get it are almost too numerous for us to even go into on the show.  It is a wonder that your average sick person in America has not gotten it.  A lot of people do have it.  But essentially, once you combine stress with one bout of gastroenteritis or just like food poisoning or something like that your chances of having SIBO go through the roof.   And some of the new research is starting to talk about the fact that just one round of gastroenteritis something like that, every time you have one of those, your chances of SIBO go through the roof.  But there are lots of other things you can have.  Valve malfunctions in your intestines; low stomach acid really feeds into it.  Essentially, how are you going to beat it is that those bacteria need a food source.  So it is just like if you dropped a spoonful of peanut butter on a side walk, the ants and the animals are going to come running.  And so that is essentially what is happening with the small intestines.  There is a food source and biology is just taking over.  Like there is going to be something that is going to step up and fill that role in the community.  And so reducing the food source through diets like the Specific Carbohydrate Diet, through the GAPS Diet is one way to begin to lower the community.  But a lot of people would need either an antibiotic protocol with typically Rifaximin, maybe some other add‑ons or maybe an herbal protocol to really get rid of it.  And from my personal opinion, and as I guess one of the leaders behind the Specific Carbohydrate Diet at this point in time, I do not believe that you can starve out SIBO.  I have been working on it with myself, and working with people for over 6 years now and this idea that you can starve out SIBO thing or candida thing infection I think it is just a giant myth.

Dr. Justin Marchegiani:  I totally agree with that.  I see that all the time with my patients.  We have to use a combination of herbal medicines whether higher dose or the oregano or berberine and Goldenseal or higher dose Artemisia, I 100% agree with that.

Steve Wright:   Awesome.  And I want to say that if people who are listening to us are like, “Man, I did that, too and it came back.”  The first thing I am thinking is your immune system is suppressed and it is probably your hormones.  So I think a lot of the recurrent candida people or the recurrent SIBO people out there if your functional medicine practitioner has not been focusing on your hormones and your immune system I think that is why a lot of the reinfections are or the colony just overgrows again.

Baris Harvey:   Uh-hmm.  Definitely.  I like the analogy made earlier with the you know, you dropped something on the floor and all the bugs and the ants are going to eat it.  It is kind of like if your body is unable to breakdown what you have then something else will and then so yes and it is hard to say, “Oh, we’ll starve it out.”  While they are still there you still have to find a way to get rid of them.  So definitely, I have looked and have researched and I have seen the same thing.

Steve Wright:   Yes, I would totally encourage people to check out Dr. Allison Siebecker over at  She has proven that these bacteria can live on fats.  They can live on proteins.  They can live on the mucus that we generate.  So this idea of starving them out is not a reality based on the new science.

Dr. Justin Marchegiani:  Uh-hmm.  Well, his name is Steve Wright.  You can find him at  As a physician myself, I highly recommend everyone to go and download Steve’s free quick start guide.  I use it with my patients.  I recommend it to all my patients.  So everyone go out there and get that right away.  Steve, are there any other ways our listeners and viewers can find out more about what you do?

Steve Wright:   Yes, I mean if you are looking at starting the SCD or GAPS or something like that or having a lot of that stuff I think the quick start guide is great.  If you are someone who is beyond that at this point and you have already tried these types of diets and you are looking for the next level of information, we recently created a new site called and on it you can go there and you can take a free quiz.  Sort of taking your risk factors into account to see what your chances of having a leaky gut are.  And at the end of the quiz you will answer a question about what is your number one complaint right now.  Is it digestive related?  Is it hormones?  Is it energy?  Skin? That type of thing.  And when you take the quiz you will get the results for free but you also will get a 60-minute interview on whatever your top health complaint is.  I would say that what we trying to do is kind of create two different sites.   One site for the people who are sort of just getting started with this more of the beginner stuff for free.  And then solving leaky gut is more for the advanced people who are on the train of autoimmunity and have had gut issues for a long time.

Dr. Justin Marchegiani:   Thanks so much, Steve.  We appreciate it.

Steve Wright:   Thank you so much for having me on the podcast.  It has been a great discussion.

Dr. Justin Marchegiani:  You are welcome.  We will have you back very soon. 




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