Natural Ways To Increase Your Glutathione Levels | Podcast #292

Glutathione is an antioxidant that is capable of preventing damage to cellular components and also gives a lot of benefits to our body. For today’s podcast, the topic that came to mind is glutathione. Dr. J and Evan point a lot of information and tips on how glutathione is important in our health, how we increase our glutathione levels the natural way, the pros and cons, and a lot more. Read and listen below. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

00:37    Glutathione as Tri Peptide

06:06    Conditions Associated with Low Glutathione

11:32    Glutathione in Helping with Treating Cancer

23:03    Food and Supplements

38:46    Tips, Ideas for Higher Glutathione Levels

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Really excited to chat with y’all today. We got Evan brand here in the house, Evan, what’s cooking my friend?

Evan Brand: Oh, not much. We cook some bacon and some pastured sausage earlier, but nothing is cooking at the moment beyond that.

Dr. Justin Marchegiani: Awesome, brother. Well, I know we were chatting about topics that for today’s podcasts in the pre show and glutathione was one of these topics that kind of came to mind based on challenges that we’re seeing with our patients based on things that we’re seeing in our comments section on our pages, and we decided glutathione will be a great topic for the show today. So really excited. Let’s just start off the day what is glutathione? So glutathione is a tri peptide. What does that mean? Tri means three, Peptide means essentially amino acid. And there’s three amino acids that make up glutathione. Glutamine, cysteine and glycine, those are the big three glutamine cysteine glycine. Now we really important because these are all amino acids. Sulfur rich amino acids and you’re not going to find a lot of these amino acids by the way in in plant based products, you’re going to find the mainly in animal based products. So for amino acids are much more rich from animal than you do plants. A lot of plant based products tend to be lower in sulfur amino acids and you actually have to combine them to even get them appropriately right. That’d be like rice and beans, right? Because they’re missing certain amino, so you got to combine them just right. So glutathione really important try peptide, glutamine, cysteine, glycine, glycine, very, very high in bone broth and collagen. Right. cysteine very high and a lot of high quality animal products. Also whey protein. Okay. And then glutamine is obviously in a lot of gut healing supports glutamine is really important for the gut lining. Glutamine can also be more inflammatory, too. If you don’t have enough B six, it can go down glutamate pathways without B six. So we also want to make sure we’re getting enough B vitamins and we’ll talk about glutathione metabolism. We’ll talk about some of those pathways and what nutrients are needed to maximize glutathione and healthy glutathione metabolism besides just those try peptides, glutamine, glycine, and cysteine. Any thoughts seven?

Evan Brand: Yeah, I think it’s all excellent. I look forward to breaking it apart more. Now, how do we measure glucose ion? One way is we like to look at organic acids testing. There’s not a direct marker that says, glutathione, boom, that’s your level. But using some of the metabolites that you can measure in the urine, you can get an indicator of it. And we know that when people are exposed to toxins, whether it’s mold, or heavy metals or pesticide or herbicide, whatever it is, you’re going to be reducing your glutathione levels. And as you mentioned, you know, people that are on veggie based diets, they’re probably going to show up low. And so we can measure that on the oat test other other ways that you know, have to measure glutathione or is that what you use?

Dr. Justin Marchegiani: So yeah, the big ones, like you mentioned are going to be the pirate glutamate. The sulfate and the alpha hydroxy butyrate. Those are going to be some of the best ways to test it on the organic acids. Those are precursors to solidify own and a lot of the the sulfur nutrients cysteine, glycine, glutamine, those are big, big ways to do it. So when you look on the organic acids section, it gives you about five different organic acids that are that are very, very helpful at looking at glutathione the big three of the ones I just mentioned, I’ll pull up a couple others that I use as well, that are more on the precursor side for glycine. So glycine is another big one. Because that’s really important for glue to found as well then there are others that look at glutathione than the cysteine and the glutamine on top of that I’ll pull that up in one second. So organic acids are great. There’s also a red blood cell glorify on that you can do doctors day that does it. I think spectra cell does it.

Evan Brand: Have you ever done it or do you run it or do you think it’s not worth it? If we’re doing that oat.

Dr. Justin Marchegiani: I think if you already have a good look at the oat, there’s four or five markers on there that you can elucidate from so I think the oat’s fine, but if someone has a chronic condition chronic detoxification issues, I don’t think it’s a bad way to just kind of give it a an extra look, see, especially if you’re struggling on the organic acids, or if the organic acids look good, but you’re still having some detoxification issues, I don’t mind running it. A lot of times I’ll run an ion panel with some of my patients which will come with an organic acid and a intercellular nutrient blood test as well. So it would be on there and then also be on the organic acids so that’s a way to kind of get a package deal on and kind of get two for one if you will.

Evan Brand: Yeah, I love the combos. Love the combos yes to like you mentioned the, like vegetarian sources where people are going to get sulfur to boost glutathione. I mean, that’s going to be the cruciferous stuff. This is why you and I will use some of these like broccoli sprout extracts. There’s some kale sprout extracts, things like that. There’s different greens powders, and there are some encapsulated products that we use and I’ve used them with children were if they weren’t able to swallow or they couldn’t stomach like a encapsulated glutathione or maybe alive was almost like they didn’t like the taste and some of the broccoli sprout extracts tend to work pretty good.

Dr. Justin Marchegiani: Totally and on the organic acid just to highlight sulfate and pirate glutamate are the big ones for glutathione that’s really big. And then the other ones are going to be to methyl hip right we’ll really look at glycine and then the gluco re also looks at glycine so those are some of the other ones that can be ultra ultra helpful.

Evan Brand: This is why oat test is like I don’t know desert island you only have one test to choose from between like a DNA stool and an organic acids. Oh, man. It’s tough. I mean, I some days I go with the oat over the stools, my only test if I had to pick one.

Dr. Justin Marchegiani: Well, it can be helpful because you get a good window into yeast and fungus, which can be really helpful. So that’s really nice. And then also, we can talk about gluten if I own the different conditions that are associated with their other nutrients that help you recycled modifying and that are very helpful in the healthy metabolism of fluidify own and we have a nice handout here. I’m going to pull up so you guys can see I think it’s under Very, very, very helpful. I’ll pull this up here for you guys to see. So there’s a bunch of different conditions that are associated with low glutathione. Everything from aging to all simers to cancer to chronic liver, cognitive issues, cystic fibrosis, diabetes, hypertension, any immuno deficiency and chronic viral issues, lupus, mental health issues, multiple sclerosis, neurodegenerative issues, Parkinson’s, I mean, this is like through the freaking roof. It’s unbelievable. The association with other conditions, it’s not saying this is a direct cause they’re just saying, hey, they test a lot of people for who to die on. And they just find this chronic association with these issues. Now, I would say there’s definitely going to be there’s definitely going to be a causation link there for me, it’s hard for research to say that it takes a while for research to do a causation thing you got to do a metabolic war and you got to really take people in, give them Low, low defiant take people out, give them some glutathione and study the different it’s really hard at metabolic Ward studies are tough. So it’s you have to kind of look at more of associative studies versus metabolic Ward that really give you the causation. Let me show a couple things here for you guys to see. me pull this up for you guys.

Unknown Speaker: Okay, can you see my screen Evan? 

Evan Brand: It’s loading. Yep, there it is. 

Dr. Justin Marchegiani: Okay, cool. So these are a bunch of the conditions here that are associated with low glutathione. And then there are the links here. So you can actually see the scientific studies right Alzheimers, the emerging role of glutathione and an Alzheimer disease, right? You can see diabetes glutathione synthesis is diminished and patient with uncontrolled diabetes is really important. And again, this is the article right here I wanted to highlight is called a review of dietary phytonutrients for gluten support. It’s in the journal nutrients September 2019. So pretty, pretty fresh study. But this pathway here I really wanted to highlight for everyone. I think this is super important. When I get this just the right size, does that look good to you? 

Evan Brand: Yeah, looks perfect. 

Dr. Justin Marchegiani: Okay, cool. So let me kind of highlight a couple of things that are happening here so people that are listening, we got a video on screen so you guys can actually see the different pathways and how glutathione gets into the cell and works. So you have your three major amino acids you have cysteine right here, which can come from an acetylcysteine and can get converted from cysteine assisting right there, you have glycine, right very high and collagen and bone broth. That’s why I like to do my 20 grams of collagen in my coffee every morning. Okay, and then you have your glutamate or glutamine inside the cell. So outside the cell, these are the big two amino acids and then inside the cell, you have your glutamine that gets conjugated here. Now also outside of the cell, look at the the green vegetables right the brassica vegetables, the high cruciferous vegetables. Some of the polyphenols like green tea are very important in this glutathione to conjugated, basically it helps conjugate a lot of these foreign chemicals xeno biotic means foreign chemicals, you know, biotics could be xeno estrogens that could be xeno neurological things from pesticides right? So basically they’re going to be chemicals that are foreign to the body that are stressor on the body this can help with fluidify on to GST and conjugate Gosh, conjugate just means binding a protein to it, typically, so the body can excrete it via the stool or the kidneys or urine, right?

Evan Brand: Now, here’s the thing. You mentioned that big list of conditions so it would make sense why cancer would be associated with low glutathione because this pathway you’re showing if you’ve got a build up of all these toxic chemicals and hormone disrupting chemicals whenever if that pathway screwed up. I mean, it sounds like you’re going to end up sick so it’s not that like you said, it’s not causation, but that pathway could be you know, if I were somebody like focusing on an anti cancer regimen, I mean, this pathway here would be a huge piece of the puzzle.

Dr. Justin Marchegiani: 100% and this GST stands for glutathione S transferase and they’re actually making drugs that are glutathione s transferase in nature. So this GST is very very very important in excreting toxins and crap outside of the body. And we know this to like a lot of the things we may use on the brassica vegetable side, we may do broccoli sprouts, we may do sulfur rich compounds like dim, which is di n Dom methane, or we may do indoor three carbinol these are all going to be so for concentrated compounds, we may even do things like calcium to glucose rate. And these can help improve this clarify own clarify on s transferase pathway. Any comments there? 

Evan Brand: I’m trying to figure out what the I would love to learn about that you’re saying they’re using or they’re making prescription drugs to work on this pathway?

Dr. Justin Marchegiani: Yeah, so let’s um, let me see I can pull it up here on screen for you. Can you see this right here? 

Evan Brand: We’re still on the image we still see the image of the pathways.

Dr. Justin Marchegiani: Okay, let me just pull this up here this is an older study but you know I like to just show people what’s going on so they can actually see it 

Evan Brand: Because here’s if they’re gonna make a prescription here’s what they’re going to do they’re going to jack up the price 1000 X to do the same thing that in AC or DC now do yes sir.

Dr. Justin Marchegiani: Okay, so you can see this the role of fluidify on s transferase. In anti cancer drug resistance. So it seems like this may be helping a lot of the cancer drugs work better. So they’re talking about who defined as transfer rates are a family of phase two detoxifying enzymes that help catalyst catalyst is a gluten independent enzyme. And it basically helps when I say conjugate that means bind a protein to it, a variety of endogenous and exogenous toxin. So endogenous means toxins that are made by your body. exogenous means toxins that are come into your So think of mold and pesticides as exogenous. Think of maybe yeast overgrowth or bacterial overgrowth and those toxins being produced like acid aldehyde, maybe being endogenous. Does that make sense? 

Evan Brand: It does. I actually found something on this. I’m looking on this drug website, and actually found out here that for chemotherapy, doses of 1.5 to three grams of glutathione have been given in a 15 to 20 minute time period right before a chemotherapy treatment.

Dr. Justin Marchegiani: Totally makes sense. Yep, totally makes sense. So I’m trying to go down to the conclusion of this one study here. I haven’t gone through it yet. Yeah, I’m just trying to look through this here. Alright, cool. I’ll have to go through this here later on. But I mean, it just shows you how important glutathione is with detoxification, cancer and also we can talk about the immune system, right. There’s the reason why that page had immune issues, AIDS and viral issues as being a low glutathione issue. Because gluten has a major, major role in immunomodulation and immune balancing any comments there?

Evan Brand: I just wonder where this conversation is happening in an oncology office though, hey, we need to boost up your clue to find out I want you to eat broccoli sprouts and take some extra NAC and vitamin C and some of the stuff we’re going to get into. It’s like, Where’s that happening? I mean, maybe in a holistic oncologist office, but I feel like your conventional guys, it’s still just the chemo model. It’s not going to be anything like this. Exactly wrong. If you’re, you know, cancer doctor out there, then let us know who you are, what you’re doing. We’d love to hear about it.

Dr. Justin Marchegiani: I mean, the problem is, people on the pharmaceutical side or conventional medicine side, their perspective when they look at things is how can we make a drug that modulates this pathway or interacts in this pathway? The problem is once you start making the drug, you’re forgetting why these pathways are low to begin with. Right? Hay diet issues, digestion issues, stress issues, exposure to toxins, right They’re forgetting why these pathways are low to begin with. And then number two, anytime you make a drug, you can’t patent Mother Nature. So you can’t patent the actual codify on building blocks, you have to do isomers, or different substrates that look similar, but may not be the real deal. And the problem is once you start deviating from Mother Nature, all drugs have what Evan?

Evan Brand: They have side effects, side effects. It’s like the designer babies. It’s like, oh, let’s play with these genetics. We’re going to make this baby have this color hair and this color scan and whatever there. It’s not what nature intended. 

Dr. Justin Marchegiani: Exactly. So once you start doing that, then you have an increased risk of side effects. And because you can’t patent Mother Nature, you know, that’s the problem. That’s the big issue. You can’t patent Mother Nature. Therefore, you have to go and create compounds that are isomers that look similar, they may work a little bit will never work as good as the real thing. And then you’re going to have a whole bunch of side effects.

Evan Brand: Yeah, let’s get back to that first paper that you and I have pulled up with the graphic on it because we wanted to go through some things that have been shown to help with this whole glutathione people think just pop glutathione pill in that scene of the day. But there’s and that’s true. You can do that. You could do your oral, your sublingual, your zomo, your intravenous glutathione. But there’s other things along the way they can help, like NAC is a game changer.

Dr. Justin Marchegiani: So let me let’s kind of let’s work from the top and go down. Okay, so we talked about what’s happening outside of the cell, right? We need cysteine. We need glycine, these are really really big pathways. We talked about maybe some of the sulfur compounds in the vegetables, we hit that right now inside. If we go to the top of this cycle and work our way down, you can see folic acid or we’ll just call it full late. Okay? And you can see thf this is tetrahydrofolate and this goes to mthfr. Right everyone talks about methyl tetrahydrofolate reductase right mthfr right. So you need full A B vitamins, and then you’re also going to need b 12 betaine, which is trying methyl glycine, so these are important nutrients that are needed. So this pathway can go around and essentially when you have an mthfr issue, this pathway up here, this enzyme is lower. Therefore, you need more of these nutrients here to run this pathway and of course not folic acid we activated fully, whether it’s cat you know, folic acid or calcium D fully or mthfr folate, we need to activate it fully. And then you can see here I’m assigning gets stuck as homocysteine if we don’t have enough of these nutrients and we know homocysteine can create vasculature inflammation, inflammation in the vasculature right? associated with heart disease. You can go look at the research of Kilmer McCauley over at Harvard, and we need enough of these nutrients to take pining to go to homocysteine and then go all the way down to cysteine down here so then you can see cysteines are really good sulfur amino acid cysteine then binds with glutamate or glutamine. Okay, and then you can see cysteine and glutamine go downstream to actually make glutathione and guess what else you need? Well, you know, if you look at some of these nerve pathways over here where you know, you know that multi level product called Protandim, right, it’s got a lot of the phytonutrients the green teas ashwagandha fits in this category, a lot of bioflavonoids like resveratrol, vitamin e omega three and guess what? Magnesium. So these nerf two which is really important for binding that cysteine to the glycine and making glue to find magnesium is really important as well. And then you can see glutathione also is very Selenium dependent. So fluidify on gets utilized in the body, it needs to be two and then also when it gets reduced to reduce go to diet, it needs vitamin C and lipoic acid to bring it right back up and to recycle it. So if you don’t have enough vitamin C or lipoic acid, which is a silver component, we may not recycle our glutathione and then Selenium is very important too because Selenium helps take the metabolism of Go to found it spits out a lot of hydrogen peroxide right here, h2o. And Selenium actually binds an oxygen off and makes it water. So it actually helps the metabolites of glutathione that are very inflammatory h2o to and it turns it in the water. And then we use a lot of these phytonutrients as well to buffer that oxidative stress.

Evan Brand: It’s beautiful. It’s a it’s amazing how that happens. So you and I’ve talked about autism and behavioral issues and detoxification issues and all that and how it’s related to mthfr defects. So what we’re kind of showing here can show how just simply improving the methylation component of this picture can improve detox because methylation helps with detox on its own, but you see the mechanism downstream of glutathione. So this is why some kids that we work with even just by improving methylation, and as you mentioned, we’ll give them like an activated, you know, l mt hf or something similar data We’ll clear up some of the mood issues that will clear up some of the skin, it will clear up dark circles under the eyes. I mean, just improving methylation alone could be a game changer. My favorite part of this whole picture is the vitamin C, because in this paper that you and I were looking at, it was shown that even just taking 500 to 1000 milligrams a day of vitamin C for 13 weeks. So what’s that give it three months or so led to an 18% increase in gluten ion levels? So that’s it. That’s such low hanging fruit. You and I are such huge fans of addressing low hanging fruit. I mean, how much easier can it get? You’re boosting Bluetooth on 20% just by vitamin C. I’m rounding at 18 but I’m calling it 20. I mean, it’s close enough.

Dr. Justin Marchegiani: I wanted to highlight this one study here so you can see it to kind of just dovetails with everything we’re talking about. I want to just make sure that makes sense. pull this up screen here so you guys can see it.

Evan Brand: Okay, while you’re doing that, I’m going to just keep ranting about other nutrients. So yeah, I just pulled up Selenium. I want to say one thing about that real quick. So Selenium. It was found that beautify on increases just by giving Selenium as well. So I’m not saying spot tree. But let’s see someone had a thyroid issue were like, Hey, you really need some extra selenium, that alone could be boosting Bluetooth ion. So it’s really, really cool.

Dr. Justin Marchegiani: And the nice thing is when we’re looking at patients, we’re testing all these nutrients because of course, yes, it’s going to help but if you’re deficient in one nutrient over the other, that nutrient could be the bigger linchpin for supporting your glutathione. Right. Now, this study, I thought was really important because one of the major mechanisms of glutathione and how it works with cancer is it modulates the immune system, better immune system, right? It controls cancer cell growth, right? What’s cancer just cells growing out of control, and then it helps with oxidation, right? oxidation is when you lose electrons and cancer is very oxidative. It causes a lot of loss of electrons which then creates a lot of free radical stress and damage. To the DNA into the immune system, so really powerful abstract here, role of fluidify on and cancer progression and chemo resistance which means resistance to chemotherapy. It talks about codifying, placing an important role in the cellular process, including proliferation and a pop ptosis. That means cells growing and cells dying, so it helps cells so they don’t grow too much until they die sooner. That’s good. We need that. Then it talks about while glutathione deficiency or decrease in glutathione ratio leads to an increase in susceptibility of oxidative stress. What does that mean translation, you lose a lot more electrons, and that creates free radical damage and DNA implicated in the progression of cancer elevated glow to final levels increase the antioxidant capacity. That means it helps you take electrons that you’ve lost it helps bind to them and stabilize the cell and resistance to oxidative stress observed in many cancer cells. The presence highlights the role of gluta thiam as a cytotoxic That means it protects the cells from being damaged. Carcinogenic means means the formation of cancer. So it protects cells from being inhabited by cancer and the sensitivity to tumors to the cytotoxic agents, or the cytotoxic effects of anti carcinogenic agents, so what that means it’s going to protect you from getting damaged by chemotherapy. And it’s going to protect you from the cytotoxic effects of chemotherapy. So that’s kind of the the layman’s translation as we go. So what’s the moral of the story glutathione protects you from the damage of cancer, it protects your cells from growing into cancer and it protects you from the damage of chemotherapy. So three ways it’s very beneficial.

Evan Brand: That’s amazing and not that this was the glutathione cancer podcast, but hey, I’m sure everybody listening would agree that you don’t want cancer. So, of course, you can’t say glutathione prevent you from getting it, but man, it’s an incredibly protective molecule.

Dr. Justin Marchegiani: 100% Evan, can you see me back on screen now? 

Evan Brand: Yes, sir. 

Dr. Justin Marchegiani: All right. Awesome. I think we hit that one really, really well. Let’s keep on rolling though, if you don’t mind. So we talked about that pathway, which I thought was really helpful. We’ll put the links down below. So if you guys want to see it, why don’t we talk about some of the big foods, so beautify on right cysteine glutamine glycine, so now we just back into it what foods are really high in cysteine, glutamine lysine? Well, of course, things like whey proteins and to be great as long as you’re not ultra dairy sensitive whey proteins great sulfur rich foods are going to be helpful like a lot of your brassica cruciferous vegetables right bok choy, broccoli, brussel sprouts, cauliflower, kale, mustard greens, turnips, again, the problem is that’s not going to really help you with a lot of the intercellular glutathione but it’s still going to be helpful. Now what other other foods that are more high in some of those intercellular nutrients? Well, you’re going to see all of your high quality animal products, beef, chicken, fish, eggs, all of these things. The higher quality the animals are, meaning the less hormones the West junk, the less toxins, the more they’re fed high quality grass, the more nutritionally dense they’re going to be.

Evan Brand: I found, I’m looking at a couple of like food data sheets. So in one large egg, you get almost 150 milligrams of cysteine. And who knows if that’s even, I mean, that could have been a conventional egg. I mean, what about like a fully pastured organic egg, you may even get more cysteine you’re talking almost I mean, if you do two eggs, you’re at 100% of even over 100% of your daily intake for assisting with two eggs. Love sunflower seeds, and a handful, a one ounce handful of sunflower seeds. You’re at over 100 milligrams of hemp seeds. You get a ton from hemp seeds as well. So like let’s say you did a smoothie in the morning where you put in some collagen with maybe some hemp seed or maybe some hemp protein added to it. Maybe a grass fed way. I mean you’re going to be stellar in the solidify on generating department.

Dr. Justin Marchegiani: Love it. 100%. So your animal products are always going to be the best way to go off the bat just because of how high they are and how nutrient dense they are. Also, when you look at amino acids and plants, you have to look at the digestibility of the amino acids, there are certain scales, you can look at that look at the digestibility because plants have a lot of anti nutrients that bind a lot of these amino acids up because plants don’t have claws and teeth to fight or flee. So how they survive is they have anti nutrients which makes some of their nutritional compounds harder to break down which means they pass through the stool and then they can grow seeds and flourish and other parts of the soil. So they have to have anti nutrients so they can pass other animals digestive tracts right. Animals just have claws and teeth to fight and flee plants don’t so there’s a lot more anti nutrients that prevents some of the digestibility whether it’s mineral blockers like fighting And oxalates, whether it’s trypsin inhibitors that help decrease proteolytic enzymes, so their proteins can’t be digested, whether it’s lots of hard to process fibers, all those things are potential and could be, could play a big role in those amino acids not being fully absorbed.

Evan Brand: Well, here’s a couple other things, too. So in that paper, they’ve got a table on there that talks about preparation of the sulfur rich vegetables. And apparently freezing of broccoli does reduce the sulfur. And then of course, if you are eating it overcooked, you’re likely gonna it’s like a sweet spot, right? Because we’ve talked about this before nutrient density of raw versus lightly steamed. So lightly steamed is going to be the way to go. But if you cook too much, then you’ve broken it down that way. If it’s frozen broccoli, then you’re already at a disadvantage state. So it sounds like it’s just too difficult. I mean, I’m not saying that. veggies aren’t important. I still eat a ton of veggies, but if I’m looking to it To increase glutathione I’m not just going to be doing a broccoli smoothie, I’m going to be focused on the way and the collagen. And also, here’s an interesting one. Number one food for my pining king crab, one crab leg, you’re over 700 milligrams of Matheny. It’s the number one source. So if you like crap out there, there’s a reason to like it because of them.

Dr. Justin Marchegiani: Love it. I love it. I think that’s really, really awesome points. So a couple of kind of deal breakers, let’s call it low stomach acid, we don’t have enough high quality stomach acid, it’s gonna be hard to break down a lot of these sulfur rich compounds. So of course, that’s going to be a big, big problem. So if we don’t have enough stomach acid or enzymes, we’re not going to be able to digest a lot of those animal products, and also a lot of the sulfur rich vegetables. Let’s be real, a lot of them are very high and fodmaps, right, fermentable oligo, disaccharide, mono and polyols. So guess what, if you have SIBO guess what kind of response to those vegetables you’re going to have? Yes. A lot of bloating and gas, they may even disrupt motility they may even cause diarrhea or constipation. So you may not really be able to tolerate much of these vegetables. So a lot of people that are like on a carnivore template, a lot of times they have SIBO, and a lot of autoimmune sensitivities and they’re really sensitive to a lot of the anti nutrients in these plants. So a lot of people kind of come down on people that are doing a carnivore template, but the reason why they do it is because they feel significantly better because of the anti nutrients and because a lot of times there’s some SIBO going on and cutting out those fermentable carbohydrates or even going carnivore can help starve out some of those critters too.

Evan Brand: Yeah, and important. And let’s point out that’s not forever. I mean, if somebody is on a carnivore template, we’re using that to stabilize those people until we can work behind the scenes on these other issues like the infections you mentioned. Yep.

Dr. Justin Marchegiani: And we may be able to add some other things down the road for sure. So a lot of your vitamin C rich vegetables are going to be awesome. A lot of the sulfur ones a lot of the lower sugar fruits are going to be awesome. Those are going to be great things to do off the bat. Of course, we talked about yourself. Millennium rich foods as well animal products, oyster seafood, high end zinc high in selenium, Brazil nuts can be excellent as long as you can tolerate the knots very, very high in Selenium. We talked about the stomach acid and the enzymes as being a rate limiting factor because of the fact that they need good acid levels and enzyme levels to be able to break them down. And also say we talked about this earlier. Vitamin D is really important for glutathione in the brain. Can you talk about that a little bit, Evan?

Evan Brand: Yeah. So I think the best way to talk about this and implement it is through the nebulizer. So there was a couple papers talking about increase included found in the brain. I don’t have it pulled up. But long story short, I’ve looked into this. I’ve done it over the weekend. I will tell you, I get more energy, I get more mental clarity. I feel honestly I feel relaxed. I mean, it’s almost like I snuck in a little bit of gamma powder into my nebulizer something because after breathing in the glutathione, I just felt relaxed. Maybe because I was like focusing on deep breathing and such while I was breathing it in. But I looked at a couple papers on the administration method. So just eating glutathione orally meaning in a capsule form like zomo, doing foods to increase it versus IV versus nebulized. The only way to get it in the brain is nebulizing. At we’re talking at therapeutic levels now, the some of the glutathione made in the body get into the brain, probably, but we’re talking if you want to just crank up brain power, let’s say you have a traumatic brain injury, maybe you had a head injury or you’re an athlete or a soccer player or you fell off a bike or you fell down a set of stairs or you have mold because we know mold damages the brain to me nebulizing with the sodium bicarbonate and the saline solution. It’s a miracle cure, so I can’t say enough good things about it.

Dr. Justin Marchegiani: No, I love it. I think it’s really, really important. I wanted to highlight a couple more things that I thought were also very important. Let’s talk about supplements. So we talked about a couple things when we review that solidify on pathway that you guys can see the video on. Alpha lipoic acid is very important in recycling clarify him. Also, milk thistle is a really good tone of fire and does help support glutathione levels as well. Vitamin C is really important, right? That helps with reduced glutathione and help activating it again, that was also very, very important. Oh-

Evan Brand: Here’s one thing. Go ahead. Here’s one thing I forgot to mention this was in the paper. So I kind of went on a tangent on the on the nebulizer. But in that particular paper, you and I were discussing it I was wrong. It is true that you can increase at least this was in rats. So is it the same in humans maybe. But by just giving an IV dose of NAC they were able to increase glutathione in the brain. So what about oral NAC? Does that increase glutathione in the brain? I don’t know. But at least in that paper IV NAC did boost Brain levels include glutathione.

Dr. Justin Marchegiani: That’s great. Yeah, I imagine over time, I mean, those amino acids will eventually cross. I know sometimes the amino acids cross the blood brain barrier and then the glutathione converted in the brain I think glutathione maybe too big to cross the brain itself. I know some of the amino acids like cysteine Oh l cysteine. can cross the blood brain and can then convert to glutathione in the brain. So I know cysteine is a big one. I don’t think NAC can but l cysteine can. 

Evan Brand: You think just because it’s smaller? 

Dr. Justin Marchegiani: Yeah, smaller because NAC gets broken down into cysteine by the body and some people they say just take cysteine because I know a lot system is very important with adrenaline. And we know adrenaline is a really big, nervous system. amino acid right? And we know dopamine actually gets converted to adrenaline and we know dopamine to adrenaline. That pathway involves sulfur in particularly cysteine.

Evan Brand: So wonder, I’m just thinking out loud just for for my purposes. So I want to People that are having issues with anxiety, if they would be able to reduce the anxiety by boosting up that pathway working more on sulfur.

Dr. Justin Marchegiani: Sulfur can be really helpful. Now in my line, I have a product called detox and he knows that we’ll have some cysteine some and acetylcysteine some calcium to glucose, which is a really good binder for mold and for hormones, refining, cysteine, taurine, glycine, so all the amino acids which is really helpful, I like that a lot. I’ll also do a lot of the the phase one nutrients, a lot of the antioxidants, a lot of the B vitamins, milk thistle, those kind of things for phase one support. Phase One is taking toxins that are fat soluble and converting them to water soluble phase two is going to be water soluble, excrete it out the body and that involves lots of sulfur, all the amino acids I just mentioned. And with some people we may do a combination of El glue or lipids almost glutathione we may do glutathione, there’s another good found has these little these little Bucky balls? Can you talk about that?

Evan Brand: Oh, yeah, I love I love the seat elated. Yeah, so there’s a couple out there with the Bucky balls that basically the idea is to try to just shrink the molecular size of it, so you can kind of sneak it into the cell. So there’s, you’ve got the light zomo where you’re going to do like a sunflower and then you’ve got this buckyball idea now I don’t know if it’s a carbon molecule, if this is the same thing as the C 60. You and I’ve been talking about or what but but there are ways to to make Bluetooth ion smaller for me, I just look at the papers on it. And the acetal version is the one that I believe you have your own I have my own as well have an S acetal ad glue defi on. I’ve had people doing here just just a quick little debate. I’ve had people doing various versions of like Bumble glue defy on and liposomal vitamin C and I’ve measured them and many of these people are still low on the test for vitamin C and glue to violence. So when we switch them over to like an acetal ated and then just a mixed ascorbate I see the levels come up so it’s not that I’m against the life was almost glutathione. But I’m just finding that the acetal works just as good if not better, and it’s capsule because the lipids almost generally tastes like crap. Or if you’ve got a really sensitive person, there’s going to be citrus oil or some other flavoring to cover up the terrible beautify on taste. And then those people don’t tolerate it, and then they’re not compliant and then they don’t get better.

Dr. Justin Marchegian: 100% Yep, I totally agree. So right now, I use a lot of lipids almost, but you still do the seagull and you still get good results with that clinically?

Evan Brand: I do. Yeah, it works great. And I feel good on it. So I’ve done an experiment on myself where I’ll go life as normal for a month and then I’ll go acetal I feel just as good Now it could be because my acetal version has a gram of NAC added to it. So I’m kind of cheating because I’m really getting the NAC plus the gluten. Maybe that’s why I’m I’m getting so much better. Oh, so while you were talking I just did a quick search on studies on glutathione and anxiety because you brought up this whole dopa mean endorphin thing and this is not for the podcast, but really more just Brain Candy for me. Turns out Yes, there’s a link between glutathione and anxiety and bumping up glutathione been shown to reduce depression and anxiety. So there you go.

Dr. Justin Marchegiani: I make a lot of that has to do with the catecholamine. The dopa means synthesis in the brain. So I think it’s really really important to know. Dr. Marty hands I think he’s over at neuroscience or neuro research. He talks about how sulfur is very important for synthesis of serotonin and dopamine and a lot of your adrenaline over time you will deplete it, especially when you get stressed and you’re taking a lot of your dopamine and you’re converting it downstream to adrenaline, you will be depleting a lot of your sulfur. Now, what does this matter? So this matters, because the more stressed you are, the more sulfur you deplete, which means you’ll have less sulfur leftover. So now if you’re stressed and now you’re exposed to toxins, or you’re living in a moldy home, you can see how stress can make everything worse because now you have less flow glutathione precursors to help you in that situation. 

Evan Brand: Yeah, speaking of stress, I’ve got a paper in nature right here. was called I’ll give you the link in case you want it in case you want to show anybody but it was called glutathione depletion, mitochondrial dysfunction induced by chronic stress. And I don’t know this is a rat thing so you know how they deal with rats they do something to them to stress them out but long story short stress in this paper had reduced glutathione brain glutathionr by over 35% so it would make sense why glutathione would help with depression too because you think about the toxicity I mean, heavy metals and such those can impact neurotransmitter function you can get depressed just for being toxic. So by reducing the toxicity, you’re less depressed. I mean, I think that’s really cool. 

Dr. Justin Marchegiani: Exactly. Now a lot of people are asking well where can you get the nebulized glutathione right now the third natural site is sold out but JustinHealth.com/glutathione would be where you can find that as the third natural site if not head over to EvanBrand.com or JustinHealth.com just put glutathione in the search and we have some of our own sulfur based compounds that we use in the lead As well mold based compounds we use so feel free to reach out to us, we’ll put pertinent links down below for you guys as well. And then outside of that, just really make sure you have good stomach acid levels because you need good stomach acid to break everything down. And then we also talked about, you know, the animal products if you’re vegan vegetarian, try to get some animal products in there, even if it’s egg yolks, or if it’s a little bit of fish, do your best on that and just try to make it healthy. And then really look at B 12. And fully, you’re not going to get enough b 12. On the on the plant based side, you really need animal products to get b 12. So if you are really plant based, you need to make sure you’re supplementing with the high quality methylated B 12. And maybe some activated full layers to be safe, because you need full eight and B 12 to run those glutathione pathways.

Evan Brand: Let’s just do like a quick 30-second recap because those with brain fog are like oh my god, what am I supposed to do? Do I go like swimming? Am I in a pool filled with glutathione? What do I do? So whey protein, grass fed meats Good cruciferous veggies probably lightly steamed over raw, maybe some greens powders or greens juices if you if you just for some reason can’t tolerate it like the broccoli sprouts, I think that’d be great for somebody that can’t eat broccoli because maybe they have digestive troubles and you could go for some of the extracts, making sure you’re doing enough vitamin C as you mentioned, adequate stomach acid, so making sure you’re testing your gut for infections. If you have H. pylori, and other infections, you’ve got to fix your gut, so possibly extra enzymes, possibly anti microbials, antifungal, anti parasitic herbs to treat the infections, maybe doing an oat test to check in on your overall levels and getting some micronutrient panels run. And then if there’s other issues that are keep depleting you then maybe looking into the mold, the heavy metals and the other toxins that are going to deplete glue to die on. That’s kind of your recap.

Dr. Justin Marchegiani: 100% now, what do you need for sulfur amino acids a day? I would say you know 1500 to 2000 milligrams on some of the NAC and some The sulfur aminos I’ll do one to two scoops, you know, 1020 grams of collagen a day, I think it’s great on the vitamin C on the low side, you know, one to two grams, I think it’s great if your diets amazing and you’re getting lots of leafy greens and some low sugar fruit, maybe a gram or nothing is probably okay, if you’re really great there, if not a gram or two on the vitamin C sides are great on the light bulbs almost go to file. And if you want to go that road, I think half a gram to one full gram is fine half a gram on the maintenance side. Or if you’re just getting sulfur amino acid, that may be enough. But if you’re under some stress with mold a half a gram to a full gram. And if you’re dealing with more acute stress, right, a lot of viral issues today can really create stress in the lungs and glorify them can be very helpful with that long stress. You may want to go up to two grams on the glutathione more acutely and those are a couple of good first things go ahead.

Evan Brand: Yeah yeah don’t forget about the NAC too. You and I did I don’t know if we did a whole show or if we just kind of rained it on it for a little bit, but NAC in regards to immune health and NAC being very very protective so I’m usually at around a gram but you could go higher possibly 2 grams per day of NAC combined with that 500 to 1000 milligrams glutathione that is an awesome one-two punch. 

Dr. Justin Marchegiani: Yeah, just be careful what the NAC cuz it’s an expectorant it will dry out your sinuses and and your throat a little bit so it’s great if you’re really mucus ease but be careful if you’re getting too dry you may want to pull back on it. So just kind of know that NAC is awesome for a lot of the excess post nasal drip excess mucus but if you go a little too much you may get a little bit too dry in some of those areas.

Evan Brand: I can confirm. I haven’t had a nosebleed but when I was going higher like, two grams. Yeah I was pretty dry I felt like I could breathe better though, man I tell you my sinuses felt clean as a whistle.

Dr. Justin Marchegiani: Yeah, so if you’re getting over a cold and you got a little bit of post nasal stuff going on, NAC you should be one of the first things you go to in your medicine cabinet specially if you get that little bit of a nagging post nasal drip cough and they cease the first thing to hit.

Evan Brand: Yep.Maybe that some Exley or nasal spray something like that you got anything.

Dr. Justin Marchegiani: Oh yeah, well you definitely the sign is flush with the X clear like that’s number one, because you got to flush things up, and the number two, you dry it up and then you do those you’re in good shape. Anything else you want to highlight Evan?

Evan Brand: No, let’s wrap this thing up it was fun and if y’all have further questions or comments of course we always want to hear your experiments and your experiences- how did it go, what did you do with glutathione, did you do like me and then I called Justin in like 10 o’clock when I hey man I took like a double or triple dose of glutathione and I got a terrible headache I remember that so now. We’re always being the guinea pigs and that’s what we love doing and we are available clinically. So if you need help, you can reach out to Dr. J at JustinHealth.com, we work with people around the world. So JustinHealth.com, my website EvanBrand.com and we’ll be in touch next week.

Dr. Justin Marchegiani: And when we talk about these things guys, this isn’t theoretical for stuff. We see thousands of patients, tens of thousands over our decade-long careers and we know it works. We know it doesn’t and if you’re leaning into glutathione, maybe put a little bit of a binder in there an activated charcoal bentonite clay taking way away from food and supplements just to kind of soak up or kind of broom up anything that may be already liberated from your body. So that’s kind of a good first step just to be on the on the alert and always start low taper up don’t ever go over the top on it always start low work your way up try to make sure you’re working with a

practitioner so you have ways to monitor, test and assess as well as figure out the best order of operations and addressing your concerns. And if you want to reach out to Evan, EvanBrand.com, myself Dr. J JustinHeatlh.com. We are available worldwide for support and health consults and feel free and reach there. All right guys if you enjoy it let your friends and family know put your comments down below and what future podcast topics you’d like to hear about. Have a good one guys, take care.

Evan Brand: I got one final comment on that sure, I’m so glad you brought up the binder. So this podcast is not designed for people to go, hey I’m you know feverishly writing down everything that Justin said. This many milligrams of this is I’m gonna go do his protocol- no, that’s not what he said. These are just guidelines okay because if you go and you do a gram of glutathione and you’ve never taken it you’re probably gonna get a headache or feel like crap because you’re mobilizing things. This thing glutathione helps push and I think of it as the push so when we’re talking about a detox protocol it’s kind of a push catch push catch repeat and if you don’t have something in to catch it meaning something to upregulate phase 2 or potentially also in addition the binders like the charcoal the clay zeolite bentonite you know chlorella whatever it is you could get in trouble so please don’t just go to glutathione, you’ve really got to have some sort of catcher’s mitt in place or just help your you know allow your practitioner to guide you because you can have too much of a good thing.

Dr. Justin Marchegiani: Excellent point, Evan. We’ll put some of our favorite products down below so you guys can take a peek and we’re here to help you as needed Evan you have a phenomenal day.

Evan Brand: Great chat with you, take care. See you later. 

Dr. Justin Marchegiani: Thanks, bye.


References:

https://justinhealth.com/

Audio Podcast:

https://justinhealth.libsyn.com/natural-ways-to-increase-your-glutathione-levels-podcast-292

The Harmful Effects of H. Pylori

How Functional Medicine and the Paleo Diet Can Address H. Pylori

A majority of world’s population have H. Pylori bacteria living in their stomach. This damaging bacterium has been revealed to be the main source of fatigue and other common health complaints. H. Pylori invades and damages the stomach’s protective mucus layer, thereby leaving your stomach susceptible to ulcers.

The Harmful Effects of H. Pylori

H. Pylori is commonly transferred by sharing food and drinks with other people, and multiplies very quickly through the saliva. Those with a weak immune system and other health issues are particularly susceptible to contamination.

H. Pylori is the primary cause of poor digestion and stomach ulcers. This bacterium impedes on the stomach’s capability to manufacture mucus, and irritates the inner lining of the stomach. The irritation turns out to be so severe that it leads to the pathogenesis of stomach ulcers. More than 80% of gastric ulcers are due to H. Pylori. This bacterium, if left untreated, can lead to stomach cancer.

H. Pylori Causes Fatigue

H. Pylori can cause fatigue by blocking your ability to absorb vitamin B12 and iron. As we know, the two common causes of anemia are a vitamin B12 or an iron deficiency. This means that if you’re taking B12 and iron for anemia but still aren’t seeing results, you might have an H. Pylori infection.

Role of Functional Medicine

The gut walls possess more than 70% of the cells that build up your immune system, and a whole host of bacteria. When you think about gut bacteria, you might be thinking of the symptoms that are manifested by gut imbalances. It’s true that a gut imbalance can negatively affect your ability to digest important nutrients. However, by making conscious diet choices, you can help overthrow the bad bacteria and promote the proliferation of the good guys!

Role of Paleo Diet

The Paleo diet focuses on eating natural food that is extensively available. If you’re suffering from H. Pylori infection, here are some great foods to incorporate into your diet:

  • Quality meats – Such as grass-fed beef and lamb,  and wild sockeye salmon.
  • Eggs – Pastured eggs, the yolks will be a deep, rich yellow-orange color.
  • Fresh Organic Vegetables and Berries
  • Natural oils –Avocado and Coconut oil are some of the best.

If you’re suffering from any digestive issues or fatigue, addressing the health of your gut with the help of a functional medicine practitioner should be your first course of action.

By treating any gut infections and optimizing your diet, you can reduce your symptoms by addressing the root issues.


Enzymes and digestive support – Dr. J and Evan Podcast #127


Dr. Justin Marchegiani and Evan Brand discuss about enzyme, its uses to the body, as well as its impact on digestion and overall health. Listen to them as they go into the enzyme mechanism related to gut issues such as infections and heartburn.

Know about the acidity levels that may have positive or negative effects to one’s digestion. Gain valuable insights regarding the different topics asked by the listeners which include hiatal hernia, PPIs, and antibiotics. And learn more as these functional medicine experts share their knowledge about diet and supplements that have huge effects on enzyme production and stimulation.


In this episode, we cover:

2:13   Enzyme Production

6:10   Gut issues and heart burn

12:30   Symptoms involved with enzyme and acid issues

24:05   Hydrochloric Acid (HCl)

30:05   Types of enzymes

35:48   Antibiotics and gut health

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Dr. Justin Marchegiani: Hey there! It’s Dr. J and Evan today. We got an awesome podcast. It’s a great Friday. We are live, too. So anyone’s that tuning in and wants to get some questions asked and/or answered, we are stoked to be able to do that. Today’s topic is gonna be on enzymes and how they can be used therapeutically to help with digestion and to overall improve your health. Evan, what’s going on, man? Happy Friday.

Evan Brand: Happy Friday! It’s beautiful here, the trees are blooming. It is freezing, though. We went from 70° to like 30° so – uhm, hopefully spring is coming because I’m ready to get outside again as soon as possible and go for an extended distance hike.

Dr. Justin Marchegiani: Got it. And people on Facebook here, if you’re not hearing Evan , do your best to head over to the YouTube channel. YouTube.com/justinhealth and click on the live view so that you can see Evan’s beautiful mug staring back at you and get your questions answered. I’ll try to be able to answer questions on Facebook as well as YouTube. So feel free and ask.

Evan Brand: Perfect. So enzymes – where should we start? I mean this is the importance of health; this is the – this is important for longevity; this is important for preventing or reversing disease because you’ve got to build a breakdown of foods with enzymes to be able to actually absorb the nutrients. Time and time again, you and I run organic acids panels on people where we look at amino acid metabolites and we look at these other biomarkers where we find that people are just not digesting their food and they’re not absorbing or assimilating any of their nutrients despite them spending hundreds of dollars a month on food, and organic food. Or they are on AIP diet, and they’re buying grass-fed beef and organic veggies but yet, they’ve got all these symptoms because they have low enzymes. So they could have hormonal imbalances; they could have fatigue; they can have excessive hunger; they could have sugar cravings and carb cravings all which could be tied into this enzyme deficiency because they’re just not breaking down their food; they’re stressed; they’re not chewing their food well. We’re kinda break all this down today.

Dr. Justin Marchegiani: Absolutely. I love that. So off the bat, let’s talk about how your body can actually make an active enzymes first. I think that’s a really important first step. So enzymes are primarily gonna be stimulated through the digestive processes and primarily the parasympathetic nervous system. So the more your nervous system is parasympathetic, right? That’s the – the rest in digest. The more you’re gonna have a nice low pH in your stomach. You’re gonna have gastrin stimulated. All these gastric juices uhm – coming about. That’s gonna lower the pH coz a lot of enzymes are actually pH driven. So if we don’t hit that first domino of parasympathetic nervous system stimulate the nice low pH and the nice low pH is from hydrochloric acid. Hydrochloric acid kinda also has the sterilising effects. So if you get some bad, kinda junkie food in there, it’s gonna have like an effective taking maybe you some bleach and putting it on a public pit. It’s gonna help clean it up. So it’s gonna be more sterile environment. So think of hydrochloric acid as like a bleach in your tummy. And also activates the proteolytic enzymes. It starts with pepsin, it takes pesinogen to pepsin. So it gets the digestive enzymes going. And that nice, low pH, all that food gets mixed up with the hydrochloric acid and eventually goes down in your small intestine at least as chyme. And then it stimulates the pancreas to produce more enzymes in the gallbladder to produce more bile which will help with fat. So that’s kinda first domino reaction and it starts with the parasympathetic nervous system response, and it starts with having good hydrochloric acid levels. Now, one thing to talk about here, “How can we stimulate our own juices?” Number one, chewing your food well is gonna be super important. Making sure you really chew, one chew per tooth is a pretty good rule of thumb. Number two is making sure you’re in parasympathetic state – not eating and not being on the go or eating when you’re in the car. Have a good relaxation kind of state. Number three, making sure you’re hydrated coz a lot of the digestive juices come from the liquids that you eat. And then number four, not consuming water for the sake of hydrating while you are eating.   The more you consume water while you’re eating, think about it- water has got a pH of 7. 7 is going to take the pH in your gut at 2 and bring it up close to the 7. So these enzymes are pH driven. So the lower the pH, the more the enzymes are activated the more water you drink in the meal, the more you dilute the enzymes that are already there, the more you raise the pH and you deactivate future enzymes from being produced. What do you think, Evan?

Evan Brand: Yeah. So people wanna know the number about the stomach. It is very, very acidic. 1.5 sometimes 1.2 to 3 is the range of the pH. I mean this is so intensely acidic that if you opened up that HCl out of your stomach and put it on your shoe, it would melt your shoe into piece.

Dr. Justin Marchegiani: Absolutely.

Evan Brand:  You’ve gotta have that. And I wanna just repeat that because you said it well, but in order to activate pepsin in your other enzymes to break down the protein, you’ve got have an acidic enough stomach. You’ve gotta have enough HCl production.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: And so you’ve got have parietal cells in there that are making the HCl. But if you’re in sympathetic fight or flight mode because your body thinks you’re running from a bear even though it’s just running from email, or you’ve got a bad boss, or you’ve just got some bad news, or you’re eating during a meeting, or you’re eating at your work desk. You know these are all things that are not going to trigger that –

Dr. Justin Marchegiani: Totally.

Evan Brand: You’ll be setting yourself up for you know, tummy trouble. And we can talk about some of the implications of what happens if you have this hypocholorydia state which is a low stomach acid state that basically set you up for infections and things like that which we’ll get into.

Dr. Justin Marchegiani: And again, we got questions coming Facebook and I apologize. People on Facebook are only seeing one side of the conversation here. But – Hey, Steve, how you doing? Off the bat with the gastric ulcer situation. If people have an ulceration or have gut lining issues in the stomach, one of the first things we do off the bat, if we know that history is present, we’re gonna use gut healing and soothing nutrients first. We’re gonna use bone broth, we’re gonna use aloes, slippery elm,  deglycyrrhized liquorice, L-glutamine and we’ll kinda coat that stomach there. We’ll make sure the food is well broken down. We may even focus more on the GAPS kind of approach. And add more liquid soups that are really easy and palatable. And we may focus more on enzymes first. Now depending on how someone is doing, how sensitive the gut is can be a good measure of how the gut’s healing. That’s a good sign. So you can start with like a 6 to an 8 to a quarter of the teaspoon of apple cider vinegar with food. Now if you’re gonna add any acids in, you can start with light acid such as Apple cider vinegar, and/or uhm – just plain old organic lemon juice and do it with food because if the stomach is empty, it’s like someone touching your raw sunburnt skin. It is gonna be more sensitive. Put a little food in there, do a nice gentle, very low dose of acetic acid, whether it’ in uhm – apple cider vinegar or citric acid in the lemon. That is a really good step. Quarter of the teaspoon and upwards and gradually work your way up. If that’s good, once you get a full tablespoon and have no problem with food, we can transition you to an actual hydrochloric acid tablet with pepsin. But in the interim, healing, soothing nutrients, and then we taper. We focus more on the enzymes in the HCl because they are less abrasive.

Evan Brand: Let’s back up a bit. Let’s talk about symptoms people may be experiencing if they need enzymes or if they are in this hypochlorydia, low stomach acid state. So I would say, any type of burping or gas after eating, that tells us you’re not breaking foods down.

Dr. Justin Marchegiani: Huge.

Evan Brand: If you’re a vegetarian or a vegan in the past, a lot of times people go vegetarian or vegan because they say they’ve lost the taste for meat. But in many cases, that just because they don’t have enough stomach acid to digest meat.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And so meat is bad for you, but it’s not. Heartburn – a lot of times people have heartburn but it’s actually too low stomach acid not too much. You’ve got that valve at the bottom of the stomach and it’s kinda regulator. And if your food is not broken down, your body’s smart, it doesn’t want undigested food in the intestines, so if it can’t go down, it’s gonna leak in one place which is up. What about the uh – lower esophageal sphincter? Can you talk about that maybe from like a chiropractic perspective? About how that valve can get stuck open. I mean, can adjustments and massages or stuff help that? Or is that more internal work has to be done?

Dr. Justin Marchegiani: Yeah. I mean you have different issues with the various sphincters that go from the esophagus into the stomach. And then obviously, the stomach into – hold on, one sec. I’ve got a little _ right here. I apologize for that. Okay, so regarding that – you have different sphincters that go from the stomach to the small intestine,  from the small intestine to the uh – large intestine. And obviously from the esophagus into the stomach. So the key elements here is we have to make sure the first domino is gonna be the esophagus to the stomach, right? If we don’t have enough acidity, what happens is that esophageal sphincter is they open. So this is one of the major reasons why stomach acid actually helps a lot of people with heartburn. It helps two ways. The esophageal sphincter gets tighten when there is enough acidity. And then number two, food will rot and putrefy and ferments and organic acids will rise up from the food. So if there’s not enough acidity, initially, that esophageal sphincter may stay open, food will rot and then those acids will rise and burn the esophagus. So 2 mechanisms: tightening of the sphincter and the breaking down of the food. If we don’t do that, it rots. So that’s step number one. Step number two, food goes from the stomach to the small intestine. If we don’t have enough acidity, then we’re not gonna trigger the bicarb release from the pancreas when it goes from the stomach to the small intestine. We’re not gonna trigger the gallbladder and we’re not gonna trigger the uhm – the bile salts. Number three, it goes from the small intestine to the large intestine. If we have dysbiosis and low stomach acid and low enzyme environments, we can have ileocecal valve patency where this  is kinda the first mechanism of SIBO or the bacteria from the colon will start migrating its way back up to the small intestine and then we start getting all kinds of extra methane and hydrogen gas is increasing. And that’s gonna create more malabsorption, more diarrhea, more constipation, more of those IBS kinda sequela. And then –

Evan Brand: I wanted to ask you one thing. I know we’re – we’re a bit biased because of the people that are coming to us typically they’ve been to 5, or 10, or 20 different practitioners –

Dr. Justin Marchegiani: Yeah.

Evan Brand: Before they get to us which is mind blowing and it’s an honor. What percent of people have a low enzyme state, low stomach acid state, therefore potentially SIBO state? I mean, you and I see bacterial infections. I’d almost say it’s 9/10. But I wanted to see what your number is.

Dr. Justin Marchegiani: Yeah. So how many people 9/10 here or out of 10 here do we have bacterial infections? I would say at least half of some type of digestive issue minimum. Uhm – I would say out of the general public, I would say the people that see us I would say a 100% have some level of a gut issue. Even if someone doesn’t know it because – people come, let’s say they don’t have a gut issue, let’s say it’s hormonally driven. If it’s a female, it’s gonna be PMS or mood issues or fog. If it’s a male, it’s gonna be uhm – energy, focus, endurance, exercise, muscle mass, low libido. Again, those issues can be affected by the gut and a couple different mechanisms. And kinda tying it back to enzymes, we always go on our diets here. But if you have enough enzymes and digestive capacity, all the nutrients that make up all the brain chemicals which help us focus and think and deal with stress, also the nutrients that help become our hormones. So the cholesterol and the essential fatty acids they’re gonna become the precursors to our cortisol and our sex steroids. So if we have any digestive issues, any of that could be thwarted by low stomach acid and enzymes. We’re not gonna have the building blocks that we need to – to build a healthy chemicals to help us feel good, deal with stress and inflammation, help rebuild our body.

Evan Brand: Yeah. Just to zoom back out, this cascade, this domino effect you’ re discussing could all happen from you scrolling on Facebook while you’re sitting down to eat your lunch.

Dr. Justin Marchegiani: Totally.

Evan Brand: And that’s the important part. So I wanna go back and just mention a few more symptoms of people that you have a need for enzymes and/or increased stomach acid. If you got undigested food in your stool, that’s an easy one. If your stool is floating, that’s an easy one because we know therefore, that the bile is likely not getting secreted potentially due to a low fat or too low-fat diet. So therefore, you’re gonna have that issue. Uh – also fingernails. So Justin and I, we talk a lot about fingernails. So if you’ve got chipping, peeling, very brittle fingernails, you’ve got ridges on the nails, that tells us that digestion is not good. You’re not getting these trace minerals from your food. Uhm – and then last one, we could just say anemia, right? Because if somebody’s got low iron or ferritin levels, we know that they’re eating grass-fed beef or bison or elk and all these delicious foods, but you’re not  rice and help knowledge delicious foods but you’re not cleaving off the iron and so you gotta have a lot of acid to do that.

Dr. Justin Marchegiani: 100%. Couple of just to kinda piggy back on that, you have the fingernail issue, if you run your finger across the other finger, across the arch of it, if you have that’s relatively, you may see some tiny, tiny lines but when you run on your finger, it should be smooth. You shouldn’t see any white spots or little speckles on the finger. That’s a sign of zinc deficiency. Your nail should be relatively strong. If you push it straight down on an axial low position, it shouldn’t really bend. It should stay pretty straight, pretty strong. People that have issues with this, their nails will start to peel. Those are to be more brittle and weak. You’ll start to see vertical ridge and white spots. That’s gonna be your first kind of sign that you’re not quite digesting protein, fat  and obviously ionising your minerals especially zinc. That’s number one.  Number two, in females, it’s super common, it’s called uhm – keratosis pilaris. So if you look on the females, back in their arm, the tricep here, like this are of the tricep, you’re gonna see this like little dots, like this reddish kinda spots. And this is called uh – Keratosis Pilaris, typically from essential fatty acid deficiencies. And a lot of times if you don’t have enough hydrochloric acid and enzymes, that will show up. So you – you know, you walk through airports or see lots of people, you’re gonna see that commonly on a lot of females’ arms, especially birth control pills can exacerbate it more.

Evan Brand: Why?

Dr. Justin Marchegiani: Uh – because it affects digestion.

Evan Brand: Oh – yeah. And my wife for example –

Dr. Justin Marchegiani: And it affects nutrient deficiencies, too. B vitamins, minerals and such.

Evan Brand: So I’ve got two personal anecdotes to what you’re talking about. So when you first looked at me, you say, “Evan, you’ve got a parasite.”

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: And you said I had two parasites and my nails were terrible. Now they start to get much better because I’ve cleared the infections and now I’m supplementing with enzymes like – you know, it’s water. I love them. I’d take them with every meal. Uh – but also, my wife, when she was on birth control pill as a teenager, she had major Keratosis Pilaris on the back of her arm.

Dr. Justin Marchegiani: Huge.

Evan Brand: It was crazy. I mean –  massive amount. And she thought that, “Oh, my mom had it, so I should have it.” No, that’s not the case. And so now, with the fish oil –high potency fish oil, the enzymes and then making sure the gut’s healthy, it’s gone and it’s amazing.

Dr. Justin Marchegiani: Yeah. Typically, the birth control pills gonna affect the pH uh –in the – in the intestines primarily the urinary track. That’s one the big things you see with females on the birth control pill. You see increase in yeast infection. They’re gonna affect pH and that vaginal kind of environment. and obviously it can have an effect in the gut, too. So the more you uhm – negative competing opportunistic microbes to kinda  invade in there, they’re gonna the shift the environment to be more favourable to them. And that’s gonna take away from the digestion capacity. And the more your digestion is down, harder  to breakdown those proteins and fats and ionised minerals. And then you can start getting those deficiencies. That’s why B vitamins, and minerals, and essential fats one of the first deficiency you’ll see on birth-control pill. So tying it back in here, enzymes are super important. Couple of questions from uh – YouTube, pH – like the whole idea pH, I mentioned, people say you wanna be alkaline, the question is where? Where do you wanna be alkaline, right?  With the stomach, you wanna be very acidic. In the stomach or in the small intestine, you wanna start becoming alkaline again. As you go back on the colon, you’ll start to be a little more acidic. The urine typically is gonna be a little bit more acidic coz you’re putting more acidic waste out through it. Uhm – you’re gonna have bicarbonate that’s gonna bind with uhm – CO2 in the blood to help rid of the CO2. So you’re breathing out acid via the CO2 and making bicarbonate in the blood. So a lot of pH regulatory systems that are happening. The biggest thing that’s gonna affect pH is inflammation. Inflammation is gonna have an effect on pH a hundred to a thousand times greater than your diet. Uhm – you’ll see –

Evan Brand: Say that again.

Dr. Justin Marchegiani: Yeah. Your pH is gonna have about a 100 to a 1000 times more of an effect because of inflammation due to your body, not because of your diet. Now you’re diet – you can have inflammatory things in your diet such as grains, excess sugar and trans fat, but again, meat – people meats are acidic, right? About 5 or so on them. 5- 5 ½  on the pH scale which is logarithmic. But grains are 10 times more acidic than, let’s say meat. And if you listen to my podcast it will be coming in a few weeks with Doctor Robert Rakowski part 2. He talks about that apect. That it’s the inflammatory things in our environment that are creating far more acidity than our diet. But again, healthy green, organic vegetables in every meal, you should be totally fine from the pH perspective and then getting some good extra minerals in your multi-support whether it’s magnesium, potassium, calcium. Those extra buffering mineral should – you should be buying.

Evan Brand: Let’s also bring up alkaline water and how big of a scam and ridiculousness it is to do alkaline water if your goal is to have optimal digestion especially people drinking alkaline water. They buy these expensive machines were they’re pumping of 9 or 10 on the pH scale of water.

Dr. Justin Marchegiani: Yeah.

Evan Brand: You’re drinking with the meal. I mean, you’re setting yourself up for failure. Now, could there be some type of therapeutic benefit of alkaline water by itself? I don’t really know maybe you’ve got some advice on that. But for me, I’m gonna go with a good spring water or a good reverse osmosis water with trace minerals back in like you do. I mean, for me, the alkaline water, it’s just been debunked so many different places and it’s not worth even talking much more about.

Dr. Justin Marchegiani: Yeah. I’m not a huge fan of alkaline water. The question is anytime  someone sells me an alkaline water, I’d say, “What are the buffering minerals that you use to make it alkaline?” And typically, they’re like, “What?” Coz if you got just a really good clean water, I mean, just adding some good-quality electrolytes or a little pinch of high-quality sea salt with the spectrum of minerals, you’re probably gonna be pretty good and that may raise the pH up a little bit. But I’m not concerned about getting up – you know, having super, super alkaline water. I’m fine with drinking water that’s clean  and filtered. Infuse some minerals back and I will have a little electrolyte solution. I’d put my reverse osmosis water filter, so I’ll put a little bit of minerals in there first thing in the morning. Or I’ll just – I have a little salt shaker there, too. And I’ll get some extra minerals. And that way,  1 to 2 glasses in the morning, one to two big glasses in the afternoon with infused minerals and just salt my with – with good Celtic or like typically like real salt better just for flavour variety. But that’s a good way to get the minerals. Not a huge fan of you know, these crazy expensive water machines that are alkaline. I think the really high-quality filters are better. And uhm – I  like things like Pellegrino and natural sparkling water too because of the extra sulphates that are in there which is so good for detoxification, too.

Evan Brand: Yeah. So, I wanna ask you, chicken or egg question and then we can probably hit some of these YouTube questions about the hiatal hernias and HCL supplementation, all that.

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’s hard to say, did someone get a low enzyme, low HCL state, which then led to undigested food particles, which then were to intestinal permeability or leaky gut, which then set them up for SIBO or parasite infections? Or did the infection come first? Like I told you about yesterday. I had a little four-year old girl that had her stool test back and she  had two parasites. And it’s like – being that young, we would assume that HCL and enzyme production would be pretty good, being a tiny little kid. But, she had tons of rounds of antibiotics. So it’s like chicken or egg. Was it the HCL and enzymes that got low that did set her up? Or was it just the decimation of the flora via about antibiotics that didn’t set her up for infections? Which one do you think it is?

Dr. Justin Marchegiani: Yes. When it comes to infections, there’s a couple of  scenarios how that happens. Number one is your stress. Your immune system is compromised and you get exposed to some infectious debris. And your IgA, your enzymes and hydrochloric acid levels are low and you can’t – you can’t quite – uh, you know, uh – knock it out. It’s just kinda like you leave the drawbridge down in the castle, you’re flying around the Star Trek ship and the force fields are down. So invader can come in, the Klingons can attack, right? Those are my analogies. Now that’s scenario number one. Now scenario number two is you’re relatively healthy and you just get exposed to a large bolus of infectious debris, right? You’re hanging out and you’re drinking some water in Mexico. You’re on the beach in Bali, you’re out in uh – Lake Austin, like I do and maybe someone water comes in your mouth, and you get some GERD, right? So those are the two major scenarios. And it’s – number three is uhm – I would just say food vector, the compromised immune vector.Those are gonna be the two biggest ones. There’s a couple of out there – ones and that’s gonna be the animal vector. You’re just getting exposed or you’re letting your animal lick your face all day, and you’re just not even – you’re not connecting the fact that your cat may have crypto and now you got the crypto infection. Or I’ve seen it with dogs and GERD is super, super common.

Evan Brand: What about this question here about, “Can a hernia cause hypochlorhydria?” What’s your experience from a chiropractic perspective on hiatal hernias? Can you fix those chiropractically? And will that cause low stomach acid?

Dr. Justin Marchegiani: So regarding hiatal hernias, and I just posted a link online for people on YouTube or Facebook that wanna see the full, kinda dual side of it. We only kinda do my side with the technology that we have here. But regarding hiatal hernia, in my opinion, if you’re only fixing a symptom of the hiatal hernia, if you’re doing a chiropractic adjusment for it. Now I think that’s fine because it palliative, it’s natural. You know, what’s the risk to reward? Very little risk, only reward. We just wanna fix the root cause. And typically that’s gonna be getting the inflammation vector away from the intestines.  Once the inflammation is better, the nerves that go to those muscles won’t be sending the inflammatory response that’s creating that tightening. It’s called the viscera somatic reflex. Visceral is organ; somatic is muscle. So the organs and muscles  are on a two-lane nerve highway and the more those nerves are stimulated, it’s like the more you do bicep curl, the bigger your bicep gets, the tighter, tighter it gets, right? The more stimulation that goes to that area that’s like pain, the more it can pull that stomach up above the diaphragm which is based the hiatal hernia.

Evan Brand: Wow.

Dr. Justin Marchegiani:  You pull it down, but then you wanna make sure you get to the root cause. Inflammatory soothing nutrients, fix the infection, fix the ability to digest the food.

Evan Brand: Okay, good. You answer the question. So you can help with physical adjustments of hiatal hernias but you also gotta be working back to the root cause to make sure it doesn’t just pop back.

Dr. Justin Marchegiani: Exactly. That’s the key thing.

Evan Brand: Okay. Here’s another question then. Uhm – “When can you start minimising HCL?”  He’s been taking them for three months. So I guess the question is – is there ever a time where you stop taking them? And I’ll just go ahead and give my two cents first, which is not really. There’s never really an expiration date of when you should uh – minimise HCL. Because if you look at Dr. Jonathan Wright’s book, “Why stomach acid is good for you?”, we look at age. With the Heidelberg test, we see that HCl just drops and drops every year that you get old. Uh – any age past twenty, actually you start reducing HCl. So for me, I consider it the foundation. But what about you?

Dr. Justin Marchegiani: So couple different theories on that. I think hydrocholoric acid is the most under rated supplements in the toolbox for any functional medicine doctor and patient. I think it’s absolutely essential because if you buy a really awesome, organic diet, healthy meat, healthy proteins, healthy fats, and you’re not quite breaking it down fully, well you’re really not gonna be accessing all the nutrients that are in those food. So I think that – from that perspective, it’s a great insurance policy to access your nutrients from your expensive diet already.  Number two, I think it’s something is you get help that you don’t need it all the time but like for instance, I’m heading down to lunch here over at Paris down in Austin. So it’s like I’m doing like let’s say, Friday lunch. I’m really excited about it. I’m gonna bring some hydrochloric acid and some enzymes. Its gonna be some nice little pork chop I’m gonna have there. So we’re gonna up the HCl and enzymes big time. That’s number one. Uh –number two,  if people don’t want to be on it all the time, there are things they can do if they need a little support such as Swedish bitters whether its gentian, or chamomile, or little bit of ginger, can very easily just stimulate your hydrochloric acid levels. Or even just a tablespoon of apple cider vinegar or a little bit of lemon juice can be really stimulatory for the hydrochloric acid. There are ways you can stimulate it naturally. And also, there are studies looking at gastrin. Gastrin is the compound that’s produced in the stomach that actually feeds back to produce hydrochloric acid. And that compound –  that chemical does not decrease as you take hydrochloric acid. So it doesn’t have a negative feedback loop. So negative feedback loop is you take steroids, right? Testicle shrink, right? The feedback is more of the steroids cause the testosterone in the internal production to go down. Now taking that analogy to the stomach, as gastrin – as hydrochloric acid goes up artificially, gastrin levels don’t drop. You don’t have this atrophy happening. So it’s good to take it if you wanna give your digestive system a break or you’re eating a bigger meal and you just wanna make sure you can break it down better so you don’t have indigestion afterwards. Totally fine. Uh – ideally, you shouldn’t need it all the time. And number three is you can artificially or just uh – naturally stimulate it with the bitters, gentian, the chamomile, the ginger, etc.

Evan Brand: Well I kinda use the three S, too. Soup, salad, or smoothie. If you’re doing any of those three, you could probably opt out of the enzymes and be okay.

Dr. Justin Marchegiani: 100%. Unless you have a lot of digestive symptoms, that’s the key thing.

Evan Brand: Yeah. See, there’s another question here. Dale asked, “Can we share a quick functional medicine perspective on vaccinations?” That – we’d have to save that for another show, Dale.

Dr. Justin Marchegiani: I went into this with Dr. Robert Rakowski last week. So I would say, Dale, check out that podcast coming up very soon. We go into that a little bit.

Evan Brand: Here’s Betty. She’s got a question, too. What’s the logic behind any acids and PPIs? Profits don’t count as logic. Ahh. Okay.

Dr. Justin Marchegiani: So I talked about this a lot. So PPI is like if you’re – if you’re trying to create the perfect drug that works but creates so many other issues that will create more pharmaceutical dependency down the road, it’s the perfect drug. Let me walk you through it.  So you have acid issues because you’re not digesting your food, right? You have you know, the esophageal sphincter ‘s open, the food is not digesting. It’s rotting in your gut, the acids are rising up and hitting the top part of your throat. You start having symptoms. The first thing you may reach for is the over-the-counter Tums, right? Calcium carbonate lowers the acidity, it works. You feel better. Eventually you need to reach for a Nexium or Omeprozole or some kinda Prilosec, a proton pump inhibitor that prevents the hydrogen binding to the chloride molecules that makes the hydrochloric acid. So then you start having less as acid reflux symptoms. It works. You feel better. Now the problem is the more you shut down those proton pumps,  the less stomach acid, typically the less enzymes – one of things that starts happening is you become dependent on it because the gut lining becomes so irritated, inflamed. You’re not digesting your foods. So then what happens is you don’t break down the neurotransmitters, you don’t break down the fat and the protein that become the neurotransmitters and the hormones. So you start having mood issues. So now your chance of antidepressants go up, your – your chance of having more anxiety – because you don’t have the L theanine and a lot of the GABA coming in. So your chance benzodiazepines goes up. You’re not breaking down the cholesterol, so your chance of needing Viagra goes up because you have erectile dysfunction coz you can’t make your sex hormones. Uhm – you become more inflamed, typically. So then your chance of needing a cholesterol medication goes up because inflammation will increase your cholesterol. And the more you can’t break down certain minerals like magnesium, your chance of Lisinopril Hydrochlorothiazide, ACE inhibitors, blood pressure medications goes up. So you can see what happens. You’re on this medication and all these other medications are needed to help manage all the symptoms that come from it. It’s crazy.

Evan Brand: Yeah. I was gonna mention some of the research, too. I mean there’s research that links PPIs to kidney disease, dementia, heart attacks, bacterial overgrowth, infections, bone fractures, and also the fastest growing type of esophageal cancer. So there is a lot safer ways of dealing with heartburn than the PPI.

Dr. Justin Marchegiani: Yeah.  And HCL and enzymes are totally safe if you’re pregnant, too. I’ve had no problems with that uhm – with my pregnant patients – not an issue.

Evan Brand: Should we go to other questions?

Dr. Justin Marchegiani: Yeah.

Evan Brand: Or was there other stuff you wanted to mention first?

Dr. Justin Marchegiani: I think there’s one other element about enzymes – that’s taking specific enzymes on an empty stomach away from food can be excellent for cellular detox, cleaning up scar tissue, and even treating cancer. Dr Nicholas Gonzales, before he passed, was doing that successfully for many years. And you know, taking high-dose enzymes on an empty stomach, for me, that’s a first-line therapy for anyone with cancer. Those enzymes get into the bloodstream and they’re gonna be able to digest any bad cancer cells that weren’t tagged by the immune system for apoptosis.

Evan Brand: And can you mention briefly just the types of enzymes? Coz I think people may think enzymes are just one thing, but we’ve got digestive enzymes we’ve got proteolytic enzymes, we’ve got systemic enzymes which you were teaching me about last night. Uh – uh – talk – talk people through just the different categories. Just that way, we know  what we’re covering here.

Dr. Justin Marchegiani: Yeah. You’re gonna have enzymes like amylase and such which are gonna be more your carbohydrate enzymes, okay? You’re gonna have various proteases that help digest protein and those will have different names like trypsin or chymotrypsin, right? Protease, etc, etc. And then you’ll have various enzymes, lipases. And these will be more for digesting and breaking down fat. And also, you’ll have bile salts that kinda work synergistically with that. So those are your major categories. Carbohydrate, protein and fat. And like you said, the biggest people that tend to move away from me are ones that have low hydrochloric acid and enzymes, so they move away towards vegetables which actually have more natural occurring enzyme. So they – people that go vegetarian, right? They’re thinking, “Oh, you know, I just feel better on vegetables and not so much on meat.” If the meat’s inherently bad, it’s like, “No, the meat is exposing a weak link in your digestive track.” That’s what’s happening.

Evan Brand: Yup. Yeah. I wanna give a brief anecdote about my use of proteolytic enzyme specifically bromelain. After I got my wisdom teeth surgery, I was taking tons of bromelain and my gums healed in rapid time and the surgeon on the one-week follow-up was like, “Evan, I never seen anybody heal this quickly. What have you been doing?” And I say, “Well, I’ve been popping arnica like it’s candy and also doing tons of proteolytic enzymes.” And he was like, “Wow, this is – this is cool!” So, it worked.

Dr. Justin Marchegiani: I love it. And when you do these kind of enzymes for systemic use,  you want – there’s a couple out there. They’re a lot more expensive coz you’re using more serrapeptidase enzymes which come from the silkworm. Silkworm if you will look at kinda look at the thread that comes from their spinning or however – whatever they produce from a byproduct. The thread that they make their nest with and such is incredibly strong. The tensile strength is unreal. So they are actually extracting the enzymes the silk worms make uhm – make their net out of and they’re using in systemic enzyme formulas. And they put these enzymes in terracotta capsules coz you don’t want to use digestive enzymes for systemic enzyme purposes coz they won’t outlast the stomach. They won’t get to the stomach intact.  So you want something that’s enterically coated that gets into the small intestine, and then gets into the bloodstream without breaking down food. You don’t want any food to be there. You want it to be in a full empty stomach. And we use high-dose arm serrapeptidase enzymes enterically coated. And again, they’re gonna be a lot more expensive than your typical digestive enzymes.

Evan Brand: And when are those cases? I mean what – what’s like top few situations where S__  would wanna be on that?

Dr. Justin Marchegiani: Oh, yes. So we’re gonna do that with any type of cardiovascular issues – issues with uh –history of blockages, cardiovascular-wise. Uh women are trying to dissolve endometriosis and fibroids that can be helpful. Uhm – people that have cancer issues that are trying to just knock down some cancer cells. And then also just for uhm – scar tissue in the joints or just  the general cellular cleanse that help cleanse out debris in the body. But again, none of these treat or diagnose, right? These are all therapeutic things to help support whatever health issues that are already there. We just have to say that as our disclaimer.

Evan Brand: Agreed. Yeah. So I wanna just mention briefly about infections. So once someone’s got an infection, regardless of how they acquired, whether it was chicken or the egg which happened first, once you’ve got parasites, you’ve got this SIBO situations, etc, you’re set up for lower and lower enzymes and lower and lower HCL. So it really is uh – a long process that we take people through where you’ve got to remove infections, you’ve got to restore the gut, you’ve got to restore the enzymes, you’ve got to heal up the gut lining that are totally damaged. It’s a long process. Uh – Samuel asked – oh no, it was Cory here. He asked what would be the best HCL supplement for somebody with SIBO. And should you take both HCL and enzymes at the same time? You wanna hit on that one?

Dr. Justin Marchegiani: Yeah. Take HCL and enzymes at the same time? Absolutely. Because –

Evan Brand: You have to –

Dr. Justin Marchegiani: I mean enzymes – the only time I give them by themselves if someone’s gut is really raw and they can’t handle it. But again hydrochloric acid will help your body make its own enzymes by activating via pH – via low pH.

Evan Brand: Well – And I wanted to mention too, you know, you and I both got professional enzyme formulas, but the dosing is pretty conservative for that reason.

Dr. Justin Marchegiani: Uhm.

Evan Brand: So you may only get 200 mg of HCL per one capsule of enzymes and that’s so low that unless you’re just terribly inflamed, you should be able to tolerate  such a low dose of HCL like that.

Dr. Justin Marchegiani: Yeah. In my line, I have two formulas with HCL. I might digest energy that has lower hydrochloric acid levels that are meant for people that are already  have pretty good digestion, but just need a little bit extra support. And then they’ll have some enzymes in there, too. And then I have my two that I break up for more – for people that have more digestive issues. We’re trying to get more of a therapeutic dose. And some can’t handle that much HCL but need a lot more enzymes. So we don’t want the fact that they are in the same capsule to limit how much we can give. So we can go lower HCL, more enzymes, or vice versa. And we’ll kinda throw in some HCL tolerance test 1-4, 1-5 capsules on the HC – HCL. Any warmness, we back off by 1. Enzymes will typically go up between 1 to 4. If we feel a lightening, or better digestion, or improved bloating, or gas, or any symptomatic relief, or just a feeling of better digestion, then we’ll keep it at that those. If not, a standard 1 to 2 capsules per meal is typically okay.

Evan Brand: Here’s another question. “My doctor put me on Ornidozole and Levofloxacin.” Oh, man. “I have hunger pains, fatigue, constipation, felt better for a week and then hit a wall. How effective are these? And side-effects?” So, those are two antibiotics and –

Dr. Justin Marchegiani: Well, anytime you take an antibiotic, one of the big side-effect is gonna be a rebound fungal overgrowth, alright? Lots of females have noticed they take antibiotic, they get a reoccurring yeast infection weeks later. And a lot of conventional physicians are actually growing wiser that their patients – their female patients a lot of time, like a Diflucan  or Fluconazole after antibiotic. Now again, you’re much better off giving them a probiotic. You can do it even during just away from the dose. And then do a probiotics after a month or two afterwards just to prevent that rebound overgrowth. And a rebound overgrowth is let’s say you have a lot of good and bad bacteria in your gut, you give antibiotic, what happens is you lower all of it. Now, the good bacteria provides a nice environment so the bad stuff can’t grow. So as soon as the good stuff is low, then the bad stuff naturally proliferates. It’s the whole idea of once you clean out your garden, the tomatoes don’t just automatically, the weeds do. You actually have to go in there and plant the tomato seeds or whatever you’re growing. You have to plant those seeds, you have to aerate, you have to put the fertilizer down to create the environment so the vegetables grow.

Evan Brand: Good analogy.

Dr. Justin Marchegiani: You don’t have to do that with the weeds. The weeds are automatically there on auto dial, so to speak.

Evan Brand: That is such a good analogy. Yeah. And it’s amazing. How about unless it’s a life-threatening situation, try not to go with antibiotics, anyway. Figure what the root cause is. There’s so many natural antimicrobials that you and I use in they’re so effective. They have no side-effects, no lasting – anything. They’re in and out.

Dr. Justin Marchegiani: Absolutely.

Evan Brand: And then we don’t need stuff like Diflucan which is also terrible, which in many cases you’re gonna just basically piss of the candida. And yeah, you’re gonna get rid of it  but then the candida’s gonna come back with a vengeance. And we test your urine, we’re gonna see massive arabinose –

Dr. Justin Marchegiani: Yeah.

Evan Brand:  Or tartaric acid.

Dr. Justin Marchegiani: Yup, yup.

Evan Brand: Back with a vengeance you’ll say, “Oh, I just finish a round of Diflucan.” And it’s like, “Whoa! Maybe it worked for a day, but candida is back and she’s mad.”

Dr. Justin Marchegiani: Exactly. Alright. So let’s summarize everything we chatted about here, Evan So like, let’s say you’re just tuning in now or you just get really overwhelmed and your eyes got a little gloss over. What’s the Reader’s Digest version? I’ll let you go first.

Evan Brand: Yeah. So to me, reader’s digest version – enzymes and HCL are crucial. They are one of the most important foundations you should have if you want to be a healthy human that lives a long life, plain and simple. And then the caveats to that are well, do have things in your body that you need to work with a functional medicine practitioner and get tested for, such as infections like parasites and bacterial overgrowth like SIBO and candida. Now, if you get the testing piece done, you find out that your free of infections, which is pretty rare, then awesome. Maybe you’re just at a lower dose of HCL and enzymes, and maybe if you do soup, salad and smoothies, you don’t use enzymes but otherwise, you’re kinda cycling on. And you’ve got a cute little glass jar like I do that I shove in my wife’s purse. It’s got may enzymes and HCL in there. I take it if we go to restaurants and I always have it on the dinner table because if its out of sight, it’s out of mind.

Dr. Justin Marchegiani: Totally.

Evan Brand: So when I sit down at the dinner table, the enzymes are right there. Uhm – as you get older, we know with the works of uh – Steven Wright. HCL is gonna drop, so to me, it’s not an optional supplement if you want to be healthy. Mother nature just doesn’t care about your optimal digestion once you’re 40, or 50, or 60 because you’re pass the hunter gatherer reproductive age which was like 16 to 20 years old. So mother nature doesn’t want to kill you but she just doesn’t care if you digest your grass-fed beef when your age 40 to 50. So enzymes become a must. You wanna mimic the stomach acid levels of when you were younger and you had an “iron stomach” You wanna try to macht that with supplements.

Dr. Justin Marchegiani: Absolutely. And then in the future, what I’m gonna do is, anyone on Facebook, I’m gonna put the link in for the live YouTube side just so we can have people that uhm – want to see the full thing, they can go to YouTube and check out the whole thing. I wish we could make a go live on both sides here but right now the technology doesn’t quite do that. So we’ll shoot over the YouTube link in the future and just to add one last thing. Get the parasympathetic nervous system response going. Make sure you’re in a stress free, kinda relaxed environment; make sure you’re chewing your food enough times, uhm – get the saliva going to help start the digestion in the mouth. Then last but not the least, if you are really gluten sensitive, and you may be getting exposed somewhere like you’re going out to eat, and there maybe some contamination that you’re unaware of, enzymes that have dipeptyl peptidase for DPP4 enzymes can be helpful because that will help break down any bits of gluten. And the more the gluten can be broken down into smaller constituents, the better the body has a chance of dealing with it better. So keep that as a little side note, DPP4 enzymes can be hepful.

Evan Brand: What – When is the right and wrong time to use those?

Dr. Justin Marchegiani: Well, the wrong time is I’m gonna have a birthday cake, but it’s okay because I’m taking my DPP4 enzymes. It’s not necessarily for that, but if you are gonna have it though, it will lessen out the blow. But we don’t wanna give someone a crutch to be able to make a whole bunch of bad decisions. But if, let’s say I’m ordering some food at the restaurant and maybe there’s something in there, having it be handled by someone that just have their gloves on that handles someone’s breaded item. So you will do it more for incidental exposure just to prevent that so your body can deal with the gluten of – from that perspective.

Evan Brand: Love it. That’s great advice. So that should in your suitcase then if you’re travelling. We should do an episode on that. I think we did a travel hack episode.

Dr. Justin Marchegiani: We did.

Evan Brand: We should do a – on the go. Like if you’re not travelling but you’re just going out and about in the city and you may stop somewhere to get some food. What should you have, just in case.

Dr. Justin Marchegiani: Totally. That makes sense.

Evan Brand: So much fun.

Dr. Justin Marchegiani: And I’m gonna do maybe another Q&A. If I have time, I’ll make you another quick Q&A taken today. We have a couple of people here that are asking questions. They’re a little bit off-topic which is fine. But we’re only gonna answer the ones that are more on-topic. And I’ll try to have more Q&A conversations wherein we can take of everyone else’s questions.

Evan Brand: Also, last thing. If you have it, you should sign up for SpeakPipe. That way, people can send us audio questions and then we can play the audio clips and put them in for our podcasts.

Dr. Justin Marchegiani: Love it. Great idea, man. Any last thoughts, Evan?

Evan Brand: No. If people need help, reach out. justinhealth.com   notjustpaleo.com We’re available and this is the stuff we work on everyday.

Dr. Justin Marchegiani: Love it, man. Well you have a- awesome Friday, man and we’ll talk really soon.

Evan Brand: Take Care. Bye.

Dr. Justin Marchegiani: Bye.


References:

YouTube.com/justinhealth

www.notjustpaleo.com

Low stomach acid could be causing your digestive problems – Podcast #99

Dr. Justin Marchegiani and Evan Brand go in depth and reveal the truth about PPIs or proton pump inhibitors when taken especially over long periods of time. Discover what they do for your body, how it affects digestion, and what other issues they can possibly lead to. 

stomach acidFind out about the roles of hydrochloric acid and enzymes. Listen to this podcast to understand how proton pump inhibitors could be affecting organic acid markers and your body’s ability to generate ATP and energy. Learn how you can get off these medications and do away without taking proton pump inhibitors and then deal with your symptoms in a much better way starting with diet and lifestyle changes and getting in touch with a functional medicine expert to help you and then you can also proceed with any testing needed.

In this episode, topics include:

1:36   Proton pump inhibitors

6:50   The risks of taking PPIs

10:49   PPI and hydrochloric acid levels

17:40   Nutrient deficiency

19:30   Summary and take aways

 

itune

 

 

youtuve

 

 

 

 

 

low-stomach-acid

Dr. Justin Marchegiani:  Evan Brand, it’s Dr. J. How we doin’ today, man?

Evan Brand:  Hey, I’m doin’ great and fired up about drugs. So let’s talk about some drugs today.

Dr. Justin Marchegiani:  Nice. Oh, by the way, this is your podcast after your newborn.

Evan Brand:  I guess it is. I didn’t realize that. Yeah, she–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  One of our friends actually made us a Not Just Paleo branded onesie.

Dr. Justin Marchegiani:  Onesie, nice,

Evan Brand:  And she’s wearing that today, so I have to put a picture up on my social media if people wanna stalk me, they can.

Dr. Justin Marchegiani:  Awesome. And your daughter’s name is summer, right?

Evan Brand:  That’s right.

Dr. Justin Marchegiani:  Love it. Excellent! Very cool.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And I actually in between I got a dog and my new dog’s name is Butter.

Evan Brand:  Nice.

Dr. Justin Marchegiani:  Which I love because she melts in my lap. She sits on my lap almost all day, even while on the calls of my patients. It’s really cool.

Evan Brand:  What is she? She looks like a shih tzu kinda but not really.

Dr. Justin Marchegiani:  Yeah, she’s kinda like a Jack Russell and a Yorkie, just about 10 pounds. She’s a little Paleo doggie. She gets all grain-free, biologically appropriate, raw, good quality foods, grass-fed meat, you know, because dogs are pretty much obligated carnivores, you know, mainly meat and such. So yeah, she does really good. She’s pretty healthy.

Evan Brand:  Good to hear.

Dr. Justin Marchegiani:  Love it. Cool, man! Well, we both got some major changes in our life, probably a lot more for you than for me.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  With the—with the child here and then me got my nice little dog, so love it! And I got two—two cats and a dog and you’re just on—what, you got one dog and a–

Evan Brand:  One dog and one baby.

Dr. Justin Marchegiani:  And a—and a daughter.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Nice. Great! Very cool. Well, let’s riff on here the proton pump inhibitor topic. A whole bunch of different drugs out there and that family, a couple of common names are Nexium, Prilosec or—or omeprazole. There’s also the purple pill, Nexium. Let’s see—Pepto—no, Pepto-Bismo. Prilosec, omeprazole, Nexium, any others that you—you can come by. There’s like about 8 of them, 10 of them out there.

Evan Brand:  They have so many different names.

Dr. Justin Marchegiani:  Yeah, so many.

Evan Brand:  It’s honestly hard to keep up.

Dr. Justin Marchegiani:  Yeah, pantoprazole, esomeprazole, yeah, I mean anything that ends in a -prazole is basically gonna be your proton pump inhibitor. You have the purple pill which is Nexium, your Prilosec, omeprazole is the over-the-counter version of Prilosec. And again, all these drugs they just block hydrochloric acid. So they’re proton pump inhibitors. What’s a proton? That’s basically hydrogen. So it’s preventing hydrogen, which is a positive charged atom from binding to chloride and forming hydrochloric acid. So that’s how it’s working. It’s mechanism of action is—is preventing those hydrochloric acids from being secreted in the stomach and binding into chloride and performing that nice acidic pH which is really important we know from activating proteolytic enzymes, enzymes that help break down protein.

Evan Brand:  Absolutely and if you look at Dr Wright’s Why Stomach Acid is Good For You, we see he tracked several different people. I believe he used—can’t remember the name of it, but the capsule that was actually like inserted, the—the piece of technology they inserted into the stomach to measure–

Dr. Justin Marchegiani:  Yeah, it’s called–

Evan Brand:  The acid level.

Dr. Justin Marchegiani:  It’s called the Heidelberg test.

Evan Brand:  Yeah, I believe he did the Heidelberg test on all these patients or people in his studies and he showed after age 20, your hydrochloric acid production begins to steadily drop until you die basically and so we’re taking people that already have low stomach acid if they’re 40-45 years old and starting to get heartburn, indigestion, bloating and these other symptoms and they’re lowering that HCl level even more which I just had a note here from Healthline that was talking about PPIs, several studies now link to PPIs to a high risk of pneumonia and an infection of bacteria which is C diff., the Clostridium difficile that you and I see often on organic acids results. So this is not just your gut that’s affected here. There’s other places in the body that can really start to dysfunction if you have low stomach acid and, therefore, you’re not breaking down your food and absorbing your nutrients anymore.

Dr. Justin Marchegiani:  Right, and then again, where these proton pump inhibitors work is they work on the stomach in particularly the parietal cells, and the parietal cells these cells also produce intrinsic factor which is like this binding compound that helps bind to B12. So B12 in your diet then hits the intrinsic factor made by the parietal. It then gets reabsorbed at the end of your small intestine in an area called the ileum. So binds the B12 in the stomach and then it reabsorbs it in the ileum. So when we have issues with the parietal cells, we can also—we also may have issues with intrinsic factor. There are things called pernicious anemia. So the more we have gut dysfunction, greater chance we’re gonna have stomach breakdown issues, and then we typically go on proton pump inhibitors and there’s a greater chance that there we may have B12 or anemia issues that are B-vitamin based after the fact.

Evan Brand:  Great, so I mean in terms of PPIs, I remember not long ago they were all prescription drug commercials. Now things like Nexium are available over-the-counter, isn’t that right?

Dr. Justin Marchegiani:  Yeah, well, I’m pretty sure omeprazole is over-the-counter now for sure and that was basically Prilosec. That was, you know, a big, big multibillion-dollar drug. I think these drugs we mentioned before the show, they’re like in—always in the top 4 or top 5 money-making drugs. And the problem is when you—when you take a proton pump inhibitor, right? I mentioned the proton something like hydrogen, and it works with your hydrogen potassium pump system in the body, which we mentioned affects hydrogen being produced via the parietal cells in the stomach, forming hydrochloric acid but there’s other areas of the body where these hydrogen potassium pumps are being interfered with and that can affect ATP production, thus your mitochondria. So we see lots of people come back on their organic acids testing with weakened mitochondrial dysfunction. We’ll see the organic acids super low or super high. We’ll see things like cis-aconitate or aconitate. We’ll see different markers like lactate and amino acid markers low for CoQ10, various B vitamins, and it’s possible that a proton pump inhibitors could be affecting some of those organic acid markers, thus affecting your body’s ability to generate ATP and energy.

Evan Brand:  Ah, so let me probe you a little bit further on that. So you’re saying here the cascade of problems that happens is we have this PPI. We’re lowering the stomach acid, so now we’re spending our hard-earned money on grass-fed beef but we’re not actually cleaving the iron and the vitamins and the amino acids from that protein, right? So we’ll show up with very low amino acids on the organics, is that what you’re saying?

Dr. Justin Marchegiani:  Correct and there’s even research showing that people that take thyroid hormone and are on PPIs have to actually increase their thyroid hormone dosage. So it doesn’t only just affect that, it can even affect medication that are natural in origin. So being on this PPIs, I call it like it’s the first domino of—of your health destruction. Because anytime you impair digestion, you impair all the nutrients that are needed to run your body’s energy systems, hormone systems, detox systems, neurotransmitters and mood systems. So once you start shorting those systems out, any type of short means increase in symptoms. It means depression. It means anxiety. It means PMS. It means fatigue. And so basically our ATP is part of how our body generates energy aerobically and the more our body is forced to generate energy anaerobically, it’s gonna lead to more fatigue.

Evan Brand:  Right, so now–

Dr. Justin Marchegiani:  It’s gonna lead to more fatigue. Go ahead.

Evan Brand:  And I was just gonna say now if you stack someone who already has mitochondrial issues, they’re not producing enough ATP and then you take that and combine it with a toxic load, say there’s still getting exposed to glyphosate, which a new piece of research came out and said 93% of people have glyphosate, the pesticide used in non-organic food, that is going to increase the toxic load, the mitochondria can’t do their work even more, so things like organic diet become even more important than before especially if you have this compromised gut issue. The number—number 2 drug in all US pharmaceuticals is Nexium and you and I were looking at the stats–

Dr. Justin Marchegiani:  And that’s the purple pill–

Evan Brand:  Yeah, so it looks like less than 10 million but well, on the way to 10 million dollars’ worth of this drug is being sold per year.

Dr. Justin Marchegiani:  Right, now here’s the triad, right? People come in or they first get their medication for a Prilosec or a proton pump inhibitor, right? Then the next thing that’s gonna happen is they may start to have mood issues. Now they’re gonna be on antidepressant. Okay, so now they have acid-blocking meds. Now they have a mood issue. And now they start having fatigue, right? And then with fatigue comes like ADD. So now they’re on like an upper. They’re on like a methamphetamine, Strattera–

Evan Brand:  Like a Vyvanse.

Dr. Justin Marchegiani:  Like a Strattera, a Vyvanse or an Adderall. So now they’re on an upper. They’re on a proton pump inhibitor and they’re also on a mood medication for the depression. Now they’re anxious all the time because they’re on a mem—methamphetamine half the day, right? So now they’re on Xanax or some kind of benzodiazepine. So all these things start to happen. If they’re a guy, they’ll probably start to have low libido because a lot of the side effects of antidepressants are low libido. So now the libido starts going down. They can’t get it up in the bed. Now they’re on Viagra an d now because they’re so inflamed, their cholesterol is going high because their body is ridiculously inflamed so you can see, right? The domino of destruction is acid-blocking medication followed by mood drug, followed by stimulant, followed by anti-anxiety, followed by anti-libido, followed by statin.

Evan Brand:  Ugh!

Dr. Justin Marchegiani:  And it’s a—it’s a common—it’s a common, common pattern. And not to mention people that tend to have all those types of problems, also gonna be inflamed, and when they’re inflamed, they’re also on what else? Pain medication, right? So then it’s gabapentin, then it’s the Enbrel, then it’s an ibuprofen, NSAID, the older meds would have like the Celebrex or a Vioxx and those killed a lot of people, too. So again these medications aren’t—be on, the more problems, the more mitochondrial dysfunction, the more energy, and then as soon as you get on an ibuprofen even though it’s over-the-counter, I mean Wolf et al, 1999 American Journal of Medicine, 20,000 people die a year taking it properly.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  These aren’t meds you wanna be on as a lifestyle medication.

Evan Brand:  Right, right. And then you already alluded to it a little bit, it’s the leaky gut situation going on, the liver burden there, potential autoimmune disease from all of this because now you’re set up for bacterial overgrowths and candida problems and parasitic infections and it gets scary pretty quick, doesn’t it?

Dr. Justin Marchegiani:  It does and I didn’t even touch upon the SIBO part.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Because you mentioned it earlier, right? When you lower—I should say, when you lower the hydrochloric acid levels, you essentially raise the pH, right? Because we need hydrochloric acid levels to be high for the pH to be low. So essentially when we—when we decrease hydrochloric acid levels, that pH goes high, we have impaired digestion, and that increases chance for opportunistic pathogens—your Staph, your Strep, your Clostridia like you mentioned, your Campylobacter. All those different pathogens start overgrowing that increases chance of leaky gut. We talked about these pathogens having these dangerous metabolites such as lithocholic acid or endotoxin or LPS which can go and create leaky gut and then cross the blood-brain barrier and create mood issues, but it also can drive more SIBO, right? Because SIBO is gonna be essentially bad bacteria moving its way up and we know SIBO symptoms cause IBS so then it’s more medications, right? You’ll be on mesalamine or some type of prokinetic or antidiarrheal medication. I know you were diagnosed with IBS and they put you on a whole litany of meds and this could all potentially stem from proton pump inhibitors.

Evan Brand:  Yeah, they tried to. I never filled the prescriptions. Thanks God. I denied them all. And you and I were looking at some other research which I just sent you the link to that we can put in the show notes is 73,000 people that were 75 years of age or older and free of dementia were analyzed and they found that people had—people that were receiving regular PPI medication, 77% of them had a significant increased risk of dementia compared to patients that were not receiving PPI. So we look at all of these places. I just saw a new giant complex got built right down the street like an assisted senior care facility primarily targeted towards Alzheimer’s and dementia. Think of how many of those people are put on PPIs. I know we have parents and grandparents listening, that’s—that’s a big deal and we’re always seeing these campaigns of Fight for the Cure, Run for the Cure—how about just avoidance? And that was the conclusion of this research here, the avoidance of PPI medication may prevent the development of dementia. So this literally, you’ve done a great job of elaborating this. This literally spreads out like a spider web into every aspect of our civilization.

Dr. Justin Marchegiani:  Yeah, absolutely and by the way, any type—anyone that tells you they have a cure for something, run for the hills. And the reason why—even when it comes to cancer. When it comes to any type of disease, the reason why there can’t be a cure it’s because when there is multiple causes, there can never be a cure, right?  Because think about it, for there to be drug, a drug has to work on—it works on a mechanistic level. So for instance, proton pump inhibitors, what’s the mechanism? It re—it inhibits proton pump—it inhibits the proton pumps. It inhibits the hydro—hydrogen crossing that, you know, potassium membrane and creating hydrochloric acid. That’s how it works. But what if your acid burn was from drinking too much water while you ate or eating too much gluten or having a lot of emotional stress and eating while you’re driving. So you see how there could be multiple different causes or it could just be old age because Dr. Jonathan Wright show that as you grow older hydrochloric acid levels drop. It could be a gut infection. So how can we have a cure that fixes all of those different causes? We can’t. Now what may happen, let’s say I just got you meditating and got you eating in a more quiet environment, that may help a lot of people but it will never be the cure for everyone. It’ll never be the catch all. But it’ll probably help everyone else. But in conjunction, we can never say it’s a cure because only drugs can essentially cure someone, right? According to FDA rules. But what we are trying to do and what our focus is on is getting the underlying causes addressed and someone may have the same diagnosis, disease or set of symptoms that are caused by different set of underlying causes, so we kinda focus on the big 5 or 10 underlying causes for each issue and that gives the greatest chance of helping that person’s symptoms resolving.

Evan Brand:  Absolutely, well said. If that segment, that 2 to 3-minute segment were aired on national news, it would be the most viral piece of health nuggets that the—the mainstream population has ever heard.

Dr. Justin Marchegiani:  Right. I mean how can you have a cure for cancer when maybe that woman’s cause of breast cancer was because of her pesticide exposure everyday where the other person over here is because she’s eating too much sugar, and this guy down the street because he’s getting exposed to round-up on a daily basis and then maybe the person that came from, you know, Japan near the—the nuclear spill 3 years ago got exposed to something there, right? But maybe–

Evan Brand:  Or—or just the person who goes and gets the yearly annual recommended mammograms which we’ve seen–

Dr. Justin Marchegiani:  Right.

Evan Brand:  Bad research about those now.

Dr. Justin Marchegiani:  Yeah, increases your chance of cancer I think 1% every year. So if you start getting them at age 30, and the time your 60, you got 30% increase there.

Evan Brand:  Right.

Dr. Justin Marchegiani:  So how can we create a drug that actually will fix all those underlying causes? You can’t.  You can’t. So we just gotta make sure we understand that, that there is no such thing as a catch all, even in functional medicine, we focus on body systems that typically get affected when people present with certain symptoms and for the most part, if there’s any catch all that you could—I would let you air on the side of, typically the gut’s a pretty big catch all for everything.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Now it may be the gut and the adrenals and the gut and something else, but typically the gut is almost always gonna be a piece of the puzzle, but it may not be the whole puzzle.

Evan Brand:  Right. So you would say, I mean, in most cases, it’s at least half of the battle is getting the gut straightened out because that is going to affect the ability to produce hormones like you mentioned, the ability to uptake thyroid hormones and have all these other systems working properly so it’s not necessarily our starting place but it’s a big piece of the pie.

Dr. Justin Marchegiani:  Yeah, and a lot times we can’t start there per se because people’s energy systems, their adrenals, their thyroid are so flogged, they can’t generate the energy and if we went after infections, they would feel like crap.

Evan Brand:  Oh yeah.

Dr. Justin Marchegiani:  So one of the first places we do work on is cutting the foods out, the bad foods, and adding the good foods. And then number two, right next to that, is adding the digestive secretions so our patients can break down their foods. Remember good food can be toxic to the body if it’s sitting there rotting. Who wants to go eat the organic spinach that’s sitting on your counter for a week versus, you know, in the fridge for a day or two and then eaten later, right? You wouldn’t wanna eat that. And then also we just touched upon the nutrient deficiency. We talked about B12, right? B12’s important for creating healthy, mature red blood cells. We also need iron for energy and oxygen carrying capacity. We need iron to make thyroid hormone. So if someone’ got a thyroid issue, we gotta look at hydrochloric acid. We gotta make sure PPIs aren’t part of the mix. What about osteoporosis? We need calcium and magnesium digestion. Well, if we got—if we’re on Boniva or if we’re on Osteo—whatever the other medications are out there—Boniva’s the big one, then you know, you’re not getting to the root cause if  you’re also on a proton pump inhibitor and not digesting your minerals or ionizing your minerals, too.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Lots of studies on that.

Evan Brand:  So you literally—you literally fall apart in every aspect.

Dr. Justin Marchegiani:  Oh, my gosh! I know! And then also there’s some studies on that talking about basically PPIs having a higher risk of heart attack and—and what could be the potential mechanism? Well, I think it’s partly some of the minerals. Alright, we need magnesium. It’s a natural beta blocker to keep our heart in check. Healthy minerals help conduct nervous system impulse. We also need it to break proteins which typically have antioxidants in them and healthy cholesterol which is an important antioxidant, building block for our hormones. Also things like CoQ10 and L-carnitine.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  To help our heart have the energy and generate the ATP for our heart to pump. So that kinda make sense, right? We got increased cardiovascular, increased nutrient absorption. We altered the gut with the SIBO and with the malabsorption. So a lot of different things come and you also mentioned the cognitive things, too. So you can see how everything gets affected here.

Evan Brand:  Yeah. So where should we go? Where should we go from this? We’ve outlined and everybody’s like, “Holy smokes! Now what?”

Dr. Justin Marchegiani:  Alright, so you’re listening to this podcast, great. You’re just listening to it for the—for the brain candy, awesome! Grab some popcorn or maybe some chocolate avocado pudding, right? To keep it more Autoimmune Paleo and just enjoy the show but if you’re like listening to it with a perspective of like, “Yeah, I got some of those symptoms.” Well, what’s your first step? Well, obviously we always talk about diet piece. So I would start with a good autoimmune diet. That’s a good important thing. So that’s no grains, no legumes, no dairy, that the auto—that’s the Paleo filter. The second filter on top of that is the autoimmune one, that’s where we cut out the nuts, the seeds, the nightshades, and the eggs. Patients do that for a minimum of 4 weeks, but if they’re continuing to get benefits at 4 weeks, don’t stop until you plateau. Patients go like, “Oh, 4 weeks in, even though I’m so much better in this area and that area, I’m gonna go back on nuts and eggs.” It’s like, “Well, hold on!” if you’re getting great results, don’t—don’t, you know, mess with the good thing. If it ain’t broken, don’t fix it. So I always say don’t go on the old foods again—autoimmune foods until you plateau. Number two, once you do that, making sure your digesting your foods is essential. Adding in a good enzyme product. I mean, I have my enzyme synergy product, probably like you have one as well. A good enzyme would be great. Now if you have acid, over acid symptoms, start with an enzyme without hydrochloric acid because people that do have digestive issues, their gut lining is so thin, even something like hydrochloric acid may be too much. Something that’s just an all enzyme would be helpful and then tinker around with a shot of lemon juice or a teaspoon to a tablespoon of apple cider vinegar. If you can tolerate that then you can start to taper in hydrochloric acid down the road. When you have been on a medication like this long-term, you really wanna work with a functional medicine professional. I always recommend letting the prescribing doctor know what you’re doing, say, “I wanna go off it.” And make sure they’re okay with it. If you have an ulcer and they’re like don’t go off it yet, let’s give it time for the ulcer to heal, you wanna heed that recommendation. So let your prescribing doctor know what’s going on. Make sure they’re okay with it and then do all the diet and lifestyle things. You can always add in enzymes while you’re on the proton pump inhibitor and then you can always make the diet changes and then work with a good functional medicine provided that can help dial in the hydrochloric acid and then go to the 5Rs because what’s inevitable is an infection’s probably present that needs to be addressed next.

Evan Brand:  Yeah, so the mainstream practice is not always bad in the case of ulcers like you mentioned. You may need a PPI for a short-time so that you can let that thing heal, but generally speaking, there’s something going on that led to that in the first place so if you’re there, then you may have to dig yourself out of that first before you can jump on it but—but yeah, that’s great advice. So then it sounds like the next step once we get the foundations in order is looking into testing. So let’s rule things in—bacterial problems, yeast problems, parasitic infections.

Dr. Justin Marchegiani:  So SIBO testing, yeast, fungal testing, parasite testing. Also just know that your conventional medical doctor, it’s not in their scope to get you off these meds for the most part.

Evan Brand:  Right.

Dr. Justin Marchegiani:  If that’s prescribed, then you’re typically gonna be on for a very, very long time. I’ve had many patients that have been on these meds for years. Now most of the time, the underlying cause is never addressed. Therefore, they need it. They have to be on it. So the medical doctor really isn’t motivated, because when the patient misses it, they’re like, “Oops, that hurt. I got that burning.” So it kinda motivates the patient to stay on it and not really look to the—the root cause. But in functional medicine land, we look deeper and we’re able to help a lot of people get off these medications with their doctors help and, you know, and backing essentially so we do it the right way.

Evan Brand:  Exactly. That’s well said. So stool testing–

Dr. Justin Marchegiani:  But also the next–so yeah, stool–go ahead.

Evan Brand:  I was just gonna outline that, so stool testing–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Maybe some SIBO breath testing. Just getting the baseline, ruling things in, ruling things out, and then what were you gonna say next?

Dr. Justin Marchegiani:  Well, when we’re on acid blocking medications, especially if our gut lining’s thin, it almost always means we have weak IgA levels and weak adrenals. So we always wanna look at the adrenals because the adrenals help reduce inflammation if we’re inflamed. We wanna make sure our adrenals, our natural anti-inflammatory, our natural ibuprofen’s working to help reduce inflammation, okay? That’s gonna help build up our gut lining, too. We need healthy cortisol levels to build our IgA up. And then also number three, we gotta have good energy, right? So if our adrenals aren’t working properly because they are too busy putting out the fire in your gut. Well, you’re gonna feel fatigued and you’re probably gonna even have brain fog, too. So the adrenals are important and then if you’re having thyroid symptoms, right? Cold hands, cold feet, constipation, mood issues, depression, outer third of the eyebrow thinning, hair loss, right? Any of those symptoms you wanna look at the thyroid, too, because that may be affected as well.

Evan Brand:  Yup. I was gonna say also making sure that you—you outlined it already, but the order of things, too. And like there’s a lot of gut-healing supplements that people may do like I’ve seen just over the past week a lot of people just taking things kind of willy-nilly just because they read about it like slippery elm and marshmallow and all of these gut-soothing herbs, aloe vera, but you may not need to jump straight to that if they infection has not been identified and removed yet. Those things may help and likely can’t hurt, but you’re gonna just be kinda be spinning your wheels and wasting your money at some level.

Dr. Justin Marchegiani:  Yeah, if you’re doing that, like in my line I have a product called GI Restore we use. I know in your line you have one as well, we’ll use those but we’re always using them in conjunction with getting to the root cause, if not now or in the next month or so. A lot of people use those just to control symptoms. It’s like, alright, instead of an acid-blocking med, here are some enzymes and hydrochloric acid and some soothing herbs and nutrients and L-glutamine. A lot better. A lot of the underlying causes are addressed there but if we’re not causing the lifestyle causes or the food causes, you know, that’s strike 1. If you’re not addressing the infections, that’s strike 2, and if you’re missing the adrenal piece, that’s strike 3, right? So we wanna really have a comprehensive approach that looks at everything. So let’s say we forget everything up to this point, right? Number one, change your diet. Paleo/Paleo-Autoimmune, that’s step one. Step two, get on some enzymes at least. This is where you wanna start working with a functional medicine professional before you go deeper. Step three would t hen be doing the testing to assess the gut and if you have deeper symptoms, address the adrenals and thyroid and then even deeper, maybe the organic acids especially because of the mitochondrial dysfunction that can happen with these medications long-term.

Evan Brand:  Well-said.

Dr. Justin Marchegiani:  Any other clinical anecdotes you wanna give about patients that you’ve seen on PPIs, Evan?

Evan Brand:  Yeah, well, one thing that was interesting last week is a female who her adrenals actually showed up fine, which I was surprised because she had so much fatigue going on but then she showed with Clostridia bacterial overgrowth and she actually had a history of a PPI. I don’t believe she’s on one currently. I think she had a history of one for 10 years, and so she showed with Clostridia bacteria. It didn’t show up on the stool panel but it showed up on the organics and then all the–

Dr. Justin Marchegiani:  Ah.

Evan Brand:  All the mitochondria markers were very high, succinic acid and others were very high and then the amino acid portion, it was so low that it hardly registered. And I was like–

Dr. Justin Marchegiani:  Right.

Evan Brand:  Oh my—oh my God. I said, “Do you feel—like how do you feel after you get done with a meal?” She was like, “I feel like I don’t absorb anything.” I’m like, “Well, we can clearly see it here. Your amino acids are flat lined.”

Dr. Justin Marchegiani:  Right.

Evan Brand:  And so it was just really interesting to me because you and I talk so much about adrenals and we work with so many people with adrenal issues that to find someone that has decent adrenals was shocking.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  And then I was like, “Okay,” and then you have to wait a few days, you know, to get the other labs and it’s like, “Oh, now the light bulb went off. Here’s why.” It’s a whole another system that’s dysfunctioning that you’re never gonna get that measured by going to the clinic down the street and getting your standard of care yearly check-in. It’s just never gonna happen.

Dr. Justin Marchegiani:  Absolutely and also I’m gonna leave everyone here with a couple of clinical pearls. Because the big benefit of this show really is you’re working with two clinicians that are in the trenches working with patients. We aren’t just doing research all week long and making theoretical statements. We’re understanding the big picture. We’re working with people and we’re taking our clinical information and sharing it. Quick clinical pearl number one, separate your enzymes and your hydrochloric acid. A lot of people are taking like an enzyme HCl product, like maybe Super Enzymes is a common one. Good product. But if you were on a proton pump inhibitor and have gut issues, you wanna separate your enzymes from your hydrochloric acid. Why? Because your gut lining may be so thin that you may not be able to handle more than a couple hundred milligrams of hydrochloric acid and now if your enzymes are bound up with that, now your enzymes are limited to whatever amount of hydrochloric acid you can take because there it’s a packaged deal. Where if you get them on separately, let’s say you can only handle a quarter of a capsule of hydrochloric acid, but you can still ramp up the enzymes to 2, 3, 4 caps where before you’ll be stuck with maybe an eighth of a dose.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Number one is that. Number two is don’t go on hydrochloric acid off the bat. Focus on enzymes. Add in a—a tablespoon of apple cider vinegar, see if you can tolerate it. See if it makes your symptoms better. Take it with food. Some people with mess up the hydrochloric acid stuff by taking it at the end of their meal and it stacks on top of their food and burns their esophagus. So we really wanna emphasize that and last thing, I didn’t really go under the main mechanism, I missed it, I say it so many times with my patients, but I forgot it today. One of the main causes of hydrochloric acid issues, one of the main mechanisms is actually low levels of hydrochloric acid, right? Because GERD and acid reflux happen because of low levels of hydrochloric acid. The food rots, rancidifies, putrefies. Organic acids from that food rotting rise up and then burn the esophagus—the top part where that cardiac sphincter comes in and tightens up and basically closes down the stomach environment from the esophagus environment, and most people with low levels of hydrochloric acid, they don’t get that tightening of the esophageal sphincter, that cardiac sphincter, number one and number two, the get their food rotting and then the get the organic acids rising up. Where if the hydrochloric acid levels were high enough off the bat, they probably would have broke down those foods without any problems.

Evan Brand:  And it would have killed off the potential pathogens in that food as well.

Dr. Justin Marchegiani:  Absolutely.

Evan Brand:  Undercooked—undercooked food, mishandled food, sushi, etc. Like I had a female that she went to India, showed up clean stool test, went to India—I think, I don’t know if I had her on enzymes at that time or not—it’s been about a month or so, came back, symptoms and infection. And I was like I wonder what would have happened if the high dose of enzymes and HCl would have been in her travel kit, maybe we could have prevented that situation from happening.

Dr. Justin Marchegiani:  Big time. I got a whole video coming out on what to do when traveling, supplement-wise, and then also some people gotta go a little deeper. They gotta do some GAPS stuff or FODMAP or SCD, specific carbohydrate diet stuff because their guts is really messed up. This is where people like me and you are great resources, so again everyone listening, grab whatever you can from this info here. Listen to it twice. Check out the transcripts. Give us a review. If you’re really liking it, go over to iTunes, BeyondWellnessRadio.com/iTunes, NotJustPaleo.com—what’s your little end link after that?

Evan Brand:  I’ll make it iTunes.

Dr. Justin Marchegiani:  Okay.

Evan Brand:  It’ll be NotJustPaleo/iTunes.

Dr. Justin Marchegiani:  ITunes, yeah, give us some reviews, guys. We’d love hearing back from you. We wanna provide great information. Our goal is to be able to touch over a million people. I know Evan has. I have, too. Let’s say 10 million people so we can really help change the world and get them off the—the addiction to the conventional medical treatment pathway so to speak.

Evan Brand:  Yup, yup, amen. I know when people hear, “Oh, leave us a review.” It’s so easy for this podcast to end and then you just put your phone away or your laptop, but I know it takes a little bit of effort. You actually have to go into BeyondWellness, go into NotJustPaleo on iTunes and you have to literally click Write a Review button on your iPhone or your computer, PC or Mac, in the iTunes app. And then you have to click some stars, whatever stars you think we deserve, and then you actually have to type.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  Type the review. Submit. That’s how you do it. I’ve gotten over 200 5-star reviews worldwide but we should get that number to a thousand, 5 thousand, 10 thousand, however many it needs to take so that we continue to beat out Jillian Michaels in her podcast.

Dr. Justin Marchegiani:  I know, my gosh. I just can’t stand the eat less, exercise more mindset. It’s so much more nuisance than that, and also everyone knows someone on these medications. Shoot this podcast over to them. Have them listen to it. It could change their life.

Evan Brand:  Amen.

Dr. Justin Marchegiani:  Evan, it’s been awesome. Make sure you hi to your wife and Summer for me.

Evan Brand:  I sure will.

Dr. Justin Marchegiani:  Oh, and then by the way, I got Butter here. She says hi, too.

Evan Brand:  Hey, Butter.

Dr. Justin Marchegiani:  Take care. She’s unsalted by the way.

Evan Brand:  Cool!

Dr. Justin Marchegiani:  Take care.

Evan Brand:  See ya!

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.

 

References: http://www.altmedrev.com/publications/16/2/116.pdf

Hypothyroidism Symptoms and Indigestion

Hypothyroidism Symptoms And Indigestion

By Dr. Justin Marchegiani

Hypothyroidism symptoms can sometimes include low stomach acid and poor digestion. Poor digestion is a major problem today. As nearly 44% of the population experience heart burn monthly and 20% of them experience it weekly. Heart burn is a paradoxical symptom caused by low stomach acid strangely enough, as you would think the problem based on its name, is caused by too much acid. What essentially is happening is the food isn’t fully broken down. So it begins to rot (putrefy and ferment) in the stomach and organic acids from the decaying food rise up and burn the unprotected tissue of the esophagus.

The top 2 medications sold in 2014 were a thyroid medication called Synthroid and an acid-blocking medication called Nexium. This doesn’t prove that one causes the other, but in my clinical experience, there almost always tends to be a link with poor digestion, low stomach acid, and chronic infection when it comes to hypothyroidism or Hashimoto’s.

Low stomach acid is commonly associated with hypothyroidism and or Hashimoto’s. Stomach acid or hydrochloric acid (HCL) has a few different roles in the body, one being the first domino of the digestive process. HCL does this by lowering the pH in the stomach. This activates the digestive enzyme pepsin, which breaks down protein. The acidity produced from the stomach acid stimulates the gallbladder to produce bile salts, which are important for fatty acid break down.

If you have chronic digestive or thyroid issues and are looking for answers, click here!

Low Stomach Acid (HCL) and Anemias Can Affect Your Thyroid

Low Stomach Acid And Anemias Affect Your thyroid

When we look at the common nutritional deficiencies associated with low stomach acid, iron and B12 deficiencies commonly show up. These types of deficiencies are also known as anemias. B12 deficiency is known as a macrocytic anemia because our red blood cells can’t mature properly and are stuck in a larger state. Red blood cells actually get smaller as they mature, so the immature ones stay bigger, hence the prefix “macro.”

Cool fact: The parietal cells in the stomach, which produce intrinsic factor (IF), are the same cells that produce hydrochloric acid (HCL). This is why the HCL and B12 connection is so common. When the parietal cells are injured, it makes sense that everything it produces will no longer be at optimal capacity.

When we are dealing with iron deficiency anemias, these are commonly known as microcytic anemias. Iron is needed to help carry oxygen to the cells in our body. Our thyroid gland needs iron to help make thyroid hormone. And our cells need iron so they can take up oxygen as well. When our red blood cells don’t get enough iron, they become very small, hence the prefix “micro.”

The Anemia Breakdown

Anemia Breakdown

  • B12 anemia: You can’t produce healthy mature red blood cells. The same cells that help carry oxygen and nutrition all over your body for healthy metabolism. The same cells that produce
  • Iron anemia: Iron is needed to make thyroid hormone and gives your hemoglobin the ability to carry oxygen throughout your body.
  • A Common symptom of anemia is fatigue, which is the most common hypothyroid symptom as well. I hope you are starting to see the thyroid-anemia connection.

Our Gut Lining is Important for Nutrient Absorption

When there is an absence of HCL in our stomach, our food tends to not digest properly. When our food sits in our stomach, it tends to essentially rot. And then various organic acids rise off of it. The maldigestion of these food sources feed various bad bacteria in our gut, and gas is produced as a by-product. The next time you feel gassy after eating, you will at least know what’s happening on the inside.

The low amount of HCL and the increase in intra-abdominal pressure cause our esophageal sphincter to stay open. The acids from the rotting food now have the ability to rise up and touch the area of the esophagus that is typically walled off during healthy digestion. This is now the beginning of gastroesophageal reflux disease (GERD). If this area continues to get irritated, over time ulcers will begin to occur along with atrophic gastritis. It is nothing more than irritation of the stomach followed by a thinning of the stomach lining.

The thinning of the gut lining and the lack of HCL causes low nutrient absorption. 

  • HCL is needed to ionize and break down minerals, like selenium, iodine, calcium, zinc, iron, magnesium, and chromium, into a suitable state so they can be taken up by the bloodstream.
  • A healthy gut lining is needed to absorb these ionized minerals and also break down nutrients, including proteins, fats, carbohydrates, and vitamins (B12, vitamin A, vitamin E, and B vitamins).
  • These nutrients are not only needed to make thyroid hormones, but certain nutrients, like selenium, are needed to convert and activate thyroid hormones (converting T4 to T3) and help quench the inflammatory by-products of thyroid hormone metabolism—hydrogen peroxide (H2O2).
  • Eating a diet low in these essential nutrients in conjunction with poor digestion is a hormonal disaster waiting to erupt!

Nutrients Needed for Healthy Thyroid Function

  • B12, vitamin A, vitamin E, B vitamins, selenium, iodine, zinc, iron, and magnesium are important for healthy thyroid function.
  • As your digestive problem gets worse, so does your thyroid problem because the nutrients you need to run your thyroid aren’t present in optimal levels.

Thyroid Hormone Is Needed for Digestion

Thyroid hormone has an effect on cellular metabolism throughout the entire body, including the gastrointestinal tract. Metabolism in the gastrointestinal tract has an effect on gastric motility. A slower thyroid can cause slower transit times, which can also contribute to dysbiosis or a small intestinal bacterial overgrowth (SIBO) and indigestion.

Lower thyroid function can cause lower gastrin levels, which are needed to stimulate HCL production. When patients are brought up to normal thyroid levels, their HCL levels return.

“Fasting plasma gastrin levels measured by radoimmunoassay were found to be low in patients with hypothyroidism. The intravenous infection of arginine caused an increase of plasma gastrin in hypothyroid patients but was significantly lower than those in normal subjects. The decreased gastrin level in patients with hypothyroidism was significantly improved after the thyroid function was normalized by treatment.”

Low HCL and low thyroid levels can cause dysbiotic levels of bacteria in the intestinal tract. About 20% of T4 (inactive) thyroid hormone is converted to T3 acetic acid (AC) and T3 sulfate (S). The conversion of T3AC and T3S into active T3 requires an enzymes called sulfatase. The only problem is, sulfatase is found only in healthy bacteria.

In essence 20% of your thyroid hormone conversion is dependent on healthy digestion as well as a healthy gut biome. It’s amazing the interconnectedness between your hormonal system and your gut. It makes sense why Nobel Prize-winning physician Dr. Mechnikov is quoted as saying, “Death begins in the colon.”

The Infection Connection

The bacterial infection H. pylori is a common infection in the United States and is infamous for causing stomach acid. H. pylori also secretes an enzyme called urease. Urease breaks down urea into ammonia, which can have an effect on lowering your HCL levels.

“In conclusion, gastric acid secretion, as a quantifiable marker for gastric atrophy, was only partially reversed after eradication in the majority of the H. pylori-positive patients with marked body atrophy plus profound hypochlorhydria, despite of long-term follow-up over 5 years.”

In other words, depending on how much damage is present in the patient’s gastrointestinal tract, it may require outside sources of exogenous HCL and/or use of Swedish bitters to help regain the patient’s own HCL productions.

The majority of thyroid conditions diagnosed in this country are Hashimoto’s, an autoimmune thyroid condition. This condition is a little different from your primary hypothyroid condition as it’s the patient’s immune system that causes the damage. Giving someone the standard of care treatment, Synthroid, will not stop the autoimmune thyroid destruction.

Research shows a significant correlation with the eradication of H. Pylori and a reduction in thyroid antibodies. It’s as if the H. Pylori is a contributing factor to the autoimmune thyroid condition.

If you are trying to get to the root cause of your thyroid condition, click here for answers!


References:

Duke, J. A. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985

Solutions to Small Intestinal Bacterial Overgrowth (SIBO)

By Dr. Justin Marchegiani

I see patients every day walking to my clinic with small intestinal bacterial overgrowth (SIBO) symptoms. Have you ever felt your stomach pooch out after eating certain foods? Do you ever feel like you can’t quite digest your food all the way? Small intestinal bacterial overgrowth can also contribute to leaky gut syndrome!

There are millions of people with SIBO-like symptoms covering them up with medications that don’t fix the underlying problem. SIBO can affect our immune system and compromise our body’s ability to break down food and absorb nutrition.

gut health

Below are 5 signs you may have SIBO:

1. Burping or belching

2. Flatulence

3. Indigestion/low nutrient absorption (low B12, proteins, and fats)

4. Diarrhea or constipation

5. Abdominal pain

SIBO causes

What Causes SIBO?

1. A lack of stomach acid

When we have low stomach acid, or achlorhydria, our body lacks the ability to activate protein-digesting enzymes in our stomach, called pepsin. We need a low pH (acidic), right around 2, to ensure our body’s optimal digestive capabilities. This is why people on proton-pump inhibitors (drugs that block stomach acid) are at an increased risk for SIBO.

A low pH also provides an inhospitable environment for bad bacteria to grow. When bad bacteria overpopulate the stomach, it’s easy to see the increase in intra-abdominal pressure. This increase in intra-abdominal pressure can open up the esophageal sphincter and allow acids from the stomach to rise up and create irritation or burn the esophageal tissue. Without adequate levels of stomach acid, SIBO is almost certain!

2. Pancreatic insufficiency

Without adequate enzyme production, our body has a difficult time digesting proteins and fats. When our body doesn’t break down these proteins and fats fully, they putrefy, rancidify, and ferment in our intestinal track. This is not good!

HCl is the first important step for enzyme production. Without an acidic pH, the foods that are released from our stomach into our small intestine will not provide enough stimulation to trigger the gallbladder to release bile acids and pancreas to produce protein (trypsin and lipase) and fat-digesting enzymes. Without the crucial release of these enzymes, our body is at an increased risk for small intestinal bacterial overgrowth, or SIBO.

3. Chronic infections

Many infections are opportunistic and are able to take hold of the person’s body because of an accumulation of physical, chemical, and emotional stress. When this happens, we tend to have a decrease in immunoglobulin A (IgA). IgA is a protective mucous membrane barrier that lines our intestinal tract and plays an important role at preventing SIBO. Because 70 to 80% of our immune system is located in the lymphoid tissue in our intestinal tract, this has the ability to throw our immune system out of balance.

Chronic infections can lower stomach acid and decrease our body’s ability to break food down. With low IgA and a lack of stomach acid, our body is a sitting duck for an infection. Bacterial and parasitic infections are known to produce toxins (endotoxin and lithocolic acid) that can actually suppress our immune system. If you’re having chronic SIBO-like symptoms, feel free to click here to see if an infection connection is possible.

Other predisposing factors for SIBO

There are many other risk factors for SIBO, including fibromyalgia and IBS. These other conditions have common threads along with the main causes of SIBO that are above.

When our immune system is compromised by various infections, we have an inability to break down, absorb, and assimilate food due to an increase in physical, chemical, and emotional stress. This accumulation of stress eventually breaks the weak link in your chain. Because the gut is so central to the immune system, so many different conditions have a common link with small intestinal bacterial overgrowth. I would go as far to say that it is impossible to have a chronic disease without some type of gut dysfunction!

What Is SIBO?

SIBO is typically caused by a migration of bacteria from the large intestine making its way back upstream into the small intestine.

“SIBO may be accompanied by both maldigestion and malabsorption. Bacteria in SIBO might significantly interfere with enzymatic, absorptive and metabolic actions of a macro-organism.”

When our digestive system becomes stressed, our ileocecal valve can become loose. The slack in the ileocecal valve makes it easier for bacteria to migrate up the gastrointestinal tract. If more bacteria starts making its way up the GI tract, it makes it harder for the healthy gut bacteria in our small intestine to produce important nutrients, like vitamin K, vitamin D, iron, and various B vitamins.

What Type of Bacteria Is Found in SIBO?

Streptococcus 60%, Escherichia coli 36%, Staphylococcus 13%, Klebsiella 11% and others, as well as 117 anaerobes (Bacteroides 39%, Lactobacillus 25%, Clostridium 20%, and others) are found in SIBO.

How Do You Test for SIBO?

1. Hydrogen or methane breath test

A solution of glucose or lactulose is consumed. Hydrogen or methane levels are measured after the test, and if hydrogen or methane is found in amounts greater than or equal to 20 ppm, it is considered a positive test for SIBO. Ammonia is a common by-product from the intestinal bacteria. Ammonia has a pH of 11, so it’s easy to see how bacteria can affect intestinal pH!

2. Comprehensive stool test

The pathogenic bacteria mentioned above can be found in the stool by a comprehensive stool analysis. All lab companies are not created equal when it comes to this type of specialized testing. I recommend only using the best companies to ensure that you are getting accurate results. My three favorite lab companies for stool testing are Biohealth Diagnostics, Genova Diagnostics, and Doctors Data. If you are trying to get assessed for SIBO or any other infection, feel free to click here!

3. Organic acid test: This test can look for metabolic by-products of SIBO, including benzoate, hippurate, phenylacetate, phenylpropionate, p-hydroxybenzoate, p-hydroxyphenylacetate, indican, tricarballylate.

How do you treat SIBO?

Conventional Treatment Options

Conventional treatments typically consist of taking specific antibiotics, such as metronidazole and rifaximin. Antibiotics are powerful medicines, and I typically recommend a natural herbal approach first. The herbs tend to be more gentle on the body and don’t have all of the side effects.

Natural Treatment Options

There are many herbal medicines that can help eradicate SIBO. One of my favorites is oil of oregano. Other great herbs include berberine, artemisia, cat’s claw, colloidal silver, and ginger.

Sometimes it’s more than just SIBO causing the problem. If you are having any of the above symptoms, it’s good to get checked by a functional-medicine doctor to make sure there are no other infections driving the problem.

Some of these bacteria use biofilms as a means to protect themselves from the antimicrobials. It can get a little more nuanced when addressing the stubborn infections. Feel free to click here if you need help!

I find many patients do better at making diet and lifestyle changes first and addressing the adrenals and hormonal system second before addressing the gastrointestinal system. When patients go right to the GI system, the side effects tend to be much higher!

Dietary Interventions

FODMAPs: Removing fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) from the diet is also important. These FODMAP sugars can fuel the pathogenic bacteria in the gut, which then leads to more toxic metabolic by-products. Many people notice great improvements in stomach distention, gas, and flatulence after removing these foods from the diet. I personally find a combination of diet, lifestyle, and herbal medicines tend to be the trick to addressing the underlying cause of the problem.

Resistant starch: Adding resistant starch type 2 or 3 into your diet can also help feed the beneficial bacteria in the gut. The beneficial bacteria in the gut produce a short-chain fatty acid called butyrate. Butyrate helps keep the pH in the gut lower, tightens the ileocecal valve, and provides fuel for the cells of the colon. Watch the above video for more information on how resistant starch can help improve your SIBO.

My Favorite Resistant Starch

  • Type 2 resistant starch—unripened banana flour by Wedo.
  • Type 3 resistant starch—potato flour by Bob’s Red Mill.

Instructions: If you have significant SIBO, start with just 1 tsp of resistant starch and work up to 2 tbs. If you have any significant gas or bloating after taking the resistant starch, half the dose the next day. When in doubt start slow. Gas and bloating are surefire signs that you have SIBO.

I can take 2 tbs of resistant starch two times per day without any symptoms. Some people may have to use herbal medicines to significantly knock down the SIBO before the resistant starch can be tolerated. Make sure you work with your functional-medicine practitioner to support you in the process.

On a low-carbohydrate diet, the E.rectale and the Roseburia bacteria can significantly decline. Adding in resistant starch can help prevent this decline in beneficial bacteria while maintaining a low-carbohydrate eating plan. Some people are carbohydrate sensitive and need to keep their carbohydrates down, and this provides an excellent option to get the best of both worlds.

Feel free to click here if you need help!

5 Signs You May Have Low Stomach Acid

5 Signs You May Have Low Stomach Acid

By Dr. Justin Marchegiani

Do you suffer from any of the following?

Suffering from Indigestion, heartburn, constipation, gas, nutrient insufficiency

  1. Indigestion: Food doesn’t sit well after you eat.
  2. Heartburn: You have GERD (gastro esophageal reflux disorder).
  3. Constipation: You don’t pass at least 12 inches of stool per day.
  4. Gas: This is primarily in the form of belching or flatulence.
  5. Nutrient Deficiency: You have a past history of anemia or are low in certain micronutrients.

What is stomach acid, and why is it important?

Your body produces hydrochloric acid (HCl) for these primary purposes:

  • It activates pepsin, a specific proteolytic enzyme found in the stomach.
  • Pepsin’s primary job is to break down protein.
  • It provides an acidic pH in the stomach. This helps to decrease the chance of outside infections from proliferating like parasites, bacteria, and fungus.
  • It produces acidic chyme (the mixture of food in the stomach). When chyme is released from the stomach into the small intestine, the acidity stimulates the gallbladder to release bile and the pancreas to produce enzymes (lipase and chymotrypsin, to name a few).
  • It ionizes minerals so they can be broken down and absorbed by the body.
  • It stimulates gastrin, which helps protect the stomach and improve digestion.

Digestion and HCl

HCl is really, really important to start the domino cascade of healthy digestion. If that first digestive domino isn’t knocked over, it’s safe to say you are at a higher risk of digestive symptoms.

As mentioned above, HCl activates enzymes in the stomach, small intestine, and pancreas to start breaking down carbohydrate, protein, and fat. If HCl secretion isn’t initiated in the stomach, you will start to see a putrification, or rotting, of the proteins; fermentation of carbohydrates; and a rancidification of fats (1).

Digestion And HCL

Indigestion Creates Gas and Burning!

When the enzymes that are needed to break down these foods aren’t present, we start to see malabsorptions occur. These malabsorptions cause an increased intra-abdominal pressure, which can cause a weakening of the esophageal sphincter. When the esophageal sphincter loosens, this allows the organic acids from the rotting foods to rise up (reflux or GERD) and burn the esophageal tissue (2). Remember, esophageal tissue doesn’t have the protection (mucus) from an acidic environment like the stomach does.

Essentially, low stomach acid provides the environment for bacterial overgrowth in the stomach/small intestine to occur, which then creates malabsorption. You are now set up for a vicious cycle of poor digestion that almost never improves on its own unless the underlying cause is addressed (3) .

When food isn’t broken down completely, gas in the form of belching or flatulence is common. A dependency on pharmaceutical medications, like acid blockers, is now created that doesn’t address the underlying problem and only creates even bigger problems down the road, like B12 or iron anemias to name only a few (6).  In my clinical experience, HCl helps reverse these conditions and improve digestion; therefore, decreasing stomach acid in the long run with drugs isn’t a good idea most of the time.

Stomach Acid Protects Your Stomach and Your Esophagus…Huh?

Yep, you heard it here first! Most people associate stomach acid as a problem. Yet stomach acid is needed for the stimulation of mucus from pyloric glands. This mucus acts as a shield against the stomach acid and protects the gastric mucosa.

The pyloric glands secrete mainly mucus for protection of the pyloric mucosa from the stomach acid. They also secrete the hormone gastrin.

~Guyton’s Text Book of Medical Physiology, 11th edition.

The more your digestive track loses the ability to break down protein, fats, and carbohydrates, the greater the chance for a bacterial overgrowth to occur. As the balance of bacteria becomes more dysbiotic (more bad bacteria in relation to good), this can weaken your esophageal sphincter as mentioned above and allow burning in the esophagus to occur.

Why Am I Constipated?

Why Am I Constipated

As the ratio of good bacteria and bad bacteria becomes flipped in favor of bad bacteria, all kinds of bad things occur. We start to see incomplete digestion, which has an effect on motility. The excess of bad microbes in the GI tract can produce chemicals that slow down peristalsis, or the wavelike contractions that move food through your intestines. If you have more bad bugs in your gut, your transit times get slower (4).

Most people I see with digestive symptoms have some sort of gut infection, either H. pylori or a myriad of other parasites that are notorious for causing these types of issues. Unless these infections are addressed, these digestive symptoms tend to linger. To learn more about how you can address these issues, click here! 

Chronic constipation can also be connected to hypothyroidism as well. I strongly recommend ruling out any potential thyroid imbalances as well.

Stomach Acid Helps You Absorb Nutrients

HCl is needed to ionize minerals so they can be absorbed, assimilated, and utilized. There have been studies showing nutrient deficiencies in calcium, iron, and B12 when low stomach acid is present. Low stomach acid can even increase your chance of osteoporosis as well (5,6).

One of the most underutilized supplements is HCl, especially if you are already spending a good deal of money on organic food; you want to make sure you are absorbing and assimilating it properly. The old adage “you are what you eat” isn’t true. “You are what you eat, digest, assimilate, absorb, and utilize!”

ONE CAVEAT!

If you have serious gastrointestinal irritation or a history of ulcers, you should not add any HCl into your supplement regimen without the guidance and support of a skilled functional medicine doctor. Some patients need more enzymes and gut healing herbs and nutrients before any HCl is introduced. This is on a case-by-case basis.

If you are having problems with you digestion, click here to schedule a complimentary consult to figure out the best solutions for you. 

Physiology References:

Guyton’s Text Book of Medical Physiology, 11th edition.


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