Managing Environmental Allergies | Podcast #309
In this latest podcast, Dr. J and Evan are sharing their approach in managing patients who are dealing with environmental allergies. Dr. J and Evan have some recommendations for good digestive support, allergens, home air filters, etc. to identify the root issue and address the problem!
Environmental allergies can cause mild to severe symptoms, including sneezing, headaches, fatigue, and coughing. Preventing exposure to environmental allergens is the best way to treat them. You may not be able to avoid the allergens that trigger your symptoms. Your healthcare provider can help you create a plan for treating your allergies through home remedies and medications.
Dr. Justin Marchegiani
In this episode, we cover:
1:32 Environmentally Sensitive Patients
4:01 Checking Environmental Allergy Issues
8:35 Autoimmune Diet
14:46 Air Filters
17:44 VOCs (Volatile Organic Compound)
23:50 Gut Healing Nutrients
Dr. Justin Marchegiani: And we are live it’s Dr. J here in the house with Evan brand. Today we’re going to be chatting about supporting and getting to the root cause of your environmental allergies. Evan, how are we doing today man?
Evan Brand: Doing well, excited to dive into this because the leaves are falling at the time we’re talking. And so many people complain, I just got a new, different I guess a a better life insurance plan and the lady came over, you know, the examiner who comes and takes your blood work and stuff for your life insurance. And she comes in and she’s like, Oh, my God, my head is some old lady, my head, my eyes, my nose, my ears. I’m like, what’s going on? And she’s like these, these outdoor allergies. And she was just completely miserable. And she’s on all the conventional meds. And I talked with her and asked her, you know, would you eat for breakfast? pastries, you know, so it’s just interesting that conventional mindset is out there, allergies are just something that happens. And there’s nothing I can do besides just take the over the counter, or the prescription allergy meds. And that’s it. And that’s as far as the conversation goes, which is kind of sad, because I would argue for many people, we’ve seen hundreds and hundreds of cases of people who actually were able to get off of their allergy meds or at least significantly reduce the dosing of them by addressing the root cause, which is what these drugs do not do, they do not address the root cause of these issues. They just help modulate the symptoms, whether it’s working on the histamine issue, or some sort of immune modulating effect, or potentially steroids, but none of that’s root cause.
Dr. Justin Marchegiani: 100%. And so the problem is, a lot of times with these type of environmentally sensitive patients, they’re going to be stuck on some kind of a steroid inhaler for a while, whether it’s computer or albuterol, or some kind of steroid, some kind of Singulair medication, which does some immune modulating or some kind of a, you know, h2, five ht to kind of receptor, anti histamine, right? These things all have side effects, they all have fatigue and brain fog as a potential side effect. And none of them are getting to the root issue. And the problem with like steroids, for instance, they tend to weaken your immune system as well. And then they tend to when you’re putting a whole bunch of steroids in your body every day artificially, your adrenal output may actually start going down, so then your adrenal strength starts to drop. And you may not be able to resist or deal with inflammation or stress as well.
Evan Brand: Yeah, yeah. So let’s talk about some of like the basic foundations of this, where would you start with somebody who comes in with allergies in regards to testing, you and I are not typically going to run like a, quote, allergy test, you know, you’ll go to like a dermatology place, they’ll run like a patch test, or an allergist, may try to run testing for graphs and all of that. But to be honest, your opinion may differ. But I don’t really care what that test says about grass or pollen allergies, because that’s, that’s the immune system that can be overreacting. So I’m going to be looking more at the functional test.
Dr. Justin Marchegiani: Yeah, so my perspective on these things, I always tell patients, I draw a line between cause and effect. Okay, causal things are things that are going to dictate and change treatment. So I put allergies, on the effect side, like it’s an artifact of something that’s happening due to other upstream issues. So as we move things around, upstream, above, below, inside out, everything works downstream and starts changing the effects. So we look at the effects, we may be able to trace them up to certain areas on the cause side, which is good to know. So I only talk about effects to the point where I can get closer to the cause and then make different causal changes, whether it’s diet lifestyle, supplement, doing different functional tests to assess the function of those underlying systems that are part of that causal link.
Evan Brand: Check your mic, it sounds like it switched over to maybe like a headset or some other mic from the big boy.
Dr. Justin Marchegiani: Let’s see here. I’m testing here. Now. We’re pretty good on my end.
Evan Brand: Talk into it closer.
Dr. Justin Marchegiani: Testing, testing, one, two, yeah, there you go.
Evan Brand: Okay, I don’t know what to put, but it was on a different one. For some reason for a minute.
Dr. Justin Marchegiani: I’ll put a little bit closer here. No problem. So the first thing I always look at when we are dealing with these kind of issues is I’m looking at inflammation. So the first kind of major lover, we’re going to change the diet. Because if we are stressed and inflamed due to inflammation in the foods, whether it’s too much processed sugar, excess omega six to omega three fatty acids, too much pro inflammatory fats from from junky conventional meats, too much carbohydrate or grains, these things are going to affect us negatively. Maybe we don’t have enough really good saturated fats or enough good omega threes, or enough you know, keeping the carbohydrates down we have too much insulin, too much inflammation. These things can affect our immune system. And the more stressed our immune system becomes the more sensitive or overly sensitive it becomes. So it’s kind of like you know, your neighbor knocks on the door and you’re like pulling out your hand gun going to your door ready to attack you being overly sensitive, right, your neighbor just wants a cup of milk, right? So I always look at it as we want to be able to respond proportionally from an immune standpoint. And part of that is is decreasing inflammation. So the first thing I look at is where is inflammation coming from. So let’s make sure inflammation from foods under control to make sure inflammation from blood sugar, how to control let’s make sure we have the really good fat soluble vitamins and not too much junky refined process, plant fatty acids. So we look at all those things make sure insulin is equal, not too much carbohydrates, cut out the grains cut out the casein written dairy all these things can be more inflammatory. So we have to look at all those vectors now. We can dive in deeper now to gut and infections and CBOE and H. pylori, but that’s the first thing I look at because that can significantly come down the immune system. Now, next, we have a lot of histamine kind of symptoms, a lot of allergy issues, skin issues, breathing issues, headache issues. We’ll also look at dropping down higher histamine foods as well. Whether it’s pork or coffee, or teas or citrus, or fermented foods, some of these foods are considered to be like the holy grail of paleo, right like oh, pasture fed bacon. Oh, that’s supposed to be good, right? Or like kombucha or sauerkraut or fermented probiotic food. Those supposed to be good things right? Well, they are but if you have a lot of histamine issues, they may be enough to put you over the top and we just got to be really careful with it.
Evan Brand: Yeah, luckily I don’t have any outdoor allergy issues, but I have had issues with histamine foods so I am following low histamine diet and I feel really good on it. I feel much more clear headed. You know, excess histamine can really affect your, your your mind to like in terms of emotions. Let me share my screen real quick before we leave the diet conversation, because this is something pretty new to me. But something I’ve been experimenting with clients, and it’s been going well, I’ve been looking at this, what is called oral allergy syndrome. And basically, we’ve talked about gluten cross reactivity, you and I’ve discussed this before, where this idea that certain foods like chocolate or rice or potato or corn can be cross reactive for gluten, meaning that certain foods will make the body think it’s getting exposed to gluten, so then it creates some of this antibody reaction. Now this oral allergy syndrome is kind of the same thing to gluten cross reactivity as foods are to outdoor pollens. So check this out. So it goes into like your rag weeds and mug warts and grasses and certain tree allergies that people have but there’s foods that can cross react for these tree pollens. So here’s some of the listing here. And people can just look it up for yourself oral allergy center, but these people that are complaining about their allergies, what I’m doing is I’m putting them on kind of like this oral allergy syndrome approach. So these are all the foods that are cross reactive. So look at fruits you’ve got like oranges, melons, watermelons, rahzel-
Dr. Justin Marchegiani: Those are high in histamine though, right? Yeah, a lot of those are very high histamine. So that makes sense. They’re almost all high histamine.
Evan Brand: Yeah, let me zoom in here. So then you go into your vegetables. Once again, these are gonna be like corn can be high histamine, so compiz. And then you go into like your nuts. So like hazelnuts and walnuts, you’ve got chickpeas, you’ve got almonds, which are interesting. I feel fine with almonds. I’ve had some people get off of them. And they feel better, though. So anyway, when you look at symptoms of this oral allergy thing, it’s itching of the throat, mouth, lips or tongue, it’s swelling. And then of course, it can be more severe. hives, asthma can be involved anyway. So So yeah, so you’re right. It’s kind of like a low histamine approach with a club basically auto.
Dr. Justin Marchegiani: It’s basically autoimmune. Low histamine.
Evan Brand: That’s right.
Dr. Justin Marchegiani: That’s basically what it is, which is good. That’s a good first kind of template because you cut out people I see a lot of patients are like, but I’ve I don’t have an autoimmune condition. Why should I do an autoimmune diet? It’s like, well, because an autoimmune diet isn’t just specifically needed for autoimmune patients. And autoimmune diet is kind of like the ultimate anti inflammatory diet. And people that have autoimmune issues, they need the ultimate anti inflammatory diet because they have excess inflammation. And their immune system is part of the reason why that is because their immune system is joining in the attack. It’s like you got self attack, it’s like you just got beaten up. And then now you’re punching yourself as well. Right? You beat yourself up. And so the more we can reduce inflammation, just think of an autoimmune diet as the ultimate anti inflammatory diet. And it’s independent of whether you have a diagnosed autoimmune condition or not.
Evan Brand: Yeah, yeah. So we, you know, we personally and clinically implement that a lot and, and it works great for people. Okay, so let’s move on. Let’s go into some of the other stuff. You know, you and I’ve talked about this bucket analogy, and I would argue the outdoor environmental allergies are really just a sign that the, the bucket is already full, so they can’t handle the outdoor environment. I mean, our ancestors, they were outside all the time. They probably didn’t have these allergy issues. Why do we have them? Why are allergies in kids such a huge thing now? Why are so many kids on inhalers and stuff? I mean, this is not something that’s happened until the last hundred years and I would argue toxins are going to be a big one. So if we’re talking pesticides in the food, if we’re talking The impact on the gut with regards to the pesticide killing off the good bacteria in the gut, and then you’ve got kids with bacterial overgrowth. As you and I did a whole podcast on cebo. And histamine, we know there’s a huge link between bacterial overgrowth and histamine problem. So meaning your buckets already going to be so full just based on you having overgrowth of bad guys in the gut, what if your kids had ear infections, you put them on antibiotics, and then they have an overgrowth of bad guys and potential yeast like Candida problems as well, that’s already going to fill up the bucket so much, they’re not going to tolerate the outside.
Dr. Justin Marchegiani: Exactly. So we have kind of the diet stuff change, that’s gonna make a big difference, right, autoimmune, low histamine, we’re gonna look at the gut, right? People that have histamine issues or allergies, they tend to have poor digestion. So even a healthy diet, with foods not broken down properly, may be an issue. So we may want to work on good digestive support enzymes acids, we’re going to want to look at the gut, like you mentioned, if they have a lot of, let’s say, mold or mycotoxins coming in from their home, that could be a stressor, they have a lot of yeast or Candida that could be a mycotoxin stressor as well. They have si Bo, or H. pylori, that could be a stressor to all of these things can be potential stressors on the gut side. So we’ll kind of set the table with all the first the first things I mentioned, we’ll work on getting the digestion better. And then we’ll look at seeing what’s going on in the guts. Now, in the meantime, as a couple of palliative things we can do, we can also get them on some natural histamine to granulators things that help us to break down histamine. So it’s not going to be hanging around us and creating inflammation. So those things could be stinging nettle, of course, the tender, Bromo leaner and acetyl cysteine, I have a product called our clear with a lot of those in there, that’s a great product, that’s great. We may also add in some da o which is dye aiming oxidase, it’s an enzyme found in kidney tissue. And it’s very effective at breaking down histamine as well. So we may add some of those one to two things in there, which are very helpful. And the next thing on top of that is doing some sinus rinsing techniques. Because what happens is, a lot of times the allergens, they sit up in your frontal sinus, or your maxillary sinus here in these areas here and here, frontal and maxillary, and they just sit there, and then your immune system is constantly exposed to it, it’s like being dirty, the dirts on your skin you haven’t showered. So think of is you’re doing a shower for your sinuses to flush these things out, because the top of the shower is not going to hit the insides. So the more immune sensitive you are, the more these allergens sit inside your maxillary or frontal sinus, there’s gonna be problems. So we’re going to be flushing that out two to three seconds with each nose with a really good sinus rinse bottle, two to three seconds of flow, kind of blowing your nose in between to really flush that out. And we’ll have a good filter that is still water with some kind of a mineral solution. So it’s pH balance, and some kind of xylitol or biofilm the structure to flush and break down some of that bacteria or mold junk that could be or it just allergens that could be up in your sinuses.
Evan Brand: Yeah. And how you know that you have an issue with that is if you do a sinus rent, and you have an increase or a decrease in symptoms, so any change at all. Now, some may not notice much and you’re still doing yourself a favor. However, most people that are already pretty hyper sensitized, they do notice a significant change. So what made us what that may look like could be an increase in brain fog. It could be anxiety, it could be some vision changes, it could be all of a sudden you feel more clear headed your mind your thoughts are more clear. So when I first started doing sinus rinses, I was just really like almost drunk. I was like whoa, I must have just started breaking down biofilm killing something off in there. Now I do the scientists rinse and I get more clarity. So that’s something you want to look for and silver. Some people use silver up the nose, there are some nasal sprays that have some silver hydrosol in there. You mentioned they actually are essential oil blends. There’s a couple that you and I use that are designed for the sinuses. So those can be really helpful. And like you mentioned, it’s going to be kind of draining the bucket. So if you clean up the diet, if you’re working on the gut infections if you’re going organic, and then now you’re doing sinus rinsing, you’ve already and you’re doing the herbal anti histamines, like you’re talking about vitamin C, I want to throw that in as well vitamin C can help to break ground. Or it can kind of speed up the degradation of the histamine. So for me, if I know there’s going to be a high histamine meal, I’ll do a little bit of the DA o or some vitamin C and or course attend beforehand, and it can really really help blunt the effects of it so histamines addicting to I mean, it is a neurotransmitter. So it’s really tough for certain people, when they go low histamine, they’ll start to crave high histamine foods. And that’s a pretty interesting phenomenon that I’ve seen. And like chocolate, you know, in general is going to be higher his domain and so a lot of people really have cravings for chocolate ramp up once on a low histamine diet.
Dr. Justin Marchegiani: And as we get the inflammation under control, we’re flushing out some of the sinus stuff. Oh, also, we may also get a really good high quality air filter to get the environment really clean. Maybe there’s a lot of pollens or cedar in your home. Maybe there’s some mold toxins. We get That flushed out in the air, we get some of the food under control, we get some natural anti histamine support, we work on better digestion, get the inflammation in the diet, get rid of some of the gut stuff that’s going on some of the gut infections or gut permeability stressors, and we can start to add certain foods back in over the next few months. So this is not like a death sentence. And it always comes down to like histamine load, right? Maybe with all those other things in the past you had you’re gonna have symptoms, right. But as soon as we’re flushing out the nose, changing the diet, adding that support may be able to start getting some foods back in one at a time. So we just got to keep an eye on that.
Evan Brand: Yep, yeah, in the air purifiers are huge. I mean, I would not live in a house period, no matter how clean new beautiful the houses, I would never live in any house that doesn’t have an air purifier. So I know you’ve got one in your office, I’ve got one in my office bedrooms, living areas. We’ve got them everywhere. I mean, and I’m not in the city, but I still want to make sure that I’ve got good filtration. And so we love and use the Austin’s so-
Dr. Justin Marchegiani: Yep, we have, we have the Austin air too. So we’ll put the links down below Evan, for kind of the links for our sites, if you guys want to support the show or want to get a high quality air filter, like we probably recommend the same, the healthmate Plus is a good first start. Or if you’re really sensitive, the allergy machine is a good second one. But the helpmate plus is my favorite.
Evan Brand: Yeah, I mean, in terms of bang for your buck, that one’s the best one, I’ve got the molecule too. We’ve talked about this in the past, but the molecule is different technology, the blue light on it is kind of annoying, especially at night, because you’re getting blasted by the light. So you’ve got it pretty much turn that thing off or put it on dark mode at night, which then all that means is it’s just running the pre filter, which essentially does nothing. And there is sort of a plasticky smell, due to the way it kills the VCs and such on the molecule. So the molecules, you could call it more of a chemical treatment of your air where it basically breaks up pollutants and toxins and kind of destroys them into really small particles versus the Austin is more of a good catcher’s mitt. So that’s why we prefer that one.
Dr. Justin Marchegiani: Yeah, the molecule has the light, the PET technology, the photo electronic light in there, which isn’t the best for bedrooms, because you don’t want those lights active. So we’ll use the Austin air, helpmate plus, which has the 15 pounds of zeolite. And activated charcoal 30 pounds total, also has the habit attached to it. And then it has the potassium chloride in there as well that filters out the voc. So that’s what makes it a little bit more unique. The right yes, mate doesn’t have the regular helpmate doesn’t have the potassium component.
Evan Brand: Yeah, it’s incredible. I mean, that thing is so heavy, it literally feels like it’s like military grade, people throw that term around. But that thing is heavy duty.
Dr. Justin Marchegiani: It is like I have some filter, I have some shelves just put into my office here. And they’re off gassing a little bit. So last night, I kept the Austin on high just to filter out any VOC’s that are, you know, in the air because of the off gassing.
Evan Brand: Yeah, let’s go into the VOC’s for a minute because you know, we kind of got off the histamine topic. So yeah, you mentioned reducing the load. Now, if you’re in a new home, and you were not extremely anal about all of your choices, there’s going to be potential formaldehyde, there’s going to be vlccs volatile organic compounds that are going to come off of your paint. If you have vinyl windows, they’re going to come off of your window frames. They’re any glues that were used on your plumbing fixtures, any of your baseboards that were painted any of your cabinetry in your kitchen that was pre finished or pre painted from the factory that comes in that stuff can off gas for literally years. And now we build our houses so tight and so energy efficient, which saves us a little bit of money, but now the houses don’t breathe. And so now these vo C’s even the EPA says indoor air pollution is 10 to 100 times more toxic than outdoor air pollution. And so I’m extremely anal and I’m actually building a course out on like healthy homes, because I’ve had to pick and choose like a lot of materials. But the long story short it and paints to even low or no VOC paints like Sherwin Williams and however you pronounce it, some of those conventional brands. They’re still toxic. Yes, they may say low or no voc, but they’re still toxic chemical. So you only want to use mineral based paints, just and I’ve talked about Roma bio, being a good mineral paint. That stuff is amazing. And then drywall too. I mean, you’ve got different chemicals that could be in certain dry walls. If they’re not gypsum based. They’re going to be synthetic. You’ve got flooring, chemicals. So you’ve got seals, you’ve got varnishes you’ve got clear coats on stuff. If you have like wood wood beams, I mean, it’s easy to fill a house with toxins is all I’m saying.
Dr. Justin Marchegiani: Yeah, I mean, just if you’re going to do painting or any of that stuff, right, just make sure you’re out of that room. Like when we do any painting. We try to be out of the room and we just put a really good air filter in that room and put it on high and just do your best to suck out the vo C’s may off gas for a while. But if you have a good vo C on there, a good voc air filter on there you should be okay. And then just you know, take your good natural support. It’s hard to avoid these things at some time. And then the more sensitive you are the more it’s an issue the less sensitive less of an issue but just have a good air filter in the background. So you’re sucking all these things up. And then of course would be some of the flame retardant things you may get on couches or Especially you see it on kids stuff, a lot of kids mattresses, carrying, you know, car seats, those kind of things. So we always get flame retardant free. That’s the pbds polybrominated diphenyl ethers, which are the flame retardants, so we’d always get those things pbde free. And then we just have a really good air filter, if something does have it, so we’re filtering it up.
Evan Brand: Yeah, it’s even in kids pajamas, which is just unbelievable. We had some clothes that were gifted to us for when our when our girls were really little, and it would say flame resistant. On the tag, we’re like, oh, my god, they’re putting flame retardants and kids clothing like this is unbelievable, because those are very hard chemicals to get out of the body. In fact, cola Starmie in a binder you can use for mold toxin is one of the only things that actually gets these flame retardants out of your bloodstream and out of your brain. So it’s pretty unbelievable that these things are everywhere. And so not to divert into the toxin podcast. But that’s the note about lowering your toxin load in your home to lower your bucket so that you can tolerate the outdoor environment better.
Dr. Justin Marchegiani: Exactly. So the first thing that we like to do is make sure we decrease inflammation in our body. That’s the first thing, we may look at digestion, look at the gut, look at the microbiome, look at things that are jacking up our immune system. Of course, if cortisol is out of balance, either extremely high or extremely low that could throw things off. We may also look at strategizing sinus flushing, I have a video on that, we’ll put that video in the show notes, you can actually watch me doing an actual protocol, getting the air filtration dialed in. If you’re going to use paints with off gassing, just try to leave their home for a day or two and have a good air filter. And those are all good strategies. And then after that would be you know, changing the diet, adding in some natural anti histamine support and kind of going from there and start with the low hanging fruit. If you have problems, get a good functional medicine doctor in there to really look at investigate come up with a plan for you.
Evan Brand: Yeah, it can go a lot deeper than that. So we’ve done podcasts on these individual things. But mast cell issues, mast cells are part of the immune system that release histamine, your mast cells can become activated when you get exposed to some sort of a pathogen or a toxin. So Lyme, bartonella, mold, these are three big ones that trigger the mast cells to dump more histamine, those are big triggers. For me, I used to not have histamine issues at all. And then I developed some getting much, much better all the time. But, you know, there was kind of a straw that broke the camel’s back for me. And so I’ve dealt with it personally. But you know, we see it a lot clinically too. So you got to dig deeper if some of the low hanging fruit is not being addressed, or you got to do that first. But then once it is addressed, if you still have problems, and there is probably something deeper heavy metals, other types of toxins, you got to you got to fix all of it. So you can’t just go pop the course attend and go gluten free. And everything’s magical. For some people, it may be that easy. But the people that Justin and I are working with, they’re people that have been to 5 10 15 20 doctors before they get to us. So these people have probably already dialed into low hanging fruit. And that’s why we’re here clinically.
Dr. Justin Marchegiani: I find with those people, they tend to have a lot of environmental stuff, there may be some mold in their system, they may have some air, they may have some air quality issues. And they may have a lot of gut issues. Because the more you’re 80% of your immune system in your gut. And so if your guts permeable and you have gut stressors, and you’re not digesting foods, well, that’s going to create more gut stress, more immune stress, the more immune stress you have, it’s because your guts more permeable, and then you’re just everything that you’re getting exposed to on the outer world is getting interacted with by your immune system. And normally we’d have some kind of a barrier protection. But now everything’s everything is now responding to your body and your immune system is seeing all of it and that can be a problem when normally there’d be some kind of a mucosal barrier protection. Now, there’s not that protective barrier is now gone. It’s like the front door is now unlocked, so your immune get exposed to a lot of things that it normally wouldn’t that gut permeability is a big, big first thing we have to look at.
Evan Brand: Definitely, definitely. So there is a place for gut healing nutrients. There is a place for probiotics like we use a lot of Bifido really, really high dose Bifido can be helpful. spore based probiotics can be helpful. Medicinal mushrooms can be helpful to help modulate the immune system. We like herbs too. There’s Andrographis and Astragulus and elderberry. And I mean, there’s a ton that we could go into these can be helpful, it really just depends on where somebody is at because you can send the immune system the wrong direction. So an autoimmune cases and such there are some times where we may not go straight to mushrooms, we may just focus on the gut first. But once again, it’s kind of a case by case basis here.
Dr. Justin Marchegiani: Yeah, exactly. Anything else you want to add today?
Evan Brand: I would just tell people that there are answers, there are solutions to this. So if your allergist is not getting to the root cause then feel free to reach out to one of us. We’d be happy to take you to the next level of healing. Look into the gut look into all of these different body systems kind of get your total body burden figured out, and then we’ll help plot the step one, step two, step three, how to get you feeling better. So if you need help clinically, don’t hesitate please reach out to Dr. Justin at JustinHealth.com or me Evan Brand at EvanBrand.com We’re here for you guys. So we love helping you we’re extremely blessed with the knowledge we’ve gained, you know, personally and clinically, and it’s very rewarding to get people relief. That’s the that’s what this whole entire episode was about relief. It’s not fun when you want to go hike with your kids or grandkids and you can’t because you’re miserable. And then you got to do your inhaler, because you can’t breathe. I mean, God, that’s just not a way to live. And there is there is there was there is a way out of it. So that’s what we’re here for.
Dr. Justin Marchegiani: Excellent. Well really appreciate today’s chat if you guys want to reach in EvanBrand.com for Dr. Evan and JustinHealth.com for myself, we’ll be happy to connect with you all and kind of go over the different algorithms and what’s going on underneath the hood so we can get to a lasting solution. Hey, Evan, great chatting with you, man. You have an awesome day. We’ll be in touch.
Evan Brand: You too. Take care now.
Dr. Justin Marchegiani: Take care, bye.