Can Parasites Cause Thyroid Problems? | Podcast #316

Parasitic infections are a big problem in tropical and subtropical regions of the world. In this video, Dr. J and Evan will share how to handle these cases. One of these is giardiasis that may cause diarrhea, gas, upset stomach, greasy stools, and dehydration; cryptosporidiosis, which may cause stomach cramps, stomach pain, nausea, vomiting, dehydration, weight loss, and fever; toxoplasmosis may cause flu-like symptoms, including swollen lymph nodes and muscle aches or pains that can last for over a month. 

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:05    Parasites and Thyroid Issues

8:05    Conventional Medicines on Parasites

12:50   Thyroid Symptoms

16:54   Adrenals as Natural Inflammatory

19:55   Gut Healing Protocols

This image has an empty alt attribute; its file name is itune-1.png


Dr. Justin Marchegiani: Hey there, it’s Dr. Justin Marchegiani. I’m with Evan Brand, Evan, how are we doing today? My friend?

Evan Brand: I’m doing well. I’m excited to dive into this, you thought of the idea of parasites and thyroid issues? And I said, Well, that’s easy, because we’ve seen hundreds and hundreds of cases at this point where thyroid issues magically get better or even resolve themselves just by fixing infections. Now, I will I will say that, you know, even though the title of this is parasites and thyroid, I would argue other infections are probably going to be happening at the same time. It’s rare that you and I, when we’re doing functional stool testing, it’s rare that you and I find just a parasite, right? Like, we’re probably going to find some Candida, we’re probably going to find some cebo type stuff, maybe some CFO issues, maybe some worms, maybe some gut inflammation, but parasites can be a really big catalyst for thyroid issues. 

Dr. Justin Marchegiani: 100%. So we talk about these topics, you know, in a lot of different ways, so we try to nuance it a little bit. So if you’ve heard topics on parasite infections before from our podcast, we’ll try to make it a little bit different for you. So you get a little bit of a different perspective on this. So parasites are really a big deal. Gut infections is general and you can kind of lump in SIBO and Candida with this as well. Parasites can be a little bit more severe. Right, we have blasto, e, histo, Giardia, Cryptosporidium, any of the immediate miba infections, d fragilis. penta trichomonas, hominess. Trying to think of some other ones here, we have different worm infections, right. And these can all create inflammation in the body. But more importantly, besides inflammation, they can create gut permeability. And when the guts more permeable, we can have more immune stress, right, the more the immune system is stressed, because 80% of the immune systems in the malt, and the golf, right malt is the mucosal associated lymphoid tissue that’s in the stomach. I’m sorry, that that’s in the small intestine and the golf, that’s the gastric associated lymphoid tissue that’s in the stomach. And we have immune cells in these tissues. And the more stressed they are, the more gut permeability we have due to infections, that can really exacerbate the immune system. And they can wind it up so to speak. And the more wound up the immune system is that can facilitate an autoimmune attack. And that means your immune system starts making B cell or antibodies to the thyroid, and you may make things like TPO antibodies, which may affect the enzyme that helps bind that thyroid together, thyroid peroxidase. And that can affect the thyroid. And you may make thyroid globulin antibodies, which work on the extra cellular protein on the thyroid, and that can attack that. And so when you start damaging and beating up the thyroid due to autoimmune attacks, that can impair thyroid function and thyroid hormone binding. And a lot of that can start with the immune system. And the biggest trigger for that can be a gut infection. 

Evan Brand: So let’s roleplay a little bit if you don’t mind. So, you know, I’m Joey, and I go down to the the local gastroenterology clinic and I tell him that I saw this guy named Dr. Justin on the internet and he told me that, you know, blast over crypto or God may be causing my thyroid issues and the gastro doctor says no, you live in America, you know, not gonna happen. What do you say to that guy? 

Dr. Justin Marchegiani: Well, that’s kind of the the big thinking with a lot of conventional doctors is, hey, these parasite infections only happen in third world countries. And so it’s a big deal in third world countries. It’s like one of the number of top five causes of death in third world countries partly because you get amoebic dysentery, massive diarrhea, electrolyte depletion, cardiac arrest, or some kind of hyponatremia symptom, because you have massive diarrhea. Now here, you go to an ER, they put you on an IV, they flooded with antibiotics, and more than likely, you’re gonna be fine, right? You may have side effects later, that’s a whole different podcast, but you’ll be fine. The problem is, we kind of look at parasite infections having this acute symptomology that results from the infection. And a lot of times, that may not be the case, you may be in this kind of functional asymptomatic place where you don’t have over diarrhea, you don’t have over constipation. You know, you may have some but not a ton. And then a lot of times it’s just enough where they kind of throw the IBS diagnosis at you, they may run a scope they may not see anything, they may run a stool test not using the best technology so they may miss whatever’s there. Now, if you have a serious infection, there technology, you know, basic stool antigen looking under a microscope, they’ll probably catch it. But if it’s there’s not a lot of bolus of that parasitic material, they may miss it and that’s where some of the DNA technology maybe a little bit better for picking up parasites. So this is why they may miss it, number one, number two, you may have kind of these subclinical symptoms that may get lumped into the category of IBS, which is a diagnosis of exclusion, meaning they ruled out krones all sort of colitis, right? They ruled out bowel impaction acid reflux, all these other inflammatory issues, ulcers, right? And now, okay, all the serious stuff is ruled out. So they just say, okay, we’re going to just call it IBS. And then they’re going to just give you some medications to control whatever symptoms you have going on, whether it’s antispasmodics acid blockers, whether it’s um, constipation, medic medicate medication like laxatives, or bloating, medication, etc, gas x, that’s all they’re gonna do after that. And we know with functional medicine world, a lot of parasite infections can actually cause energy and mood issues. And so this is totally over their heads in conventional medicine world, because now they’re used to connecting gut infection to gut symptoms. It’s like an A, it’s like a one to one relationship. Right? Now you start going three dimensional here, when you start talking about gut infections, exacerbating your thyroid, causing an autoimmune attack, and now you have anxiety and heart palpitations in in fatigue and depression all throughout the day. Now what? And then now if those symptoms happen, you’re more than likely going to be prescribed a anti depressant or medication to treat those symptoms. So you’re kind of getting this really big cascade of symptoms that don’t quite match up with the conventional mindset. 

Evan Brand: Yeah, and it blows their mind and then they get overwhelmed, and then they’ll dismiss you and then they may send you off to the psychiatrist. And they say, Well, you know, I don’t really help with anxiety. I’m focused on the gut portion of this. Luckily, you know, what we do as practitioners we come in and we’re not neurologists and gastroenterologist and endocrinologist and, you know, kidney experts, but we’ve had enough experience to where we can actually address each piece of this spiderweb. I mean, you you eloquently described it here, you’ve got the GI complaint that most people think about, they think, okay, if I have parasites, I’ve got to have diarrhea, I’ve got to have stomach pain, not necessarily. We’ve seen hundreds of people where they’re just a little bit tired. And maybe once every few weeks, they have kind of a cyclical gut issue. Right? So for me, it was definitely, it was definitely like a cyclical pattern. And I was trying to track it down to the diet. I thought, okay, you know, is it dairy? So then we got off dairy and then we like, reintroduce grass fed dairy without Okay, is it that Okay, what about the grains is the grains? No, it was the infections, but they had a cyclical pattern. So when you start bringing stuff up like that, you’ll literally you just lose the ear of the the conventional practitioner. So back to the thyroid piece, or you mentioned like the immune cells, you mentioned the immune stress. Now, we’re also going to be looking at blood for this right? So you would suggest if we are seeing a lot of these hyper hypo symptoms, yes, we’re going to run some DNA stool testing. But we’re also going to want to look at blood too, because we may find some other answers there. Now, I would argue, and I’m guessing you may agree with me that the blood is going to be more of looking at the effect, not necessarily the cause. Meaning if you look at the gut infections, that’s more of a cause. But we may see the TPO antibodies, you may see the tg antibodies, you may sit, we may see like a high reverse t three. But but that doesn’t necessarily change the game plan, right? Because you still have to go to the gut to fix the parasites that caused the high reverse t three in the first place.

Dr. Justin Marchegiani: Correct. So how conventional medicine looks at things right may not pick some of these things up. So let’s say they’re even looking in the thyroid, let’s say they’re kind of let’s say they’re entertaining. And let’s say you listen to this podcast, you go in, and they’re testing your gut, and you’re like, Hey, can you also look at my thyroid, too, they may not even run these markers, as they typically run just TSH, and maybe if you’re lucky, you can get a T for free your total. That’s it. Now, if your TSH is overly high, then it’ll get picked up. But what is overly high, you know, maybe greater than four and a half to five. But it can take a long time for the TSH to go that high. Like TSH doesn’t just go high like that, in the snap of your fingers, it takes a lot of years, maybe even decade to get to that level. So if you have high TSH, you can just guarantee that that issues been going on for a long time. So that’s pretty much how you know if it’s a if it’s been going on for a while. And then now you have the downstream t four and T three that need to be looked at and T three is very important because T three gets converted from t four. So t four is your inactive thyroid hormone. T three is your active thyroid hormone. We almost never test this T three number. And a lot of times we can have a conversion issue. So your T four may be adequate. And then we have a drop in T three. So t three is not at an equal par In regards to the percentile of the reference range. And then we definitely know antibodies aren’t tested. That’s really tough. And partly because they don’t do anything because of it because treating a thyroid autoimmune condition with conventional medicine standards. They use high dose prednisone and immunosuppressive medications, those medications for a thyroid issue that would actually cause more side effects than the thyroid issue itself. So they tend to stay away from treating a thyroid issue. So they don’t really do any tests to reveal that it’s there. If it’s autoimmune, so you kind of get stuck in no man’s land. 

Evan Brand: Oh god, that’s a great point. That’s what I was gonna say. I mean, it just frustrates me where you and I will have you know, new patients come and they’ll send us bloodwork and we’ll look at these, you know endocrinologist that may have even extra credentials, but yet their their thyroid panel is still more generic than what you and I are running. And it just infuriates me, because these people, they’re spending so much money, they’re traveling to Mayo Clinic and whatever else, and they’re still not even getting what you and I would consider basic or foundational screening, it’s really frustrating.

Dr. Justin Marchegiani: Yeah, it’s a combination of two things. It’s a combination of one they’re not aware, because they’ve kind of been like handcuffed, like, Oh, we can’t do anything about it anyway. So they kind of feel a little bit handcuffed and defeated. And then number two, they don’t want to piss off the insurance company. Because if they’re ordering via the insurance company, they don’t want the insurance company kicking them out of network for doing unnecessary testing, right? So you get in this position where you’re like, crap, well, how do I how do I handle this? How do I navigate as a doctor? And so we exist in the world of cash medicine, so we can do what we want and do what we recommend and need, what the patient needs. And we don’t have to worry about some insurance company dictating what we can do for the patient. The problem with insurance is they can’t they get in the middle. And they’re basically imagine someone getting in between you and your doctor and questioning everything you’re doing and saying, well, you probably don’t need that. So well. Let me talk to the patient about that. And see if the patient thinks we need it or not. I’m going to make a recommendation most of the time the patient’s like, yeah, that totally makes sense. Let’s do it. But imagine that insurance company stepping in between you and saying, Well, I don’t know about that. So we have that advantage in on the functional medicine side not going through insurance, because we can give the patient exactly what they need. 

Evan Brand: Yeah, great point. Yeah, I mean, the question my grandfather, for years, I would push him, Hey, I really want you to get full thyroid panel, I really want you to get vitamin D, and then the doctor would immediately push back, well, vitamin D is not going to be covered. Are you okay with that? You know, and then of course, it always ended up being covered. So it was this weird, like in between land where you feel like you’re not getting the proper care that you need, because they’re fearful, you know, the doctors are fearing that they’re going to go, like you said out of the network, or kind of out of their normal bounds of training. And then also, like you mentioned, that would illuminate any deficiencies they have in their treatment model, because if all of a sudden, they run TPO antibodies, and you do the follow up, and they’ve never looked at TPO antibodies, they don’t have a clue to say, Hey, why don’t we do a DNA stool test? Let’s go look at these infections in your gut. Now I’m connecting the dots here, you’re having anxiety, heart palpitations, you’ve got elevated TPO antibodies, and you’re having cyclical diarrhea, Hmm, I don’t know what the heck to do. Here is your thyroid medication. Here’s your Synthroid, or whatever. And then here is maybe, like you said, an IBS type drug. And that’s it. So let’s get back more to the action steps. I think we’ve done a great job of kind of illuminating, how does this happen? But first step, when somebody comes in and you see thyroid, you see gut issues. You mentioned DNA stool test, are you going to run blood immediately? Or is that more of like a downstream effect? So you don’t worry about it up front? 

Dr. Justin Marchegiani: You mean blood for the thyroid? 

Evan Brand: Yes. Like, are you going to do thyroid panel at the same time as a stool? Or are you going to just focus on the gut? 

Dr. Justin Marchegiani: Only if I see over thyroid symptoms, if there’s any family history, because a lot of times thyroid can overlap with adrenals. So I always look at the adrenals. First before thyroid unless we see a lot of hair loss, a lot of cool hands, a lot of cool feed stuff, a lot of weak fingernails, if we see a lot of low thyroid symptoms, that I’m going to take a look at it. Now most people they’ve already done some digging around their thyroid before they come see me. So usually, there’s some labs that have already been run that I can look at. And if not, then if we have those issues, then we’re either going to one, just go after the adrenals month one if we don’t have any overt symptoms, and see how we do. And then if we’re not having improvements out of the gates in regards to temperature, energy, those kind of things, then we do it. If we see that temperature and energy is a big deal out of the gates and we know cold hands cold feet hair loss, we can quantify that maybe with some basil, temperature testing, and we know it, then we’ll probably just rule out that low thyroid out of the gates just to make sure so it just kind of depends where patients are coming in from. And of course, if it’s family history that that’s we’re going to really dive into that. And because autoimmunity affects women five times more than men, if it’s a female patient, I’m a lot more on point with it. And if we have history of it, sister, aunt, uncle, mom, dad, whatever, then we’re going to be looking even more closely. But if I’m on the fence, usually I’ll just have patients do some basil, temperature testing with a really good digital thermometer. And we use the protocol in the members area, which is, you know, testing armpit axillary area and 97.8 to 98, two in the morning, or 98 to 98 six for the mouth. And we’ll just kind of test that we’ll do three, three temperatures test in the morning before you get up and move around. And we’ll just kind of get a window of how good that temperature is or not. 

Evan Brand: So if you’re on that low end, did you say 97.8 was at your low end?

Dr. Justin Marchegiani: That’s armpit axillary, same thing. So when you’re nine to 98, six for the mouth oral. 

Evan Brand: Okay. So if you’re at that very low end, is that still okay? Or you start to get concerned in that 97.8 level.

Dr. Justin Marchegiani: It would depend it would depend where the patient is if they have thyroid symptoms, I’d be more I start to get more concerned when they’re going below 97. Mm hmm. You know, also, I’m always I’m always in 97, like, I’m 97.8 all the time, and I’m thinking, well, crap, you know what, why am I not 98. But that isn’t that big of a deal. Like I’m getting a little more concerned, I’m below 97. But with women, you got to be careful because women’s temperature can dip right before oscillation and then peak as going through regulation. So if you grab that temperature, right before isolation, it could look a little bit artificially low. But also, if you grab it right in and after ovulation, it could be artificially high. So as a female, you know, the best time of the cycle to test is part of that first five or six days? 

Yeah, okay, that’s good information, you know, what’s it want to first aid, you bleed so that first five or six days, from bleeding onward.

Evan Brand: It’s a little bit of a tangent, but I’ll just mention it because you’re on temperature. So apparently, Lyme spy repeats affect the hypothalamus, which affects body temperature. So I’ve used temperature as well as kind of an investigation tool. And as we’ve treated people with Lyme issues, sounds like maybe the hypothalamus starts working more efficiently. And then boom, temperature regulation gets better, because that was a big issue for me, where, you know, I had major issue with the cold. And we’d always look at thyroid, we knew, you know, you know, my my gut story with parasite infection. So I would look at thyroid, and I would never see any issues, I was always perfectly in the functional ranges. So there are some other pieces to this puzzle. But I want to hit on the adrenal piece, too. That was interesting. So you had brought up like this adrenal thyroid connection to and that’s going to be tied into the gut, right, you’re going to see potential adrenal issues because of the immune stress based on the gut stress. So it could go gut affecting adrenals. And then adrenal is affecting thyroid, right? It might not just be gut thyroid, you’re saying the missing link in between those two is adrenals. 

Dr. Justin Marchegiani: It can be because the adrenals are your natural anti inflammatory. So if you have a lot of inflammation in the body, from a infection, your adrenals are going to be spitting out cortisol, natural corticosteroids to help with that inflammation and stress. So like conventional medicine, a lot of times we’ll do prednisone, right? That’s like a really strong steroid. Well, your body has its own natural steroids it would use so of course, if you’re whipping that tired horse, that can be something that gets affected. And then of course, when your immune system starts getting overly stimulated from infections from now, maybe an increased chance of food allergens, because now your guts more permeable, undigested food particles can kind of make their way into the bloodstream and create more immune stress because now your immune system sees foods floating around the bloodstream and digested that shouldn’t be there. And so then now, you know, your, your immune is maybe tagging those proteins. And we know the surface proteins on gluten, for instance, maybe dairy, those the surface proteins look very similar to the thyroid, so your body can actually start mistakenly attacking thyroid tissue because those proteins look kind of similar. 

Evan Brand: And yeah, and I just want to clarify this issue is going to be more common. It’s going to happen more frequently, when there are gut issues disrupting the immune regulation, correct. It’s not like in every person, dairies magically going to trigger thyroid antibodies, you’re saying in these gut compromised people that may have infections because of the intestinal permeability being increased? Now there’s more antigen getting in to the bloodstream and then boom. 

Dr. Justin Marchegiani: Yeah, I mean, it’s gonna be heightened more with an infection, because like, imagine the infection is like already kind of cracking the door open and your gut lining a little bit more. But let’s say you didn’t have an infection. It’s possible certain food allergies could be enough to crack that door as well. Right. Okay. But either way, let’s say you are sensitive and you have food allergy issues, and you have an infection now, it’s a double whammy, instead of that door being cracked open. Now it’s wide open, right? Yes, that makes makes that makes perfect sense. Yeah, for me, I mean, I used to do really, really poorly with dairy now really high quality dairy, I can get away with a little bit because I’ve healed my gut so much. So for me, I saw it. And it depends, right? Because not all dairy is created equal. So butter, fats and high fat dairy is usually different than dairy that has more casein, right? casein based areas tend to be like, more cheese or milks, right fat based areas and they’ll be like ghee, butter, maybe heavy cream. So casein tends to be the more allergenic portion of the dairy. And then, of course, we have lactose and lactose is the sugar portion of the dairy. So lactose, it’s more of an intolerance. And you just get more digestive disruptions where casein could be more of that immune stimulant. So things like people that have dairy intolerances, still may be able to tolerate ghee or butter. Because Because it’s not, it’s pretty low in casein much higher in the fat. Fats tend to be more neutral for people tend to be able to tolerate good fats, especially saturated fats because they’re, they’re not easily oxidized. 

Evan Brand: Yes, yes. Well said that’s a great point. So what about the influence of the gut healing protocols that we implement, and thyroid because people are hearing parasites, so they’re thinking, kill, kill, kill. And that definitely is part of it. And you and I’ve seen where just by eradicating infections, we’ve seen multiple things happen, which is pretty cool. So number one will see that the Secretory IgA, which is a marker, we look at on stool testing secretory, IGA will come up just as a side effect of clearing out infections. And that already indicates, hey, look, we’re starting to get on the healing path before we even did a quote healing protocol. And then we’ll see thyroid antibodies come down sometimes hundreds, sometimes 1000s of points, just by clearing the infections out. Okay, so that’s really like boom, clear infections out. But what about the gut healing phase? What are you seeing there? Are you seeing that that’s the, you know, the secret sauce, where thyroid really comes down in the gut healing phase? Are you finding, you know, if you had a pie chart, are you saying killing is doing most of the work for leaving the stress on the thyroid? Is it the gut healing phase? is there is there one that’s a bigger importance than the other? 

Dr. Justin Marchegiani: Depends on how acute the infection is, but we’re doing so many things at once. Like, this is the question I get, like, what’s causing What? And it’s like, it’s very difficult to know that because what’s the most important number in a combination to your safe log? what’s the what’s the most important ingredient in the recipe your mom makes, right? Well, it’s a combination, everything, right. And so when you’re dealing with an infection, I’m very rarely coming in there and practicing Acute Care Medicine where we’re just going after an infection where we’re changing the diet, we’re decreasing inflammation by having a healthy anti inflammatory kind of paleo template, we’re improving digestion, that in its own right starts to improve nutrient absorption, we may add in some extra nutrients as well, that are easily bioavailable. So then we can get those in our bloodstream and start utilizing the metabolically. Obviously, the thyroid needs some zinc, it needs some selenium, it needs some iodine. Of course, we don’t want to ever go overly high with iodine because that can actually increase autoimmune attack, but a couple 100 micrograms, as long as there’s not an acute attack may be fine. And then of course, we’re working on supporting hormones, right, we working on maybe supporting thyroid, if the thyroid is depleted, meaning you’ve had a decade or so autoimmune attacks, you may need some thyroid hormone, depending on how much that that thyroid been beaten down. If the thyroid still functioning, well, then just doing a lot of the good nutritional strategies may be enough to help it do what it’s what it needs to do. And then we’re coming in down the road going after the infections a little bit later. Now we’re an antibiotic kind of focus generation, right? It’s like, Oh, I have an infection, you have this antibiotic, antibiotic antibiotic. So that’s kind of translated to people wanting to kill whatever they have right away. Now, if it’s an acute infection, you went to Mexico, you ate something like you just got diarrhea, and you’re having like a dozen VMs a day, right. And it just diarrhea, that we may have to handle that differently than like a chronic infection that’s been happening over the long run. So I always put infections in two different groups, acute or chronic. And then we always still have to work on doing all the foundational things. If it’s acute, it may be a lot more compressed over a couple of days versus a month or two, if it’s a more chronic issue, and regarding how we start going after the gut. 

Evan Brand: Yeah, and the adrenal is maybe less important to deal with right away, if it’s a really bad, acute thing. It just depends upon like, Hey, I’m great, I’m great, I’m great, boom, I’m going to the bathroom a dozen times a day, it’s not good. My tummy feels like crap. If it’s that kind of an acute thing, and you were relatively okay ahead of time, then we’re going to look at that differently than a chronic infection. I love the analogy, what is the what’s the most important, you know, numeral to your to your safe code? Because I know the answer to the question I asked you, which was like, what’s a bigger deal here? Is it clear in the infections? Is it you know, healing the gut? Is it reducing food allergens? And I asked that just because I’m just playing devil’s advocate, because that’s what clients and patients always ask, you know, when we’re working with them, they’re like, Okay, well, you know, what’s my biggest priority right now? It’s like, I’m all of it. So it may sound a little overwhelming. But as we’re taking small steps with the diet, the lifestyle, we’re getting you to bed sooner, we’re helping with adaptogenic herbs to support the adrenals where, you know, let’s say you’re in between jobs, you’re moving house, I mean, there’s lifestyle stuff that’s important. You know, that’s, that’s affecting your hormones, which is affecting your sleep, which is affecting your gut and your recovery. And so we’re factoring in all of this at the same time, so rarely in a vacuum. Are we just coming in, like you said, and just boom, here’s your random microbials. Have a nice day. That’s very rare situation, right? 

Dr. Justin Marchegiani: I mean, like, let’s say, you’re healthy, right? You go down to Mexico, you pick up crypto, and then you just start having really a lot of diarrhea, we may handle you a lot differently. But like a lot of people that come in and I see usually there’s a combination of maybe some kind of a food allergy issue happening in the background. So then we clean that out, that maybe helps a third and then maybe they’ve really had poor digestion for a while like you know inadequate HDL or enzyme levels, that starts to help maybe a third or a quarter. And then that starts to modulate and calm down the immune system. So now the immune system kind of can relax a little bit, maybe that’s 10% 20%. And that we have, we’re getting access to maybe more Selenium or more zinc in our diet now. And that starts to help modulate the immune response, maybe that nourishes thyroid conversion, and then let’s say the infection, right, let’s say that’s the last 20%. So it could be a combination of certain things, you know, 10%, here, 20% there, 30%. There, and it just adds up. And so in the end, it’s hard to know exactly which one’s going to be the winner, right? And sometimes it’s equally spread out. That’s why if we just do the things that we know, we need to do on our checklist, our chance of results, good results is going to be much higher. 

Evan Brand: Absolutely. Well, I’m out of time. So I don’t know if you have a lot more to say if so I’ll just leave but if you don’t, then let’s wrap it up together. 

Dr. Justin Marchegiani: That sounds great. I think let’s wrap it up here to reach out to Evan head over to again, Evan and I are available for consultation worldwide, which is excellent in today’s day and age. And then myself, Dr. J over at We’re happy to help you out and work deeper on any thyroid issue. Gut issue infection issue where we can kind of dive in deeper and get to the root cause make sure you put your comments below and subscribe and share the episode with friends and family. We really appreciate it. 

Evan Brand: Absolutely. Yes, sharing is caring and there’s probably someone in your family or your life that has a thyroid issue. So please give this to them. Hopefully, even if they have to listen to it two, three times. Hopefully it helps guide them in the right direction to heal to recover to live life fully. So take care. 

Dr. Justin Marchegiani: Awesome and have a good one man. Bye


Audio Podcast:

How To Treat Toenail Fungus or Discoloration


How To Treat Toenail Fungus or Discoloration

Let’s go into like the most common things that you would see or hear of with complaints regarding nails. The biggest one is going to be toe fungus under the nail bed where it’s going to be a yellow or just a fungal-infected toenail.

Why Should We Address Gut Issues?

If it’s on the toenail, there’s definitely implications that it could be in the gut. The problem is you can address the gut a lot of times but that’s not going to be enough to address the toenails well. Just because the time you put herbs into the gut or whatever time it gets into the bloodstream, makes its way all the way down to your toe. Unless it’s a very minor fungal infection, most of the time you’re gonna need to hit it topically because your immune system and all these antifungals take a long time to get to the outer periphery of where this fungus is located. So in general, we should address the gut and then we should also address it topically on the nail. So we’ve got to hit it from both ends, inside and outside, to kind of put that fungus between a rock in a hard place.

Click here for a consultation with a functional medicine doctor to find out about treatments for toenail fungus and discoloration!

How To Treat Toenail Fungus or Discoloration

How Fungus is Treated Conventionally

Let’s just say you go to your foot doctor or your podiatrist and you say, “Hey, I’ve got a fungal infection on my toe.” They’re going to end up giving you Lamisil or some other type of a prescription or over-the-counter antifungal. But to me, I think that’s a shortsighted approach because that toenail is not having that infection for no reason.

How To Treat Toenail Fungus or Discoloration

How Fungus is Treated Functionally

If it’s really bad, you definitely want to be addressing your diet because a lot of the fungus or yeast, which is primarily that yellow-discolored nail is going to be fungus in that area.

  • You got to stop what’s feeding it. Look at the diet and stop feeding it all the refined carbohydrates.
  • You want to address the gut issues to begin with. The Candida, which is a kind of yeast or fungus, whether it’s Microsporidia Rhodotorula. You want to address and knock down some of these yeasts. More than likely we’re going to topically hit it as well.
  • Some of the Lamisil or the other medications that are antifungals are very hard on the liver. So if you’re going to go that way, definitely take some herbs like milk thistle and take some extra glutathione to help support and tonify the liver if you’re going to go that way.

How To Treat Toenail Fungus or Discoloration

Alternative Treatments for Toe Fungus 

  1. Topically, we can use things like Melaleuca or tea tree and/or oil of oregano and topically rub it on the nail.
  2. We can also do a fungal soak as well. The fungal soaks work phenomenal. There’s a herbal concoction that you mix it with apple cider vinegar which works amazing. You can do that and then topically rub something on after you soak your feet for 5 or 10 minutes. Some people they’ll just do the topical nail as well. I like doing the whole foot. That way if there’s any fungus between the toes or in the heel or wherever in the skin, you kind of get all of it versus just some of it. So nail fungal soak with also topically hitting the nail as well.

Anything that we can do to reduce that process of AGEing — the advanced glycation enzyme process — is also going to be one of the critical steps to this. The less stress in your body, the better. Nail fungus is really unique because once you fix a lot of the root cause stuff, that may not go away. So you gotta really topically hit it as well.

If you have any questions about toenail fungus and discoloration, please reach out to a functional medicine doctor and learn how to treat this condition.

Thyroid Reset Summit | Podcast #218

Thyroid Reset Summit is here! It is Dr. J’s compilation of expert interviews and advances talks on the topic of thyroid health. Don’t wait, don’t suffer, support your thyroid now!

In today’s podcast, Dr. Justin Marchegiani and Evan Brand engage in talk that covers the compelling topics around areas of thyroid health like autoimmune thyroid, gut infections, trauma and stress and how that affects thyroid and hormones. Listen as they discuss live interactive podcast with viewers and gain insights about the issues involved in thyroid and ways that go to the root cause to address them. Stay tuned for more!

Dr. Justin Marchegiani

In this episode, we cover:

03:00    Trauma

06:41    Reverse T-3

14:19    Maca and Hypothyroidism

19:55    Molecular Mimicry

26:28    Iodine and Iodide

28:03    Low Dose Naltrexone (LDN) and Hashimoto’s

30:38    Desiccated Thyroid

32:01    Natural Thyroid Glandular

37:37    Nascent Iodine

40:38    Oxalates and Hashimoto’s

44:09    Thyroid Replete or Balance

46:50    Candida Overgrowth and Kale Intolerance


Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. Guess what’s up, the Thyroid Reset Summit is live today. So, make sure you click below, there’ll be links where you can access the summit, make sure you register. I’m giving up my full, free 88-page eBook, it’s the first 3 chapters in my 12-chapter book, it’s gonna be amazing. I’m here with Evan Brand as well. Evan’s a- was a phenomenal interviews as well. So, make sure you subscribe to go access Evan’s interview. There’s gonna be links below where you guys can access it all, I appreciate it. Evan, welcome today’s chat, I’m excited that thyroid summit is here.

Evan Brand: Yeah, I’m excited too. Your talk is today. So, if people wanna hear me interviewing you, that’s a day 1 of the summit. So, your pretty face is on there, and you great- you gave a stellar interview, and there’s already tons of good comments, we were just reviewing that together, there’s tons of good comments and feedback coming in already on the summit and we’re still in like, you know, day 1. So, this is like the open house so to speak, of the summit. If people, you know, have been living under a rock, or they just don’t know how summits work. Basically, what it is, is Justin put together 30+ expert interviews. These are anywhere between 30 and 45 minutes in length, and they’re all on the topic of thyroid health. So we- he’s gonna get in to anything from autoimmune thyroid to gut infections and thyroid, to mitochondria and thyroid, to chemical toxins to trauma, and stress and how that affects thyroid and hormones. So, each different expert has their own unique view, and he make sure to extract as much information as he can, it’s all free. You just register free. So,, you go there, you register free, put your name, your email in, you can access it as long as you get on your computer or your phone, on the day of the talk, you can access about 5 talks for free every day for a week. And then after a week, depending on what your all’s feedback is, they’ll probably do an on-core, you get one last chance to view him for free, and then, what I recommend you do, is you buy the summit, it supports Justin, it supports the mission, it gets his information out to the masses because your average doctor is not having the type of conversations that Justin is having on this summit. These are conversations that are very advanced. And something that’s still broken down, simply free to understand, but in terms of timeline here, it could be another 10 years before mainstream doctors are even addressing the stuff that’s being discussed now. So, don’t wait, don’t suffer. Buy the talks, it ends up being like 50 bucks or something. That’s ridiculous how cheap it is, and you could own all 30 talks, you’ll get transcripts, etc. Is Justin paying me to promote this thing? No, he’s not, it’s just freaking awesome and I’ve already read the book. And, the book is amazing, and the summit is amazing. So, please buy it and support him so he can keep buying grass-fed stakes so- he’d to stay healthy so that he can do a podcast with me.

Dr. Justin Marchegiani: I appreciate that Evan, thanks so much. So, I just, you know, being a thyroid expert and also being a part of the summit yourself, what are some of the topics that you feel like were most compelling for you in and around the area of thyroid? I have a couple in my mind but, what reason they would give the most?

Evan Brand: Oh, man. Well, I would say the ones on trauma. Uh, you’ve got ___[03:03] on there, which is just incredible, because, I think trauma is something that, well, we already know this, uh- a- as Americans, we repress our emotions, we repress our traumas, we try to just move on, we ignore traumas, we throw ’em under the carpet and we just don’t wanna talk about this stuff, but what you and Nicky discussed was amazing which is the fact that, depending on how your childhood uh, was. You talked about the ACE score, the Adverse-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -Childhood Experiences score-

Dr. Justin Marchegiani: Yup.

Evan Brand: -and how- what you all are seeing. And I’m seeing the same thing too, is that, the higher the ACE score, the more likely it is that you’re gonna have a problem, and it could be a thyroid, and/or an autoimmune thyroid problem, all linked back to something 20 years ago. And so, you all had a great discussion about, well, how do you start working on these things that happen to you? It’s not to say, “Hey, we need to go back to counseling, and, you know, go take the guy into counseling with you, who beat you up 20 years ago, it’s not that, it’s no, there’s ways you can clear these traumas from your body, and a lot of it is free. So, I think that’s probably the most powerful starting place.

Dr. Justin Marchegiani: Yeah, and also a lot of these traumas too, they affect the HPA access. And, some people that they may have addressed the issue but, they’re kinda dealing with the collateral damage, whether it’s adrenal issues or gut issues, and- and/or compromising the immune system, maybe even infections just from all that stress, or maybe even they developed an ___[04:23] disorder which is created all kinds of adrenal and blood sugar and nutrient deficiencies. So, we gotta look at everything from the root cause. Okay, is the root cause addressed, okay good, and now, we gotta also do damage control as well. But, while fixing everything in a ___[04:37] root cause kind of, manner using nutrients and- and sport.

Evan Brand: Yeah, now, I will say, if you just focus on traumas and nothing else, and let’s say you start doing the EFT, the Emotional Freedom Technique which is the tapping that you and I both love. I love tapping. I’m gonna start tapping-

Dr. Justin Marchegiani: Yeah.

Evan Brand: I’m [crosstalk]… uh, so, when you start tapping, this is basically like acupuncture without the needles, so you’re helping to basically recalibrate your nervous system, so you’re not stuck in fight or flight. And I’ll do this, like if  I going stage or if I’m gonna go on an airplane, I’ll just tap, tap, tap, tap it out, and I just feel really good from it. And, there’s practitioners, this is such a powerful tool. There are practitioners that’s all they do, is tapping. Now, you and I, we both agree that tapping by itself is probably gonna be pretty limited, it’s not gonna be fixing root causes, but can they help reset the nervous system, which could therefore improve your thyroid health and potentially lower your thyroid antibodies? I would say, absolutely.

Dr. Justin Marchegiani: Yeah, I mean, if you have significant unresolved traumas, especially in the area of sexual abuse, or just issues growing up. Uhm, even disorder stuff, control issues or any kind of abuse. I think it’s really important especially if- if I’m talking with a patient and, “Have you really fully adro- uh, you know, resolve that?”, “Can you go back and think about it, and talk about it, this is not really bring your emotion up let’s say, pass a 3 out of 10”. And if they can’t answer that, or you start to hear them sob on the phone, or on- on the video, and that tells me we gotta work on that. So, it really just depends on how much they’ve done to resolve and to move past that. Uhm, but, if- if they haven’t done- I have people that I refer out to, they had- they really dive in with that work for sure.

Evan Brand: Yup.

Dr. Justin Marchegiani: [Crosstalk]…that activates the sympathetic fight or flight kind of nervous system response and, if that keeps going, that can just be a drain on your adrenals. And we know how important a cortisol is to inflammation, and if we have thyroid issues and autoimmune thyroid, and we don’t have enough healthy levels of cortisol to- to deal with that stress, or if our cortisol levels had been depleted, uhm, the HPA access dysregulation that- that brain talking to the adrenals, that feedback loop is disrupted, that can definitely creates some major challenges for sure.

Evan Brand: Yeah. So, we should talk about reversed T-3. We actually had a question here from the Doc J.C., uh said, “Please go over the significance of reversed T-3. What range do you feel as optimal? It seems to be frequently ignored or not seems to be so significant. Thanks, looking forward to the summit”.

Dr. Justin Marchegiani: Yeah, I hundred percent agree. Now, think of reversed T-3 as like metabolic blades for our metabolic uh, magazine, or gun- gun cartridge so to speak, right? We put all the bullets in it, uhm, the metabolic blades, they take up space where an actual metabolic bullet would be, we fire the gun, we get the noise but we have no bullet coming out. Basically, these reversed T-3 compounds, they’re blocking the receptor sites; every single cell in the body has receptor sites for thyroid hormone. So, when we had excess, reversed T-3, it’s gonna clog up that receptor site for T-3, and it’s gonna decrease the ability for that T-3 to fill up the receptor sites. Also, you had T-4. Let’s say you have 80%- let’s say you have a higher percent of T-4 convert to reversed T-3 over T-3, it’s also robbing the ability for that T-3 to- to be fully expressed. So, imagine we have, let’s just say, let’s just say we have 10 units of T-4, alright? Just hypothetical numbers here. And let’s say we’ll typically converting 80% to T- to T-3, and 20% to reversed T-3, there’s naturally gonna be some reversed T-3 levels. Let’s say, anywhere between the low 10’s to the upper 10’s, right? Then you know that’s a good level, alright? That’s the actual lab reference range. In my analogy, let’s say we have 20% goin’ reversed T-3, 80% go into T-3, our actual metabolic active thyroid hormone. Well, typically, when stress starts to happen, low calorie diets, more stress, adrenal issues, inadequate levels of selenium, we may start to see a 70-30, a 60-40 split, where more of that building block is going to reversed T-3, less going to actual T-3. So, we’re having less T-3 but we’re also having the congestion of the receptor sites. So, that T-3 that’s now there, the lesser T-3 it’s there, it’s not able to dock in to that receptor site, the locking key methods not able to go in because someone put gum in the keyholes, so to speak.

Evan Brand: Yeah, great analogy. So, let’s take it a step further. So, what happens then? ‘Cause you and I , we’ve tracked my blood for several years, little that I know, I was living with mold, and that mold was messing up my thyroid, that was part of the problem, I had elevated reverse T-3, and you and I been looked at and we’ve been like, “Okay, let’s look at gut”, “Okay, stool test is clean, let’s look at adrenals, okay, adrenals look decent. Well, where the heck was this reversed T-3 be coming from?”. I’ve- in my opinion, I believe it was all the stress that my immune system was dealing with because I had elevated white blood cell count, at the same time as I had elevated reverse T-3. So, it’s not that it changed my game plan of my protocol at all, it was really just an indicator of “Okay, so here’s why I probably have cold hands, cold feet, my body temperature was running like a 97.7. Unless you tell me I’m wrong, I think that was all related to that reversed T-3 being so high. I was in the 30’s.

Dr. Justin Marchegiani: Yup. Yup, it could’ve been. And we also know, you know, if you have a- a liver stress, right? Livers’ really important because it make enzymes that are gonna help activate thyroid hormone, and it also helps to clear reverse T-3. So, make sense over stress, glutathione form toxins in the environment that can affect our ability to clear it as well.

Evan Brand: Yeah, I think I was like 35, uh, on my [crosstalk]

Dr. Justin Marchegiani: And again, how- you know, we can see low calorie diets, increased reverse T-3, that’s why- that’s why in the long run, cutting calories to lose weight doesn’t work ’cause it just slows down your thyroid. So, then when you come back to reality and you actually are eating a normal amount of food, now, your metabolism slower, so now you end up storing more fat on the buckets.

Evan Brand: You wanna know something crazy related to hormones and-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -gaining weight and all that? So, something that I learned the past few weeks, is that mycotoxins can actually bind to your leptin receptor. And this is why some people have gained weight on like 800 to a thousand calories is ’cause the mycotoxins are preventing leptin signaling from working properly.

Dr. Justin Marchegiani: Yeah, I know. I had a conversation with Dave Asprey a couple of years ago. There’s a compound called the Zearalenone. It’s- it’s a mold kind of herpes that actually put into the ears of these cows. And the Zearalenone literally causes the cows to convert more of their calories to fat.

Evan Brand: Oh my gosh.

Dr. Justin Marchegiani: That’s what it does. So, they would use some of these connection-

Evan Brand: And that’s a mycotoxin?

Dr. Justin Marchegiani: That’s a mycotoxin, they put it in their- in the cow’s ear, be the- like a little pellet-

Evan Brand: Oh.

Dr. Justin Marchegiani: -and they re-absorb it through the ear canal. And this is, you know, first hand from Dave Asprey. And it will cause more fat gain, so it would allow them to convert more calories to fat which, you know, bottom line, more weight on scale, so, more- uh, more cost per cow, so to speak, ’cause it’s all weight-driven. So, yeah, mold and mycotoxins are- are a big one, alright? And we’ll do another podcast on that-

Evan Brand: I did another interview- if I did another interview on your summit, my whole talk would be about thyroid and mold because I’ve had tons of hypothyroid symptoms. Now, I still have 6 pack abs, I’m still ripped, uh but I had like cold body temperature, cold hands, cold feet and all that related to mold. So, if I did an “Evan on Justin’s Summit Part 2” it would be all about mold and how I think so many people with thyroid problems probably have mold in their house that’s helping to destroy their immune system and cranking up reversed T-3, elevating liver enzymes, reducing detoxification, and the body’s got to try to focus on mold, and then they can’t focus on other stuffs-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -so then chemical toxins get built up, it seems like a huge like lynchpin.

Dr. Justin Marchegiani: Yeah, I- and the only thing I would add is do all the- the natural- do all the things first and leave that to the end-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -because, you did it that way too. And then we saw there was an issue and then we dealt with it on the back end, uhm, my biggest concern is mold and things like that can be- can be more in the expensive side, and it can be a rat hole for some people, meaning, if they do the foundational things first, they may get some significant relief upfront, and it won’t be as cost- it won’t be as costly as dealing with the- the mold in the back end. But, some people-

Evan Brand: It won’t be as overwhelming.

Dr. Justin Marchegiani: Yeah. And the only exception being, hey there’s active leak, you got water stains on your ceiling, uhm, you know, there’s- there’s an act- you can actually actively visualize mold or water leaking, then I would say that it has to be dealt with right away. [crosstalk].

Evan Brand: I’ve- I’ve probably stayed afloat a lot longer than I did before I developed a lot of major symptoms because I had all the foundations in order-

Dr. Justin Marchegiani: Yes.

Evan Brand: And so that’s- that’s why the summit is gonna be key- it’s not to- it’s not designed to replace a consultation with Justin if you have thyroid problems, you still need to consult with Justin, for sure, but this is more designed for you to get the information you need for you to get the questions answered that you have in your head. And once you have all those questions answered, you’re gonna learn more about types of thyroid lab testing that you need to run reversed T-3 being one of those markers. These are things you can bring up to your endocrinologist or your GP and tell them, “Hey, I heard on this summit, this guy Dr. Justin talked about “XYZ”, can you do that for me?”. And we’ve had clients report back to us and say, “Hey…”, you know, “…thanks to you, or thanks to your podcast, I was able to get this and this, and this run on my blood work, and my doctor only ran it because I asked them to”. So if you just go with the status quo, you’re probably not gonna get the result you’re looking for from the mainstream. Now, if you find a really good endocrinologist or a doc that’s gonna listen and run these extra important thyroid markers that are not generally run, you may be able to make them work, or you gotta go to the functional side. My opinion, I’m gonna say go to the functional side, ’cause your endocrinologist is never gonna look at the stuff Justin’s looking at and saying, “Hey, you know, these bacterial infections do this; this parasite does this”, it’s the last thing you’re gonna hear from them. They’re gonna say, “Oh, you can go to an infectious disease doctor, you think you have parasites?” And then they’ll just refer you out and you’ll go nowhere. That’s why we’re kinda generalist and specialist on the same token.

Dr. Justin Marchegiani: Exactly, that’s really good point. Let’s kinda dive in to the next question here, let me pull it up. Uhm… let’s talk about Maca. Maca and hypothyroidism. So, number 1, if we see- Maca’s gonna be really good especially for women. Uhm, there are some good Maca forms for men too but it’s gonna really help modulate estrogen levels that can even help with progesterone levels. So, why is this helpful? If we have estrogen dominance, that can definitely increase thyroid binding globulin and decrease the amount of free thyroid hormone. So, it can definitely lower our free thyroid hormones. So, if we modulate our female hormones and improve that balance in that estrogen and progesterone ratio that can definitely improve the amount of biologically active thyroid hormone. Also, for in a, estrogen dominant state, we need good levels of progesterone. And progesterone help stimulate thyroid peroxidase and make thyroid hormones. So, good enzyme activity from TPO is important, and that can help make thyroid hormone. So, good levels of progesterone help with that as well.

Evan Brand: Can you talk a little bit about age? I mean, this is something that you ask your average women, aged 15 above, they’re gonna say, “Oh, my thyroid”, or “Oh, my hormones”. Can you talk about kind of what happens when you’re transitioning from a normal cycling female to you go into perimenopause- menopause ___[15:33] when you go to those stages. And ___[15:36] to say, “Oh, oh it’s my hormones”.

Dr. Justin Marchegiani: Yeah. Yeah. So, in general, typically, women may start their perimenopausal phase in their early 40’s. This is where like a lot of these menopausal symptoms start to happen. Whether it’s skipping a cycle, mild hot flashes, mild hair loss, mood issues. And again, it’s- it’s- it can be- it’s hard to distinguish perimenopause and just PMS and cy- and cyclical hormone imbalances. Especially where I see a lot of these symptoms happening with women in their 20 and 30’s, it’s hard to distinguish, but you’re typically seeing some of these menopausal symptoms, they may happen throughout the month, where the premenstrual symptom that are just tend- tending to happen a week, maybe a couple days, sometimes 2 weeks before period. So, you- you gotta look at it and distinguish. Typically, what’s happening is you’re having a decreased ovarian reserve and then the estrogen and the progesterone are starting to drop. And sometimes you see estrogen drop a little bit slower than progesterone, so then you still have low hormones, yet still have estrogen dominance. And again, perimenopause is done once you’ve had cycle for one year. So you have that kind of in between phase and lower adrenal functions in a predisposed at because your adrenals are making a lot of precursor hormone that’s gonna provide building blocks for your sex hormones. So, lower adrenal function, cortisol stress, HPA access stress, that communication from the brain to the adrenals, when that’s dysregulated, you’re draining that backup ge- battery generator to help make more of the hormones. So, when that follicle starts to drop, then the adrenals gonna help pick up the slack.

Evan Brand: So, would you say all women post-menopausal should be on some type of adaptogenic herb hormone support, and can that replace or remove the need for like bioidenticals?

Dr. Justin Marchegiani: It depends how strong their hormones are, uh, it depends how strong their adrenal glands are already.

Evan Brand: Okay.

Dr. Justin Marchegiani: Number 1. And number 2, it depends on how severe their symptoms are.

Evan Brand: Okay.

Dr. Justin Marchegiani: So, we’ll use specific phenotypes of Maca for perimenopausal women or menopausal women, that can help, some do need adrenal support obviously than some may need some of the bioidentical progesterone, estrogen support, it just depends on their severity of symptoms, how long it’s been going on for, and how their hormones look, adrenal wise, female wise and thyroid. And this is where it stop because hair loss, it’s a thyroid symptom but also lower female hormones can cause it too. So, so can like cool their temperature when waking, that could be a thyroid issue, it could be a female hormone issue. This is why testing is so important. It really allows you to like, walk into the situation clinically, feeling like you’re on top of what’s going on.

Evan Brand: Yup, well said. And- and, I wonder, does that change much? If a woman’s had like a partial or a full hysterectomy, or maybe she’s got her ovaries gone, the uterus is gone, is that like, hey, there’s no way adaptogenic adrenal support’s gonna help you?

Dr. Justin Marchegiani: Well, soon as they go- as soon as they have a uhm- a full hysterectomy where the ovaries are gone, they’re menopausal right away, right? So, they’re automatically in menopause. If it’s a partial hysterectomy where the uterus is gone, typically that’s happening from maybe a fibroid, maybe some endometriosis. Uh, a lot of times it’s done in- in haste because there’s excessive bleeding or he- hemorrhagia, and the doctor’s like, let’s just pull it out which is crazy like, let’s fix the hormones, let’s fix the underlying issue, a lot of times you can keep your uterus. Now, there’s some literature, you know, if you look at some of the endocrinology techs, there’s some people saying that, “Hey…”, you know, “…your uterus maybe producing some level of hormone. So, it’s possible that you keep your ovaries, you get your uterus removed, but you- there’s still maybe some hormone stuff that happens, right?

Evan Brand: Yeah.

Dr. Justin Marchegiani: It’s kinda like with guys and they get a vasectomy, there are some research showing it, you can still have a drop-in testosterone after vasectomy. What happened? You didn’t touch the testicles, right? But when you mess around with that anatomy there’s probably some feedback loops that are disrupted, there’s probably some hormonal secretion that’s happening from that tissue that were not quite, you know, fully aware of. So, that’s why when in doubt, always try to keep the tissue in place-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -if you can.

Evan Brand: It’s crazy. I mean, for to think, oh, it has no purpose when you’re aged 60 just ’cause you’re not menstruating, those organs have no purpose. That’s- that’s bizarre. Yeah, I mean, if you have no purpose anymore, it would come out just like a placenta comes out after a woman delivers a baby. That organ is there, and then that organ is not needed anymore, and the mom pushes the placenta out and then you’re done. You don’t push out the uterus. So, it- it needs to be there.

Dr. Justin Marchegiani: Exactly. It definitely needs to be there for sure. So, uhm, on that road, I think we answered that question.

Evan Brand: I’ve got another question for you.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Okay. So, we got one here, “Can you discuss molecular mimicry?”.

Dr. Justin Marchegiani: Yeah, so, diff- i- in general, we have surface proteins on foods, especially gluten and casein, and these surface proteins, they get tagged by our immune system. And there are other surface proteins on tissue in the body like the thyroid that can look similar. So, imagine you have someone who just did a- a crime, and they’re driving a black Honda Civic. Well, Honda Civics are pretty popular car. Please come on the AP- you know, on the radio, APB, you know, be careful and just person, and the authorities driving a black Honda Civic. They’re driving the Honda Civic, you get pulled over. Why? Because you have a similar identification that was called on the APB there. So, what does that mean? Its surface proteins can be similar, and so of course, when that APB is called up by your immune system, A.K.A, the immune system makes antibodies to target these surface protein, and other tissues have a similar surface protein like the thyroid, then that can, uh, your immune system can attack it. And that’s why you’re see- that’s why gluten is such a big deal. Also, gluten also opens the gut lining. And when the gut lining’s more open and we have gut permeability or leaky gut kind of the slang, there’s more chance of your immune system to get in contact with undigested foods and create more antibodies for more stuff. So, leaky gut’s a big thing and, there’s a lot of data saying, “Hey, even if you’re not reacting to the gluten, gluten may still be opening up that gut lining, creating more gut permeability”.

Evan Brand: Well, here’s one other thing to take it even further on the anti-gluten train, which is the fact that people say, “Oh, I’m not sensitive to gluten, I don’t have any rashes, I don’t have any headaches, I don’t notice joint pain after gluten. It doesn’t matter, we’ve seen, and many, many, many pieces of literature, just google “Non celiac gluten sensitivity” and you could read about it for yourself. Even if a person that says, “I noticed…” quote, “nothing”, from eating gluten. We still notice that the secretory IgA gets lower, that gut barrier gets broken open, you get leaky gut. There’s no like, “I’m a tuff guy, I grew up in Wisconsin, grew in corn and I eat corn and gluten and I love it”, no, it doesn’t matter. You’re gonna have a leaky gut no matter if you noticed anything or not and, why is that important for thyroid health, wll, ’cause once a gut’s leaky, now, let’s say you get bacteria and parasites and toxins from the food supply, you breath in some guy’s diesel truck in front of you on the highway, those toxins have direct access to the bloodstream. And we know that when the gut is leaky, the blood brain barrier is also gonna be leaky, and then you’re getting toxins into the brain. So, you go and need some tuna fish on your night out and sushi, and that mercury can go into your brain now because your gut was leaky and they had access. So, you know, I kinda have like a zero tolerance, you know, policy. I like how, uh Rodney Ford, he was a gastro doc I had on a podcast-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -like, 7 years ago or some crazy, as if one of the first steps which I did. He said, I don’t like to term gluten-free, he said I like to term gluten-zero, because gluten-free sounds- you- you know, just like it’s toys or like, it’s- it’s a rec- it’s a recommendation. But he said, the idea of gluten-zero, is much more direct and blunt. It’s like, “no”, you don’t want any. Because even we’ve seen we- you and I, we test the antibodies, we look at anti gliadin IgA on the stool test, and what we see is that, even up to 3 months, 4 months after somebody’s had gluten, you know, here we are in early March, at the time of this recording, someone could had a bunch of cookies at Christmas and we could still see 3 months later, the antibodies elevated because of that.

Dr. Justin Marchegiani: Yeah, so, I mean, I’m pretty puritanical when it comes to gluten. I will- I met- I do have a cinnamon bun last night but it was gluten free, and I typically never cheat, I ended up getting within 30 minutes after the sore throat, and it’s lingering right now. I’m doing some-

Evan Brand: No way.

Dr. Justin Marchegiani: -essential oil lozenges to help- help [crosstalk].

Evan Brand: Rice flour, what was it that did that to you?

Dr. Justin Marchegiani: It was rice flo- it was rice flour, and it could have been just the carbs, it was pretty carb-heavy. But, you know, it just makes me think like, there’s one more sin in the fridge, am I gonna have it tonight? Hell no, you know?

Evan Brand: [Laughs]

Dr. Justin Marchegiani: I’ll- for my cheat, I’ll do my ___[23:49] chips and some fresh homemade guacamole instead for my little kraut treat. But yeah, e- even that, I still had the decision, you know, should I stop at dunkin doughnuts and get like the awesome cinnamon bun that I have memories of 20 years ago, when I used to eat lots good food but, now, I at least chose the healthier option, but still, I kind recalibrate and say it still not worth it. So, try to find the healthier option if you want a spurge. If you’re autoimmune condition’s under control and you don’t have an autoimmune condition, maybe you spurge every now and then on the holidays. My recommendation though is, you find a healthier option, and if you have thyroid antibodies, you definitely need to. I have thyroid antibodies, so you really gotta make sure that you’re on the right track. There’s a lot of healthy options these days. It’s crazy, I mean, I had some- some I think it was uh, Danielle Walkers got a new pizza that’s like, a yuca based pizza, and it’s freakin’ awesome. It’s really good, and the crust is great. It’s a little carb heavy, so I save it for my carb night, but uhm, it’s a great pizza.

Evan Brand: Wow, she makes it?

Dr. Justin Marchegiani: Yeah, it’s in the whole food section now, it’s frozen. But it’s a yuca based crust.

Evan Brand: And is it already, uh, it’s just a crust and you gotta put all your own toppings? Or-

Dr. Justin Marchegiani: No, it’s got everything on it already. But she’s got some I think where you can buy without the toppings. But I just love yuca for crust ’cause yucas just like- it’s a soft, it’s really uhm, moist too.

Evan Brand: I’ll have to look for it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: I- I wanna point out what you said. I think it’s very important which is that, you may go off your diet for a bit and play with this food and play with that food is kind of a treat, but like you said, it’s not worth it. And, you know, people think when we come up with a diet protocol for ’em, then it’s like a diet of depravation. But overall, I would say you and I are not deprived at all. We’re eating good fats, good meats, good veggies, I mean, this is not a deprivation or starvation diet required.

Dr. Justin Marchegiani: No, I mean, last night for dinner, I had a dry aged Kansas City strip steak, step 4 from wholefoods. And, I had it last night with some green beans and grass-fed butter and some sea salt, and it was phenomenal. So, I should have eat really good like that, like, keep it simple, you know. The night before that, we threw some stuff in the instapot, 40 minutes later, some vegetable. I think we had some celeries, some uhm, carrot, and some chicken, it was great. I mean, keep it really simple, easy.

Evan Brand: I did some haddick last night-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: I had couple different fish, I had some haddick and some cod, and then we did some sweet potato fries that we baked, and then we did some broccoli. My wife is all into fresh broccoli now, because we were doing frozen broccoli, but it’s a game changer to do fresh. So, uh, hopefully when I get my garden, we’ve got snow on the ground, hopefully I can get my garden going and get some fresh broccoli. Last year, even despite my really good fencing operation around my- around my race guard bed, those darn rabbits, it ate on my broccoli, so I didn’t get any, I had to buy it all to store [chuckles], or the farmer’s market.

Dr. Justin Marchegiani: Uh, hundred percent man, that’s really cool. Uhm, very cool. Let’s talk about- someone asked about “Iodine and iodide”. So, basically, iodide is the ion form of Iodine. So, you have basically uh, the chemical structure of iodine is- is 2 molecules of iodine, and so essentially, iodine is one. So, typically, iodine’s bonded to a salt whether it’s a sodium salts or a potassium salts, and then in your body, your body converts it and- and puts it together and makes iodine out of it. So, you can have one molecule’s iodide, 2 is iodine, you take it and the it converts it in the body and it goes to through iodination and it- it can makes it iodine.

Evan Brand: How do you approach that with clients in terms of supplementing?

Dr. Justin Marchegiani: I typically use a potassium iodide.

Evan Brand: Yup. How often do you supplement it, is that something where it’s like, yup, a little amount is always gonna be okay ’cause there was a whole, you know fear mongering about “Oh, you know, supplementing iodine could- or iodine can uh… increase your thyroid antibodies”, but I’ve not found that to be true, let alone know.

Dr. Justin Marchegiani: Well, I mean, it’s potential, but, if someone has active thyroid autoimmune stuff, we just don’t go more than the RDA which is between 150 to 250 micrograms.

Evan Brand: Mm-hmm.

Dr. Justin Marchegiani: And if we see they’re stable, and/or they don’t have any that we may play around with going up to a gram or maybe a 1.3 gra- uh- sorry, 1.3 mg, 1.5 mg, alright? RDA’s a 150 to 250 micrograms. So, typically, within 5 or 10 x of the RDA.

Evan Brand: Okay.

Dr. Justin Marchegiani: It can. It- there’s a lot of data in the literature on that. So, uhm, I can just tell you, I see people go too high in iodine and lose their hair.

Evan Brand: Oooh.

Dr. Justin Marchegiani: So, you gotta be careful.

Evan Brand: Wow. I’ve got another question for you if you’re ready.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: Uh, a little one here rom Doc Jacey-

Dr. Justin Marchegiani: Yeah.

Evan Brand: “What is your take on using LDN for hashimoto patients? I do see the antibodies dropping and symptoms improved. Curious, if you’ve seen the same”.

Dr. Justin Marchegiani: Yeah. So, first off, it’s not the first place I go, the low-hanging fruit’s gonna be, uhm, obviously uh, autoimmune template to start getting good nutrients onboard, getting enough selenium onboard, CoQ10, magnesium, these are really important. Then after that, I would go to like curcumin, uhm, curcumin, things like that fur, you know, fur. So, it’d be the first things I would get in there first. You could even play around with resveratrol, uhm, I would do that first, and then maybe even CBD. I would try to do CBD over LDN, but I had seen some people do okay in LDN. I’ve seen some people do worse on LDN. So, I try to go to the more natural compounds first before I go to uh, an ___[28:54] blocking drug.

Evan Brand: Agreed. And I can’t prescribe it. So, even if I could, I wouldn’t because I’m, you know, my toolbox is limited to using natural professional grade products and nutrients and herbs, so I just don’t even have it on the table for me, so I just have to assume that I gotta fix the issue with other things. And you and I’ve seen hundreds of times that, when we just fix the gut, we’ve seen antibodies drop from it.

Dr. Justin Marchegiani: Yeah.

Evan Brand: 2000, 3000 to sub-500-

Dr. Justin Marchegiani: Yeah.

Evan Brand: Just [crosstalk]… the gut and changing nothing else.

Dr. Justin Marchegiani: Yeah, I mean, the gut’s obviously the next big component. But supplement wise, curcumin, resveratrol, selenium, CoQ10, magnesium, a- autoimmune template, and then of course working on the digestion, working through all the 6 hours. Enzymes [crosstalk]… bad foods, replacing digestive support, hormones, moving infections, re-inoculating, repopulating probiotics and then retest it.

Evan Brand: We’ve got a couple other questions here. What’s your- what’s your schedule look like? How much time you got left?

Dr. Justin Marchegiani: I got enough time, I got 10 minutes here.

Evan Brand: Perfect. I’ll just uh, give people another plug. If you haven’t register to Justin’s summit, please do., it’s great. If you’re like geekin’ out on this, you’re about to geek out times 30 for the next week. Every day, you’re gonna get to hear Justin in your ear for like 6 hours. So, better put some headphones on, get your nice cup of camel milk tea and sit down and have a good listen. And uh, Justin did videos too, so that’s cool. If you wanna see the interviews, as opposed to just listening, you can do both, and if you end up buying his summit, you do get transcripts. So, I know, we’re getting a little, yo know, a little tricky, a little complicated sometimes in these interviews, you may want to have the transcript available so you can refer back to that.

Dr. Justin Marchegiani: Wonderful. Hundred percent. [crosstalk]

Evan Brand: Yeah, so that’s my plug. And uh, the next question from Colin is, “Any recommendations for…”, he said, “dedicated” but he meant desiccated, and we know what you meant. So, “Any recommendations for desiccated thyroid? Have you heard of the company thyrovanz?”. And I have not.

Dr. Justin Marchegiani: I have not. I have not in my life. We have a product called thyrobalance that is a natural glands. We’re support- I use with my patients, that I’d formulated, I’ve- I love that, it’s for credit, I use it on thousands of patients. And uh, on the prescription side, I do like WP thyroid, it’s a very clean formula. Uh, NP thyroid is another newer one out that’s very similar to iron, it- it does have a little bit of maltodextrin from corn in there, so you gotta be a little careful. The other good ones gonna be Nature Throid. Supposedly Nature Throid has a couple more ingredients than WP. Some people, if you check out my summit interview with Guillermo Ruiz, we talked all about that but, he said, there just not have extra ingredients and the same formula but, if you look on the back, there is lactose Nature Throid, there’s no lactose in WP. So, WP is the cleanest but, he seems to think they are both uh, equivalent. So, Nature Throid, and/or WP will be kinda number 1 and 2, WP first, Nature Throid second if you’re gonna go the prescription road.

Evan Brand: Supposedly Acella, A-C-E-L-L-A, it’s supposed to be- [crosstalk].

Dr. Justin Marchegiani: That too makes NP- That- that too makes NP.

Evan Brand: Oh, okay.

Dr. Justin Marchegiani: I’m pretty sure, that too makes NP thyroid.

Evan Brand: Okay. Excellent. Alright. Uh, here’s another one-

Dr. Justin Marchegiani: And then just to be- to be hundred percent clear on the question though, is with a natural thyroid glandular, you’re getting T-4, which is typically all you get in a centroid  levoxyl levothyroxine support, but you’re also getting T-3, T-2, T-1, T-0, calcitonin and proto morphogenic proteins which are in there that was your natural growth factors and- and taking thyroid glandular can also help lower your antibody levels too which is great. So, if you need a great, we don’t wanna give it unless we need it.

Evan Brand: Yeah, I was gonna say how do you rate when you need it versus let’s say someone was on a prescription, you know, is it possible that they are not doing well their prescription like centroid, but they may do and feel better and be able to use a glandular instead of that with the help of their doctor getting them off of the drug.

Dr. Justin Marchegiani: Well, you know you’re gonna need it if 1 of 2 factors or both are- are there. TSH is elevated, that could be the conventional range which is 5 and a half on the east coast, 4 and a half on the west coast, or, I use the- uh- uhm- the Association of Clinical Endocrinologists standings, once there’s a- above 2 and a half, I’m careful, okay? We’re about 2 and a half, 3’s kind of my cut off, but, then I look at the free T-3 levels. I’d look at T-4, T-3, how’s that conversion happening, and is there adequate levels of T-3, at least 3.0 on a free T-3. If we see a little bit than that, we could look at symptoms and we’ll see if it’s necessary to do anything for on the fence or a close, and then adrenals are shut, we may leave it alone and go after the adrenals come back on that. ‘Caue sometimes that’s enough to fix it. If the adrenals look okay, or the thyroid’s very low, we’ll come in there with support, get the TSH under control so the brain’s not screaming at the thyroid and getting it swollen, and then we’ll also get that functional T-3 level up to an optimum range. You know, 50% of the reference range. So, typically above 3 or so. Other country is different, but you wanna be at least 50% in the reference range.

Evan Brand: With that, you’re saying, take care of everything else like adrenals and all that? You’re saying circle back to the thyroid gland- glandular is kind of a last stage effort you would approach adrenals, maybe thyroid nutrients first, before thyroid glandular?

Dr. Justin Marchegiani: If we’re close- if we’re close. The only exceptional will be if the TSH is high, you know. Even if they didn’t have any symptoms but the TSH was high, let’s say above 3 to 4, then I would definitely look at putting that on a little bit sooner. If it was 3, I may hold off and just see maybe if we get the HPA access back on track, we’re good, if we’re on the 4 or up, I’m definitely gonna at least bring it down to 1 in the meantime.

Evan Brand: Okay, so, if we got a TSH of 5, we’ve got a free T-3 of 2, you’re saying, yeah, probably gonna need the glandular?

Dr. Justin Marchegiani: Definitely. Definitely need the glandular. Now, if we have a TSH of 3, and a T-3 of let’s say 3.2, that’s where it becomes very questionable. I’d wanna look at symptoms, and I wanna look at the thyroid, uh, the adrenals as well as the thyroid. And I probably- I’d probably say, let’s table doing anything directly with hormones on the thyroid for at least a month, and just focus on more nutrients and the adrenals and I come back and retest probably in 4 to 8 weeks and see where we’re at.

Evan Brand: Well said. We’ve seen massive swings in hormones in the right direction-

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: -just by focusing on adrenals, it blows my mind-

Dr. Justin Marchegiani: Yup.

Evan Brand: -because I wasn’t someone that was comfortable with thyroid glandulars personally and recommending those to clients, I’d kind of stayed away from it, because I saw with doing rhodiola, and as you mentioned some of those special Maca extracts, and Ashwagandhas and Schisandra berries and helping the liver in detoxing, uh, and all of the sudden we looked and it’s like, whoa, TSH is normal. We didn’t even- we didn’t even try to focus on thyroid and it fixed itself, just with fixing the body, I love when that happens.

Dr. Justin Marchegiani: A hundred percent. I love it. And we’re getting to the root cause, we’re not just gonna throw everything on- throw everyone on the same thing. We really try to individualize the approach, just [crosstalk].

Evan Brand: Uh, I’ve got a question here from Paul, “How is Calcium D-Glucarate daily for detoxification?”. We use Calcium D-Glucarate all the time.

Dr. Justin Marchegiani: Yeah, it’s in my the detox aminos product. It binds to estrogens, so it really helps aid in estrogen detoxification. So, if a woman has extra detox, or if we see estrogen levels with the guys as well, I mean, it’s good to help bind it and pull it out, so I think it’s great. Just wanna make sure that we’re also getting to the root cause. If it’s just part of the general detoxification program, I think it’s great. It’s gonna help with thyroid binding globulin, and help with increasing free T-3 if there’s excess estrogen.

Evan Brand: Yeah, I- I- I don’t use it in isolation, same thing as you. I do have within a liver support product-

Dr. Justin Marchegiani: Yup.

Evan Brand: -our uh hormone support product, there’s kind of a couple things out there that we use will be blends of herbs plus Calcium D-Glucarate added in for PMS and, you know, breast tenderness and moodiness and irritability and all that stuff, we do see a Calcium D-Glucarate does move the needle.

Dr. Justin Marchegiani: Hundred percent. Hundred percent. Next question.

Evan Brand: Uh, Laura gave us some feedback, “Thank you so very much for explaining crucial information about gluten. I have tried for years to get people to realize that gluten hurts us all”. I agree Laura, thank you for the feedback and some people have to hit rock bottom before they listen to you. So, unfortunately that’s a reality.

Dr. Justin Marchegiani: Yeah, and again, some people, you know, they have the mindset of like, e- everything in moderation, it- it just depends. I don’t necessarily buy that, I mean, there’s probably never gonna be in the- in the- in a monitored amount of cocaine or methamphetamines that’ll ever do. But I get the fact that some people, you know, may not have that genetic predisposition. They may not have an autoimmune genetics that are active. But I just- I still think uhm- you gotta be careful if there’s an option to do something on the safer side on the gluten free, grain free side, it’s better. It’s- it’s better to do that. But I get why some people may feel like they- they get a little bit more freedom. You know, when you have a little bit more uhm, uh, health, so to speak, and a little bit less genetic predisposition, it makes sense why you do that.

Evan Brand: Yup. Got a question here, “My friend has hashimoto’s and only 20% of her thyroid. She tried nascent iodine and her face broke out with little lumps like pimples. Any idea why and what she can do to supplement iodine?”.

Dr. Justin Marchegiani: Well, if she has hashimoto’s, uhm I know that’s Dr. Group’s product, it’s a good iodine product, you just gotta be careful because you can go really high in it number 1, and that can elevate antibodies. Number 2, you could be pushing out other halides like bromine, right? And that could be causing the detoxification issue with the skin, is you’re pushing that out to the skin. [Crosstalk].

Evan Brand: Let me ask you this-

Dr. Justin Marchegiani: Yeah.

Evan Brand: This is- this is mind-blowing. So, that you’re saying that nascent iodine can kind of clear out that receptor site?

Dr. Justin Marchegiani: Potentially, but it could also activate autoimmunity if that’s there too. It could-

Evan Brand: Yeah.

Dr. Justin Marchegiani: -too high. So, I mean, if I were to do it, I would make sure that- if she’s my patient, we’re working for a few months, we’re stabilizing inflammation in the diet, all the other nutrients are present, ’cause with high amounts of iodine, the iodination process spits out hydrogen peroxide, H2O2, and with, inadequate selenium levels. Hydrogen peroxide’s inflammatory in the thyroid. So, with adequate selenium, we convert that H2O2, we pull off an oxygen to it and we make it H2O and make it water, something benign. So, we gotta be careful with the iodine and the lack of selenium, especially if antibodies are elevated.

Evan Brand: Yeah, well said. Selenium’s huge. That’s like, critical if you don’t address that, it’s very easy to fix that too. It’s like one of the cheapest supplements ever. Its funny people question the whole Brazil Nut thing, people say, “Oh, only a few Brazil Nuts per day is enough for selenium”. I’d look at some studies comparing that, like supplementation of actual selenium like chelated selenium versus a Brazil Nut, it actually surprisingly, the Brazil Nut actually held up, it actually did worked.

Dr. Justin Marchegiani: Yeah, I mean, the big difference for the Brazil Nut is there’s like a uh, a 10 to 1 ratio of how much selenium could be there. So, it’s just you don’t know if you’re at- if you’re doing 2 or 3 Brazil Nuts, hoping for 20 or 40 microgram, or 200 microgram the selenium, you may get 20, you may get 30, right. That’s the problem with it. So, I think it’s okay if you wanna do 1 or 2, but I think at least get your insurance policy of 200 micrograms of selenium via supplement formula, that’s your insurance policy.

Evan Brand: Yeah, I l- I love the idea of food as medicine but I agree with you. That’s not something you wanna dabble with, like, why try to get it from Brazil Nut if you can spend $8 and get the best selenium product on the market in capsule form, and you know exactly what therapeutic dose you’re getting in terms of milligrams right there on the bowl versus, “Oh yeah! This is a big Brazil Nut! This must be 20 milligrams”, it’s like “No!”.

Dr. Justin Marchegiani: E- exactly. And Brazil Nuts are commonly moldy too. So, if you have mold issues, there could be a problem there.

Evan Brand: [Crosstalk]

Dr. Justin Marchegiani: You know, if you wanna 1 or 2, fine, but just get your 200 from- from supplement.

Evan Brand: Yeah.

Dr. Justin Marchegiani: From selenium ___[40:20] primarily.

Evan Brand: Well, pesticides too, I’ve never seen organic Brazil Nuts on the market, I don’t want some sprayed.

Dr. Justin Marchegiani: I know, and then you also have the phytates and the other types of oxalate compounds in there too, for sure.

Evan Brand: I thought we had a question about oxalates. [Crosstalk]

Dr. Justin Marchegiani: Someone asked about “How do oxalates affect your thyroid?”, I think, right?

Evan Brand: Yeah, here it is. “What are you guys know about high oxalates and Hashimoto’s? Is there a connection?”. Let me just say something first.

Dr. Justin Marchegiani: Yeah.

Evan Brand: What I’ve seen, is that high oxalates are directly can’t- uh, related to uh, high candida. We’ve seen a lot of yeast, like, when I see candida high, I always see oxalates high.

Dr. Justin Marchegiani: Mm-hmm.

Evan Brand: And then when you fix the candida, the oxalates magically go down. So, I would just throw- I would- I would kinda change that question and I would just say “What do you guys know about high oxalates, candida and Hashimoto’s?”, and I would say the answer is they’re all related.

Dr. Justin Marchegiani: Yeah, also, I would say that uhm, a lot of high oxalates foods are high goitrogens too. And these goitrogens can block iodine uptake. So, if you’re doing a lot of raw cruciferous vegetables, broccoli, cabbage, right? Uhm, those type of things that can easily block iodine uptake. If you’re doing a lot of it raw, that’s gonna really have some major impact. So, if you’re cooking it, you’re steaming it, you’re putting it in soups, you’re gonna have less in it for sure. But, you know, too much of that, if we have low thyroid, we gotta be careful with too much of that on the raw side ’cause that can definitely block our iodine uptake.

Evan Brand: I’m guessing you’ve seen raw vegans that have thyroid problems.

Dr. Justin Marchegiani: Oh, yeah, I mean, that’s a huge thing. Also, raw vegans tend to not have enough protein to make other hormones, so they can have other problems going on too.

Evan Brand: Did you see that article that was a uh- uh- an article the other day that went kinda viral. This medical wrote, that the- the vegan diet killed my mother early? Did you read that?

Dr. Justin Marchegiani: No. I think I heard of this though.

Evan Brand: Let me see if I can pull up-

Dr. Justin Marchegiani: Go ahead.

Evan Brand: -so I can say it, yeah. So, here it was, it was in the U.K., it was in London, this guy, Dr. Aseem, we may wanna get him on the podcast.

Dr. Justin Marchegiani: Yeah.

Evan Brand: He wrote a letter basically about this. And, yeah, he’s a cardiologist, his name’s Dr. Aseem, M-A-L-H-O-T-R-A. He said, my mother’s diet was full of ultra- aah, see here’s the thing I didn’t read before. Her diet was full of ultra-processed foods. So, talks about how uh, she was a vegan, her vegetarian rather, but, that she was consuming tons of, uh, biscuits, crisp and starchy carbohydrates. So, she probably had an unhealthy vegetarian diet. But the way-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -he wrote it, made it just seem like the vegetarian diet overall, killed her but, no, she’s eating that crap, that makes sense.

Dr. Justin Marchegiani: Yeah, she’s on a lot of carbohydrates but, yeah, one thing that you’ll see, you know, this is good for anyone listening is, with vegans’ vegetarians, go look at their hands. ‘Cause what they’re doing is they’re getting a lot of plant-based, uhm- beta carotene, and they’re hoping that converts to Vitamin-A. With low thyroid, you’ll see a lot of the orange deposits or their hands, or their feet, ’cause they can’t convert that beta-carotene, the Vitamin-A, the active uhm, retinyl palmitate. Uh, and- and- Vitamin-A is important for the thyroid receptor sites. So, you’ll see with some of these vegan vegetarians, they’re not getting active Vitamin-A form animal products or Cod-Liver Oil, so you’ll see beta carotene deposits in their skin, orangy skin.

Evan Brand: Whoa! Well, I- you know, I always trip people out about looking at the ridges on your fingernails-

Dr. Justin Marchegiani: Oh yeah.

Evan Brand: -for [crosstalk], but now I have something else to look at, “hey, let me see your hands, I’m gonna look at your nails, now, I’m gonna look at your palms”.

Dr. Justin Marchegiani: Yeah, I mean, it’s always good to look at it, just shouldn’t be excessively orange, but that’s a big thing. And Vitamin-A is really important for your thyroid, uhm, excellent sources of course are gonna be healthy, you know, egg yolks I think you’re gonna get it in, you’ll also see it in any type of high quality grass-fed meat, we’re gonna see it on Cod Liver Oil, and you’ll also gonna see it like liver glandular, for sure.

Evan Brand: There’s a question here which says a treatment-oriented questions so you’ll have to become a client of Justin if you wanna like dive in to supplements and protocols, but I’ll still read the question anyway incase Justin you wanna say something else.

Dr. Justin Marchegiani: Yeah.

Evan Brand: “With slightly low free T3, should…” uh, “…thyroid balance 1 capsule be taken every day?”, and “Dr. J., do you take your thyroid replete or balance?”.

Dr. Justin Marchegiani: I do not need my thyroid replete or balance. My T3 levels are above three and my TSH stays in the low-2’s or in the mid-1’s. So, I- I just don’t need it but, my Malte has enough selenium in there, and other nutrients uhm, for my thyroid to work. I- I just don’t need it based in my labs, so, I only recommend things that patients need that we can objectively quantify.

Evan Brand: Yup.

Dr. Justin Marchegiani: But in general, uhm, the levels are what again? Low [crosstalk]…

Evan Brand: …low free T3 , it was a 2.7.

Dr. Justin Marchegiani: Yeah, so, depending on the other symptoms that are going on there would depend on how the adrenals are doing. But that’s border line. What was the TSH?

Evan Brand: TSH, 1.3.

Dr. Justin Marchegiani: Uh, I probably would say no on that. I’d wanna look at the adrenals more thoroughly. I’d probably say no. Uh, I- I’m- I’m- for- if- if other- if TSH and T3 are- uh- TSH is good and T3 is close, I tend to say, “Let’s hold off and work more on nutrition and the adrenals”.

Evan Brand: See, here’s the problem though, we’re trying to get advice like that on YouTube or wherever else on internet, we know nothing about this guy, we don’t know how he sleeps, we don’t know he’s stressed, we don’t even know what his symptoms-

Dr. Justin Marchegiani: -Diet.

Evan Brand: -are, he may feel perfectly fine [crosstalk].

Dr. Justin Marchegiani: Yeah, exactly.

Evan Brand: You may feel amazing, and then you’re trying to fix something that doesn’t really need to be fixed. If you feel amazing, you- you might not need do anything. So kinda, you know, don’t fix it if it’s not broken. Obviously, if we knew, “Hey I had terrible anxiety and heart palpitations and I couldn’t sleep, and I had skin rashes, and we have a more complete picture”, then Justin maybe able to say, “Well, you know, maybe your free T3 is a little low because of ‘XYZ’ and we can fix that, and here’s the data to prove what you got in the gut”.

Dr. Justin Marchegiani: Yeah, exactly. So, there could be other things that are causing it that- on the gut that only improve it. So, hold off, but, you wanna dive in and become a patient we can also talk a little bit deeper on that.

Evan Brand: Yup. Uhm, Missy, “Thanks for your summits, I’ve learned so much and appreciate both your time and knowledge”. Missy, it’s our pleasure.

Dr. Justin Marchegiani: Appreciate it. Then someone write in about potato juice curing diabetes type 2, it’s a little off-question but because uhm, diabetes is intimately connected to thyroid issues. Diabetes commonly, uh, causes low levels of thyroid conversion because high levels of insulin can disrupt thyroid conversion. That’s why blood sugar is so important in keeping inflammation down. But uh, I’d be careful, anytime juice, I get concerned with, excess sugar and insulin resistance being a problem. Uh, that being said, there’s a high amount of… potassium in potatoes, so could just be some of these extra minerals that are there. But I would say, uhm, probably stay away from the excess sugar if there’s high levels of insulin in your type 3 diabetic.

Evan Brand: Uh, there’s other question here, “Are you saying candida overgrowth in the gut can be linked to kale intolerance?”. Uhm, maybe and around about way, yes, but no, not directly. What I was saying is that, when we see on the organic acids test that we have an elevation in oxalates, generally speaking, candida is a contributing factor to why oxalates are driven up. I had high oxalates one time on my organic acid test, I did not eat hardly any leafy green vegetables for significant period of time when my gut was a mess, and I still had high oxalates, I didn’t have many other foods with oxalates in ’em, so, I saw when I fixed the yeast in my gut, and then eventually found out I had candida in my home, and had to fix the candida in my home because especially if you have dogs, dogs have candida on ’em and then they jump in your bed and they spread the candida to your bed, and then you breathe it in, and it recolonizes your gut. So, if you’re working with a practitioner, and you keep beating yourself up because you feel good and then you feel bad, you feel good, you feel bad, you could have candida, driving that oxalate problem. And if that gets to extreme levels, you can end up with kidney stones and all sorts of problem. So, you know, fix your gut, but fix your home too, that’s gonna be like my new motto.

Dr. Justin Marchegiani: Yeah, I mean, the more people, let’s just say have inflammation, dysregulations in guts- and gut issues, that can create more oxalate sensitivity. Uhm, again, things like potassium and magnesium are really important for oxalate cleaner. It’s now- kale is actually kind of a lower oxalate food. It’s the spinach. Spinach is the big higher ones, so you gotta be careful with spinach. But again, you know, having enough good quality magnesium and potassium in your diet or supplementally can also help clear oxalates. [Crosstalk]. Oxalates high in organic acid test, that’s more of indirect candida marker. So you’d wanna look at like D-Arabinitol, or ___[48:31] if using the GPL test. Uhm, and, you know, uh, tartaric acid, other things like that.

Evan Brand: Yup. Well, that’s all the questions, I think we killed it in, we donated an extra 10 minutes of time here, so why don’t we wrap this thing up, I’ll tell people again about your summit website.

Dr. Justin Marchegiani: Excellent.

Evan Brand: It’s, it works. Expecting probably 50, 60, maybe 70, 80, who knows? Thousand registrants. So, if you’re not coming to the party, then you’re missing out. So, this is gonna be probably one of the biggest events of the year honestly because thyroid problems are epidemic in the U.S. I’m sure I can pull up some random statistic for you from the CDC if you wanted to, but I’ll just tell you what, Justin and I see which is that, there are countless men and women out there with hashimoto’s, and they don’t even know it, it’s undiagnosed, autoimmune thyroid conditions around the world, these men and women are having anywhere from one to a million symptoms, it could be heart palpitations and anxiety-

Dr. Justin Marchegiani: Yeah.

Evan Brand: -one day, and they’re energetic, and then the next day they’re exhausted and they don’t know why. And then the next morning, they wake up in the middle of the night and they have heart racing in the middle of the night, they don’t know why. When that thyroid gets attacked by the immune system, it can squirt out little pieces of thyroid hormone and cause you to feel crazy. So, please make sure that you get your antibodies tested. Your TPO, your TG, maybe your TSI if you think you need to, because something you educated me on is that you can have hashimoto’s, and you can have graves at the same time, which sounds insane.

Dr. Justin Marchegiani: Yup, you can and, 1 out of 5 women have, uh, a- autoimmune issue, and, one of the most common thyroid issues, over 30 million people have it and don’t even know is, hashimoto’s. And the big issue with that is, it’s gonna create inflammation, it’s eventually gonna destroy your thyroid tissue, low thyroid hormones and it create all kinds of symptoms, and women tend to be more predisposed. I mean, on the guy, I’ve hashimoto’s too, so this isn’t you know, just me only reaching the females out there, men have it too, so you gotta look at it. Women are a little more predisposed, ’cause estrogen can- can affect the CD4 to CD8, uhm immune cell ratio and can make you more predisposed to autoimmune issues, but heck, we know guys are getting exposed to lots of estrogens too via the food, and the plastics and the pesticides. So, that’s another predisposing factor that can even make guys more susceptible even like myself, so, make sure you register. Thanks, so much Evan for the great podcast today, make sure you sign up and get that free 88-page eBook, my real book, the thyroid reset is coming out in the coming months is head. So, stay tuned, thanks so much, and have a phenomenal day. Take care.

Evan Brand: Take care. Bye-bye.

Dr. Justin Marchegiani: Bye.


Thyroid Testing and the Importance of TSH | Podcast #214

There are different symptoms of thyroid issues that need to be considered in thyroid testing. These are symptoms that are subclinical, the less talked about and the typical. A bit overrated? Find out more and learn from Dr. J’s interactive and live podcast!

Today’s podcast talks about thyroid tests and the importance of TSH. Learn about the symptoms of thyroid issues, the physical assessment of thyroid gland or palpation, addressing different TSH issues and all other factors that may affect thyroid functions. Stay tuned for more!

Dr. Justin Marchegiani

In this episode, we cover:

00:42    Thyroid-Stimulating Hormone

02:38    The Less Talked About Symptoms of Thyroid Issues

03:57    Physical Assessment of the Thyroid Gland

04:36    Poly Autoimmune Conditions

05:40    Indicators used by Endocrinologists to Assess Thyroid Hormones

07:42    Optimal Thyroxine Conversion

08:47    Addressing High TSH Volume

12:32    Other Factors that Affect Thyroid Functions


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani. Today, we are doing a live podcast. We’re gonna be talking about thyroid labs and TSH. Why is it important? Why is it- maybe a little bit overrated. We’re gonna go into this. And again, make sure you hit the thumbs up, give me a uhm- subscribe, hit the bell as well so you get notifications. I’m one of the only health professionals that sees patients and does lot of these live, interactive podcast, slash Q&A hybrids. I really wanna get lots of uh- interactive involvement, and I wanna get your feedback, I wanna get your thoughts and I wanna interact in the podcast live information so we can make it even better. Alright, so, let’s dig in.

So, when we’re sessing thyroid function, you know, one of the big obvious things that we’re gonna do is- is blood testing, to look at your thyroid. Now, even before that, you may have thyroid symptoms, you may have cold hands or cold feet, you may have hair loss, outer third of the eye eyebrow issue, you may have mood issues like brain fog, mood issues, depression, constipation, those are more of a subclinical, meaning, let’s say- a typical, like they aren’t typically- they are what comes to mind if you go see your medical doctor when it comes to thyroid. The typical ones are gonna be cold hands, cold feet, hair loss, for sure. The depression, the anxiety, the mood issues, uhm- the constipation, low or slow bowel motility are typically gonna be less talked about, just FYI.

So, we’re gonna- maybe do a palpation. They’re gonna look for thyroid swelling. They’re gonna look for thyroid inflammation. Why would that thyroid be swollen? It could be because TSH is elevated. TSH is the whipping thyroid hormone. Its the- it’s the person that sits on the horse-carriage that whips the horse to make the horse go faster. Think of the conductor whipping that- the harder, and the more he whips that, that’s like TSH going up, tryin’ and get that thyroid to make some thyroid hormone, typically T-4 – tetraiodothyronine. T-4, tetra means 4, ‘kay? And then iodothyronine, so that’s 4 molecules of iodine bound to typically uh- thyroxine molecule that makes your T-4, your active thyroid hormone. That gets converted and activated down the road with the 5-deiodinase enzyme that’s selenium-based, so we need selenium. And we need other nutrients like vitamin-A, copper, zinc, magnesium, uhm- ye- yeah, Vi- Vitamin-C, uh- typically some glutathione, maybe some superoxide dismutase, a lot of good compounds there that are really designed to help with that conversion. Also, cortisol imbalances, too high or too low, same with insulin, too high or too low can also thwart that thyroid conversion.

So your conventional docs’ gonna- number 1, kinda do an audit of your symptoms. Number 2, they’re gonna do some palpation to look at the swelling, could be high TSH, could be an elevation in thyroid antibodies, TPO, thyroid peroxidase , or thyroglobulin antibody. And that could be whipping the thyroid- not quite the same as the TSH but more like someone putting daggers or stabbing your thyroid, your antibodies actually attacking. So TSH is different ’cause that’s your pituitary talking to your thyroid but raising the volume, and that can cause swelling if the TSH goes too high, then we have the thyroid antibodies which are your immune system coming in for the attack. And that’s really trying to attack the thyroid, that’s a little bit different ’cause that can actually cause a lot of long-term damage as well, and a lot of that functional thyroid tissue that makes thyroid hormone can really be impacted and produce less hormone overall, and you may need to actually be on thyroid hormone for a longer period time, if not, your whole life, depending on how long an autoimmune attack’s been going on. For most people that I see, there’s been an autoimmune attack to some degree for at least a decade, typically, before I see them. So, tends to be happening at a very subclinical level for many years, before people even notice any symptoms. That’s kind of a scary thing about it that can be going on for such a long period of time.

Alright, so we talked about kind of the physical assessment, right? They may have you swallow some water, they may palpate just above and below the Adam’s apple while you swallow. So here’s your Adam’s apple, they’ll go and just- maybe just a centimeter or so outside. And they’re feeling, if there’s any nodules, right? Typically, you’ll just feel like a little bump, it’s a nodule, they’ll feel if it’s swollen, where- it’s just- it’s a little puffy, it’s sticking out more the normal. Of course, you need a- a baseline to know what normal feels like. But when it feels a little bit more puffy and kinda sticks out a little bit, once you feel a couple of normal, once you can get an-  a sense of what that feels like, and looks like.

Now it’s a poly autoimmune, TPO thyroglobulin. It could also be potentially Grave’s, but that’s usually a- a minority percent of the cases, usually 1 or 2%, 90, 95%+ are gonna be hashimotos in origin. Now, hashimoto’s is an autoimmune attack that involves TPO and thyroglobulin, and it tends to fatigue the thyroid out overtime, but you can’t hyper off the bat, and then, the Grave’s tends to affect the receptor sites or the stimulating imm- immunoglobulin that causing the thyroid to make more thyroid hormone. Hashimotos can feel like Grave’s in the beginning, so it’s really tough to know the difference. Typically you’re gonna be looking at TSI and thyroid receptor site antibodies to differentiate the two. Again, hyperthyroid symptom with hashimoto’s isn’t that big of a deal. With Grave’s it could be a bigger deal because it can cause potential stroke, because you can really ratchet up those uh- thyroid numbers very-very high, much higher than you could with let’s just say hashimoto’s type of an attack, but, always good to get both of that asses.

Now, most people that are going to see their doctor, they- they’re kinda in this “no man’s land” where the first thing that’s really being looked at, to assess what’s going on is TSH. Now, I mentioned earlier, TSH is like the whipping hormone, right? That’s the con-  that’s the person in the- in the carriage whipping the horse, right? So, they’re looking for that- that whipping to start going up a little bit above. Now, according to the American Clinical Association Endocrinologists, AACE for short. AACE, anything above two and a half, may be a problem. So, we start looking at things a little bit more closely, once the TSH goes above two and a half… me, about 3. Once it’s going above 3, I’m a little bit perked up and I’m paying very close attention. Now, conventional endocrinologists typically won’t care until it goes above 4 and a half, to 5 and half. I always tell patients, “The easy way to cure your hypothyroidism, if you’re diagnosed ‘conventionally’, is if you have a high TSH on the west coast”. Remember, the TSH on the west coast is a 4 and a half. You go to the east coast, its 5 and half. You have a 4.75 on the west coast, think of ship from L.A. to Boston and now you’re cured overnight. I wish it was that simple though, that, seriously, you’ll see in the lab-reference range that changes that easily. So, 4 and a half to 5 and a half I think is a little bit late when it comes to assessing thyroid hormones. Some don’t even care ’till it goes even 10 or even above. So, we like to use that TSH of an indication of 3- 3 or so. But we also wanna look downstream, you wanna look at T-4, 3 and T-4 total. We wanna look at how much hormone that the thyroid actually making. ‘Cause sometimes we see TSH high, right? And then we see T-4 is adequate. Meaning, okay, the thyroid is compensating by making enough thyroid hormone, but it’s having the whipped at horse a lot. Meaning, “Hey, that horse is going that normal speed, but having a whip it a little bit more than we should”, meaning, we’re eventually gonna fatigue that horse out, over time if we have to maintain that level of whipping. So that goes, okay, good- so the horse is able to do its thing, but, over time it’s not a good thing if we whip it that much.

And then we have some areas where we see T-4 starting to drop. And that’s a concern ’cause that tells me that, alright, we’re overstimulating, we’re over-whipping, and the thyroid is still not motivated enough even with that stimulation to make more thyroid hormone, that’s a concern. We also have to look at the conversion downstream ’cause some people, we see, okay, that T-4, that horse is going a good speed, but the conversion to T-3, the active thyroid hormone, doesn’t really fit into the horse analogy, but that active T-3, T-4 is relatively inactive, 300% more inactive than T-3. That T-3 has to convert, and has to- you go from typically like uhm- a T-4-free, and like, let’s say around 1 to 1.5, that has to convert downstream to T-3 and about 3 to 3.5 . And if it starts dropping below that where we have a good level of T-4 around 1 to 1.5, and that T-3 drops into the low 2’s, we got a problem, ’cause that’s a relatively active thyroid hormone being that T-3. So we have to make sure it’s converting optimally, that’s number 1.

Number 2, we have to also address the TSH. We hope- we won’t want the volume of that TSH to be so high. We wanna get that under control as well, and we also wanna make sure the T-4 is good and the thyroid conversions’ good. So, we’re looking at TSH, we’re looking at T-4, number 2, we’re looking at T-4 to T-3, number 3, and then number 4, we’re looking at thyroid antibodies, is that TSH being attacked, or is that TSH compensating because that thyroid that’s being attacked in the hormone is not quite optimum. And then number 5, the 5th variable is gonna be reversed T-3. Are we converting some of that T-4 to reverse T-3? So, we have TSH is the first domino, T-4 is the second domino, T-3 is the third… this is where the T-4 to T-3 co- conversion happens. Zinc, selenium, magnesium, healthy CoQ10, uhm, of course glutathione’s gonna be involved, superoxide dismutase, uh- co- uh- cortisol and insulin. This conversion happens here, we have the sub-conversion which is reversed T-3, and this is the blanks in the metabolic gun. So when we see T-4 going to reverse T-3, that reversed T-3 congest and blocks up that thyroid receptor site and prevents active T-3 from going in there. This is vitally important if we have thyroid issues.

So, most conventional medical docs are looking at TSH, that’s it. Maybe they look at T-4, but, they’re not really looking at it in depth, they’re not running T-4, 3 or total, they’re not looking at the conversion downstream and give very rarely have thyroid antibodies looked at because, well, thyroid autoimmunity doesn’t matter, we’re not gonna do anything from a conventional standpoint, we’re not gonna give immunosuppressant drugs, we’re not gonna give corticosteroids typically ’cause the side-effects are worse than the actual disease. So they’ve kinda made- let’s just say an analysis that we’re gonna save those from more serious autoimmune conditions like crohn’s or also the colitis, those kind of things, ’cause the medications aren’t warranted for the symptoms. But, the problem is, if we see autoimmunity which we know about 50 to 90% have an autoimmune mechanism involved, that means a lot to us functional medicine docs. Why? ‘Cause we’re gonna look at leaky gut, A.K.A. gastrointestinal permeability. We’re gonna look at infections, we’re gonna look at gluten sensitivity, we’re gonna look at certain nut- certain nutrient-deficiencies that are really important for autoimmunity such as low zinc, low selenium, low CoQ10, really important nutrients to run our thyroids. And also CoQ10 is gonna get blocked if we’re taking a statin. So of course if you’re taking any statin medications, you’re gonna have some problems with your thyroid as well, ’cause you’re not gonna make your own internal CoQ10.

So, kinda recapping, right? Conventional analysis, alright: analyze symptoms, palpation. Palpation’s only gonna be good if there’s an extreme autoimmune attack, and then of course, uhm- they’re gonna assess, maybe run TSH, T-4, if you have a better doctor whose assessing the autoimmune stuff, they may run a thyroid ultrasound. Okay, great. So now, we get in assessment of inflammation, typically, not too much will be done with that because the drugs typically are worse than the actual symptoms of the autoimmune thyroid. Next step is how does that hormone cascade look? TSH, T-4, 3, and total. T-3 for you and total, reversed T-3, thyroid antibodies only can even look at T-3 uptake as well. We wanna look at the whole kit and kaboodle. Now, if you wanna dive deeper I’d refer you to other podcast where we can look at adrenal halve ’cause cortisol plays a huge impact. We also know as a female, right? Estrogen-dominance, alright, A.K.A. higher estrogen, lower progesterone relatively speaking.

Progesterone has a big impact on thyroid function as well. And then we add in the elements of insulin-resistance, excess carbohydrate, insulin resistance or reactive hypoglycemia, can exacerbate autoimmunity, affect thyroid conversion as well, and obviously deplete a lot of nutrients just through having a run more glycolysis for our fuel. We tend to burn up a lot more B-Vitamins and magnesium and really important minerals. And then if we add in the extra vector of hypochlorhydria, those stomach acid from gut infections, then it makes it even more apparent, that we don’t have enough acidity to ionize our minerals, get ’em into the blood and be able to breakdown, absorb and digest our fatty acids, cholesterol and amino acids, so it’s quite the cascade. So, most people need to get the full thyroid workup, ge- go to your conventional doc, fine, get at least the big things ruled out. But then once your- once your to- hey, it’s all in your head, you really wanna go see, or they don’t give you much of an option, or maybe they just say, here’s some centroid, the other option with that is a lot of people, when we talk about that T-4 to T-3 conversion, my clinical experience is about 80% don’t make that conversion optimally because of all the other important nutrients that are involved in that conversion. So that’s why you gotta look at the full, complete picture. And most people, centroid won’t get the job done and may make your TSH look pretty, meaning get it back below- get it back to about a 1, but it may not help the rest of that hormone cascade because the conversion is not there, it’s just T-4, and many people don’t have all the other nutrients to make that conversion downstream.

Alright, so I’m live here, I’m gonna open it up to some questions in the topic of thyroid, thyroid health and anything that we can tangentially connect back to thyroid and thyroid lab testing. So, let’s go dig in to what the listeners have to say here, will be got y’all.

Neem writes in, “Low TSH, insulin, bile and cholesterol due to chronic infection, any recommendations?”, yeah. So if TSH is low, that means your hypothyroid, your- your- I mean your pituitary is going basically low, right? You- almost the hypopituitary issue, and if you’re not taking too much thyroid hormone, it’s probably just because of stress and cortisol and inflammation so you have to get the diet right, get the adrenals right, and get the gut right. So, 6 hours on the gut, remove the bad foods, replace the enzymes and acids, repair the gut lining and the hormones, all of it, thyroid, female hormones and adrenals, and then eventually deal with body system too and getting rid of the gut infections.

Hey Ahmet, hope you’re enjoying today’s show. Uhm, Soupper writes in, “Hashimoto’s, high cortisol, please the Vitamin-C”. So, yeah, Vitamin-C’s helpful, I have no problem with that, it’s gonna help with inflammation, no problem there.

Justin G writes in, “Hi Dr J. I am 64 Male, low to normal T-4 and T-3, 6.4 TSH. No swelling, no symptoms other than anxiety. No meds taken. Some evidence of autoimmune antibody. Doc says monitor without meds”. So if you’re having some thyroid symptoms, personally, with low normal T-4 and T-3, I’d wanna know is there any antibodies at all? You mentioned some evidence of autoimmune antibodies, so I wanna know what those levels look like, and I would definitely add in a little bit of bioidentical thyroid hormones to knock that TSH down. I didn’t go into this but I think it’s important. A lot of doctors get freaked out over TSH going too low. I had a patient just before I jumped on today’s uh- live podcast, whose doctor was concerned about TSH that was too low. And this is the problem when were you- actually using thyroid supports, sometimes that TSH can go too low because we’re supporting the thyroid, that the brain saying, “Hey, we can lower our volume because the thyroid’s getting extra support, so let’s lower the volume”. Now, when that TSH go so low, let’s say below .3, a lot of doctors get concerned of grave disease. Remember, we talked earlier, grave’s is uh- autoimmune attack where it affects TSI, thyroid stimulating immunoglobulins, or TSH receptor antibodies where it stimulates the thyroid to make more thyroid hormone. So when they see TSH low, they’re thinking that maybe a grave’s attack that’s hyper stimulating the thyroid. But, really, it’s just we’re giving a little bit of thyroid hormone and we’re- we’re focusing on the thyroid hormone being in the therapeutic range and not necessarily worried about the TSH being in the right range. The problem is, TSH, when we give exogenous thyroid support or hormones, the TSH tends to be more receptive to these exogenous hormone than the actual tissue is. So, what does that mean? My analogy, my famous analogy is, go outside and try to figure out on the hot- in the hot day, what the temperature is by touching the sidewalk. Well, the sidewalk conducts heat, more or better than the air temperature does. So, a hundred degree outside in Austin, is gonna be like a hundred and seventy degrees or- like a hundred and fifty degrees sidewalk. So, your pituitary is like the sidewalk in this analogy, it’s more sensitive and picks it up so, you tend to see a lower TSH when we give thyroid support. Now, problem is, if we base everything off a TSH, we tend to be under supporting the thyroid hormone levels. Meaning, if we’re shooting 50% to 25% of the reference range, right? So if we have a range of let’s say T-3, T-3 is like between 3 and 4 and a half. Let’s say we’re shooting for 3 and a half to 3.75, we may undershoot it if we’re trying to just hit the TSH. So, essentially, you wanna look at the thyroid hormone, you wanna look at the TSH too. Ideally if we can have the TSH not go below .3, maybe ideally have it settle around 1, that’s great. But sometimes, my patients that, their TSH is at 1, but they still have low thyroid symptoms, we go up another grain with their thyroid support and it’s like boom, the symptoms are gone. So, what should we do? Should we make the TSH in the lab look pretty? Or should we focus on the patient’s clinical outcome, their symptoms, and their actual thyroid hormone levels. Meaning, let’s say they’re in the top 25% of the range, that’s where their symptoms go away, but at the top 25% of the range for T-3, 3, that may cause your TSH to go a little bit low. But if we go let’s say, 50% of the range for T-3, their TSH looks perfect but some symptoms creep up. So you got to gotta weigh out all the options. A lot of doctors, even some natural ones, prioritize TSH over the patient’s symptoms and thyroid values. I weigh both of them up. Sometimes we can do both, sometimes we can’t. So we have to look at all of the issues. Are we addressing the adrenal issues, check. Are we addressing the thyroid issues, check. Are we addressing any female or male hormone issues, check. Are we fixing the gut, check, are we supporting the nutrients that help the thyroid get better? Are we supporting blood sugar and insulin resistance. If we have to look at the whole, entire picture, if you just look at the thyroid and your whole treatment plan off a TSH and these numbers and that’s it, maybe missing the forest for the trees, so to speak. So, we gotta have a complete perspective we have to take, the TSH and the T-4 and the T-3, all in context ’cause most people on the conventional side, they prioritize the TSH, partly because that is the main thing they are looking at to analyze grave’s, and I think because conventional medical doctors are conce- overly concerned about grave’s ’cause it can mean stroke or heart attack, so they are v- you know, are thyroid storm essentially, so they are hyper focused on the TSH where in- in functional medicine land, we look at the the full thyroid hormones typically, so if there is grave’s we’re gonna see it down the road with T-3 being excessively high, and our T-4 being excessively high, and then we’re rule it out by ordering additional thyroid stimulating immunoglobulin and TSH receptor antibodies as well. We won’t just ever take it for granted.

Okay, let me keep on rolling guys. I went into a pretty in depth on that one, but hopefully it was helpful. Uh, “T-4 to T-3 conversion issues?”, yeah, that’s gonna be nutrients. Uhm, the 5-deiodinase enzyme is gonna be an important enzyme, it’s selenium-based. It comes from the liver. So liver stress, liver issues, toxic livers, low selenium, low glutathione, uhm- magnesium, zinc, important digestive nutrients and minerals, Vitamin-A, cortisol higher or low, insulin too high or too low. And this is probably why lower carb can sometimes cause low thyroid symptoms, we had a little bit of starching, boom, low thyroid goes away, or the other way around. We see high blood sugar, we get the blood sugar under control, we go on a keto-paleo template, and then boom, magically, insulin gets better and thyroid gets better too. So we gotta look at everything is connected, alright?

Uhm- pa-pa-pa, Ahmet writes in,”Hypoglycemia, autoimmune relation…”, yeah, so when you have reactive hypoglycemic, blood sugar swings, this is when you make- consume too much carbohydrate, alright? Not enough proteins or fat, or you’re just going too long between meals and then you’re eating a bunch of carbs, blood sugar goes up, and then your body over secretes insulin and it crashes. And the crash is the reactive part, meaning, you’re going, you’re reacting into low blood sugar because the pancreas made extra insulin. And that drop creates lots of cortisol, lots of uhm- adrenaline to bring that blood sugar back up. So, what you’re seeing is lots of cortisol and blood sugar, cortisol and adrenaline surges to bring back up that blood sugar if you will.

“Would very high TSH and normal T-3 and T-4 in postmenopausal women mean adrenal issue due to estrogen dominance?”, “Would very high TSH and normal T-3 and T-4…”, potentially, I mean, it’s one thing that would be on our checklist that we’d wanna cross often. Make sure it’s not a vector. So, yeah, it’s potential but it could be autoimmune, it could be other things with the adrenals too.

Uh, “Best grave’s treatments?”. So, I mean, we treat grave’s the same way as we treat hashimoto’s in general. Of course, if thyroid hormone’s really high, we may recommend PTU or methimazole which is a- the conventional drugs that actually block iodine uptake, or we may use more natural things like carnitine, or lithium lithium orotate, uhm, or blue flag, various herbal compounds. Again, it just depends on how severe, how bad the symptoms are, and we wanna look at the numbers. Make sure they’re not too high. Typically, refer out to an MD just to get stabilized while we work on all the other underlying things, gluten as well is a big one. But you wanna have a good conventional MD as well as a functional MD. The problem is, a lot of conventional MD’s can over-freak out, and sometimes I had some patients get recommended to get their thyroid removed right away, which is a terrible move, right? You kinda- you gotta understand what’s going on here and try to give the body a chance to get back in the balance as long as the levels, let’s just say aren’t excessive, and we’re having cardiovascular issues, worst case, we use a medication to stabilize while we go deeper.

Uhm, Sherry write in, “Do I still have grave’s disease if my thyroid has been completely removed; it’s been 2 yrs and my levels are all over the place”. So, number 1, you never actually get your thyroid all the way removed. Getting your thyroid removed is like ripping up gum on your shoe. And it’s probably always gonna be some, and some of it can grow back, not all the way but you may have some grow back. And then number 2, the underlying autoimmune stress is still there. So you have to get the autoimmune mechanism whether it’s leaky gut, or other nutrient issues or gut permeability or infections or foods, you have to slow, get the underlying mechanism removed, right? Why there’s grave’s or hashimoto’s, or an autoimmune thyroid, a- happen. Well, what happens, ’cause the conditions are just right. If I remove my thyroid, does that change the conditions being just right? No, it doesn’t.

Lisa writes in, “What are appropriate levels for reverse T-3?”. Ideally between 10 and 20. 12 and 20-ish.

Yoli writes in, “Dr. J., my lymph node on my neck is swollen and it’s uncomfortable and painful what can i do if anything, uhm, to help… and can I continue doing my sinus rinse?”. Yeah, continue doing your sinus rinse. Obviously there’s swollen lymph nodes in this area, so there’s obviously bacteria or your lymph system and your macrophage are trying to gobble up stress in the throat area. So, adding ginger, add natural things are gonna help with flushing out the lymph. You could do lymphatic massage right here by the back angular of your jaw, and you can just do kind of clo- kinda clockwise turning and massaging, like this, and then you can just drain one side right into the- thoracic cavity, and just drain it all down, that’s helpful. You could also add in some burdock tea which is great for the lymph, and or ginger tea, and you can even throw in some red roots or red clover is great for the lymph. But something is going on with your immune system it’s attacking stuff, and it could just be bacteria and junk that’s making you sick so continue with the sinus rinse because any mucus here can go down the Eustachian tube and then- and then go to your ear and create an ear rakes, so you wanna keep your sinuses flushed out with Xlear and Neomed, that’s fine. And also make sure you’re doing the ginger and/or some immune support or you can even do some Reishi mushroom to make sure you are fully supported.

Emmah writes in,”Graves’, pins and needles on my feet. and extreme discomfort. Hair loss and eyebrows. On neurontin, not as effective anymore”. So, yeah, you gotta go see a conventional MD. More than likely Emmah, all the issues that we talked about in today’s podcast are happening to you, and you need to get a full workout to see which one’s are the top priorities.

Roshan writes in,”Outside of hashimoto’s, what are the hardest to cure thyroid issues? Are most thyroid issues completely curable?”. Uhm, it just depends. The more severe the autoimmune attack is, obviously the harder, especially if- it’s because of infections and leaky gut, and there’s lot of other autoimmune conditions like let’s say you have, uhm hashimoto’s but you also have rheumatoid arthritis, or crohn’s, right? It’s something called PGAS, polyglandular autoimmune syndrome. If you have one autoimmune condition, there’s a- a 76% chance that you have a second autoimmune condition. And if you’re a female, it’s even higher. Uhm, females have issues because of the fact that they have more estrogen than guys, right? Part of the reason why they’re fertile and the women, in general, that higher amounts of estrogen can throw off the CDH, CD4 cell balance and make them more prone to autoimmunity. So, that estrogen can really have an effect in the- and the more the estrogen dominance goes into effect, the higher risk of autoimmunity, ’cause that CDH, CD4 ratio. CDH being the natural killer cells, the T- uh- the CD4 being the natural- or the helper cells. When that balance goes out of whack, increased autoimmunity, that’s why estrogen dominance is such a big deal and needs to be addressed. And again, that also includes environmental estrogens, right? Pesticides, round-up, uh herb- herbicides, rodenticides, uh- fluoride in the water and junk in the water, birth control pills in the water, hormones in the meat, all of that stuff, hormones in the milk, all of it.

Rhonda writes in, “Is it bad to have any TPO antibodies? My levels are 9”. No, that’s okay. It’s natural to have some antibodies because there’s a natural recycling process that happens, we just don’t want it to be excessive. So, like LabCorp uses a range of I think 34 or higher as positive. I think Quest uses 9, so I typically say keep it below 15-ish, and that’s pretty good.

Roshan writes in, ” How do fungal or bacterial infections drive hypothyroid?”. Well, I mean, bacterial and fungal issues can increase leaky gut, of course, bacteria contains lipopolysaccharides, fungus consain- contains acid aldehyde and mycotoxins that are put stress in the liver, uh, more leaky gut, and of course they can eat and uhm, that cause malabsorption of nutrients as well.

Paul writes in, “Could Hashimoto’s cause Crohn’s? Or other way around?”. Well, no, basically, hashimoto’s and crohn’s are the effect. None of that’s the cause, right? These are the effect, crohn’s, hashimoto’s, rheumatoid arthritis. The underlying cause can be a combination of genetic predisposition, which is then triggered by gluten sensitivity, by cortisol fluctuations, by insulin resistance, by inflammation in your diet, by high amount of Omega-6 to Omega-3, nutritional deficiencies, gut infections, poor sleep, right? So, of course, genetic predisposition, is what loads the gun, what pulls the trigger is gonna be the stressors that I just mentioned and then the effects are hashimoto’s, crohn’s, RA. Now, the difference is, you may just have that gun ready to go and that hammer already backed, right? So, you’re more predisposed. Or others, let’s say that can actually put the bullet in, cock the hammer back and pull the trigger, meaning, a lot more things going on for a lot longer for that effect to happen. But either way, we have control if we pull the trigger or not, whether your guns are already loaded, we still have control over- over you pulling the trigger.

Yoli you are totally welcome there. Uh, Paul writes in, “How does low thyroid give cold hands and cold feet?”. Well, because thyroid hormone controls metabolism, and that’s basically the sum of all chemical reactions in the body. So, of course, uh- the more chemical reactions you have which is controlled by your thyroid hormone, which increases metabolism, the byproduct of your meta- having a healthy metabolism is heat. It’s kinda like, you know, do you get enough heat to keep you warm from a small fire or a large fire? Well, a large fire, why? Because there’s more reaction with the oxygen and the fire and the wood, right? And that gives off heat as the byproduct, of course. So, of course, you need more fuel, you need more metabolic reaction happening, more metabolic reaction with the air, and the combustion of the- of the wood gives you more heat. It’s the same thing with what’s happening in your body. And then of course we need thyroid hormone to be able to break down cholesterol and breakdown our hormone metabolites and hormone building blocks so we can make more female, or male, or adrenal hormones too. So, when you have low thyroid it can affect a lot of your other hormonal systems as well.

Rhonda writes in, “Are all thyroid hormone tests reliable (ZRT, Everlywell)?”. Well, great question. I mean, when it comes to some of the ones like ZRT or- they have some good spot tests. I- I’ve use ZRT, I use their spot test only if someone does not have a conventional lab to get an actual draw on. My concern is, I used to run some of the Theranos test like couple of years ago before they went out of- out of business, uhm and I found, I would compare ’em to like LabCorp, Quest and they were very inaccurate. So, the spot technology, meaning like it’s a little finger spot, hmmm- it- it’s getting better but it may still be off a little bit so I only use ZRT or the spot ones if someone does not have a lab test within 3 hours. If not, we run a- a Quest or LabCorp, which is pretty standardized. You need more blood to run those so it’s hard to do it with the spot. Meaning, just a little finger print one like you went on a blood sugar meter. Uhm, but the technology is getting better but if I can run a Quest or LabCorp and actual, you know, vial or 2 is run, and that is always better.

Let me jump on to Facebook here and give here and give you some Facebook love. Sorry you guys, I did not given you the attention here. Alright, Annie writes in, “So, a whole bunch of…”, let’s see here, “…I was 17 years old. Ever since recent illness resulting in gall bladder removal, my body has been out of whack – gut issues, anxiety, never had that before”. Yeah, I mean, here’s the deal. If you don’t have a gallbladder, it probably means you have hypochlorhydria, it definitely means you don’t have enough bile salts to break down fat. You’re gonna have a hard time probably breaking down protein and fat because of the- the low stomach acid and the low bile. And that puts you in the position to have a lot of nutrient i- issues, so you really have to work with a good functional medicine doc to get the diet better, to get the digestion better, and to get your hormones better. Lot of issues going on there.

And Lara writes in, yeah, gluten is huge, I totally agree, it’s a big issue. It’s a one of the major drivers of leaky gut. So here… “Without giving synthroid can we cure better hypothyroid situations?”. Well, I mean, yeah, if there’s an autoimmune attack, as long as we’re getting the autoimmune attack under control, synthroid will help bring that TSH down which helps prevent whipping of that thyroid, right? Remember, TSH, the whipping of TSH is not the same as an autoimmune thyroid attack. Not the same but still, it’s still stimulating the thyroid. So, by giving a little bit hormone that does bring that TSH which is good. Lots people were concerned about, you know, excessive bone loss, or thyroid nodules with TSH going too low. Uhm, but again, err- from my s- situation here, as long as it’s not excessively too low from grave’s, you’re more than likely okay. Just make sure your doctor’s monitoring your thyroid levels.

Megan writes in, “Can excessive sweating in warm weather be your thyroid?”. Hard to say, I mean, it’s pretty normal to sweat in the warm weather. Uhm, I would just run a basal body temperature test and- and make sure you’re utilizing your, you know, regular indoor room temperature. That way you’re not using any extreme high, low, to assess your metabolism. So, we wanna be between 97-8 and 98-2 for an axillary temp, armpit, and 98 to- to 98-6 for your oral temp. Do it first thing in the morning before you move around and eat.

Paul writes in, ” When is last time your hashimoto’s gave you issues Dr. J?”. I- I’ve been able to keep it under control. I mean, my levels, my TSH stays below beneath 2, my T-3 stays above 3, my T-4 stays between 1 to 1.5, my antibodies stay right in the border, been able to keep in control.

Donna writes in, “Is intermittent fasting ok with hashimoto’s?”. Only if it’s in control. Only if it’s stabilized and in control. If it’s not, do not do it. Make sure you’re having your hormones stable first.

“What nutrient support the pancreas?”. Well, I mean, of course, for you to give enzymes- for you to give more enzymes to prevent the pancreas to have to make extra enzymes, we’d give a stomach acid to help. Those are gonna be the big things is, you know, the exocrine function of the pancreas which are gonna be enzymes and lipase, enzymes, pancreatic, proteolytic, or cer- essentially these are- they’re pancreatic enzymes and they have proteolytic function, meaning, protein, and then lipolytic functions, meaning, fat digestion. So we’d to give a lot of those things to take stress off the adre- uhm, the pancreas, and we give more acidity as well to the stomach which is an important trigger of pancreatic enzyme sec- secretion.

Ahmet writes in, “Hypothyroid situations. Some doctor recommends low fat, low calorie diet. Is it true?”. I mean, would some doctors recommend it? Yeah, it’s terrible. Go into PubMed, type in “hypocaloric diet”, and “hypothyroidism”, low calorie causes low thyroid. It make sense because if the sum of all your chemical reactions, essentially your metabolism, right, is controlled by your thyroid and you stop giving fuel into your thyroid, or meaning, you sta- you start giving low calorie I- A.K.A., low nutrition, low fuel, you are not gonna have enough nutrients to run your thyroid, and that’s gonna cause low thyroid hormone functioning. The same thing, if I put less gasoline in the tank of your car, eventually you run empty. It’s the exact same thing.

Rhonda writes in, ” If my basal temperature is in the lower 97 degrees, is that thyroid problem?”. May- maybe not, it really depends on your symptoms, and it depends on what your thyroid test says as well. I don’t ever go all one- all in on the- the basal temp, because that can be other issues, and sometimes that can just be a broken thermometer too, so we wanna look at your symptoms, and we want to look at your hormone levels.

Alright, jumpin’ over to Facebook, “Hypothyroidism and diabe…” uhm- “Hypothyroid and diabetic, have beginning of gastroparesis and concerned of the meds prescribed… Armour, might not be metabolized if it sits in my stomach too long”. So, yeah, so- if we have digestive issues Kathi, I definitely recommend absorbing your thyroid hormone in your mouth sublingually to bypass a lot of that, then swallow after 1 to 2 minutes. But you wanna work with the good functional medicine doc as well.

Uhm, Rejjiie writes in, “Been suffering from autoimmune thyroid condition for the past few years. My throat was enlarged, but after taking some herbs mixed with garlic, pau de arco, oregano leaf, zinc and Vitamin-C, it has gone back down”. Yeah, a lot of those herbs are also anti-microbial, so I wouldn’t be surprised if there’s some gut issues, bacteria, yeast or fungal that could be part of what’s stressing out the body, it’s very possible.

Alright guys, I think we answered a lot good questions here. Just make sure you guys sign up for the thyroid reset summit. We’re gonna go into all these things. I have 30 experts that I’ve heard, interviewed, amazing interviews where we go into depth in all these different topics. So, totally free to sign up,, you’ll be able to see my own personal interview, Evan’s interview, and a bunch of other amazing expert’s interview. You guys are gonna love it, and it helps support the channel, and it helps support more content coming to you. So, appreciate you guys signing up, and I will be back tomorrow for a live Q&A. I’m trying to get better at giving you guys heads up, so sometimes I’m like, “Oh, a patient”, like, you know, is “mister console”, I jump in, or at the end of the day, and I put my sun down for bed, I have a half hour free, let me jump on. So, I’m gonna try to get better like giving you guys, what, maybe 24-hour heads up. Let me know how much time you want, put your questions down below, I’ll answer it later. And uhm, let me know future topics, future live podcast topics you guys would love to hear about. I love being on the fly and dynamic so we can make the show interactive ang get your questions answered. So, I appreciate it, you guys have a phenomenal day, and I will be back tomorrow. Take care, bye. 


Xlear Sinus Rinse Kit

Ketosis and Safe Natural Sweeteners | Podcast #210

If you’ve exceeded the pleasure that you’re getting out of pizza, cake, wine and everything else, diets may not just be suitable, as they are temporary.  In order to get that lasting change, you really need to engage in a lifestyle shift.

In today’s podcast, Dr. J. invites Thom King to share his experience and insights that led to his writing of the book “Guy Gone Keto”. Watch as they tackle about the effects of sugar to our body, safe and natural sweeteners, how meat have more nutrition than vegetables and all other good things. Sharing is caring!

Thom King

In this episode, we cover:

00:41    The Springboard of Discipline: Engaging in a Lifestyle Shift

08:23    Healthy Sweeteners

10:56    Effects of Sugar Intake Frequency to Insulin or Blood Sugar

16:57    Allulose, Stevia and Monk Fruit

21:17    Sugar Alcohols

23:04    Benefits of Ketogenic Diet on Thyroid

48:15    Metformin

33:46    Importance of Journaling


Dr. Justin Marchegiani: Hey there it’s Dr. Justin Marchegiani, welcome back to the podcast. We have Thom King here in the house. He is the author of the book, “Guy Gone Keto”. We’re gonna dive in to some ketosis topics today, we’re gonna talk about natural sweeteners that we can incorporate in. Uh- they aren’t gonna affect our blood sugars much, and we’re gonna just– what– whatever else may come about but, Thom, welcome to the podcast.

Thom King: Dr. J., such pleasure being on here. Thank you for having me and uh– this is truly an honor.

Dr. Justin Marchegiani: Well thank you so much. So, let’s just dive in a little bit and just talk about your book. What inspired you to write this book, “Guy Gone Keto” and– and what are the top 2 or 3 things that you’re hoping for the readers to– to pull out of it?

Thom King: Uhm– well the book was a– the book kind of draw organically so, I had, you know, I– I own a– a food manufacturing business and a– ingredients supply company. And we supply sweeteners to sports nutrition companies, I love those companies, uhm– actually supply and manufacture ketogenic-friendly foods. So, I was in Vegas for trade show and went out with uh– with a customer. And they bought dinner and I way overdid it as usual. Uhm– went back to my room with a– beautiful luxer, and– could not stand to look at myself in the mirror. I was 35 lbs. overweight, I– my blood pressure was like 190/99 and I– I felt like a tremendously huge fraud because I’m catering to the– to that particular industry and not following at all so, at that point, sort of the pai– the pain of my, I guess dishonesty, the pain of my, you know carrying extra weight and being sluggish, and not following any type of discipline, I’ve exceeded the pleasure that I was getting out eating the pizzas and the cake and the wine and everything else, so at that point, I’m like, “Look, I need to make a lifestyle change”, so I really started doing a lot of journaling. And I was doing data collection on my weight, my blood pressure, temperature, I mean, all of the data points that I could find. And– err– and also like, use it as a springboard for discipline, so after about a 6 to 8 months period, I basically had a book on my hand. So, I just took it to it to an editor and, we added a day and it’s really– it’s more about my journey–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –on making a lifestyle change than it is keto. And, so the take home, I would say for your listeners on this, uhm– the points that I wanted to– I– I guess bring up in the book are– it– you can’t actually have a diet like, diets are really temporary–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –solutions.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: In order to get lasting change, you really need to engage in a– in a lifestyle shift.

Dr. Justin Marchegiani: Mm-hmm, mm-hmm.

Thom King: Uhm that’s one thing, and then the second thing is, why does it take to– to make a lifestyle shift and what are those– what are the components of the discipline uhm, you know, that’s required.

Dr. Justin Marchegiani: Very good points. Yeah, I mean, when I work with patients personally, we’re always talking about what’s the template, right? The template kind of gives us the flex– flexibility with our macronutrients, uh– some people may not need a– a keto template. I think most, tend to go better with a– you know a lower carb kind of paleo template so to speak. And typically, when your carbs get low enough your start spitting ketone as an alternative fuel source. And then, there you go, you have the keto diet is kind of off of that so we can adjust macronutrients in– in a bunch of different ways. But I think the commonality that needs to be present in all diet or lifestyle shift is where you need high amount of nu– nutritional density. Lot of nutrients per bite, we need an anti-inflammatory diet, right? Not with the junky omega-6 uhm– fats and the trans fats, and a high sugar stuff, and then we also need low-toxicity organic, you know, low hormones, all those good things. Any thoughts in that?

Thom King: Yeah, a lot– a lot is the definitely coming up for me. Uhm– and so, when you know, when you’re working with your patients, and– you know, you’re [clears throat]– when you say dense micronutrients, I mean, are you referring to– like more– like I would say, uh– like carbohydrates or vegetables, leafy greens, preciferous vegetables, you know, that– you know that have like those micronutrients, and then also you know, the– the fiber. Is that the– is that what you’re talking about in–

Dr. Justin Marchegiani: Yeah.

Thom King: –this nutrition?

Dr. Justin Marchegiani: Yeah, yeah. Absolutely, so, of course like, uhm– vegetables, bone broth, uh– organ meats are incredibly nutrient-dense. If we really look at a lot of the nutrient-density– you know scales that are– that are more out there today, they kind of favor a lot more of the vegetables. But when you’re really lo– and– and they also hinder. They have a negative impact for salts and saturated fat which isn’t really fair because that kind of negates the nutrients that are actually found in an animal products. But once you kind of control for the sodium and for the saturated fat, and you just look at the nutrient, you’d be surprised at how much nutrition’s in like, bacon, or high quality uhm– meat, especially organ meats. It’s pretty insane. Uhm– if you look at the amount of– let’s just say, uhm– nutrition that’s in like, 8 ounces of grass fed meat, you’d had to have 15 cups of kale to equal it. So yeah. So–

Thom King: Wow.

Dr. Justin Marchegiani: –we’re looking at the vegetables, we’re looking at the high quality uh– meats, and even organ meats to a possible, ’cause those are super nutrient-dense.

Thom King: Right. And so, you also mentioned like, anti-inflammatory, like properties of particular food? And, so, I found in uh– you know, in– in a ketogenic lifestyle, particularly uhm– you know, with me, it’s that I’ve been giving a lot of my– I guess fats– some of my fats, put a lot of my proteins from dairy. [Clears throat] you know, whey protein, KCN, and– and stuff like that. What– what are your thoughts on– on dairy and inflammation?

Dr. Justin Marchegiani: Well I think, whey proteins are one of these proteins that tends to be– it’s lowering KC in about 99% KC free and also 99% lactose-free. So most of the negative effects that you’re gonna see in dairy are gonna be in KC and they’re gonna be in lactose, right? You hear lactose intolerance, people can’t break it down. They get bloaty or gassy.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And then KC tends to be the more inflammatory component. So, when you do whey protein, you don’t like get that. Whey proteins are great– are great precursor to glutathione which is just like awesome master antioxidant because the amino acids are so– uhm sulfur-rich. And uhm– you know, I think there’s a lot of like, what’s tonight price talked about, you know, activator X, which is just Vitamin-K2, it’s commonly found in ghee or grass fed butter. So, I think if you’re doing like, those good he– healthy, higher quality dairy thing is better. I think some people tolerate, you know, the milk and the cheese, better is well, especially if it’s raw, unpasteurized, those kind of things. I don’t even do well with that, I get bloaty and gassy. So, I think it’s really individual but if you’re gonna do the dairy, it– you know, you wanna make sure it’s raw, unpasteurized. But I think the– the butter and the ghee tend to be awesome, really good.

Thom King: Interesting. And do you find– do you find that fermented dairy is easier to tolerate?

Dr. Justin Marchegiani: Well I think fermented dairy is gonna be better. But just because you want, you’re gonna have more B-Vitamins and– and more vitamin-K2 and such. I– it just tends to be have more enzymes. Those enzymes are gonna help with the processing of lactose, processing of the KCN. So just kinda like, predigest it a lot for you. So, they– and that’s kind of a benefit, but when I’m dealing with patients like, I’m cutting dairy out initially, but then that’s one of the first things we’ll have back in are gonna be like ghee and then butter. And ghee is just like a more clarified, filtered-out butter. It’s just les K– less KCN, less lactose.

Thom King: Interesting. And then so, don’t you need– you need Vitamin-K2 in order to– to be able to absorb Vitamin– uh– Vitamin-D3, right? Is that right?

Dr. Justin Marchegiani: Yeah but, connect the D3 and then A and then– uhm– Vitamin-K2 is really important. It kind of help escort the calcium into the bone. So, we wanna have healthy, strong bones as well. And then on that note I wanted to highlight uhm– ’cause you’re in– in the– in the sweetener industry, and I know that, you’re kind of like, you’re looking at things like stevia–

Thom King: Right.

Dr. Justin Marchegiani: And you– yeah monk fruit which are really interesting, and I’ve seen a lot of uhm– different videos where people are testing their blood sugar and I’ve seen it not actually go up, I’ve seen it actually drop a bit. What’s been your experience with kind of a healthier sweeteners that are out there?

Thom King: Well, so, I’m like huge on that a collection. And so, part of that data collection is I pull blood continually so–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: I’m trying to see where my blood sugar levels are, I’m trying to see where my ketone levels are. So, and– and plus, since I provide ingredients, you know, to food manufacturers, I always make sure that I’m testing you know some of our sweetening systems and even the compounds we carry on myself. So, like I feel confident when I go in the lab but, you know, that what I’m– what’s going out to the consumer is, you know, is– uh– you know, is healthy or at least they’ve he– healthier options. So–

Dr. Justin Marchegiani: Right.

Thom King: –I’ve– what I’ve done is I’ve– I’ve pull blood sugar, you know, after consuming Aspartame and–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –I’ve pull blood sugar after consuming uh– Sucralose. Uhm– I blood– pull blood sugar levels with stevia and monk fruit. And I’ve found that stevia and monk fruit don’t affect my blood sugar levels whatsoever–

Dr. Justin Marchegiani: Yeah.

Thom King: However, like Aspartame and Sucralose does. And I’m not sure if it’s because of the uh– like dextrose or maltodextrin that they use to, you know–

Dr. Justin Marchegiani: Yes.

Thom King: –to– you know to– to cut it. Or uhm– another theory that I had and I think that this might not be too far off is that, your body– you know, your body recognizes things that are– exist in nature. And you have the ability to metabolize those particular things are recognizes it. And I think when you put something that’s been chemically manufactured like sucralose which is a– chlorinated sugar molecule, uhm– you know, or– or Aspartame which is a modified phenylalanine. You know–

Dr. Justin Marchegiani: Yes.

Thom King: –your body doesn’t recognize those. You know, it’s like, “Hey, this is super sweet, why do I do with this? I don’t know what it is”. So, you do get the– you do get the benefit of calorie abatement. Uhm– but the downside is that your body doesn’t really recognize it and you– it– what’s it say– uh– insulin response. Uh– what the– what are your thoughts on that?

Dr. Justin Marchegiani: Well, I think I’ve seen some of the same date. I’ve known some of the functional medicine docs that have done like, you know, they– on their YouTube page. They said, “Hey, you know, let’s– everyone, let’s a study and let’s test your blood sugar, you know, fasting 1 hour, 2 hours, 3 hours. Let’s compare regular meal then let’s add a little bit of stevia to your coffee or to whatever that drink is, mo– and then monk fruit”. And I’ve seen, you know, it’s not a scientific study, but you know, these studies cost millions of dollar to do–

Thom King: Right.

Dr. Justin Marchegiani: –in a formal setting, so I think this is– this is even better because it is instantaneous.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And I’ve seen people test their blood sugar and then they post their data really showing it didn’t go up, if not, dropped.

Thom King: Hmm…

Dr. Justin Marchegiani: And my– my big concern is I think it’s– I think it’s a viable alternative, and it’s something that I use sparingly.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: The question is, is there like a dose-dependency where you frequently added so much, or maybe there starts to becoming a problem because you are telling your brain sweet. Now in punctuated periods, you know, 20% of the time, 10% of the time, it’s probably okay– do you find if it’s– if it’s frequent all the time that you’re starting to increase insulin or your blood sugar may go up over a longer period of time?

Thom King: Uhm I have not found that to be the case with myself. So–

Dr. Justin Marchegiani: Okay.

Thom King: I actually use bo– uh– we have a proprietary sweetener called KetoseSweet– uh KetoseSweet+. And it’s actually a blend of allulose, uhm– stevia and monk fruit.

Dr. Justin Marchegiani: Allulose is that new sugar alcohol I’m seeing? Couple places do. I wanna hear on that later on. I’ll– I’ll plant the seed now, we’ll– we’ll come back to that. That’s great.

Thom King: Perfect. That’s– that’s ___[12:00] sweeteners, so, you know, and I– wha– I’d noticed this over the past few years, you know when I really, you know, became a– committed to leading a ketogenic lifestyle, that my– uhm– my desire for sweets actually went down quite a bit, and foods that I would normally have eaten before, uh– you know, before I– I started keto, uhm– just don’t– they taste way too sweet to me. Like some of the bars that I used to eat, super sweet. So, I think that your palette shifts uhm– you know when you engage a– uh– a keto diet and you don’t–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –have the desire to– to have the– you know–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –have stevia or monk fruit. As far as like dosage levels go, uhm– I mean, we’ve got scientific papers that we use in conjunction with you know, with a formulation, and we– err– generally suggest that people stay under 5 to 10 grams of– of stevia or monk fruit, uhm on a daily basis. Uhm– and that is a lot– that’s a lot of stevia and a lot of monk fruit. But–

Dr. Justin Marchegiani: Totally.

Thom King: But– you know, at that point ’cause I’ve dosed myself to that level and I’ve dosed myself to a hundred grams of erythritol, I’ve dosed myself to a hundred grams of uh– uh– allulose and so, I mean, I’ve tested blood sugar levels and– you know, also, you know jotted down notes on– uh– you know, like GI effect, because if you have too many like alcohol sugars, it can definitely cause bloating cramping, diarrhea, uhm– which you know, nobody wants.

Dr. Justin Marchegiani: No, that totally make sense. And I’m just curious, so, I like to also see– I’ve seen that as wll with the blood sugars not going up. I really like to see what fasting insulin’s doing. Is insulin for– potentially compensating at any level at all? Is insulin rising even though blood sugar’s dropping? Maybe insulin’s rising to compensate for that? I just precarious, you have any data on that?

Thom King: I don’t have any data on that. I mean, I would certainly collect data on that. Is there– is there a way to test for– for T4 and T3 uhm– like a home kit or something like that without having to go in and pull blood?

Dr. Justin Marchegiani: With T4 and T3, yeah there’s a couple of lab CRT and already in Valley lab’s definitely have them. And insulin I think you— I think you probably just have to just get like a– a ___[14:21] to have that done.

Thom King: Yeah.

Dr. Justin Marchegiani: Go everything in there with– I be curious, but I– I do know that those are gonna be things that typically don’t increase the blood sugar as much. Now one thing I– I do notice though is that some people that may have a negative experience, and I’m seeing just a lot of maltodextrin and corn sugar–

Thom King: Hmm.

Dr. Justin Marchegiani: And some of these sweeteners. What’s the deal with that?

Thom King: Uhm it’s cheap. [Laughs] So, any time you–

Dr. Justin Marchegiani: Does that defeat the purpose though? I mean, people are– are consuming these products to avoid sugar and then you have sugar in it. Which is like, “What?”.

Thom King: Well, I mean, it– it’s that– I think that that’s typical and, you know, in food manufacturing.

Dr. Justin Marchegiani: Yeah.

Thom King: That– you know, [clears throat] there’s– it– it’s tough ’cause it’s the– you know, people are trying to keep an eye on their cost of good sold, right? They’re trying keep high margins and– and the food that they’re selling. And– and maltodextrin and dextrose are so cheap that it’s easy, you know, it’s easy to use that as a– as a uh– as a filler or a bulking agent. So, uhm– you know, when you– when you look at typically like a high-grade sucralose, it’s gonna be 700 times sweeter than sugar. So you can’t really put something 700 times sweeter than sugar into little pocket, uhm– because– it there be a minute such a small amount you wouldn’t be able to actually detect it. So, you do have to use in those particular situations bulking agents. And so for larger, you know– uh manufacturers that don’t have, you know a contingency of consumers, uhm– you know that lean into natural uhm– they’re not even gonna question, you know, maltodextrin. But–

Dr. Justin Marchegiani: Right.

Thom King: ___[16:02] getting to your– to the point of– yeah, it’s completely counter– counter productive and counterintuitive to add back sugar into something [laughs] you’re trying to cut the sugar out. Well, so, yeah, it’s ab– absolutely 100%.

Dr. Justin Marchegiani: It seems like on a liquid, you’re probably have more ability to– to manipulate that because it’s a liquid, right? You can use a glycerin or some kind of liquid carrier that– you know, you don’t need a certain– a– a bulking if you’re using liquid drops. So, I’m just curious, uhm– what’s the alternative if you are trying to– to get it in a powder. Which are company using what have they found to be better.

Thom King: Uhm– we use lots of different, you know, uh– uh different sweeteners and different sweetening systems depending on what uh– you know, depending on the– the functionality in the outcome that the customers looking for like–

Dr. Justin Marchegiani: Can’t we rate down the ingredients in your keto-sweet product?

Thom King: Sure. So, uh– we have a product called a KetoSweet+ and it is– it’s allulose, stevia and monk fruit. And we have it both in a powder form, and we have it also in a liquid.

Dr. Justin Marchegiani: Is there a bulking agent with though with that at all?

Thom King: That’s the allulose. So, we usually–

Dr. Justin Marchegiani: Oh.

Thom King: The allulose is the bulking agent ’cause allulose is only about 70% of sweetened sugar. So–

Dr. Justin Marchegiani: I see.

Thom King: — in order to get to parity with sugar, we add stevia and then we add monk fruit as well. And so what we found is that, the combination of stevia and monk fruit actually mask each other’s off notes. Uhm– which is–

Dr. Justin Marchegiani: Aaahh.

Thom King: –super interesting. And then, you know, adding those two high intensity sweeteners to allulose which is 70% is sweetened sugar brings it to parity. So, our liquid– our liquid– KetoSweet+, I’d say you can compare it to like DE-42 high fructose corn syrup, or like–

Dr. Justin Marchegiani: Yeah.

Thom King: –any of like kerol or syrup that you would like, you know at the store. Uhm– and then, the– the powders just– very-very similar to sugar. Uhm– it’s not a sugar alcohol, it’s actually considered– still considered a saccharide, uhm–

Dr. Justin Marchegiani: Okay.

Thom King: So, think fermentation. So basically–

Dr. Justin Marchegiani: Yes.

Thom King: Uh– allulose exist in nature in small amounts.

Dr. Justin Marchegiani: Yes.

Thom King: It’s been considered a rare sugar.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: And so, basically, take a– uh– fructose molecule and you treat it with an enzyme. So think fermentation.

Dr. Justin Marchegiani: Yup.

Thom King: And then, metabolite after that is a rare sugar called allulose. So– in allulose, your– you know, your– your body recognize it, recognizes it because it exist in nature. But your– because it’s been– you know, because it’s been enzymatically treated, your body is unable to metabolize it. So, it just basically goes through urine and feces and doesn’t affect blood sugar levels or uh– ketones. And what I have found is it actually drops your blood sugar levels slightly. Uhm– and I think it’s because of the enzymes that are used to– to manufacture that. Uhm– the beauty of the allulose, is its functionality. So, it participates in mallard which is the interaction of proteins and sugar that causes uhm– or creates a ___[19:13]–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: So you’re using it in the baking process when you are making cookies or a cake, you’re not gonna get something that’s like brick, you are actually gonna get something–

Dr. Justin Marchegiani: Right.

Thom King: –that’s you know, crispy on the outside, fluffy and moist, you know, in the middle. So, it has that functionality and, I mean, to me, this is gonna be most definitely a– a game changer.

Dr. Justin Marchegiani: So, this– this allulose– and I have a couple of dark chocolates too that I– I do consume that are very low sugar that have allulose as this kind of sugar substitute. So I am seeing that catch on. And allulose is not in the same family, it’s like a paleo like– like xylitol or erythritol–

Thom King: Yeah.

Dr. Justin Marchegiani: –this is a– a polysaccharide you’re saying?

Thom King: It is. So, it’s actually a– [crosstalk]

Dr. Justin Marchegiani: Yeah?

Thom King: It– well, it’s actually a monosaccharide.

Dr. Justin Marchegiani: Monosaccharide is in the sugar?

Thom King: Yeah, but it’s not– but it– yeah, it’s definitely not at all like– like an alcohol sugar like xylitol, or maltitol or any of those–

Dr. Justin Marchegiani: And you don’t get any bloating if you consume too much?

Thom King: Uhm– I’ve dosed myself to a hundred grams, which is like err– like, 4 times which you, you know, you should be taking in, probably even more than that. And what I noticed is that, I had– it created some gas but it didn’t create like cramping or laxation. Uhm, I think that whether was happening is a level of fermentation. So, there’s probably some, you know, some bacteria in my gut that’s metabolizing it and–

Dr. Justin Marchegiani: Yeah.

Thom King: –off-gassing, but it wasn’t anything serious. And a hundred grams of that is a lot, like you have to force yourself to get it at your body.

Dr. Justin Marchegiani: Yeah, that’s like 3 and a half ounces, that’s– that’s a decent depth for sure.

Thom King: It is. And so, at that point, I would say don’t exceed that. I would say if you’re going to use allulose or something like that, uhm– you know, not to exceed maybe 15 or 20 grams.

Dr. Justin Marchegiani: Okay. Let– it makes a lot of sense. Uhm– anything else you wanted to highlight regarding other sweeteners? Is this the only major sweetener you have, or do you have any others like, what’s your opinion on like the birch bark xylitol? Any other opinions on the sugar alcohols, anything else you carry similar to that?

Thom King: Yeah, we carry all of the sugar alcohols, we carry xylitol, we carry–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –uh erythritol, and I mean, right now, erythritol is probably our biggest seller like we have an erythritol stevia blend, and we are able to process it in a natural powder so it dissolves into solution better, uhm– you know, companies that manufacture bars that are sort of extruded process, are able to use that sweetener, you know, ’cause it– it does dissolve uh– easier, so, in my opinion, like– so I have worked quite a bit with paleo’s, uhm– paleo’s have a tendency to increase water activity in the lower intestine.

Dr. Justin Marchegiani: Yeah.

Thom King: Uhm– which is– which can lead to bloating, cramping, diarrhea, uhm– xylitol I find, I mean, when you start talking about the m– maltitols of the world.

Dr. Justin Marchegiani: Yes.

Thom King: Maltitols of the world, the laxation effect that those had is pretty extreme.

Dr. Justin Marchegiani: Right.

Thom King: And I would say away from those unless you have really doped up the tolerance to sugar alcohols. Uhm– xylitol is a little less, but still pretty intense. If you over consume xylitol, you’ll definitely get a laxation effect. And I would say that the least, the– the sugar alcohol that has the least amount of– of uhm– of GI impact is gonna be erythritol.

Dr. Justin Marchegiani: Okay.

Thom King: And I think I would still recommend that people stay under 15 grams of erythritol per day.

Dr. Justin Marchegiani: Mm-hmm. Yeah, I think the big issue with a lot of these a m– m– mo– most are gonna come from uh– GMO corn. So, you could potentially get that round up– or that– that– that glyphosate pesticide uhm– potential trace in there as well which is common with a lot of the corn processing.

Thom King: Right.

Dr. Justin Marchegiani: Like the birch park, tends to be a little bit more of uhm– let’s just say the unadulterated form.

Thom King: Right, yeah. And we– you know, we– we have very– every one of our raw ingredients that comes in, uh– third party tested. So, and I mean, if you guys are– like any of your audience are gonna do business with, you know, with a ingredient company, you should actually 100% demand third party testing and see evidence of a thrid party testing. And part of our third-party testing is to test for like a GMO protein indicator. So, we’re always looking at, you know, we don’t anything in-house that’s GMO at all.

Dr. Justin Marchegiani: Interesting. I’m just curious, what are you finding in the– I mean, I’m not saying you guys did this but what have you found in the past when you started testing these things, did you find any of the round-up residue, did you find any lead or metals or mycotoxins that kinda– can you give us some of the bad stuff you found, in the past?

Thom King: [Laughs] Those are awesome questions. Uhm– and that is why we started doing third party testing. So, uhm– you know, I would say 10 years ago, when we just started getting into third party testing, we would find crazy, like shovel handle, uh– glove, like all sorts of adulteration in the products that we are getting.

Dr. Justin Marchegiani: Hold on, I wanna make sure I heard that. So, like, meaning like, particulate of a shovel handle? Particulate?

Thom King: No, I mean a shovel handle.

Dr. Justin Marchegiani: Like an actual piece of it in there?

Thom King: Yeah. And–

Dr. Justin Marchegiani: So, okay– I think the whole handle, you mean?

Thom King: No, probably 68 inches of the shovel handle.

Dr. Justin Marchegiani: Oh, my gosh! How does that happen? Like it’s crazy.

Thom King: I have no idea, or in the glove, like we found the glove, and–

Dr. Justin Marchegiani: Okay, got it.

Thom King: –so, I mean, a lot of these things– you– I mean– we– we do visual testing, so every– you know, all the raw– and this is back in the day. And we– we you know, we would– obviously not use those particular ___[24:51] after that, but anything that we bring in now goes into QC’s cluster. And we– you know, and we send it out for third party testing which test for heavy metals. Uh– test for Coliform, you know, various like yeast–

Dr. Justin Marchegiani: Yeah, bacteria.

Thom King: Or– uh– pe– uh– petrochemicals, uh– GMO protein indicators. So– we– we tested all that way, and I would say that our current blenders that we have in place, we don’t generally run into issues with them, uhm– I like to also add that everything that comes in and goes out of here runs through a metal detector. Uhm– you know, so, we– you know, we’re able to– to pull anything out that maybe the smallest piece of uh– of metal that, you know, got into it.

Dr. Justin Marchegiani: Yeah.

Thom King: But, uhm– when we– so when we start vetting new ingredient suppliers, I mean it’s a pretty– it’s a pretty rigorous uh– uh– task for them, you know, they have to give us all of their documents, their organic search, we send it off for third party testing, uhm– we will bring in, you know we could just bring a load from them, and then all of that gets tested. So, uhm– I wish more companies did that, because we’ve had products coming through our warehouse once we send ’em to third party, boom, they’re out of our warehouse and it’s like, no, this isn’t what we ordered. So, everything has to fall within a spec. And I would– it was really highly encourage, your– your listeners, to– I mean, and I know that they’re probably are getting a lot of their supplements through you and you’ve already vetted those companies, well I would say, oh, my God, like, I would say that, we’re just sweeteners. So, this is like, not a big deal but when you start looking at companies that are selling supplements and they’ve got a lot of compounds going in there, it– absolutely everything should be third party tested because I know in the supplement industry, 75% of the supplements out there don’t even contain any active compounds.

Dr. Justin Marchegiani: I agree. And this is a problem and that we test all of our– raw ingredients independently and I found increases in lead and some of these–

Thom King: Oh yeah.

Dr. Justin Marchegiani: –raw material back, and that can happen, of course, you know, you just over time find out who the best ones are–

Thom King: Right.

Dr. Justin Marchegiani: –where the qualities at. And then so you are also testing for like, round-up and or GMO type of contamination as well?

Thom King: Yeah, and I mean, in petrochemicals and heavy metals. So we test–

Dr. Justin Marchegiani: Oh.

Thom King: –for cadmium and lead, and, I mean, we’ve had products come in specifically from China which is kind of interesting, uhm– you know, that are showing up super high in cadmium and lead.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: So, we do– I do a ton of formulation for companies. So companies will send us their product then in order for us to push it through our queue– our-our RND, uhm– we’ve gotta have ___[27:35] and then we also get that third party tested. And I found that, there’s a lot of P-Protein, uhm that is out of China that is super high in lead. And–

Dr. Justin Marchegiani: Oh.

Thom King: –I think it’s just because of the amount of the petrochemicals that get better in the air and then settle out into the soils. So, uhm–

Dr. Justin Marchegiani: Yes.

Thom King: Yeah, so we test– we test for– yeah, we test for all of those things–

Dr. Justin Marchegiani: Totally

Thom King: Uhm– you know, and– occasionally we find something but– at the more rigorous our– our testing has become, the more we are able to weed up the suppliers that are unscrupulous.

Dr. Justin Marchegiani: Yeah, very good. Now we talked a little bit earlier about in some of the benefits of being ketogenic earlier on the thyroid. I wanna just kinda peg you back to that because you are asking me some questions in the pre-interview like, you know, who’s gonna benefit from the ketogenic diet on– on the thyroid side? And this is a question I get a lot because you have some data– uhm, people saying, “Well, I– my thyroid gets worse or weaker on a ketogenic template and some gets better”, and I think a lot of it has to do with how insulin-resistant, how numb someone’s cells are to insulin. So the more numb you are to insulin, your body has to compensate by making more insulin to overcome that numbness. And I think that’s the big issue and kind of the physiological imbalance that’s driving a lot of issues with people’s heath and thyroid, and finding healthier sweeteners like you mentioned, getting the carbs down can really dese– uh– really increase the sensitivity, meaning it lowers the insulin–

Thom King: Mm-hmm.

Dr. Justin Marchegiani: –and that allows thyroid conversion to happen better because insulin’s a big blocker of thyroid conversion if it’s too– too high. Just answer that question.

Thom King: Right, yeah. And I mean, I found that with my– with myself. So, I was carrying about 35 lbs of extra– uh– of extra weight. And I mean I was definitely insulin– uh– resistant. And so, I did show a depleted T4, uhm– you know, when I started, and then that T4 leveled out. Uhm– but I’m not sure like on a– real long-term basis, uhm– how the thyroid will be affected, I mean, I test– like I do a batch test and–

Dr. Justin Marchegiani: Yeah.

Thom King: –and like I do full blood panel batch test and then I also uhm– do stool sample once a month–

Dr. Justin Marchegiani: Yup.

Thom King: –to track my microbiome.

Dr. Justin Marchegiani: Okay.

Thom King: So, yeah, I’m like, really– so I’ve really found some interesting stuff in this data collection that I’ve– have done. But I found that the ketogenic diet really did help my insulin resistance so I became more– more sensitive but you know, another– I– I would have like a question I guess, have– have you do you have any experience with uh– berberine with your patients?

Dr. Justin Marchegiani: Yeah, I mean, I use berberine a couple different ways. Uhm– with some patients it’s typically used in my SIBO-clearing programs where we’ll try to knock down SIBO or bacterial overgrowth.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: And this– a bunch of different berberines, Goldenseal, ___[30:29], Barberry, you know, those kind of things. Obviously, yeah, berberine HCL. Uhm– but berberine’s also a really good insulin-sensitizing compound. It can really help lower your blood sugar, and– and lower your insulin levels. So there’s some really good benefits there as well.

Thom King: Right, ’cause I added that as a supplement and I almost wonder if that was, you know, if that really helped me become more uh– you know, more sensili– sensitive to uh– to insulin. And another thing too, is I’d like to hear your thoughts on– on Metformin.

Dr. Justin Marchegiani: Yeah, I think uhm– berberine kind of works similar, in a similar way it helps us uh– on the insulin sensitizing side. Metformin ‘s gonna work more by decreasing like the glucose absorption in the gut, and then it also kind of shuts down gluconeogenesis in the liver. Uhm– part of that decrease in the glucose absorption though, it can also decrease the absorption of B-12. So, if you’re on Metformin or Glucophage, you really wanna be on some supplemental B-12 on top of it. Uhm– and then, you know Metaformin’s relatively natural like the extract from Metaformin comes from the French Lilac flower, so it’s–

Thom King: Mm-hmm.

Dr. Justin Marchegiani: –it’s kind of on the natural side, uhm– but I tend to like be more impartial for like the Berberines and the other more nutrient-based insulin-sensitizing compounds. But if people are on it, you know, you just gotta make sure the B-12’s dialed in there too.

Thom King: Interesting. And do you feel like getting a B– uh– B-12 supplement with it or just increasing the amount of like– of– of uh– like organ meat would– would suffice?

Dr. Justin Marchegiani: I would just be a– I just make sure you’re on at least a good Malt tea with some extra B-12 on top of a really good diet.

Thom King: Interesting.

Dr. Justin Marchegiani: A– a– and again you can monitor that with you functional medicine doc like, you know, I like methylmalonic acids are really good tests to look at to assess your B-12 levels. Whien methylmalonic acid goes high, that actually means lower B-12, right? Methylmalonic acid gets metabolized to succinic acid. And so you need B-12 to make this conversion happen. So if there’s not enough B-12, methylmalonic go– acid goes up, if you don’t have that B-12 that convert it. So, let’s ___[32:31] if people are gonna be on it, you wanna be careful because, you know, lo– low B-12 can cause, you know, alzheimer’s dementia-like symptoms.

Thom King: Interesting. And then so, do you find like with your patients, that– that taking– taking these vitamins and supplements orally and/or do you feel like there’s greater efficacy in IV’s?

Dr. Justin Marchegiani: Well the– I mean, I think IV’s are good, the problem is they’re impractical for people to do daily, that’s the only issue.

Thom King: Mm-hmm.

Dr. Justin Marchegiani: Just because uhm– you know, people got a work, they don’t have, you know, 30 or 40 minutes to get drip in there, and that can be more expensive but–

Thom King: Right.

Dr. Justin Marchegiani: –uh– Iv’s here, they I think can be really good but, ideally you want good food and supplements are those easier take–

Thom King: Defenitely.

Dr. Justin Marchegiani: And that’s the big benefit. If I see patients that do a lot of gut issues then we will go on the– s– the sublingual B-12 side, and that can really help too because it can kind of get more of the absorption via the oral mucosal kind of buccal tissue versus the gut, and that can help too.

Thom King: Wow, awesome. [Laughs]

Dr. Justin Marchegiani: And then I’m just curious–

Thom King: Yeah.

Dr. Justin Marchegiani: What other– like what other key things, you know, you wrote the book, Gu– uh– uh– “Guy Gone Keto”, and you also–

Thom King: Great.

Dr. Justin Marchegiani: –come up some of these great sweeteners. What other cool tools are out there that you found kinda as– in your transition to a healthier diet, and making a lot of these health thing you think really impacted you?

Thom King: I would have to save the th– the thing or modality that had the greatest impact or what I found was the– the– the– lent itself to the success that I had was probably journaling. So, you know, that is– w– you know– and being mindful. So, when– when I get up in the morning, one of the first things I do, grab a cup of coffee, sit down and I start to journal, and you know, I journal with real intentions of things I wanna manifest. Uhm– you know, I do some data collection like my weight and blood pressure. Uhm– so, I think journaling was really-really-really huge. And really taking time to do that first thing in the morning sets the– sets the stage for your day. And then within that, I incorporated what I called “My Arrow of Power”.

Dr. Justin Marchegiani: Yup.

Thom King: Uhm– journaling, run, cycling, you know, I do try, and then you know, every other day, I do yoga and then I finish out my workout with a meditation. Uhm– and I think that those real things can actually helped me the most.

Dr. Justin Marchegiani: That’s really good to hear, that’s excellent. That sounds like something like a little Tony Robins kind of morning progress. That’s what it sound like.

Thom King: [Laughs] I’m totally influenced by Tony Robins.

Dr. Justin Marchegiani: That’s cool. And then I’m just curious too, just kind of piggyback on a couple things, where do you guys source your Allitol from the mean like– not like what company but like, wh– what’s the raw ingredient it comes from?

Thom King: You mean the allulose?

Dr. Justin Marchegiani: Yeah, I’m sorry, Allulose. I said Allitol– Allulose. Great.

Thom King: I don’t know but that’s a weird interesting compound. That’s not like the– the mix of– [laughs] of– erythritol and allulose.

Dr. Justin Marchegiani: Exactly, exactly, totally.

Thom King: Uhm– so, we– so I’ve been working woth allulose for the past five years and part of it was so new, uhm that the supply chain really wasn’t there.

Dr. Justin Marchegiani: Yeah.

Thom King: And we weren’t really able to verify stuff, so we won’t add– we won’t add something as an ingredient unless we’re– unless we’re 100% confident that the supply chain is solid, and also reliable like everything is– that arrives is within spec. So, the– the allulose, you know, we’ve got 3 different suppliers, and all three of those suppliers uhm– are using non-GMO uhm– corn fructose uh– substrate to– to enzymatically create the allulose.

Dr. Justin Marchegiani: Got it. So it’s corn fructose but it’s GMO-free and– and ___[36:11].

Thom King: Great.

Dr. Justin Marchegiani: Are they able to separate the– the sugar from the protein component pretty well?

Thom King: I think so, I mean– ’cause when we third party test, we’re not showing any proteins. Uhm–

Dr. Justin Marchegiani: Oh good.

Thom King: So, I mean I– I– I don’t have any reason to believe that there’s any problems with the– the– with them separating it. I know that they use like what’s called resin– resin column uh- filtration. So it pulls out like any of the pure– the– the impurities of– so– yeah, I mean we’ve been working with it for a while, and we third party test it and we haven’t found any– you know, any proteins in it to indicate that there’s, the– you know, the genetically modified uh– corn was used in that process.

Dr. Justin Marchegiani: So someone was gluten-sensitive and one of the ___[36:55] out, you’d feel like it would be filtered enough, it wouldn’t be a problem for them?

Thom King: Uhm- well, we’re also uh– allergen free– uh– facility, so we always test for– we test for gu– uh– you know, gluten? Uhm– and absolutely the allulose is gluten-free.

Dr. Justin Marchegiani: Good. And if they were sensitive to corn, like the corn protein like the zein protein, you feel like it’d be– it’d be filtered enough for there wouldn’t be an allerenic reaction to it?

Thom King: Yeah, I do, well, ’cause we test for proteins and there’s no proteins– there’s no proteins left in there, so I would– I would feel confident thst, uhm– yeah, that, that people, they are sensitive to that but not, you know, be affected by it.

Dr. Justin Marchegiani: Very cool. Well, we’re gonna have to put some links down below where people can find the KetoSweet+ formula–

Thom King: Oh.

Dr. Justin Marchegiani: Anything else Thom you wanted to highlight for the listeners here?

Thom King: Uhm– no, not really. You– we were the– the questions you asked worked totally through, and I appreciate that.

Dr. Justin Marchegiani: I appreciate you comin’s on. Anything else you wanna leave to listeners with for just– how– how they can find more about you and more about your products too?

Thom King: Uhm– well if you want to get a copy of the book, and we also have uh– we released a line of ketogenic uh– condiments like ketchup, barbecue, sauce–

Dr. Justin Marchegiani: Oh, cool.

Thom King: And– teriyaki sauce. And so, if you just go to guygoneketo, you can find all of that.

Dr. Justin Marchegiani: Right.

Thom King: Uhm– you can reach me through that too. Uhmm– all of the social medias under this Thom King, T-H-O-M, K-I-N-G. Uhm– reach out to me if you ever got– if you ever have questions. If they want to buy the KetoSweet+, I think kwe– the KetosSweet+ is available on the guygoneketo site. It’s also available on, that’s S-T-E-V-I-A “dot com” that’s we have all of our compounds on there available for retail. And if they wanna see what kind of madness we’re up to in the– in our lab, they can go to and follow us on linkedIn and you can see some of the craziness that goes on in our lab, things we’re inventing.

Dr. Justin Marchegiani: Very cool. And is it possible the coke with the KetosSweet+?

Thom King: Oh, absolutely, yeah. So, it does– it does actually participate in maillard at lower temperature, meaning that uhm– like with sucrose or table sugar, you– you’d probably about a hundred and forty-five–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –to a hundred and fifty-five as when it starts to caramelized, and you’re gonna noticed that you’re gonna get that a little sooner with the uh–

Dr. Justin Marchegiani: Mm-hmm.

Thom King: –with allulose, probably in the 130 to 135 range.

Dr. Justin Marchegiani: Mm-hmm, mm-hmm.

Thom King: So, probably wanna bake it and cook at little lower temperature for a little– e– extended period of time.

Dr. Justin Marchegiani: Mm-hmm.

Thom King: But then, you know, other than that, yeah, you can– cook and bake just like you would for a sugar.

Dr. Justin Marchegiani: Awesome Thom, well, thanks for all the great information here today, appreciate it. And you have a phenomenal day.

Thom King: Thanks, you too Dr. J., thanks for having me on.

Dr. Justin Marchegiani: Thank you. Bye now.

Thom King: You’re welcome.


Leaky Gut and Autoimmunity – Dr. J. Podcast #161

Dr. Justin Marchegiani and Evan Brand dive into a discussion about the link between gut infections and autoimmunity. Gain knowledge about leaky gut, how it occurs in the body and it’s connection to Hashimoto’s.

Explore the different stressors which affect gut health and contribute to a weakened immune system. Learn about Dr. Justin’s 6-hour template, which includes his expert recommendation regarding healing, nutrient and supplements.

In this episode, we cover:Leaky gut and autoimmunity

00:34   Leaky Gut and Autoimmunity Connection

04:05   GABA and the Blood Brain Barrier

06:48   Hashimoto’s and Gut Health

12:23   6-hour Template

22:40   Thyroid Health: T3, T4




Dr. Justin Marchegiani: Hello, ladies and germs! Dr. J in the house. Evan, how we doing, man? How was your Holidays? How’s your Thanksgiving?

Evan Brand: Holidays were great. Let’s dive in. I know we’ve got a short limited of time. But we’re doing this on the fly because this conversation of gut health and gut infections and autoimmunity is huge and hardly anyone is talking about this. Conventional doctors don’t have a clue about the link between gut infections and autoimmunity, so dude, let’s dive right in.

Dr. Justin Marchegiani: That sounds phenomenal. So we talked about in the show, kinda chatting about leaky gut and autoimmunity, which is really important because leaky gut is kind of like one of the primary mechanisms of autoimmunity kinda starting, which is kind of gastrointestinal permeability cells in the gut called the tight junctions. They start to unzip, kinda like you unzip your coat on a hot day and undigested food particles can get in there in this kind of creates this uhm— cascade of reactions call molecular mimicry, where certain food proteins— the surface proteins on these foods are similar to surface proteins of the thyroid or the brain or the pancreas, the beta—the beta cells of the pancreas, whatever. So you have this kind of immune system getting primed to similar proteins in foods which then prime the immune reaction for the immune system. It starts attacking these tissues in the body. So that’s kinda one of the first defenses is this autoimmunity leaky gut, molecular mimicry and that while they gut’s leaky, you have undigested bacterial compounds also getting in there, too. And then kinda just perpetuate and windup that immune system. And then also make it prime to—for other infections that kind of slip in there because the immune system now has weaken. Other infections can slip in. And typically, we’re gonna have a lower stomach acid environment so you’re gonna have less sterility in the stomach coz that low pH really prevents a lot of bacterial and critters from growing. But now that pH is like, you know, it’s like walking over to the dirty picnic tables and normally you spray it down with maybe some bleach. Or let’s say in a healthy version, maybe a really good antimicrobial essential oil. But now, we don’t have that because of the stress from the gut.

Evan Brand: Yup. Well said. Now, Hashimoto’s for example, is probably most common autoimmune condition that we’re going to see and deal with and that probably you guys listening are aware of. Leaky gut has to take place for Hashimoto’s to happen. That’s one of the dominoes that happens. So you’ve got the leaky gut situation. You possibly got the gluten in the diet. You got the immune stress, which could be internal or external. So bad boss, bad spouse, bad relationships, bad job— those are kind of the big dominoes we see. And when you all those up together, that’s how you get autoimmune disease. It’s really just that simple.

Dr. Justin Marchegiani: Totally. And then we have people on the live chat here. And again, this is a great reason why you should subscribe to our YouTube channel—justinhealth. Uhm because we have these podcast going live as well and we’ve also incorporated other technology in the background to get a higher quality audio versions. So if you want better audio, you can subscribe to Youtube, but also check out our podcast uhm—Evan Brand, notjustpaleo and then beyond wellness radio myself. So just keep that in the back of your head. And then your question was—I just missed it. We talked about—Oh, yeah! Leaky brain. Leaky brain is connected as well coz we have these live questions coming in. And so we are multitasking like it’s no tomorrow. So leaky brain’s important because we have these called astrocytes or the brain blood or the blood brain barrier which is kind of the interplay between systemic blood and then the passing over to the brain. And we have the cells called astrocytes. And again, same thing, when we have gut lining integrity, it tends to affect integrity of the lungs, integrity of the sinuses, integrity of you know, vaginal wall area, urinary tract. So you have people that have gut issues—gut integrity issues. It almost always can cause sinus issues, brain fog, brain issues, UTI issues, bladder issues, right? So you have all of that mucous membrane barrier, it’s gonna be compromised throughout the body not just the gut. But the guts kind of that first major domino that falls and then everything else tends to follow along with it.

Evan Brand: What you think about the GABA test for the blood brain barrier, where you take like a 500 mg GABA and if it works and you get relaxed, that says you have a leaky brain. Do you agree with that?

Dr. Justin Marchegiani: I’m not sure I buy that because I’ve seen people that do—that are really healthy and that do well with GABA.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And they, you know, symptomatically, they’re doing pretty good. They’re eating well. Again, certain supplement companies have kinda put that out where they have a GABA challenge. They say, “Hey, GABA is this really big amino acid compound and it shouldn’t go through that blood brain barrier; therefore if it does, that means your major blood brain barrier is permeable.” I’m not sure I buy that. I think it’s something to keep in mind, something to try. I have a lot of patient that have gut issues and they’re sick and that use GABA or will only give them GABA and they don’t notice much benefit either.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So, you know, how do you sparse that? That’s hard.

Evan Brand: I know. Who knows, man. That’s a good question.

Dr. Justin Marchegiani: Everyone tries to be a little bit trendy and nuance in this functional medicine field.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Because they wanna make a name for themselves.

Evan Brand: Yeah.

Dr. Justin Marchegiani: And I get that from a marketing perspective, but just looking at the clinical application, I’m not sure there’s ton.  But, heck, if you have GABA and you want to try it and you get uh—benefits, that’s great. I notice a little bit of improvement with GABA. Like when I take it, I feel little but relax. I also do that with Ashwagandha as well. I feel it with magnesium. Someone chimed in and asked if magnesium can be taken with Ashwagandha. Yeah, sure. I’ve no problem with that.

Evan Brand: Works great.

Dr. Justin Marchegiani: Hope everyone’s listening had a great Thanksgiving, too.

Evan Brand: Yeah. Tesa wants to know, “Have you reversed your Hashimoto’s, Dr. J, by healing the gut?”

Dr. Justin Marchegiani: Well, so we have to be careful when we say reversed, right? So have we decrease the inflammation? Have we address underlying issues that made people susceptible to having autoimmune attack? And we—can we lessen those and decrease them to the point where we are no longer symptomatic because we have the inflammation down or quench enough? Yes. I’m just very careful because you know, eyes in the skies and people listening in they’re— they’re looking for that the cure the cure-all word, right? We just got to be careful. We don’t cure anything. We support the body’s ability to—we support the underlying stressors that cause the issue to begin with. And we support the underlying systems that weren’t functioning well. And then the body can start to get these symptoms under control because the symptoms are just a manifestation of the symptoms— the systems not working. Symptoms occur because systems aren’t working. Systems breakdown because of underlying stressors. As functional medicine doctors, we come in, we fixed the underlying stressors, we support the systems that aren’t working and then the body starts to heal itself, right? The body’s on autopilot. We just got to get the stressors in the systems work. If the system’s working, then get the stressors out of the way.

Evan Brand: Yup. Well said. So you had some— you had some gut bugs and things going on, do you care to talk about your story for a minute with the – Hashimoto’s?

Dr. Justin Marchegiani: Yeah. I have—I have a low level of Hashimoto’s kinda in the background, I had elevation antibodies TPO and thyroglobulin antibodies and you know, I had some adrenal stress going on. And I just really worked on fixing the gut issues, which I had a handful parasites—Blasto, uhm— yeast, significant yeast overgrowth and H. pylori. Addressing those, fixing nutrient issues to help with the antibodies, fixing the digestion, fixing gut bacteria balance is of course working on stress reduction, sleep, all those important diet and lifestyle things. And again, the antibodies for me are just still slightly elevated, but there they’re in a range where you know, functionally my thyroid is not beaten up to the point where I need any thyroid hormone. My TSH is in a pretty good place and my T3 levels are pretty good. I actually have to go on for test real soon. So, yeah, I mean it’s possible to—to address the stressors and the system dysfunction to the point where you may not— you can call yourself cure. We just won’t call you cure for me, a functional medicine perspective.

Evan Brand: Yeah. Agreed. I need to get my thyroid panel run to. You’ve been pushing me to do it.

Dr. Justin Marchegiani: Yeah. You should.

Evan Brand: I need to do it. I mean you and I both have had these infections. I had H. pylori as well. I had a Crypto, Giardia and yeast and Pseudomonas Aeruginosa.  So, you know, that’s a fun thing about Justin and I. We both had all the things that we deal with in the clinic. So when you guys are looking to work with somebody, it’s— to me it’s a lot more honorable if you’ve had somebody that’s been in the trenches themselves, where we had to fix us to keep going to help other people. I think that’s always pretty cool. Uhm— what else I know we would have limited time, but what else should we mention here about kinda this autoimmunity piece, the gut piece. We mentioned the leaky gut, we mentioned some of the triggers just in a roundabout way. So Candida, bacterial infections, parasites, H. pylori, low stomach acid, gluten in the diet, dairy, possibly eggs, other food sensitivities. These could all contribute to that permeation of the gut barrier; therefore, causing the situation.

Dr. Justin Marchegiani: Hundred Percent. So, let me just kind of answer some of the things that you’re talking about while injecting some of the live questions we get. That’s the reason why the show is so unique compared to other shows coz we are off-the-cuff. This is the real deal here. So some patients are talking about having a lot of mucusy stools, right? And uhm— wanting to know where they should go for help, right? Of course, I recommend coming to see either myself or Evan, but typically one, we want to make sure food allergens aren’t driving this, right? Number two, we want to make sure we have enough digestive support on board to help those foods be broken down enough. So if there’s fat maldigestion issues, of course, adding in more bile salts or more lipolytic enzyme, right? Lipase— things like that. Uh— protease—proteolytic enzymes, right? These are all really important. And then, of course, once we can have the deck kinda dialed in, if foods are still a problem even with that, we may make them more palatable. We may go with more crockpot kinda GAP specific carbohydrate kind of eating template, where the foods are just easy—more processed via cooking, they aren’t raw, they are peeled or mashed. We’re decreasing salicylates and phenols and potential gut irritants so those foods can be consumed better. And then, of course, we’re gonna look deeper at the hormones because hormones have a major effect on inflammation and energy. And a lot of people that have gut issues, their guts are inflamed, we have to support the inflammation of the gut lining. And then, the big one is getting rid of the infections.

Evan Brand: Yup.

Dr. Justin Marchegiani: And that’s where you know, we’re probably go next.

Evan Brand: (laughs) Yes. You’re right. So uh—Cent50 here, who asked the question. Yeah, the loose, mushy stools, I mean that was me. I had Cryptosporidium, I had Giardia, I had H. Pylori, I had bacterial overgrowth. Until my gut issues were addressed, just FYI, I had IBS for 10 or 15 years of my life and conventional doctors had no solutions for my—my stools. And it wasn’t until actually cleared out the infections that my bowels and my stools became normal again. And so, yeah, you got to get yourself tested. Justin and I run several different companies. Uh—stool testing just depending on you know what—what we’re looking at. But, yeah, get a comprehensive stool test. Your conventional doctor may be able to order through your insurance, if you tell them you want diagnostic solutions Lab, it’s unlikely. You probably have a functional medicine guy like us to run it for you. But either way, once you get the diagnostic tool, you can fix this pretty quick.

Dr. Justin Marchegiani: There’s a lot of healing nutrients. So like, when we work with the patient, we kinda follow that 6-hour template— template that I’ve created over the last decade or so. There’s a lot of ones that are out there— three hours, four hours. In my opinion, a lot of them stink and they’re the wrong order. So the six that I’ve created and began to follow as well, in my opinion, is the exact clinical order which I follow things. So the first hour is removing the bad foods. And again, it’s not cookie-cutter because that maybe just getting someone from a standard American diet to a Paleo template. That may be taking someone from a Paleo template to an autoimmune template. Maybe someone on an autoimmune template and the Paleo template taking them to a GAPs or specific carbohydrate diet or low FODMAP template. I had patient last week who’s been Paleo for three or four years—chronic pain, chronic issues, chronic mood issues, chronic sleep issues. We took him from a Paleo template to an autoimmune-Paleo template and all of the symptoms went away in one week.

Evan Brand: That’s it.

Dr. Justin Marchegiani: This is someone that’s like already been on point for a long time and we just pulled out a few foods. So we have those— that kind of progression because you’d be surprised, the smallest things that we do have a huge effect. And it’s like, whoa! you would’ve thought I would have created the awesomeness protocol ever and found a you know, this hidden infection that everyone missed and got rid of it for that kind of improvement to happen. But sometimes it happens, we’re just removing some food. So, first, I remove the foods, second, I replace enzymes, acids, digestive support, bile salts, too. Third hour is gonna be repairing the gut lining. It could be also repairing the thyroid and adrenals and sex hormones, too. Fourth hour is removing infections. That’s where we go after— bacteria, parasites, uhm—fungal overgrowth. Those kinda things. We may even go after co-infections future podcast on that soon enough. Fifth hour, repopulating or reinoculating probotics. Some of these nice and beneficial bacteria. They’re transient. They only hang out for a month or so and pass on. So, getting some of that it in there periodically is helpful. Sixth hour is retest. We want to make sure infections are gone. And maybe even address family members too to make sure they are not being passed back and forth you know, playing hot potato.

Evan Brand: Yup. Well said. Riley asked a question about—he said, “Evan is your IBS completely healed now after addressing anything?” Uhmm—kind of a confusing question about addressing anything. Yeah, I don’t have IBS anymore. I’m infection free, no more H. pylori, no more parasites, no more bacterial overgrowth, no more yeast overgrowth and I feel good and feel completely normal, which was an amazing thing because after so long, you know, it took me to be so long to get here.

Dr. Justin Marchegiani: Totally. And with your situation, right? Like if you start eating bad foods again and your immune system got compromised, you may have another critter or two that pops back. You may have some inflammation from the food and such. And then those symptoms, they start coming back, right? So it’s not like a cure, like, “Hey, you have scurvy. Here’s vitamin C.” And then as long as the vitamin C is there, you’re good forever, right? It’s like, “Hey, there may be other stressors that may cause the systems to weaken again and those IBS symptoms start to occur, right?”

Evan Brand: Oh, Totally! Yeah. I mean I could go— I could go out to a restaurant and get some type of contaminated food and all the sudden creates a leaky gut situation. Maybe I pick up a gut bug, maybe I was eating while stressed during a week and I didn’t chew my food good. And then I picked up a parasite and have to start all over again. So, yeah, definitely, you know, you could always backtrack. You’re—you’re never permanently in a good place.

Dr. Justin Marchegiani: Totally. And again, one thing I see out there on Facebook, and I see it marketed, and it’s–  I have to call—I’m not  gonna call anyone out directly—

Evan Brand: No, come on. Do it.

Dr. Justin Marchegiani: I’ll call out the concept. But lots of people, they’re like, “You gotta heal leaky gut. Here’s a gut healing program.”

Evan Brand: Yeah.

Dr. Justin Marchegiani: And if you look at it, a lot of times, you know, it’s bone broth or just a lot of healing nutrients and a lot of probiotics, right? And maybe a little diet change. But if we go look at the six hours, what are they really doing? They’re doing the third hour, maybe a little bit of the first, maybe a little bit of the second, maybe a little bit of the fifth, right? They’re kinda skipping around. They don’t have a system and how it’s being integrated a lot of times. And I would say 99% of the time, it ignores going after and getting the infections fixed. Totally ignores it. Because you know, these people are recommending a general program to like thousand people at once in a huge kind of a webinar kind of style, right? Well, how do you get all the types of testing and customize everything in that format? You can’t. So it’s a very general kinda overview approach. And in my opinion, it’s going help some people, which I think is great. It’s admirable. But it’s also gonna  a miss a lot of people and those people that don’t get help may lose faith in functional medicine or say, “This is not for me.” So I’m just kinda calling that out because think about it, right? If the root cause of what’s going on is an infection component and you’re doing let’s say the first, second, third, fifth alright but you’re not getting rid of the infection. Well that’s like me giving you this healing aloe, right? You get a sunburn, you come back from the beach, I give you this aloe, right? The underlying cause of the sunburn is the— is the sun. And then you go back out the next day and you get sunburned again and I just give you more aloe. That’s the equivalent of what a lot of these people are doing. Well, just have some more bone broth, have some more of glutamine, have some more of this healing compound for your gut lining. So we got to get to the root cause. A lot of people are just being very general out there. And you know, the listeners of our show will get it and say, “Hey, I see that the missing piece there.” And that’s why we have those six hours that way coz then you can look at it and you can say, “Hey, this is a really specific way we go about addressing things here.”

Evan Brand: Yeah. Well said, man. And that’s the food is medicine, people. And we love the food as medicine people, but that’s why you know, we pursued functional medicine because the food is just the first step, right? It’s just one pillar of the house. It’s not gonna hold the house by itself as a single column. And also, I want to mention the order—the order of operations. If somebody just go straight to bone broth and probiotics and L-glutamine, that’s the wrong order. And sometimes people get worse. They’ll come to us and say, “Oh, Justin and Evan—“

Dr. Justin Marchegiani: Yup.

Evan Brand: “I took XYZ probiotics coz I heard it on a podcast or a blog and I felt terrible and I had a flare up of my condition. Can you explain what happened?” Yes, if things are just terrible in the gut,. sometimes you have to hit the reset button. You can’t immediately just add in all these probiotics and expect it to work. Sometimes we have to fix the balance first and eradicate the bad guys before the good guys can come back in.  So that’s why the order of operation is just a second when Justin said it’s so important. And this may explain why you’re spinning your wheels even though you’re all—you’re doing everything about the Paleo gurus are saying to do.

Dr. Justin Marchegiani: Yeah. We just want to make sure everyone’s educated. I mean, we have some people out here, they’re chiming about, “Hey, I really want a functional medicine doctor but I don’t have the—the money for it.” Well, guess what? The best thing that you can do right now is be listening to our podcast coz all this information is free.

Evan Brand: Yup.

Dr. Justin Marchegiani: We’re providing tens and thousands of dollars for free information off of people and I get messages all the time. “Hey, made a couple of these changes or recommendations and my autoimmune condition for 10 years is gone.” Right? I didn’t cure him.  I promise. I didn’t cure him, right? The body just heals itself, right? We got to say that as our disclaimer. But that’s you know, what’s that worth. When someone is you know, seeing a rheumatologist for 20 years on lots of expensive medication that’s tearing up their gut and their body and creating more symptoms than they’re actually helping. What’s that worth? So just utilize the pickup as much of the free intel as much as possible. And then you know, allocate some savings or HSA or flex spending. So if you want to dig in deeper, that’s an option. But utilize as much of the free stuff as possible because the diet is the foundation.

Evan Brand: Yup.

Dr. Justin Marchegiani: 50% is gonna be the diet so work on that first. Once you max that out, and you’re seeing some decent results, then you’d want to go in deeper. You can reach out, for sure.

Evan Brand: Yeah. And you can contact likely so. You can contact your conventional doc and try to get some stuff run through insurance. But it’s likely that they don’t have accounts with these functional labs and they likely just aren’t going to do it. Fut if you’re really lucky, you’ve got a really good M.D., you may be able to push push push push at least get the lab so you have the data. Now what you do with the data? Well then maybe that’s where you come to a functional medicine guy that can help in terms of creating a protocol. But getting the data should not be impossible.

Dr. Justin Marchegiani: Totally. And a lot of functional medicine docs that do a podcast or websites, I find that they take information, they wrap it up and they try to make people feel so confused where they walk away from the podcast or the video, being like, “What the hell just happened? What I do now ?” And they walk away feeling less certain. I want to make sure no one walks away from any podcast or video I do, gaining more certainty. And at least walking away with one action item that they can add into the repertoire of whether it’s a lifestyle or a supplement or just a different perspective on the6 hoir healing so they get better and they feel more confident.

Evan Brand: Yeah. I watch a couple of functional medicine videos like over the weekend and they were like hour-long videos I made it through 10 minutes. And I thought, “This is not gonna help me at all.” So I decided to turn it off. So let’s do it, let’s do our action steps and summary here.

Dr. Justin Marchegiani: So of course, we have our six hours, right? So everyone listening kind of our general feedback is gonna be a Paleo autoimmune template to start. And again, depending on where you’re at, that maybe really a lot of— really overwhelming for you, cutting out grains, legumes, dairy and primarily having healthy fats, proteins, uhm more veggies and fruit instead of starch. And having healthy fats like you know, if we’re doing a Paleo, maybe a little butter or ghee. If we’re going fully AIP, no nuts, no seeds, no dairy. Just coconut, Olive oil, may be avocado oil, some healthy animal fats. And that will be a good starting point for people. And then again, an AIP or an SCD or autoimmune diet, again, I’m just kinda laying out the Paleo template to start coz that’s probably the easiest buy in without pre qualifying anyone. I would say that after that, at least getting some digestive support going there. And again, you know, the ones that we formulated, we recommend the most coz we’ve put our stamp of approval. High-quality HCl or enzymes. In my line, it’s HCl supreme or enzyme synergy or I’ll add in the liver supreme for extra bile support for digest energy. And Evans line—Evan has a similar products as well. Uhm— so that’s a good starting point there. And then seeing where you’re at, I think is the next step coz there may be infections, there may be other testing that has to go in deeper. So I think if you can get that, that’s number one. And then I think if you can just make sure the hydration component and the sleep component is dialed in next, that’s a good second step. And that gives most people of really good you know, path to go down and if people are listening, they’ve already done that and they’re like, “what’s next?” well, that’s where I think you’d want to reach out and do a little bit more testing because that’s what I think the infection component and/or the hormone component and/or the nutriend malabsorption component from the infection could be the next vector we’d really have to put up in our sites, so to speak.

Evan Brand: I’m gonna address one comment here and then I’ll bring up a question then we could uh—we could wrap it up. Leslie mentioned the diet’s the foundation which kinda sucks no more pigging out in the middle of the night. The good thing is that could be related to infections. I mean for me, for example, when I had parasites, I would get these food cravings that just didn’t make sense and it wasn’t me. It’s these bugs. They are stealing your nutrients, they want food so they’re cannibalizing your muscle tissue and when you’re eating, they’re messing up your ability to digest especially coz I had H. pylori. My stomach acid levels were lower. I was basically hungry all the time and I was losing weight. Getting to like a scary point of weight loss. So really, the diet is not too hard once you just address your gut bugs, that— the whole like binging type thing on food, it really doesn’t happen once your gut is healed, once your adrenals and your thyroid are helped out and your blood sugar’s more stable. It’s not an issue. I mean you could fasted for a long time and feel stable. You shouldn’t have to get hungry or go on a crisis stage. Justin, a question for you. Uh—some doctors say T3 doesn’t matter; they don’t test it on Thyroid labs. The person’s taking T3 now slowly increasing. Would you be lowering T4 when adding this?

Dr. Justin Marchegiani: Well, I would typically be adding more than likely a T4, T3 put together so there’s gonna be a combination of both. Most doctors don’t care about uhm—T3 because the major pharmaceutical companies, Abbott’s the big one, that has a patent on Synthroid is a synthetic T4. It’s easier to monitor uhm— giving a T4 the half-life’s five days, so it’s really easy. It’s not like a T3, which could potentially have more side effects. Uhm—and it’s patentable, right? It’s the basically tetraiodothyronine with the sodium salt on it. So that’s how they get the patent to it. Uhm—again, they don’t m__ it because that’s just not what they do. They give you the T4, they get the TSH back in range. All your thyroid symptoms could still be present. Cold hands, cold feet, anxiety, mood issues, hair thinning, you know, gut here fitting things you know, gut stuff, constipation all could still be there, but if the TSH is in range, they’re happy. They checked off the list, you’re gone. So that’s where you got a dig in deeper. You got a look at the T4, T3 conversion. You got to look at the autoimmunity. You got a look at the nutrients. You gotta look at the adrenal conversion, the gut conversion connection and the liver detox conversion connection, too.

Evan Brand: Yup. Yup. Should you ignore TSH? No. It’s definitely worth factoring TSH in. You just don’t want to use that as the end-all be-all only marker. But you— but when you have the free T3 and the reverse T3, the TPO, the TG antibodies kinda all the stuff we run, the TSH makes a lot more sense when you got a full picture.

Dr. Justin Marchegiani: Yeah. We like to keep TSH in the equation and look at sometimes people come in with the TSH that’s perfect, but their T4 T3 conversion sucks. And then what do you do? You know when you’re treating the TSH or are you treating the actual patient? So we’ll try to increase thyroid hormones, see if symptoms change and we’ll try to support HPT access communication with specific herbs. And of course, stress modulation and getting infections— getting rid of infections coz that can really mess up the HPT access, the Hypothalamus Pituitary Thyroid connection.

Evan Brand: Yup. For sure. Uh—Leslie and a couple other comments about you know, where to go next? Well, I mean, you know, if people may say, “Oh, we’re biased.” But the answer is get tested. Our philosophy is “Test, don’t guess.” So if you’re confused, you’ve got symptoms that don’t make sense, get tested. That’s the first step. You can look at adrenals, thyroid, gut, get all the puzzle pieces laid on the table. That way you’re not just buying random supplements that you might not actually need. We’ve seen so many people with 20 and 30 supplements that they’re taking and they still feel terrible. And we cut that down to five supplements because it’s based on labs and all of a sudden people get better. So you know, save up your money for that. Maybe you don’t go buy the next newest supplement you hear about. Maybe you— you focus on investing into some testing first.

Dr. Justin Marchegiani: Exactly.

Evan Brand: And you can check it out on Justin’s site. It’s You can look at the supplements, the labs on there. Same thing on my site, and we’re happy to help. So, feel free to reach out.

Dr. Justin Marchegiani: Totally. And also, couple of people asked about Dr. Gundry’s The Low Lectin Protocol. I think it’s the plant paradox. Again, my thing is if you’re just going to a Paleo template, you’re gonna cut a lot of those lectins out. If you actually cook some of the plants, some of the starches,  some of the vegetables and lower the lectins even more, if you still have a lot of gut issues, upgrading it to an autoimmune protocol, you decrease lectins more. If we still have issues and we can move to a specific carbohydrate or GAPS protocol and we decrease lectins even more. So it just depends on where you’re at cooking knocks a great chunk of that out and just going to a Paleo template, where we’re cutting out grains, legumes, dairy and focusing more on non-starchy veg, uhm— lower glycemic, low sugar fruits and safe starches that aren’t grain-based, you’re gonna have a huge effect and grains, where most of the lectins and irritants come from. So again, that— my opinion matches people making things a little bit more complicated than they have to be.

Evan Brand: Marketing.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: I mean, he’s done a good job that book is spread.

Dr. Justin Marchegiani: Yeah. It has gone viral. Everyone asked me about it all the time. I can’t get a go of a— one day without a patient asking me about it. So I have to follow it. I think I found it on fast reads on Amazon. So I got a—like uhm—abridged version of it that I’m siphoning through.

Evan Brand: Nice.

Dr. Justin Marchegiani: I’ve got a couple of services where they do these summaries. And it’a great.  I mean I get 90% of the information.

Evan Brand: Exactly.

Dr. Justin Marchegiani: Suck it up in a half hour and I’m like, “Oop, got it!” That’s it. On to the next one. Well, any other questions you wanted to answer here, Evan?

Evan Brand: I think that’s everything. I think that’s all we can—we can chat on today and we’re gonna do a podcast soon on co-infections. We’re gonna talk about Lyme, Bartonella and Babesia Uh—Justin and I, I mean, we’ve literally got the books like right here that we’re—we’re diving into.  We wanna make sure we’re the most educated and current up-to-date with our information before we broadcast to you guys. So make sure you hit subscribe on Justin’s YouTube channel while you’re at, hit subscribe. And uh—we’ll be back again soon.

Dr. Justin Marchegiani: Totally. And one last thing. Patient asked here—person asked here on the chat list, uhm—“How do you—how do you choose your functional medicine doctor? How do you trust them?” He said, “I can’t trust them. How do I choose them?” Well, number one, I think they should have some kind of content out there whether its video, audio and/or blog post where you resonate with their information. Like their philosophy, their information, you should resonate. I find most patients are the biggest reason why they don’t get better is because, number one, compliance, and number two, they’ve been burnt and the past or they failed in the past and therefore they’re kind of priming their subconscious to fail again. So they don’t follow through and they’re off to the next one other, you know, they’re making a 180 move in can’t see someone else because some little thing happened. They’re not following through enough. So I think keeping—one, making sure you choose someone based on their philosophy and the information and making sure you resonate at an emotional level and just a logical level. Here’s the plan, generally speaking, right? And then number two, making sure you’ve given enough time and then follow through uh—for it to work.

Evan Brand: Yup. Well said. I’ll address— address this last question, then we’ll roll here. Uh—Is it common to have to go through a few rounds of infection killing protocols? Yes.

Dr. Justin Marchegiani: It can.

Evan Brand: You can. It took me a couple of rounds to go through, some herbs to knockout things coz I have multiple infections. When you’re trying to kill five or six or seven things at once, yeah. I can’t take multiple rounds. Why is that? Depends on the person’s immune system health or stress levels, how long they’ve had infections, the amount of damage that’s there, how much inflammation is there, are they sleeping well, do they have a good diet. You know, there’s million factors to answer why that— why that could be. Hope that helps.

Dr. Justin Marchegiani: That’s great.

Evan Brand: Andrea is asking a question about his father’s prostate cancer. PSA levels are rising rapidly. Can we cast opinions or advice?

Evan Brand: I can’t. Justin?

Dr. Justin Marchegiani: That’s about thyroid, it’s about uhm— prostate issues?

Evan Brand: Yeah. Prostate. Prostate cancer this drug—Enzalutamide had been recommended for father’s prostate cancer PSA levels are rising rapidly. Can you cast opinions or advice?

Dr. Justin Marchegiani: Well, let me describe– I have one formula here that’s been helpful. Yeah. I have one compound here that I’ve been using here, just I had a couple of supplement companies reach out and I’m using it. It’s the pomegranate extract, and the flower pollen extract and its cranberry extract. So cranberry, pomegranate and flower pollen. This is an excellent support. Lot of research behind those extracts as well. Lycopene is phenomenal, getting adequate levels of selenium 200 mics a day is phenomenal, enough zinc as well is phenomenal saw palmetto’s great. These are excellent compounds that help. Lycopene is phenomenal as well. Again, the diet has to be in place. You want to get the lifestyle things going and again, these things don’t grow overnight. They probably taken decades to kind of move. So coffee and Coffee enemas may also be helpful to kind of early push detox in a faster more acute kind of way. But some  couple of compounds that I mentioned are phenomenal and wouldn’t hurt getting them on board in the meantime.

Evan Brand: Yeah. And look at my podcast I did with the lady named Dr. Nasha Winters.

Dr. Justin Marchegiani: Uh-hmm.

Evan Brand: She did a book that’s called, “The Metabolic Approach to Cancer” She— she had cancer herself and she’s been holistically supporting people with cancer for about 20 years. So uh— look up Nasha Winters and uh look up her book and you could implement some strategies there hopefully.

Dr. Justin Marchegiani: Also, get the insulin levels under control. Make sure fasting insulin is five or below at least. That’s important because insulin is gonna cause a lot of cells to grow and then also making sure xenoestrogen exposure is mitigated, right? Don’t drink out of plastic bottles, avoid pesticides and GMO’s and glyphosate and Roundup. These are chemicals that you’re gonna get from conventional foods. Obviously, eat organic, right? Pasteur-fed meats. Again, these things— I shouldn’t have to repeat them, but I just can’t assume that everyone knows these stuff.

Evan Brand: They don’t. Not everyone does. So, yeah, keep repeating it and keep preaching. And I think that’s all the questions. So we did— we did really good. That was fun.

Dr. Justin Marchegiani: I heard a quote back. It’s a quote from the 1940s, where Joe DiMaggio was interviewed and they said that Joe said, “We noticed that you sprint on and off the field every single time at full speed no matter what.” And he said, “Well, there may be someone coming out to see me for the first time ever that seeing me play the way I’m playing and I wanna play at 100% every time.” And then maybe some people that are coming out for the first time seeing us play here, and we want to make sure that they get that information that we may assume that other people uh— may have, right? The equivalent will be like us jogging on the field, so to speak, if we just assume that.

Evan Brand: Yup.  Well said. Well, reach out if you need help. You can schedule with Justin. if you’d like to schedule consults with us. We should have some availability in the next 3 to 6 weeks or so. So just take a look and  we’re happy to help you soon as we can.

Dr. Justin Marchegiani: Oh, by the way, I’m adding in the Mimosa Pudica as well. So I’ll be reporting back on that in the next couple weeks. I think you as well Evan. So we’ll chat about that.  Again, I just got that in stock. That’s the Para-1 in my store. I think you have it in your store as well. So, we’ll put that in the show links, too. So that’s a cool new herb that we’re working on. We have a couple other herbal compounds in the mix that we’re using for different types of co-infections that we’re researching uhm—in the background, too.

Evan Brand: Awesome.

Dr. Justin Marchegiani: Hey, Evan, great chatting with you, man. You have an awesome day. We’ll chat soon.

Evan Brand: You too. Take care

Dr. Justin Marchegiani: Bye.

Evan Brand: Bye.



Low Body Temperature! – Dr. J Podcast # 156

Dr. Justin Marchegiani and Evan Brand engage in a very informative discussion about low body temperature. Learn how different potential stressors like thyroid issues, adrenal issues, gut health, autoimmune conditions, nutrition and low calories cause low body temperature. Find out about the role of micronutrients in thyroid hormone conversion and be aware of the medications that have a negative impact on mitochondrial function.

Gain information about the different foods, including modifications in macronutrients, and various supplements, which will improve your health and prevent different stressors that are possibly causing low body temperature.

In this episode, we cover: low body temperature

03:27   Thyroid issues

07:05   Beneficial Nutrients

14:14   Toxins and Medications

22:51   Food and Supplements

33:46   Calorie Intake






Dr. Justin Marchegiani: And we are live here on YouTube. It’s Dr. J in the house. Evan, my man, how are you doing brother?

Evan Brand: Hey man, happy Monday! We’re talking all fair about that shooting this morning so my mom, she worked right next door last night at the Hotel Luxor which was uh— right next door to that shooting event in Vegas. So I called her this morning and she’s safe and sound and she got released, so she’s home, hopefully sleeping. I’m sure she’s extremely adrenally stressed at this point, but hopefully she’s resting and settling down from all that.

Dr. Justin Marchegiani: Yeah. Lots of empathy for all the people out there going through that. It must be just incredibly stressful.

Evan Brand: It’s insane.

Dr. Justin Marchegiani: It’s just so difficult. So wishing everyone, you know, speedy recovery from that. That is just so difficult and man, everyone’s adrenals are revved up from that, right?

Evan Brand: I know.

Dr. Justin Marchegiani: So let’s go into some stuff here where people, we would get— put some information out there about improving everyone’s health.

Evan Brand: Yes.

Dr. Justin Marchegiani: Uh—and just continue to empower more people. So let’s dig in, brother.

Evan Brand: Yes. Yes, so you and I want to chat about low body temperature, which is something that so many people have. I’ve had it in the winter for a long time. I’m hoping that since I work so much, my gut and my adrenals that I don’t have it this winter but cold hands, cold feet you know that had been something that I mentioned going on with me for—for several years. I know there’s a lot of different causes that you and I wanted to go through. So how should we open this thing? Should we talk about hormones, thyroid, how do you want to lay the groundwork?

Dr. Justin Marchegiani: Oh, we look at body temperature. Temperature is probably one of the best indicators of your metabolism, right? Because the more energy you have, typically the— the better your temperature is. And so typically, you’re gonna have symptoms of cold temperature which are gonna be cold hands, cold feet those kind of things. Also, fatigue, but now there’s also objective ways that we can test your temperature. You know, with the thermometer, obviously. We can do axillary temperature, which is armpit. 97.8 to 98.2 is—is Fahrenheit is a pretty good range to be in. Or 98.2 to 98.6 orally. And so you can kind of assess your temperature. You can do it in the morning and then you can also do it in the afternoon as well. Kinda do it just for before eating. That gives you a pretty good indication but if your metabolism is low and your temperature is low, it could be caused by an interplay of different things. We’ll go into it. It could be thyroid issues. It could be adrenal issues. It could be gut issues. It could be nutrient issues. It could be mitochondrial issues. So all of these things are potential stressors that could be driving that problem.

Evan Brand: I’d say number one is probably thyroid issues. Wouldn’t you suspect because so many people we talk with they have adrenal issues with them on top of that there is a thyroid problem. Like maybe elevated reverse T3, whether you’ve got that blank bullet going on or they just got a low free T3 or like you and I’ve chatted about with adrenals, you’ve got the conversion process that happens where you take the inactive T4 hormone, you convert that to active T3.That conversion process gets messed up if you’ve got chronic stress. And chronic stress as you mentioned, could be gut infections, it could be emotional stress, could be chemical, heavy metals. It could be circadian rhythm stress if you’re working third shift, for example. That could be enough to change this whole cascade. Wouldn’t you say?

Dr. Justin Marchegiani: Oh, yeah. Hundred percent. I mean, again, all of those things can be intimately connected. The first we look at is thyroid because thyroid hormone has a major effect on our metabolism. And our metabolism is the sum of all chemical reactions in the body. And our metabolism is pH driven, right? So if our pH becomes too alkaline or too acidic, like you know blood pH, which exists in a very fine-tune range, right around 7.35+ or -1/10 of point there. And if that pH shifts up or down, that can affect how all of our enzymes in our bodywork. So that can affect temperature and there’s things like—uh like a diabetic coma, right? Where blood sugar can go to he— or too low typically. If someone’s type I dependent and they don’t have insulin, they don’t get sugar into their cell, which can create ketoacidosis. And that can really, really drop that pH and that put you into a coma. So our pH is very driven and has a major effect on our metabolism, so, totally.

Evan Brand: So let’s hit on—let’s hit on the thyroid peace. Now autoimmunity is something we talk about so much. Would you say a common symptom of someone with Hashimoto’s, for example, could be low body temperature or possibly even a fluctuating. Maybe their low body temperature if they’re a bit underperforming but then couldn’t they just bounce right back and get actually hot if they bump into hyperthyroid. If they’re in the Hashimoto’s state, and things are still fluctuating.

Dr. Justin Marchegiani:  Yeah. So, if you’re having Hashimoto’s and your immune systems constantly attacking your thyroid, your thyroid hormone can spill.

Evan Brand: Right.

Dr. Justin Marchegiani: Coz every time it’s attacked, hormone spills out. Eventually those follicles run dry and you’re not gonna quite have that hyper kind of symptoms. So in an acute attack, hyper symptoms may be increased temperature are common, right? You can have like PVC’s periventricular contractions. Uh—you can have, you know, kinda this—kinda heart palpitations. Your heart’s kinda beating erratic and hard, uh—anxiety, night sweats, irritability. These are all hyper thyroid symptoms. You feel warming, right? You feel excessive warmth or temperature. But then, in a chronic state, that will eventually lead to a hypothyroid kind of environment, where your body temperature just gets very low.

Evan Brand: So someone has had Hashimoto’s for quite some time, let’s say there’s been a pretty significant tissue destruction, you would say someone will not end up being hyper long-term with Hashimoto’s. It’d probably be hypo long-term.

Dr. Justin Marchegiani: Yeah. I mean you can—hyper feels very similar. Hyperthyroid Grave’s feels very similar to a hypothyroid autoimmune attack. The difference is with hyper, typically, there’s a specific antibodies or immunoglobulin compounds that come back. So with Grave’s, you’re seeing TSI immunoglobulins or you’re seeing thyroid TSH receptor site antibodies. So that’s what’s typically common in Grave’s. And when those things are high, it’s accelerating the thyroid hormone to produce excessive amounts of thyroid hormone. So there’s like a production stimulation where with the autoimmune attack, from like thyroglobulin antibodies or TPO antibodies is it’s more the spilling of a thyroid hormone out of the thyroid. It’s spilling out where the antibody attack from Grave’s, it’s stimulating the thyroid to produce more.

Evan Brand: Exactly.

Dr. Justin Marchegiani: With Hashimoto’s, you’re not getting the stimulation. You’re more or less getting that spilling effect, which eventually, you know, will run dry.

Evan Brand: Got it. Got it.  Okay. So we hit the autoimmune piece. What else would go on thyroid-wise that will be an issue with temperature regulation?

Dr. Justin Marchegiani:  Well, again, there’s also certain nutrients that have a major effect on thyroid uh—conversions. So we know things like selenium are super important for thyroid conversion. So someone may have decent thyroid levels from a T4 perspective, uh— but they may not have that activation, right? They may not have that conversion uhm— that’s so important.

Evan Brand: So could it just be the lack of trace nutrients, trace mineral selenium, zinc— things like that activators.

Dr. Justin Marchegiani:  So here, we are live on Facebook now, too with the low body temperature podcast. So getting back onto our common thread. Yeah, micronutrients like selenium are gonna be important for thyroid conversion. It’s a five—the enzyme that converts T4 to T3 inactive thyroid hormone to active thyroid hormone is a 5 deiodinase enzyme. It’s also important with glutathione and detoxification. So, yeah, that’s totally uh— important micronutrient that will affect thyroid activations. So when we look at thyroid function, we’re looking at are there blood sugar fluctuations? Are you eating grains or foods that are gonna cause that thyroid antibody attack that could cause the hormones to spill out and eventually deplete the hormones? Your thyroid follicles carry about four months of thyroid hormone. So again, if you have a chronic Hashimoto attack, where the thyroid hormone’s spilling out faster than you can synthesize and make more, then you’re going to definitely get to that depletion state where you’re gonna go hypo from a temperature standpoint. You’re gonna go almost hypothermic. That temperature will drop below that 97.8 – 98.2 armpit temperature wise or 98.2 to 98.6 and I’ll put a handout down below to my uh— metabolic temperature handout. So people can actually track their temperatures and it’s basically a graph of three different lines. And then the top brackets where you want your temperature to be through which ranges 97.8 – 98.6 We want to be checking off daily that your temps are in this bracket not the bottom or the very bottom.

Evan Brand: Got it. Okay. So what else? Should we talk about the nutrients next?

Dr. Justin Marchegiani: Should we talk about the nutrients, right? Vitamin A, we talked about uh— zinc, copper, selenium, magnesium very important nutrients for thyroid conversion. Now if you’re eating a whole food diet, you’re gonna be typically pretty good. If you’re having enough HCl and enzymes, you’re gonna be good as well because we need those type of compounds to be able to ionize the minerals. So it’s the diet component. It’s making sure we have the ability to break down the foods in our diet that are nutrient dense. Uhm— number three is making sure our stress response is okay because stress hormones will affect thyroid conversion. Cortisol being hyper— very high— will affect thyroid T4 to T3 conversion that inactive to active thyroid hormone. Also, if cortisol is too lo from chronic stress. So there’s this, kinda Goldilocks effect that we see here with thyroid hormone kinda need it to be not too high, but not too low to have optimal conversion. Does that makes sense?

Evan Brand: Yeah. It does. Well said. Let me mention about the gut, too, coz you just hit on the fact that you’ve got to have absorption. So even if the diet’s good, which many people listening to us, they probably already dialed in like a Paleo template but they could still have this symptom. You may want to check for infections. Coz like Justin and I talk about almost every week at some level, there could be an H. pylori, bacteria, yeast, fungus, something going on in the gut that’s stealing your nutrients or preventing you from optimally digesting. And then that issue is compounded, if you’ve been taking any type of anti-acid where acid blocking medication something simple as Tom’s or something more strong like a prior was it Prilosec or Zantac.

Dr. Justin Marchegiani: Yeah. So, yeah. Totally.

Evan Brand: Keep that in mind. If you’re looking at your medication list and that includes acid blockers and you have cold body temperatures, it’s probably cause you’re not digesting your foods therefore the thyroid is not getting fed the nutrients it needs.

Dr. Justin Marchegiani:  Totally. And also a lot of medications could affect your mitochondria. Just Google antibiotics and mitochondrial function, you’ll find that antibiotics can negatively impact mitochondrial function. And you’ll also find that other medications can impact the mitochondria. And the mitochondria is like the little powerhouse of your cell where it generates a lot of ATP, which is that currency of energy in which your body runs. So that’s really important and also an important nutrient call carnitine really helps that mitochondria utilize fat for energy, generate ATP out of that good fat, you know, it’s called uh—beta oxidation where you’re generating energy from fat. And carnitine is an important nutrient primarily made from methionine and lysine. Now, I did a video call why vegan and vegetarian diets can make you fat? Now—no—don’t make you fat. But you know, why they the can—meaning it’s not a hundred percent. But if you’re insulin resistant and you’re doing it the wrong way, where you’re emphasizing maybe too much carbohydrates, not enough protein and more gut irritating foods, yeah, it can definitely predispose people that have an inflamed guts and work more on the insulin resistance side to gain weight. And one of the big things is that when you eat certain animal rich amino acids, there are some plant ones as well, you activate the cells in the brain that are called—hold on, one __my notes—uh—tenocytes. And these tenocytes are receptor sites in the brain in the third ventricle area of the brain. And there’s a direct blood flow between them and the hypothalamus. These tenocytes, one, they sense satiety but the big thing that senses satiety for them is arginine and lysine which are really high in animal-based foods. So these amino acids really get that sense of satiation so that means you’re one, gonna have appetite regulation. Coz when you actually start feeling full, you tend to not eat all the crap, right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So the more you can keep your cravings in check, the more you eat healthier foods because you got control over your biochemistry. You’re not reacting. You’re acting based on what you know you need to be healthy. But those amino acids are primarily gonna be higher in animal-based foods especially lysine as well.

Evan Brand: Yeah. Well said.  So in a roundabout way, if you are a vegetarian or a vegan and you’ve got low body temperature, it could just be something as simple as a carnitine deficiency. I mean you could probably get a little bit in beans maybe—

Dr. Justin Marchegiani:  A little bit in beans, a little bit in almonds, a little bit in plums and avocados, for sure.

Evan Brand: But even then, once we talked like—we talked all the time, digestion of those foods is probably not very good and the concentration of those is gonna be much less as opposed to a grass-fed beef.

Dr. Justin Marchegiani: Yeah. In my video, I talked about, you know, if you are a smart vegan where you’re not emphasizing a lot of the grains, you’re doing safer starches, you’re getting lots of fats from avocado, olive oil, coconut oil, you’re supplementing DHEA in the form of algae, right? And if you’re getting B12 uh—supplementation and you’re getting a good multi- in there and you’re getting lots of— you’re getting some protein supplementation in there, maybe from pea or hemp, right? You may be okay on a vegan-vegetarian diet, but it’s just— it’s still less than optimal just because of the fact that you gotta go through such extreme lengths to get high-quality protein sources without all the carbohydrate. Coz vegetarian-vegan diet’s typically are packed with 60 to 80% carbohydrates for that 20 to 25% of protein you get.

Evan Brand: Yup.  Well said. You hit on the mitochondria, too. We should take  that a bit further and talk about more toxins. You hit on antibiotics, some mitochondrial issues there. Makes perfect sense. We work with people all the time where they say, “Oh Justin or Evan, as soon as I took a round of antibiotics, all of a sudden things went bad.” And it could be temperature –temperature issues, it could be sleep problems, it could be gut issues, digestive problems. And so also with mitochondrial issues, we’ve got toxins. So if you’re not using 100% organic, that’s an issue because glyphosate and these other pesticides and herbicides, fungicides and insecticides— they all compound with each other. So it’s not that one chemical by itself will kill you, but if you get a little bit of glyphosate from your non-organic berries, you combine that with a little bit of conventional vegetables coz you did a salad at a restaurant, you combine that with in antibiotics that you’re getting from meat. If it’s not labeled “no antibiotics” you stock all those upon each other, you’ve got some bad mitochondrial problems here that you need to fix. And we can measure the—

Dr. Justin Marchegiani: Yeah. The enzymes that are needed to help move those gears that  kinda crank around that mitochondrial Krebs cycle and then flow in so the beta oxidation process. Uhm— you need certain nutrients. You need B vitamins, you need magnesium, you need zinc, the healthy levels of amino acids. You also don’t need all the toxins— the aluminum, the pesticides, the glyphosate. So those things can kinda gunk up the gears of that metabolic machinery. So it’s not only what those gears need to keep it lubricated, but what it is we don’t need to put in that will prevent those gears moving. So it’s a combination of avoiding certain things, right? And again, the medications are a double-edged sword. I’m not saying don’t use them. I’m saying just really make sure they’re— they are prescribed specifically for what you need. And it’s the last case kind of thing with antibiotics. We really want to go to herbs and botanical nutrients over antibiotics. They may have a time or place, but we want to use it only when we’ve exhausted other options.

Evan Brand: Yeah. Well said. And you and I were talking off air, we can quantify a lot of this stuff, too. So you’re talking about measuring your temperature. We can quantify what’s going on in the gut, right? We can test the gut, we can test the thyroid with—with blood using functional reference ranges and using functional numbers that conventional doctors don’t use. They’re only going to detect disease. We’re going to detect the issues before disease occurs. We’re gonna look into the gut so we could test you for infections. We could test the adrenals, look at your free cortisol rhythm so the uh— HPA axis, the hypothalamus, pituitary adrenal axis, you hear us talk about, you know, that is a factor in all of this. If your brain is not connecting the signal to the adrenals and adrenal to the thyroid, that whole system gets often chronic stress. And it’s up to us to figure out when we talk about stress what’s in that bucket. Is it just your job, your bad boss, your relationship, the divorce you’re going through? Is it that stuff only or is that stuff plus chemicals in the diet, plus nutrient deficiencies, plus infections, plus not having enough quality meat in the diet.  You see how these things can all add up.

Dr. Justin Marchegiani: Totally. And just to kinda look at the thyroid component again, there’s dysregulation up top where the TSH is either high extreme, higher extreme, low. Now it can be extremely low because you’re on thyroid hormone and the body needs more thyroid hormone. The body is sense— sensing more thyroid hormone in the brain, but there’s less than the actual tissues. So that you’re keeping the thyroid hormone higher, but that’s keeping the TSH low. That’s step one. The TSH may be low because of HPAT access dysregulation. That hypothalamus pituitary and that adrenal thyroid axis. There’s some kinda short-circuits happening in there because of the stress— the emotional stress, because of the physical stress, because of the chemical stressors. And we have to address those while we support the nutrients to get this hardwire back on track. We can also have low T4 levels. Coz if T4 is low, we’re gonna have low T3 over here. So we got to make sure the nutrients for T4 in there like I mentioned before the vitamin A, the zinc , the copper, magnesium, selenium, uhm— amino acids, tyrosine and potentially iodine. As long as we know that there’s not uh— autoimmune attack that’s the lease active going on. And then number three, after that, we let see how the T4 to T3 conversion is. If T4 is good, how does T3 conversion look? Is it this big drop off? Or also is there a very high amount of reverse T3 because of that stress? All those can make a big difference. And then one person ask here—James asks, “Well, is hypothyroid and hyperthyroid hypo and hyper kind of the same for treatment?” Yes and no. With hyperthyroid from a TSI thyroid stimulating immunoglobulin or TSH receptor antibody attack, we’re more concerned about coz it tends to be more chronically high which can increase the chance of a thyroid storm and then potentially a stroke. So we take that very seriously. We refer that patient out to their medical doctor uh—for monitoring. We don’t want—we wanna make sure there’s not a stroke going on. But typically, the treatment will be, you know, PTU. Uhm—basically  uh—propylthiouracil or methimazole. Things to basically block iodine uptake to make thyroid hormone. Or though— you know, typically, go to a thyroid radioactive thyroid kind of ablation or even a thyroidectomy. I’ve had patients where we’ve been able to avoid those because we give nutrients to help modulate the thyroid response and modulate the autoimmune response like carnitine, like blue flag, like lemon balm, melissa uhm—into certain adaptogens. They could also help kinda dampen that response. There are some protocols that even show higher amounts of iodine can block that sodium uhm— iodine’s import that transfers iodine into the thyroid. So there’s a couple of different protocols you can use to help. And of course, all of the diet and lifestyle things are the same. But we take the Grave’s autoimmune attack a little bit more seriously just because of the repercussions of it not being treated appropriately, what will happen, we really want to sidestep those.

Evan Brand: Yup. Well said. So get the TPO antibodies checked. Get your eTG antibodies checked, you talk about the TSI. Now, have you seen where TPO TG would be high at the same time as TSI? Where it’s gonna look like Hashimoto’s and Grave’s at the same time?

Dr. Justin Marchegiani: It could. I’ve seen it before.  Yeah. It definitely can. So get—we’re  gonna really get patients on an autoimmune protocol to help lower any autoimmune attack from the food, from the gluten, from the leaky gut. And we’ll also work on blood sugar stability coz high and low blood sugar fluctuations have a major effect on the immune system.

Evan Brand: Yup.

Dr. Justin Marchegiani:  Now another person asked here, the reason why you know I’m such a huge fan of how we do our podcast is coz it’s literally on the go and we’re infusing questions from people on YouTube here right into the conversations. So it’s like—remember those books you read when you’re like a kid and you read it and it’s like, “Oh, if you want the character to do this, turn to this page. If you want the character to do this, turn to this page.”  You can totally change how the book goes.

Evan Brand: Yup.

Dr. Justin Marchegiani: Well, it’s kind how our podcast are. So interjecting here uhm—, Gerald asked, “What about T3? How does T3 work?”  Well number one, T3 can just help support low T3 levels. And if there’s some kind of conversion issue, that can kinda biased time to fix the conversion aspect, number one. Number two, giving that T3 in the Wilson protocol uhm— that can have some effect on clearing out the receptor sites. So that now the T3 works better and binds better uhm— in the future. You can do that by starting low and then tapering up, holding it and then tapering it back down. In the Wilson protocol, Dr. Dennis Wilson does that with time-released T3. But we do a glandular’s in it. That can still be helpful as well. We’re using that as a way of clearing out the receptor site but were also not, you know, thinking that that’s gonna be the only issue. We’re also banking that there’s other things that we’re gonna be fixing that will allow it to be a long-term solution, right?

Evan Brand: Got it. So you’re saying the thyroid glandular’s can be used for low—a low  T3 situation.  That’s the fix that’s going to get you better enough to keep moving the needle in other departments.

Dr. Justin Marchegiani: Correct. Like in my line, we have Thyro Balance which is a—a really glandular uhm—nutrient thyroid support from a glandular perspective. And then we have that we have Thyro Replete which is nutrients for the conversion. So there’s some herbs that help with conversion like coleus forskohlii and ginseng and then we have the nutrients for conversion that I mentioned—the vitamin A, magnesium, copper, zincs, selenium—all of those—and tyrosine’s. We wanna make sure all those are in there. Uhm so we hit it from all angles. I mean if we knew exactly what that missing like nutrient component was, we could hit it more practically. But it’s too difficult to do that.

Evan Brand: Right.

Dr. Justin Marchegiani: You’re better off using multiple methods to hit it. That way the patient can get better faster.

Evan Brand: Agreed. And you mention the adaptogens. I’m so glad you did. We use those all the time. I take them every day in some shape or form, whether it’s ashwaganda, holy basil, shoshandra. There are so many options and people ask, “Well, can I just take a bunch of adaptogens and fix myself?” Uhm— it doesn’t work like that. You just want to use them as one piece of your toolbox. You still want to be getting to the root cause. So adaptogens are life-changing but if there’s root causes, you can take all the adaptogens in the world and it won’t fix you.

Dr. Justin Marchegiani: I’m gonna take my ashwaganda right now—

Evan Brand: Perfect.

Dr. Justin Marchegiani: A little bit of immune support. But I mean, like yeah, if you’re doing okay and you’re like, “Hey, Dr. J and Evan talked about some ashwaganda and some of these nutrients. I want to try it out.” Fine, go ahead.  But if you’re actively having issues that are you know, the symptoms that we mention here whether it’s on the hyper or hypo side, you really want to get someone on board to help guide you because it’s never just one magic bullet. It is—it’s a whole bunch of things that we’re doing together. And the more chronic it is, the more you have a you know, that momentum working against you. You got overcome that inertia to stop that— that snowball effect and start pushing it back uphill. So, yeah, if you’re in pretty good shape, fine you know just try some of these things. But if you’re in not so good shape, you want to reach out, for sure.

Evan Brand: Yep. Cool. Oh, we got time for one more question. Uh James said, “It’s not a thyroid question.” He’s taking an antibiotic for root canal this week. “Will this affect the result of organic acids test and stool test if he collects the samples while antibiotics are still in the system?”

Dr. Justin Marchegiani: I mean if we’re doing some of the genetic base testing, it shouldn’t have an effect on it. If we’re doing a stool base to antigen-based testing, then it would.

Evan Brand: Right.

Dr. Justin Marchegiani: So you should be okay but we’re doing the G.I. map which is you know, what my go-to is. It should be okay according to the lab. I try to avoid it— doing it. So I would say in a perfect world, if it’s not gonna delay your treatment, I would say get to the antibiotics give it like a day or two to let it wash out and then do it. But if uhm— timing doesn’t work out, just do it, get done.

Evan Brand: I would also look at Mercola root canals and read about those. I mean maybe you’re too far down the rabbit hole and you can’t avoid the root canal. But you know there are some other options you may have available if you’ve got a good biological Dennis maybe will sit down with you and say, “Okay, root canal’s option A but maybe there’s a option B C you could look at too because we’ve had a lot of people to come to us with infected root canals and maybe Jessica can speak on this a bit. But I’ve seen it as a big needle mover for people.

Dr. Justin Marchegiani: Yeah. There’s a book by Ramiel Nagel that talks all about root canals. It is highly recommended. You take a look at it. Uh— fat-soluble nutrients, vitamin A, vitamin K are very helpful. Uh—oil pulling that kinda help extract any toxins that may be in there and you don’t want a root canal you want to get the tooth pulled out. Uhm— you want to get an implant put in using biologically appropriate material. You don’t want the gangrenous tissue still in the system without the blood flow. And the immune response to be able to get it is just a harboring place for a whole bunch of bacteria and viruses to hang out.

Evan Brand: Right. Yeah. Well said. So James, look into that. Maybe it’s not too late. Uh—hopefully, you’ve got some other options you can pursue it’d be much— much safer and much healthier in the long term. That way, you don’t have a hidden dental infection. There’s a guy named, Simon Yu that you and I should reach out and interview. He’s over in St. Louis he talks a lot about hidden dental infections. I think that’d be a good show.

Dr. Justin Marchegiani: Okay. Absolutely. Hundred percent. So couple of things we wanna talk about. Oh, also carbohydrate, I think is important. Again, my bias is towards a lower carbohydrate template—Paleo template. And again, I hate the word “diet” because it assumes something is temporary and it assumes that it is fixed; where a template gives us flexibility and modification and may change day to day. It may change uh—meal to meal. I tend to be very lower carbohydrate my first two meals of the day and then after that, I may increase in carbohydrate at nights uhm—you know a bit of the starchy based. So I’m very strict during the day. It’s high-quality. It’s— set—it’s 60 to 70% fats, the only carbohydrates are vegetables and then good proteins and then I go higher at night. On the carbohydrates side, maybe a little bit of sweet potatoes and some butter and cinnamon or maybe I have a—some dark chocolate or have couple more berries than I normally would. So there’s that component. So I always go lower carbohydrate to start because so many people are insulin resistant just because of the fact that we eat too much carbohydrate and were inflamed. So I always go lower carbohydrate to start and then typically, patient will do be better and will feel better because insulin resistance can affect T4 to T3 thyroid conversion, which can cause lower temperature. Now, in the double edge side of the fence, if people go too low insulin, they may also get poor thyroid conversion as well. So just like I mentioned cortisol has a major effect on thyroid conversion. Well, guess what? Insulin has a major effect on thyroid conversion. Type I diabetics— guess what? With low insulin levels coz of the autoimmune attack to the beta cells of the pancreas, they have low body temperature. So if you go too low carbohydrate, and this is for certain individuals not everyone, I know people are gonna be like, “But I’m low carbohydrate and I felt great and it reverse my low temperature.” I get it. Again, there are exceptions to every rule. There are tall Chinese people that play basketball even though they are more shorter in the population. There are exceptions to everything, okay? We got to get that in. So yes, there are some people that a low carbohydrate diet, the majority I would say would help partly because our consumption of refined carbohydrate and sugar is higher, but there are some people when they’re chronically load, they may increase that carbohydrate just a bit. And that ups the insulin a little bit which then helps that thyroid conversion. They’re like, “ Dude, my hair started to grow back better, my temperature’s better, my energy is better.” Boom! You at least now figure it out for you. So exceptions to every rule, figure it out. And uhm—if you feel great going low-carb, great, keep it there, hang out. But if you start getting some of those hypo temperature symptoms, then we’ll just ratcheted up a little bit.  And I primarily ratcheted up starting at night.

Evan Brand: Yup.

Dr. Justin Marchegiani: They’ll still get the benefit of keeping it lower carb during the day.

Evan Brand: Well said. I mean that’s me in a nutshell. I went very, very, very low-carb ketogenic, I guarantee. I was probably ketogenic most of the time and then I started to get cold and so I added in some starch with dinner and all of a sudden my body temperature’s perfect now. I feel good. So uh—if I go too low-carb again, it may come back or if there’s a huge piece of stress on my plate, the low body temperature may come back. But for now, I’ve been able to reverse this and been able to clear out all the infections with your help in terms of protocol a couple of years ago getting rid of all my gut bugs, plus supporting adrenals, getting the diet dialed in, getting my sleep improved, blacking out my room. All of those things are still important. So I hope this has been helpful. I gotta run. You’ve gotta run, too. Uhm—or are there any last questions that we could answer? I closed out the chat window. Uh there’s just one thing I want to say is it’s not about being higher carb or lower carb, have a –have a foundational template which you— which you go back to and then you can customize it. And then if you increase carbs, you can still get some of the benefits by having that first 20 hours of your meals relatively lower carb, higher fat, moderate protein and those last four hours you pop up a little bit and so you can still get some of those benefits. If you’re like, “Oh, I feel better with higher carbs.” You can still get the benefits of the first 20 hours of your day kinda in that ketogenic state and then pop up the carbohydrates later. So it’s not an either or thing. We can kinda straddle the fence but we want to customize it. I don’t give a crap if—if low-carb is your missing link and being low-carb all the time helps you, that’s what we’re gonna do. If being low-carb and a little more high carbohydrate helps you out, I don’t care. I’m all about the results and not about what tool I have to use to get the job done.

Evan Brand: Yup. Well said. For me that looks like the breakfast like a pastured sausage, maybe a handful of macadamias, maybe a handful of organic blueberries. Lunch—I  probably do some leftover steak and veggies like a big thing of broccoli with some butter. Dinner— that’s when I may do some type of pastured meat, a little bit of some veggies and then starch, so it could be a medium-size baked sweet potato, butter, cinnamon. That’s all it takes and I feel good. So just to kind of give people an idea what is that look like. That’s what it looks like.

Dr. Justin Marchegiani: Totally. That’s great. And a couple of questions here. Uh— Stephanie talks about menopausal women with lower estrogen and a low estradiol vaginal tablets. Well, this is interesting because typically low estrogen can cause hot flashes. And why does that cause hot flashes? Because typically the FSH and the LH starts to rise in the pituitary which is that signaling hormone trying to yell to the ovaries to make more progesterone and estrogen. So when LH and FSH primarily FSH goes high, that can create some vasodilation effects and create the hot flashes. So by giving a little bit of thyroid—giving a little bit of uhm— female hormone support, we can drop down that FSH then we can also modulate the receptor sites with some herbs as well to help with how flashes. Whether we use maca, or  we use dong quia, or black cohosh or raspberry root, or shepherds purse. There’s different nutrients or herbs we can do to help modulate that. So again, you could still have hypo, low thyroid issues, but have menopausal issues because of the low estrogens, which could drive the hot flashes up. So it’s kind of a conundrum. The hot flashes may—may overshadow this low thyroid thing over here. So as we get the female hormones fixed, you may notice the low thyroid comes back later on because it’s just not a secondary issue and the primary issue is the menopause. Once that’s ruled out, now this one comes to the surface.

Evan Brand: Got it. Well said.  We should probably do a whole show just on low estrogen if we haven’t.

Dr. Justin Marchegiani: I think that’d be great. I mean, I see estrogen dominance is a big problem.

Evan Brand: Right.

Dr. Justin Marchegiani: Where estrogen –the ratio of estrogen is higher than progesterone, right? So progesterone should be like this 25 to 125 times more than estrogen. But if that ratio starts to creep up where estrogen gets higher, that’s estrogen dominance. The problem is a lot of people, though, where that ratio—they’re estrogen dominant, progesterone’s slow but estrogen is also low. So they get this estrogen dominant, but also low estrogen sums at the same time. So it’s kinda like this conundrum. It’s like this little tug of war that’s happening there.

Evan Brand: Wow. Put it on this to do list. It sounds like it’s gonna be a fun one for us to dive into more. And I’ve probably got some stuff to learn from you on that topic as well.

Dr. Justin Marchegiani: I think it’s great. Well any last questions, comments, or concerns, Evan?

Evan Brand: No. I think this has been good. People, you got to get the testing run because if you don’t test, you’ve guessed. So if you’re trying to figure this out on your own, even if you’re not working with Justin or myself, then get the test run. Find a functional medicine practitioner they can take care of you. We are accepting new clients, so if you do need help, feel free to reach out justin We run these labs on all of our clients because it’s the foundation. We’ve got to have the data. We’ve gotta have the puzzle pieces on the table; otherwise, you can’t move the needle. We could throw a bunch of random stuff at you might help, can’t hurt, but we want to get you better. There’s a systemic process that we do step by step by step to take you through this. So happy to help. Reach out if you got questions and thanks for tuning.

Dr. Justin Marchegiani: Oh! One last thing, man. I forgot to add.  This is so important. Low calories.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Just not eating enough calories will cause low body temperature. It’s shown to cause a low level T3. Now this is important because if your diet is 25% crap Ola and let’s say you’re eating 2000 calories a day and then we switch you over— we switch you over to a uh— autoimmune kinda Paleo template, but you’re only able to—to—to switch over 75% of your diet because you don’t—you don’t have enough you—you can’t replace all the crap that you’re eating with the good stuff, right?

Evan Brand: Right.

Dr. Justin Marchegiani: Because if you’re eating a whole bunch of crappy carbohydrates and stuff and then you replace it with a whole bunch of really good vegetables or lower sugar foods, well guess what? You’re probably didn’t replace the calorie amount either. So now you got this 25% calorie deficiency. So now instead of having 2000 calories, right? Now you’re having 1500 calories and maybe metabolically you need 2000 calories. Now you’re 500 calories in the hole which means your 500 calories deficient of various nutrients. So now your metabolism goes low coz there’s less fuel. That’s important. I see a lot. So you gotta  work with someone that really can make sure you’re exchanging the foods and you’re getting enough calories as well. Coz calories equal nutrition. if you’re eating real foods.

Evan Brand: I’m glad you mentioned that. That’s such a simple but common issue. If you’re going AIP, you are going Paleo, you’re eating real foods, you could have an entire plate full of broccoli and it may only be 50 calories.

Dr. Justin Marchegiani: Exactly.

Evan Brand: Yeah. Dude, great job. Way to kill it.

Dr. Justin Marchegiani: And of course, the infections like you mentioned can really suck down the energy. Of course, acute infection, you know, you’re causing a fever, right? Because the immune system’s trying to up regulate itself because a lot of the bacteria and crap there uhm—they’re like—they’re mesophilic. They—they thrive in a medium temperature. So when you go a little bit higher, you can actually kill them off with a higher temperature. But these chronic bugs can really deplete the energy the body and create this kinda lower temperatures as well. For sure.

Evan Brand: Yeah. And I went—I went to low-calorie for a period of time, not intentionally, not on purpose. It just happened. I was eating meats, I was eating veggies and  I track my calories for a few days and I was eating m—and my activity level  and all that. I was probably 4 to 600 calories deficient. So just added in an extra tablespoon of butter here and there, half of an avocado here and there, handful of nuts and seeds. And I was right back up to where I needed to be.

Dr. Justin Marchegiani: Like here’s a seesaw right?

Evan Brand: Yup.

Dr. Justin Marchegiani: So if like carbohydrate is here, if carbs go lower— this is fat over here. The fats have to go up.

Evan Brand: Yup.

Dr. Justin Marchegiani: If you keep the fats here, you keep the fats on—on this side low, and drop the carbohydrates, that’s where the problem happens. The fats also have to go up. That’s the biggest issue. Proteins typically stay in the middle. Typically, proteins only go up if you’re doing a whole bunch of protein powders because proteins and fats are intimately connected. Uh so if you’re eating real whole foods, you know, it’s hard to get just proteins in whole foods, unless you’re doing maybe like venison or rabbit or like boneless chicken breast. But if you’re eating full fat foods, you’re gonna get fat. And then if you’re adding fats to your vegetables, you’re gonna get extra fat without the protein there as well.

Evan Brand: Yeah.

Dr. Justin Marchegiani: So keep that at the back of your head.

Evan Brand: Perfect.

Dr. Justin Marchegiani: Anyone listening here, give us comments below. Give us some shares. Give us some likes. We want to hear thoughts in the comment section. If you’re listening to us on iTunes, that’s great. Click below and subscribe to our YouTube channel. You can see Evan and I’s mugs going back and forth in our little combos here. And then you can give us some comments below here on YouTube. We love the see the feedback. And Evan, hey man, you have a great day. We’ll talk soon.

Evan Brand: Take care.

Dr. Justin Marchegiani: Take care. Bye.

Evan Brand: Bye.




10 Essential Nutrients To Heal Your Thyroid

10 Essential Nutrients To Heal Your Thyroid

By Dr. Justin Marchegiani


The thyroid is a bowtie type of gland that sits just below the Adam’s apple. It regulates your metabolism and weight, and thyroid hormones are required for almost every physiological process in your body.

The thyroid secretes a hormone called T4 that gets converted into an active thyroid hormone called T3 which is needed for all cells of the body to be metabolically active.

T4 is inactive, while T3 is active. 20% of this important conversion happens at the thyroid gland. The other 80% happens peripherally. Out of the 80% that happens peripherally, 60% is converted in the liver, 20% is in the healthy gut bacteria, and the other 20% is via healthy adrenal function and stress regulation


Signs and symptoms of a potential thyroid issue include:

Unexplained weight gain

Fatigue and tiredness/energy issues

Numb or tingling fingers/toes

Muscle soreness

Menstrual and fertility problems, PMS,

Thinning of outer third of eyebrows


Dry, flakey skin

Poor concentration and memory

Temperature intolerance


*Thyroid vs. Adrenals*

It’s important to note that adrenal fatigue is often found alongside thyroid disease, and many of the symptoms of the two overlap, so it is important to look at the thyroid and the adrenals side-by-side. Remember, 20% of the T3 conversion process relies on healthy adrenal function and stress response. One huge step you can take to support both the adrenals and the thyroid is by paying attention to your iron levels. Low iron is linked to low cortisol, a hormone produced by the adrenals which is necessary for proper thyroid function.





We want to look at the body as a whole in dealing with thyroid issues: hormones, diet, lifestyle and nutrition. To avoid supplement overload, the first thing we want to do is to clear out all the dietary and lifestyle sources of stress on the liver. This means cutting out aspartame, junk food loaded with additives, gluten, and anything else the liver has to work extra hard to detox. As we learned earlier, 60% of T4→T3 conversion happens in the liver. Because our liver is always giving detoxification support, we want to take off excess stress (and stop giving our liver stress to detox in the first place), then use supplements such as Liver Supreme.


Selenium: The thyroid is our organ with the highest selenium content and is necessary for production of T3. It can reduce autoimmune issues, as well as decreasing anti-thyroid antibody levels. Besides supplementation, whole foods sources of selenium include grass-fed beef, beef liver, eggs, chicken, spinach, brazil nuts, and yellowfin tuna.

B Vitamins: Thiamine and vitamin B12 help balance hormones, and aid in combatting chronic fatigue. Vegans and vegetarians need to pay special attention as they are much more likely to be deficient in these essential nutrients. Beef liver, sardines, grass-fed beef, eggs, lamb, raw milk and cheese, and salmon are great sources of these vitamins.

Probiotics: Healthy gut bacteria balance is vital for a healthy self. Thyroid conditions have been linked to leaky gut (when proteins such as gluten can leak through the gut and get into the bloodstream, which causes inflammation throughout the body, including the thyroid). 20% of T4→T3 conversion happens in the gut. Probiotic-rich foods include sauerkraut, kombucha, kvass, kefir, and natto.

Iodine: Iodine deficiency is often linked to hypothyroidism. Iodine can be found in whole foods such as fish, sea vegetables, eggs, raw dairy, and seaweed. For 10% of people, iodine can resolve thyroid disfunction, though those with Hashimoto’s should avoid higher dose iodine supplementation, as it can potentially aggravate the autoimmune condition especially in the environment of low iodine.


Tyrosine: In a process called iodination, iodine, tyrosine and thyroglobulin bind together in making your T4 molecule. Tyrosine is found in protein-rich foods such as chicken, turkey, almonds, avocados, beef, and eggs.

Zinc: Zinc is required for T4 to convert to T3, and is also required for T3 to function properly. Zinc impacts many areas of your health, including digestion, skin and eyes, the immune system, omega-3 fatty acid metabolism, and thyroid function. Zinc is found in red meat, pork, oysters, and chicken.

Fat-soluble vitamins: Many essential vitamins and nutrients required fat to be properly absorbed and used by the body. For example, high cortisol levels are associated with low vitamin D levels. But if you are on a low fat diet, you are not going to be absorbing as much vitamin D as you might expect. It is important to have quality sources of fat, such as grass-fed butter, in order to get the full benefits of your supplements.

Vitamin C: The adrenal gland contains the highest concentration of vitamin C in the body, and as we know, there is correlation between adrenal function and thyroid function.

Omega-3 Fatty Acids: Can help “decrease inflammation and help with immunity” for thyroid support. Research shows that omega-3 fatty acids can increase thyroid hormone uptake.

Iron: Research shows correlation between low iron and low cortisol, and cortisol is necessary to convert and activate T4 to T3.

Glandular supplements like Thyro Balance can be beneficial for individuals not getting adequate daily nutrients, particularly those that support the adrenal and thyroid glands. Another supplement that helps provide extra nutrients for thyroid hormones synthesis and T4 to T3 conversion is Thyro Replete.


Conventional medicine generally takes one of three routes in dealing with thyroid issues.

If a patient is labeled as having Hashimoto’s or hypothyroidism, they are prescribed Synthroid.  Most people that are given Synthroid, synthetic T4, don’t convert it to T3, leaving them with tons of thyroid symptoms.

If they’re diagnosed with Graves’, doctors typically just want to perform a thyroidectomy- meaning they pull the thyroid out!

Thirdly, they might want to use radioactive iodine, and shut the thyroid gland down.

The majority of people have hypothyroidism/Hashimoto’s, meaning there are underlying issues affecting thyroid T4-T3 conversion outside of their control, and the mainstream medicine routes aren’t going to tackle the real root of the problem.


While supplementation is valuable and always available for extra support, a balanced life and a healthy diet are the necessary foundation pieces for proper thyroid function.

If you are looking for supplementation to help your thyroid, we offer thyroid support in our store.

To listen to Dr. Justin’s podcast with Evan Brand on the thyroid, check out podcast #54.


Immune System, Tapping Technique and GI infections – Podcast Live with Dr. J and Evan | Podcast #131

Dr. Justin Marchegiani and Evan Brand engage in a lively and informative discussion about their recent clinical successes with their patients using the functional medicine approach. Listen to them as they dig into the root cause of their patients’ issues and turn chronic and seemingly complicated problems into success stories.

Know about the tapping technique which involves turning something negative into a better, positive thought. Learn more about GI infections, the bacteria or parasite that may be involved, as well as the tests and treatment options that are proven successful in the functional medicine world. 

 In this episode, we cover:

 03:50   Immune System, bacteria, and infection relationship

 15:50   Tapping Technique

 19:17   Treating Hypochloridia

 24:10   GI infections

 28:34   Enzyme Tests






Dr. Justin Marchegiani: We are live on YouTube here. Podcast live on demand. Also, live here on Facebook. Evan, how are you doing, man?

And again, Facebook people you gotta click on the link here uhm—I’ll put in the comments to see Evan’s pretty face and go back and forth on this. How we doing, man?

Evan Brand: What’s going on? I’m feeling really good today. We’ve got a blue skies, the trees are blooming which they probably—

Dr. Justin Marchegiani: Awesome.

Evan Brand: a year ago in Austin. So I’m enjoying myself.

Dr. Justin Marchegiani: Very good. So we got podcast on demand. So anyone wants to write in some suggestions as we chit chat here, we’ll figure out what exactly we want to talk about moving forward.

Evan Brand: Yeah. And I might as well post a link over here to my Twitter page and see if uh—people are paying attention over there. That way, if they’ve got questions, they can get them answered here.

Dr. Justin Marchegiani: Love it. Totally makes sense. Same thing, anyone on Facebook, too, every  chimes in first we can get this thing moving. But let’s uh—just talk about some clinical successes in the last week with patients. Any updates from you, man?

Evan Brand: Yes. So interesting update is uh—there’s a female client that comes to mind and she had seven, I believe, I have to go back at here stool test and count. But I believe it was seven infections and this is a combination of two parasites which—let me just pull it up, that way, I’m not just shooting into the dark here, but—Uhm— with these infections, we started a gut protocol and symptom improvement was seen. She was having a lot of irritable bowel symptoms uhm— running to the bathroom. So she showed up with H. pylori, Blastocystis Hominis, Entamoeba and Fragilis and Proteas  and Citrobacter. Somehow, cal protectin level was still low  which is intestinal inflammation where—

Dr. Justin Marchegiani: Yeah.

Evan Brand: –I look at but I was surprised. And so anyhow, we put her on this protocol. And this is like 8 weeks.  And the H. pylori while it’s still positive, instead of two viral factors, now she’s got one viral factor. The level of H.Pylori has dropped. The Citrobacter is completely gone. The Proteus completely gone. The Blasto is completely gone. But we still got Entamoeba. So there’s still the parasite and there is still the H. pylori there. So we’ve got work to do but yet, we’ve seen 3 or 4 things disappearing. So I think what the takeaway message is from me is that the bodies gonna heal in an interesting way. It may not heal everything at the same time. Some things may be easier to kill. Some things may disappear first, but you gotta heal yourself especially your gut, your microbiome. You gotta heal these things in layers. And that’s what we’re seeing here.

Dr. Justin Marchegiani: Yeah. So typically with a lot of patients that have chronic issues is there are some underlying stress, right? Emotional, physical, chemical stress but even deeper above and beyond that, there is some level – there’s some level of  infection that’s deeper that creating inflammation even though it didn’t show via calprotectin or it’s just creating leaky gut. And the whole leaky gut mechanism is getting the immune system fired up. The more the immune system is fired up, it’s just an energy suck for  your body. It’s like uhm—let’s say guests in you guest bathroom that you never go into your house. And they just leave the water on. Just a little bit—little drip, drip, drip. And then you get your water bill at the end of the month, and you’re like, “Where the heck did that bill come from?” And you’re like, “Oh, yeah. The faucet’s on.” But it’s like that with your energy resources. When got these bugs, it really—when the immune system is overactive. And even just a leaky gut, right? The more your immune system is overactive, the more it’s gonna suck your energy dry. That’s why when you get sick, the first symptom you get when you get sick is what? You get a lot of fatigue and malaise coz the immune system is sucking resources. Go ahead—

Evan Brand: I wanna hear uh—a recent case from you, but first I wanna ask you the question that I get asked all the time. And the answer really doesn’t matter because we need to fix the root cause no matter what. But people often ask well– chicken or egg? Was it that ma—my immune system got taxed first? And then I picked up these bacterial pathogens or these parasites? Or did I pick up the parasite and the bacterial pathogens and then that that set my immune system? What’s your take? Can it go either way?

Dr. Justin Marchegiani: Yeah. So typically it’s one of two scenarios, right? Typically someone gets exposed to a very high amount of infectious debris, right? Parasitic—parasites. So you drink some really bad water, you to go Mexico, you have really bad meal or at a foreign country, you get the Bali belly, so to speak. And then you’re overwhelmed with all of that infectious debris and then there’s so much of it that it compromises your immune system, you get diarrhea, you have a lot of gut inflammation that creates malabsorption. That malabsorption puts stress on all of your glandular systems and then you spiral downhill. That’s scenario number one. So just the infectious—the infection was so overwhelming, it just threw everything else downhill. Scenario number two is there some type of immune compromisation  that’s happening. Meaning adrenal stress, poor diet, poor sleep, or poor diet and lifestyle habits, low nutrient density. The immune system’s kinda a little bit weaker underneath the surface then you get exposed to some of these infectious debris at smaller micro levels that are in the food. And eventually makes its way to the system and creates inflammation.

Evan Brand: So yeah—so let me—let me clarify there. If we’ve—If we’ve got diet, lifestyle mostly dialed in, but let’s say people are cheating with gluten, for example. They still got intestinal permeability going on. You can still have good class, good sleep, blah, blah, blah. But if you’ve got just a simple thing like leaky gut, for example, you could potentially be more susceptible to pick up these infections regardless of whatever else is dialed in.

Dr. Justin Marchegiani: Yeah. I mean—here’s the deal with leaky gut, too. If you’re creating leaky gut, and then there’s some research, you know, on the non-celiac, gluten sensitivity side of the fence, that looks at these foods. Even if you’re not like reacting to a it, like symptomatically, and even if you’re not like having like IBS -like symptoms,  bloating, you know, gas constipation, diarrhea, that gluten can still create leaky gut. Where the undigested food particles in the gut can make their way into the bloodstream and create stress. And then the LPS that comes in there along with that, that’s the— the bacterial debris can get into bloodstream and create a lot of mood issues as well. So you can still have leaky gut and not risk from gluten— and still not respond to gluten in general.

Evan Brand: Yup. Yup. I just posted a post on uh—Facebook which I think might be a slightly controversial which was I wrote this little bit of a letter and I put kind of like these five things that have happened over the last year or so where people have said, “Evan, I’ve ditched psychiatrist or I’ve ditched my psychologist or my marriage counselor, or my conventional doctor because of functional medicine.” I kinda wrote the reasons why of how if you lower inflammation, you may need less adjustments at the chiropractor, for example. If you heal the gut, you start producing your neurotransmitters optimally, you might not you’re your antidepressants anymore, so you might not need your psychiatrist. Or if you heal your adrenals, you’re not gonna snap at your children anymore, so therefore you’re not gonna need the marriage counselor that is telling you need to stop yelling at your kids. And how basically how functional medicine can literally, not intentionally, but it’s just a side effect is that we can replace these other industries. I’m not saying these other industries are bad for mental health care or anything like that. But a lot of times, this is not root cause medicine. And my wife and I went out you with a friend of ours yesterday and she said she had a lot of stress, she had to put her dog down and she called up her psychiatrist and said, “Hey I need help, I’m freaking out.” What does he do? He prescribed her 60 Xanax and says, “Here’s your Xanax bars and take these.” And I told her, I said, “Listen, your anxiety and your stress from this issue is not a Xanax deficiency.

Dr. Justin Marchegiani: Totally.

Evan Brand: How about we do some emotional freedom technique. We start tapping. How about we cleanup the diet? And then before we left, out the parking lot, I had her do the quick coherence technique, the Heartmath, like the heart focus breathing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And focusing on someone that she loved and we got done with it, and she said, “That was weird.”  I said, “What happened?” And she said, “I got tingly and warm.” I said, “Oh, it worked.” And she said, “What happened?” I said, “Well, you just took yourself out of fight or flight that you’re probably stocked in which is causing you to be dependent on Xanax and now we’ve pushed you into that parasympathetic rest and digest mode.” And she feels better. And this is what this is all about. Uh—a little bit of uh—off-subject uh—, but I just wanted to mention to people, check on my Facebook post and you’ll read about what I’m saying. I’m not saying these other uh— practitioners out there are garbage. What I am saying is that if you’re not getting a practitioner to focus on root cause, even if they are psychiatrist, if they’re not a root cause psychiatrist, then what the hell are they doing?

Dr. Justin Marchegiani: It’s all about resources, right? And in functional medicine world, we’re trying to help enhance your resources. So just like someone with more money in their bank account can buy more things, well if we enhance our mental, emotional bank account via healthy and diet and lifestyle functional medicine principles, we have more resources to deal with stress in our life. Whether it’s family, friends, being a parent, being present for our partner, just being able to do the hobbies of a hobbit—hobbits—uh—

Evan Brand: Haha

Dr. Justin Marchegiani: The hobbies and the habits that we have going on in our life.  I got uh—I guess I’m missing my uh – Lord of the Rings movies there. Yeah. So—It ‘s all about resources, right? So we have to make sure that we have enough resources in our system so we can allocate them toward these stressors. And I always tell my patients, “Have you ever tried dealing with stress on 0 night sleep? or “Try doing your taxes the next day when you’re getting like three hours of sleep?”  You’re just  not gonna be able to handle it. You don’t have the resources. So everything we’re trying to do is let’s test the resources of our body systems, let’s look where the hormone’s at, let’s look at where the gut resources are at, let’s look at detox and nutrient resources are at, let’s support them and let’s work on fixing them.

Evan Brand: Well, the analogy I like to use is we’re just using a big spotlight. Because a lot of different industries and health care, what they do is they use like a little laser pointer or like one of those tiny little keychain flashlight. And they shine something real dimly into one corner. And you’re like, “Oh, Justin looks like we found something. We found some anxiety issues, here’s the Xanax.” But instead, we come in with a giant spotlight and we’re like, “Whoa, look at the left corner of this microbiome. We got parasitic and bacterial infections, which can steal your nutrients, can mess up your blood sugar and cause anxiety. Look over here,  we’ve got some adrenal issues. You got spiking of cortisol that’s gonna need to be addressed.” And then we shine the spotlight over here, “Oh, take a look at our detox pathways on the organic acids, you’ve got trouble over here.” And “Oopp, we shine the spotlight behind us, here’s mitochondrial issues. This is why you’re so fatigued.” And that’s the—I think that’s the greatest analogy. It’s a little laser pointer or a little small keychain flashlight, which is just pinpointing one industry of psychiatry or psychology or whatever versus exploring everything. Which is why for you and I, it’s tough for us to become the blank guy. You know people out there, “the thyroid guy” “ the detox chick” “ the bone broth chick” You know what I mean? It’s really gonna be tough for you and I to just say we’re the blank person because I don’t want to limit myself. I wanna let everyone know it is all encompassing.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And if rest and niche yourself down, I think it’s a bad thing.

Dr. Justin Marchegiani: Yeah. Like from a marketing standpoint, right? Marketing is just telling the truth attractively. You know it’s good to have the niche because you wanna reach the people that have special conditions. Because if like, my specialty is thyroid. Number one, I have—I have or had a thyroid issue. It’s under control. Autoimmune thyroid issue. So I’m more passionate about that issue. But again, to treat  a thyroid issue, you have to be able to treat all of the systems. So it’s kind of a mythology, like you don’t just ever treat thyroid, you treat the whole thing. But you may mark and put information out there that’s gonna resonate and speak to someone with a thyroid issue more. But again, the underlying issue is from education and clinical standpoint. We’re addressing the key underlying surface issues and the deep root issues as well. So we’re never ignoring it. We may speak to someone uhm—more specifically and get into the more nuances of that condition, but it all comes back down to the foundational stuff that we always talk about.

Evan Brand: Right. I would say my specialties would be— it’s become parasites really. I mean, I’m seeing so many each week and it’s just so fun. I guess because I had parasites.

Dr. Justin Marchegiani: You had a parasite, you.

Evan Brand: Uh—Yeah. And also depression, I mean because depression is what got me into this whole thing. IBS and depression in college, I mean, like I told you before, I had to figure out when I went  into a college class, where’s the bathroom. Coz I have to get out in the middle of the class to run to the bathroom.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so for me, depression, IBS, parasites, you know, those are all linked together—the whole gut-brain connection. And I really am empathetic for people that have struggled with that because it’s so common and if you diagnosed with IBS, that’s a pretty generic diagnosis. And unless you’re with functional medicine practitioners, you’re gonna get an acid blocker, an antispasmodic—

 Dr. Justin Marchegiani: Yeah. Absolutely.  

Evan Brand: — or some other drug and—

Dr. Justin Marchegiani: Well actually, you were diagnosed with IBS, right?

Evan Brand: I was.

Dr. Justin Marchegiani: And you use the antispasmodic, you used the medications that helps with the gastroparesis. You know—

Evan Brand: Well, they never –

Dr. Justin Marchegiani: They even do that—

Evan Brand: Well they never got to use it. They try. They wrote me the prescription pad but I denied all three of the drugs.

Dr. Justin Marchegiani: And the thing is, too, we can also use natural medicines for a lot of those things. That may not fix the root cause, right? There’s root cause medicine and there is using natural medicine in a way that’s gonna help alleviate the symptoms that’s gonna up regulate physiology so things work better. But we have to still be investigating and digging to the root cause, right? So we’re dealing with someone with gastroparesis or low motility, we may add in things like ginger. We may add in things like carnitine. We may add, you know, higher amounts of mag citrate to keep that uhm—migrating motor complex moving. But we are still digging in deep. We’re still making the diet, the lifestyle. We’re still enhancing digestive nutrients, uh—hydrochloric acid enzymes. And then we’re digging deep for the infections. And we’re trying to lock in those diet and lifestyle habits, right? The supplements are great because they can give us that symptomatic relief while we continue to dig over here to the root cause. So as long as you have, you know, that  four pace envision that addresses some of the symptoms without the side effects, you know of some of the drugs, which may have more side effects than what you’re treating, and then working on the functional medicine plan, I think we’re in a really good place. 

Evan Brand: I agree. Yeah. I actually got a good—good success with that IB Synergy product from designs which get Bonigut in there. It’s got the 5-HTP. I had a guy with just super bad IBS and I said, “Man” I mean he was critically, critically stricken with both diarrhea and constipation just alternating every other day.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So I have him going with that 5-HTP Bonigut blend. And he got better. Now we start to wait for lab results but yeah—I mean  sometimes we will do some of the quick fix of band-aid situations to fix things, but we still got to work backwards. I guess to answer these questions uh—should we answer the question about the cancer question here or shall we just make a whole show on the future?

Dr. Justin Marchegiani: Yeah. We’ll do a whole show on that. I’ll get some experts on. I got Dr. David Jocker is coming next month as well. He was in the truth about cancer series. And we’ll go on ketogenic diets and we’ll talk more about therapeutic ways to address cancer outside of just the natural chemotherapy. So we’ll hold that one that—we need more time for that.

Evan Brand: Yeah. Agreed. Uh—Samuel asked, “What is the tapping technique? Can you show us? Well since most of our audiences are gonna be audio listeners we’re not gonna take up the air time to show you the technique, but the best resources—EFT (Evan-Frank-Tom) and you can just view the different acupressure meridians that you’re gonna tap. But then also, you’re gonna learn about the affirmations that you can use for emotional freedom technique and that’s something Justin and I use all the time.

Dr. Justin Marchegiani: I think it’s helpful. I’m—I’m gonna just give it 15 seconds of airtime here, so—just—I do two hands coz it’s adding it’s more efficient. But you just tap the  inners part of the eyebrow, the outer parts of the eyebrow, under the eyes, I do under the nose, and the bottom part of the chin the same time. And then I do both collarbones. So I do this, and you can go top of the head and tap midline. So I do two hands coz I just feel like you get more stimulation. So I go here, and I’m just thinking about whatever is pissing me off, my wife, I just think about it.

Evan Brand: Haha

Dr. Justin Marchegiani: I kinda give it a number. So if I’m a t like 6/10 regarding irritation, I just think about it. Whatever that issue is, whether it’s like, you know, the person driving  in front of me is so slow  or whatever. And I try to knock that 6 out of 10 so that 10 is the worst.  6 is like 60% to being at the worst. I try to knock it down to a4 to a 3. And so every round—every 2 rounds or so, you kinda just check back in and see if you knock it down. And you go as you kinda knock everything down to a 3.

Evan Brand: Yeah. And we have—I—I start at the top of the crown which I usually like—many ways—

Dr. Justin Marchegiani: You can do that. You can start there, you can end there.

Evan Brand: Now do you do the sides? I know Mercola, he’s big on the side of rib cage under the armpit.

Dr. Justin Marchegiani: Yeah. I do that, too, sometimes. It’s just wasn’t good for a video.

Evan Brand: Yeah. So you criss cross?

Dr. Justin Marchegiani: Yeah. I do two at the same time just coz it’s stimulation.

Evan Brand: No. I mean you criss cross your arms so the underarm’s like this. I do like a monkey.

Dr. Justin Marchegiani: Haha

Evan Brand: And then—and then finish with the wrist. I typically finished by tapping the insides of the wrist together then doing the affirmations. So even though I’m angry, or even though I’m anxious, I deeply love and accept myself. But you gotta say the affirmation verbally. I tell people if you can, if you’re just embarrassed, then don’t do it. But why be embarrassed? Nobody—nobody is paying that much attention to you.

Dr. Justin Marchegiani: Yeah. That depends, too. Like you can do this stuff, and you can kinda say like if you’re at—let’s say, if you’re lying in bed and you’re just really stewing on something and your wife’s next to you and you don’t wanna wake her up, then you can just kinda think it in your head. And then you can just, you know, do the affirmations, tap like this.  And then you can tap here, and think about the issues.

I like them to end, though, with a positive thing. So you can end with something positive. So then I just go into like, “What is it that I want to manifest?” So I’m going into right there. I’m thinking about whatever I’m gonna try to create or produce in my life, I just tap it while I’m thinking about it. And the whole idea of tapping is you’re just stimulating various meridian systems that have been mapped out via acupuncture system for thousands of years. And really what it’s doing is it’s neutralizing the negative response that’s stored in the limbic system or in that subconscious of your—more in the psychological side of it. And you’re trying to kinda rewire it so you can get a good pattern there instead. So then, naturally that reflux is to go back to the better thing and not to the negative thing.

Evan Brand: So if you do affirmation about the bad part, would you do like an affirmation about the bad part and an affirmation for a positive?

Dr. Justin Marchegiani: Yes. So I start off with the negative and just try to lessen—lessen it first.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Coz if you’re—feeling negative, it’s really hard to be positive when you’re negative so I try to decrease the negative to about a three. And then I go into the positive because then, you are in a better place to deal with the positive, right? It’s kinda like when someone tells you to relax and you’re pissed off, like relax, calm down. You just wanna punch him, right? Like, “No, I’m too wound up, come on.”

So I wanna get that dialed in and then now I’m relaxed, now I can rewire it and create some positive things.

Evan Brand: I like it. I like it.

Dr. Justin Marchegiani: So calm down first, and then work on manifestation.

Evan Brand: Should we answer a couple of more questions here?

Dr. Justin Marchegiani: Yeah. Let’s hit it, man. Let’s hit it.

Evan Brand: Solam asked, “How long does it take to heal hypochloridia?”

Dr. Justin Marchegiani: It totally depends, right? If you have emotional stressors that are unresolved ore you’re eating foods that are incredibly inflammatory, maybe never. But if you’re making the root causal changes and your managing your stress, and you’re fixing the underlying gut stuff, I would say within 3 to 6 months, you have a really good chance of not needing hydrochloric acid to digest your food. But again, everyone is different. A longer—the longer the issues been going on, the more severe the infections, and the more infections that are layered in there, I’d say longer, up to a year, at least.

Evan Brand: Yeah. I’ll just have my two cents to that, too. If you had a previous history of a prescription, as a blocker’s proton pump inher—inhibitors are now it’s open to counter like the Xanax or the Toms, or anything like that, or—

Dr. Justin Marchegiani: Yup.

Evan Brand: Or if you’ve had H. pylori which we’ve chatted about many times, then I would say it may lengthen that time, too, to fix that stomach acid issue.

Dr. Justin Marchegiani: The longer that gut’s has been worn down, the more the immune system is revved up like you get patients are just supersensitive to every little thing. Like I can’t even put in an enzyme, I can’t even put in our apple cider vinegar or lemon juice or the smallest fermented food sets them off. It’s really hard and you’re looking at a couple of years to really dive into it because the immune system is so revved up and it’s so ready to attack the smallest invader that it’s so hard to put things into help and heal it because it’s looking at everything as a foe not a friend.

Evan Brand: Right. We really, really have the baby step in those cases so that’s why—

Dr. Justin Marchegiani: Totally. Yeah. I mean, just like you heal, with you know, food is medicine there, you go really slow and you do lots of things in broth form, in soup form so it’s – so it is so palatable. There is very little digestion that has to happen. And typically one supplement at a time and one nutrient at a time, titrate up from low to high. Even if it’s something that they can handle, if they go high dose, off the bat,   their immune system just freaks out.

Evan Brand: Well I wanna hit on something you just mentioned which is if we’re talking 1 to 2 years, it takes extreme patient—extreme patience for patients and clinicians because for us, that is a very intensive case for us to take on.

Dr. Justin Marchegiani: Totally.

Evan Brand: And you know, maybe this is to toot our own horns, maybe it’s just calling out the obvious that we do take the time, you know, with people we’re working  with. Sometimes it maybe 30-45 even an hour-long call for a follow-up just to take these baby steps. Whereas, let’s jus say some of the clinicians that we’ve seen out there, it’s too cookie-cutter approach and they don’t have the mental bandwidth or capacity for empathy to baby step this people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So it’s here’s your cookie-cutter protocol, good luck.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Where with us, we’ve really, really, really gonna get super details.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And so this is why if you go and you buy like a leaky gut online program or some other type of program, and you get limited results and you get to us, we’re not gonna be surprised if you suffered through that, and you didn’t get a good result. Because at the end of the day, that’s why  Justin and I haven’t created  online courses at this point because it’s—it’s hard for us to sleep at night thinking that we’ve created a program that’s too cookie-cutter. We’ve really got to figure out a way that we’re gonna be able to work in all the minutiae and the small details and the variations—variation A, B and C, D for different people.

Dr. Justin Marchegiani: Yeah.

Evan Brand: So if someone uh—packages something up all beautiful and says, “Oh, it’s $297 and all your problems are gonna be healed.” Uh—please be a little bit skeptical  of that.

Dr. Justin Marchegiani: I agree. And I’ve talked to you about a patient that I had today that email in that was dropping out of care. And we try to always set realistic expectations. This person just had her labs reviewed a month or two ago, and had multiple parasitic infections, severe adrenal dysfunction, HPA axis dysfunction, and then a lot of issues on her organic tests. Uh— detoxification issues, mitochondrial issues, and we just started with simple adrenal support, made diet and lifestyle changes and she had some— some side-effects so we try to cut things down, go slower. And we’re gonna kinda reconvene and work on supporting detoxification, but person had dropped out. Now, the problem is, to have expectations that things will work off the bat when so many things are wrong like that, expectations are incorrect. So  a lot of people they have preconceived notions even if you spell it out to them and you let them know, “Here’s where we’re at now, here’s where we’re going.” They forget because they—they want it done now. And they think because things didn’t work in that initial uhm—in that initial experience, that there is no way to fix it. So continuing to harp on patients in managing their expectations, even though they have a lot of stuff they’re projecting from past failures, we kinda have to get through it. Make sure expectations are real and that make sure they know, “Hey, here’s where we’re going now. Here’s where we’re going next.” These things ahead that may have to be dealt with for us to really see great changes.

Evan Brand: Yup. Well said. We got another question here.

Dr. Justin Marchegiani: Let’s hit ‘em.

Evan Brand: Let’s hit Steve’s question. After all GI infections are eradicated, how long does it take the gut to fully heal? All my infections are gone, but I’m still dealing with IBS, leaky gut and issues after H. pylori.” I’m gonna hit on this first Dr. Justin Marchegiani, if you don’t mind.

Dr. Justin Marchegiani: Yup. I know you’re gonna say it, by the way.

Evan Brand: Okay. So – haha if—

Dr. Justin Marchegiani: If you say it—If you say it, I’ll—I’ll tell you that.

Evan Brand: Okay. Alright. Please. Alright. So here’s what I’m gonna say. You say all your infections are gone, but you’re still dealing with IBS, leaky gut, and issues, I would like to know what test was this that says all your infections are gone because I bet all of your infections are not gone.

Dr. Justin Marchegiani: Yes! Whoo! I knew it. Yeah. You’re totally right.

Evan Brand: Haha

Dr. Justin Marchegiani: Yeah. You’re totally right. And then also, just making sure that you have the digestive nutrients on board to help heal the gut lining and the digestive support to break down the food and then I would make the food more—more palatable right now. I’d be looking more at the GAPS or an SCD or more of a soup or broth approach that makes the food really easy to take in. No raw veggies, uhm—try to keep it really palatable so the body can access it without much stress.

Evan Brand: Alright. So the beauty of the Internet, Stevie says—Stevie replied and he says, “DRG” Well, uhm— Justin–

Dr. Justin Marchegiani: It’s missing a lot of them. It’s missing a lot. You gotta do the DRG with the GI map. I a—I never do the DRG by itself for the most part—always both. You gotta do both.

Evan Brand: Yup.

Dr. Justin Marchegiani: And if there’s still an issue with the DRG and the GI MAP, I want them go for the  41 side-by-side.

Evan Brand: Yup. Agreed. So, Stevie, not that—you know, we’re not diagnosing you. That’s not what these calls are for. But, hey, Justin and I have seen a lot of false negatives with DRG and some other test out there. So potentially some stuff going on. And I would like to add a couple of points about like the—the issues, the leaky gut type stuff. You know, make sure you are doing some of the easy supports, too. You know, chamomile is great. You can do chamomile in a supplemental form. You’ve got chamomile teas, uhm—you’ve got L- glutamine. So there are some leaky gut supplements that why your til—still trying to figure stuff out, you can still be taking support of nutrients in the meantime while waiting for retest.

Dr. Justin Marchegiani: Absolutely. Totally. Let’s hit  the uh—last question there by—E Center Riley. See here, just diagnosed with Hashimoto’s, TPO and TGB bodies, 465 is that high? Eliminated the foods, gluten, dairy, soy, balance in blood sugar, hard with 5 kids. What should I focus on next? So 465 is definitely high. The LabCorp reference range for TPO is 34. Anything 34 above is considered positive—I think it’s above 34. 34 below is considered positive. And anything about 20, for me, I considered to be subclinical. So that is high. Anything above or around 500 is definitely high. I’ve seen patients at 2000, though. I’ve seen patients that go from 2000 to below a 100. Now, my goal is to get people—If I were you, I’d like to see a 70 to 80% reduction in that. Again, maybe you were higher before you made those changes. So I’m not sure if it was  gluten, dairy, soy. That stuff was cut out and then you saw the drop. But either way, uhm—getting enough selenium in there, 400 micrograms of selenium, addressing the underlying infections, things like H. pylori, Blasto and Yersinia can be coming to increase the antibodies. And then making sure the adrenals are looked at. There’s a strong adrenal-thyroid connection and a lot of people who have thyroid issues also have adrenal issues. And remember, TPO is a microsomal or essentially it’s uh—intracellular microsomal antibody that helps bind the thyroid hormone together. So if you’re making antibodies to that, it’s gonna prevent that thyroid hormone that I—Iodination process from occurring. So making sure we have the adrenal support there because the adrenals help produce cortisol. Cortisol is an anti-inflammatory that’s gonna help with the inflammation. And with the TPO there uhm—you could potentially have increase in hydrogen peroxide, especially if there’s small amounts of iodine getting in there. So get them the selenium will help neutralize that hydrogen peroxide into H20. High quality H20 which is uh—not gonna be as inflammatory.

Evan Brand: Well said. Yeah. And so uhm—Isabella Wentz, I just did podcast with her a couple of weeks ago. Actually that was my last uploaded episode. And uhm—we’re talking about bacterial infections, too. So you mentioned some of the parasites and she’s seen the same thing the parasite but also the bacteria. The Klebsiella, the Citrobacter, and all these autoimmune triggers has been bad guys for uh—these Hashimoto’s situations and these antibodies, so—

Dr. Justin Marchegiani: Yeah.

Dr. Justin Marchegiani: So, look for the bacteria, too, and you can definitely fix this stuff and you can make significant progress.

Dr. Justin Marchegiani: Absolutely. I mean one person here, wildlab access, “How do you test for various enzymes?”Number one, if you have gut stress, you probably have low hydrochloric acid. And if you have low hydrochloric acid, you probably have low enzymes. Why? Because hydrochloric acid is important for acts of—for converting pepsinogen to pepsin which is the proteolytic enzyme. Hydrochloric acid lowers the acidity of the chyme, which is the mixed up food in the intestine. That inten—that food that chyme that goes into the small intestine which the acidity then triggers the pancreas to make bicarbonate, it also triggers CCK that then caused that the gallbladder to produce bile that also stimulates the pancreas to make light based trypsin and chymotrypsin and all the enzymes that come down. So if you have enzyme issues, you also have hydrochloric acid issues, but we can also assess it by looking at enzyme markers, like elastase, too, which will uhm—look at that in the DRG or the GI MAP test.

Evan Brand: You better get that frog out.

Dr. Justin Marchegiani: Frog out. It just attacked me, man. I’m like, Ugh—

Evan Brand: Alright.

Dr. Justin Marchegiani: My water—so uh—yeah. Elastase, I think it’s elastase 1 is the enzyme marker we typically look at for uhm— low enzymes. But typically, just assuming that we have digestive stress, let’s assume it for sure.

Evan Brand: Yeah. I mean that’s the same—the same answer that I would say for the leaky gut. I had people say, “Oh, can you test me for leaky gut?”  It’s like, “Yeah. We can go to Cyrex and spend 500 bucks if you want to, but based on your symptoms, I guarantee there’s intestinal permeability. You’ve got XYZ. And we can—we don’t need to spend the 500 bucks on that test. Save your money for the organic acids, your comprehensive stool panels, the GPL-TOX, maybe heavy metal testing. Save your money for that stuff that you can’t really guess on.

Dr. Justin Marchegiani: Yeah. Absolutely. I agree, man. Well, anything else you wanna hit off the bat here? I mean I think—I had some really good successes last week, too, with some patients that had chronic pain, chronic mood, chronic energy, hair loss. And I mean—just really simple things. We—we fix their hormones, this person has autoimmune thyroid, uhm—hypothyroid as well. T3 was super low, it was uh– T4 to T3 conversion issue, dysregulated cortisol. They had a lot of malabsorption and they had a couple of infections and we just—we just took them down the map. An then just everything first time around, uhm—just knocked in place. I mean it’s like you swing the bat once and it’s connected. It’s gone. Those were the patients where its like, “It’s just so rewarding coz it’s just—it’s easy” And then you have  some patients where it’s a lot more trial and error and digging in. So it’s nice to have those home runs every now and then.

Evan Brand: Oh, man. I—so I had a home run earlier with this guy that I got off the phone with name Dion. And he was on an inhaler. An asthma inhaler.

Dr. Justin Marchegiani: Yeah.

Evan Brand: And also I believe he was taking uh—allergy medication, like a prescription allergy medication.

Dr. Justin Marchegiani: Yeah.

Evan Brand: Maybe it was one or the other. He alternated or he was on the inhaler something. But he was on prescriptions for allergies. And all we did is we cleaned up the diet, we’ve addressed some gut infections. He had candida and I believe a couple bacterial infections. I don’t believe he had parasites. I have to look back. But I remember a couple of infections, fix the gut, uh—supported adrenal’s basic adrenal support, some adaptogens. And I talked with him today and he said, “Evan, I’ve not used my medication in the last six weeks. And everything is blooming here right now. All the trees and plants and everything are blooming and normally, I’m debilitated. He said, “I’m completely fine.”

Dr. Justin Marchegiani: Isn’t that awesome?

Evan Brand: How in the world just by working on the gut and adrenals am I not allergic to the environment anymore? It’s just like, “Oh, it makes me feel so good.”

Dr. Justin Marchegiani: I see that all the time, too. And hydrochloric acid is one of those things that’s really great with allergies, too. You notice that?

Evan Brand: Ain’t that weird? I mean since digestive enzymes, I told him, I said, “Man, we’ve gotta keep up digestive enzymes.” And then actually I am gonna send him a bottle of some of the like natural herbal anti-histamines, just in case. Because he started sneezing on the phone. I’m like, “Whoa, maybe you’re not all the way out of the water yet. Have this on hand, in case you need it.” So the coresatin in, the rutin, some of those–

Dr. Justin Marchegiani: Hesperetin

Evan Brand: Yeah.

Dr. Justin Marchegiani: The things I love for allergies: number one, just really get a good air filter. I used one by Advanced Air. You can see that at Look at the approved products. I like it. It’s good. Uhm—and then your natural anti-histamine degranulating compounds. In my product, Aller Clear. Stinging Nettle, coresatin, and then you’re gonna have like some vitamin C in that, some potassium bicarb as well. So those are really good. And you can go up to eat. The nice thing about it, just not gonna be drowsy. So you can get that allergy support without getting the drowsiness and then really make sure the diet is anti-inflammatory. Up the hydrochloric acid because HDL is really important with low—with allergy. It’s gonna make a big difference.

Evan Brand: Yup, Yup.

Dr. Justin Marchegiani: Ginger. Ginger is phenomenal, too, for allergies. Really good.

Evan Brand: I love ginger. So it’s a great nutrient. I’d do teas, ginger kombucha, there’s so much you can do with ginger.

Dr. Justin Marchegiani: Oh, yeah. By the way, right after this, I’ve got a new grill. So I’m gonna go out, I’m gonna grill some grass-fed hotdogs, right? And then I’ve got some sauerkraut with mustard. And I’ve got a nice ginger kombucha, I’m gonna open up. So I’m really excited for my lunch break today.

Evan Brand: Nice. What kind of grill? Is that one of those  pellet jobs?

Dr. Justin Marchegiani: I actually—I got a new Webber just because it’s—it’s—my other one was 10 years old. And then the knobs are starting to go. So I got a nice, little Webber Spirit. So it’s great. It’s got three burners. Love it. And uhm—I got a smoker that I use sometimes for ribs on the weekend just like a 4-hour job. So it’s good to have a day or an afternoon to kinda be at home to enjoy that one but—Yeah. So love my grilling. Try not to get things charred. Try to keep the heterocyclic amines and the polyaromatic hydrocarbons to a minimum.

Evan Brand: Agreed. Agreed, man. Cool. Well I don’t have one on my end.

Dr. Justin Marchegiani: You wanna have a share?

Evan Brand: No.

Dr. Justin Marchegiani: Hope you guys are liking these calls here. We wanna do more. We wanna connect with the listeners. Our purpose really is to serve and help people get their health back. If people want more feedback, or want more kinda like rolling up the sleeves and specifically diving into your case, go to or, click on the schedule buttons. And we are here to help you out. Evan, anything else, man?

Evan Brand: That’s it. Have a great day people, drink clean water, get rest, reduce stress, be grateful. It’s gonna go a long way.

Dr. Justin Marchegiani: And people on Facebook, I’m hoping we can get Evan on here soon. We gotta just  figure that out. So hopefully, soon we’ll do that. So Evan, great chatting with you, man. We’ll talk soon.

Evan Brand: Take Care. Bye.

Dr. Justin Marchegiani: Bye.



Dr. Ben House – Enhancing testosterone and improving your health- Podcast #130

Dr. Justin Marchegiani welcomes his special guest Dr. Ben House, a functional medicine doctor based in Costa Rica who also works with a lot of athletes. Join them as they engage in a very stimulating discussion about boosting up performance athletically as they focus on the role of testosterone in the male body.

Gain valuable insight about the recent researches related to Dr. Ben’s area of expertise. Know about the different tests, markers and treatment approach that he uses to address his patients. Get to apply some valuable information related to effective movement patterns that might be related to your health and body goals.

In this episode, we cover:

2:35   Nutrition Recommendation

9:40   Overtraining and Cortisol: Testosterone Ratio

13:33   Functional Medicine Tests for Athletes

18:37   Steroid and Insulin Use

33:30   Movement Patterns

42:40   Blood Markers and Patterns in Athletes







Dr. Justin Marchegiani: Hey, there! It’s Dr. Justin Marchegiani. Today we have Dr. House in the house. Dr. Ben, how are we doing today, man?

Dr. Ben House: I’m doing great. How are you?

Dr. Justin Marchegiani: Excellent. We got you on Skype, too. So anyone listening to the MP3, feel free and click below and check out the YouTube channel as well. And Dr. House is over at

Dr. Ben House: Yeah, that—that’s me. That’s where I’m at.

Dr. Justin Marchegiani: And you’re seeing patients virtually, as well, which is great. So if you feel like you jive at Dr. Ben, feel free head over there and reach out to him. Dr. Ben is also a PhD grad over at UT. Hook ‘em horns, baby. I’m in Austin now, too. So I’ve given up my Boston College UMass. I’m a modern now. And UT Longhorns, baby. So, congrats on that. Excited to chat.

Dr. Ben House: Yes. I miss Austin. It’s an amazing city for sure.

Dr. Justin Marchegiani: It is. And I know you used to work with a lot of athletes. Were you working with the UTF-8 as well? And the football players and such?

Dr. Ben House: Uh – I worked on a time, right, in basketball.

Dr. Justin Marchegiani: Basketball.

Dr. Ben House: Uhmm – Yeah, yeah. So now he’s in the Philadelphia 76ers. So I consult with couple of proteins but uhmm—it’s—yeah, I primarily work with males and athletes.

Dr. Justin Marchegiani: So tell me a little more about that. Like what are some of the low hanging fruits mean? Maybe we don’t have a lot of professional athletes listening here today. But what are some of the low hanging fruits are, you know, average people are listening can take and apply to themselves to make them better athletically?

Dr. Ben House: I think a lot of times we put professional athletes on the pedestal.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But most of the time, professional athletes are—uhm—they’re successful in spite of what they do.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Because of what they do.

Dr. Justin Marchegiani: Totally. So it’s probably not best to look at what they’re doing. Uh—uh there’s obviously exemptions to every rule. There are really some teams that are really pushing the envelope as far as nutrition. But you gotta think in the pro circumstance, there’s not a ton of motivation and drive to get guys healthy if it doesn’t get them performing.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Uhmm—so kinda sell there is—is Dr. Bob is really good about this—it’s you’re selling longevity.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Coz can you—after someone’s thirty, can you give him 10 years in the league, right? And that’s—that’s pretty important. And so, if we take this to the weekend warriors,  someone who’s—who just loves to train like me. I’m not a professional athlete.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I played college football, but after that, the dream was dead.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhmm—And so it’s—it’s we really gotta—I think the low hanging fruit is the fundamentals—the things that we always talk about. Coz most athletes—they—they don’t—they overtrain because they’re under recovered.

Dr. Justin Marchegiani: Totally. Totally. Now on the diet side, that’s probably a foundation. I think you’ll agree with this. On the diet side, are you kinda following the paleo template? What is the food quality? What does the macros look like with an athlete like that?

Dr. Ben House: So when I lecture on or talk about nutrition, I always talk about three things. So we have quality is the first thing for me. Quality is super important. Uh—we have quality in there, we have timing.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: Those are kind of—For me those are in the order of importance. Uhm—but we have to be really careful. Like Michael Phelps.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Who probably eats 68,000 calories a day.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You obviously can’t eat brussel sprouts and sweet potatoes and get it done. Uhm—so when you have—when you have some who’s just training 20 hours a week, your quality has to drop. And you have to make sure your adjustment’s on point as well.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: Coz otherwise you gotta just stop, put the car in the garage, and really kinda figure it out. And so it’s—we’re at a really cool point where I think we have some technology coming out where we can just individualize.

Dr. Ben House: So all these—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: –hypothetical, best way shit can just go away.

Dr. Justin Marchegiani: Totally. So we got the basically, high-quality proteins, high-quality fats. They’re probably—maybe these guys are gonna be higher on the macronutrients with the carbs and such, correct?

Dr. Ben House: That all depends – So carb work—

Dr. Justin Marchegiani: And in sport maybe.

Dr. Ben House: The carb world is really—there’s—I think of carbs as n__

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: And so if—if you want somebody to go fast, you need carbs and glycogen assistance. And so you can’t—you can’t feed high-intensity exercise on fat. It’s—it’s—

Dr. Justin Marchegiani: Right.

Dr. Ben House: We know that if your fat adapted, you’re actually—you’re actually metabolically inflexible so that you can’t burn carbohydrates at those—at those faster intensities. Uhmm—so for me, it’s all about what is athlete doing. What if they’re, you know, 40 year old, strength athlete and they’re 20 pounds overweight, uhmm—I’m gonna stay at the 5 rep range. Probably knock down carbs pretty well. If—are they a 20 year old athlete who’d never had any problem with weight, and I got their blood sugar, all looks fine, I’m gonna—how many carbs do you take, right?

Dr. Justin Marchegiani: Got it. Okay. Alright, got it. So we have kinda the macronutrients, we’re obviously cutting out—organics gonna be obviously dialled in, right? Food quality’s gonna be dialled in. We’re eating enough calories—that’s big. We’re mak—making sure the in the HCl and the enzymes are up to snuff so we can actually break down and digest those foods. We’re making sure we’re drinking, we’re sleeping maybe 8-10 hours. That could be big thing as well. Uh—more exercise, more muscle breakdown requires more recovery. I think with Steve Nash and Tom Brady, too. I mean they get like 10 hours sleep a night. I think that’s the biggest thing. Huge.

Dr. Ben House: Number one. Like if you wanna increase performance, like this is out of  Stanford, like sleep more. Spend more time in bed.

Dr. Justin Marchegiani: Yeah. You get to bed between 10 PM and 2 AM and you’re asleep during the cycle. You’re getting access to maybe $3,000 to $5000 of growth hormone a month just by getting in bed during those timeframes. Would you agree?

Dr. Ben House: Yeah. And I mean, testosterone is also secreted. GNRH works in that—inside that time block, too. So it’s—the circadian rhythm hormone. So you start jacking up your circadian rhythm. And a lot of the—one of the probably because athletes we see, they’re just hooked up on cell phones all the time like this is perpetual, you know, Twitter, Facebook, social media feed. Man, that’s—that’s a whole lot of bull S.

Dr. Justin Marchegiani: Yeah. Totally. So you get the nutrients, you get the digestion, you get the right amount of exercising. That’s a really key thing coz a lot of times it’s train, not drain. And you see a lot of overtraining with your athletes?

Dr. Ben House: Well, I think we have to be mis—I come from a strength coach background. So in the college setting, the strength coaches it—it’s unfortunate. And you even saw it at the  University of Oregon.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: When they got rid of radicals who was like, “who’s the man?” Uhm – and I bump into this other guy and he started smoking people and he put three guys in the hospital. Uhm—so the saying with this coach is pri—it’s sometimes they’re thought of as the punishers. So they have to dole out like someone doesn’t show at the practice. And so, if you’re in a team sport atmosphere, like—you don’t have that much control over the overall, though. There’s some people that are using like Zephyr or some really cool GPS program to over—to like measure overall look.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—but some of that is outside of your control.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: The cool thing—in the general population and if you have—while like private is because you can have total control over the athlete.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And—one of my favourite examples is Rutherford who like—he was like the 200 best in the world. Uhmm—and now, when he—he was training like typical like four days a week. And they brought him to like one-two hard training sessions every 10 days, and he won the gold medal. Alright. So—

Dr. Justin Marchegiani: Wow.

Dr. Ben House: So it’s kinda—it’s like everybody is individual and so if you can individualize that protocol and—and volume’s a hammer, right? And so that’s not the thing sometimes that we wanna use all the time.

Dr. Justin Marchegiani: Right. Right. That totally makes sense. So when you’re exercising these guys, are the movement patterns gonna be standard for each person like the functional ones like squats, deadlifts, lunges, step up, like core pushing and pulling movements. How do you adjust those and tweak those with the sports with the athletes?

Dr. Ben House: I—So that’s gonna be all dependent on the sport, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the position that they play. Uhm—so if you got a baseball player, like it’s all rotary power, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: It’s probably getting them—getting them at the right side of the right handed. Getting them kinda even and obviously not getting injured. from up your eyes standpoint.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Uh—so—it, it’s so rare but I think for that, it’s also gonna depend. Like is strength, is arm strength really doesn’t apply unless like you’re a full-back or a line man. Uh—sometimes the best guys in the weight room are the worst kind in the field. Uhm—

Dr. Justin Marchegiani: Right.

Dr. Ben House: It’s uh—we have crossfit now. I think that’s kinda—that—it’s really cool. And now the weight room is the sport.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And so weekend—it’s open right now—we can do crossfit as much as we want. But I think it just produced some people that can take insane amounts of volume. Uhm—and not everybody can. And they get—It’s very Spartan type society.

Dr. Justin Marchegiani: Oh, totally. Now when you’re working out with someone, is there a certain heart rate that you want people to get back down to? Maybe with your adrenal dysfunctional patient, is there a certain heart rate you want to get back down to before they go into the next set?

Dr. Ben House: Uh—I’m kinda __heart rate isn’t our best.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: It’s an okay marker.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: I—there’s a new technology that we’re using called mock C—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Which is essentially muscle oxygenation. So we wanna see that muscle is just resaturated with oxygen (O2).

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And it’s get—it’s probably not a horrible for just the average person right now.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But it will get more affordable, uhm—it will get more usable. Right now, it’s not that user-friendly. Uhm—I think you probably want to get back to a good resting heart rate. Also the—the research is pretty clear cut if you’re chasing hypertrophy. Uhmm—that 2-3 minute window for rest is probably where you wanna be.

Dr. Justin Marchegiani: 2-3 minutes. Got it. And are you looking at free cortisol to uhmm—I’m sorry, free testosterone to cortisol ratio to assess overtraining in any of your athletes?

Dr. Ben House: So I look at total testosterone. I don’t put a lot—this is my personal opinion—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’ve done a lot of research on salivary panels and I don’t like cortisol panels coz they’re just like—their—they’ve done 30 days of salivary test and they’re super variables especially in athletes. Uhh—so I don’t—If I could get a week of them, I would use them. But if I could only get one day, I don’t wanna just—I don’t wanna live and die by that one day. Uhmm—so, and I—you can ask questions. Like you know, probably the best indicator of overtraining is like hey, how you’re performing. Like how do you feel, how’s your mood like. So a lot of times, we can get a lot of information just by asking questions.

Dr. Justin Marchegiani: Got it. And what’s your total cortisol cut-off? Your total testosterone cut-off be like? Is it 100 above?

Dr. Ben House: Yeah. I mean the research is—I don’t really get, I don’t like the whole bench press number of testosterone.

Dr. Justin Marchegiani: Right.

Dr. Ben House: I think it’s only looking at production. We don’t know the sensitivity and the receptor. We—we can get such binding globulin and the albumin.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: We can get free testosterone but I mean the ment—the mental strain of that for guys like, “Hey you’re inadequate, you have a testosterone of 5.”

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I don’t like to do that.

Dr. Justin Marchegiani: Do you see correlations, though? Do you see like, “Hey, these are the althletes that are responding the best, that are recovering the best or getting the best results” Here is where his numbers at. Do you see any correlation there?

Dr. Ben House: Yeah. I think—we can’t really make that correlation—

Dr. Justin Marchegiani: Okay.

Dr. Ben House: inside of physiological ranges. Uh—we don’t have a lot of data on that as far as research. Anything I would say would be anecdotal there. Uhmm—do I think, do I have a hunch that it’s better to be at 800 than 380?

Dr. Justin Marchegiani: Yeah. Yeah. Totally.

Dr. Ben House: Do I know that 800 is better than 600 or 500? I don’t know. I haven’t seen that. I’ve seen—I’ve seen some beast that are in the 500 range like 10% body fat, like 210—like they’re front squatting 400 pounds. Like, so—

Dr. Justin Marchegiani: Testosterone can be really variable. I think it peaks more in the AM right? And they can drop down in the afternoon. It can be the variables. So you may just catch it at the wrong window.

Dr. Ben House: Yeah. And in some circadian rhythms are screwed up like you have no idea where you’re measuring. So, like it’s—it’s to me—it’s the lab value is not the person so I always wanna like, “Who is this person?”

Dr. Justin Marchegiani: Totally. Yeah. You gotta look at the clinical outcome along with the—the objective values. Totally makes sense. Are you doing any adrenal testing with your regular functional medicine patients?

Dr. Ben House: I don’t do a lot of adrenal testing. Uh—you interviewed Wakowski here, kinda one of my favourite sayings, like 99% of new-age primates are cortisol resisting or have cortisol dysregulation so—

Dr. Justin Marchegiani: Totally.

Dr. Ben House: To me it’s like why do I want to measure chaos? I’m a big fan of not measuring chaos. Uhmm—and that—that’s just my viewpoint. So I would be apt to use like—I would use it later.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So if you’re sleeping, if you’re doing all the things that you need to do, then I’ll run that—if we’re still not getting what we need to do. But the other way you can kinda frame it, too, is well, if I put this—I try to make it as least financially kind of—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—

Dr. Justin Marchegiani: Yeah. You’re trying to make it that the buying financially is low as possible so you can help more people, right?

Dr. Ben House: Yeah. Yeah. But for the testing standpoint, so—if—if someone—if I don’t—if they don’t care about money, I’m gonna get this test coz then if I show them, right? Then they’re gonna have it buying.

Dr. Justin Marchegiani: Yeah. Exactly.

Dr. Ben House: Yeah. And lever is gonna be higher. Okay, your free testos—you’re free cortisol’s jacked. You have no DHEA. You start to do the shit that you need to do, right?

Dr. Justin Marchegiani: Exactly.

Dr. Ben House: Uh but if I can get that from other means, If I can them dialled in the fundamentals, then—and doing all the things that they need to do—coz nobody in the general population’s doing that. I mean slow—today is low.

Dr. Justin Marchegiani: Exactly. So looking like at the palette of test, functional medicine test that you’re using with your patient, with your athletes, what are those top tests?

Dr. Ben House: Uh, so I – my top 2 are definitely a comprehensive blood panel

Dr. Justin Marchegiani: Got it.

Dr. Ben House: And then CSA. Like uhmm—

Dr. Justin Marchegiani: Stool analysis.

Dr. Ben House: Yeah. And if someone doesn’t—if that doesn’t pop, maybe I’ll go grab a SIBO breath test or something like that if they have—if they’re carbon tolerant—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But we gotta immediately fix the digestive component. And obviously you don’t fix that without fixing the cortisol component. But uhmm—that’s my—that’s what I do. And then I’ll run precision analytics sometimes.

Dr. Justin Marchegiani: Yup. Okay. So you will do one of the—the drug urine testing for the adrenal rhythm sometimes.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Okay. Good. I do those tests as well and their good.

Dr. Ben House: I want to see uh—so a lot of functional med—I think we can get in trouble coz I’m a PhD so I’m very research oriented.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So if a test doesn’t have a ton of research behind it, I—I’m not very apt to use it.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: And that can be good and bad. Uhm—but I think like 5 years down the road, like is that lab gonna run like duplicates for 30 days? Are they gonna—are they gonna just do everything in their power to validate that measurement? Or are they just gonna this is it. This works? Then that’s—that’s what I wanna see.

Dr. Justin Marchegiani: Yeah. That totally makes sense. And Biohouse got a new one out, called the CARS, the adaptive response. And they’re doing cortisol I think three times in the morning.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: And it’s interesting because you do cortisol right away, you do it an hour later, you do it two hours later, and you see a major change in that first two hours. So I think people are really getting more stringent on when you do cortisol especially in the AM which is helpful.

Dr. Ben House: Yeah. Our lab at UT actually did a bunch of stuff on the cortisol awakening response. Which is—which is—that’s kind of—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You knew that’s oughta things go as well.

Dr. Justin Marchegiani: Yeah. I totally agree. Now looking at growth hormone, how does growth hormone interplay? Kinda potentiates the effects on testosterone? How does growth hormone interplay? I know it’s connected to IGF-I goes to the liver. How does that affect testosterone and basically when you put on more muscle?

Dr. Ben House: So—

Dr. Justin Marchegiani: I know it’s a lot—

Dr. Ben House: Testos—testosterone’s gonna feed in IGF, right?

Dr. Justin Marchegiani: Okay.

Dr. Ben House: A lot of times and we can get the liver obviously want to work—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: growth hormones gonna be secreted at night and then the liver’s clogged is not gonna make IGF. To me, we can— from an IGF perspective—I’m not super well versed in IGF because I work with a lot of young athletes. And I don’t think we’re gonna have a lot of  IGF problem, like IGF-1.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’ve never—I used to measure IGF-1 all the time and like no one was out—like no one was—everybody was kinda in range. So I stopped running it. Uhm—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And that’s just my take. Now, could they benefit from growth hormone? Probably, right? Uhm—but we also have to be careful with that because IGF-1 is a growth factor.

Dr. Justin Marchegiani: Yeah. It causes cancer.

Dr. Ben House: Yeah. And well the research on that’s kinda another thing HGH is not related to increase cancer risk but I think—I think the evidence there—is there—just a little bit caution especially if you have a lot of cancer in your fate. Uh—

Dr. Justin Marchegiani: Yeah. Totally. So basically, the big things to increase testosterone: sleep, protein consumpt—ad—adequate protein, I imagine, right? The right amount of stimulus and then how about the timing of nutrition? Where does the timing come in to really potentiate testosterone and growth hormone?

Dr. Ben House: Well, I don’t know if we have a lot of research on that. Like acute—acute feeding of either fat or carbohydrate will actually lower testosterone uhm—especially in the fasted state. So to me, the bang for the buck there is probably from and under recovered mechanism. So if you just crash your glycogen stores, you probably wanna refuel. Uh—in—we know the biggest thing is gonna be total energy intake. You drop your total energy intake by 15%, you’re gonna lose D3, you’re gonna lose testosterone, so getting—if—if someone’s not—if someone’s training hard, they need the—in my mind, they have a body comp issue. And they’re training hard, they need to eat as many calories as they can to maintain their weight.

Dr. Justin Marchegiani: So when you see these guys in the NFL, for instance, let’s say a linebacker that needs to be big, strong, but relatively lean and fast, is it really just the quality of nutrients and getting enough of it? I mean these guys literally eating two-three thousand calories   more than what they would need just at that height and weight to keep that mass on?

Dr. Ben House: Yeah. In season, like you’re gonna see—you’re gonna see insane amount of calories going and going on their mouth. Like—they—they have to. They are that active. They’re—like you have a 230-250 pound man, they need a ton of food –three to five thousand calories easy. And so uhm—that’s—you gotta be careful coz that’s hard to get. And if—and that’s why we can get into trouble like intermittent fasting with that athletes.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And Paul Quinn is like very, very against intermittent fasting in athletes. And — I—I’m—I’m in the same camp. Uhm—if you—body composition is completely different, health is completely different, but I think—especially in season if you have an athlete that—you gotta get—you gotta make sure that you get him first.

Dr. Justin Marchegiani: Totally. What’s your take on steroids in general? Using steroid and/or using insulin as well. What’s your take on that?

Dr. Ben House: I—yeah. Yeah. This is awesome. Uhmm—

Dr. Justin Marchegiani: Let’s do it.

Dr. Ben House: From a TRT perspective, I think we’ve—and—a lot, just like a lot—like marijuana and I say marijuana’s bad or good. Nothing is bad or good, right? It is all context.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—I think we’ve had a veil dropped over our eyes as far as testosterone the same way.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—and everybody thinks their testosterone is very negative because of baseball, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But—the overall, the evidence for testosterone replacement therapy is overwhelmingly positive.

Dr. Justin Marchegiani: Right.

Dr. Ben House: Overwhelming. So—uh—now, we don’t want the same thing. We don’t wanna just slap that on every guy. We wanna make sure—we wanna use all these lifestyle strategies first, but traumatic brain injury—I – you know that’s gonna affect testicul—the—testicularitis. And so—And also, blaunt trauma to testicles. My best friend played __cross. He got hit by a 110 mile cross bow in the nuts. He had three concussions, right? So is that guy—

Dr. Justin Marchegiani: Aww, man!!

Dr. Ben House: Is that guy gonna be able to produce his own testosterone, right? And that’s not that abnormal like you talk—

Dr. Justin Marchegiani: Right.

Dr. Ben House: You talk—you talk to a lot of professional athletes like how many testosterone do you have?  I don’t know—right? Especially—especially in contact sports. Ask any of the guy.

Dr. Justin Marchegiani: That’s crazy. And elbo—also the xenoestrogen exposure is gonna disrupt LH- luteinizing hormone feedback loops, too, right? So we have the—we’re bombarded with the xenoestrogens and if you’re a female, obviously just in birth control pills will scrap the females as well. But you have it in the water, you have it in the pesticides and yeah—the plastics as well.

Dr. Ben House: Yeah. This is something like—male health—this is why I feel so strongly about male health is coz we have no idea what’s gonna happen, right? Babies—they—their PON1’s are not very active. And PON1 is that enzyme that kids rid of persistent organic pollutants, right?

Dr. Justin Marchegiani: Totally. Yup.

Dr. Ben House: And so we got—30—the top 37 pesticides that are used in our foods are anti-androgen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So we have no idea what’s gonna happen, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And then so the—and they only run test on one of them. They don’t run it at all of them. Uh—it’s—it’s very scary. Uhm—and this is—from my protecting you have to do everything in your power to eliminate all of those potential pollutants, right? Skin care products, everything. So we gotta get kinda weird. Uhm—and you don’t know if that’s gonna have an effect but you have to—you have to make sure. You cannot—especially babies. Like we cannot put that on—Look at the male population it’s going up today like it’s pretty scary.

Dr. Justin Marchegiani: Oh, especially if you—you can’t breastfeed your child and you’re feeding them soy protein isolate. My god, the phytoestrogen content that you’re getting on that can rise up to potentially a birth-control pill in amount. Especially that’s all they’re relying on for the first six months to a year.

Dr. Ben House: Yeah. It—it’s wild, man. Like it—it’s—it’s gonna be—it’s gonna be really, really interesting as you see what happens in 30 years. Like when this generation gets so like their 20’s and 30’s and 40’s, it’s gonna be—it’s gonna be wild.

Dr. Justin Marchegiani: Absolutely. I have some people here in Austin, they’re uhm—doing some run care in melatonin and I’m researching helpful companies that’s more essential oils and more natural compounds and reusing like dying to meet—dying to make just earth to treat the fire ants or using boric acid for natural things. And peppermint oil for the Hornet’s and vinegar for different things. So we’re trying to limit our load naturally. But I see people everywhere else they’re putting a lot of chemicals out there. Are you familiar with the research on lung care products and like childhood lymphomas and leukemias and such?

Dr. Ben House: No. I haven’t—Well I haven’t looked at a lot of that research coz that’s not in my wheelhouse.

Dr. Justin Marchegiani: Got it.

Dr. Ben House: But if you look at people just eating organic vs. non-organic p—produce like if you eat organic produce, you’ll get higher sperm count—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Your sperm is clear. It’s hard—that’s the dopest study at Harvard Med.

Dr. Justin Marchegiani: Yeah. Yeah. I totally get that one, for sure. I’ll plug the documentary, too. The disappearing male.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Excellent PBS documentary that talks about basically these estrogenic compounds in the environment that are hurting men and our future babies. So, keep that mind, too. That’s really good.

Dr. Ben House: You can kinda educate me on this, but I think all of those are gonna be mitochondrial toxin-based, right? If you jack up the mitochondria, you’re gonna have trouble with cancer.

Dr. Justin Marchegiani: Oh, absolutely. You’re gonna have issues with cancer. There’s a great book it’s called, “Tripping Over the Truth”. That’s a really good book on cancer and the connection with the mitochondria. That’s a really, really, good one. And also, just the fact that it affecting the HPT access coz you screw up LH, uhm—you screw up the pineal gland, that affects melatonin that affects puberty. All these things that antagonizes itself. And then the more fats cells you have, the more estrogen you produces, then it’s a downward cycle, the more insulin-resistant you become. And it’s just this downward cascade—this metabolic accident, so to speak.

Dr. Ben House: Yeah. It’s just loops everywhere. And you gotta figure out how you’re gonna break those loops and—and that’s the thing, some guy, they have like 25 loops right in. And you just wanna give them to—that’s not gonna fix the problem. You have—That’s not—you’re not helping anyone.

Dr. Justin Marchegiani: Yeah. And what about things like anabolic steroids? The more synthetic ones? DBOL and such?

Dr. Ben House: Yeah. I don’t use those. Uh—I have clients who do. Uh—

Dr. Justin Marchegiani: Yeah. What’s your take on that?

Dr. Ben House: I don’t—I don’t manage any of that.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: What I do is I just wanna make sure that—that’s their choice, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So I—as a—as a—as—just a male in general and as a clinician, I don’t ever wanna change someone’s goals. I just wanna help them do what they do better. And so, if you wanna be a pro body builder—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re gonna have to play in that realm. Now I’m not the guy to run your anabolic regimen. But I can at least see like what’s going on? Are you—are you able to get rid of it? What’s your liver doing? How’s the hematocrit? Can manage all the things that could go wrong in that situation? 24:33 Uhm—the research on that is—is—is—is I think one thing that I would like to highlight—so they’ve done studies where they give a guy 600 mg a test.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the average builder like 1100, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And so they give these guys 600 mg a test in 12 weeks. They give 20 pounds a muscle without an exercise regimen.

Dr. Justin Marchegiani: Whoa!

Dr. Ben House: Yeah. So you’ll think about—

Dr. Justin Marchegiani: That’s insane!

Dr. Ben House: You’ll think about like instagram phenoms, like you got a lot of people out there—a lot of males that I think are chasing things that aren’t physiologically possible. Uhm—and that—

Dr. Justin Marchegiani: You mean—

Dr. Ben House: Yeah. Go ahead.

Dr. Justin Marchegiani: You mean like the people you’re seeing align, they’re doing those things that you mention. The 600 mg of tests and they’re just getting massive amounts of muscle that you may not be all to cheat naturally. Is that what you’re saying?

Dr. Ben House: Yeah. The ethotomy is uhm—so that’s a—that’s a calculation that you can do. And anything above 25 is—it’s kind of—then you start asking questions.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like my ethotomy is like 24, right? And I’m, you know, 1—190-185-190 and anywhere from 8-11% body fat. Maybe a little bit more if I’m off my game. Uh—and so there’s kind of a line in the sand that we can cross naturally. And obviously there’s gonna be people that are above that just from a statistical perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But if someone just looks on godly jacked, I mean maybe—well—who am I to say what they’re doing and I don’t wanna be the guy that’s the ultimate whistle blower.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But I think we just gotta—we just gotta—when you look at everyone else’s highlight here, you’re gonna start questioning your own self-worth and I don’t know that you wanna do that.

Dr. Justin Marchegiani: Totally. Totally. And what do you think about uhm—tendon growth when you’re on hormones like that? Let’s say, I know more of the artificial, but in general, do you get the compensatory growth in the tendons to support the increase in muscle mass?

Dr. Ben House: Yeah. So that’s one of the problems, right? It’s uh—you think about how the body responds like to__

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: The first thing that we’re gonna have is neural, right?

You can get that in minutes. And the second response is muscular. And so that’s gonna take, you know, 8 minutes, maybe last if you’re—you’ve never__

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But that—that collagen response that you know, that’s building up the fascia, building up all the tissue and the bones. That takes a longest time. So when you take shortcuts, if I put a 25 lb muscle on you, and I haven’t—I haven’t build up the structure, I’m gonna—that’s when you like—biceps tear don’t happen. Like you see a bicep tear on a deadlift, like, “Uhmm” I’m thinking, what’s going on?

Dr. Justin Marchegiani: Yeah. Totally. So do you uhm—

Dr. Ben House: Does that make sense?

Dr. Justin Marchegiani: Yeah. That totally make sense. So you—something you’re careful of and you increasing collagen supplementation to help provide extra tendons building blocks, too?

Dr. Ben House: Well, everybody had—everybody is pretty much using that I have is collagen protein.

Dr. Justin Marchegiani: Great. So you’re doing that.

Dr. Ben House: Yeah. Especially in the beginning, I take everybody off away for 30 days just coz it’s a common allergen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And if they can handle that, I want it back in. Uhm—but yeah—yeah I would say that’s kind of a non-issue for me.

Dr. Justin Marchegiani: So you sub out—will you sub out like the way for like a high-quality, hypoallergenic pea protein in the meantime?

Dr. Ben House: No. I’ll use—I’ll use uh—

Dr. Justin Marchegiani: Beef?

Dr. Ben House: I think if you take enough pure paleo, I think you’re gonna be fine on losing content.

Dr. Justin Marchegiani: Got it.

Dr. Ben House: That’s like a 3-gram threshold. So yeah, less than whey but if you take 30-40 grams of it, you’re gonna be fine.

Dr. Justin Marchegiani: Nice. Awesome.

Dr. Ben House: Well, I know you post a lot on Facebook. You got a home gym, you’re dad in Costa Rica now, you move from Austin down there. So you got a pretty awesome lifestyle going. Give me a quick walkthrough in the day of a life of Dr. Ben. What time do you get up? What do your meals look like? What does your work out looks like? What is post and pre work out nutrition look like? What does sleep look like?

Dr. Ben House: Yeah. That—that’s fun.

Dr. Justin Marchegiani: Ahaha.

Dr. Ben House: So my days, I wake up—one of the cool things of why I’d wanted to move here is getting closer to the equator.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—So I go to bed like 8:30. Can’t keep my eyes open.

Dr. Justin Marchegiani: Wow!

Dr. Ben House: And then I’m up naturally like you talk about cortisol awakening response, like I can’t sleep past 5:30. So—

Dr. Justin Marchegiani: That’s great.

Dr. Ben House: So I wake up—I wake up and I immediately sit, right? So I sat for—I meditate for 15 minutes. Done that for years. Uhm—

Dr. Justin Marchegiani: Great.

Dr. Ben House: Never—never will stop. That’s kinda—

Dr. Justin Marchegiani: Any kind of meditation? Just kinda like a blank slate in the head and you’re breathing or—

Dr. Ben House: I use mantra practice. Sometimes my dad is a—is Zen teacher.

blank slate and had new breeding or is much about is sometimes my dad as it is in Zen teacher is an ordained Zen priest.

Dr. Justin Marchegiani: Oh, awesome.

Dr. Ben House: Yeah. So in—I started—I took my whatever you wanna—I’m kinda involved when I was about 19. Uhm—probably the best gift that I was ever given uhm—was that to be able to go to that—come to that mindful practice early.

Dr. Justin Marchegiani: That’s great.

Dr. Ben House: So I’ll do—I’ll do some calming. Sometimes I do some Tibetan practice which is like—it’s one of my favourites where you wish someone well that—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And the next breath, you wish someone well that you’re kinda apathetic about.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: someone that you don’t know very well. And the last, you wish someone well that you hate.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: That you don’t really like.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And it kinda—it really helps you and by the end, you’re kinda like, “Man, I don’t have that many people that I—that I don’t like and why I don’t like them.” It becomes mostly probably, you know, you start looking to word about that.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: That’s one of my favourites.

Dr. Justin Marchegiani: Love it. That’s great. So morning routine, you’re getting up 5:30, you do your meditation 15 minutes, what’s next?

Dr. Ben House: Uh—so if it’s a training day, I’m probably gonna have some type of easily digestible carbohydrates and Natchan in the morning coz it’s hot here. Uhm—also, I train in I’d—I like to smash myself with prob—I’m NEAT head, there’s no way around it like I’m gonna be that guy probably even if—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: ills me. Uhm—And so I’m—I’m working that glycolytic high intensity pathway uhm—3x a week. In my youth, I do it unbelievably too much, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But—so I’ll do that and I’d work for about 3 hours in the morning depending on what I got. I usually don’t take clients until the afternoon. Uhm—And then I’ll train or if it’s a non-training day, I’m just working. Uhm—and then right now, we’re building a retreat center so I have a lot of things that I—I’m the gen—I’m essentially the general contractor there so—

Dr. Justin Marchegiani: That’s awesome.

Dr. Ben House: And so half my day is in Spanish, the other half is in English. Uh—sometimes I have to run up there and do stuff but—

Dr. Justin Marchegiani: Nice.

Dr. Ben House: I spend—I spend 4 hours at least a day on Pub Med in researching and writing. That’s my—that’s my thing. I love it.

Dr. Justin Marchegiani: And you have awesome Facebook posts, too. I appreciate it. You really condense a lot of the research down.

Dr. Ben House: Yeah. I think that’s how we move people, right? We just consistently hit them. And you do it with a podcast.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like this is a—even if it’s—even if it’s repetitive affirmation like if it produces an action, that’s what I’m all about.

Dr. Justin Marchegiani: Totally. Got it. So Pub Med 4 hours a day, that’s awesome. And then patients and then what’s next after that?

Dr. Ben House: I try to stop working.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—I think a lot of us are super passionate about our craft. I’m better about that when like something isn’t coming like I have uhm—big—big presentation’s coming up in a month. So now, I’m kinda—I’m always prepping for that. Those are kind always in my mind. So I use a lot of hard mat to kinda like turn my self-doubt.

Dr. Justin Marchegiani: Yup. Yup.

Dr. Ben House: Uhm—And I try to shut it down. Shut it down in the evening, definitely by 5 or 6. And I’ll just do fun stuff with my life, right? Maybe we’ll read. Maybe I’ll read something like super unscienc-y. Maybe we’ll just watch a movie. We kinda watch— I tend to push for comedies. He tends to push for dramas but uh—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And I always make sure—one thing I’m really, really like big on is you have a treadmill test. It’s just baseline of movement. Like—

Dr. Justin Marchegiani: Huge.

Dr. Ben House: We put all these—we put all these pressure on exercise and it’s just a small bucket as far as like movement. It’s like NEAT is where it’s at, Non Exercise Activity Thermogenesis. And so if someone is not gaining 10,000 steps in a day, like all of the core can take can be just regulated. They’re not gonna be able to sleep. So so many good things happen if people just move.

Dr. Justin Marchegiani: Oh, I agree. I mean I just got seen patients yesterday. I’ve got 25,000 steps yesterday. I mean I walk about 10 miles a day. I’m on my leg uh—my fitness power here. And I’m like—you know, there’s a leader board section and I’m always like—I always like try to be number one. So there’s yesterday right there, 21, 500. So, super. I love it.

Dr. Ben House: You’re living it.

Dr. Justin Marchegiani: Oh, yeah. Absolutely. And then the key thing is to I kind have my kettle bells down over here and then some push-up bars so I try to rep some of the that stuff in between patients even if I can do 2-3 minutes in like 5 or 6x a day. It just keeps the metabolism up.

Dr. Ben House: Sounds good.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I’m—I’m—I train so hard that you could I mean—

Dr. Justin Marchegiani: Yeah. I get it. I get it.

Dr. Ben House: I’m not doing pull ups—

Dr. Justin Marchegiani: You’re done. You’re done after that. You’re done, man. Absolutely. So right now, we have a lot of listeners that may not be at that professional level, right? You know, frankly, they wanna be healthy, they wanna be energised, they wanna have good relationships. And then probably I can say that they probably wanna good look naked, right?

Dr. Ben House: Yeah. Yeah. That’s the point also.

Dr. Justin Marchegiani: Yeah. So what are the top 5 movement patterns those people should be doing? And maybe you wanna differentiate man and woman so in case something is different there.

Dr. Ben House: Uh— So I would say first of all, like just how people are gonna come see us for a lot of like metabolic stuff and all the—everything that we do for functional med. See somebody who’s good at movement—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Like—like you’ve been at a desk your whole life and you can’t take an exhalation. Like you probably shouldn’t be deadlifting.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Like if you’re stuck in this state of extension. I don’t know that that’s—are you really gonna even activate your hamstrings? I have no idea, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Especially __Uh—so I think we wanna be able to use—we have to be able to use the big guns. We gotta—you know—hamstrings, quads, back—

Dr. Justin Marchegiani: Yup.

Dr. Ben House: Chest, right? And so you’re gonna—you wanna squat, you wanna deadlift, you wanna benchpress, you wanna military press, but it’s always risk vs. reward. So the risk of anytime you strapping somebody, 2 hands in a bar is higher than if you put on single limb, one arm weighted, right? Or one leg weighted.

Dr. Justin Marchegiani: Yes.

Dr. Ben House: And so for me it’s all about how do we individualized this to the person? And if you don’t individualize this, what we’ve seen is—so one of my—one of my good friends in—we used to—we have a business together in Austin, his name is Erin Davis. He’s probably—he’s like the most unknown exercise scientist. And he’s like purposely so. He’s like a hermit. And he’s a—

Dr. Justin Marchegiani: Nice.

Dr. Ben House: He’s an insane, right? And so he straps up all these gadgets to this dude. And he’s like—and – he just messes bench pessing. He’s like, “What the hell? You’re chest doesn’t even turn on.” Right? And so he can’t even—out of a barbell  bench pressing, he can’t even get the guy’s chest to turn on because of his positioning. Gives him a dumbbell, boom, he can get—he can get pec activation. So I think it’s—

Dr. Justin Marchegiani: Oh, wow.

Dr. Ben House: So I think it’s really important that you see somebody who’s good at movement evaluation so you can look at your position, right? Coz muscles are slaves to position.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So the position—who the he—what are you gonna do? Uhm—and I think there’s DNS, PRI. There’s a lot of uh—FRC. There’s a lot of things that are looking at that now.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—and there’s a lot of people that are really good at it. And so see them, pay them for their time. Uh—in Austin, there’s a guy Steve Cuddy who’s amazing.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhmm—Erin Davis and Pad__ is obviously really good and Dave R__ has done the same as Marcus—who’s awesome as well.

Dr. Justin Marchegiani: That’s great. So what are the top 5 movements?

Dr. Ben House: You tell me. What’s gonna activate the biggest muscle groups?

Dr. Justin Marchegiani: So for me, off the bat, it’s gonna be deadlift coz that’s the only one that connects upper body and lower body but actually doing with correct form really activating the lats, locking them down. Number two would be squat. I wanna get your take on front squat or back squat, though. I would do uh—pote—I’m a big fan of unilateral single leg like deadlift movements. I like those with cables. Big Paul Chek fan with that. I would say step ups and/or lunges and then after that, I mean, If I’m doing a movement, I would wanna do something that has explosion. So I would wanna do either uhmm— snatches or uhmm- cleans or sprints.

Dr. Ben House: Yeah. I would—I would pick like maybe one of those. Haha—

Dr. Justin Marchegiani: Oh, let’s hear it.

Dr. Ben House: That’s good. That’s great.

Dr. Justin Marchegiani: I want—I want your take. Let me hear it.

Dr. Ben House: Yeah. Yeah. Uh—So you gotta—upper body pulling is like super—you gotta have—you gotta have one of those in there.

Dr. Justin Marchegiani: Yup.

Dr. Ben House: So whether—that’s probably a lot. Maybe a pull up if you can do it right.

Dr. Justin Marchegiani: Okay. So you’re talk—Alright. Got it.

Dr. Ben House: Uhm—if someone’s goal is just health, probably most people’s goal is hypertrophy.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So in my mind, they need to get really, really really good at the fundamentals.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: Variety may not be your bestfriend.

Dr. Ben House: You may need some of it just to keep you—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: –in the game. But you gotta be—I would probably use a trap bar. Uhm—safer for the general population. You can load it up.

Dr. Justin Marchegiani : Yeah.

Dr. Ben House: Uh—it’s gonna be more quad dom. Uh—

Dr. Justin Marchegiani: Yup.

Dr. Ben House: I’m—So the—From the—from the deadlift perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: I think it’s great but if you’ve been a gymnast or if your hamstring length is really, really long, if someone can palm the floor, I’m gonna be very—I’m not gonna use—I’m not gonna throw a deadlift at somebody right there.

Dr. Justin Marchegiani: Okay.

Dr. Ben House: I’m probably gonna use—I’m gonna use maybe couple of Bulgarian split squats, Which is probably my favourite exercise for the general population. Where you like get to activating the hamstring uhmm—from a front squat, back squat perspective, the muscle activation is fairly similar. Uhm—I would probably lean in the general population more towards the front squat because you’re gonna have more anterior core, you’re gonna have to stabilize, right? And also, like if you can’t do it, you—you drop it.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Whereas the back you can like—you can—you can—

Dr. Justin Marchegiani: Yeah. You’re gonna overpower it, for sure.

Dr. Ben House: Yeah. You might hurt yourself. Uh—so those are my view points. Again—and I use uhm—I think speed and doing things that people love is really important so—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You know how to Olympic lift, and you like to snatch, you like to clean obviously. I love those things. But if you don’t like doing Olympic lift, there’s a lot of—like sprinting is a great way. But in the jumping—there’s a lot of different little things that you can do to come and get that fast twitch movement coming. Uhm—

Dr. Justin Marchegiani: Are you doing any single leg stuff?

Dr. Ben House: Yeah. You can do single-leg hops, you can do, you know, whatever. You can—I do it ton. So I don’t—I do myself in all my single leg and kinda that prep toy stuff. That’s one of my cool down. So that never leaves, right? I’m doing a lot of like prehab, rehab stuff. But my meat and potatoes is my meat and potatoes. Uhm—it’s like you can’t lose sight of that. But if someone has never train in their life, their entire workout might be prehab, rehab.

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Okay. That makes sense.

Dr. Ben House: Does that make sense?

Dr. Justin Marchegiani: Yeah. Totally. Now you’re reading a lot of studies. You’re spending 4 hours a day on Pub Med.  What are the key things that you look at in the studies so that you don’t get tripped up by you know—coz sometimes the conclusion might not match what the actual study has done. Just—I know we don’t have an example here, but what are the key things people should be highlighting or looking at when they’re reviewing the study?

Dr. Ben House: That’s a—that’s a problem to question. So like UT was kinda burning to us in the PhD department really, really early.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—the first thing he looks at is the chart.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So you go straight to the figures. Uh—you look at the figures and then—and then you kinda look at the stats section. You figure out— And this is from a research perspective.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Then you look at the stats section, then you look at the subjects and then you start digging the—everything that’s going on the method section. Before you look, at the conclusion and maybe—sometimes I’ll just—I’ll buzz your abstract to see what I wanna read. I’ll definitely do that. Uh—but the problem is most people, even myself, being out of the grad school for, you know, a year and half-two years. We don’t—I don’t like looking at a ton of stat research. So like Microbiome data. It’s probably the best example here. Like our lab run a ton of microbiome data.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: We got stool samples on many people, we sent that out – yeah we send it out to another lab. Uhm—and that guy get all the analysis—all the genetic analysis on the poop.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And then that guy couldn’t even analyze the data. So had to send it to a statistician to analyze the data so that we can have—we can think about it. So think about all that. Like that is—

Dr. Justin Marchegiani: Lots of steps.

Dr. Ben House: Now you ask the general population. You’re asking the general population to look at some kind of general linearized cluster analysis. But I don’t even know what day it is, right? And so—that uh—that—like—you know—and so they have—they tend to digestible and take away. So there’s a lot of reliance on science. If you see a study, and this is kinda something that we could talk about. You see a study that’s running like 20 paired T-test, I’m immediately like, “What the hell are you doing?” Like you can’t run—it’s—you have this 95% like a .05 alpha.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So in order for something to be statistically significant it only has to happen 5% of the time, essentially.

Dr. Justin Marchegiani: Right.

Dr. Ben House: And so if you run 20 tests, one of those is gonna poll just from a statistical standpoint. So that’s—you gotta be careful with that. So in that situation, I’m looking for a manova instead of an inova.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—so if you see kinda like this fishing explanation which you’ll see a lot, you just see the smorgasbord of data. Uhm—be careful with that. And so—coz it can—that’s one of my favourite things to pick apart.

Dr. Justin Marchegiani: Anything else? So let’s summarize that. So you like the manova—you look at the—the uh T-score, right? The .05 you’re looking at that as well.

Dr. Ben House: Yeah. Yeah.

Dr. Justin Marchegiani: You’re looking at—

Dr. Ben House: You go ahead.

Dr. Justin Marchegiani: You looking at the graph—you go ahead.

Dr. Ben House: Yeah. You just—so we wanna make sure that something is—something can be  statistically significant but mean to us.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: So if it is— if it’s like say, you have a .1 rise in testosterone, but it’s at the .001 level, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Okay. You have a statistically significant finding but it’s clinically meaningless. So we gotta make sure that—that their findings actually mean something.


Dr. Justin Marchegiani: Totally. Awesome. That’s helpful. Anything else you wanna add on that?

Dr. Ben House: Yeah. I think that Alan Aragon, the best way to learn about research is to read other people’s critiques of research. Uhm—and Alan Aragon has his research review. And it’s a steal. It’s 10 bucks and you get 8 years of monthly research review. So if you wanna get good at reviewing research, the best place is you just read it.

Dr. Justin Marchegiani: Yeah. Totally makes sense. Now you mention back earlier that you are looking at a lot of blood patterns. What are the big patterns that you’re seeing pop up? Are you looking at thyroid? Are you looking at protein digestion by some of these markers? What are you seeing in blood?

Dr. Ben House: Yeah. So the first thing—the first thing that I’m gonna look at is haemoglobin and glucose control.

Dr. Justin Marchegiani: Yup.

Dr. Ben House: Uhm—that’s not the best measure for athlete because they’re gonna dispose of red blood cells faster than general population.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: So if you see a high HbA1C in athlete, you might actually be a little bit more worried. Like maybe like 5.6, you’re like, “Uh—what’s going on with you?” uhmm—

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: And that all goes to context, too. Like are they gonna gain? Are they trying to gain weight? Then I’m not—they’re not probably not gonna get diabetic if they have a ton of muscle mass.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uh—And that’s all context dependent. And I actually like—I’m—I don’t put a lot of weight in my fasting glucose and fasting insulin.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uhm—you’re probably gonna see this, right? I don’t work with a lot of chronic patients. So that—that—C peptide and those measurement fasting can be really good for those kind of patients.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But when you—when you got a guy who’s 6’1, 8% body fat, that’s probably not gonna tell you much.

Dr. Justin Marchegiani: No.

Dr. Ben House: Uhm—and so I—what I really like to do is I like to use glucometer protocols.’’

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: Uh—and so I have people grab—

Dr. Justin Marchegiani: Come on right here.

Dr. Ben House: Just grab it 13x a day and see what happens.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And send me—send me a graph and send me when you eat and let’s have a—let’s have a discussion. Coz if you eat 3 rice cakes and you go to, you know, 200. That does not happen.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re storing glucose in urine like we don’t want that to happen. So that’s the way we can kind of, you know, tweak carb load. The next thing uhm—obviously, you need thyroid support.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You need thyroid hormone. It runs in every cell of the human body. So I’m gonna drop—from there, I’m probably gonna drop down to thyroid and see what’s going on there. Uhm—I mean I’ve picked up so many like—Hashimoto’s in like 14-year-old kid like one of the best pictures in Texas.

Dr. Justin Marchegiani: Wow.

Dr. Ben House: And he couldn’t recover, right? He constantly has this stupid injuries. And we grab  his lab work, his TPL is like 300.

Dr. Justin Marchegiani: Whoa!

Dr. Ben House: And we’re like—Yeah, and we’re like, “okay”  And he feels better, right? All these—we can’t—I can’t—his dad is like, “Oh, he needs to eat like Brady.” All that stuff—

Dr. Justin Marchegiani: No.

Dr. Ben House: I’m like, “No, he doesn’t.” Like—and now the kid is taking ownership of it which is amazing. He’s like—he’s like, “No, I’m not gonna eat that.” And so now, he on—he pretty much eats only autoimmune paleo. He have some rice, he does okay with rice. Uhm—and he couldn’t—he was overweighing, still crushing it like meanest curve ball uhm—this side of Mississippi. And so—but now—he’s—he’s—he looks amazing, right?

And if you play at these schools, these Texas schools, you gotta look the part. Like even if you’re—even if you’re amazing, you have to—you have to look like an animal.

Dr. Justin Marchegiani: Absolutely.

Dr. Ben House: That’s kind of unfortunate.

Dr. Justin Marchegiani: Yeah. I mean have Hashimoto’s myself and I play baseball and sports and football growing up. And I had lots of injuries coz I was trying to eat 11 servings of grains in the food pyramid, so there’s a lot of misinformation out there. And again, a lot of people are seriously inflamed. And the more inflamed they are, the more catabolic. The more catabolic, the more they can’t recover and uh—put on muscle and heal, essentially.

Dr. Ben House: Yeah. To me it’s like—it’s all about breaking cycles, right? My dad has celiac disease.

Dr. Justin Marchegiani: Wow.

Dr. Ben House: We found out—we found out when he was like 40, like 10 inches of his colon moves—

Dr. Justin Marchegiani: Oh, man.

Dr. Ben House: His gallbladder is tightening up.

Dr. Justin Marchegiani: Yikes.

Dr. Ben House: Like that’s why I got into this. I was gonna go to medical school.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And my dad got super screwed up by the conventional medical system. He was having pain killer on demand. Uh—and then I was in Colorado and I—Breaking the Viscous Cycle, I’ve read the book—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: And I was like, “Hey dad, let’s just change your diet. Three A’s set him free, he was struggling like 10 years.

Dr. Justin Marchegiani: I know. Isn’t that crazy? Dude, I know. I see it everyday. I mean—it’s—we have he most rewarding job in the world.

Dr. Ben House: Yeah, for sure.

Dr. Justin Marchegiani: Because you get someone banging his head against that conventional medical wall for 10 years plus, at some point, they started throwing it back on you. Saying it’s in your head, and they start making the Psychophol, right? And writing scripts for Zoloft and such. And then you’re just like, “ My god, this can’t be real.” You know—it’s gotta be real. So looking where you’re at, uhm—you mentioned uhm— blood markers. Anything else? You’ve talked about thyroid. Any specific cut off that you wanna talk about with TSH, T3 or antibody levels?

Dr. Ben House: Uh—Yes. So what I’m—I’m use uh—I use a software And so I’m always looking at total T3, total T4, free T3, free T4 and—so I’m always looking at what’s going on with that. Are they producing a ton of T4 but then they’re not converting any of it to T3?

Dr. Justin Marchegiani: Right.

Dr. Ben House: All the thyroid hormones are bound up. Like are they on—which is to me—like I see it constantly like if I take on a female client. I’m like, “Oh, your thyroid hormone is bind up, are you on birth control?” “Yeah.”

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: There it is, right? It upregulates thyroid body globulin.

Dr. Justin Marchegiani: Right. Uptake. Uh-hmm.

Dr. Ben House: One of the ways that we know—we know that testosterone increases lean mass and metabolism is that it dominates your thyroid binding globulin. So—

Dr. Justin Marchegiani: Totally. Yeah. Makes sense. You see that in PCOS, right?

Dr. Ben House: Yeah.

Dr. Justin Marchegiani: Yeah. Exactly. So we got the thyroid. What are you looking at for protein digestion? Are you looking at globulin, creatinine, serum protein, albumin? What are you looking at?

Dr. Ben House: Uh—so yeah I think total protein and globulins are soft markers for—I always think of them as like check engine lights. They’re not like end-all be-all.

Dr. Justin Marchegiani: Yeah. Uh-hmm.

Dr. Ben House: But if I see them low, “Oh my god, let’s keep some work add on that situation.” Uhm—and then kidney markers—In athletes, like this is like—

Dr. Justin Marchegiani: Bone creatinine.

Dr. Ben House: Oh my god, this is like—I love talking about this because that—does can actually—kidney markers are essentially useless, right, in athlete. Because blood urine nitrogen is the breakdown of protein products.

Dr. Justin Marchegiani: Right.

Dr. Ben House: So if you’re in a Ketone, high protein diet, you’ve already—you’ve knocked that up. Now creatinine is indirect measure of muscle mass. So if I have a jacked gorilla who’s in a ton of protein, he’s automatically gonna have a GFR that’s probably pretty screwed up. But his kidney function maybe fine. Uh—so the best marker there is statin C. And so if someone is super worried about their kidney function, I’ll run that coz that’s not affected by protein intake or muscle mass.

Dr. Justin Marchegiani: Statin C for the kidney?

Dr. Ben House: Uh-hmm.

Dr. Justin Marchegiani: Okay. Yeah. Yeah. And I’m not seeing patients that are at the same level as you know, being an athlete but I do try to keep them 48 hours away from strenuous workout so you don’t get those false positives.

Dr. Ben House: Yeah. I do that as well.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Uhm—but the re—it’s all individual. So they’ve done studies, it can be 10 days that you’ll see like liver enzyme’s high, bilirubin high. So you can—you can see those things. It all depends, some people get back in 48 hours and obviously we can’t tell people not to train for 10 days. Uhm—that’s not gonna work.

Dr. Justin Marchegiani: Right. Right.

Dr. Ben House: We won’t do that. But I think 48 hours and making sure that their hydration is really, really solid.

Dr. Justin Marchegiani: Yeah. And do you think muscle soreness would also be a pretty—pretty good subjective indicator? Making sure that they’re not incredibly sore or like in pain or you know, hurting from the workout?

Dr. Ben House: Yeah. I think it’s probably good from an inflammatory standpoint.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: You’re gonna—with CRP, you’re gonna see an acute rise with exercise and that is a positive in that overtime. Uhm—I—I hate muscle soreness like it’s— maybe—I don’t know if we have research to say that. It’s such a subjective indicator.

Dr. Justin Marchegiani: Yeah. Totally.

Dr. Ben House: And it’s so variable.

Dr. Justin Marchegiani: Got it. Is there anything else you wanna let the listeners know? Anything else on your health pocket that you’re kind of researching or on top of mind?

Dr. Ben House: Yeah. I think we can kinda get lost in kind of the little things, right And so—just make—I see a lot of people that are, you know, worried about something regarding their health.

Dr. Justin Marchegiani: Totally.

Dr. Ben House: And that—that’s probably not good. If you are incessantly worrying about your health, that—that’s a problem.

Dr. Justin Marchegiani: Uh-hmm.

Dr. Ben House: I saw, you know, a lot of type A people that come to functional med and so one of our jobs is like, “Hey, like, you’re not gonna die.” Like—

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: This is okay. Like—

Dr. Justin Marchegiani: It’s alright.

Dr. Ben House: You have a homocysteine of 9, you’re not gonna get killed tomorrow. There’s things that we can do.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: Let’s do all the things. So I’d say focus on the effort—not necessarily— always focus on effort. Uhm—and that’s my biggest thing.

Dr. Justin Marchegiani: Got it. And who is your ideal patient? Coz I know you made the switch from the athletic world to the functional medicine world now. You had your experience with your dad with the celiac thing. So you have some autoimmune experience. Who is your ideal patient? Someone who wanna come to see you?

Dr. Ben House: Yeah. My ideal patient is a male, any—any age range, uh—but probably a male that just wants to look good, feel good, look good naked, right?

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: That’s my prototypical client. Uhm—and then, anyone is free to email me, obviously. And like I have—I get crazy emails like, “Hey, I have a—I have a tumor in my hypothalamus. Can you help me out? And no, I can’t but uhm—let me—let me refer you out to someone who might be able to reboot your entire endocrine system.

Dr. Justin Marchegiani: Totally. So ,right?

Dr. Ben House: Yeah. That’s the website.

Dr. Justin Marchegiani: Love it, man. Very cool. Anything else?

Dr. Ben House: Thank you for all that you do. And just uh—just putting out there information that we all have—we all have our mediums. And you do a really good job in just finding awesome people and interviewing them. And—and letting them tell story. So thank you.

Dr. Justin Marchegiani: Right. I appreciate it, Dr. Ben. I appreciate it. And the last question for you, if you’re on a dessert island, you can only choose one supplement, one herb, one nutrient, what is it?

Dr. Ben House: Uhm—

Dr. Justin Marchegiani: Haha—

Dr. Ben House: I’m gonna pick magnesium.

Dr. Justin Marchegiani: Magnesium. Okay. Alright.

Dr. Ben House: I’m probably get—If I will get a multi, I’m gonna—I mean—If I’m training on this island, uhm—maybe a protein supplement if I can’t find enough meat.

Dr. Justin Marchegiani: Yeah.

Dr. Ben House: But uh—yeah definitely—I mean most athletes are deficient in magnesium. It’s—if you give an athlete magnesium, and they’re deficient and like, they’re gonna feel a lot better. Uhm—

Dr. Justin Marchegiani: Awesome, my man. Well, thank you for that great feedback. Doctor House in the house. You can see him at

Dr. Ben House, I appreciate you being on the show.

Dr. Ben House: Thank you, sir. Have a great day.

Dr. Justin Marchegiani: You too. Take care.


Documentary on The Disappearing Male

Tripping Over the Truth by Travis Christofferson

Breaking the Viscious Cycle by Elaine Gottschall


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.