The Gut Connection With Urinary Tract infections (UTI) and Yeast Infections | Podcast #367

Urinary tract infections (UTIs) are a common medical problem affecting millions of people worldwide. The primary source for UTIs is presumed to be the gut. That’s why in this video, Dr. J and Evan talk about how gut bacteria can contaminate the urethral opening, eventually propagate themselves in the bladder, and cause symptoms of a UTI and possible yeast infection.

They also added that women are significantly more likely to get UTIs than men. It is due to anatomical differences that make it easier for disease-causing bacteria to travel to the urinary bladder after accidental transfer from the bowels. They also discuss the other clinical and evidence-based factors with helpful tests to find the root cause of these issues.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00  – Introduction
1:53   – Urinary System
10:54 – Antimicrobials and probiotics
18:55 – UTI and Yeast Infection

Dr. Justin Marchegiani: Excited to be here with Evan Brand. Today, we are gonna be chatting all about the gut connection with urinary tract issues, UTIs and yeast infections. Really excited to dive into this topic. This is the common female topic that we deal with. I mean, men deal with UTIs as well but men have a longer urethra area so it’s harder for men to have UTIs with them. Women have a much shorter urethra so bacteria can make its way up to the urinary tract and blood much faster and easier and so probably more of a female issue but we’re gonna dive in. The physiology is similar between the two so men listening will still get something of it as well. Evan, how are we doing today?

Evan Brand: Hey, doing really well. And so, looks like about 90% of infection in the bladder, 90% of these cases of these infections of bladder, urethra and kidneys, it’s all related to E. coli, which of course E. coli are in your poop and can generally just take route up that way and they can migrate and populate within the urinary tract and so women obviously know these symptoms if they’ve had it but it’s you have to urinate more frequently, it’s painful urination. It could be pressure in the pubic area. It could be fatigue. It could go more severe into kidney injury but most women are usually so miserable before they get to that point that they end up doing some sort of conventional treatment. So, why don’t we just talk about the conventional approach because I think it’s great to highlight what people are doing and then what we’re doing differently that we may argue is a far more sustainable solution without the side effects. Antibiotics are gonna be huge and we’ve got some statistics on this. Antibiotics are prescribed for 33% of women to combat a UTI before the age of 24 but of course these synthetic antimicrobials are not without short- and long-term consequences.    

Dr. Justin Marchegiani: I’m gonna just share one thing here on screen just so everyone can see. So, you can see the female anatomy, right here is the urethra, here’s the bladder so you can see a very short distance from the urethra to the bladder. You can see here in the male anatomy, right at a much longer distance to get up here. Obviously in the urinary tract, you’re just typically with the UTI, it’s the bacteria that’s making its way up here, okay, into the urinary tract that’s causing the infection like Evan already mentioned that’s mostly gonna be bacteria, right?  Usually on the UTI side, it’s gonna be E. coli there, can be some Pseudomonas, it’s mostly E. coli. And so, it’s really easy for women to get bladder infection because you can see it goes up faster. Again, things like birth control pills we’ll talk about and antibiotics really shift the urinary pH and the intestinal pH which has a major effect on the bladder and the urinary tract and it makes it easier for bacteria to grow that tends to be why women are a little bit more susceptible than that for bladder infection obviously but in general you’re gonna see that with birth control pills because how estrogen affects the pH and then also women when they menstruate, right, just that whole vaginal area right there, sloughing off that endometrial lining. All that blood flow does shift that whole entire are to be way more alkaline because bloods around 7.3 pH so it does shift that whole vaginal tract to be more pH higher on the pH side which can increase other bacterial infections more on the vaginal side but hopefully that helps. Any comments on that, Evan?  

Evan Brand: Yeah. It’s totally interesting and this is stuff that maybe you didn’t pay attention to in school and biology class but now in adulthood it’s a lot more important and I think people just don’t even understand the anatomy of it and this is something that according to the research here, 25% of people treated for UTI, they will experience a recurrence 6 – 12 months later. So, I mean, that’s a quarter of these people that now have another UTI and they just go on this merry-go-round. And of course, every time you go on these antibiotics, you’re damaging the mitochondria, you’re damaging your gut microbiome in total, so it’s not just this one thing that you’re doing, it’s the sum to your system and it can really add up.   

Dr. Justin Marchegiani: Yeah, when we deal with urinary tract issues, I kind of look at, okay, you have yeast issues over here. They’re kind of, they intermingle right and how the different things happen. You have bacterial issues over here, right? So, your UTI issues are primarily bacterial, right, affecting the urinary tract. You can have BV, bacterial vaginosis, that’s another bacterial issue. Usually, Gardnerella bacteria is one that’s affecting the vaginal canal. So, a little bit different, right? Different, you know, same general area, different anatomy per se. You’re gonna have similar sequelae of tissues affecting it, right?  The big difference with the BV issue is you’re gonna get the potassium hydroxide odor which is, that’s kind of the fish smell. That’s what the bacteria in the vaginal canal does, it creates that potassium hydroxide that’s the fish odor. You’re not gonna quite get the odor with the UTI but you will have the burning during peeing. So, that’s gonna be the big differentiating factor. Sometimes, more odor on the BV but sometimes you can have none and then of course more pain during urination on the urinary tract issue and then if that continues to be left up that bacteria will eventually continue to go north and eventually hit the bladder as you can see that anatomy pretty short on video here. But, one of the big common issues is I would say like the big three, anytime I look at this problem, they tend to be the same. It’s gonna be a combination of antibiotic use so we’re wiping out a lot of the good flora in our intestinal tract which also affects the vaginal or urinary microbiome and then that affects the beneficial probiotics that actually make hydrogen peroxide like probiotics usually make hydrogen peroxide which is antibacterial. They’ll make different acids, glucuronic acid, they’ll make acidic acid. Different acid acids that actually help keep the microbes in check. They make hydrogen peroxide H202 and it keeps a lot of the bad bugs down. So, the first thing is we have a wiping out of the beneficial flora that also drive yeast overgrowth too so the same thing where it wipes out the good stuff, the beneficial probioflora, the probiotics the Bifidobacter, the Lactobacillus. The different species within the Bifidobacter and Lactobacillus, right? There’s Rudaea, casei, plantarum, lactis, these are all beneficial species, okay, that keeps the bacteria in check but also when you knock down a lot of the good stuff that can also causes this rebound overgrowth and yeast and that’s a lot of doctors today even on the conventional side tend to give an antifungal after an antibiotic in a lot of these female patients because they see a lot of these symptoms happen frequently. 

Evan Brand: Wow. And, you’re mentioning the antibiotic that starts this whole cascade and that’s not necessarily the antibiotic to treat an existing UTI and then we’re talking about these recurring UTIs. We’re talking antibiotics for something simple like, I’ve heard of some women going in for a dental cleaning or something just that seems benign and then boom the antibiotic just really had forced them to take another fork in the road with their gut health and of course the vaginal health is affected. 

Dr. Justin Marchegiani: Exactly. Now, with urinary tract issues, I mean they’re simple things, right? Sometimes, just after intercourse, after sex, just not peeing. Sometimes that sperm and the semen being up there can kind of create some issues with bacteria so urinating after sex can be very helpful. You’ll see it with younger kids just wiping the wrong direction, right, essentially wiping back to front bringing some of the bacteria in the stool into that urinary vaginal area can be a problem. Sometimes different contraceptive methods like that involve, like a spermicidal intravaginally can sometimes mess up the milieu of flora in the vaginal tract. Having bladder stones or kidney issues can sometimes have problems, going in for a surgical procedure where they put in some of a catheter, you know, those are, you know, gonna be way unlikely but you know just kind of given the gamut of those across the board. And then of course, you know, the antibiotic exposure and I would even say just too much sugar, too much carbohydrate, a lot of bacteria like acellular easy to digest refined processed carbs. So, more carbohydrates, more sugar, more grains, more flours are definitely gonna work, you know, increase those microbes’ kind of having a feeding frenzy if you will.   

Evan Brand: And, how can you find this out? Well, there’s an easy to do at home test that you can buy for less than 10 bucks. You can do these test strips at home. These urinary test strips and if generally, you see a dark purple, you’ve got a big issue and so it’s something that people should have on hand if you’ve suffered for a while. I know a lot of women; they just hate having to go to the doctor’s office and get tested and then they leave with another antibiotic and then they’re on this merry-go-round. So, we talked about the conventional approach, they really as far as it goes antibiotics 

Dr. Justin Marchegiani: So, with the test strips, I think most of them are primarily looking at either immune cell in the urinary tract. I think, a lot of times with yeast or bacteria. They’re looking for, like leukocytes or leukocyte esterase, they’re looking for bacteria or I’m sorry immune cells in there. I know, some of the yeast ones are looking at pH so they’re looking at a more alkaline type of pH. The more alkaline the pH moves from six to seven to neutral, right, neutral is around 7. Into the 7-ish range, that tends to say that okay we have more yeast issues or we’re starting to move back in the direction of bacteria if we’re starting to see some of these leukocytes moving into the urinary tract. 

Evan Brand: Yes. It’s kind of an indirect marker, right? You’re looking at those leukocytes and that’s what you would be seeing in terms of like, the light purple, dark purple, extreme purple on the test strips.  

Dr. Justin Marchegiani: Yeah. So, they’re looking at the immune system starting to come in there and obviously with a BV issue, bacterial vaginosis. They probably need a swab to see what’s going on there, see if it’s like a Gardnerella or a Pseudomonas or Klebsiella, you know, what the bacterial species is. Now, typically with yeast issues in the urinary tract, I’m sorry with, uh, yeast infections primarily gonna be Candida or Candida subspecies. With BV, it’s primarily Gardnerella and with UTI’s it’s gonna be E. coli, typically.    

Evan Brand: Now here is the cool part. Are you ready to talk about some of the transitions you hit on the diet piece of a bit of sugar process things? Maybe we should hit this first and then we’ll talk about, like, the functional strategies that kind of thing. You and I were talking about this before we hit the record that so many people, they want the solution to an issue like this but they haven’t even got the foundation styled in, in regards to their sleep, in regards to stress, proper hydration, nutrient density, lack of antibiotics if possible. Just those foundational pieces, a lot of times, are gonna keep women in a place where they’re not gonna end up with this problem so if you’re just tuning in, somehow you found us and you’ve not been listening for a while and you’re just now hearing us and you’re looking for this magic remedy, you got to make sure you get the foundations in order first because in theory, this should not happen if you’ve got the foundation style then.  

Dr. Justin Marchegiani: Correct and so first thing out of the gates is just foundational things like hydrating enough because if you have a UTI issue just having constant good water flow and also you know with some electrolytes in the water that can be very helpful kind of having an antibacterial effect. And just keeping that good water flowing, the solution to pollution is dilution so that can really kind of keeping things flushed down. Obviously, being very careful if you’re having antibiotics. Why did you have the antibiotics? Was it for routine preventative things? Was your diet off and your immune system’s weak and you got sick and you needed it? Why, right? So, you want to look at that and if you had chronic antibiotic use, you know, what does the bacteria in your gut look like because odds are, if your bacteria or yeast imbalances are present in the vaginal tract or the urinary tract, you probably, also have issues in the digestive tract. You may have SIBO, you may have bloating, you may have gas, you may have poor digestion, low enzymes, low acids, H. pylori, parasite infection, you may have to look deeper in the intestinal tract and actually work on knocking down some of those microbes fixing the gut and then really work on repopulating some of the good bacteria after the fact to really work on fixing the gut because you start to fix the gut pH and the gut bacterial milieu that does help improve IgA levels and that does help with the immune system in the vaginal area as well. 

Evan Brand: Yeah. Well said. So, if you’re coming in with the UTI, most of the time, there’s gonna be more than just a UTI present. There could be as you mentioned a number of, we have someone coming in and UTI or recurrent UTI is one of their complaints, I can tell you, you and I are gonna wanna run the stool panel and we’re gonna run organic acids because we’re gonna want to look at the whole microbiome and certain things may get missed on the stool and the urine should feel in the gaps like we might find Candida in the urine and it got missed in the stool. So, stool and urine, there are things that your typical doctor and your lab locally is not gonna run. They might run a urine panel but this is not the same urine panel as an organic acid, we’re talking something far more advanced, far more comprehensive whereas the urine panel, locally, is primarily just gonna look for bacteria or maybe leukocytes as you mentioned you might get a positive or a trace or something like that but it’s not a detailed description of what’s going on you mentioned several bacteria too, like Klebsiella and Prevotella, we can identify this on a stool panel. So, that’s why it’s so important to get the data and could we just throw a woman on an herbal UT formula, we could but you know, we want to do our due diligence, we want to do a good work-up on these people too to make sure that we’re not just cut straight to the chase and we skip something huge that we would find on these tests.  

Dr. Justin Marchegiani: Right. I mean a lot of the antibiotics they’re gonna be using are gonna be like Bactrim or any of these kinds of, um, Mors, Augmentin’s a big one. Bactrim and Augmentin, those are a couple definitely be very wary of any of the fluoroquinolone families because they have significant side effects regarding tensing tendons and ligaments and mitochondria so be really careful of using fluoroquinolones. Of course, when we work these patients up, we’re doing a really good history so we understand how everything came to fruition regarding the UTI, yeast infection or bacterial vaginosis. We’re trying to understand it, right? Obviously, with certain things like yeast infections, BV, like making sure things are dry in that area. If you’re in a very moist environment keeping things dry helps because yeast and mold love a very moist environment. So, keeping things dry tends to be very helpful. Soaping up some of those areas you’d be very helpful too that you can use a really nice, um, as long as the mucosa is not like really, um, irritable, you can really use a really nice sulfur soap especially in the outside air if there’s anything yeasty on the outside are, anything internally. There are definitely internal things that we can do. So, on the internal side, just getting water in there, maybe helpful using raw cranberry juice, not anything with added sugar but raw organic cranberries, you know, 4 ounces at a time diluted some water is pretty good. You can drink that. That’s gonna have a nice low pH in it, which helps prevent the bacteria from growing. It also helps with some D-mannose in the cranberries. Can also internally do things like different berberines, can be very helpful, that’s excellent boric acids, another excellent compound. You gotta be careful with these by, enlarged by itself because they can be a little bit irritating so you want some nice things that provide some moisture whether it’s aloe or shea butter. There’s different, like moisture compounds that can provide the moisture so you don’t dry out that tissue as well. 

Evan Brand: You know, how about some of the suppositories. Have you used those before? I’ve seen some of these like pH suppositories, those have been helpful, also I think it’s integrative, I know Aviva Romm did a talk or an article on it one time. There was a specific probiotic that we had used, I think, it was called pro-flora that we had used, uh, that was supposed to be inserted vaginally and that was like a game changer for BV and some other related issues. So, not only taking oral probiotics but vaginal probiotics as well. That has been a game changer for many women. It’s not something we have to go to a lot but it is a good tool if someone just in bad shape and the conventional strategies failed them or made them worse then something like these vaginal probiotics are helpful. So just to be clear, there’s some strains specifically for vaginal health that are taken orally but then there’s also other blends that you can insert vaginally and the women have reported great success with those. 

Dr. Justin Marchegiani: Yeah. You want to make sure the hydration is there, whether it’s aloe or beeswax or shea butter or coconut oil, some of those can be helpful. Again, the antimicrobials that we may use would be the boric acid, some of the neem, some of the different berberines. And again, we may want to also add probiotics in and around there that can be very helpful. In regards to, like yeast issues or, um, UTI issues, you got to be very careful because when you women menstruate, well more with yeast and more bacterial vaginosis because that’s affecting the vaginal canal more. When women menstruate, that blood is like 7.3, right? So, that’s very neutral to alkaline. So, when you’re menstruating, you’re taking that acidic pH in the vaginal tract and you’re moving it backup to a more neutral pH when you menstruate so that’s gonna actually make it easier for bacteria and potential yeast to grow and you could have a BV issue or yeast issue that can happen due to your menstruation. So, when you’re already more susceptible in that vaginal area, you know, you gotta, you may actually wanna do a suppository in and around your period too, because that pH is gonna move up and that can start to cause microbes to grow. Some women have to be more careful with that, you know, if they have a chronic yeast or bacterial issue just to make sure it doesn’t come back. 

Evan Brand: I want to hit a few more herbs and then I want you to riff on the birth control conversation because I think that’s huge. So, you mentioned berberine and some of the other related herbs. Also, we’ll use the antifungals at the same time. So, you and I have our own custom blends that we use and so we may use something like Pau D’arco, French tarragon, horse tail, olive leaf, things that have antifungal and antimicrobial properties. So, that’s the cool thing about what we do is as you mentioned Backstrom or some of these other conventional strategies. It’s just a big sledgehammer, right? It’s not a targeted tool. It’s one sledgehammer. We don’t know exactly what we’re gonna kill but it’s an antibiotic, were just gonna drop the nuclear bomb into your gut and we’re gonna disturb not only your gut microbiome, we’re gonna negatively affect the production of your nutrients in your gut. We’re gonna negatively affect your mitochondria. We may knock out the UTI but as you saw in the papers, 25% of those UTIs are gonna come back within 6 months to a year and so when we’re coming in with these antimicrobial herbs, also, throwing in antifungal herbs, that’s where the magic really happens because there could be a combination as we talked about. It’s rare to see just UTI, it could be a combination issue meaning there’s some Candida, there’s some bacterial problems, maybe there’s parasites in the gut too. Maybe there’s H. pylori like you mentioned. And so, that’s the fun part is when you take a blend and you’re working people through this protocol. You’re now knocking 4,5,6 issues out all at once in one fell swoop when they originally just came in with the complaint of UTI. When you do the labs, you wanna uncover so much more and that’s where the beauty is. 

Dr. Justin Marchegiani: 100%. Here’s one study here looking at the perceptions using contraception birth control pills. So, usually this is like a synthetic estrogen mostly, right, an ethanol, estradiol. I’m looking at the influence on the vaginal microbiota and so really the take home here inside of the gate, the vaginal state was significantly modified hormone administration apparently corrected the alterations uh, but has the potential of being an accurate tool. Where is it? Right here, um, there it is, I’m sorry. Statistically significant association between, this is, um, this is contraception and normal microbiota was observed after three months when the vaginal microbiome was modified at 6 months inflammatory reaction was detected in almost half of the women. So, only seven women but you can, it created an inflammatory state in the vaginal microbiota and then also yeast colonization was increased and it created an inflammatory reaction in three out of seven women and it altered some of the beneficial bacteria in the vaginal area. Now, small study but you can see, you know, three out of seven, it affected this and this is what we see clinically with a lot of our female patients is some of these things can be affected because it’s affecting: one, it’s creation; two, it’s causing yeast to grow impacting some of the good bacteria and how does it do this, it does it mostly via LDH. If you alter someone’s digestive pH, right, let’s say you give them a proton pump inhibitor, you’re gonna have all kinds of digestive issues and maybe even nutrient deficiencies that can affect things long term. Obviously, with birth control pills, there’s other things they do, they can create issues with nutrient absorption or they can cause nutrient deficiencies in areas of B vitamins, folate and also calcium and magnesium. So, we see a lot of women that do birth control pills have a lot of those nutrient problems. So, if you’re on a birth control pill, ideally, it’s better to use something that’s more barrier based or if you want to set it and forget it method, you know, potentially looking at the ParaGard which is a copper IUD, you just have to make sure you can handle the copper. I find if you want to set it or forget that the copper tends to be better than the hormones but ideally, you know, a barrier method it’s not internal all the time. It’s probably better so that just kind of gives you a couple options there. 

Evan Brand: Yeah. I’ve heard some stories, some horror stories about the copper ones too. So, like you said it cold be a problem but

Dr. Justin Marchegiani: Not everyone has problems with it. I mean, women that like tend to cramp a lot, they could have, because that cramping, IUD being in that uterus sometimes that can cause pain but it just depends kind of where women are, you know. Some parents may be pushing kids to have a method because they don’t want their kid getting pregnant and maybe they feel like they aren’t responsible enough at maybe 18 or 19 and they set it and forget it method. If you want that, I would recommend doing the ParaGard before you go to a hormonal method. 

Evan Brand: Yeah, for sure. And, not to mention too we’re already in a society of so much estrogen dominance and you and I have done podcasts about the impact of gut imbalances in issues with the glucuronidation pathway which is then causing further issues. So, we could see this estrogen problem in a woman who’s not on birth control. You could still see that manifest in this way and so that’s why you’re getting off of the xenoestrogen, you’re cleaning up your makeup. You’re getting rid of plastics. You’re fixing your gut. You’re improving detoxification. All these other functional medicine strategies are directly impacting your ability to beat this situation. So, we know, we always want people to look at the big picture. Don’t just look for the magic, uh, like, berberine, Pau D’ Arco remedy. And there’s a question here in the chat, ‘how many Pau d’ Arco capsules is needed for someone who has Candida in their gut?’. I have no clue because we rarely use it in isolation. We’re always gonna use it in a blend. And I doubt you have just Candida. You’ve probably got other issues too. 

Dr. Justin Marchegiani: Yeah. Somewhere when they come in, they could have a combination of a little bit of a bacterial, a yeast issue, UTI thing. That could be a kind of combination of 2 or 3 different things happening. This one may be more predominant. So, we never wanna just go all in on one thing. Again, if someone’s having vaginal issues specifically, there’s gonna be things that we insert intravaginally like some of the boric acid, like some of the neem or the berberines and we’ll probably interchange in some probiotics because part of the big problem is you have to get the bacteria flora in the vaginal area, back up to where it should be because it’s the good bacteria that will help keep the other bad bugs in check through their natural acid and hydrogen peroxide production. 

Evan Brand: Well said. 

And so, the point I was making is that I don’t want people listening and going okay just give me the freaking remedy. What’s the natural urinary tract remedy? That’s what I’m here for. And we’ve talked about some of those, you know, the mannose, the cranberry, the berberines, the Pau d’ Arcos, the French Tarragon, this whole blend, you know, that may be the solution but what got you here is important. Have you fixed the other issues that have gotten you here. And so, I hope people see the big picture. Sometimes, you and I are happy to just go boom, hit the oregano oil and were happy to just throw out just this natural solution but like you said before we hit the record, you don’t want people skipping out on the low hanging fruit. 

Dr. Justin Marchegiani: Exactly. And so, it’s always good to do history. I find the big issue is antibiotics can be a big factor. I also find just some of the low-hanging fruit like the intercourse and hydration can also be a big factor as well. You’ll be surprised. And so, my wife comes to me, she’s like, ‘my friend has this issue, what should I recommend?’. Well, it’s hard, I can’t really recommend a lot of things because I don’t know much about them if eating like crap and they’re not hydrating and they’re drinking lots of soda and they’ve been on lots of antibiotics, you know, I may say, hey, all right, do this [24:34] but that’s gonna be palliative and not fix the whole lead up and how everything went down. And so, the lead up and I call it the timeline history of how we get to this point matters so much because, you know, if not, you were just becoming naturopathic doctors that are using nutrients and herbs like MDs use drugs. Now, again, I think that’s better because a lot of these things are natural, have less side effects but still we want to be holistic and still root cause. 

Evan Brand: Yeah. Well said.  That’s the problem. There’s a difference between naturopathic approach to this issue and functional medicine approach to this issue. So, I think you made that clear, which is, you go to the naturopath, it’s hey, here’s the oversee, functional medicine is gonna come in and say, ‘okay, well, how did you get to the UTI?’. Oh, you took antibiotics, you’re on birth control for 20 years, you had a sexual partner who had extremely poor microbiome health, maybe there was some issue there, maybe you had multiple partners, maybe one of them had H. pylori. You have low stomach acid. You ended up with dysbiosis, then you got Candida overgrowth, then you drank too much alcohol, you loved to do wine in the evenings. You ate a little too much chocolate, you know, it’s like, that’s the more investigative route and that’s where people need to be thinking.  We’ve got friends that are naturopaths, good people, but you just got to go deeper most of the time.  

Dr. Justin Marchegiani: Yeah, and a lot of times too, if I’m, if someone has chronic issues, I wanna know more about their gut because the microbiome has such an impact especially with IgA and with the overall immune system. So, if there’s chronic issues in the vaginal area, you have to look up to the intestinal tract. Very important. 

Evan Brand: Yeah, and you would say there’s gotta be some link between the low secretory IgA that you and I are seeing on the stool test and what’s going on with the vaginal microbiome too, right? You would assume that’s a system-wide defense shield that’s gonna be affected.  

Dr. Justin Marchegiani: Yeah. It’s part of the mucous membrane barrier. So, mucous membranes in the eyes, the mouth, the intestinal tract, the urinary tract, the vaginal canal. So, if we see low IgA issues in the intestinal tract, that barrier is a little bit weaker. Think of the force field, you know, you see star trek, they put, like their force field up, right, so they, so when the Klingons go to shoot them, it kind of bounces off, right? Think of the force field we have in our intestinal tract and our vaginal canal and our urinary canal that kind of protects and so probiotics can help, obviously getting rid of the dysbiotic microbes can help, avoiding a lot of things that create the imbalances to begin with, which would be a lot of the antibiotics or maybe pesticides or GMO foods that produce a lot of antimicrobial compounds too. All those help avoiding those things too. 

Evan Brand: You know, what’s happening even in the functional medicine world, is that everything’s becoming isolated. Are you noticing that? Like people are focusing on just the gut. So, it’s like this leaky gut formula, this leaky gut protocol and they’re ignoring the fact that you just mentioned this IgA, this mucosal barrier is kind of a system-wide problem. So, there could be oral, vaginal, gut all at the same time, all related to the same dysfunction of these force fields being down. I think it’s just marketing, right? People just want to market that they’re the gut guy, they’re the parasite guy, they’re the Candida guy. I think that’s just a marketing probe but hopefully people are seeing this and of course if they’ve been listening to us for months or years, they’re seeing that this is a system-wide problem, it’s just manifesting in this way. 

Dr. Justin Marchegiani: Yeah. In the functional medicine world, a lot of people market to niche areas and symptoms which is fine because a lot of people when they get focused on something, they think they have these issues, they’re going into google or they’re typing that issue. So, for you to be relevant and for that person that has health issues to find you, you do kind of have to market to a symptom but then when you find that person and you talk to them, you wanna make sure that their approach is globally where they look at things holistically and you’re not seeing the gut person that only deals with the gut and they’re not looking at your thyroid or your anemia or your low glutathione. They’re not connecting the dots. So, you got to make sure they’re still able to connect the dots but multiple systems and they’re not just focused on one issue. So, it’s okay for doctors to market to that, you just have to make sure that their philosophy is a holistic philosophy that encompasses everything in there. 

Evan Brand: Yeah and holistic spelled w-h-o-l-e a wholistic, the whole thing, the whole body, the whole person, not just holistic as in natural, it’s gonna be the whole piece and I think that’s where I suffered for a long time because I focused on my gut for so long but I was ignoring toxicity issues, I was ignoring dental issues, I was ignoring tick bite infections. So now, oh crap, I see the whole picture and I would miss that if I just dialed in the gut so and that’s what you and I do. We’ve done this over with clients worldwide, we look at the whole picture. If you’re suffering, if you’ve been through the conventional rabbit hole or maybe you’ve been fortunate to avoid the conventional rabbit hole, you don’t want to go down it but you need help, feel free to reach out. Dr. J and I work with people around the world. We can send these labs that we’re talking about stool and urine. These are at home, these are non-invasive. It’s rare that we need to do invasive testing but most of the time it’s at home functional medicine tests can be sent to your door, you do them, you send them back to the lab. We get the results. We jump on a call. We run you through them. We interpret those. We make a protocol for you and get you better and get you off the merry-go-round. So, if you need help, feel free to reach out, Dr. J is at and me, and you can reach out, book a call with us, we’d love to talk with you, help you, find and fix the root causes if you just have UTIs and you think that’s all it is, maybe you’re right but maybe not, either way, we’re gonna help you get to the bottom of it. 

Dr. Justin Marchegiani: Very good. Excellent. So, for women that are listening and kind of want to recap here, first thing, make sure your diet is right, keep in the process refined sugar, grains, flours out, makes a huge difference. Omega-6, seed oils, in general, should be reduced as well. Hydration, make sure hydration is good, clean and filtered water, um, you know, good mineral water, especially if you have more health issues, more minerals in there is gonna be better. Next thing out of the gate, you know, urinate after intercourse, those kinds of foundational things. If you have chronic gut issues, definitely, get your gut looked at. If you’re on hormone, if you’re on birth control pills, definitely get your hormones looked at and figure out why you’re on them. Most women aren’t even on hormone or birth control pills for birth prevention. They’re on it for off-label issues like acne or headaches or lots of PMS and so most women could totally get off it because they’re not even using birth control pills for the original intention. They’re for off-label use and so that would require looking deeper at the hormones. Next, you can get tested, you can do either a, um, a MONISTAT test to look for yeast, you can get those at the drugstore, you can do one of the strip tests to look for leukocyte esterase or I think it’s nitrites in the urine for more of the UTI issues and of  course, if you have a lot more of the odor-like, uh, issues, you can get a vaginal swab from your OB or your primary to rule out any of the BV issues as well, again, similar solutions, you know, some maybe more internal in regards to what we recommend, some maybe more internal like with swallowing pills so maybe internally, intravaginally and of course the more chronic the issue is, the more we have to really support the vaginal microbiome with the right beneficial bacteria getting in there internally as well. And then, of course, just keeping up with a lot of the menstruation because that can really affect a lot of the, um, the bacterial issues and yeast issues in the vaginal canal because it’s gonna shift that pH from very acidic to more neutral to alkaline at that time of the month when you menstruate. So, hopefully, that’s a good kind of crash course, out of the gates and kind of you guys understand kind of our spitball kind of philosophy and how we look at the whole history and really connect the dots and we have our little toolbox of all these things but we just got to make sure it’s catered to the history.  

Evan Brand: And alcohol too, I think, we briefly mentioned it but alcohols got to go. It’s just, it’s not gonna help you. It’s going to promote all sorts of issues. It’s gonna aggravate the immune system. It’s gonna affect your IgA levels. It may promote dysbiosis and it may promote more yeast problems and so I’ve heard many stories where a woman’s like, oh yeah we went to Napa Valley and we drank wine and ate chocolate and salami and cheese all weekend and now I had a flare up. It’s like, well, yeah, duh, I mean, that’s incredibly damaging. Everything that you’ve done, you binged on wine all weekend so I think wine kind of gets like this people think that they’re not drinking alcohol. Somehow, they think they’re getting off the hook. Oh, it’s just wine, like, it’s so socially cool, it’s like coffee. It’s like coffee and wine, like wine is so accepted into the culture but it can be a big problem, I tell you. Some of those California women, the ones in San Francisco, like, it’s part of the culture here. I had one woman argue with me that she didn’t want to get off alcohol. I said, well, what if it’s gonna help your gut. She’s like, well maybe I’ll consider it. So, sometimes as practitioners, we’re having to bargain with people and try to make trades and make healthy swaps, we’ll swap it for this and try this and what if you do a binder afterwards. So, sometimes, you gotta work with people, they’re not just in a vacuum. We got to work with them and help educate them so that they’re more dedicated to the lifestyle changes but I just want to mention alcohol because I think a lot of people, don’t even consider the impact it has on the gut but then on this flora.    

Dr. Justin Marchegiani: Yeah. A couple things with alcohol, number one it’s diuretic so it will increase the frequent urination and kind of make you more dehydrated so good hydration helps prevent a lot of that bacteria from growing. Number two, out of the gates, you know, it may be necessary out of the gates for the first month so as you get things under wrap. There’re also healthier versions of alcohol. I mean, you can always get, like a Cosmo martini that has the fresh lime juice in there and cranberry juice. Just make sure it’s, like not the cranberry with sugar or the lime with sugar. Make sure, it’s fresh lime or actual juice cranberries with, like a nice Tito’s vodka, I mean, Tito’s vodka is, um, it is charcoal filter, right? So, it’s gonna be really clean and you can get some nice cranberry and lime in there that should be almost be beneficial in a way, obviously, you know, keep it, you know, a drink or two maybe once or twice a week max but once you better that maybe a good option to add things back in and just stay away from a lot of the sugary stuff and of course the glutinous drinks and you’ll be in a lot better position.   

Evan Brand: Yeah. It’s a funny thing you have to mention. There’s got to be real cranberries because most of the time you go to a bar, it’s like that. It’s garbage. The heart or it’s the high fructose corn syrup concentrate. 

Dr. Justin Marchegiani: Yeah. So, worst case, you can always just do a fresh lime squeezed in there and see if they have anything that’s just a pure, you know, extract and that’s a much way to do it. Of course, dry or white wines and you know just a good Tito’s vodka is always great with just the lime in and of itself. That’s an easy way to do it and keep the sugar and junk down but also keep a nice acidic pH there which is helpful for the vaginal area. 

Evan Brand: Yeah. We’ll hope, as you mentioned, no I think we covered It so if you need help, we mentioned the links here Dr. J, that’s Justin at You can reach out for consult worldwide. Me at, either way, we’re here to help you guys. We love what we do. We have a blast and it’s fun to educate people. It’s fun to empower people and take back your health and it’s possible. Whatever you’re dealing with it’s possible to make progress so just keep your head up. Stay motivated. Don’t always run straight to that antibiotic if there’s another way. You may try another solution. If you’ve been doing this for a decade now and you’re still battling it, you’re not out of the woods yet, it’s time to look deeper.    

Dr. Justin Marchegiani: Excellent. Great chat, Evan. Everyone, have an awesome week. We’ll talk soon. Take care of you all. 

Evan Brand: Take care, now. 

Dr. Justin Marchegiani: Bye now. Peace. 

Evan Brand: Bye-bye 

Functional Medicine Approach for Urinary Tract Infections (UTI) | Podcast #356

One of the most common human infections is one that people rarely speak about. Urinary tract infections (UTI), also known as bladder infections, impact 10-20% of women at least once a year, and the specific treatment intervention is prescription antibiotics. Middle-aged women with chronic conditions like autoimmunity, dysbiosis, and hormone dysfunction are regular patients in functional medicine, so regular taking of antibiotics could pose a problem.

Dr. J and Evan talk about that when optimizing microbiome health, hormone production, and immune tolerance, it is crucial that bacteria are allowed to thrive, and antibiotic use poses a warning to that opportunity. With that said, if urinary tract infections (UTI) are among the most common conditions physicians see, and we are attempting to avoid circumvent antibiotic use, what functional medicine approaches do we have?

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

0:00 – Introduction
6:31 – N-Acetylcysteine in protecting the urinary bladder
11:17 – Foundational strategies in keeping the urinary tract healthy
17:10 – Antibiosis versus the association of N-Acetylcysteine, D-mannose, and Morinda Citrifolia fruit against UTI
19:11 – Men’s role in preventing UTI

Dr. Justin Marchegiani: Dr. Justin Marchegiani here with Evan brand. And today we are excited to talk about functional medicine approaches to address UTI or urinary tract infections. My immune system is just a little bit under the weather, so I’ll be channeling my inner Barry White today. Really excited for that. Evan, how you doing man? 

Evan Brand: Hey, pretty good. Yeah. I hope you feel better and get back to kicking butt, which you’re still kicking butt but most people would call it in but I’m glad your brain is working enough and we’re gonna get this thing done. So, 

Dr. Justin Marchegiani: I haven’t had a sick day over a decade. I don’t, I don’t plan to have a sick day ever.  

Evan Brand: Good. Good. Good. Alright. So, now, uh, with UTI, I mean this is something that’s extremely common. We see it a lot in young children because their poop gets in to their urinary tract whether they’re wiping the wrong way or whether this is a young child that’s still using diapers, so I’ve seen it with our children, we’ve worked on our kids. I’ve seen it with a lot with the kids I worked with clinically. And then adults we see this a lot, where a lot of it is due to sexual transmission. I mean we’ve seen many cases where if we support the female, the male is the vector and the woman start to get almost resentful towards their husband because they know every time, they have sex they’re gonna end up with UTI. So then, that really affects their sexual health and their relationship. And so, today’s podcast hopefully will encourage people to take this seriously and we’ll have some strategies you can implement to get both you and your spouse if that’s what’s happening and better shaped where this is a non-issue. 

Dr. Justin Marchegiani: Do we have any data on the semen quality, the semen quality affecting, uh, urinary tract infection of females?

Evan Brand: I’m gonna look it up but I know clinically and I know you’ve seen the same thing that we hear that story all the time of where everything is fine and then boom they have sex and then all of a sudden it’s they have a UTI. 

Dr. Justin Marchegiani: Yeah. I know in, um, in men 

Evan Brand: So, here’s the study right here, semen culture and the assessment of genitourinary tract infections in the male. It says here is, uh, contributes approximately 50% of the cases.

Dr. Justin Marchegiani: Yeah. I wouldn’t be surprised if nutrient deficiency has a lot to do with it because I know zinc is very high in semen, right? Um, very important for the health of the sperm and I know zinc also has anti-bacterial, anti-viral qualities to it. So, I wouldn’t be surprised if someone’s more nutritionally deficient they’re gonna have less zinc in the semen and that less zinc will make it harder, make it easier for bacteria and other critters to grow. So, just a thought, again, you know, we try to, you know, high level thinking, you know what’s the mechanism, look at all the downstream signals that could be one component though. 

Evan Brand: Yeah. It’s talking about these different types of bacteria in this male study talking about how it plays a role in genital tract infections and some of these are natural inhabitants of the male urethra which can contaminate semen during ejaculation. So, there’s your answer.  

Dr. Justin Marchegiani: So, it’s almost like men could have a subclinical kind of UTI. 

Evan Brand: Exactly. 

Dr. Justin Marchegiani: That could be affecting it. So, if you’re a female having chronic UTI issues, you have to have your partner looked at or addressed. And we’ll talked abour natural strategies of course keeping sugar down is going to be one of the big ones because one of the biggest bacteria involved in UTI is gonna be E. coli. E. coli you’ll see high in bacterial imbalances in the gut, you can also see some, I think some Pseudomonas in some as well as some Klebsiella but it’s mostly gonna be E. coli.

Evan Brand: They were talking about E. coli and even Mycoplasma in that study, which kind of interesting. 

Dr. Justin Marchegiani: Yeah. Exactly. I know, um, yep, that’s a big one for sure. 

Evan Brand: Some part, you know, some families or couples, they’ll end up just going to using condoms because obviously that’s gonna work and that’s gonna prevent the critical transfer but really the better thing is to get the health of your spouse improved and so, if you’re a female who’s done some of the conventional strategies, let’s kind of go into that now. Some of the conventional stuff that’s being done and we’ll compare it to the functional strategies but if you’ve done some of this stuff and you’re still struggling that’s when it’s time to get your spouse on board. And I know, you and I, we really like to work with couples and we like to get the whole family healthier together because we find that if we just focus on the female that her results are not as good and you know, this actually kind of carries over into H. pylori and all the work, you and I do with gut infections because we see cases where a female will use herbs successfully to eradicate certain infections in the gut. She’ll then get reinfected from the spouse even not into sharing cup, spoons, drinks, kissing and then they’ll get infected. So, as much as I can, I’m trying to bring the husband on board into these health protocols. 

Dr. Justin Marchegiani: Yeah. So, a couple of things out off the gates that men can do to help support the women is cut the sugar out of their diet or at least drop it down to the point where you’re not growing some of the microbes in the urinary tract. That’s helpful. You can also add some things in. Like ginger is actually very helpful so maybe some ginger kombucha can be good or some really strong ginger tea is wonderful. You can also add a little bit of Manuka honey because there’s a lot of data on Manuka actually decreasing E. coli and Staph in the urinary tract. So, these are some simple kinds of easy things. You can even take some raw cranberry juice. Raw cranberry juice is very high in D-mannose, which is a large sugar molecule. The body does not digest but it creates like, uh, magnet-like effect. It’s like dragging a magnet across a surface and grabbing iron filings and pulling them out. Think of the iron filings is the E. coli and so it kind of pulls them out. So, those are some easy simple strategies for some men out of the gates is ginger, cranberry. I would say just make sure you’re hydrated enough, right solution to pollution is dilution, Manuka, and keeping the sugar down. Those are excellent strategies out of the gates. 

Evan Brand: Yeah. And NAC, so we wanted to talked about NAC because NAC has been pulled from Amazon and this nutrient is getting harder to access as just a regular consumer. Fortunately, we work with professional companies, so we still have access, we still do manufacture NAC-Glutathione combos but there was a paper that we have here on NAC and the cool thing is I know you’re taking NAC right now.  

Dr. Justin Marchegiani: Yep. I’m taking up to four grams a day to help biofilms if in the sinuses, it also, um helps with decreasing virus replication in case I have any viral stuff going on. I think I have personally just a little, uh, rhinovirus. That’s what I personally think and then outside of that, um, increasing glutathione, antioxidant support, biofilms, helps with mucus, so it keeps the mucus kind of flowing from. So, it’s, so it doesn’t, um, impair oxygenation and blood flow. 

Evan Brand: See, if you can pull up or highlight that paper, I just shared on the screen there. You know, for folks listening you’re just missing out on this part of it, but that’s okay, we’re just trying to just show you at least maybe a couple of studies a week. That kind of 

Dr. Justin Marchegiani: Yeah. If you’re listening, yeah and if you’re listening here, we’ll put the video link below, so don’t worry about it, just come and check about it later and we’ll put the link down below. 

Evan Brand: All right. So, this is titled, N-Acetylcysteine Protects Cells from Bacterial Invasion, I like how they call it an invasion, and Displays Anti-Biofilm Activity against Urinary Tract Bacterial Pathogens. So, long story short, they discuss using antibiotics, which were really, we can dive into that. But really that is the conventional approach with this stuff, and the problem with antibiotic resistance problems and so you’ll have women that’ll do these formulas whether it’s in this study they’re talking about cipro which is dangerous stuff. I don’t like the sound of cipro at all, for many of the potential permanent tendon issues and other side effects associated with it. 

Dr. Justin Marchegiani: Yeah. Cipro’s in the fluoroquinolone family which can negatively impact mitochondria and connective tissue so if you’re gonna use antibiotic, try to use one, not in the fluoroquinolone family. Maybe amoxicillin, a tetracycline, just talk to your MD if you’re gonna go that route, to avoid that antibiotic at least. 

Evan Brand: Yeah. But here’s the conclusion, NAC is a non-toxic, antibiofilm agent and can prevent cell invasion and formation by uropathogens. So, once again, NAC for the win. This stuff is incredible. 

Dr. Justin Marchegiani: Yep. And again, with antibiotic is like I’m always about, let’s do the more natural things first and kind of go, least invasive to more invasive, right? And antibiotics to be the top part of the more invasive side. 

Evan Brand: This is interesting, I guess this was an Australian researcher, doctor who put this study together. They’re saying here that in Australia, you know, there’s an estimated 150 million infections and this is 12% of hospitalizations. 

Dr. Justin Marchegiani: UTIs are?

Evan Brand: For UTIs

Dr. Justin Marchegiani: Wow. Holy smokes. 

Evan Brand: And 30% of all women have a recurrent episode of UTI and then of course the problem with the UTI, right, UTI kind of sounds like, oh it’s not too bad. But I mean this stuff gets up and infects your bladder that gets really bad and then it can even farther ascend and then infect your kidneys and then that’s when you get into a really big trouble and that’s where they talk about sepsis and some of these other literally and potentially fatal infections from UTI. So, when UTI is kind of one of those, it sounds like, it’s just like this easy, not a big deal, but it can turn into a big deal. 

Dr. Justin Marchegiani: Yeah. So, just kind of like out of the gates, like what are the symptoms of UTIs, right obviously, like pain, pain during urination, you can see a lot of cloudiness in the urine, right? Potentially, even blood in the urine. It can have a really strong smell as well. It can even create pelvic pain in that area that pelvic or pubic area for sure. It can also move up so women have a very short urethra unlike men, that urinary tract can go to the bladder very very easy just because the distance is really short, so once it goes to the bladder, right, you’ll see pelvic pressure, you may see blood in the urine, frequent painful urination, lower abdominal discomfort and then it can continue going up from there into the kidneys. That’s where’s you’ll start noticing a lot of back pain, flank pain, um, you may notice starting to get chills and fever and maybe nausea and vomiting. And usually, once it starts to get into bladder into the kidneys, you know, you may want to look at seeing conventional medicine for the antibiotic at that point, definitely in the kidney. But, I mean, I think if people can be educated about this and be on top of it, I think you can avoid a lot of that upstage, um, conventional need for medications.

Evan Brand:  Well, like many other things that we’ve talked about. Early treatment is key. So, if you can come in and hit some of this stuff hard with D-mannose, your N-acetylcysteine, we use these cranberry extracts very effectively. You and I have also used some professional formulas that contain hibiscus and parsley and horsetail. So, the goal really, I think is to try to break down into like three main categories. So, you go the biofilms, breaking components like your NAC for example or you could add in like natto, Cerezyme or some sort of other proteolytic systemic type enzymes maybe even lumbrokinase would help. So, that’s your number one is your biofilm busting. Number two, you’ve got your antimicrobials that you and I use like bearberry, barberry maybe even clove or oregano might be helpful. Silver, I think, is worth to mention. And then, I would say the third mechanism of action is the anti-adhesive properties so you’re really trying to help flush things out. So, that’s where just hydration comes in. 

Dr. Justin Marchegiani: Yeah. Mannose. 

Evan Brand: And some of these herbs, 

Dr. Justin Marchegiani: Mannose too. 

Evan Brand: Yeah.  

Dr. Justin Marchegiani: Because that’s gonna pull, that’s gonna help pull the E. coli off like iron filings, right, like I gave that under the gates. So, just couple of foundational things. We’re kinda, we’re kind of hitting some of the meat here, I want to just kind of make sure we set a good foundation. So, out of the gates, women are gonna be more prone because of a couple of reasons. Okay. Number one, we talked about the intercourse and the injection of semen that may either have bugs in it or it may just essentially expose a weaker urinary tract so of course the first thing is hydration if you’re a female and getting up after the sex, getting vertical and going to the bathroom. Get that urinary tract moving, get’s some hydration in you. That’s a really good first strategy our of the gates and of course if you’re prone to having UTIs, you may wanna have a powder of D-mannose like we mentioned or some of the formulas that Evan mentioned, some D-mannose, Uva Ursi, um, parsley is excellent maybe a little bit of silver but you can just start a little bit of D-mannose, a little bit of cranberry extract and a little water and drink that before bed or you know, after a, um, interaction like that. The next thing is, if you can look at the hormones, right, hormones can play a big role so you have the high, you have the low. So, women that have very high levels of estrogen especially women that are on birth control pills that’s gonna shift the urinary tract pH based on the high levels of hormones, that can make it easier for the E. coli to grow because E. coli does not like an acidic environment. And when you started to make the environment more alkaline, right, you usually hear alkalize or die well not necessarily. The urinary tract if it’s alkaline can actually grow bugs, so birth control pills can actually cause the bug to grow to the alkalinity.  You can also see the opposite, right, the goldilocks effect. When women go into menopause and their hormones drop, low hormones can also have an impact on the immune system in the urinary tract and that can cause, it can be more, you can be more prone to have UTIs if you’re menopausal with low progesterone, low estrogen because that plays a role in the environment and the immune system and the IgA levels in the urinary tract and so not too hot, not too cold, right? Not too much hormones, not too low hormones, so birth control pill on one side too much, menopausal issues, low hormones on the other side. You really need to work with a good functional medicine person to get the hormones dialed in it, may not be a simple, hey take to something that you may have to fix the hormones too. 

Evan Brand: Yeah. Good call, good point, bringing that up. And that’s more of like a longer-term thing. That’s like if you’re trying to get well and stay well, that’s stuff we’re gonna be looking at. So, is it possible to come in and use some calcium D-glucarate or something like that to help that pathway and get rid of the excess estrogen? I think it could help but is it going to like acutely get you out of the UTI maybe not so I think it’s good you’re mentioning to have a plan meaning like a long-term health functional medicine health plan that then prevents you from having to do some of these acute strategies we’re talking about.  

Dr. Justin Marchegiani: Yeah, I mean there’s a palliative kind of, um, non-root cause support that we have but we try to always package in the palliative stuff with lifestyle changes that make it more holistic and make it more root-cause and then we also dive into the hormonal aspect and also, I would even say gut aspect. I’ve seen imbalances in the gut bacteria, shift and influences the urinary tract microbial balance too. So microbial imbalance in the gut has a way of shifting microbial imbalance in the urinary tract and it could be just 80% of the immune systems in the gut and that’s having a major effect. It could just be some of this stuff’s working its way down there through moving the intestinal tract. It has a way of shifting or migrating or moving in some way, you know, those kinds of things. But either way look at the gut, that’s where a lot of the immune system is. Look at the hormones, look at medications that could be influencing these things. Look at hydration, those kinds of the root, I think starting situations, you really wanna have your head wrapped around. 

Evan Brand: Yeah. In regards to testing you can do this at home. They have companies that make at home UTI test strips that you can do, where you just urinate on the strip and you’re gonna be able to test your leukocytes and they have a little reference range that you can look at and basically the dark on most of these it’s purple, the darker the purple, the more severe the infection is. And we had incredible results with our daughter using some of the D-mannose, we some chewable versions, we did some of these herbs mixed in some apple sauce and we retested using these little pee strips and I want to say, I’d have to ask my wife to confirm, it was either two or three days, we completely got it from a deep dark purple indicating a very intense UTI to nothing. It was completely white. So, the brain is called azo, A-Z-O. And they also make other things, I think they make like ovulation strips and that kind of stuff for more like female health. But this urinary test strip, you’re looking at maybe ten bucks for a pack of these. So, if you do have suspicion or if you’ve had chronic UTIs, this is something that I would recommend you at home because so many times you and I hear a story of a woman having to schedule an appointment, get into the doctor. Yep, I have a UTI. It’s like you could have done that and figured it out at home in two minutes for 10 bucks. The accuracy is very very good. 

Dr. Justin Marchegiani: Absolutely. 100% And of course, um, there’s some tests if you do like a uroscopic or a microscopic urinalysis, you know, we’ll be looking at leukocytes, we’ll be looking at protein in the urine. We’ll be looking at pH, we’ll be looking at potentially bacteria. E. coli, looking at the actual microbes in the urine, that’s helpful and then obviously just from a diet, just for me a lifestyle strategy. This is obviously going to pertain more to kids, right? Just teaching your kids how to wipe the right way, right? Females, front to back, kind of common sense, but kids obviously develop blood habits and that could be a simple, easy lifestyle methodology. They can, they can fix that problem and just getting more water, more hydration, if, um, kids have a compromised immune system due to the too much sweets, um, obviously artificial sweeteners like aspartame, Splenda, those can impact the microbes as well. Those things can compromise the immune system and shift the micro, the micro, um, kind of balance, microbiota balance in the gut and in the urinary tract. 

Evan Brand: Yeah. Let me show this one more thing. Do you mind bringing this, highlighting this paper? 

Dr. Justin Marchegiani: Yeah. Absolutely. 

Evan Brand: There’s one more that we wanted to show people, this was just titled, Prospective study to compare they said antibiosis, they’re talking about antibiotics versus NAC, D-mannose and Morinda fruit and the conclusion of the study at the bottom here, D-mannose and NAC resulted in similar to antibiotic therapy. So, even if somebody wants to nitpick and argue, well antibiotics are like

Dr. Justin Marchegiani: Better. 

Evan Brand: They’re not. They’re not. Now, I’m not saying that in a severe situation where your kidneys are affected and you’re going septic, I’m not saying, I’m going to try to do this, but I’d be doing all of it, I’d be doing the mannose, the NAC maybe the antibiotic if I had to, but I mean, based on the stuff you and I’ve seen clinically based on more than what we’ve looked at in these papers alone. I mean, the cool thing about PubMed too, is you’ll be able to have related articles pull up like you could go into this one. D-mannose and Hibiscus and Lactobacillus probiotics. You know.  

Dr. Justin Marchegiani: Yeah. Probiotics are gonna have a major influence as well due to the acidification of that area. I mean, you can depend, depending on where you’re at, you could potentially even do intervaginal probiotic, you know, you could put the capsule in let it dissolves or you can mix it in, uh, with little, a little bit of aloe or shea butter or coconut oil, something that’s gonna dissolve and um, you could essentially mix it in, you know freeze the cube or refrigerate the cube so it’s solid and then insert intravaginally and that will kind of dissolve and then it will contain some of those nutrients to help support the vaginal canal and depending on where you’re at for some yeast you could even do that same thing with boric acid too. I recommend some kind of a carrier though, just so, it’s uh, just so, it’s not as abrasive if that canal or that tissue is really sore or irritated it just provides some moisture to that area as well and won’t irritate it. And if you’re unsure test the, test the moisturizer whether it’s aloe or shea butter or coconut oil, test it before you put any of the extra stuff in it, so you know, if that’s a problem at all.    

Evan Brand: You know, what I’ve also seen to be beneficial, I’ve seen some homeopathic vaginal suppositories for UTIs. I don’t know much about them, but I’ve had women try them and they have worked, when everything else failed, so I think you should be open to it. And the probiotics are game changer too, as you mentioned, you could do intravaginal with the capsule it’ll just dissolve or just oral probiotics has been helpful so as you mentioned the gut, you know, that’s something we’re gonna look at. So, if we see a female who suffer with UTIs and we see she’s got a lot of issues on her stool test, you know, we can’t say directly, hey this is why you have UTIs. But if we fix the stuff in the gut, chances are high that they’re gonna suffer less and less frequently from UTIs. It’s really, really important as you mentioned you got this vaginal microbiome, you’ve got the oral, you’ve got the gut, you’ve got the skin microbiome, so, I mean if anywhere there’s dysfunction or dysbiosis going on, I think they can affect the whole system. 

Dr. Justin Marchegiani: Absolutely. And then, men play a part of the role, you know, in this whole thing. So, get your sugar consumption down, better hydration, could always throw in a little bit of ginger or cranberry kombucha that’s a really easy simple thing. Just to add in as a routine. Sometimes, it’s easier to add things to a routine than pull things out. 

Evan Brand: Well, think about how many men, you and I have seen and work with over the years with gut issues so, I mean getting their gut straightened out too is gonna be my goal because I’m sure that’s gonna affect what’s we’re seeing in these paper zone like semen quality, and they’re not passing these microbes, you know, via sperm. So, man, you gotta get on board. Women just I, you know, I feel bad for them because they take a lot of the blame, they take it upon themselves like there’s something wrong with them and in many cases, there definitely are issues with the dysbiosis and the female but in the men they kinda get off the hook so, we’re calling all the men out here, you gotta get involved too, you gotta get your health involved. If you’re over there, eating pizza while your wife is sitting here cooking a paleo meal, you gotta get on board because, you know, this is a team sport here. 

Dr. Justin Marchegiani: Yeah. And you can always use a barrier method if not, right, that’s an easy way at least in the interim and then also just getting the hydration up and avoiding the sugar can make just a huge difference. Sometimes, it’s not even 100%, just an 80 20 can make a huge difference on that. 

Evan Brand: I know how men are, being a man, so if the wife says, uh, honey you’re gonna have to use condoms for the rest of our, uh, sex life, I think that’ll be a, easy quick motivator to get them on board and they’re natural. 

Dr. Justin Marchegiani: Totally. Yeah. I find like kind of in the men sphere, there’s like two kinds of men. There’s like the men that are like biohackers that are like always into like optimal performance trying to improve and get everything kind of optimized in their health and their life and their come some guys that they kind of just, they’re  a little bit more slow to the punch and they’re motivated by what the rest of their family is doing, their wife’s doing, and then their wives kind of get them on board, there’s like kind of two classes like that, I think me and you tend to be more in the biohacker class and we see a lot of biohackers that are in, right, you know, that are really motivated and they’re all about performance, performance and then some their wives are more on that side of the fence and the wives kind of get them motivated but most of the time though, once someone can see their life improve and usually if you get healthier, you don’t just improve in the urinary tract, you improve in cognitive, mood, libido, energy, digestion, so women, if you can get your husbands on board, they’re gonna see a lot of buy and hopefully other areas and hopefully you’ll be able to get them a long-lasting buy in which is really important for energy and just, you know, people being, um healthier which is important. 

Evan Brand: Yeah. Well said. We can mention this comment here that came in the live chat and then we can wrap it up. We’ve kind of hinted at this but we didn’t say it directly, when we talked about UTIs, I mean a lot of times, we are referring to the bacteria but in many cases there’s a yeast component too, so there’s a fungal component, here’s the cool thing though, you and I are always using blends and these blends are not only antimicrobials but also anti-fungal, anti-yeast. So, someone in the comments here wrote that they kept getting UTIs even after getting treated until they started yeast treatment and that’s a cool thing. Think about if you come in with antibiotics, so let’s just quickly compare the conventional and functional approach. You come in and do the antibiotics, those are not anti-fungals, but if we’re using something like bearberry, barberry, berberine, cloves, silver, Saccharomyces boulardii probiotics, we’re creating an antifungal, anti-microbial, anti-parasitic protocol all in one, which is awesome because sometimes we’re killing multiple birds with the same stones and that’s why we love what we do. 

Dr. Justin Marchegiani: 100% and of course, you know, a good history will kind of figure this out, based on you know, if you have a new sexual partner or not, STDs always can be a thing, so we’re looking at Chlamydia, maybe Gonorrhea, right? And so, these types of infections, I think we could probably see some improvement with some of the natural things especially if we add in silver and such but these types of things, if you’re not having results, they may require a special kind of antibiotic, if that’s at play. And so, obviously, you know, it’s gonna be history dependent, if you’re in the steady relationship then that may not be a thing or if you’re not sexually active that probably isn’t gonna be a thing but it’s always good to kinda keep that in the back of your differential list of things that you kind of work up through from least likely to most likely. 

Evan Brand: Yeah. Good call. So, on that NAC paper, it actually did talk about Chlamydia and it talked about the mycoplasma and there was a couple others in there and it was talking about the anti-adhesive, anti-biofilm properties of the NAC. So, even if it were STD, I think NAC is something you’d still wanna implement. 

Dr. Justin Marchegiani: Yeah, I mean, usually you’ll gonna see some level of discharge too with some of the STD stuff but worst case, you know, you can just tested try some of the simple things out of the gates. A lot of times the history will tell you, especially if you know, if you’re, um, had intercourse in the next day, you know with your husband or partner and the next day you’re starting to feel some issues, then it’s probably gonna be on the E. coli side of the fence which is 90% of the time, so you know, if you have 90% odds with something, we’re gonna go with that out of the gates for sure.  

Evan Brand: Yeah. Okay. So, testing strategies just to summarize, you could do the at-home test strips for this, we think a good stool test would be, in order to figure out what’s going on with you’re gut and how’s that affecting your microbes down south same with your partner, if we can get them on board, get your stool looked at, a urine test is helpful too because we’re gonna be able to look to Candida overgrowth and other types of fungal colonization. So, we like the organic acid, so an oat, a stool and some of the at home test strips, I think that would be a great starting place because you could do other things, blood work, and as you mentioned like the urinalysis and like in the conventional lab, you could do that too. But you might not, if you do these top three. 

Dr. Justin Marchegiani: Absolutely, and then the big symptoms that would differentiate an STD over UTI are gonna be like more systemic symptoms, so like nausea, fever, swollen joints, sore throat, symptoms that are kind of gone more systemic and of course there can be some localized symptoms that can be more severe like extreme discharge, severe rash in that area, blisters in the genital area, but look for more systemic type of symptoms that could be driving that. 

Evan Brand: Okay. You’re saying more systemic symptoms would be what? 

Dr. Justin Marchegiani: The ones I just mentioned, so pelvic

Evan Brand: No, would be a UTI?

Dr. Justin Marchegiani: No, that’s gonna be more of an STD, so think of STDs are more severe therefore the symptoms are more severe. They’re more systemic. So think of systemic symptoms are things that are more severe, localized symptoms, right, that means the microbes haven’t spread as much and they’re less severe, so more severe think of the STDs. 

Evan Brand: Got it. And then you mentioned in the beginning if the UTI is more severe that’s were the back gets involved in the case of the kidneys, you know, there are people that, they perish due to UTIs if they go septic so obviously, you would have a lot more issues than you would know by then. You’d be in real bad pain.

Dr. Justin Marchegiani: Absolutely. Yep. 100%. And again, like you know, UTI, on a desk, can go to the bladder and then the kidneys and then, you could have a fever, you could have these things, so as a UTI gets more severe that could definitely drive the symptoms up as well. But usually, what people can see it because it’s just following that urinary tract, it’s going from the urinary tract to the bladder, to the ureters and then up to the kidneys. So yeah, usually you can see that and feel it, the pain starts to move up. Well, anything else, you wanna add? 

Evan Brand: No. I’m just gonna say, we work with this issue all the time. We’re really happy to help people and to provide solutions to what have been a major issue. A pain, an issue and like I said with people’s sex life and with just people’s personal health. I mean this is something that’s a big burden for a lot of people especially women. So, we’re really happy and fortunate to have outside of the box tools that we use with great success and we don’t only back it up with clinical experience, we backed it up with some of the research we’ve dove into and the professional formulas we use are tried and true. So, if you need help, please reach out, we’d love to help if you wanna reach out to Dr. J you can at justinhealth. If you wanna reach out me Evan Brand, you can do so at and we both work worldwide via facetime, phones, skype and we send products to your door, so if you need to get any of these labs done, investigate you, it doesn’t matter if you’re in California or Oregon or Michigan or Florida or New Mexico or Australia or Canada or Europe, we can do it, we can help and we work with people around the world, we have for decades so it’s just a true, true pleasure to get the hands-on experience with this issue because I think the most empowering thing is to know that you’re not a victim meaning you’re not just going to have to go on antibiotics. That’s just the foghorn of the conventional approach, and it’s just so empowering and inspiring to know, there’s other ways, other tools, there’s other approaches that are very, very successful. 

Dr. Justin Marchegiani: 100% Yeah and if you guys enjoyed it, There’ll be links right there to work with us. Hit that thumbs up, helps the search algorithm improve so more people can see our information and give us a share, give us a comment, write us a review, we’ll put links below to do that. Thanks, y’all, you guys have a great day, we’ll talk soon.   

Evan Brand: Take care. 

Dr. Justin Marchegiani: Bye Evan. 

Evan Brand: Bye. Bye.


Audio Podcast:



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

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

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

Dr. Justin Marchegiani

In this episode, we cover:

02:30   SIFO is Definitely an Issue

05:20   Conventional Treatment of Candida and SIBO

07:19   Urinary Tract Infection

10:00   Treating UTI by Just Hitting the Gut.

21:36   Top herbs for Candida Overgrowth


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

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

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

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

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

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

Dr. Justin Marchegiani: Love it.

Evan Brand: existed.  

Dr. Justin Marchegiani: Wow, man.

Evan Brand: Well, I did an interview uh—

Dr. Justin Marchegiani: Now you know.

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

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

Evan Brand: Yeah.

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

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

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

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

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

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

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

Evan Brand: Yeah.

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

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

Dr. Justin Marchegiani: It’s the same.

Evan Brand: …falling off.

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

Evan Brand: Yeah. Okay.

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

Evan Brand: Got it.

Dr. Justin Marchegiani: …toe or finger.

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

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

Evan Brand: Okay. And then [inaudible]—

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

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

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

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

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

Evan Brand: Is there a brand for that?

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

Evan Brand: Okay.

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

Evan Brand: Cool. Okay.

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

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

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

Evan Brand: Right.

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

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

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

Evan Brand: Okay.

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

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

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

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

Dr. Justin Marchegiani:Per warm water?

Evan Brand: Yeah.

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

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

Dr. Justin Marchegiani: That’s it.

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

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

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

Dr. Justin Marchegiani: Yes.

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

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

Evan Brand: Good.

Dr. Justin Marchegiani: …and see what at.

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

Dr. Justin Marchegiani: Yeah.

Evan Brand: It’d be a fun show.

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

Evan Brand: I know.

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

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

Dr. Justin Marchegiani: Yep.

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

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

Evan Brand: Okay. That’s cool.

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

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

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

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

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

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

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

Evan Brand: Yep.

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

Evan Brand: Good.

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

Evan Brand: I think you were talking about—

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

Evan Brand: Oh.

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

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

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

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

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

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

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

Evan Brand: Oh, oh.

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

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

Dr. Justin Marchegiani: Yes.

Evan Brand: If you don’t mind.

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

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

Dr. Justin Marchegiani: Uhmmn—

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

Dr. Justin Marchegiani: One hundred percent!

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

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

Evan Brand: Yeah.

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

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

Dr. Justin Marchegiani: Totally. Yep. Absolutely.

Evan Brand: Samuel. Want to read that one?

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

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

Dr. Justin Marchegiani: Top herbs for Candida overgrowth?

Evan Brand: Yep.

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

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

Dr. Justin Marchegiani: Anything like a medicine?

Evan Brand: Yeah. Olive leaf.

Dr. Justin Marchegiani: Olive leaf, yep.

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

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

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

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

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

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

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

Dr. Justin Marchegiani: Yeah.

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

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

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

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

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

Dr. Justin Marchegiani: Everywhere, in the ether.

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

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

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

Dr. Justin Marchegiani: Two  to four months.

Evan Brand: …[inaudible] models.

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

Evan Brand: Okay.

Dr. Justin Marchegiani: Kind of thing—

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

Dr. Justin Marchegiani: Absolutely.

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

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

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

Dr. Justin Marchegiani: Hit the bell!

Evan Brand: …we’re back [inaudible]…

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

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

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

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

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

Evan Brand: Yeah.

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

Evan Brand: Yeah.

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

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

Dr. Justin Marchegiani: Yes.

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

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

Evan Brand: Yeah. For sure.

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

Evan Brand: Take care.

Dr. Justin Marchegiani: Bye, Evan.

Evan Brand: Bye.


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