Uncommon Causes of Mysterious Weight Gain | Podcast #283

Hello and welcome to Beyond Wellness Podcast! Today’s episode is interesting because a lot of us complain about sudden weight gain, or having no changes on weight loss at all after trying out diet plans. Dr. Justin, together with Evan Brand explains the uncommon causes of weight gain in the functional medicine world. Listen to this podcast or read the transcript below. Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

01:40      Insulin

05:42      Inflammation Toxin, Metabolism

10:30      Carbohydrate-rich food vs. The Proper Nutrients

16:20      Gut Health

21:12      Mold Toxins

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Dr. Justin Marchegiani: Hey, Evan, it’s Dr. J here. How are we doing today? Man? I’m really excited for a great podcast. What’s happening? 

Evan Brand: Doing very well. We’re going to dive into a mysterious podcast. You have so many people that say, You know what? I gained 10 pounds I gained 15 pounds, I gained 20 I gained 25 30 40 50 100 pounds mysteriously. I didn’t change anything, quote, what the heck is going on? So we hope to shed some light on this because if you go down the street to your conventional doctor, and you tell him Hey, Doc, I gained 20 pounds. What’s going on? 95% of the time, my clients have reported the doctors tell them, you’re just getting old. This just happens when you get old things slow down and you gain weight, you get more tired, you get weird lumps on your skin. It’s just part of aging, and I disagree.

Dr. Justin Marchegiani: 100% I mean, your weight is a pretty good sign of your metabolism. It’s a pretty good sign of inflammation as well. So we call Like your tummy or your gut like the inflammation meter. And of course, there are a lot of variables right common sense things like eating too much. But and then obviously exercise these play big roles right now. There’s also the macro nutrient content of the foods that you’re eating right protein, fats and carbs and we know the carbohydrate connection, right all the way back from Dr. Atkins with you know, the more processed the carbs are, the more refined they are the more starchy the more those carbs break down to glucose and fructose, the more that’s it a stimulate insulin release, and the more the insulin is secreted by your pancreas, the more chance your cells are going to be numb to it if you’re not exercising or more active. So of course insulin then opens up the the gates for glucose and fructose to be stored as fat or glycogen in the liver and then obviously fat in yourself. So of course, there’s a big insulin component. A lot of people know it, they just don’t really know how to test it or how to quantify it. So that’s kind of a common sense thing. We know people have been talking about that. For years, and how we look at that as we’ll look at fasting insulin levels, and we’ll even do a functional glucose tolerance test to see how your body handles glucose and or sugar like fructose. Okay, so we have typical table sugar which is sucrose, which is like half and half glucose fructose. We have high fructose corn syrup, which is 55 45 fructose to glucose. These are going to go into our body, they’re going to stimulate insulin release, they’re going to get stored as glycogen in our muscles or if it’s more fructose, it’s stored as glycogen in the liver. Once those sources are stored, and they’re at capacity, it’s like a rag that you’re cleaning up your kids mess on the table with it’s fully it’s full, it needs to be wrung out once it’s full, all that glucose and fructose gets stored as fat. So that’s one of the first one so we’ll look at a functional glucose tolerance. We’ll look at a fasting level of glucose. And then we’ll do a one hour, two hour three hour after a meal and we’ll see how fast Those glucose levels come down the faster they come down the less insulin spike to make it come down so ideally between 120 and 140 within an hour and ideally below 100 within two hours and definitely below 100 within three that’s kind of my frame of reference and then ideally in the sweet spot on a fasting insulin we want our insulin levels between two and five definitely below seven if we’re going to be testing our blood levels of of insulin fasting in the morning.

Evan Brand: Yeah, well said and this is not something commonly tested right? I don’t recall I mean, we’ve had hundreds and hundreds and hundreds of people send just standard bloodwork they’ve got further conventional MD and fasting insulin is rarely on there as standard protocols that correct?

Dr. Justin Marchegiani: 100% not on there. Okay. You’ll see glucose on there but nothing else.

Evan Brand: We see yeah, maybe A1C if you had some sort of history or if you were actually confirmed diabetic but you know, I’ve looked on many people and they don’t even do A1C it’s like, I don’t know how much we run it for maybe 12 bucks, 20 bucks, I mean, A1C is cheap to add on, I just can’t believe it’s not standard procedure.

Dr. Justin Marchegiani: I don’t love A1C because it can definitely be a little bit higher, the more the healthier your blood cells are and the more the longer your blood cells live, they can accumulate more sugar or more glucose over time. So there is that component. So I don’t love it, but it’s nice to have. It’s nice to look at for sure. I agree.

Evan Brand: Better than not having it when you say.

Dr. Justin Marchegiani: Yep, I agree as long as you can look at it in context of the whole big picture. And if someone has a false high, you don’t go over the top. That’s why I like my functional glucose tolerance tests with the at home blood sugar meter the best. Okay.

Evan Brand: Make sense? Yeah, that’s the low hanging fruit, right people. You could look back at even just in the 1950s. I mean, the obesity rates were nothing to what they are today. I know my grandparents grandparents were out on 300 acres and eating chickens in the backyard and they ate lard every day. None of them died of heart disease. They all lived into their 80s and 90s. They were outside working the land getting exercise and sunlight every day they were eating foods that were likely much, much richer and micronutrients and minerals because the soil wasn’t depleted. Cliphosphate and other herbicides weren’t invented yet, so they weren’t getting those low dose antibiotics killing the good diversity. It’s possible that and this is just me casually transitioning into the next point, this could be all related to an imbalance of bacteria in the gut. Why don’t we talk about dysbiosis? Because you and I look at the GI map stool test. And if we look at Firmicutes that are elevated or other bad bacteria, that can make you fat.

Dr. Justin Marchegiani: 100%. So, of course, inflammation plays a huge role in your metabolism, right? inflammation is going to cause more cortisol to be secreted. High levels of cortisol, it’s an anti inflammatory, but it also creates a mobilization of sugar or glucose. So people think well, like I’m not eating a whole bunch of glucose or carbohydrate, you know, but you could be surging a whole bunch of cortisol because of the inflammation and that cortisol could be mobilizing glucose. And so this is why it’s important that if you are surging, a little bit more inflammation, going for a walk, doing a little bit of a cross, not across CrossFit or interval or some kind of a circuit training to kind of take that glucose and soak it up can be helpful, because the higher that level of glucose is up because inflammation, your cells getting numb to insulin. So that same thing of eating too much carbohydrates, that’s driving up insulin, that same thing can actually happen from inflammation, so independent of just the carbohydrates, so you may have carbs coming in, let’s say from gluten, right? But then you have the inflammation component, the more gluten sensitive you are that can also surge more cortisol, which can then also create more glucose than what you actually ate in the actual bread to begin with. And that creates more insulin resistance, more court, more courts. are mobilizing sugars. That makes sense.

Evan Brand: It does. Yeah. And if you’ve got the cortisol issue that’s affecting your gut barrier further, which is in allowing infections to create more inflammation so it can become a vicious cycle. What do you think about? So for me, I lost weight. When I had all the gut infections, certain people will see they gain weight and when you get rid of their infections, all of a sudden their weight normalizes in the 20 pounds, they gain go back to normal. Do you have any thoughts on why some people lose weight, some people gain weight, I think it depends on the type of infection or what?

Dr. Justin Marchegiani: Yes, it definitely depends on the type of infection and also depends on the individual. Some people can kind of be more prone to be in an ectomorph stage or they, as they go lower calorie as they have malabsorption they drop weight, some people gain weight, it’s just I don’t really have a an exact rhyme or reason why. I tend to see over time though, people will eventually start gaining weight over time. Whether it’s gaining weight because their body fat goes up and their muscle mass goes down and their weight still stays the same, they’re still going to be losing high quality, lean muscle mass over time, you’re never going to see someone’s body fat drop, and then also have their muscle mass go operate the same. So usually there’s gonna, there’s still going to be a reduction in their high quality muscle, even if they are dropping weight, you’ll become more sarcopenia, right? Yeah, you’ll may lose a little bit of weight, but you’re also going to lose muscle mass, bone mass, etc. So in the short run, though, why you lost weight versus someone else, it’s hard to say, you know, there’s probably some genetic variations there. And that may be different from you and your 20s to you and your 50s, right, so maybe a variation of just where you’re at metabolically and as you get older, that may change. But either way, this is why we focus on body composition when weight loss is occurring, because you could have weight loss but muscle mass is dropping, right? So the body, the body composition really matters the most and you can actually gain weight. Have muscle mass drop as well. So this is it. These are important components to keep in mind muscle mass really matters the most. And it’s one of those things if you don’t use it, you lose it. So that’s why getting a little bit of move, whether it’s push ups or pull ups or some bodyweight stuff, or we talked about doing some circuit stuff, some interval stuff to kind of keep those the muscle mass. They’re really really, really important.

Evan Brand: Good answer, I definitely lost muscle. I definitely lost strength. Some people will say, Oh, I wish I had a parasite. And I can lose 20 pounds without trying. It’s like, No, you don’t trust me, that’s not a good way to lose weight at all. And the weight that you’re losing is not body fat, your body is going to hold on to that body fat. It’s not like you’re magically going to get six pack abs. If you get gut bugs, trust me. You’re losing muscle, you’re losing strength, you’re losing, like you mentioned, possibly bone density, bone strength as well. So not a good thing to have. And we know that just addressing those gut infections could be could be huge. So you mentioned the whole insulin cortisol connection, but a lot of what we would consider low hanging fruit for us because we do It all the time every day all day with people is we help them to test and fix gut infections. So if it’s an H pylori issue, causing low stomach acid, you’ve then got the malabsorption of food, the body sort of freaking out looking for nutrients. It’s like okay, I’m not getting well fed, well nourished, let’s go into fat storage mode because we’re not getting fed well, even though the quality is good, it could be a grass fed steak. If the absorption is so bad, it can still trigger that fat storage mode in the body because you’re you’re not getting the nutrients you need.

Dr. Justin Marchegiani: 100% and again, you could have a lot of carbohydrate rich food and a lot of caloric rich food and not have the nutrients you need. So in general, you kind of already alluded to it, you need B vitamins, you need co Q10. You need alpha lipoic acid, you need carnitine you need a lot of these important nutrients to run your mitochondria to run fatty acid oxidation. So you can generate ATP, which is the cellular currency for energy in the body. So you can burn fat for fuel you need They’ll all be vitamin nutrients for your Krebs cycle, right? Or to run and generate, basically to gain all these hydrogens, right? We call it the reducing compounds FADH2, and NADH, they dump all these hydrogens into the electron transport chain. And this generates more fuel 36 to 38. ATP is going through glycolysis to the Krebs cycle to electron transport chain, right and fatty acid oxidation. So these are very important pathways to generate energy. And when you have someone who’s gaining weight, what that tells me over time, is there an energy store, not an energy burner, and we really want our body to be in this energy burning mode. Because burning means to we’re not our body isn’t allocating it to fat, right? Fat storage, so when we’re allocating it to fat, that means our body’s kind of saving it for a rainy day, which may be okay if we’re saving financially, but not necessarily if we’re saving and we want to be you know, lean and have good muscle mass.

Evan Brand: So let’s keep unpacking what you’re saying, because this is important. We’ve had people say, Well, I’m doing keto. I’m doing little to no carbs, I still can’t lose weight, what the heck is going on? And I know this isn’t the only mechanism. But let me say this one and then if you want to build on it, my thought is if I and I’ve had people who say I’m full carnivore, I’m just eating grass fed steak couple times a day or something like I have zero carbs, why am I not losing weight? Or why am I even gaining weight? My argument would be, as you mentioned, the carnitine and all the nutrients you need to fuel those cycles. If you’re not absorbing or assimilating that grass fed steak due to low HCl infections have some stored inflammation in the gut, it doesn’t matter if the if the food itself is good because you’re still not getting the nutrients you need to run those cycles.

Dr. Justin Marchegiani: Correct. So if we are going lower carb, we want to make sure we’re consuming for the most part on a ketogenic template, unlimited amounts of non starchy vegetables for the most part, it’s fine. You know you most people are going to be in that 20 to 30 maybe 40. net car grams per day. And you’re looking at three to four carbs nets with your green vegetables serving. So you can be eight to 10 servings a day on your green vegetables. And you’re probably going to be in that ketogenic range, so that the vegetables tend to not be a problem. And you can do organic and make sure the nutrient density is high. You can also consume things like organ meats, and obviously high quality grass fed pasture fed meats and egg yolks and all those things that are nutrient dense so we can make sure those foods are there and in the diet. Some of the hidden things could be like you mentioned having with you is having inflammation in the gut from infections not having enough stomach acid or enzymes or bile salts. So those foods overwhelm the system and may actually create more inflammation because we can’t digest them. So there also is that as an X Factor, we have to keep that in the back of our head. Most people are going to lose weight, dropping carbohydrates if their carbohydrates were previously high, just because for you know, for one molecule of glucose, there’s three or four molecules of water right behind it. Okay. So as you drop down the glucose, you drop down water weight. And so of course, you’re gonna see that as well that’s like a no brainer. So most people off the bat are going to see some level of drop. If not just the insulin dropping, then the glucose drop or the glucose dropping, then the insulin dropping, and then the insulin, dropping the water, and then the water and then the sodium. And so you’re going to see a massive reduction in water weight, okay? Now, if we’re struggling, and we’re still not seeing that weight reduction, we’re going to have to look at the gut, we’re going to have to look at the inflammation and the food, we’re going to have to look at how you’re digesting the food, is that food nutrient dense. And then if we’re looking at all those things, and we still been following this for a solid month or two, and we’re still having problems, that’s where we have to look at the adrenals aka cortisol, cortisol rhythm, that’s we’re looking at the female or male hormones, definitely more with the females females are going to struggle more because if they if they’re already in estrogen dominance, right, that’s already going to create more storage hormones. They’re like insulin right? Because estrogen is kind of a it’s kind of a growth hormone. could promote more fat growth as well. And then of course, thyroid and it could be a low thyroid, it could be a thyroid conversion issue. It could be an autoimmune issue. And a lot of people improve their thyroid going keto, because one insulin does affect our way conversion. And when you’re typically going keto, you’re not eating grains and things that could stimulate autoimmunity. So kind of like our is a lot of people out there that are like keto is the solution, keto solution, but what if you’re that person? It’s not why. And that’s where functional medicine comes in when we look at those next levels above, and then then we have to get more specific.

Evan Brand: Yeah, here’s another hidden part of this whole issue too, since you brought up estrogen is when we’re looking at someone stole panel, we’ll see the enzyme the beta glucuronidase that goes high, typically due to dysbiosis. There’s other causes as well. But when this enzyme malfunctions if your guts not working properly, now you’re going to recirculate estrogen. So even if you weren’t taking an estrogen birth control pill or anything like that, you’re like, you know what, where Why? Why would I have excess estrogen? Well, it could be what you’ve had in your body is is simply getting recirculated and that’ll cause tons of issues. And so part of our goal is we have to get that enzyme working from that enzyme functioning properly. And some people lose weight just by doing that. I mean, it could be simple as fix the gut and they lose 20 pounds. We see it every day.

Dr. Justin Marchegiani: 110% so the guts a really important component. And then the hormones play a really important role as well. And we already talked about how important healthy gut function is for detoxification and we have in previous podcasts, healthy gut function is important. That’s where we eliminate our stool. we eliminate a lot of toxins via heavy metals or mold via the hepatic biliary system. That’s liver, gallbladder into the gut out the stool, or liver, gut, you know, kidneys out the urine. So we there’s a lot of different ways that we eliminate now. to dive in one step above we’ll kind of get there is things like mold and mycotoxins can slow down thyroid. There’s different studies on like, the mole toxin is Elena and they actually put that mole toxin in the ears of cows. And they do that because that the cows actually convert more of their calories to fats, when they expose them to that mold toxin. So we know different molds can slow down thyroid function, they can affect T4 to T3 conversion, and they can cause more fat gain. So mold can definitely be a component in this whole thing. And it’s not the first thing I go to. It’s not the low hanging fruit. But if we do a good history, and we address the other things and we’re still at a standstill, then then it’s something that we can definitely dive into eventually, if history leads us there.

Evan Brand: Yeah, my wife and I, we were looking back at some pictures of ourselves and we both lost weight. You know, we just blamed it on my wife breastfeeding all the time, we thought Oh, she’s just you know, putting out so many calories. She’s not eating enough. We’re pretty low carb. Maybe she wasn’t eating enough. But we both had lost weight. And then once we improved our air quality, we both gained our weight back so I can confirm that your weight could go either way, just like it came with gut infections. You could lose weight when you’re exposed to to mold or you could gain weight. So it can go either way. Now, for those that have been following for a while, you may know this, but if not Dr. J is working on a thyroid book. So I want you to maybe give us a little more insight on this thyroid mechanism. You mentioned it but what specifically is going on with Is it the antibodies? It’s, that’s the problem is it just thyroid receptor sites being blocked? What’s going on when you’re saying thyroid is one of those pieces of the weight gain?

Dr. Justin Marchegiani: So mold toxins can affect thyroid conversion, T4 to T3 conversion, you can see an increase in reverse t three, which is our inactive thyroid hormone. It’s kind of like someone being in the parking lot, right? And instead of having an open parking spot, someone just kind of put some cones in the parking spots right? And so you can’t go park in there because the colon there. Well imagine the receptor site is the parking spot and the thyroid hormone is the car. Well if you got a whole bunch of parking spots that you wanted to park in, but now they have a cone in it. Well you can’t dock right that thyroid hormone can’t work. Right think of the cones as reverse T3, it’s blocking the receptor site for thyroid hormone your car from being able to use it. So that’s a big role in thyroid increases your metabolism, heat energy, etc. So there’s that. Also, that’s-

Evan Brand: -so that’s the mechanism that people need to know. It’s that, you know, I think of it kind of like a blank bullet, too. So you’re saying that if that cone is in the way, no matter if the blood level, so you’re saying like free t three could look okay? But if you’ve got elevated reverse t three, that free t three can’t get into the receptor, therefore the metabolism never fires, right? The sparkplug doesn’t fire, is that correct? 

Dr. Justin Marchegiani: Yeah. And usually with higher levels of reverse t three free t three starts to go down because you only have so much t three building block or T four building block, and it’s either going to go to t t three or reverse t three, okay? And the more reverse t three is increasing. That means less of it’s actually going to the active t three. And then the more reverse t three, it makes that active t three that’s there even less viable. Does that make sense? 

Evan Brand: It does so it’s like a diversion. I’m picturing like a garden hose with one of those little two way splitters. Bingo. And I had this, I remember you and I looked at this in my blood, I had reversed t three almost to a 30, which is really high at one point. And basically the diverter switch was flipped. And so luckily, that is now resolved, and I feel much better. 100% you’re really tired, too. I want to mention that too. Because I want people to know, okay, you’re all getting into this receptor site and all that. Well, how does that affect me on my day to day life? Well, I’ll tell you, from someone who has high reverse t three, you can feel it, you feel that you can’t push the gas pedal, it’s as if somebody put a rock under the gas pedal, and you now can’t get the pedal to the metal. So you’re lethargic, you just feel blah, your mood is not as good. Your energy’s not as good. So these are the people who are like, Oh, I know you’re telling me to go do high intensity interval training. I friggin can’t do it. And it’s because of that issue. And so sometimes you have to work backwards meaning you’ve got to resolve elevated reversed T3. You’ve got to resolve the gut issues to even get the mitochondria working enough to give you the ATP so that you’re actually have enough energy in the tank to do the exercise that you know will make you feel better. 

Dr. Justin Marchegiani: Correct. So then you have the mold toxins right affecting thyroid conversion and activation. Also, what affects the conversion? Well, typically the enzymes the di dnase enzyme, the five prime di enzyme is coming from the liver. It’s coming from Selenium. So of course it delivers more burden, right, and glue to ion pathways and our top detoxification pathways are stressed. It makes sense why the conversion may be effective because the detoxification pathways are impaired, and then our body. Like it’s always trying to sequester things like it’s going to try to flush things out first, but then if it really has a hard time, it’ll store things in the fat second, so the body will tend to store things more on the fat side of the fence just to kind of keep it sequestered. It’s kind of like your kids running around causing a whole bunch of problems in the home. You’re probably going to say go to timeout or go to your room, right. So they’re not running around causing a ruckus. It’s kind of the same thing with your toxins in your body, hey, you know, hey, mold, I want you to go to the fat cell, right? That’s kind of what’s happening there. And of course, the more fat cell you have, the more the body wants to store they’re just like that just kind of it creates momentum in regards to fat storage and slows down the metabolism. And of course, the less Selenium included IO and you have the less the thyroids going to be supportive. And then if you have, God forbid autoimmune issues, now that autoimmunity is going to be tamped up, and it’s going to be harder for the body to modulate or downgrade that inflammatory response.

Evan Brand: And that’s because you’ve basically gone into attack mode right now you’ve got you’ve got the cop shooting the wrong bad guy, you hit your thyroid, now the thyroid could be damaged and therefore it could produce less active hormone is that right? So I mean, after years and years of thyroid damage, you literally can produce less Is that true?

Dr. Justin Marchegiani: Correct and and also the new Treatments needed to quell that inflammatory response is too busy dealing with the mold toxins. Does that make sense? Yep. And then kind of a very similar mechanism, again with heavy metals, very similar again with heavy metals, Mercury lead, are they going to be the big two? And then we also have like cadmium, arsenic, aluminum, those kind of ones as well. So of course, we have those kind of having a very similar mechanism, as I just mentioned, stressing out thyroid conversion, potentially affecting autoimmunity being stored in the fat cell creating stress on our metabolism.

Evan Brand: Yeah. And how does this look because people like oh heavy metals, right, it just sounds so kind of airy fairy in the air. This could be as simple as something we’ve seen this we’ve seen dozens of cases like this. Someone goes in for a routine dental procedure. They go get a major deep cleaning done while they have silver quote silver fillings which are 50-53% mercury. They go get a deep cleaning. After their deep cleaning, the person is scrubbing and scrubbing and scrubbing. They’re getting millions and millions of micro particles of mercury into the brain via inhalation. They’re swallowing it into the gut. And all of a sudden I gained 20 pounds after a dental procedure. What was the dental procedure? Oh, it was a deep cleaning, ah, bingo. And then if you if we need to, we could do a, like some sort of provocation and then run a urine heavy metal screen to look for this on paper. But if we just go in and do the binders and such to actually get rid of heavy metals, sometimes we could just confirm using an educated guess and history. All of a sudden, the heavy metal protocol we use, boom, they lost 20 pounds. It could be that simple.

Dr. Justin Marchegiani: Yeah, it definitely can be that simple. So we have to look at everything holistically. So I think we hit the mole toxin, we hit the heavy metals. We talked about a lot of just the general inflammation. We talked about some of the hormones, we talked about cortisol. We talked about, of course exercise, what exercise does is it’s going to help decrease insulin. It’s going to help improve insulin sensitivity, and it’s going to help me Take more space in our muscle for the glycogen to which is helpful. 

Evan Brand: Justin’s cat is in the background. She is interested in glycogen to she wants to increase her glycogen by getting fed. Yeah, the exercise. Exactly. Well, actually, it’s a boy though, isn’t it?

Dr. Justin Marchegiani: Yeah, Dexter.

Evan Brand: Dexter wants to get his glycogen reserves up. And so regarding the exercise piece, you see why people get this wrong. And it’s not their fault. It’s just you don’t know what you don’t know. They think okay, I just need a $10 gym membership. And I’m just going to go pound the weights and magically I’m going to lose weight, right? Because diet and exercise. Those are the two variables that everyone on Good Morning America talks about. Look at this celebrity trainer. If I just do what he does, I’m gonna friggin get in shape. And it’s like, maybe if you don’t have all these other root causes, but the problem is everyone in the modern world based on looking at thousands of toxic people. People are very toxic. It’s not that easy. anymore maybe 100 years ago, it would have been that easy. But now there’s so many other variables, we have to get out of the way so many other roadblocks.

Dr. Justin Marchegiani: Yeah. And everyone can at least start out, they can at least try it, they can start going with it, that’s fine. And then if they have an issue, then they at least know why we’re on their radar, we’re kind of in the back of their head. Or if they’re going through all the exercise stuff, and they’re just the exercises, speeding them up, and they’re just feeling like crap. And there’s at least a next level we can go to if we need.

Evan Brand: Well, I knew something was wrong with me when I was having three to four days of recovery times when I previously had one to two day recovery times, even though the intensity of the workout wasn’t much different. And also when I was getting diminishing returns, so I put in the work and my weight or muscle mass or strength would stay relatively the same. I thought something is not right. And then that’s when I found out I had gut infection. It’s like, okay, I’ve been getting robbed of all of my amino acids. I can’t even manufacture more muscle mass right now until these infections resolved. And then here’s the funny thing. I literally started building muscle looking more fit With less exercise than I did before here, I was working so hard and go, I worked out less. All I did was clear the infections and then boom, the muscle came on. And people might argue well, oh, and you were just overtraining. And the cortisol was eating away your muscle tissue? No, no, no, I’m talking like going from three days a week exercising 20 to 30 minutes to like, one or two days a week. And I gained more muscle that way. It was crazy.

Dr. Justin Marchegiani: Yeah, yep, that can definitely be a thing, you know. So I think we hit a lot of the really important things here regarding the diet component, which is foundational, and that’s going to be your 8020. You know, that’s where 20% of you know, 20% of the results are going to happen. 80% of the results are going to happen from from those 20% right there. Okay, then everything else gets a little bit more nuanced. And that’s where we layer and stack and functional medicine is a good next option. And then of course, all the different toxic things and the hormonal components in the gut and the absorption stuff that all make sense. Anything you want to add to that.

Evan Brand: The good news is you can resolve this and so if you do a good workup on somebody, you can find out exactly what going on. Now, we may not go straight away to do on the blood work, we may not go straight away to doing the cortisol. It really just depends on your history. We’re going to ask you about sleep. We’re going to ask you about stress, we’re going to ask you timeline. So when did all this happen? like we talked about the lady who got the dyno cleaning, and all of a sudden she gained weight after the dyno cleaning, or, oh, you gained 20 pounds after the divorce or you gained 20 pounds after you moved into this new house, right? So we’re going to base our lab testing investigation protocol on what gets uncovered during the history. So you can’t take that lady who got the dental cleaning, and assume that that’s your issue, right? You really want to stack all the puzzle pieces out on the table together and just see, okay, Look, she’s got some mercury here. She’s got the gut inflammation over here. She’s got the elevated cortisol at night. She had water damage in her basement, you see and then we start adding all those puzzle pieces so that way you can get her 20% better, they’re 20% better there. And then you get the person fully well, so if something is The gym is not working. You don’t feel like it’s not working. There’s probably something going on under the hood. And not always but as, as we’ve talked about, we’ve tested thousands of people. modern humans are extremely toxic from gasoline additives to paints, nail polish, hairspray, hair color, the pesticides and herbicides, the pharmaceuticals that are in tap water, I mean, there’s endocrine disrupting chemicals in the tap water if you’re not drinking filtered water, and we’re not talking just a fridge filter, that’s not sufficient. You could get fat just from drinking tap water. And people say, Oh, that’s ridiculous. No, it’s not. You can look at the studies on the Environmental Working Group and many other people have done studies on tap water across the US and across cross globally. And trace amounts we’re talking parts per million of certain drugs like antibiotics and birth control pills and things can end up in the water supply, therefore affecting hormones therefore making you fat. So it’s no surprise when you look at the amount of time toxins, it goes up like a hockey stick just like the obesity rate. Can you blame all obesity on toxins? No, but I think it’s a huge part of the puzzle.

Dr. Justin Marchegiani: 110% 110% Yeah, I agree, man. That’s really, really important. So I think you hit some really important components there regarding the food stuff. Inflammation toxin. I think we did a really good job kind of laying everything out. Is there anything else you want to touch upon here?

Evan Brand: I don’t think so. Unless you had any questions. I don’t have any on my side.

Dr. Justin Marchegiani: Well, there’s one more thing I want to highlight is people talk about eating too much or too much calories. Now, that’s always a possibility. But the problem is when you’re consuming good fats and good proteins and your blood sugar is not on a rollercoaster ride on the foods nutrient dense that you’re eating. The odds of overeating gets lower because of the fact one you have nutritional density to protein and fat signals, a lot of satiating compounds in the brain adiponectin peptide Why Why? It’s gonna simulate colon assisted kinda in a lot of these things are going to help you feel satiated and help you feel full. So it’s harder to overeat fats and proteins. I mean, is it possible, if you’re just doing scoops and scoops almond butter or straight up butter, it’s possible. But if you’re eating at a normal pace, and you’re eating, you know, vegetables and protein sources and good fats together, and you’re not chopping things down super, super fast, I recommend eating till you’re about 80% full, and then kind of giving yourself five or 10 minutes to kind of let things digest because sometimes there can be a delay, and that satiation signal, and that kind of helps your body but Okay, yeah, I’m good. You actually had enough you’ve got to give yourself that equal your 80%, not to your 100% and give it that five or 10 minutes to kind of get that feedback loop back up to the brain and be like, yeah, I’m satiated. I’m, I’m good. So that’s kind of my big strategy on the calorie side. And then of course, of course, of course, of course. eat the right foods. When you do too much carbohydrate. You don’t get The satiating signal that you get with fats and proteins. That’s why the Pringles commercials are the 90s. Everyone knows that if you’re if you’re that old, once you pop, you don’t stop, right? Or everyone has the experience of buying a pizza and eating it, you know, in back in their college days to their whole face, right? They eat the whole thing. Why? Because they like gets, yeah, the Lay’s chips. You don’t get that satiation signal or it comes way late in the game. And that’s why you can overeat carbohydrates, it’s much harder to overeat, let’s say, a dozen eggs, right? You’d be nauseous because of all of those compounds, cck, etc. that will make you feel really nauseous.

Evan Brand: You know, we ought to do we ought to do one of those. React video where you’ll see like health practitioners react to certain videos, you and I need to pull up like a bunch of commercials from the 80s and 90s and just share our thoughts on them because it’s really sickening. If you think about it like the Lay’s motto, wasn’t it a bet you can’t eat just one. It’s like, Well, duh, because you’re getting no satiation. You’re getting no leptin response from that nutrient devoid food with hydrogenated cottonseed oil on it.

Dr. Justin Marchegiani: And they’re also putting a lot of stuff in there to stimulate appetite. They’re putting more things to stimulate it right? You’re using a lot of sodium in there. They’re putting a lot of MSG in flavor enhancers. And then don’t even get me started with the low fat phase. They started adding me olestra and the olestra was the fat but it was digestible. So you’d get disaster pants after you consume it because your body couldn’t break it down. So you’d have the fat you taste the fat, but then it will go out your pants. It was terrible. Remember that stuff, the olestra in the late 90s.

Evan Brand: It’s absolutely horrid. I can’t believe what Americans have gone through in terms of the food supply. If you were someone who lived in a rural area, maybe you bought your food from farmers back then and you kind of avoided supermarkets. Maybe you dodged a lot of this but unfortunately a lot of people are victims to what’s happened with the food supply. So this is just more reason to connect with yourself. farmer buy your food locally, it’s going to have better soil density of nutrients, hopefully, you’re going to have less transit time. So therefore you’re not eating blueberries from Mexico that were picked way too early, and they didn’t develop in origin picked at the peak. So there’s a lot of benefits to going local with your food supply. I could go on a whole rant about that. But regarding the the satiety hormone stuff with the fluids, it’s huge. I mean, and so that message that 80% full thing goes to all those people. And this was me, I’m going to admit it. This was me, even though it was like a grain free cookie, you know, almond flour or something with coconut sugar. You know, I would eat a meal. And I’d be like, hmm, I’m not satiated enough. I need to have something sweet. It’s like I wasn’t getting that, that full signal. And once I’ve detox and mold, I don’t have that anymore. And if I just sit there to table for a couple extra minutes, all of a sudden, Oh, you know what, I am full. I don’t need anything else. And we have that report all the time from people like Oh man, I gotta go run and get my piece of chocolate. After the meal, if you If that’s you, then there’s something not right that’s not now too common response, but common doesn’t mean normal. So if you eat grass fed steak, baked sweet potato butter and cinnamon and a big old fat plate of some butter with broccoli, and you don’t feel good after that, and you’re still running for the cookie or the chocolate investigate because there’s something going on.

Dr. Justin Marchegiani: And it’s okay if someone is having a little bit of dark chocolate after a meal, just make sure it’s going to be lower sugar high and Macau, so then you’re not getting much carbohydrate, you’re getting a lot of nutrient nutrition in that or just choose the healthier option. Maybe it’s some low sugar coconut yogurt with some fresh blueberries in there, right? So we can always, you know, kind of look at making your fruit making it like a dessert almost right. So if you’re going to do some low sugar fruit or put some good fats in there, that way one, there’s good fats too. There’s not a whole bunch of sugar in three there’s a lot of nutrient density there so you can kind of still kind of have that little bit of satiation and that like desert feel without having Having all the side effects true and it’s in it’s totally awesome and beneficial to do that. I’m not trying to demonize it or make, make it seem like you should never enjoy yourself. That’s not what I’m saying. But just for those people that say, I have to have it, like if I don’t have my chocolate, you know, you don’t want to be around me those things. That’s when it seems like it’s an excess, but just for enjoyment. Yeah, I think you could do some awesome stuff. Yeah, I mean, if you look at like a 50%, dark chocolate or milk chocolate, right? A whole bar half a bar isn’t that 2025 grams of sugar versus you go have a dark chocolate maybe at 88% like an endangered species brand. Well, now you’re at four or five grams. So you see how there’s a that’s a 90% reduction in the sugar, just from choosing one dessert over another dessert so that it’s a total totally big difference there. So if you guys are like hey, I want something, just choose the healthier option.

Evan Brand: Yeah, absolutely and cool. The dark chocolate thing too, even if it is super high dark chocolate content and it’s not much sugar. If you’re going for that too often in your emotions. sensitive and it’s comforting you to have that then your endorphins are probably burned out. We measure that on organic acids testing. Yeah. All the time. Well ask those people Oh, yeah, like, Oh yeah, if I see a commercial, it’s not even sappy, but I cry, and I have to have dark chocolate every day. Well, then you got an endorphin problem most likely. But that’s a whole nother podcast, we’ll save that for a brain chemistry show.

Dr. Justin Marchegiani: Exactly like my go to right now has been just like some really nice, clean, unsweetened coconut yogurt with a little bit of cinnamon and maybe some fresh blueberries or strawberries, something really simple, nutrient dense with some good fats. And just trying to keep that that mindset of eating till you’re about 80% full is a good indication because that 80% once you stop eating, you may notice you start getting full for the next 10 or 20 more minutes, even without eating because that signals just a little bit behind. So that’s why it’s good to have that mindset. So then you’re not eating too. You’re 100% and then you’re like, Whoa, I gotta undo the belt buckle a notch or two. It’s like Thanksgiving Day dinner, right? That’s what we want to avoid. Very, very good where it’s uncomfortable to move right, we should be able to move comfortably afterwards.

Evan Brand: Yeah, that’s a good statement. We talked about that too, with HCl production and such if you if you eat and then you need to go lay down. Something’s not right.

Dr. Justin Marchegiani: Yeah, exactly. Well, anything else you want to highlight Evan, I would just say that to the listeners if they want to dive in deeper, and they feel like they need a next step person, a coach to help them get to that next level, head over to EvanBrand.com. You can schedule with Evan, head over to JustinHealth.com. You can schedule with myself, Dr. J. If you want to dive in deeper, sometimes these tests are necessary. Or maybe you’ve already gone a lot of the route that we’ve talked about and you’re ready for those next things where there could be a hormone issue or a toxic stressor and you want to roll it out. That’d be your next step. Anything else? Anything you wanna add in? 

Evan Brand: No, that’s it. You did a great job. Check out the sites JustinHealth.com, EvanBrand.com. Thank you for being there. And we enjoy having you on the other end of the microphone. So stay tuned. We’ll be back next week. 

Dr. Justin Marchegiani: Excellent. And people that are listening. If they have friends or family that could benefit please give it a share. Your comments down below we want to know what you think. Whether it’s future topic ideas or just comments on today’s show and make sure you hit the bell and noticing hit the subscribe button and the bell so you get notifications of great content coming your way. Alright Evan, you have a great day, man. Take care. 

Evan Brand: Take care. See ya. Bye. 

Dr. Justin Marchegiani: Bye.



Audio Podcast:


Meditation for Cortisol Regulation

By Dr. Justin Marchegiani

Stressors are plentiful in our modern world: paying the bills, relationship troubles, meeting project deadlines… While some amount of stress is normal, chronic stress can affect your daily life and oftentimes leads to long-term health consequences. Luckily, there are ways we can balance our stress response naturally.

Stress Throughout History

When you’re stressed, your cortisol rises: this is nature’s alarm system, your body’s main stress hormone. Chronic stress raises your cortisol levels, and over prolonged periods of time, this can lead to fatigue, hormone imbalance, weight gain, and feeling burnt out.

Evolutionarily, stress is actually a good thing! It’s a part of the “fight-or-flight” response responsible for keeping our ancestors alive. However, the disconnect is in how often we feel stressed out. Back in the day, stressful situations came, a human reacted, and it was over. For example: If confronted by an angry lion, our ancestors would have kicked into fight-or-flight and either fought the lion off or ran away. Either way, once they reached safety, the stressful situation was over and they could continue going about their life.

On the other hand, you have modern day stress of the digital age. Our stressors last longer and are more complex than 10 minutes of “Oh no, lion.” Our stress is often situational and compounding, lasting for months or even years. The stress response that was originally intended to help us adapt to new environments and challenges thrown in our path is now an overwhelming state of mind that impacts daily life.

Long-Term Effects of Stress

Stress makes us moody and irritable and might mess with our sleep, digestion, and attention span. These are just the immediate symptoms of stress—when our cortisol levels are raised for long periods of time, even more, serious effects begin to take place.

Weight Gain: Most of us crave junk food when we’re stressed: fatty, salty, or sugary. This can contribute to weight gain, but even more damaging is the link between stress and insulin resistance, a major trigger for weight-gain and a precursor for diabetes.

Inflammation: Elevated cortisol levels are linked to inflammation, which is said to be the root of all modern disease.

Accelerated Aging: Stress damages the blood-brain barrier, putting you at a higher susceptibility for Alzheimer’s.

Memory & Learning: Chronically elevated cortisol is linked to a shrunken hippocampus—the part of the brain responsible for memory and learning.
Immune System: Chronic stress lowers your immune system. When confronted with a lion, our body isn’t worried about fighting off pathogens; it justs wants to make it out of the immediate system in one piece. High cortisol levels leave you susceptible to getting sick more often, and it may take you longer to recover from colds.

How Meditation Can Help

Meditation practices have been around since as early as 1500 BC, and modern science has recently taken a fascination with this ancient practice. Some of the proven benefits of meditation include:

  • Less Stress: Meditation can lower stress, anxiety, and inflammation.
  • Lower Blood Pressure: A daily meditation practice can lower blood pressure and heart rate, and increase circulation.
  • Body and Mind: Meditation is a booster for your body and mind, with positive effects on the immune system and brain function! Research shows that meditation greatly benefits memory, attention span, and peace of mind.
  • Better Sleep: Studies show improvement in sleep quality and duration in participants who meditate.
  • Healthy Weight: Meditation lowers the risk of obesity and overeating.

Starting a Meditation Practice

Meditation is a powerful practice that’s free to do!

Pick a quiet spot, where you feel comfortable and won’t be interrupted. This could be in your bedroom, or maybe even somewhere outside. You can start with a short session and work your way up to longer sessions: go at your own pace. If your mind starts to wander, let it. Focus on your breathing and quieting your thoughts, but don’t force anything.

It can be intimidating to get started; many people worry that they don’t know how to meditate the “right” way. However, there is no right or wrong when it comes to meditation: the end goal is a reduction in stress, so don’t work yourself up worrying about being perfect. Namaste!















Leptin resistance and weight gain – Podcast #101

Dr. Justin Marchegiani and Evan Brand take an in-depth look at hormones that affect appetite and they explain why some people are easily satiated while others get a lot cravings. Discover how leptin is connected to insulin. Listen as they share with us information on how we can control blood sugar better and burn fat.

Leptin resistanceIn addition to the hormones, learn about toxicity and how you can improve the environment and why clear air is important as well as clean water. Find out why keeping fructose consumption to a minimum can greatly help and what types of fruits you should be eating more (or less!) of. If you are struggling with weight loss, this podcast episode is for you.

In this episode, topics include:

00:50   Hormones

04:00   Toxins

06:34   Weight loss and detoxification

17:31   Diet and food recommendation

26:53   Summary












Dr. Justin Marchegiani:  Evan brand, it’s Dr. J, man. How you doin’?

Evan Brand:  I’m doin’ great. What about you?

Dr. Justin Marchegiani:  I’m doin’ pretty good, man. It was really hot down here in Austin. I was on the boat last weekend doin’ a lot of water skiing, trying to stay cool.

Evan Brand:  Yeah, I’ll say I don’t miss the 110º days. I’m happy with like 85-90.

Dr. Justin Marchegiani:  Yeah, it’s not getting that hot. It’s probably like 95-99 kinda thing.

Evan Brand:  I was dyin’ last—was it? I guess it was almost a summer and a half ago, 2 summers ago there. It was incredibly hot. That was when the drought was still there. I think it’s a lot better now, isn’t it?

Dr. Justin Marchegiani:  Yeah, it’s much better now. Absolutely.

Evan Brand:  Cool. Cool.

Dr. Justin Marchegiani:  Well, how your weekend?

Evan Brand:  It was great. I don’t even remember what I did but I know it was good.

Dr. Justin Marchegiani:  Well, I know we talked pre-show. We were gonna talk about some of these hormones that affect appetite, two for instance being leptin and ghrelin. And these are two hormones that have a major effect on energy balance. So leptin is one of these hormones that helps kinda with satiation and the more leptin sensitive you are, the—the more apt you are to be satiated and do not have these massive cravings, and leptin and insulin are 2 hormones that work together. So when we talk about resistance, like leptin resistance or insulin resistance, they kinda are connected because insulin is this hormone and it helps kinda open the doors in the cell so to speak so we can get nutrients from the bloodstream into the cell so the cell can essentially use it for energy. Now insulin, too much of it can drive, open the door so it goes into the fat cell, right? It can go into the fat cell and it can cause fat storage and the more that insulin bell is rung so to speak, the person that starts to, you know, open that door becomes less, you know, more resistant to open that door and the more resistance we have with insulin, the more that blood sugar accumulates in the bloodstream and the more blood sugar gets converted to fat, the less we burn our calories for energy. The more we store our calories and the more resistant we are to burning sugar. So essentially that’s insulin resistance and the whole downstream effects then affect leptin because leptin is higher in obese patients, same as—same with insulin resistance, and the more leptin resistant we are, the more appetite kinda gets away from us and it’s more out of control and we’re more likely to eat bad foods which then perpetuate the same problem again.

Evan Brand:  Right, and these the people that they can graze all day and they never get satiated. You’re just constantly eating. You’re never really getting that full signal of, “Ah, I feel good. Now I’m gonna go back to life.” You’re just constantly—you’re the person who if you open up your desk drawer right now, maybe you got a protein bar in there. Maybe you got a candy bar, maybe you have some other type of snack food. You could potentially have some leptin resistance if that is-if that’s you. I’m all about being prepared. If go on a hike, I’m gonna bring some jerky, some nuts, some other foods. But it’s not, I don’t have to snack all day every day.

Dr. Justin Marchegiani:  Exactly. Exactly, that’s the big thing. So we keep insulin and leptin essentially in balance, doing the same things. Some of those are gonna be one, keeping refined sugar out of your diet or at least out 80-90% of the time. If you’re obese, you have a BMI that’s, you know, upwards of 30-35. You have waist that’s greater than 40 inches as a male, 35 as a female, that’s a pretty good indicator off the bat. More than likely you’re obese and more than likely you have this whole insulin-leptin resistant pattern happening. Now—go ahead.

Evan Brand:  I was just gonna outline some of the—the main factors here that are influencing people and their hormones. One is the diet which you’ve already touched upon. That’s gonna be influencing these hormones. Two and three, are going to be toxins. So whether this is like environmental toxins like endocrine disruptors you know hormone—hormone disruptors here or just things that are going to trigger our nervous system be—to—to act up. So if you have adrenal issues, it’s likely that you have some other hormonal issues that could be tied into this and you’re having the blood sugar crashes. You’re not getting satiated. Maybe you’re getting lightheaded when you stand up. Things like that.

Dr. Justin Marchegiani:  Yeah, absolutely. So we really wanna make sure we keep the refined sugar out of our diet. Excess fructose. Fructose is one of these major fruit sugars but we really see it higher in high fructose corn syrup. So these are gonna be almost of all our refined junk foods are gonna be very high in fructose which are gonna drive this whole insulin resistance mechanism from happening.

Evan Brand:  And I doubt most people listening to this show are consuming high fructose corn syrup intentionally; however, if you go out to restaurants somewhere you get a decent quality meat but then you do some type of sauce with it. I guarantee the sauces are gonna have some corn syrup in there. So is it gonna kill you if you do one dose of it? No. But if you are having issues with your weight then you may have to a little bit more dialed in.

Dr. Justin Marchegiani:  Yeah, and a couple of the patterns we’ll see on blood work when we see like excess fructose is we’ll see higher cholesterol and cholesterol by itself being higher, you know, mid-200s and up, is not necessarily a bad thing. But we’ll also see the elevations in triglycerides with it.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So typically over a hundred for the triglycerides is a pretty good sign or even more specific is a triglyceride to HDL ratio that is greater than 2. So what does that mean? That means, well, if your HDL is at 50, that’s the so-called good cholesterol. Not really good cholesterol but that’s what everyone knows it as. That should be around 50 in this example and if your trigs are let’s say greater than 100, well, there’s your greater than 2:1 ratio. You have over 2x more trig—triglycerides for short—than we do have for the HDL.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  That’s a pretty good sign off the bat. We can also see elevations in blood pressure as well. And one of the things we’ll even start to see is we’ll potentially see even things like slightly elevated liver enzymes. We’ll see that in—in NASH—nonalcoholic steatohepatitis—that’s basically liver issues like this liver kind of disorder that we see in alcoholics but it’s a non-alcoholic version.

Evan Brand:  Wow, it’s amazing.

Dr. Justin Marchegiani:  Absolutely, any comments on that, Evan?

Evan Brand:  Well, so I wanted to talk about people that are struggling that weight loss. That’s mainly who this—this episode is geared toward. It’s important to learn about these hormones in general, but if you are having with weight loss, you and I both, we help people with that, but it’s not the first priority. A lot times we have to get these other foundations in place. We have to build the house, build the foundation, build the walls, get the adrenals in check, try to optimize the function of the gut, before we come and focus on weight loss. But the issue with these hormones here is that people are not able to detoxify and so if we look at your fat cells, your fat cells are gonna be storing all of these toxins. So whether this is hormones, whether this is various pesticides and other chemicals, whether this is chemicals from your conventional skincare products, maybe before you went all-natural with your skincare products—hopefully you’ve done that—you still have the residual impact of these toxins in the fat cells. It’s not like they’re just gonna magically leave the fat cell and flush out of the body. So when we’re talking about these hormones, you know, getting the adrenals healthy, getting the gut healthy, those are our first priorities, and then after that we wanna try to help to improve your elimination of some of these toxins so that these hormones can work better—these insulin cycles, these leptin cycles, and so if we’re talking things like magnesium supplements, we’re talking things like vitamin C, maybe some charcoal, maybe some physical exercise, too, to get these fat cells burning up and excreting the toxins, so whether it’s something like yoga if you’re really adrenally fatigued, Justin and I both are not gonna tell you to do a CrossFit workout. So it could be some yoga, it could be massage, some body work, it could be some infrared saunas—I like near infrared saunas, those are good, massage and then other detox stuff. I know you talk a lot about amino acids helping to detox. So there’s that route, too. Basically we’re trying to just help the liver do its job a little bit better so that it’s not so busy focusing on all these toxins. Like the average person out in America, in the world, their liver is so busy just trying to keep up with all the toxins that re coming and the onslaught of toxins from the food, the water, the air, the soil, etc. that your body can’t process the hormones the way that it needs to. So really detoxification should be a daily thing, but also it should be an intervention that we’ll use at the right time when a person’s foundations are in check.

Dr. Justin Marchegiani:  Exactly and you mentioned a couple of things regarding toxins and obesity, there’s one article here that was written by Dr. Mark Hyman. He was quoted as saying that “toxins activate neutrophils”. Now neutrophils are the largest percentage of blood cells in our body—our neutrophils, and these will typically upregulate with bacterial infections especially. Now these things will increase these various inflammatory cytokines of the, you know, the Jeopardy words for them are TNFα, interleukin 6, and they promote insulin resistance, they affect a couple of these different mechanisms such as PPAR and nuclear factor-kappa B and they create inflammation and that’s one of the big things they do and they create inflammation by suppressing cytokine signaling. Now what’s the big take-home there? A lot of different big words but what that means is inflammation makes your body hard to be satiated and makes your body more likely to store fat. That’s the big take-home right there. So infections drive inflammation. Inflammation will then affect some of the cytokine signaling and more likely to make you leptin-resistant. When you’re leptin resistant, you’re less likely to be satiated. When you’re less likely to be satiated, you start eating more foods that are gonna be detrimental to your health and to your weight.

Evan Brand:  Yup. So if we’re trying to do chicken or egg here like I always like to do with you, we could start at the top of the food chain with just some type of chronic stress, right? So whether this is like an environment stressor or emotional stressors, something that’s contributing to the leaky gut situation in the beginning, now the gut’s leaky, so now these toxins can get into the bloodstream even more driving up more inflammation. Then let’s say someone picks up a parasite infection, now they have even more inflammation. Now the, let’s say they had something like Blasto or H. pylori, now their small intestine’s damage, so there’s more inflammation there and now their completely inflamed, maybe they jumped on an acid blocker, maybe they jumped on aspirin. So they’re becoming more toxic. Now the liver can’t keep up with what it’s doing because it’s trying to flush out the acetaminophen, right? So it’s crazy how things can spiral out of control. So I guess if we zoom back out and then try to look at the take-aways, the foundational supplements are very helpful. So if we’re talking about our foundations here. This would be something like probiotics. If it’s the right time for you to use them—not always should you just jump on a probiotic—some fish oil, some good fatty acids for inflammation. I would say some glutamine could be really helpful for this. Some trace minerals could be helpful. What about you, Justin? What do you think about like foundational supplements? What would be something like a—a generality that we could make for people that—that have everything else in order?

Dr. Justin Marchegiani:  So we’re already assuming that sleep’s dialed in, right? Because we know leptin and sleep’s pretty important. By the way, leptin is secreted by your fat cells, too. So the more weight you have on your body, the more the downward essentially gets worse and worse. So like if you’re leaner, you already have a big advantage, right? But if you’re leaner, you already have more muscle and you already are more insulin-sensitive. So it’s kinda this like downward cycle where the more overweight you are and the more problems you have, the more feedback mechanisms feed back in to make us more insulin resistant, more leptin resistant, more cravings. So the problem becomes even harder to deal with, the more overweight we are. Does that make sense?

Evan Brand:  Yeah, I—actually I’m glad you brought that up because I almost forgot to mention it. I actually did, when I was writing REM Rehab, I actually did some research. It was a study from the International Journal of Endocrinology and they looked at sleep deprivation. So people that got 4 hours of sleep per night which hopefully most people listening are getting more than 4 hours, but when they had that—that little of sleep, their leptin levels decreased. So people were gonna be less satiated and then their ghrelin levels, their hunger hormone was increased by 28%. Even after the subjects were given a sleep compensation of 10 hours per night the following 2 days. And then it said that it increased their carbohydrate cravings by 45%. So there’s a few different numbers there, but if you’re sleeping poorly just a few nights per week, it sounds like here, that’s enough to really destroy these hormones. So if you think you’re doing everything great during the day but like you mentioned, maybe your sleep hygiene’s not in order and you’re not sleeping restfully, that’s going to be driving up these hormones and you’re gonna wake up with carbohydrate cravings instead of wanting say some good sausage and eggs for breakfast instead.

Dr. Justin Marchegiani:  Yes, and when I look at leptin resistance, Gary Taubes had a great analogy years back I—I spoke with him and he said, you know, stick your thumb out, right? Imagine a hammer comes down and that hammer whacks your thumb. Now all of the swelling that happens, these various interleukins and cytokines and all these different pathways that are happening underneath the skin, you know, that’s like leptin and all the TNFα and all the interleukins and the PPAR, you know, gamma agonists, all these different fancy Jeopardy words, that’s what’s happening underneath the skin. But he said, insulin resistance is the hammer and then the hammer hitting the skin and that initial response, that’s leptin, and then everything else kinda spirals out of control. So he’s like, “Well, my focus is on the hammer.” Other people they go into all the little dominos that knock over many, many times down the road. So if we look at the top 2 things, I put more of my focus on the hammer, and then you can say that maybe leptin’s the—the next domino that falls over after—after insulin if you will.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Does that make sense?

Evan Brand:  Yeah. That makes perfect sense.

Dr. Justin Marchegiani:  So looking at that, really simple, we keep fructose to a minimum. If you’re significantly overweight, you know, 30-50 lbs more, keep fructose under 25 to 15g a day. You know?

Evan Brand:  What would that look like? Explain people how would that actually be like a handful of blueberries per day, what are we talking?

Dr. Justin Marchegiani:  Well, my patient have access to the member’s area on my website and other there I have a specific handout that kinda outlines all of the fructose that are gonna be in every type of food source. I’m gonna pull it up here and I’ll—I’ll read a couple of things off it right now, but typically vegetables aren’t gonna have very much fructose, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  So you’re gonna be pretty good with fructose on a vegetable standpoint. Now–

Evan Brand:  Yeah, if you’re doing something like a Paleo template or if you have to go the AIP route, you’re gonna have that dialed in. You’re not gonna have to worry about that.

Dr. Justin Marchegiani:  Yeah, and I did an article I think last year on Is Fruit Bad For You? And I think I outlined that in that article.

Evan Brand:  Uh-hmm.

Dr. Justin Marchegiani:  But let me just give you, for instance, if you do something like strawberries you get, you know, 1 cup of strawberries is 3.8g of fructose. If you–

Evan Brand:  Wow, and nobody’s eating 5 cups of strawberries per day.

Dr. Justin Marchegiani:  No, that’s—that’d be a lot, right? Maybe—even if you did 1or 2 cups, I mean you’re still only at 8, not a big deal.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  But then when you go over to like watermelon, that’s 11 or you go over to like mango, that’s 16 for a half a cup. So you just gotta be more careful of like the tropical more sugary fruits, so I just say if you keep to medium to lower sugar fruits which are gonna be berries, even an apple will have about 9.5 so you just gotta be careful. If you do an apple and 2 servings of berries and maybe a banana, now you’re in the 30 range. So you just gotta be careful with that. So just keep to the moderate to lower sugar fruits, especially your berries, lemon, lime grapefruit, passion fruit, green apple, maybe an orange. You’re gonna be pretty much okay.

Evan Brand:  I wild harvested, wild foraged some blackberries last night. We went on–

Dr. Justin Marchegiani:  Nice.

Evan Brand:  We went on a hike and I found a couple blackberry bushes, they’re not all the way ready but there were a few, like at least maybe a half dozen of black ripe blackberries.

Dr. Justin Marchegiani:  That’s awesome.

Evan Brand:  It was amazing.

Dr. Justin Marchegiani:  That’s awesome. Very cool.

Evan Brand:  Some—my fructose level was approved.

Dr. Justin Marchegiani:  Yeah, you just gotta be careful of your FODMAPs, that’s one of the only berries that have a higher content of FODMAPs in it.

Evan Brand:  Blackberries?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That’s my trivia for the day, Evan.

Evan Brand:  Good.

Dr. Justin Marchegiani:  So kinda recapping, like you have the diet piece in, like if you’re significantly overweight, you know, 50 pounds plus for a man, 30 or 40 for a female. You know, keep that fructose down. Keep it below 25, ideally below 15. That’s number 1. Cut all grains out. Because remember inflammation plays a role on leptin and we know grains have things like lectins in there. It has phytates that block minerals. There’s a significant percent of the population that is non-celiac gluten-sensitive, right? Where they have genes that are creating inflammation and inflammatory response in their body because—that their genetics, the gluten proteins, whether it’s gluten in wheat, barley, rye or it’s the other grains that are cross-reacting with it. And so we have the diet piece dialed in. We’re eating good proteins, fats, and carbs, that’s great. And now we make sure the—the quality is up, right? We’re making sure we’re eating organics, because we know that toxins can create leptin resistance. So the easiest way to decrease toxin exposure is make sure you’re eating organic. Make sure it’s clean fats. Make sure your proteins, antibiotic and hormone-free. Make sure your water is filtered, right? We know certain drugs have an increase on obesity, potentially affecting weight gain and leptin such as like the MAO drugs, the monoamine oxidase anti-psychotics, or lithium or the SSRIs, these are like the serotonin reuptake inhibitors.  So-

Evan Brand:  I’m sure you and I have both heard that stories a dozen times of women that jumped on an antidepressant and they gained 20 pounds.

Dr. Justin Marchegiani:  Uh-hmm. And also their libido goes in the tank, too.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  So that’s all—so that’s hormonal-related, also neurotransmitter-related it sounds like.

Dr. Justin Marchegiani:  Absolutely. Remember hormones affect the reuptake systems in the brain. That’s why women will take birth control pills that kinda even out their hormones so their mood balances out, too. So we can do that naturally by fixing why their hormones are out of balance which typically is driven by some adrenal stress and some blood sugar stress and some infection stress and a lot of times, they’re swimming in a sea of estrogens because of our environment with chemicals and toxins and fluoride in the water. So if we clean up our food, we clean up our water quality. We balance our blood sugar. We make sure we’re not overdoing fructose even with super healthy things, like if you’re having 2 or 3 servings of berries at every meal, and then a banana at night or this or that, then you get your 50g of fructose. You gotta be careful with that.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So you just gotta make sure that we have the blood sugar under control, and then remember protein and fats and are gonna help with your appetite more because the big issue with leptin, it’s that kind of like inhibitor valve for our appetite and we know certain things like adiponectin, peptide YY, CCK cholecystokinin, these are really important hormones that help tell us we’re full.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And when we eat high quality meats and fats, like proteins and fats, we get that feedback signal better. That’s why, if you think about it, how many people have gone and just eat a dozen eggs in the morning?

Evan Brand:  Never.

Dr. Justin Marchegiani:  No, but–

Evan Brand:  Unless they’re trying to do Rocky-style and they put them in a blender, but that’s not eating them.

Dr. Justin Marchegiani:  Yeah, but how many you know have eaten a whole box of cereal?

Evan Brand:  A million.

Dr. Justin Marchegiani:  Yeah, I mean, it’s very common or a pizza, late night pizza?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? Try looking at that like, you know, pizza and imagine it like a steak that big or something, right?

Evan Brand:  That’d be insane.

Dr. Justin Marchegiani:  Yeah, you wouldn’t be able to do it. You give me a 16–20-oz steak, you’re done. That’s it.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  But with a pizza, you’ll eat that whole thing, and everyone’s had that experience, especially everyone that’s gone to college. They—they can recall those—those memories of their time. So the reason why is, right? Well, if you go back to the Pringles commercials of the 90s, I’m dating myself, remember that—let’s see if it’s in your subconscious, Evan? Once you pop–

Evan Brand:  You can’t stop.

Dr. Justin Marchegiani:  That’s it. See you got, man. And that’s the thing, right? What they’re saying is, once you eat this carbohydrate-rich, not to mention the MSG, monosodium glutamate, which actually–

Evan Brand:  Which, appetite-stimulant.

Dr. Justin Marchegiani:  Yeah, but it also doubles and triples your insulin levels. There’s research on that and if you’re doubling and tripling your insulin levels, guess what you’re doing to your leptin levels?

Evan Brand:  Yeah, that’s not good. Also, you know what, another thing which most people don’t think about, too, is you’re hyperstimulating those brain cells, too. So you’re causing neurotoxicity or revving those little brain chemicals up so you’re getting high from it, too. It’s crazy. It really is.

Dr. Justin Marchegiani:  Now we can have this podcast be like a couple hours on this topic, but that’s why we talk about like an organic, whole food, kinda Paleo template, we automatically cut out like the MCG.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  We automatically cut out like the aspartame and the crap to it. So there are articles linking MSG to leptin resistance because of the extra insulin and the extra leptin. So remember when we talk about eating good, organic foods, we’re automatically getting insulin resistance under control and we’re automatically as a result—remember the Taubes analogy, right? Insulin’s the hammer, leptin and all the other cascades are the effect after the fact that we get leptin under control and then we get your willpower under control. I mean, you can choose the right foods and you can feel satiated.

Evan Brand:  Yup, well-said. So I think maybe just wrapping this up then. We talked about the diet. We talked about looking for infections, because if the diet’s clear and we know that that’s not your cause of inflammation, then we have to look for the other sources, too. So we talked about adrenals–

Dr. Justin Marchegiani:  Uhmn.

Evan Brand:  You brought that up.

Dr. Justin Marchegiani:  Yup.

Evan Brand:  You brought up the gut, ruling in, ruling out infections with people, that’s a big cause. Any other hidden—hidden causes of inflammation like if we’re talking besides gut, besides adrenals, besides exogenous endocrine disruptors?

Dr. Justin Marchegiani:  Well, I would just say the fact that we are exposed to toxins in the environment outside of just what’s in our food, right? Just stuff we’re breathing, I mean God forbid, but there’s 2 billion pounds per year of pesticides dumped in our environment even if you’re not eating it, you may still be getting it in via water supply or just run-off, who knows? Pharmaceutical drugs are in the water supply now. So if you don’t have a really good water filter, there’s probably some ways you’re gonna get exposed to it. If you’re walking downtown, like I was in Austin over the weekend, well, you walk by–

Evan Brand:  Water traffic.

Dr. Justin Marchegiani:  You walk by a big truck that has a whole bunch of, you know, exhaust coming out. I know Dr. Kurt Woeller mentioned with you in your one year interviews that he’s seeing a lot of gasoline like benzene and gasoline molecules in some of the organic acids testing, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Yeah, so we’re getting exposed to this stuff and some people may need extra detoxification support. They may need extra antioxidants and extra phase 1 and phase 2 detoxification support in their diet because of the accumulation of these toxins, so we may have to stack on top of a good diet and on top of a good lifestyle, specific extra supplements to help fill in the gaps what’s going on.

Evan Brand:  Right, yeah so you’re saying basically in a perfect world, if we didn’t have this toxin exposure, maybe the diet would cover us but in the modern world, it’s just not. I’m almost convinced that—that I could be classified with someone with like chemical sensitivity.

Dr. Justin Marchegiani:  Right.

Evan Brand:  I mean, if my wife and I walked past someone with like extreme amounts of perfume on, I get an instant headache. So I think there’s probably still some liver stuff going on with me. I probably need to up my antioxidants. So you’re saying we need to counteract this. In a perfect world, if we had, you know, 100 acres of forest to live in and then we had a perfect diet, our toxin load would be less and the antioxidants we get naturally in the food may be enough, but if you’re in rush hour traffic and you don’t have your recirc on in your car and you’re breathing that stuff in, you need the extra antioxidant support.

Dr. Justin Marchegiani:  Exactly, there’s a phenomenon known as TILT, toxin induced loss of tolerance. That’s where you get, you know, sensitive to certain perfumes and things like that, just because your body has lost that tolerance because of the cumulative effect of the toxic load that you’ve been under. Now I think with you, it’s probably just that you get so used to being healthy that when you get exposed to some chemical, you’re just really in touch with it like a lot of people find that with sugar. Like they don’t eat a lot of sugar then they get exposed to like maybe a sip of soda or they eat one of their—their kid’s like fruit snacks, and they’re like, “Whoa! That was way too much sugar.” And it could be just that like–

Evan Brand:  So you’re thinking it’s maybe not dysfunction. It might just be that I’ve got back to baseline of pretty low toxin exposure and then when I do, the body’s like ding, ding, ding!

Dr. Justin Marchegiani:  Yeah, that’s kinda how I look at them. My analogy to my patients is well, it’s like saying that you—the alcoholics has a stronger liver than you just because he gets drunk off of 20 beers and you get tipsy off of one.

Evan Brand:  If I took 1 shot. I’m—I’m almost toast.

Dr. Justin Marchegiani:  Wow.

Evan Brand:  So if you ever take me out to drink, you’ll know that.

Dr. Justin Marchegiani:  That’s—that’s really good. I’ll have to—that’s good, next time I’ll fly you in here to Austin, I—I know you’ll be a cheap date at least.

Evan Brand:  Yeah, exactly. One shot of tequila for example, I’m done. That’s it. Game over.

Dr. Justin Marchegiani:  I hear you, man. I’m very similar. I don’t need much alcohol, maybe one or two and I’m—I’m just, you know, gently buzzed. You know?

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Just enough to like kinda like lubricate the conversation, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  That’s it.

Evan Brand:  Oh, actually a lot of people, they have to drink to have my level of social lubrication. Like I’m so socially adequate as—as I am naturally, that most people have to drink to get to my level of being able to have a conversation.

Dr. Justin Marchegiani:  Nice. I will give you 5 Paleo brownie points for that one, Evan.

Evan Brand:  I—I pride on that one.

Dr. Justin Marchegiani:  Very cool. So kinda just summarizing that whole TILT phenomenon, that tolerance induced loss, or that toxicant induced loss of tolerance, the more toxins that you get exposed to and the less ability your body has to excrete them, the more you’ll have this TILT-ing going on. So what Evan was saying before right on, diet and lifestyle’s like solid, very, you know, very important. If you’re in a city area, you may want to think about getting a really good high quality air filter. I have one by Advanced Air in my store that I recommend and use. So justinhealth.com/shop and it’s my air filter over there. I think Evan may have one, too. So a good air filter especially if you’re in the city. Clean water, organic food. If your gut’s not working, remember if you’re—if you have an infection and your gut’s not working, you’re not absorbing nutrients, that means you’re not absorbing the antioxidants and the sulfur-based aminos to run your detox pathways adequately so we may have increased oxidative stress and—and lower nutrients to run our phase 1 and phase 2 detoxification. So get your gut looked at. Run a good quality organic acids test to see if you have enough nutrients to run those pathways. If not, fill in the gaps, supplement a really good diet so you can be at optimal function.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Anything else, Evan?

Evan Brand:  Yeah, I wanna direct people to stateoftheair.org. It will take you to lung.org, the American Lung Association and you can actually go to stateoftheair.org and you can select your state and then you can look at the particle pollution because some of the biggest offenders are in the summertime when ozone is created from all of the exhaust and car fumes and things like that. We actually had some high air quality alerts in Lowell last week and it was in the high risk category. So not just, you know, how sometimes they’ll say elderly people need to stay inside or very young, it was saying even the average person should be inside because the ozone level was so high and then you also have something that’s more damaging called PM2.5 and then PM10, really, really small microns that’s from other like industrial operations, those were high, too, in my state, in my county. So look it up. Look up your state. Check out your county. We had an F for like several, several, several days out of the past few weeks which is just horrible. Surprisingly, even Los Angeles was better. I guess due to the—the ocean air over there.

Dr. Justin Marchegiani:  And that’s stateoftheair.com?

Evan Brand:  Stateoftheair.org.

Dr. Justin Marchegiani:  Ah.

Evan Brand:  And you can—and you can go and you would just go for—and look up Texas and just look into—I can’t remember the name of the county now. What county is Austin in?

Dr. Justin Marchegiani:  That’s Travis county.

Evan Brand:  Travis, that’s right. You can look up Travis or some of the outer, it’s there.

Dr. Justin Marchegiani:  Okay, cool. Oh, just summarizing–

Evan Brand:  You have–

Dr. Justin Marchegiani:  What? Go ahead.

Evan Brand:  I was just gonna say, people so check that out. Check out your air quality because it’s not to say you need to live in a bubble but it’s something to consider and–

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  It’s another factor. There—there’s not one thing that makes you or break you which is why you and I have these discussions every week because people can always make little improvements to—to their environment.

Dr. Justin Marchegiani:  Yeah, exactly. And then also, people that are, you know, cigarette smoke goes without saying, hey, if you’re smoking marijuana, too, remember there’s still incineration that’s going on there with the plants or with the—the wrapping paper if you’re doing a joint. Remember there are polyaromatic hydrocarbon (PAHs) or heterocyclic anion compounds that you get to the incineration, so remember that’s adding to that, you know, oxidative load, right?

Evan Brand:  Yup, so use the vaporizer if you’re gonna, you know, consume it orally. If you’re gonna do topical, if you wanna do soft gels–

Dr. Justin Marchegiani:  Do it oil.

Evan Brand:  CBD oils, yeah, tinctures.

Dr. Justin Marchegiani:  Or you can do in a tincture, so those are safer ways to do it so you don’t get the incinerating compounds there.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And also we touched upon it but why does exercise help? Exercise helps because if you’re doing the right exercise, it puts on muscle and the more muscle you have, the more insulin sensitive you are, right? The more you have these little GLUT4 receptors that reach out in the muscle and they pull sugar in better so the more sugar you’re able to pull in, the less insulin resistant you get. So muscle makes you more insulin sensitive by having more GLUT4 to pull sugar in, but also when you’re doing the exercise itself, you—you’re pulling that blood sugar out of your bloodstream and burning it up, too, which is gonna make you more insulin-sensitive as well.

Evan Brand:  That’s great.

Dr. Justin Marchegiani:  So toxins in your food, clean water, clean air, diet, lifestyle, exercise stuff, and then we also mentioned the guts and the supplements that may be needed extra if we have extra stuff going on. That’s where patients should see their doctor, their functional medicine prov—practitioner or physician, and/or reach out to us because we see patients like this all the time and we are experts at treating these issues.

Evan Brand:  Absolutely, well-said.

Dr. Justin Marchegiani:  Evan, great day, man! You were on fire today.

Evan Brand:  Alright! You, too, man.

Dr. Justin Marchegiani:  Love it. Take care.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Buh-bye.



High Fructose Foods – Is It Bad For You? Truth About Fructose and Its Biological Importance

By Dr. Justin Marchegiani

Fructose is a monosaccharide, or single sugar, that has the same chemical formula as glucose but a different molecular structure.  Most people aren’t aware that too much fruit can be bad for you due to it’s excess levels of fructose. Unfortunately, it seems that fructose is in everything today. It can damage the liver and increase the presence of free radicals in the bloodstream. We see it in unhealthy processed and refined foods. Foods that are mistakenly thought to be healthy, and of course, in whole fruits. The key is knowing what to look for when decreasing and managing your fructose consumption.

high fructose

What Is Fructose?

Fructose is the primary sugar in fruit. Glucose and fructose compose table sugar. Table sugar is sucrose (50% glucose and 50% fructose).

In high fructose corn syrup, these percentages are modified (typically, 55% fructose and 45% glucose). However, there is a wide variation (42%–90%) in the percentage of fructose in HFCS. Fructose consumption continues to increase with higher and higher percentages being manufactured and consumed.

High fructose corn syrup also goes by other names, so you won’t always see “high fructose” on labels. “Isolated fructose” is another name showing up on labels. Do your research and know how to find HFCS on labels.

You might have heard that agave is healthy (after all, it comes from a cactus), but it’s actually 90% fructose, so stay away.

What’s Different about Fructose?

Don’t let fructose’s lower glycemic index fool you. The problem with fructose is it’s metabolized much differently from other sugars. While glucose goes to the muscles and other parts of the body to be metabolized and used for fuel, fructose is primarily metabolized in the liver. When the body takes in more fructose than the liver can metabolize, this creates a number of problems.

The liver only holds about 60 grams, so fructose will either be converted to glycogen (the energy storage form of glucose) or, if we’ve exceeded our capacity of 60 grams, be converted to fat.

Over time that fat (fatty acids) will seep into the bloodstream. The major cause of a fatty liver is the consumption of extra sugar or fructose. Nonalcoholic steatohepatitis (NASH), inflammation of the liver, can occur as the fructose converts into fat. This can cause a number of issues.

Associated Issues with Fructose Conversion to Fats:

Foam Cells—Fatty acid particles are small and dense. So small they can fit into the endothelial fissures in the arteries. Once in the artery, fatty acids create foam cells, which cause inflammation in that artery that can lead to a blockage and decreased blood flow.

Insulin Resistance—Because one of the liver’s major roles is to stabilize blood sugar in the body, if we create insulin resistance at the site of the liver, that means the body has to pump more insulin for the liver to work. More insulin creates more fat, which leads to more inflammation.

Fructose Malabsorption—With all of the fructose consumption, we tend to have fructose malabsorption. Gut bacteria loves to feed on fructose, and a lot of that bacteria is going to gobble up that fructose and create more dysbiosis and malabsorption of various nutrients. It may even leak various toxins into the bloodstream, like lithocholic acid and endotoxins.

Metabolic Syndrome—The following symptoms encapsulate metabolic syndrome:

  1. Lipogenesis, a high amount of fat, is a result of fructose getting converted by the liver.
  2. Insulin resistance is a result of our liver becoming more numb to insulin, so our body needs more.
  3. Dysglycemia, abnormal blood sugar, is a natural result of an abnormality in our insulin.
  4. High blood pressure is the result of an increased amount of uric acid, another byproduct created as the liver metabolizes fructose. It can be inflammatory. Uric acid decreases endothelial synathase, the molecules that vasodilate blood vessels. When we decrease our vasodilator, we naturally constrict the blood vessel. Higher uric acid results in higher blood pressure.
  5. Obesity is a result of the abnormalities in our blood sugar and insulin, our primary fat-storage hormone.

Don’t Sugarcoat Your Proteins (High Fructose Foods)

Fructose glycates, which means that it sugarcoats your proteins. Have you ever ordered crème brûlée at a restaurant and watched as a blowtorch burns that crisp coating on the top? That coating is like the coating fructose creates on your proteins as it travels through your bloodstream.

Glycation is a magnet for free radicals, which come in and chip off pieces of your DNA and cause the following:

  • Additional damage and accelerated aging
  • Cross-linking of proteins, which causes wrinkles, aging, and other skin issues
  • Cell adhesion, which increases the risk of cardiovascular conditions, stroke, etc.

Normal Fructose Consumption

For thousands of years, people consumed 16–24 grams of fructose per day, primarily in the form of whole fruits and honey. Today, we consume closer to 80 grams per day, and much of that is in unhealthy processed foods that contain high fructose corn syrup.

Fructose levels in fruit

Consuming fructose in whole fruit is far better for you, even at the higher end (24 grams) of the scale, because fruit contains pectin, soluble fibers, that binds the fructose. The fiber slows the process and lessens the effect of the fructose.

Unfortunately, we are consuming far too much free fructose, meaning it’s not bound to fiber. We’re going to see that primarily in high fructose corn syrup.

Fructose-heavy diets are causing obesity, gut dysbiosis, rapid aging, and diseases associated with cell adhesion. However, fruit doesn’t have to be bad for you if eaten in moderation. The best course of action is to replace high-fructose items in your diet with small amounts (16 to 24 grams of fructose) of whole fruits.

Click here for help in making a change to fructose in your diet.



Blood Sugar and Hormone Stress

By Dr. Justin Marchegiani

More than one-third of the country has a condition known as metabolic syndrome.

Metabolic syndrome has some important features that are seen in nearly all cases, and these are blood-sugar imbalances and insulin resistance.

When blood sugar or insulin becomes elevated, it can create inflammatory cascades that can contribute to obesity, high blood pressure, diabetes, and cardiovascular disease.

Metabolic syndrome or blood-sugar imbalances is one of the biggest public health concerns of today. And if left unaddressed, it could bankrupt our economy.

Most conventional treatments to address metabolic syndrome and blood-sugar imbalances do not address the root causes. Essentially, people with the condition can live longer with the symptoms; yet nothing is done to address the root cause of what’s driving the condition in the first place.

Below are some of the typical treatments that are used.

Conventional Treatments: 

  • Statins
  • Blood-pressure medications
  • Metformin or Glucophage
  • Surgeries to remove gangrenous limbs (this happens in most long-term diabetics if their blood sugar isn’t addressed)
  • ADA or food-pyramid diet (this actually makes the problem worse)

Below are some functional-medicine tests that can help detect early signs of blood-sugar imbalances or metabolic syndrome.

Functional Tests:

waist to hip ratio chart

  • Waist-hip ratio
  • Elevate triglyceride to HDL ratio >2
  • CRP >1
  • Elevated in LDL particle size B vs LDL particle size A (FYI: Statins do not have an effect on the particle size of cholesterol.)
  • Low thyroid levels TSH >3.0 or free T3 <3.0 (these markers are designed for early detection of a healthy imbalance)

Did you know that blood-sugar imbalances are one of the biggest stressors on your endocrine system?

If you are suffering from any type of hormonal imbalance, whether it be hypothyroidism, PMS, menopause, or even fatigue and weight gain, your blood sugar needs to be addressed.

Blood-sugar issues are almost guaranteed to be a foundational part of any hormonal problem. Every time your blood sugar ebbs and flows up and down, your adrenals and pancreas have to come to the rescue. When your blood sugar goes up, your pancreas has to produce insulin to help lower your blood sugar. While at the opposite end, your adrenals have to spit out adrenaline and cortisol to bring your blood sugar back up. Oh, and did I mention when cortisol goes out of balance it causes belly fat!


blood sugar out of balance

The more your blood-sugar handling system is stressed, the more it predisposes your body to hypothyroidism and adrenal fatigue!

The typical pattern tends to be this: Eat a meal with excess refined carbohydrates, and your blood sugar spikes very high. Your body responds by producing a whole bunch of insulin to knock that blood sugar down! The pancreas overshoots, and produces too much insulin. Now, our blood sugar is super low, and we may start to feel anxious or jittery. Also, we may crave lots of sugar and sweets. The next thing we do is eat more carbohydrates and start the cycle all over again.  This is the cycle of death that is common with most patients who have hormonal issues. It may not be quite so blatant for most people, but at some level it is happening, and it’s very addicting!


Low blood sugar really makes you stupid!

When blood sugar drops (hypoglycemia), your body also increases production of an excitotoxin called glutamate. The combination of low blood sugar and high levels of glutamate decrease activation of the frontal cortex. The frontal cortex is the part of our brain that allows us to have higher levels of thinking and brain function;  it differentiates us from almost all other mammals. When we lose activation to our frontal cortex, it’s common for us to make stupid decisions, act irrational, and eat more unhealthy food. When we eat poorly, we literally lose our brain, and it’s so easy for this vicious cycle to perpetuate itself again and again and again (1).


hormonal balance

The same type of excitotoxin response can happen when you consume aspartame, food dyes, and MSG. Avoiding these food additives can have a tremendous effect on lowering your glutamate levels and thus not allow you to use your frontal cortex as efficiently. If it’s your goal to perform at the highest level, you want to make sure you are using your head!

blood sugar in balance


Excitotoxins also excite your brain neurons to death, another great reason why you want to avoid them.

If you’re having hormonal issues, one of the best things you can do is stabilize your blood sugar. Eating high-quality protein and fat first thing in the morning, within the first 30 to 60 minutes of waking, is very helpful. The more your blood sugar is stable, the more your endocrine glands can focus on helping you have energy and healthy sex-hormone balance.

If you’re having problems with your blood sugar, click here for more help!


1. The Effect of Acute Hypoglycemia on Brain Function and Activation A Functional Magnetic Resonance Imaging Study

Blood Sugar and Your Hormones

Blood Sugar And Your Hormones

By Dr. Justin Marchegiani

Americans now consume an average of 150 pounds of sugar a year, which is 20 times as much as was the norm in 1700 when Americans were consuming only 7½ pounds per year! This crazy sugar consumption, about ½ a pound a day, has lead our country to obesity, disease, and all sorts of health issues that are now seen as normal. Today we are going to examine the causes and effects of sugar cravings, and what we can do to properly balance our hormones.

Inflammatory Meal And Effect On Fat Burning

Causes of Sugar Cravings

Sugar cravings can be caused by blood sugar imbalances, which occur due to poor diet (including inflammation-inducing high doses of sugar) or going too long between meals. Blood sugar imbalance leads to more inflammation, hormone imbalance, and sugar cravings. The sugar cravings continue the negative cycle of eating sugar, crashing, and craving more, which only causes hormone imbalances to worsen over time.

The HPA axis, the hypothalamus, pituitary gland, and the adrenal glands, can be disrupted by a poor diet, stress, and emotional toil: all of which are symptoms of a sugar overdose. The disturbance to the HPA axis can lead to adrenal fatigue, which can lead to blood sugar imbalance and more cravings for something sweet.

Consuming sugar releases dopamine, a feel-good “rewards system” neurotransmitter which is responsible for motivation and emotions. This release of dopamine can be addictive, making it very difficult to cut out sugar, which effectively becomes an addition.

Sugar and Your Hormones

We know consuming too much sugar contributes to blood sugar imbalances, adrenal fatigue, and inflammation. But is goes deeper than that: overconsumption of sugar can throw our hormones out of whack, leading to serious health conditions. Weight gain or weight loss that’s unexplained by your diet and exercise, depression, anxiety, changes in appetite, low libido, irregular periods, fatigue, insomnia, digestive issues, hair thinning or hair loss are all signs of hormone imbalance.

Common hormonal imbalances include:

Hypothyroidism and hyperthyroidism: Hypothyroidism causes the metabolism to slow, meaning weight gain is a common issue. Hyperthyroidism is the opposite, causing the body to speed up and weight to be lost quickly. Both thyroid disorders can come with anxiety, sleep issues, and other irregularities.

Low testosterone comes with weight gain, fatigue, mood swings, erectile dysfunction, and muscle loss.

Low estrogen can lower your sex drive, cause menstrual and reproductive problems, and cause mood swings.

Estrogen dominance can change your weight, appetite, and sleep patterns. Easier to become overwhelmed by stress, and the metabolism slows.

Diabetes comes with weight gain, nerve damage, fatigue, skin problems, and vision loss.

Adrenal fatigue plagues many people in our over-stressed society. Fatigue, anxiety, depression, insomnia, brain fog, and muscle aches and pains are common.

PCOS, or Polycystic Ovarian Syndrome, in which elevated androgen (male hormone) levels cause many cysts to grow in the ovaries of women of reproductive age. Infertility, weight gain, acne, and abnormal hair growth are symptoms of this condition.

Click here to work with a functional medicine doctor to test your hormone levels!

How to Balance Your Hormones

Adaptogen herbs are a class of healing plants that are very powerful in protecting against stress. They can support the thyroid, reduce anxiety and depression, support the adrenals, and stabilize blood sugar. Ashwagandha is your go-to for balancing hormones. It can help with hyper- and hypo- thyroidism, as well as help with adrenal function. We recommend Ashwagandha Supreme, or a more complex supplement, like the ashwagandha-containing Adrenal Revive. Holy Basil, or tulsi, also regulates hormones and can help the body deal with emotional stress, as well as give protection against environmental and ingested toxins.

Vitamin D is more of a hormone than a vitamin. Vitamin D keeps inflammation low, and is a very important component of a healthy body; read more about vitamin D here. A high-quality vitamin D supplement, like Emulsi D Supreme, is very beneficial in protecting against hormonal imbalances as well as autoimmune diseases.

Healthy gut function is crucial in virtually all aspects of overall health. Leaky gut, inflammation of the gut lining allowing undigested food particles and toxins into the bloodstream, cause inflammations in other areas of the body, including glands such as the thyroid, which are responsible for regulating our hormones. A high quality probiotic, or probiotics from foods such as sauerkraut and kombucha, can repopulate the gut with good probiotics. Bone broth is also good for healing the gut, as it is soothing to the intestines and contains collagen and other healing compounds.

AntiInflammatory Meal And Effect On Fat Burning

How to Beat Sugar Cravings

As we know, sugar feeds inflammation and messes with our hormones. Despite knowing that sugar is not good for us, strong cravings make it hard to resist! In the heat of the moment, apple cider vinegar, lemon, or lime water can help curb a sugar craving.

Sugar cravings can also be due to dehydration or a mineral deficiency. Using healthy pink himalayan salt on meals and maintaining proper hydration will allow your body to properly balance your hormones and improve blood sugar.

In the long-term, switching from a diet high in processed foods and carbs to a cyclical keto diet, or a lower carb diet rich in complex carbs and healthy fats, can help you feel satiated and balance your blood sugar.

Click here for a consultation with a functional medicine doctor for a personalized health plan!






Adrenal Fatigue and the Thyroid Connection Part 1

Adrenal Fatigue And Thyroid Connection Part1
By Dr. Justin Marchegiani

Your adrenal and thyroid glands produce certain hormones that allow you to have optimal energy, health, and metabolism. When these hormones are out of balance, symptoms like fatigue, depression, and weight gain are common.

Cortisol is one of the first hormones to go out of balance when you are not managing the physical, chemical, and emotional stressors in your life properly.  Cortisol is a glucocorticosteroid. I know this is a really big word, but when you break it down, “gluco” means pertaining to or regulating glucose (blood sugar) and energy. The more your blood sugar goes up and down throughout the day, the more your adrenal glands have to come to the rescue to stabilize your blood sugar. Therefore, over time if your blood sugar isn’t stable (because of missing meals and/or poor food choices), your adrenal glands will have a difficult time regulating it, and thus your energy levels will start to decline.

Adrenal Fatigue And Fasting

Adrenal Fatigue and Intermittent Fasting

If you have adrenal fatigue and/or low thyroid function, intermittent fasting is one of the worst things you can do. Your body’s ability to regulate blood sugar is already unstable; therefore, stressing the system even more puts additional undue stress on the fatigued glands.

I understand the health benefits regarding intermittent fasting and stimulating cellular autophagy, but my professional opinion is to fix the adrenals first and thyroid second (typically done together, yet thyroid hormone can drive cortisol lower).  In other words get healthy first and then you can partake in this excellent therapeutic modality.

Your Stress Hormone Cortisol

As your energy starts to go down, your adrenal glands can have a difficult time regulating inflammation. The second part of the word glucocorticosteroid is “corticosteroid.” Corticosteroids’ main job is to help squelch out inflammation in the body.

You may have heard of corticosteroids in the form of cortisone injections, which are used to relieve various painful areas of the body; hydrocortisone creams for chronic rashes and skin inflammations; or cortisone inhalers which are designed to dilate the bronchioles to help improve breathing for asthmatics.  These are all examples of how conventional medicine treats the symptoms of adrenal fatigue and inflammation, but it does not address the root cause. It’s important to note that all of these medications have side effects if used for prolonged periods of time. In other words it’s in your best interest to figure out why you’re chronically inflamed and not just rely on a medication long-term that is only covering up symptoms.

Want to know if you can benefit from intermittent fasting? Click here to find out.

Your Adrenals and Inflammation

If the body is chronically inflamed, cortisol can help abate the symptoms for a while.  In the end, however, the chronic insidious inflammation will overcome the adrenal glands’ capacity to manage it unless the underlying cause of the stress is discovered and addressed.

That’s why as cortisol becomes more and more out of balance over longer periods of time, eventually fatigue, weight gain, allergies, hormone imbalances, and chronic pain inevitably set in. So if you are a person with any of these symptoms, looking deeper into the function of your adrenal glands will be a necessity.

Excessive Cortisol and Weight Gain

First objective indicators of cortisol imbalances:  The waist-hip ratio can be an excellent tool to assess this. Simply divide your waist measurement in inches by the measurement of your hip in inches. You can compare the results to the chart below.

Exceptions to Every Rule

I do find some patients who are skinny with severe thyroid imbalances and adrenal fatigue. So if you do have any of the above symptoms and have a normal waist-to-hip ratio, I strongly recommended getting an adrenal cortisol rhythm assessment as well as a full thyroid panel.

circumference chart

Adrenal Cortisol Rhythm Testing 

Second objective indicator and gold standard:  This rhythm test measures cortisol at various times throughout the day so the total amount of cortisol can be assessed along with the rhythm of cortisol.  Most medical doctors are looking for disease-based pathologies regarding cortisol function. Diseases such as Addison’s or Cushing’s are normally assessed using an ACTH stimulation test, and if you’re not in this diagnostic category, you are told your adrenal glands are normal.

This couldn’t be further from the truth. Conventional medicine is operating in a disease-based paradigm while functional medicine is operating on a spectrum-of-health paradigm. The goal of functional medicine is to look at your overall health on a spectrum with the number-one goal in mind to address the root cause of your underlying health challenges so you can experience health at the highest level.

Your Adrenals and the HPA Axis

HPA Axis

Cortisol should be highest in the morning to help provide the energy to get out of bed and function, and it should be lowest at night so we can relax and go to sleep.  When this rhythm is off, it’s a sign of stress in the body.  It’s essentially a sign that the brain has lost communication with the gland.  This would be akin to a thermostat breaking and losing the control of the AC or heating units in the house.

The stress that occurs disrupts communication between the brain and the thyroid and adrenal glands. The whole goal of supporting someone’s thyroid and adrenal glands is to help take the stress off the glands and to help establish the connection and rhythm from the brain back to the glands. This can be accomplished using specific nutrients, precursor support hormones, and herbal medicines to help jump-start the system. These natural medicines need to be prescribed specifically to the patient’s needs, ideally based off of the patient’s clinical presentation and lab tests.

Adrenal Fatigue Stress

The adrenals are intimately connected with the thyroid gland.  As the adrenal glands start to dysfunction, so does the thyroid gland.  Healthy adrenal glands are responsible for thyroid-hormone conversion as well as the thyroid hormone getting into the cells’ receptor sites.  This is why many people who are on thyroid-hormone replacement, whether bioidentical or synthetic, still may have thyroid symptoms—because their adrenals are still being ignored.

If you’re having a difficult time losing weight, one of the most important things you can do is to assess your thyroid and adrenal glands to make sure they are functioning at optimal capacity. The people I find who have the most difficult time losing weight tend to be people who  have both thyroid and adrenal fatigue. I find the individuals who are in adrenal fatigue yet still have good thyroid function can stay pretty lean.

The next blog post will be about simple things you can do to help get your thyroid and adrenal glands back on track.

If you need help getting your adrenals back on track, click here!

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