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

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

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

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Well said. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Evan Brand: Take care, now. 

Dr. Justin Marchegiani: Bye now. Peace. 

Evan Brand: Bye-bye 

Fixing fungal and candida overgrowth – Podcast #102

Dr. Justin Marchegiani and Evan Brand take time to address another prevalent issue that they come across in their practice — fungus and yeast. They share about their personal experiences as well as more valuable information about this topic in this episode. candida overgrowth

Listen so you can find out what diet changes to make to help get rid of fungal infections and the difference it makes when you pull out foods that are high in mycotoxins and aflatoxins. 

Learn what the most common symptoms people experience and the markers to look out for when checking the organic acids test. Then discover the steps to take and the additional treatments to do to really overcome any fungal or yeast infections after listening to this podcast.

In this episode, topics include:

00:20   Fungal issues and anti-fungal foods

05:27   Organic acid test markers

07:52   Symptoms

12:40   Antibiotics and steroids

17:23   Alkaline vs Acidic

20:28   Remedies

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Dr. Justin Marchegiani:  What’s up, Evan brand? It’s Dr. J here. How you doin’ today?

Evan Brand:  Hey, I’m great. I’m excited to talk with you about fungus and yeast. Something that you and I see weekly but it’s been like very prevalent so I figured this is something we should probably address.

Dr. Justin Marchegiani:  Yeah, fungus and yeast. That’s something we see in the practice a lot. I know you see it a lot. I actually had chronic fungal issues myself. So I’ll share some intimate stories about fungus in my life and how much of a—a difference it made in getting rid of it and overcoming it.

Evan Brand:  Wow. What happened? Did you have on toenails? Was it on your skin? How did it manifest?

Dr. Justin Marchegiani:  Yeah, I mean with fungus issues? I had like, you know, the typical like jock itch, athlete’s foot, you know, something like tinea rashes, like my whole life. Like really, really bothering me. Like I remember like scratching my toes like ‘til they would like bleed because it would just be so itchy. I never understood what the heck it was. Now obviously making diet changes, it—it really helps, right? Because pulling out the sugar, pulling out foods that are high in mycotoxins which are basically fungal toxins. They made a huge, huge difference and then also treating the actual fungus with specific herbs and getting rid of deeper infections really made a huge difference ‘til they just totally going away.

Evan Brand:  Yeah, so when you see diet’s talking about anti-candida–

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  Anti-fungal diets, that’s a good start, but until you get to the treatment, you dig deeper, you probably won’t resolve it 100%. Is that safe to say?

Dr. Justin Marchegiani:  Correct, and like there’s foods that need to be addressed, need to be eradicated or pulled out to really maximize it. So for me, like cutting peanut out was a big one, that really helped.

Evan Brand:  A lot of mycotoxins–

Dr. Justin Marchegiani:  Uh-hmm.

Evan Brand:  In peanuts?

Dr. Justin Marchegiani:  Yeah, a lot of aflatoxin which is a—a specific type of fungal toxin and fungus is like kinda this big branch, this big umbrella. Under the fungal branch we have things like candida or yeast, right? Candida—we have different kinds of candida. We have candida albicans which is like the most common type of fungus. We have other kinds like krusei and rhodotorula and these different types of fungus that are under that umbrella. So the most common ones, the albicans, but again I don’t even go break it down to those subtypes. The question is do you have this fungal overgrowth? And there’s gonna be some level of fungus there. The question is, is there an out of balance overgrowth? If there is, let’s knock it down, number one. And number two, let’s starve it out and not eat foods that have mycotoxins in it, number one, and also number two, don’t eat excessive sugar foods that are gonna drive that fungal overgrowth.

Evan Brand:  Yeah, so would that be if people are drinking coffee? Supposedly some people say that the whole mycotoxin thing on coffee is overstated. Some people say that it’s not BS. I don’t know. I—I personally don’t drink coffee, so I think it’s something to look into but I don’t know how much it will move the needle for people.

Dr. Justin Marchegiani:  Yeah, I know Dave Asprey is a big guy on the mycotoxins and a lot of his Bulletproof diet is based off of eating lower mycotoxin foods, which I think is great. I mean, I think cutting out peanuts and another big one is balsamic vinegar is a big one that’s really, really high in mycotoxins. Here’s an article over at Science Direct—see here—it’s called mycotoxins in fruits and their processed products. And it’s Analysis, occurrence and health implications. And they’re looking at different foods and the mycotoxin levels in it and balsamic vinegar is one of those things that popped up in this article. And again, so when you go out to eat, most people think, “Oh, I’m doing such a great job,” by, you know, avoiding the crappy salad dressing they have that’s loaded with Omega 6 refined vegetable oils. We’re having the olive oil and balsamic, but that’s high in sugar and also high in some mycotoxins.

Evan Brand:  Yeah, and I’ve also heard of I don’t know if it’s on that article but rice being a pretty common fungal exposure, too. So I’m not sure if you’re safer by getting organic rice or not, it’s really hard to say.

Dr. Justin Marchegiani:  That’s interesting. I’ll have to do a Ctrl-F here and see if that pops up in the column for mycotoxin, but balsamic vinegar was one of those ones that commonly came up.

Evan Brand:  Yeah, so you—you talked about—I’m gonna list off some other things here that people may notice in terms of like their fungal and yeast infections. So you talked about something like the—the top layer of the skin issues, the jock itch, athletes’ foot, ringworm is another fungal–

Dr. Justin Marchegiani:  Yup.

Evan Brand:  Infection and then you got fungal nails. So people with the—you know, sometimes the yellow nails. I remember seeing the commercials as a kid, of the angry little yellow nails on the TV commercial. Dr. Justin Marchegiani:  Yup, exactly.

Evan Brand:  And then I—I haven’t heard of this one. I didn’t know this was the actual name for it, but intertrigo yeast infection in the skin folds. So it’s talking about how people with a lot of skin folds, the yeast can grow in between the warm mor—moist areas where your skin is all folded and–

Dr. Justin Marchegiani:  Yeah, typically you’ll see that with the gut. People that have overhanging guts in the abdomen area and that’s referred to as impetigo. Yes, that’s very common.

Evan Brand:  Yeah, and then thrush and that’s basically it. That’s the round up. So there’s a lot of different ways it can manifest. Many people think, you know, when we talk to them, I’ve heard many women say, “Well, I don’t have a yeast infection right now.” And they think that it’s only limited to the vagina but it’s not. You could basically have this yeast anywhere, internally, externally, and it will show up on the organics with the arabinose marker and then the tartaric acid. And then you and I will also see it on other markers, too. I mean, there’s like probably half a dozen or more markers that show up on the organics with yeast and that’s how you know it’s really bad when everything’s flagged.

Dr. Justin Marchegiani:  Absolutely! Let’s break it down. So we have this yeast or fungal overgrowth. Also we have various toxins produced by these critters. So aflatoxin’s one, that we see that in peanuts. Also another thing here on aflatoxins, it’s also found in foods at specific temperature typically between 13 and 40 degrees Celsius, typically 30. And one of the big ones they mentioned was sometimes almonds, pistachios, brazil nuts, maize, rice, figs, cottonseed and spices. So you can see spices are a big one. If you look at Dave Asprey’s Bulletproof diet, certain spices such as like pepper and such–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Was one and also people that leave their spices like above the stove where a lot of heat’s coming, right? That can really drive some of that mold, so making sure like if I do like almonds, I try to make sure they’re either soaked or like roasted a little bit and you know, I don’t do them a ton. I just try to really cut out a lot of the foods that are higher in these mycotoxin and aflatoxins, and a good Paleo diet is gonna be helpful on that. So the foods are a big driving factor and then how fungus manifests. You mentioned in the skin. It could be tinea, tinea versicolor’s a big one; it could be the impetigo or other types of rashes and then also in your nails and in your vaginal area, in your—in your groin area or on your toes.  So those are really big common areas that we look at and again we can address it 3 ways. One, we stop feeding it. Two, we stop putting it—the toxins of it in our body through food. Number three, we kill it topically. Number four, we kill it internally.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And then number five, we add back in quality probiotics and also maybe even competitive yeast like Saccharomyces boulardii to help compete for those internal niches that these fungus live in.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  That make sense?

Evan Brand:  Yeah, yeah, and something is pretty common, too, is we’ll see a yeast problem with a parasite problem. Like a lot of times if there’s candida, there’s not always, but a lot of times there may be something like Blasto show up, too. So these things are together. So we kinda killed 2 birds with one stone, when we get to the protocol portion of this, but maybe we should talk about like what people would be feeling if they have a yeast problem. I would say like the general, most common symptom that people are gonna have is just fatigue. I was pretty shocked the other day. I had a lady that I would have almost swore and—and placed a large amount of money betting that her adrenals were gonna be low but they showed back almost perfectly great on a salivary panel even, but she had an insane level of candida overgrowth on the organics and then a bunch of mitochondria issues, too. So fatigue would be a big one for yeast and then brain fog. I would say those are number two. What about you in terms of symptoms? Like what other categories people may have issue with?

Dr. Justin Marchegiani:  Yeah, so yeast can also increase things known as oxalates which can essentially poison the mitochondria or make the mitochondria malfunction. So a lot of people are like, “Oh, my gosh, I’m like super tired.” Their adrenals may look good but when it comes to energy, oxalates can really poison the mitochondria and make the mitochondria function less optimally. So when we look at energy, we kinda have this triangle of energy. We have the adrenals on one side, thyroid on the other, and the mitochondria on the other. So my analogy that I created over the years to explain these complicate concepts to patients in a really easy distinct manner is imagine you’re driving your car. The car in neutral is your thyroid. Typically your average car rest at about 700 to 1,000 RPMs in neutral. That’s like your thyroid. Hypothyroid is low RPMs. Hyper is high RPMs. That’s a neutral. Now we all know if you drive a standard and your car in low RPMs, right? What happens to the car?

Evan Brand:  Yeah, it bogs down.

Dr. Justin Marchegiani:  It can stall out though, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  But if it’s relatively higher in RPMs like you’ll see it high in RPMs like when it’s super cold out, right? Because the engine’s trying to get warmer. It goes up maybe to 1300 to 1400 RPMs that’s like hyperthyroid. But imagine that happening on a regular day where it’s not cold out.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So that’s kinda like you’re hypo–hypo—hyper–hypo thyroid and then your body or the car shifting gears from 1st to 2nd, 2nd to 3rd, 3rd to 4th, that’s like adrenal. Those are your adrenals. Healthy adrenals can shift to 2nd to 3rd, and—and 3rd to 4th and also downshift from 4th to 3rd, 2nd to 3rd, 2nd to 1st. That’s analogous to your body being able to adapt to stress, upregulate to deal with stress and downregulate to relax and go into parasympathetics. When you have adrenal dysfunction, it’s like your gears get stuck either in the high gear and you can’t downshift, so you’re wound up all day or you’re stuck in the low gear and you can’t adapt and get your energy ramped up.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So we have the stuck in neutral. It’s the thyroid, the inability to upshift or downshift is the adrenals, and then the mitochondria is nothing more than the fuel in the tank, right? The fuel in the tank. Whether it’s the oil in the engine, with the lubricant and the spark plugs and the gasoline in the tank. All the fluids in the car that make it work and function. Evan Brand:   So you have to have that, otherwise, it don’t matter what the adrenals are doing.

Dr. Justin Marchegiani:  Yeah, so connecting that back to fungus. I know I go on these little tangents here, bringing it back home, what’s the take home? Well, with fungus you can produce these things, oxalates that can really affect the mitochondria and some of the OAT test or the organic acids test, we’ll look at the oxalates which is a good marker of candida. We’ll look at the D-arabinose, which are metabolites, right? They’re indirect markers of the byproduct or the exhaust of these funguses and then we’ll also look at stool testing to look at, is there st—is there fungus in the actual stool? Whether it’s via culture or whether it’s via DNA, polymerase chain reaction DNA, or we’ll look at it clinically? Do we have a tinea rash? Is there a slight coating on the tongue? Does the woman have a history of yeast infection? Does the guy have jock itch or is there athlete’s foot history? So we’ll look at all those things. If we don’t see candida on a lab test but they have clinical indicators, what do you think trumps, Evan?

Evan Brand:  It’s gotta be the symptoms, I mean we can’t–

Dr. Justin Marchegiani:  Clinical.

Evan Brand:  Treat in a vacuum.

Dr. Justin Marchegiani:  Big time.

Evan Brand:  We can’t treat in a vacuum and some of the other markers, too. Like you talked about the arabinose, I mentioned the tartaric acid, some of these Furan markers like the oxoglutaric marker’s another one. That’ll be real high. So like on the first category of the organics of Great Plains at least; it’s a little bit different Genova—I’ve seen people where their entire numbers 1 through 9 is off the chart so there’s yeast, there’s fungus, it’s all together and then there’s bacterial issues, so it’s—it’s pretty common to have multiple things here. I was just gonna–

Dr. Justin Marchegiani:  100%.

Evan Brand:  I was gonna list off some other—some other symptoms. Dr. Mark Hyman, he had an article about hidden fungus infections making people ill. So he listed off some other symptoms and there was things like depression and chemical sensitivities, low immune system function and maybe we can talk about like what contributed to some of this. We talked about the diet but also many people have gone through rounds of antibiotics.

Dr. Justin Marchegiani:  Bingo! That’s where I was gonna go next.

Evan Brand:  Yeah. So and then what about—what about steroids, too? How does this affect? Because this is something you’ll see in research that steroid hormone usage could contribute to that but I’m not—I don’t know the mechanism. How—how that actually happens.

Dr. Justin Marchegiani:  A two-fold mechanism when it comes to steroids. Number one, steroids increase blood sugar because when you take a synthetic steroid like prednisone which is typically 10x the strength of like—of a corticosteroid like cortisone or corticosteroid cream or even like Cortef, right? That’s like your natural cortisol. This is like synthetic at a much higher level and one of the big risk factors that we see with like prednisone over time is diabetes. We also see adrenal failure because it stops the internal production because it’s so high, it’s like the equivalent of being on steroids and a man having his—his testicle shrink. Alright.

Evan Brand:  Oh, man.

Dr. Justin Marchegiani:  So it’s the equi—the equivalent of that. So number one, adrenal shutdown. Number two, that affects the immune system. Number three, it’s incredibly catabolic on the tissue, right? Osteoporosis, the big risk factor with long-term prednisone. Number four, it ups blood sugar. Go Google prednisone and diabetes, right? When you have corticosteroids that are glucocorticosteroids, the first part of that word is gluco– pertaining to blood glucose and when it take it a very pharmaceutical level that is prednisone, you’re gonna up your blood sugar.

Evan Brand:  That’s amazing. So people are going on these steroids for whatever infection or whatever issue they had and then they get diabetes and then they go on all these other meds. That’s insane to see the cascade again.

Dr. Justin Marchegiani:  It’s vicious cycle.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Because then what happens is, I had a patient just yesterday put on prednisone 50mg. Doctor pulled her off and then boom! She felt like crap for 6 months because her adrenals were just turned off.

Evan Brand:  So they basically just downregulate and the body thinks it’s stupid, “Oh, I don’t need to make hormones.” There they are. Is that—is that how it happens?

Dr. Justin Marchegiani:  Yeah, it’s like the guy on D-ball coming off and doesn’t cycle down and there’s testicles the size of raisins and they can’t come, you know, they can’t rise to the occasion with the LH from the brain saying make some testosterone. There’s just too small.

Evan Brand:  Oh, my gosh.

Dr. Justin Marchegiani:  So–

Evan Brand:  That’s amazing. So basically, limit antibiotics.  Limit steroids and hormones unless they’re absolutely necessary.

Dr. Justin Marchegiani:  Yeah, I mean, if you needed like a steroid for like something very, very specific ideally get to the root cause, support the adrenals first, and if it’s absolutely necessary, the more specific you can get, keep it at the natural cortisol level because that’s at least more natural and then if it’s like on a skin area like do it topically right there. Don’t take it systemically, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  So try to always address those things and bigger, is get to the root cause of why your body can’t regulate the inflammation in the first place. So getting back to—because everything is so connected. So when we talk about one thing, it’s like hitting a spider’s web. It—the whole thing shakes.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So it’s so easy for us to get into other parts of the web, but how those corticosteroid and those meds affect fungus, it suppresses the immune system, number one, which then affects IgA which is important for kinda keeping those things in order, right? And then number two, it also drives blood sugar upward which then could feed more of these critters.

Evan Brand: Wow. It makes sense. So you talked about repopulating the gut coming in with the probiotics. We talked about the diet that doesn’t feed the yeast and then we talked about watching out for antibiotic steroids, and then you talked about treatment a little bit using anti-fungal herbs if necessary, and then the last piece I would say is the environmental molds and fungus that people are exposed to where which believe it or not, my wife and I we got some Tempur-Pedic pillows and we had them and we loved them, and I guess we slobbered all over them or something, but we flipped over the pillows and on the bottom side of the pillows was a ton of mold that had grown. So needless to say, we trashed them. So who knows if we were waking up a little bit congested due to—due to that mold and getting exposed to it there. So whether it’s in the walls or in your pillow, I mean it’s something to consider. Your—your household exposure.

Dr. Justin Marchegiani:  Exactly, so good air filters, you know, opening the window if you can. They’ve done studies, more fungus inside than outside, so keeping the air as open. Using a good quality air filter. I have one on my website I use by Advanced Air, very good. And then one other—a couple other things is the antibiotic use drives it because you get this rebound overgrowth, right? You create a vacuum when you’re knock out all the—the crud in your gut with antibiotics that are indiscriminate, fungus tends to grow naturally, right? Weeds always tend to grow naturally number one. And then number two, women on birth control pills. That’s gonna alkalize the urinary tract and increase chance of yeast infections, and yes, I said alkalize. A lot of people don’t realize that birth control pills are alkalizing to the urine tract and that’s actually not a good thing, alright.

Evan Brand:  You want it to be slightly acidic, you’re saying.

Dr. Justin Marchegiani:  Yeah, I mean look at, let’s say a beneficial probiotic called acidophilus. You know what acidophilus means?

Evan Brand:  I don’t.

Dr. Justin Marchegiani:  It means, acid-loving. Wait, a minute!

Evan Brand:  Ahhh!

Dr. Justin Marchegiani:  I thought acid’s bad! How does that work?

Evan Brand:  That’s funny!

Dr. Justin Marchegiani:  Right? And then wait a minute, people—they have all these stories and anecdotes of apple cider vinegar being really good for you, right?

Evan Brand:  Right.

Dr. Justin Marchegiani:  Because that’s acetic acid.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Right? And then, oh, wait. What about vitamin C, isn’t that really good for you? What’s that? Well, that’s ascorbic acid.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Right.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Or–

Evan Brand:  Yeah, you and I are not what—well, maybe—maybe I don’t know. I can’t remember what your thoughts but my thought’s like people drinking tons and tons of extremely alkaline water with these expensive–

Dr. Justin Marchegiani:  Terrible.

Evan Brand:  I’m not even gonna mention the name of the company because I don’t want people to guy buy it. Yeah, so the water system’s that people are buying they’re drinking like 9.5 alkaline water. That’s not good. That can’t be good for the gut. That can’t be helping people that already have low stomach acid levels, that cannot be helping that and potentially making them worse with this whole issue here.

Dr. Justin Marchegiani:  Especially if they’re drinking with food. I mean, I’m okay with pinching a little bit of alkalizing minerals in there, maybe a little bit of magnesium or some potassium salts and using it with some natural sea salt; there’s some electrolytes. But remember acidity, especially in the stomach is very important for digestion, and if you put things that are overly alkalizing in the body especially when you’re trying to digest it, where’s the first place it hits once it goes down your throat?

Evan Brand:  It’s gonna hit the alkaline stomach there.

Dr. Justin Marchegiani:  Yeah, exactly, which is not good. That’s gonna decrease your proteolytic enzymes and that’s gonna affect digestion. So I would say, you’re 100% right, like a Bulletproof kinda diet, which is you know, good meats, good vegetables, not too much sugar. There’s some evidence that fungus can feed on ketones. Chris Kresser has talked about this, but in my opinion with the Standard American Diet and insulin resistance, the real threat is too much sugar not too much fat and ketones.

Evan Brand:  Agreed. Totally agreed.

Dr. Justin Marchegiani:  I mean, you may be able to find a scientific article on that but clinically what are we seeing? And this–

Evan Brand:  Yeah, it’s not that.

Dr. Justin Marchegiani:  We’re not seeing that and that may be an issue for some people. I’m not saying it’s not, but I’d say 80-90% it’s the other way around.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And so when I deal with fungal issues, we kinda use like a, you know, a Bulletproof, Doug Kaufmann Anti-fungal, fungal link diet where kinda Paleo-esque, cutting out the higher mycotoxin foods like the nuts, maybe the mushrooms and even the dairy, maybe some butter if you can handle it, and 1-2 servings of lower sugar fruit a day. A lot of people go too low sugar and that actually creates these fungus to go into the cyst or spore-like states where they kinda hibernate and then they don’t—they kinda live, so to speak and then they come back out later on. So a little but bit of sugar in there. Natural sugar can be helpful to kinda keep them bated to the surface.

Evan Brand:  Yeah, let’s spin—I know we only got just a couple of minutes. Let’s spin the last few minutes telling people about a couple of the remedies. Now you and I both have come across people who say, “Oh, I listen to your podcast and then I started trying to do “blank” and then I hit a wall, and then I came to you guys.” Please, if we talk about supplemental options for treatment, don’t just go willy-nilly with it on your own because there has to be a protocol in place. There has to be a specific duration, dosage, timing… like we’re very precise about this stuff so you know, I’m not saying don’t be cheap, but invest in yourself if you think you have this issue because if you just go and take some of the stuff we’ll talk about you could potentially just aggravate these issues and not get yourself better. So if we’re talking like oregano, garlic, berberine, I know there’s a bunch of other herbs that you use, too, that can be really helpful but it’s gotta be in a protocol. It’s not just 1 or 2 little things, let me just throw and—and try it and see what happens.

Dr. Justin Marchegiani:  Yeah, so overall if we line up our testing, we have like candida antibodies, IgG, IgA, IgM. We have the organic acids testings with the—the tricarballylic acid, the oxalates and the D-arabinitol. We have the fungus in the stool DNA and culture. Those are the big ones off the bat and then from the diet standpoint, kind of a lower carb Paleo-esque, Bulletproof, Anti-fungal kinda diet’s a great starting point. And looking at the treatment side, number one, the fungus may be there from a parasitic infection. I’ll say it one more time. If you’re going after fungus and you’re not getting resolution, I consider fungus to be downstream infection from a parasitic infection or H. pylori. So if you have a deeper infection and it’s not resolving with the typical herbs Evan just recommended, I’ll list them off one more time, berberines, cloves, oil of oregano, Pau d’arco, undecylinic acid, silver—if you’re using a lot of those things and they’re not going away, you gotta look deeper at underlying infections that may be present and this is where working with someone that kinda lines up and looks at the thyroid and the adrenals first and make sure the diet’s in place, looks at the deeper infections and then goes downstream to the fungus, that tends to be best way to fix the problem in general.

Evan Brand:  Well said, and I’m textbook example. I had candida show up with the elevated arabinose on the organic acid and then I had the parasites. So–

Dr. Justin Marchegiani:  Bingo!

Evan Brand:  There we go and if I wouldn’t have the stool panel with the organics at the same time, I would have thought, “Oh, I just have a candida problem, maybe the treatment protocol would have been a little less intensive,” and then I would have never got better from parasites. So–

Dr. Justin Marchegiani:  Yeah, and the last piece is, okay, you got fungus on the skin. You got this tinea versicolor or this fungal rash. How do we do that? Well, number one, we don’t feed it. Number two, we treat internally but number three, we also gotta treat externally and that may be using some topical oil of oregano or melaleuca or tea tree oil. Okay, that could be done on the toenail. In my clinic, we use an herbal foot fungus soak where we soak the feet 5 minutes a night in this antimicrobial soup mixed with apple cider vinegar and that’s helpful, and then we’ll also topically treat the skin with different soaps. One of my—two of my favorite brands are Purely Northwest and Artnaturals. They’re some really good soaps that are excellent and you rub it on area. Let it stay for 1-2 minutes in the shower or go brush your teeth while you’re waiting and then go and rinse it off. Very, very helpful for the topical treatment and again, some of the pharmaceuticals, like ketoconazole or fluconazole, they’re good but they’re also very stressful on the liver. So if you’re doing it, make sure you’re supporting your liver because they really, you know, the Lamisil they put a lot of stress on the liver.

Evan Brand:  Wow. Well said.

Dr. Justin Marchegiani:  Boom!

Evan Brand:  You killed it.

Dr. Justin Marchegiani:  Well, I think we really added some good info in there today. Fungus is a huge issue. I know I see it in my female patients with chronic yeast infections. We see it in people with the chronical fungal infections on the toes especially and remember, Dr. Mark Hyman said it many times before, what are some of the other symptoms connected to fungal overgrowth? IBS, brain fog, fatigues, joint pain, and even can drive some autoimmune conditions such as multiple sclerosis and even chronic fatigue as well.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it can even drive all of the gut conditions. All of the gut conditions—IBD, IBS, it can be a really driving factor bef—behind all that.

Evan Brand:  Absolutely.

Dr. Justin Marchegiani:  Oh, and also Hashimoto’s. The fungus is known to improve or increase antibody or thyroid destruction. So all these things are really a big factor. Evan Brand:  Wow. Dr. Justin Marchegiani:  Anything you wanna add there, Evan?

Evan Brand:  I think that’s it. You know, if you suspect it, like we always mention but we can never say enough, get tested. Rule things in, rule things out and go from there. Check out Justin’s site, Justin Health and new design coming you way. It’s gonna be fresh and clean, easier to access the health information that we provide and then you could check out my site, too—Not Just Paleo.

Dr. Justin Marchegiani: and if you guys want to thank us right now because we’re dropping awesome knowledge bombs. We’re giving you some anti-fungal brain candy right now, and if you wanna thank us, head over to iTunes or click just below the link if you’re listening on the podcast audio or the YouTube, click below. Click the Review button and we would love an awesome, authentic review and share with one of your friends or family so we could help them, too.

Evan Brand:  Absolutely.

Dr. Justin Marchegiani:  Evan, it’s been great, mam. You have an awesome day.

Evan Brand:  Take care.

Dr. Justin Marchegiani:  Bye.

Evan Brand:  Bye.  


Antifungal Tea Tree Oil Body Wash

Ariella Nail Fungus Treatment for Toenail and Fingernail

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.