Dr. Justin Marchegiani and Evan Brand dive into a discussion about having a healthy pregnancy. Gain some valuable information as they talk about nutrition, diet and lab tests before and during pregnancy.
Learn how different factors such as estrogen dominance, autoimmune diseases, toxic substances and nutrition issues affect fertility. Find out about In Vitro Fertilization (IVF), understand the reason why some people choose this option of conceiving and discover some of the natural solutions and recommendations to health-related and nutrition issues that hinder people from having a natural and healthy pregnancy.
In this episode, we cover:
11:08 Factors affecting fertility
21:36 Food sensitivities and miscarriages
25:00 In Vitro Fertilization
35:14 Blood sugar in pregnancy
36:08 Thyroid issues in pregnancy
Dr. Justin Marchegiani: And we are live here. Dr. J in the house with Evan. Evan, how you doin’ man? How’s your day goin?
Evan Brand: Life is good. How are you doin’?
Dr. Justin Marchegiani: Very good. The first podcast officially as a dad—feels really good and really rewarding. Little bit sleep deprived and my wife is taking the brunt of it, but I'm doing my best to uh— be a supporting about— a very supportive husband providing all the nutrition she needs, cooking all her meals. We got a little fridge right outside the baby’s room put upstairs. And I got—it’s stuffed with bone broth, Kombucha, sparkling mineral water, uh— filtered water electrolyte and hence, she's got a handful of meals. Paleo meals I already prepared. She’s got some really good healthy snacks. She gets some collagen smoothies and shakes up there, so I got her like stock up some. My goal is to try to feed the baby uh—kinda proxy, right? getting all the nutrition she needs and therefore, she could take it in as easy as possible and then provide the best nutrition for the baby.
Dr. Justin Marchegiani: Absolutely, man. Well, congratulations. I'm super happy for you. It’s been a— been a long time coming. When you’re waiting for stuff like this, a day feels like a week and a week feels like a year, so—
Dr. Justin Marchegiani: Yeah. And the baby's name is Aiden Raymond Marchegiani. And Aiden means little fire, so. The boy— we’re really, really stoked to have him and we’re just trying to provide him as much nutrition as possible. He was in the NICU for a day and a quarter. Maybe two days, let’s just say. He had a slight collapsed lung birth. He was doing great and then as soon as the cord was cut, which we’re trying to delay clamping as much as possible—but it’s a C-section, right, so like you know while the baby’s got the cord attached, you know, mom's open bleeding, right, so with the weighing out the benefits—
Evan Brand: Ahh..
Dr. Justin Marchegiani: Normally we’d wait ‘til that cord with pulse turn til it’s white. You know, go white and such, which maybe 10 minutes or so. We didn’t quite have that luxury, so, you know, we framed it out with the OB. Had a time we delayed as long as we could, and as soon as that cord was cut, he crashed. His O2 suction levels dropped. They put a C Pap on him. They got his O2 up; they run a chest x-ray and right after there’s a slight collapsed lung. But in a day and a quarter, day and a half—healed.
Evan Brand: Wow!
Dr. Justin Marchegiani: So he was super, super resilient. And we just—you know, we have to contribute the fact that my wife's nutrition and sleep and all that stuff was just really great during her pregnancy. And that probably attributed to his resilience.
Evan Brand: I’m glad it all worked out.
Dr. Justin Marchegiani: Yeah.
Evan Brand: And you guys are home safe.
Dr. Justin Marchegiani: Yeah. I mean the NICU docs were pretty—I think very shocked. They were telling me if we could be in there up to three weeks. And she was like, two days.
Evan Brand: Wow!
Dr. Justin Marchegiani: So it was pretty great to see that.
Evan Brand: So the people are probably like, “what happened?” you know, “You guys talk so much about holistic self why a C-section? Do you care to elaborate some of that?”
Dr. Justin Marchegiani: Oh, yeah. Let’s talk about that. I’ve talked about it in other podcast, in other episode, but people may not listen everything, so will kinda make it so it all connects. My wife had a large fibroid removed about a year and a half ago— about the size of a baby's head. There’s a very big fibroid. She’d taken birth control pills for 15 years, you know, in her late teens into her early 30s.
Evan Brand: You think that might have caused it?
Dr. Justin Marchegiani: I think that's a contributing factor if you listen to my podcast with Dr. Horwitz, he's a fibroid expert and he says that you know, estrogen dominant states can definitely drive fibroid growth. There’s not a lot of research on it. I don't think there's gonna – there's gonna be a lot of motivation to do a lot of research on it, but we know estrogen dominance can cause things like fibroids to happen. And then the question is, what can drive estrogen dominance, right? We know stress drives it. we know, you know, estrogens drive it. We know phyto estrogens, right? We know low progesterone states can drive it. We also know birth control pills can drive estrogen dominance, right? So it's the milieu, the hormonal milieu. And also, just not getting pregnant. Getting pregnant later in life can also drive it because when you get pregnant, you’re really driving a progesterone dominance state. And then breast feeding, right, you're keeping progesterone levels really high, too. So my wife got pregnant at age 40 and we decided that to get the fibroid removed just because one, it was so big and number two, we just have a smaller fertility window.
Evan Brand: Yeah.
Dr. Justin Marchegiani: The fertility window’s a lot smaller and we can get that fibroid removed we can get pregnant like that. And again, her hormones are that of a young 30 year old woman. So we had done work with her, helping her hormones, PMS, all that was really good. Her hormones were that of someone 10 years younger. She just had this big fibroid which acted like an IUD, right?
Evan Brand: Wow!
Dr. Justin Marchegiani: Intra Uterine Device which basically just— imagine this fibroid there just sucking up blood flow so that when an egg comes in, it’s not gonna be able to stick because there’s not enough blood flow to sustain it, right? So soon as that fiber was removed, we get pregnant. Two weeks after it was removed. And the doctor was like, “Okay, you know, you can try.” But he’s kinda not expecting much. But as soon as we tried the first time, we got pregnant. And yeah, we actually uhm— lost that baby but it was a blighted ovum. So none—is really a baby. There was no like heartbeat or anything, which is the sack but we lost it which was tough, but you know, we just kind of attribute it to the fact that she's went to a major surgery, right? She was under general anesthesia. She's on pain meds. Probably wasn't the best time to try to get pregnant. We only did because the doctor said it would be okay. But as soon as you know, that— the hCG dropped and she got her period back, we tried again and then we got pregnant. So uh—that’s the baby we had now, Aiden, so, we’re very stoked. So the reason why we had to do the C-section, coming back, is because the incision was along the posterior section of the uterus which had kinda weaken the uterus which had her increase her chance of a uterine rupture. And because of that increased chance of a uterine rupture—the uterus rupture is you know baby and mom can die. So they had to pull the baby out four weeks sooner week 36 just to ensure that uterus wouldn’t rupture. It’s only a 1% chance but you know we spoke to midwives and OBs and no one recommended— no one would even do a natural birth.
Evan Brand: Oh, wow!
Dr. Justin Marchegiani: Just because of the liability was so high. But I was able to watch the whole entire surgery. And I literally—you know, they her uterus in her hand and I was like, “Hey, can you look at the backside?” This is after the baby was born. They turn at the backside. “How’s the posterior incision? Let's look at it.” And she was like lookin’ at it, “I can't even see an incision.” So the uterus healed up so strong and what I attribute that to is I have my wife on the Tru Collagen every day. She was doing about 30 g of collagen every single day. And I know that those collagen, amino acids had to— made a huge difference in helping to provide extra building blocks to the— to her uterus to heal up. But they couldn't even see an incision to the back.
Evan Brand: Well, also, you mentioned she had no stretch marks, too, which is a pretty remarkable testimonial.
Dr. Justin Marchegiani: Yeah. She had no stretch marks. Again, the baby came four weeks early so some women will say, “the stretchmark comes that last 2 to 4 weeks” But again, in my opinion a lot of people are getting a lot of their protein from muscle meats which is, you know, still good. But, again, collagen is gonna be connective tissue protein. That’s ligaments, tendons, cartilage, hide skin, right? So you’re getting a lot more building blocks that are gonna help the connective tissue and the skin. And a lot of what's happening with the stretching of the skin and the fascia and all that tissue is gonna be connective tissue-based. So I think that providing one, lots of healthy fats and two, providing all the extra collagen peptides really help number one, her uterus heal, number two help the skin heal and number three, I also think it will help uhm—the breast. A lot of women, their breast tissue kinda gets flattened and kind of, you know, really just kind of uhm—just flattened a bit. Maybe the breast will start sagging and hanging and such after a long time of breastfeeding. I think the connective tissue support will also help the integrity of the breast tissue as well.
Evan Brand: Ahh.. That's interesting.t I believe that there's probably gonna be benefits. I mean, I wonder if we compared standard American women compared to hunter-gatherer women. Like what was the difference in their skin quality probably huge difference coz the hunter gatherers eating the marrow and the collagen and the bones and doing more stuff than typical women do.
Dr. Justin Marchegiani: Yeah. I mean if you look at some of the anthropomorphic kind of research, like they talk about literally taking the organs and like harvesting them. And the organs would be like literally given to the women that were fertile, that were trying to get pregnant because they knew the organs were incredibly, you know, nutrient dense. And there’s also research to these women like would literally give birth uhm— that— that day and be back out on the field later on that day or that next day working.
Evan Brand: Wow!
Dr. Justin Marchegiani: It's crazy, right? I mean they probably had a lot less stress in her life, too, right?
Evan Brand: True.
Dr. Justin Marchegiani: Very, very little stress, but still uhm— it's amazing what the body is capable of doing. So that is kinda like my back stories that just kinda summarizing uh—history of fibroid and there are natural ways to reduce fibroids and I've seen them reduced and it help with those kind of situation in the past. We just—we’re dealing with the time window, right? And if a woman's like in her 20s or early 30s and has a few years, hey, that may be a good thing to try, but in my opinion, uhm— you know, if you're up against a pregnancy window, getting it surgically removed is good. But if you listen to my interview Dr. Horwitz he said women that he's removed the same fibroid three times. So what does that tell you? That just because you remove a fibroid, that does not fix the underlying issue of why that fibroid is growing anyway, right?
Evan Brand: That makes sense. So the birth control, for example, could’ve been one thing. There gotta be an insulin components, my guess.
Dr. Justin Marchegiani: It’s probably an insulin component, too, for sure. There’s probably toxicity component too, right? Coz a lot of toxins are estrogenic compound.
Evan Brand: Yup. Right.
Dr. Justin Marchegiani: So there’s some of that. So we’re trying to do our best to support all that and again one, of the protocols will be doing is using some systemic-based enzymes or peptidase etc. to really help. She has one tiny fibroid still there. It’s in around the fallopian tube. The fallopian tubes is so patent. So it’s still open and I literally was like, you know, you’re yellin’ at the OB, “Hey, can you check out her left fallopian tube. How does it look?” She’s like, “Oh, that little, tiny fibroid—like you know, half of the fingernail, still there in the fallopian tube, but it’s not growing. So, you know, our goal is we’re gonna try to work on dissolving that one naturally uhm—you know, over the next few years.
Evan Brand: That’s amazing. So when it had to be cut out, you can just go in there with tweezers and yank it off or something, it’s not that easy.
Dr. Justin Marchegiani: Yeah. The fallopian tube’s kinda—you could, but you’d compromise the fallopian tube.
Evan Brand: Oh, wow!
Dr. Justin Marchegiani: And the fallopian tube is still open, so it doesn't make sense. She had one little, tiny fibroid actually uhm— there at the incision site, where they cut the uterus to deliver the baby. So actually, she got two for one. They removed that little baby fibroid at the incision.
Evan Brand: Wow! Did you see that? What did it look like?
Dr. Justin Marchegiani: I mean, it’s just—I got pictures of it, but uh—yeah, it’s just like a little, like mini golf ball.
Evan Brand: Really? And what—what’s the texture of it?
Dr. Justin Marchegiani: It's kinda like uh—fibrous.
Evan Brand: Oh, that makes sense.
Dr. Justin Marchegiani: So like uhm—I’m trying to think of a consistency— it's just— it's dense but it's a slight bit of squishiness to it, but it’s still—
Evan Brand: Yeah. That makes sense. That’s amazing.
Dr. Justin Marchegiani: Yeah. Almost like a tennis ball-like consistency.
Evan Brand: Yup.
Dr. Justin Marchegiani: But it’s still pretty firm.
Evan Brand: Yup, I understand.
Dr. Justin Marchegiani: So that’s kinda like the back— the back history on myself and my wife but when you're looking at fertility, right, we look at a couple of things. Number one: How are the hormones, right? How are the hormones? Number two: How—how are the pipes, right? Are the fallopian tubes open? How’s the endometrial lining? Is it—is it okay for something to be able to, you know, implant there. And then number three: is we look at the dad.
Evan Brand: Exactly.
Dr. Justin Marchegiani: How’s the sperm count, motility, morphology. I was actually, really has no problem at that moment—that I was rock solid on all those numbers. So I felt very, very good about that.
Evan Brand: See that’s the problem, you know, You and I worked with so many— so many women. Primarily, men aren’t coming to us for fertility issues, but they have to come on board because it's part of the equation. And a lot of these women that we speak with, the men, they just have a terrible diet. So we may put the mom or the future mom on AIP, but then the dad is still eating ice cream and pizza. And then they end up at the—in the—what do they call it, the vitro fertilization doctors, who want to spend what? 10-12-15 grand. But they may be unnecessary in most cases if we get the dad straightened out as well.
Dr. Justin Marchegiani: Exactly. I mean, a lot of times, you know, what’s gonna affect the fertility is number one: having a nutrient poor diet; not having enough high-quality nutrients like zinc and arginine and healthy fats and proteins. And then also uhm— mitochondrial support coz sperm needs mitochondria to move or needs a healthy mitochondrial nutrients to be able to the kind of propel it, so to speak, right? So we have to make sure a lot of the good mitochondrial support there. And then we’re just not putting a bunch of toxins in there, right? Like we’re avoiding the plastics, we’re avoiding the pesticides, the chemicals, the round up, the glyphosate—all these compounds that are not gonna be so good for it.
Evan Brand: Yeah. The endocrine disruptors like you mentioned, like the plastic, so getting men and women off of Tupperware. I guess, by the way, if you haven't figured out, this topic we’re— we’re talking about fertility today. Since Justin and I are both dads and our wives are both moms. This is a good topic for us. We've had first-hand experience on. So this is not theory and there's also some science behind what we talk about. But that the endocrine disruptors that can cause things like the PCOS, which a lot of women that come to us, they've had PCOS. Previously are there—they’re trying to get help in reversing PCOS. That can be a huge, huge hormonal function disruptor that can affect fertility. So we've got to get rid of the the plastics. Plastic straws are a big one because your saliva, you know, my opinion, you're breaking down that plastic a bit and you’re absorbing some of the— the phthalates in the plastic softeners when you're chewing and using straws as toothpicks, that's not a good one. Also, you've got flooring, too, like vinyl flooring. So if you’re walking barefoot on a vinyl floor, that's typically gonna have phthalates in it. You've also got issues with the men as well. They’re just as susceptible to exposure to phthalates and other type of toxins. You mentioned pesticide so definitely going organic. If someone's a mom, a lot of times women they’ve already had her first kid but they wanna have another kid and they are coming to you or I would see that a lot, too. You know, I tell a lot of moms have got to stay away from a lot of the playgrounds because they use the rubber tires, the recycled tire playgrounds and those are very, very toxic and I've measured moms with the GPL tox chemical profile test from Great Plains and they've got the rubber toxins off the chart. And I say, “where are you playing?” And they say, “Oh, we go to one of those playgrounds with the recycled rubber tires” And that stuff is just super toxic or let’s say the mom has a kid who started sports, my God, I work with the woman last week who lived in London, and her child he was off the charts himself. So we haven't tested mom yet, but we tested the kid coz we’re working more with him than her. And the kid was off the charts with 2,4-D— the agent orange chemical that they used in Vietnam. And I said you know, “Where are you guys playing?” And she goes, “Oh, he plays soccer” I said, “Is that football or soccer?” Coz she call it football. So is that football football or is that soccer?
Dr. Justin Marchegiani: Right.
Evan Brand: And so she's on the field with this kid multiple times a week. In the field, just sprayed, I'm sure, pounds and pounds and pounds of glyphosate and 2,4-D
Dr. Justin Marchegiani: Yeah. I mean I kinda go back and forth, what's worse, right, being on the artificial turf stuff or being on the grass? Coz you know the grass has given a whole bunch of chemicals, right?
Evan Brand: I Know.
Dr. Justin Marchegiani: So I—for me, and again, how many research? I’m just—a lot of what I do is common sense and based clinically.
Evan Brand: Yup.
Dr. Justin Marchegiani: Coz I probably rather be on the synthetic turf grass because at least you know it's not being spray with round up.
Evan Brand: Yeah.
Dr. Justin Marchegiani: ..and pesticides all the time.
Evan Brand: I know. I don’t think they spray anything. One other thing about men, you know, when we’re talking about fertility for men, sperm quality. Heavy metals is huge. Mercola had an article about infertility where he was talking about how men are much more susceptible to issues in their fertility with heavy metals than eggs. So the eggs in the female were less affected by heavy metals and other pollutants than men. So that's pretty interesting. A lot of guys have metal amalgams in their mouth. So we may— I've not personally had to go that far with any of my clients but what would you say? Would you say that could be a possible step? Does the man have to— may have to get a amalgam removal is done?
Dr. Justin Marchegiani: Yeah. I mean I think that’s definitely an option. If we’re seeing elevations in heavy metals—anytime I have someone a male with fertility issues, once the diet’s good and we've eliminated toxin exposure, then it's about what nutrients can we add to enhance sperm quality, and then what things can we add to enhance detoxification.
Evan Brand: Right.
Dr. Justin Marchegiani: Maybe phase I or phase II detoxifying nutrients and maybe things to help push the heavy metal binding. So again, I'd wanna look at all that and if we’re seeing high levels of metals, and we know Mercury's there, and then we’re seeing the person also the history of fillings— heavy metal fillings and then we wanna get that removed.
Evan Brand: Tapwater. Gotta have a good clean water that the person is drinking. We talked about the— the phthalates. So the xeno estrogens—coz that’s gonna affect the males.
Dr. Justin Marchegiani: Yeah. So if the male is more like a woman, you know, he's got a lot of excess breast tissue and things like that, and we can assume, “okay you've probably got some estrogen problems” So just like you mentioned about females. Same thing for men, it could be an estrogen dominance problem.
Dr. Justin Marchegiani: Yeah. And we can look at that from two perspectives. I did a video called the “Hormone Switch” I recommend everyone to take a look at that. Will try to put links below for the “Hormone Switch” But when men's blood sugar’s off, when they start moving into a direction of insulin resistance, they increase this enzyme called aromatase, which causes the hormone to switch. It will cause their testosterone to go more towards estrogen. And we see that quite frequently. And again, one of the best thing get one of the best thing you can do is put on more muscle. That will make you more insulin sensitive. A high intensity training type of regimen where you're doing like a long, slow movement to get muscle activation or to get HGH, where you’re doing interval stuff. That’s gonna help significantly get the blood sugar under control and get the inflammation under control. A lot of these stuff, we always go back to the foundation coz we know there are people that are new that are listening every day so we don't want to assume that the foundation is there. And all of our patients that listen, you know, listeners they get that. We kinda feel like a broken recored, but just to emphasize for new listeners.
Evan Brand: Yeah. We wanna get rid of dairy. I mean that’s gonna be huge on the diet piece. We’re talking about or talk about stabilizing blood sugar; we’re getting refined carbs out; were getting sugars out, but dairy, too. You know, depending on what piece of research you look at, that could be 60 to 70% of the estrogens consumed is coming from dairy, especially these cows that are not organic. So for us, the dairy is always gonna come out. Organic veggies are always good come in, organic fats, your nuts, your seeds, your vegetables. Unless the woman has some type of like Hashimoto's problem which that can complicate things with fertility. Sometimes if there's a thyroid issue, but let's just assume that the person can do a good quality butter, can do some nuts, some seeds, maybe a little game meat even. That’d be cool. If we could get the mom eating some—some deer, or some type of game organ meats, or sardines.
Dr. Justin Marchegiani: Yeah.
Evan Brand:..or other home-cooked, home-sourced wild turkey, which we have ton of turkeys here. Those are awesome, too. Unfortunately, it doesn't seem like local fish is an option here in Kentucky. I was reading the report by the Kentucky Department of Fish and Wildlife. They said that most of the fish are toxic here, unfortunately. With the— with high levels of mercury. So they set for people wanting to get pregnant or pregnant people should avoid the fish, which kinda sucks.
Dr. Justin Marchegiani: Yeah. Actually when it comes to the fish component, uhm—I have an article that I give my patients but really, it comes down to number one: trying to get the wild—you know, the wild Alaskan or like some kind of flash frozen, kinda wild fish, I think is great, is ideal. But it's looking at the selenium to mercury ratio. Because fish are going to have a little bit mercury. The question is, “Is there enough selenium to combat it?” Because the selenium is the natural chelator of mercury. So just try to choose high selenium to mercury ratio fish. So skip Jack tuna. It’s gonna be the best type of fish off the bat uh—cod, haddock, sole, halibut. Those things are good. I have a good article in my member’s area for my patients. But if you just google like “high selenium to mercury ratio fish” you’ll get a nice list there.
Evan Brand: Uh—cool. I love cod, haddock. Those are awesome. I had something pulled up. I was trying to see I may have lost it, but just mentioning the link between food sensitivities and also miscarriages. Basically what happened is the link between having some type of allergenic reaction, you've got the cytokines that are basically suppressing the killer cells.
Dr. Justin Marchegiani: Yup.
Evan Brand: But when the immune system is off, the body can accidentally attack the egg. So basically, long story short, it sounds like just searching, investigating and finding out for food intolerances, which we’re gonna push most people into kind of a Paleo template as the starting place. Probably no grains, but at least no gluten, no dairy as a starting place. Will probably gonna rule a lot of those food intolerances out within the first month.
Dr. Justin Marchegiani: Yeah. Even push to autoimmune shtick as well. I know you kinda talk about a deer. That’s good when you're doing autoimmune shtick, but I think adding at least back in the ghee and definitely the butter, as long as you can tolerate it, as long as like, there my patients are following the reintroduction protocol, which is adding the food back in over a three-day period. Gently increasing the amount as long as no negative reactions that's fine coz you know, butter butyric acid’s a 1:6 uhm— carbon fatty acids. So it’s a medium chain triglycerides, so to speak, right? It’s very short chain length. It’s four carbons or six carbons, but it's a really good fat; it’s a lot of nutrition, a lot of vitamin K which is really, really good for fertility uhm— so that's uh—excellent fat as long as you can tolerate it, I think that’s great.
Evan Brand: And other bad things, too, like alcohol.
Dr. Justin Marchegiani: Of course. Like alcohol number one: it’s a toxin. Again, in moderation maybe okay but number two: it gets metabolized to sugar. So if you have a little bit insulin resistance or blood sugar stuff, that can be a stressor. Again there's ways to hack it by just using higher-quality alcohol and by timing it with protein and a little bit of fat uh—with your meals. It can slow down some of the absorption but you know, for a time period, if you have health issues, cutting it out for a month or two maybe a good idea to start with. And then choosing some of the drier, you know, white wines or drier champagne or Presecco or doing a really clean tequila or really clean vodka. Again, my Dr. J Moscow mules is one of my go-to’s use with uh—Tito’s vodka and the ginger Kombucha and some lime. Or I just do a really good like Sean Don or like a really good brewed Presecco, very dry. I like the bubbles. Bubbles are uhm—you know the uh— the seltzer or like the CO2 carbonation. The bubbles are actually—there is actually research studies where they increase alcohol absorption with the bubbles. I was reading one study. I was like, “Damn, I love to be in the study.” Like— you know, 15 years ago when I was in college, they were like, “ Yeah. We had a group of college kids and we gave one group alcohol and one group alcohol with you know carbonation and soda water.” I’m like, “that’s a great study for college.” Right? I know like, yeah, the group that got the carbonation with their alcohol uhm—you know, felt the effects, felt the intoxication effects or the buzz, you know, the so-called buzz effects sooner. So there’s some research with the carbonation in there helping to absorb the alcohol. So what does that mean, right? It means you’re a cheaper date.
Evan Brand: Yup.
Dr. Justin Marchegiani: You— less of it to get that same buzz, which means less toxicity on the liver. So that’s why like add the bubbles in there, that's better. And you get that with my Dr. J Moscow Mule. Uh—you can do it as well with my Norcal margarita and we just you know, do a little bit of soda water in there when you can also do a really dry Sean Don or brewed Prosecco kinda drink there.
Evan Brand: Perfect. Let's talk about IVF just for a minute. A lot of people and you know, the in vitro fertilization is like the first step if they are struggling. Diet, lifestyle, stopping smoking, which is insane. My wife had some friends that she's not friends with them anymore because they're just there were not good people overall. So we— we cut them out. They were too toxic in many ways.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Emotionally and physically, smoking cigarettes around her when she was pregnant, all sorts of crazy stuff. So we got rid of them.
Dr. Justin Marchegiani: It’s hard for someone to truly be emotionally balanced and healthy if they’re not physically healthy because the mind-body connection is just— it's so strong, right?
Evan Brand: I know. Uhm—so anyway— but these people that used to be her friends.
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand: The guy, the dad, they were struggling with years. I think they were in their early 30s. They were struggling for years. They still do not have a child to this day. The guy was drinking beer almost every weekend, daily smoking of cigarettes, Mountain Dew's. But yet they went to an in vitro fertilization doc and they were gonna spend 10 or 15,000 for the therapy.
Dr. Justin Marchegiani: Yeah.
Evan Brand: It’s just insane. You're not addressing the root cause.
Dr. Justin Marchegiani: No, you’re not. I mean, typically the first, you know, thing they're going to do is they’re gonna do some kind of Clomid or FSH stimulating drug. The core goal of that is to increase the eggs, increasing amount of eggs, right? So they’ll do like Clomiphene Citrate or some kinda Clomid and then depending on sperm quality. If the sperm count is low, they may do IUI which is like intrauterine insemination kinda fancy turkey baster.
Evan Brand: Yeah.
Dr. Justin Marchegiani: The sperm up and they may wash it and stuff and pick the best ones and then they’ll inject it right into the uterus. So then there's no journey of these guys have to— the sperm cells have to make to get up there, right? Coz if they’re a little bit more mitochondrial depleted, or they don’t have good mor—motility, like they’re not moving in the right direction or their shapes not good. They may not be able to make the journey. So the whole idea is to use that uhm—artificial turkey baster. You can get it right there, so their journey is shorter, right? You’re cutting their journey down by 80% and then they're stimulating the heck out of the eggs. That’s the first step. And the next step is full IVF which is they’re basically giving you drugs like Lupron to shut down your HP AG access, you know, your hypothalamus pituitary axis, And they’re gonna give drugs to stimulate FSH. Uh—they’re gonna give drugs to then manipulate ovulation. And then they’ll probably give some kind of uh—progesterone afterwards to help hold the implantation of the egg. That’s pretty much the cookbook. There are new medication that comes in—Gonal-F, Follistim, Lupron. All these different drugs may be used uhm—but the goal is kinda the same— stimulate, you know, egg production, enhance ovulation, help hold onto uhm— progesterone levels so the eggs stick better.
Evan Brand: Well, I remember seeing a picture. I think it’s a picture of my wife that showed me where this couple had had hundreds of vials— like an entire couch or an entire floor full of vials that were daily injections, I believe, for that whole process. Which this is one: it's expensive; two: that just doesn't sound very fun; and three: in a lot of cases, I don’t have any numbers. I’m not gonna make up a number on the spot, but in so many cases, if you just address diet, lifestyle infections, thyroid health, adrenal health, you're doing the fatty acids like you talked about, the collagens, your zincs and selenium's, and your natural folate's, and your vitamin C, and your omega-3's, it's like that's a prescription that’s gonna have far higher success rate and it's gonna be virtually free because you have to eat to survive. So you're going to be eating all these good things, anyway.
Dr. Justin Marchegiani: Totally. And we do things like chase tree and tribulus to modulate LH and FSH. So like that will modulate FSH; the tribulus will modulate LH with chase tree. And these are things that help talk—help the brain talk to the end gonads, you know and create stimulate the follicle or help the progesterone, right? So will do that with some herbs. We can always c_ augmentation protocol where we put estrogen—I’m sorry—progesterones in there, right? at certain times of the cycle, day 15-27. We can even add in some uterine supporting herbs like maca, m__, dong quia, alpha alpha, raspberry leaf extract. These are great uterine tonic herbs that really help the blood flow get to the uterus which is good because that uterus— these adequate blood flow to help support that egg when it sticks. So I tell patients think of progesterone as a sticky glue that helps the egg hold, but we need good uterine flow. That's why my wife and I had a hard time getting pregnant at first because we have this fibroid that was sucking a lot of the angiogenesis out, right, the angiogenesis’ blood flow. So it’s creating a lot of blood flow to the fibroid and not to whatever else was gonna stick there i.e. the egg.
Evan Brand: So did you all have to do herbs? Or did you do herbs or just the diet lifestyle is all you needed?
Dr. Justin Marchegiani: Uh—we had herbs going in the background the whole time.
Evan Brand: Okay.
Dr. Justin Marchegiani: Yeah. We had that the whole time there and uhm— a little bit of progesterone going as well. And again, we just— I measured it, like I want 15 or higher, 20 is ideal. So Iike after she got pregnant, we measured progesterone. We make sure it was adequate. And it was, so we pulled off it.
Evan Brand: And what were you doing? Like drops or—
Dr. Justin Marchegiani: Progesterone drops. Yup. Exactly. So, like typically like a 100 mg is a good starting point once you get pregnant. And again, we just monitor it and it just kept on rocking. And again, if the ACG is high enough, typically the progesterone will be high enough because the hCG is uhm—gonna be produced by you know the follicle and also the placenta will kick in and produce it as well. And that hCG will then jack up the progesterone, too.
Evan Brand: Oh, that’s cool. all that's cool okay you didn't you didn't have to continue, you’re saying?
Dr. Justin Marchegiani: Correct. You know, we didn’t have to. But some women who have lower progesterone, they may have to keep that progesterone going for the first trimester.
Evan Brand: Now is that something you have to get via prescription or are there over-the-counter natural ones you can get?
Dr. Justin Marchegiani: It depends. I mean, I typically give my sublingual one until I can get the fertility OB to write one, just more from a legal standpoint. I rather have the OB write about identical prescription just so, you know, if they're working with that person that we know it's covered. But the protocol is gonna be the same and typically will do like an intervaginal uhm— progesterone just so we know it's getting right to the tissue. It's—it's— it's being released closest to the tissues. So will do that. If we have an option, some OBs that they won't do it uhm— just because they’re not looking at the progesterone or because a woman doesn't have a—a history of miscarriage. They’re not gonna even look at it. But I mean, do you really wanna go through a miscarriage then know your at risk to then wait to the next time to do it?
Evan Brand: No joke. Right.
Dr. Justin Marchegiani: Yeah. I rather be monitoring it. And you know, if it’s below 15 or you know, I’m gonna be supplementing with some progesterone to make sure their support there. You can't go wrong with it. Just make sure you’re using the good-quality progesterone. And again, we’re giving a lot of clinical advice here. And there maybe a lot of people that are just lay people listening. I don't recommend doing this by yourself if you really want to work with the provider that's done this a lot, so uhm— you know what's going on and you wanna have everything looked at. So you want to make sure that we’re supporting the adrenals. Typically when someone's pregnant, the only thing I'll keep them on are nutrition, nutrients, whether it’s vitamins, minerals, amino. I’ll typically keep them on probiotics, I’ll keep them on digestive support, HCL enzymes and the only hormone I'll typically keep them on, when they are pregnant, if it's necessary “necessary” is the progesterone.
Evan Brand: Yup. Well said. Well that’s the thing. We love talking about adaptogens so much but nobody's gonna do the research on rhodiola or these other herbs and how they could impact the fetus. So we just, you know, we love those things but we just can't safely recommend them because we just don't know.
Dr. Justin Marchegiani: It's probably safe, but again, like, think about it, who's gonna sign up for that study?
Evan Brand: I know.
Dr. Justin Marchegiani: Right. Whose gonna sign up? “Hey, by the way, congrats! You’re pregnant. Hey we’d love to have you sign up for this study where we test these adaptogenic herbs on health and viability” “Uh—no, I’m good.
Evan Brand: Right. So I mean—some of it we can draw from—from ancient peoples what they’ve used. Like you mentioned the chase tree which has been used in extreme long time. So a lot of it, we’ve probably already lost due to just modern life. We've lost touch with our hunter-gatherers, what herbs and plants and trees and stuff that they use during pregnancy, unfortunately. But like you said, diet lifestyle, foundations, HCL, enzymes, probiotics, fish oils, vitamin D. Did you hit— did you mention that one?
Dr. Justin Marchegiani: We did not. But vitamin D is definitely important. We have to have to look at potentially even give my baby a little bit extra. I was speaking to one of the in the neonatal uhm— docs there and he was telling me you know, you may want to give your child an additional above and beyond what's in the breast milk 400IU sublingually uhm— for the baby. So we’re looking at getting some extra bit of that, but, you know, we’re gonna weigh it out. If we can get the kid out there at 8 AM in the morning 15 minutes out in the sun at 8 AM that may be enough, right? We don’t even need the drops.
Evan Brand: Yeah. What the—lady we spoke with said. She said as long as my wife was getting 6 to 8000 units that which I think this is just probably her making up numbers on the spot but she said that if my wife were supplementing with 68,000 units daily that the baby would probably end up getting at least 500 to 1000 units from that that would pass through.
Dr. Justin Marchegiani: I think that, too. I asked that and they were like, well you should still give it. But it’s probably like a CYA comment.
Evan Brand: Exactly.
Dr. Justin Marchegiani: You don't know exactly, but I think if she's getting 6 to 10,000 the day, I think you’re gonna get 5% transfer to the—the baby in the breast milk.
Evan Brand: I guarantee it.
Dr. Justin Marchegiani: I think it's probably good. So we’re probably gonna make sure she just getting 10,000 a day with the K2 and just get the kid out in the sun a couple times a week in those early morning hours and you know, just enough to give him a little sun kiss. Nothing else.
Evan Brand: Yup. Do you wanna talk about lab test for a couple minutes and just talk about what we would recommend someone get if before they even think about conceiving. You know, we kinda talk about pregnancy and birth and delivery and all that, but really, it begins far before that. So you and I kind of talk a bit like a five or six trimester is really what pregnancy is coz you gotta do the preparation then the postnatal care is important, too. So vitamin D—we hit on that. As a blood panel, insulin or blood sugar if you knew you, had a history, you could get the stuff done. Uh—fasting insulin.
Dr. Justin Marchegiani: The fasting insulin's great. We want less than seven, ideally, less than five. We may even want to just do some functional glucose tolerance testing, i.e. just testing your blood sugar with a blood sugar meter. Fasting one hour, two hour, three hours after a meal. Choose a couple of different meals a couple times a week, breakfast, lunch and dinner. Some people we hire in the morning coz of the somogyi effect which is totally cortisol driven. So you’ve gotta keep that in mind.
Evan Brand: Yup.
Dr. Justin Marchegiani: And uhm– I would say, we’re gonna do an adrenal test, for sure. And we may just do a female hormone test around day 20. We’re looking at estrogens and progesterones and such and testosterone, but if there's a more of a fertility history there, we may run was called the “month-long test” or on the 209 panel from Bio health which is a month-long panel. Will look at progesterone level starting at day 2 every other day in the cycle.
Evan Brand: Thyroid markers. I’m gonna look for antibodies, your TPO, your TG antibodies..
Dr. Justin Marchegiani: Yeah.
Evan Brand: To see if there’s autoimmune going on.
Dr. Justin Marchegiani: Yeah. If there’s some history going on, or symptoms, will definitely do it, but you know, TSH, T4,T3 antibodies, reverse T3's is great. And you know, one of the things that I give my wife during pregnancy is a couple hundred extra micrograms of iodine a day. There’s some good research about helping the babies IQ. So we did a little bit of that.
Evan Brand: You can have a genius baby now.
Dr. Justin Marchegiani: Now the goal is to give the kid all of the all the resources it possibly can, right? That’s the goal of you know, being a great mom and great dad is giving your kid as much potential as possible. And a lot of that's gonna be uhm— healthy pregnancy, right? Healthy nutrition, healthy prenatal nutrition.
So healthy fats, healthy protein, healthy carbs, nutrient density has to be high, inflammation has to be low and uhm— making sure there’s enough calories and good macros. And we’re going a little bit higher on the carbs right now. But this is true when you eat for two.
Evan Brand: A 100% man. Tell me, my wife, she— she ate way more than me and she still—she actually weighs now than she did before she got pregnant which is interesting. I mean—
Dr. Justin Marchegiani: It’s a great benefit in breast feeding.
Evan Brand: It's definitely depleting, though. It can be depleting, so we’re doing our best to keep her— to keep her full and—and satiated.
Dr. Justin Marchegiani: Yeah. We also did placenta encapsulation as well.
Evan Brand: Oh, sweet man. Yup. Cool.
Dr. Justin Marchegiani: I actually have pictures of a placenta. It’s pretty cool.
Evan Brand: I planted my wife’s with a tree.
Dr. Justin Marchegiani: Really? Wow!
Evan Brand: A little tree sprout, a little maple tree sprout at our old house. I had the placenta coz we’re going to do encapsulation. We had a doula that’s gonna do it for us, so we decided—she felt so good postnatally that she didn’t need it. And—and so I had the placenta in the freezer, took it out so I could actually mold at first, you know, mold it a little bit and dug uh— dug a giant hole, buried it couple feet under with the— with the little maple sapling right there. So there should be a tree there one day.
Dr. Justin Marchegiani: Wow! That’s amazing. So we had it encapsulated, so she’s doing three capsules 3 to 4 times a day. And then we have uhm—we actually had a tincture made, too, which is pretty cool.
Evan Brand: A placenta tincture?
Dr. Justin Marchegiani: Yeah. And we’re gonna save that for menopause for her.
Evan Brand: Really?
Dr. Justin Marchegiani: When she transition to menopause, we’ll use that tincture.
Evan Brand: That’s a thrift.
Dr. Justin Marchegiani: Yeah. Isn’t that cool?
Evan Brand: I did not know that. So what’s—what’s the idea there? There’s gonna some naturally occurring hormones in the placenta that will help to ease menopausal symptoms?
Dr. Justin Marchegiani: Exactly.
Evan Brand: Ahh—Okay. We've got uhm—we’ve got a couple questions. I think they may not be related to our topic because our topic’s pretty niche today. But do you want to look at these questions here?
Dr. Justin Marchegiani: Yeah. We try to grab the ones that are most relevant for sure.
Evan Brand: Okay. There was a person named, Chris here, that said he was diagnosed with Hashimoto's and is displaying signs of hypoglycemia with perfect blood sugar, what could it be? That’s gonna be a good question. Do you get that question?
Dr. Justin Marchegiani: Yeah. So his blood sugar may look good but why does it look good, right? The question is— are the adrenals coming to the rescue to make that
Evan Brand: Uh-hmm.
Dr. Justin Marchegiani: Coz if the adrenals are coming to the rescue and lifting that blood sugar up, there’s gonna be a lot of cortisol and adrenaline in the background which are gonna create a lot of anxiety, and mood issues, and irritability, and a lot of things where your blood sugar may look good, but the question is, what’s lifting that blood sugar up? Ideally, we want healthy blood sugar by diet, meal timing, nutritional density so the blood sugar is lifted up naturally not relying on the adrenals to keep it lifted.
Evan Brand: Yeah. With the adrenals are kind of the backup generators of the adrenals are getting involved with your blood sugar regulation, that's not good. That means something else is off elsewhere, but if the diagnosis of Hashimoto's is there, too, could we say that if—if there signs of hypoglycemia maybe it's not hypoglycemia, maybe it's thyroid as well because I mean the thyroid can make you feel like your fatigued and lethargy and then all of a sudden, you're over stimulated.
Dr. Justin Marchegiani: Totally. If you have hyp—If you have Hashimoto's there’s probably potentially some T4 to T3 conversion issues.
Evan Brand: Yeah.
Dr. Justin Marchegiani: And there’s probably some adrenal issues so all that stuff needs to be looked at and then again, we don’t even know where that— this person is in the hierarchy of diet and lifestyle.
Evan Brand: Right.
Dr. Justin Marchegiani: So we’re assuming that diet and lifestyles are already even adjusted. 30 g of protein in the first waking, eating— eating healthy proteins, fats and the right amount occurs every 4-5 hours or assuming that that’s already dialed in.
Evan Brand: In preferably on an AIP approach and until the antibodies are very, very minimal in the single digits or less.
Dr. Justin Marchegiani: Yeah. If possible, I typically wait till there's a there's plateauing of uh symptoms. Some people may not be able to get them all the way low but you know, we at least want to get them under 500 or so. It depends. If we could get someone under 500, that's a pretty good reduction.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Again—
Evan Brand: What’s the highest you’ve seen with TPO? I think the highest I’ve seen was like 1600 on a TPO.
Dr. Justin Marchegiani: I’ve seen over 2000. I mean I have patients literally go from over 2000 to under hundred.
Evan Brand: Yup. What’s the timeline? A year?
Dr. Justin Marchegiani: I’ve seen it happen in six months to a year.
Evan Brand: Yup.
Dr. Justin Marchegiani: Yup. The average person that I work with, we have at least a 50% reduction in antibodies.
Evan Brand: Right. That's awesome. I love seen that on a piece of paper. When you actually get to validate it, but then their symptoms are better, too. It’s such a double win.
Dr. Justin Marchegiani: Oh and I had so many patients say their endocrinologist just says, “there’s nothing you can do about that”
Evan Brand: No.
Dr. Justin Marchegiani: And it's like over and over again, and we just continue to prove them wrong and it’s just like, “man!”
Evan Brand: It’s a great feeling.
Dr. Justin Marchegiani: I feel so bad. It's just like, you know, imagine having someone like, you know, hiring someone to fix your house and all they have is just a hammer. It’s like, “dude, you’re missing the saw and the screwdriver, this and everything” It’s like functional medicine is that we get so many tools at our disposal. We’re not limited to just like that one pharmaceutical tool that's supposed to be in our toolbox, right?
Evan Brand: Yup. Well the same thing with fertility question. I mean, you and I have talked to dozens and dozens of men and women who've been told that they will never be able to have children, yet we've aided, and many, many babies, you know, just being made by helping women get their hormones back on line and fixing the underlying issues, so—
Dr. Justin Marchegiani: That’s it, man. I 100% agree. So, I hope that helps there. Anything else we can grab before__
Evan Brand: Yeah. Let’s see what we have here. That was unrelated questions—
Dr. Justin Marchegiani: Someone was asking about Probio Flora and Sacro Flora. And again, those are some of my probiotic products. Sacro Flora is a high-dose saccharomycin, Probio Flora is a high-dose bifido-lactobacillus uhm—probiotic. We typically do that for at least 60 days after a parasite killing protocol.
Evan Brand: Here's a good— here's a good question here from Naomi. She said she's been diagnosed with blastocystis hominis, which for those listening, that’s a common parasite infection we see. She’s exclusively breast-feeding a six-month-old and the antibiotic metronidazole did not seem to work. “Is it possible to treat while still feeding baby?
Dr. Justin Marchegiani: The only way I would treat it is with probiotics right now. I would not do any herbs. I would choose two probiotics. I would do Saccharomyces and high-dose probiotics that’s the only thing I would do right now to treat it.
Evan Brand: Yup. So, Naomi, when the time comes for you to wean off the baby which if it six months this may be another year or so, we don't know how long you intend to breast-feed, at that time, reach back out to us. Justin and myself we can help you get rid of the blasto using herbs but, yeah, with these anti-parasitic herbs, we—we just— it’s just not—not a safe. Well it might be safe, but we just don’t know. We don’t know if that’s—
Dr. Justin Marchegiani: It probably would be safe, but we don't want a chance and we rather be just conservative, right? Always do no harm. So I feel very comfortable recommending probiotics. There’s been studies done on kiddos, actually, looking at Saccharomyces polarity uh—compared to Flagyl Metronidazole Tri and Blasto, and it’s just as good, if not better.
Evan Brand: Yup. So look it up, Saccharomyces polarity. Check out Justin's, we both got Saccharomyces polarity products. There's a lot of good ones out there. Just make sure you get professional grade, so that actually works.
Dr. Justin Marchegiani: Exactly.
Evan Brand: Cool. Yeah, I think that’s it, man. We can wrap it up. Will send people back to your site if you wanna learn more about you or work wit you. justinhealth.com myself, evanbrand.com Check us out. We’ve got hundreds and hundreds of episodes. So if we just hit the surface of one piece of the conversation you like today, then I'm sure we dove deep somewhere else and give us a review. I know you may be watching elsewhere, YouTube, Facebook etc. but iTunes is where it counts. So we need to continue to beat out people like Jillian Michaels who promotes just not sound advice and so we wanna really bring functional medicine to the forefront of humanity and help to save some of the crises that are going on in terms of depression, anxiety, infertility, obesity diabetes, cancer. We want to put a dent in the universe. So give us a review so that we can do that and stay in the top of the charts.
Dr. Justin Marchegiani: Awesome! And you guys, subscribe right now, my YouTube, justinhealth.com; Evan’s YouTube. Uh— click on our YouTube link. We appreciate the subscriptions, care—you know, sharing is caring. We love it. And again, give us feedback. We want feedback about what you guys want to hear because this is all about how we can serve you guys better. So let us know so we can provide more awesome information. And again, what makes us different Evan I different is, we keep it real. You’re gonna walk away from our show and our podcast with actionable item not esoteric BS that’d gonna make sense you up in the ether, right? But what can you actually do. So that's how we’re different. We’re trying to keep it real and make it actionable for you guys. So we appreciate you listening. And everyone have a great day.
Evan Brand: Take care.
REFERENCES:
https://justinhealth.com/products/sacro-flora/
https://justinhealth.com/products/probio-flora/
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