Hello, everyone! In today's podcast, Dr. J talks about bloating and its connections with mold, low stomach acid, bacterial overgrowth, h. pylori, fungal overgrowth/candida and parasite infections. Mold and mycotoxins may also play a role in causing sympathetic and adrenal stress that could affect digestion. Food allergens and too much-processed carbohydrates may also feed bad bacteria that could contribute to bloating and gas. The cause of your bloating might not be what you think it is. And how does mold fit in this puzzle? Dr. Justin Marchegiani is drawing a line between the root cause and palliative solutions. We're also looking at more natural solutions to help treat and relieve your bloating. Of course, very important is the root cause and checking back to that so everything connects and encourages better digestion and less bloating. We're talking about the tests we conduct to help get down to the root of your bloating, chronic vs. acute bloat, and the next steps. Let's ditch the discomfort of bloating!
Dr. Justin Marchegiani
In this episode, we cover:
01:06 Lab Testing, Root Cause and Palliative Solutions
9:55 Mold Exposure
15:33 Digestive Support, Infections, and Fungal Overgrowth
17:21 H. pylori and Mold Connection
25:19 Working with Functional Medicine Practitioners
28:02 Best Practices' List
Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here with Evan Brand. Today, we are gonna be chatting about functional medicine solutions for bloating. Really excited to get to the root cause. Evan, how was your weekend, man? What’s going on?
Evan Brand: Oh, not too much. It was very good. I’m excited to dive in to this topic. I figured we would divert from the coronavirus. We’ve done, I don’t know, hours and hours and hours and hours of content on that and what we’re still seeing clinically is that people still have issues outside of that, being concerned with that, and one issue that’s popping up pretty much every single day and that could be because we focus so much on helping improve gut health in people is the issue of bloating, and people will come in with the sort of preconceived ideas of what’s going on. They’ll say, “Oh, I have bacterial overgrowth or I have this or I have that. I have parasites.” And that’s what they think is going on but in a lot of cases, and this is why you and I focus so much on doing advanced lab testing, in many cases the people wrong. What they thought was wrong with them is not what’s wrong with them and then we find a different solution. So why don’t we dive straight in to the testing? Maybe talk about some of the tools that we use to investigate these issues and then we could dive in to maybe the specific things that we are seeing that are these triggers or root causes.
Dr. Justin Marchegiani: Absolutely! So when we look at root cause, we always want to draw a line between root cause and then palliative solutions that may help symptomatically. We always want to draw a line, right? And of course, there’s palliative solutions that are more conventional-based, right? Whether it’s like bloating, whether Gas-X or some type of drug to address, Imodium or something else on the tummy side that’s gonna just manage symptoms on the drug side, right? And then there are even more natural things that do the same like activated charcoal, right? And then there are some things that are more palliative but may connect into the root cause like digestive support, like enzymes and acids. As part of a lot of bloating issues, there tends to be some kind of a gut infection or gut stressor followed by low stomach acid, low enzymes, low bile salts. So there are some palliative things we may throw into the mix that may help support and allow us to feel better but they are also part of the root cause. So we—we want to always plug in solutions but also make sure we are checking back to the root cause so we’re not—we’re making sure that everything connects. Palliative, root cause, and they all want to connect and ideally, we’re choosing root cause stuff that’s gonna be more—more natural that’s in alignment with what your body needs for good digestion to begin with.
Evan Brand: Well said and there could be a lot of overlap between the palliative stuff and the root cause stuff like the enzymes, great example. So testing-wise, what are we looking at? How are we identifying the root causes of bloating? Number one is stool test. We do a DNA stool test on pretty much every single person. Unless they’ve already had something run and it was very good or recent testing from a previous practitioner or doctor, then we may use that but in most cases, we’re looking at a DNA sample to try to figure out what’s going on and not only what’s going on, but what specific species of bacteria, what specific pathogens like worms, what specific parasites, what’s the gut inflammation look like, what’s the gut barrier look like, what about H. pylori, is that going on? Because if enzymes make you feel better or enzymes making you feel better because you have an H. pylori infection that’s—
Dr. Justin Marchegiani: Uh-hmm.
Evan Brand: Suppressing stomach acid, so I would say stool test is probably the best but not always the best place to start testing-wise. What would you say?
Dr. Justin Marchegiani: Absolutely! So I mean, there’s just—we look at underlying physiology, right? You can tell a lot by underlying physiology with symptoms. The difference is a good functional medicine doctor is gonna look at the symptoms and go upstream to the body systems that may not be functioning optimally. So if I’m seeing indigestion, I’m thinking okay, maybe we don’t quite have enough enzymes and acidity to activate our digestive support, right? Because we need nice low acidity, right? Low acidity is like a pH of like 1-1/2, 2-1/2, that helps activate enzymes and the acidity also helps then trigger bile release once that chyme goes into the small intestine, and it also triggers more pancreatic enzyme release whether it’s lipase or protease. These are enzymes that break down protein or fat, so we need that acidity. Also, acidity makes it harder for bacteria to grow. So think of acidity as like the—it’s like the Clorox bleach on the dirty picnic table, right? It just really kinda cleans things up and makes it really hard for a lot of the not so nice guys to grow. So we know that’s kind of a foundational tenet and that’s always good to look at that. Now, we have other outside things like emotional stressors and any type of emotional stressor or any type of stressor plays into the adrenals. Because when we activate the adrenals, we’re either surging cortisol or adrenaline, right? One is from the outside of the adrenal gland, right? The cortex, that’s cortisol. One is from the medulla, the inner part of the adrenal gland. Either the inner half or inner third and that’s gonna be surging a lot more adrenaline, right? Both are intimately connected, right? Adrenaline gets to the scene first. Cortisol follows by about 20 minutes, okay? And these are gonna activate a fight or flight sympathetic nervous system response and that nervous system response will take blood flow and shunt it away from the intestines and bring it to the arms, hands, and feet, so we can run, fight, and flee. So if we have emotional stress and it’s unresolved, or we are putting our body in stress from food allergens or from eating on the go or not chewing our food up well enough, we’re just consuming a lot of toxins in our food, whether it’s mold or pesticides or chemicals, that could be activating that fight or flight response. So that’s why looking at the adrenals can be helpful because if we have this chronic digestive stress, that could be stressing out the adrenals and a lot of people that focus on digestion in the functional medicine world, they don’t ever bridge the gap between digestion and hormones, and they really come full circle.
Evan Brand: Yup, so that’s your answer. Your answer is what will the next test—my question was what was the next test you would say is important for investigating bloating? So your answer would be adrenals.
Dr. Justin Marchegiani: The adrenals would be a really important part because the fight or flight, the sympathetic nervous system is helpful. Now again, this is gonna be more on the chronic element. This is like a chronic issue, right? If this is more of an acute problem, the adrenals may be at play but they may not be a big piece in that person’s healing recovery. But it’s always good to look at because the problem with stress, people associate stress like when you say emotional stress or stress, you’re thinking like family, kids, finances, work, right? The problem is if you have an underlying Giardia infection or H. pylori infection, even though you are on beach totally relaxing, you know, drinking Mai Tais, you are still gonna have stress in your body that could be activating a little mini sympathetic nervous system response because of the infections. So that’s why the gut stuff, if it’s chronic it can be under the surface and you may not even be perceptible what’s happening.
Evan Brand: Yup, and that was my case. I mean, I had Giardia and other infections, my adrenal test looked terrible.
Dr. Justin Marchegiani: You had three amigos, right? You had three amigos, right?
Evan Brand: Yeah, it was the H. pylori, the Giardia, the Crypto and when I ran an adrenal profile, I didn’t feel stressed, right? I was taking a lot of adaptogenic herbs, so maybe that was helping but if somebody said, “Are you stressed?” I’m like, “Nah, not really.” But when you looked at my adrenal profile, my system was clearly stressed. I’m glad you pointed that out that even though you don’t “feel stressed” or you think your life is fine or “Oh, my kids are great. My husband’s wonderful.” It’s like, okay, cool but that doesn’t matter actually. You could have plenty of co-adrenal stress and have nothing going wrong in your life at all but that—let’s take this a step further. So you mentioned the cortisol release and all of that, so what is that actually doing to affect the gut? Well, the cortisol, it’s catabolic. It eats things away, so you know, you’ll read or hear about people who go run a marathon and then they’ll have diarrhea. That cortisol just tears apart the gut barrier. So I’m sure there’s other mechanisms involved but to me that’s one that comes to mind.
Dr. Justin Marchegiani: Yeah, also you can look at post-marathon and then look at immune system deficiency. You’ll see chronically low or at least, you know, for a few days to a few weeks on the low IgA side, from long-distance aerobic exercise. So you could be over-exercising or just doing too much aerobic, and that could be really compromising your immune system, right? So that could be playing a big role as well. So like you mentioned, chronic cortisol can rip up that gut lining and then the more that gut lining is ripped up, greater chance of food allergens. So then now if you’re consuming, you know, questionable foods, there’s a greater chance that you may start reacting to those foods as well.
Evan Brand: Here’s the funny thing. I’m thinking out loud. So in terms of like Buzzwork–Buzzfeed type titles, you know, I kinda brought this up to you before he hit record. I’m like, hey, let’s do something on like top 5 causes of bloating. But the funny thing is when you’re a practitioner, it’s really tough to just go, number one, number two, because as you see, you and I are—we’re connecting all of these dots. So we could end up coming up with more of like 20 different mechanisms leading to the bloating whereas people, when they go to click on an article or something, they want it to just be one, two, three, four, five. But when you really do functional medicine and you see this stuff clinically, it just does not work like a one, two, three, four, five. It’s not like car where it’s like—okay, it’s a bad carburetor. Remove the carburetor. No, it’s like, okay, you got the adrenal stress from the gut bug you picked up and then that’s affecting the gut barrier and then you’re training Crossfit four days a week. That’s affecting it. So it’s really difficult to just go bang, bang, bang. So we’re hoping to zoom in but also help you wrap your head around the whole picture of this.
Dr. Justin Marchegiani: Yeah, it’s really tough, right? Like let’s go look at your situation, Evan, if you don’t mind. So—
Evan Brand: Sure.
Dr. Justin Marchegiani: You know, you had some blood sugar issues, right? You also had three major gut infections—Giardia, Crypto, H. pylori—three amigos. You also had some potential tick bite stuff, right? And then we also had some chronic mold exposure. So it’s like—like if you just went and saw the mold specialist, you’d still be sick. You know what I mean?
Evan Brand: Uh-hmm.
Dr. Justin Marchegiani: Because it’s like it’s not just about grabbing the mold. Now, the mold was important but you know, we also worked on blood sugar and made sure you were getting enough food, made sure you were digesting your food, you started gaining weight, you supported the adrenals, cleared out the infections. Then we saw there’s all those chronic molds. Let’s work on the mold stuff. You also, in between there, you know, address some of the cavitation stress that may or may not had been a big issue. By the way, do you think the cavitations were a big underlying issue with your health issue? Do you think it was just kind of a side thing for everything?
Evan Brand: It’s tough to say because the heart palpitations that I had for years, I mean when I was living down in Austin, I was 20 lbs lighter than I am now. So—
Dr. Justin Marchegiani: I know. You were really skinny.
Evan Brand: Yeah. So I put a lot of weight back on, thank the Lord, and my wife did, too. Here’s the interesting thing. We thought that she was skinny due to breastfeeding, you know, because she had been lower weight than she was when she was in high school and we thought that it was just breastfeeding all the time but no, it was probably the mold exposure because when we got her on binders, her weight restored back to normal. So to answer the question about the cavitations, I mean, you know, I was having heart palpitations almost every single evening. I’d sit down on the couch and then, oh my God, you know, the heart palp and then as soon as I got—that night of the cavitation procedure when they cleaned everything out, that was the first night I didn’t have heart palpitations for I don’t know, at least a year. So it stopped that immediately. My blood pressure—
Dr. Justin Marchegiani: The question becomes like well because you were already in pretty good shape before that, what if—what if the mold was addressed before that? Would the heart palpitations even be an issue? Would the cavitations even been able to cause a heart issue? Does that make sense?
Evan Brand: I don’t know. Well, it’s hard to say. Yeah—
Dr. Justin Marchegiani: And the reason why I’m bringing this up is because I have a lot of patients come in and no one has, you know, very little people have unlimited resources, so like, where do we start? And when you have like big picture, when people say like mold or like cavitations or heavy metals, like they’re thinking a lot of money is gonna be thrown out those resources, so our job is to be like, well, how do we prioritize that? How do we get the best results, you know, for the least amount of money.
Evan Brand: Yeah.
Dr. Justin Marchegiani: That’s really the tricky thing because when you go to like myopic practitioners that are the cavitation person or the mold person or the Lyme person, it’s very hard to get a—or the gut person, it’s very hard to get a holistic perspective because you know what they’re gonna be doing. You’re seeing that person. That’s what they’re gonna do. That’s their stick.
Evan Brand: Yeah, and the truth is that my blood pressure issues, I have having these weird blood pressure spikes, those mostly resolved but the mold exposure—another re-exposure to mold didn’t happen for a couple of years after that and then the blood pressure issues came back. So, did it temporarily fix some sort of orthostatic hypertension-type stuff and some hypoglycemia stuff? Maybe but you know, it was—you have to travel, so the expensive travel plus $5,000 for the procedure. So, you could have bought a lot of binders for $5000 bucks. That’s a lot of charcoal.
Dr. Justin Marchegiani: Or, you know, home remediation stuff but you know, just kind of setting the tone for people that are listening. Being a patient myself, right? And helping to fix myself and you as well, and working together, it’s really overwhelming. But I just want listeners to know that if they wanna find someone like you or like me who had been through this and have the mind’s eye and focus on prioritizing and really figuring out what are the first steps and doing things in an order of operation, I think that makes it less overwhelming and that also plays into the whole stress because if you’re doing a treatment plan that’s gonna be so expensive or so segmented like, oh, we’re gonna do this and then that, then it becomes a little bit convoluted and hard to jump on board because you feel like it’s gonna take so much out of you to get going.
Evan Brand: True. True. Yeah, I’m glad you brought that up and I would say that every step along the way that you’ve had in your health journey, every step along the way I have had in my health journey taught us a lesson. Maybe it wasn’t the secret sauce, right? But let’s say it got me 10% better. That 10% better was what I needed to regain the weight that I lost from my parasite infections and then getting the exposure and then using detox solutions, you know, that got me maybe 50% better and then using immune-supportive herbs and antimicrobial herbs, that gave me 10%, 15%. So, I think what you’re saying in so many words is that many people come in kinda thinking that they have a need for silver bullet if you will and it’s kinda like, “Hey, Dr. J or Evan, I think I have got this parasite and that’s wrecking me.” And then we do all the labs and we see there’s no parasite. We see it’s actually a huge candida problem or it’s a huge nutrient deficiency or major gut inflammation or something that. And so we focus on that and then they’re 80% better. Then we kinda go back and we’re like, “Hey, remember how you thought it was parasites? Well, look, the 80% progress you’ve made by pursuing this and that instead. So, back to the bloating conversation, when we’re looking at somebody that comes in and it’s like the major complaint like bloating, what is really interesting is when you unpack all of it. There’s actually more coming along with it. So, it could be like, yeah, bloating is the uncomfortable part but then you look at the bowel habits and then you look at the disturbed sleep and the teeth grinding and then you look at the skin rashes.
Dr. Justin Marchegiani: Yes.
Evan Brand: And then you look at the dark circles under the eyes and then you look at the 20 lbs of weight gain with doing nothing, and then you start looking at thyroid labs and then as mentioned, adrenals. So, I guess my point here is that, it’s okay and good to have a one primary complaint, but it’s very rare for it to exist like that.
Dr. Justin Marchegiani: Yeah, exactly. Yup, 100%. So, we wanna prioritize everything. So we look at digestive support. We may look at infections. We may also wanna look at fungal overgrowth. Now, a lot of times fungal overgrowth may come with the stool testing but sometimes that can be missed. So we’re gonna look at clinical symptoms like fungal toenails or tinea versicolor rash or chronic yeast issues or chronic jock itch, or those kinda things, right? Maybe chronic dandruff. We’ll look at that. We may also run organic acid testing that will look at D-arabinitol or oxalic acid. Things that may give us a window of fungal metabolites in the urine, and then we may also run a breath test, too, to get a little bit more of a window of what’s happening with other dysbiotic bacteria and we may even see imbalances and commensal bacteria which is normal gut bacteria. So, a lot of times that always come at the end because if you have imbalances with infections that will always or could drive commensal bacteria, normal flora out of balance. So, we also want to prioritize things on that note and of course, the diet is gonna be a foundation. So coming off, we may typically lean more on the Paleo side. We may cook more of the fibers down. We may lean more on the lower FODMAPS, lower fermentable carbohydrates especially if there’s more bloating or gas because those fermentable sugars even in healthy vegetables like garlic and onions could drive a lot of these problems, and people tend to like lean into the fact that like, “Oh, I have SIBO. I have this infection.” But sometimes, like in Evan’s situation. Evan had three major parasites and so it’s really good to have you kind of your mind’s eye wrapped around it because if you only thought he had H. pylori and then address H. pylori, and the problem still persisted, you’ll be like going insane. You’ll be thinking like, “What’s going on?” So, it’s good to really have that holistic perspective and address everything systematically. It just gives you the better chance that you’re gonna fix things, you know, a lot sooner than later.
Evan Brand: Yeah, and you and I haven’t talked about this but I’ve kinda come up with this theory that H. pylori is—and some of these infections are really like a secondary infection due to like a primary mold exposure. So, I remember being a kid playing in my grandmother’s basement that had flooded on many occasions, they—all they did was turn on a couple of box fans and it took several weeks to dry out. I guarantee I had H. pylori and parasite issues for many, many years. You know, I had gut issues as long as I could back into my childhood. I just wonder because you and I have talked about this idea of like commensal bacteria and there’s this argument, right? That H. pylori could—you could co-exist with H. pylori and that it shouldn’t cause any problems, but why is it getting so out of control, so out of balance? Now, granting my diet was terrible as a kid and all of that, but what if the immune-suppressive aspects of mold toxin weaken the immunity so that I wasn’t able to fight off candida? I wasn’t able to fight off H. pylori and that’s what allowed those infections to thrive and take over.
Dr. Justin Marchegiani: Exactly, and I think a lot of the argument is more at the level, like maybe there can be a tiny bit of H. pylori present but when it hits a certain threshold, right? Then there’s a greater chance that it can cause a problem, right? And then of course, the more food allergies you’re consuming that are gonna inflame the gut, now that maybe makes it cause a problem, and then if you have enough decrease in stomach acid and enzymes from the H. pylori, that can cause a problem, too. I mean, we know Dr. Marshall who got the Nobel prize for discovering H. pylori, I mean, he thought it was crazy. He had to give himself H. pylori to see that it caused ulcers and infections or it can, right? So, we know there’s a connection with it. So, kinda my issue is let’s lower the infections, fix everything else, and a lot of times people get better and get better much faster. Now, the problem with a lot of people in a lot of medical approaches to an infection is the antibiotics just a drop a bomb down there and they may not get the infection and they may create rebound fungal overgrowth and disrupt the immune response, so a lot of times you can get sicker from antibiotics with some of these chronic gut issues. So, you really have to be addressing the problem holistically.
Evan Brand: Yeah, well said. So, I mean, if you go to a conventional doctor and you do get diagnosed with H. pylori, the first problem is the testing is really bad in the conventional world and so a lot of times, they’ll miss the infection but if they did find the H. pylori, they’ll do triple or quadruple therapy, 3 or 4 antibiotics at the same time, often multiple rounds of that due to the antibiotic resistance.
Dr. Justin Marchegiani: Correct.
Evan Brand: And then as you mentioned, now you’ve got even more–let’s say you came in with bloating as we talked about but you went the conventional rabbit hole, and then now you’ve got the yeast problem and then you feel got even more bloating there. So, you know, I would never do this study but it would be very interesting to see, to test this theory if you take 10 people that have high H. pylori that also have high mold toxin that we know is suppressing the immune system in various ways, what would happen if you just focused on a mold detox protocol? Would the immune system gain the upper hand on the H. pylori to get it back in balance? I would never test that, right? We’re always gonna do both at the same time, use antimicrobials and use detox support at the same time, but it’d be interesting to test this theory of it being an “opportunistic bacteria” that in theory—
Dr. Justin Marchegiani: Yeah.
Evan Brand: You could shut it down if the immune system was strong enough.
Dr. Justin Marchegiani: Yeah, and then kinda my theory, if I am gonna address any mold toxins initially while doing other foundational stuff, I mean, my general theory is don’t push, don’t dump too many toxins right away. If I’m gonna do anything I may just gently nudge in some binders or some gentle lymph support but I’d probably spend more of my time and effort fixing the home if there’s an acute exposure on where those infections, where the mold may be coming from. What’s your take on that and how your peer does that?
Evan Brand: The home is always part of the investigation. So if you see that there’s like high levels that show up, and people are like, “Why—why are you going a tangent about this?” Well, it is a huge gut issue. If you just look up Dr. Ritchie Shoemaker, he is the guy who has been working on these issues for 25 years, tons of people manifest only as gut symptoms. So that’s just the disclaimer but if we see that something shows up on the urine, then we’re gonna go the house to try to match up the species and see, okay, because you’re growing Aspergillus in your gut, you know, you can see it on the organic acids now, at least on Great Plains they’ve got on the first page, they have certain markers that are tied in to Aspergillus. So you can kinda see, hey, you’ve got mold colonization and then we’ll try to look and see if it matches up to the house at all and in some cases, it doesn’t at all. It’s like the house has Fusarium but the gut has Aspergillus, so yeah, the house could be a problem but it looks like it’s more you internally. You’re more of a factory or manufacturing plant, so then we’ll just throw in some silver or something else to try to knock that internal colonization down, and then still working on the other stuff. It’s rarely a number one priority as you mentioned. It’s like, hey, here’s a little binders. Here’s some antifungals that also will happen to kill the candida overgrowth that you have and plus these other herbs that we mix it with are antimicrobials, so that’ll knock down some of the bacterial stuff you have. So it ends up being like a 3 in 1 combo and assuming the constitution of the person is strong enough, but maybe we need extra liver or adrenal support, they usually do fine.
Dr. Justin Marchegiani: Yeah, I always pause going after mold right away. I just find that well, if there’s a lot of symptoms or we have a lot of house symptoms, right? Any visible mold, tell-tale sign, any chronic humidity in the home, tell-tale sign. If we see things tend a little bit moist on the wall, right? We can get a moisture meter. We can detect some of that stuff. History of leaks, those kinda things, then we’ll definitely just do a simple house test. Because the thing about a house test is, if you got 5 people in the house, then all 5 benefit from that test, so it’s kinda like a 5 in 1. So, I definitely like the house testing because it definitely gives you your best bang for your buck, number one and then we’ll typically remediate or address some of those things or if we don’t see any big red flags, we’ll just maybe get a higher quality air filter. So, we’ll do a lot of the Austin Air stuff which is a great one because of the zeolite and the activated charcoal and so either for Austin Air or Justinhealth.com/shop. Evan has his site as well—evanbrand.com, store button. If you guys wanna get a high-quality air filter that we personally use with patients and ourselves, that’s a great option. And then for me, I tend to always pause that stuff because I can see major benefits a lot of times without that but we’ll kinda put it on that treatment plan on that path. I like to get gut stuff fixed first because a lot of times the body will dump a lot of mold via the hepatobiliary system. Hence, Shoemaker and a lot of these protocols binding up stuff that comes from the liver and gallbladder, right? So that’s kinda my approach to it and that dovetails with bloating because if we have digestive issues, you really wanna make sure. People don’t think their digestion could be affecting detox, right? They kinda think of those as compartmentalized things but if we have digestive issues, it could easily be impacting detoxification, so whether it’s metals or mold or just general pesticides from conventional food, all those could play a role and your digestive issues could be affecting that.
Evan Brand: Yeah and here’s the funny thing. You know, you and I had thousand plus cases under our belts before we even became educated about mold. So it does pop up into our conversation a lot and a lot of people come to us and ask us these questions and we’ve done some really great interviews about this but the funny thing is we were getting people better before you and I knew anything about it. So, I do want to focus on or at least point that out. Now, I think it’s just helping us to add an extra puzzle piece to the puzzle. Because there are certain cases where resolving the gut issues, like the parasites and the bacterial stuff, you’ll look at the gut report, right? We’ll have side by side. Oh, great! We cleared out the infections but we still have these symptoms—the brain fog, the dizziness, the sleep issues, right? So now we know, hey, that other puzzle piece could be this because we did clear out the gut infections. But I would agree with you and argue maybe what 80%, 90% of the time, you could resolve those type of symptoms—the bloating and such, just from the gut issues, the liver, the gallbladder support alone.
Dr. Justin Marchegiani: I get scared for my patients or any patient that comes in and is going to see just a Lyme practitioner or just a mold practitioner. I get really scared if they have not done the foundation because with practitioners like that that are so myopically focused, anytime they’re treating the Lyme or treating the mold and they have a negative issue, it’s that it has to be die off and that means we’re on the right track. So it becomes this kind of vicious cycle where their—by them feeling worse, it supports them continuing to do that thing which them feeling worse may mean it’s the wrong thing or it’s too fast or it’s not in the right order, and a lot of times those protocols can be very expensive especially if you see a Lyme practitioner that does antibiotics and you are on antibiotics for years. That can be scary or if you are looking at a home remediation and you don’t know how to do it the right way, and you’re looking at tens of thousands of dollars on a home remediation. That could be scary, tool. So you really wanna be able to hit things in the most sequential way possible and the biggest knowledge understated that I have dealt with the last year or two with you and me on our mold side is really how to fix some of these mold issues with our homes as cost-effective as possible.
Evan Brand: Yeah, I wish I have my $10,000 back. I was just desperate.
Dr. Justin Marchegiani: –therapy.
Evan Brand: Yeah, for the enzymes.
Dr. Justin Marchegiani: Yeah.
Evan Brand: You know, I was sick. I was symptomatic. I didn’t feel well. My daughter had stomachaches. My wife wasn’t sleeping well. You know, and we were looking up holistic solutions. We didn’t have time to fully do the research and figure out what we know now and here we go dropping 10 grand, and my situation was no better and even in some cases, it was a little worse and so, I don’t wanna turn this into the mold podcast but just pointing out the fact—
Dr. Justin Marchegiani: Yeah, it’s connected for sure.
Evan Brand: That yeah, yeah, it is. But the fact that you could pursue rabbit holes like that and be no better off, right? Symptomatically, I was just as sick as before and that 10 grand could have used for several years worth of adrenal support and liver support and gallbladders and binders and all the stuff I really needed but I was desperate to fix the house because to me that was kind of the blame but I also had some internal gut digestive stuff going as well. So, I guess the point really here is that you wanna make sure you have all the puzzle pieces and try to work with the practitioner who can be zoom in and zoom out, and that’s what we try to be really good at. We try to be really good at making sure that if we do need to hyperfocus we’ve got the skills and tools to do that. We’re gonna use this specific protocol, this many times a day for this many weeks to address this infection. However, we may also need to zoom out and get your house in better shape and get your spouse in better shape in case they are re-infecting you and we’re also gonna help with those pieces, too.
Dr. Justin Marchegiani: Exactly. So, just kinda recapping for people listening. When I work with a patient, when Evan works with a patient, we kinda have like our best practices’ list and we really make sure we hit things. So, of course, we are removing the bad foods, we’re dialing in the diet, and of course, that could be more nuance that just a really good whole food Paleo template. There can be other foods like we mentioned FODMAPS on other sides, chewing our foods, cooking foods, those things. Number two is replace. Replacing enzymes and acids, maybe bile salts. That’s important. Sometimes other things need to be addressed like prokinetics and such. Third R is repairing the adrenals, repairing the hormones, repairing the gut lining, partly because of the sympathetic stress that may be driven by the hormones and how that can affect digestion and gut lining. Fourth R, removing the infections and this could be parasitic. This could be H. pylori. It could be bacterial overgrowth. It could be SIFO or small intestinal fungal overgrowth. There could be even, we could throw mold toxins in with that as well. And then the fifth R will be repopulate, reinoculate good bacteria. Sixth R, re-test and sometimes you’d come back with a new infection, that can happen, and that’s frustrating. So there’s a kinda an order of operations and again, there may be a certain deviation and certain ways we go deeper based on our experience, but that’s just a general framework at how we’ll dive in deep, so we don’t miss anything.
Evan Brand: Yeah, it took my daughter three rounds. You know, we’ve done—
Dr. Justin Marchegiani: Right.
Evan Brand: Like five stool tests on her and she’s not even 4 years old yet. You know, she showed up with one bug, knocked it out, re-test it. New bug, got rid of it then H. pylori showed up and then candida, knocked those down. I mean, it’s crazy so it can be a little bit of whack-a-mole and that just comes with the territory. It took me several rounds, too. You know, we kinda joke about the gut being like an onion having different layers of infections.
Dr. Justin Marchegiani: Yup.
Evan Brand: But it does appear that they do kinda come out in layers. It’s, you know, is it possible that H. pylori with that little tail structure you see in the microscopic images?
Dr. Justin Marchegiani: Yeah.
Evan Brand: Is it possible it’s burrowed deeper in the intestinal wall and it comes out later? I don’t know. It’s tough but we just—
Dr. Justin Marchegiani: It’s hard to say. It’s hard because with kids, too, you can’t quite hit it as hard either, you know.
Evan Brand: Yup.
Dr. Justin Marchegiani: But yeah, that’s why—and again, that situation is pretty rare to go that many times. I mean, that’s more in the extreme but it happens, you know. We always wanna be upfront with people.
Evan Brand: Kids are barefoot. They’re out playing in the creek, playing in the dirt, you know. So it’s kinda like—
Dr. Justin Marchegiani: Yeah.
Evan Brand: How your kids are.
Dr. Justin Marchegiani: Kids are a little magnet for critters, right? I mean, we kinda know that. They—
Evan Brand: Yup.
Dr. Justin Marchegiani: Fall down. They have no problem picking up dirt, putting it in their mouth, the whole nine yards. So yeah, I get that. Is there anything else, Evan, you wanna leave the audience with today?
Evan Brand: I would just say get a good—get a good workup on yourself. Could you just go to Whole Foods and go buy a bottle of oregano oil off the shelf because you read some blog that said that oregano oil kills fungus and that may be the cause of your bloating? That might work, but is it the full piece? Is it the full picture? Are you gonna take it forever and then you kill the good bacteria and then you’ve got a more imbalanced gut than you did before? Maybe. So, my advice would just be get a good workup. Try to have a practitioner on your side that’s gonna be able to look at all the pieces, not just zoom in on one tiny piece of the puzzle—
Dr. Justin Marchegiani: Correct.
Evan Brand: And convince you that’s everything and if you do want to reach out to us, we are those people. I mean, we do look at the full picture. So, Justin’s website is justinhealth.com. He is available worldwide for consults via phone, Facetime, Skype, Zoom, whatever you gotta do to connect, and my website is evanbrand. Same thing. We both work across the world. So we are very blessed, very grateful to be in the opportunity to help you, so thanks for tuning in.
Dr. Justin Marchegiani: And then if you’re listening here, 99% of the people we don’t get the chance to even see in person or you know, over the phone or such. So if you feel like you could benefit or your family could benefit, you know, share this information. At least it’s gonna get people moving in the right direction, taking a couple of good action steps, and then put your comments below. We really wanna know what your experience is, what has helped with you, etc. What were some of the missing lynchpins to help your care and also a thumbs up and a share. We would really appreciate it. Alright, Evan. It was a phenomenal chat, man. You take care.
Evan Brand: You take care. Buh-bye.
Dr. Justin Marchegiani: Bye.
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